HomeMy WebLinkAboutBuilding Permit 99-0333
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
t.f-Iq~qq ~
ADDRESS
Sqz'Z..
t.k- tidu..
OcJ.c,.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq- 333
COMMENTS:
~)
V
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING
o ~LATION
...B""I!iNAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
( \()~
0\ ~ r\fJ/I (A,
/
/
/
ri WORK SATISFACTORY, PROCEED
o CORRECT n~ON AND PROCEED
o CORRECT [;t' CALL FOR REINSPECTION BEFtlRE COVERING
Inspector: / ~ Owner/Contr:
, 1/
CALI: 44}-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODEVQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
----
~
( ~
~
"Fe \rJ
-.
')
/
~
//
/
:;il~7;1ED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-333
, DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
O.....,.Ks
Lj - /~-59
~\
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS
s-/ ::2~
)I,}/J ~-J
I
l~
C~
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
ADDITION
4. OWNER
10
H-IDDErd
BLOCK
PID 25 - 0,3 - 0 I () - 6
() A Ic::.S
A Do rJ .
13. TYPE OF CONSTRUCTION
5. ARCHITECT
(Name)
::5:,' ,.,....
(Name)
/h.JO/!tUI<;
(Address)
S9;Xci
(Address)
(Tel. No.)
)I.~'pQ,oIeP/fr~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
1./<
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/JJ &~ i? VI 'I {)o,t:.s
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofingllil Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney Cl Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will confo to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building officia~e thi~it for just cause~rm ,hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X I //. //~~ ~oo 0 C/s5'? {,I-/~-99
F (,..;"-Signature ...- '" License No. Date' r
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
8ack Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 2..~ ,-.rl./ PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~v; KII2....
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward ....,............. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
14-.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
L 2-S-
Penalty....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... It
This Application Becomes Your Building Permit When Approved.
By Date
Issued
Total Due .............................. $ 7v .0 0
Paid {(". 00 Receipt No. "3 ~OD+-
Date "+/ra,/qc, By .AttL...
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinlnce and may proceed ;J requested. This document when
signed by the City Planner constitutes a temporary Certificate Df Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
CertificatB of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850