HomeMy WebLinkAboutBuilding Permit 99-0641
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
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ADDRESS \lo 'Z-B 7
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Avt:.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FRAMING
~INSULATION(f)
J':!. FINAL
o FDUNOA TIO ""
o DEMOLITION
o FIRE PREV.
COMMENTS: ~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
h AI;:;'E INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORENYETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
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" WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~R~ cPt FOR REINSPECTION BEFORE COVERING
Inspector: ~.. Owner/Contr:
V
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
16, PROJECT COSTNALUE
,j/A~.. -
Chimney 0 Misc. -r. U' !l'y
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq,Ft. ;)1'/3 0 Widt.h Depth V.s No U- Y-'j9
I hereby certify that I have fumiSh~d onnation on this application which Is to the best 01 my knowledge true and correct. I also certify that I am the owner or authorized agent for
the abov~entlOned property and ~II struction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building i1la~n ~ev~~ thi~e, or u cause. Furthennore, I hereby agree that the city official or 9-fleslgnee may enter upon the property to pertorm needed inspec~s9
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Signature . License No. Date
&~~
DATE RECEIVED
5/~'7jqt:r
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
cnONS
~ES NUMBERED 1 THRU 17 MUST BE FILLED IN
I BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12, SITE ADDRESS I' . T51l I J
Li' a u I...Q "'.J .~h
1. DATE
5- ;)j-9q
fLu.L
3, LEGAL DESCRIPTION
LOT
ADDITION
4, OWNER
Pto ?~-/)~- Olq-O
BLOCK
/I1e:;/r-.::>' /N
,) (Nam.) _ I J
YI-tnf1ll1'\
aWli/o.,
I . I (Addr.ss) I
A l\JI~/rl.
-(Address)
L/LJ J (~.'300,4 J
(Tel. No.)
..r.i!....GIII"fE.Q.T
(Name)
6~~1~~ .
(Nam.) ..J r (Addr.fS)
L-elJeL- cz.C1<je LO VI ~i-.
q 1'10 w. IJ-7>'h-.#.
( t . (T.L No,) , "
t I l'f"l-1/0'fo"
~~(8J) YL/,)-lJQo9
7. TYPE OF WORK
New Construction CI
Fireplace CI
Alterations CI
SepticCl
Addition CI
DeckCl
Finish Attic CI
Ae-roofing" Porch CI
Ae-siding CI Finish Basement CI
l. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. q 1'.& ~ I
BUILDING INFORMATION
11. SIZE OF STAUCTURE
(Height) (Width) (Depth)
12, NO, OF STORIES
13, TYPE,?F_CO;:'S~RUfT'~ Ir. ()
^UV-f7'r1:( . .
14, FLOOR AREA APPCI!TIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEAT!"
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Par1< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... It
$
Pressure Reducer .......................... $
Meter Horn ... .... ............................ .t
Water Meter ................................. <I:
Sewer & Water Connection Fee ........... <t
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7', OV R.celp1,No,
D.t. <; /2-7 / q q By A1tf...-.
This is to certify that the request in the above application and accompanying documents is In accordance with the City Zoning Ordln~nce and may pr~s requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PEAMIT VALUATION
z.,.nfb, cfV
USE OF BUILDING
I?~s I"t /~
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM A S U
City:
Division 1 2 3 4
Permit Fee ................................... $
74.7>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
t. -z.. r-
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~:::I~ln~.rrn:l,.::LI~I~~.~..:~.t nAg ves:J?
By ~ ?"iIA Oat. ~7 If. '1
I
1ifica.te of Occupancy
'"
City Planner
Date
Special Conditions if any
24 hour notice lor aU inspections 447.9850
MATERIAL FILED WITH APPLICATION
SOIL TESTS Cl ENERGV DATA Cl
PILING LOGS 0 PERCOLATION TESTS Cl
PLANS & SPECS 0
SUAVEY CI
SETS
COPIES
PLOT PLAN
Cl
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