HomeMy WebLinkAboutBuilding Permit 99-0801
DATE
~
1442-5" V-;~I!J~ 7i-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FRAMING r{J) 0 MECHANICAL
o INSULATION A 0 WATER HOOKUP
..,.21 FINAL . f\ 0 SEWER HOOKUP
/0 FOUNDATION 0 SEPTIC INSTALL
o DEMOLITION 0 PLUMBING FINAL
o FIRE PREV. 0 SITE INSPECTION
COMMENTS: 4-. ~
JU.~#_ Q.Ao7~. ~~
-"- "iF" , .
r. :" . t "r~A'" ""'11'.' ..' .'.-..
(i~~
TIME
(0: Ol)
"/9'-$0 I
o EXC/GRAD/FILLlNG
o LKSHOREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
:.7": - j) ,. . J) flo.=-/
V
~ORK SATISFACTORY, PROCEED
o CORRECTijCTION ND PROCEED
o CORRECT C LL FOR REINSPECTION BEFORE COVERING
Inspector:, Owner/Contr:
CALL 447'4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~1
;l~m
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
';/~ ,49
tv ~ / t;;;,t::S E:V aC 712- /26..0
PID:)5 -J /q - OJ7 -0
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99 -eo J
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDREi4 4 z5"
3. LEGAL DESCRIPTION
31
40uo//I/->
(Name)
6o~oO~
12. NO. OF STORIES
-
LOT
BLOCK
ADDITION
/'1t4/1/t!'~
13. TYPE OF CONSTRUCTION
4. OWNER
(Address)
p,e 0 CHAS,c::.4
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
~6
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. lYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Ae-roofi~ Porch 0
Ae-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished 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 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building o~can revo e this permit for just 'i.~se. Furthermore, I hereby agree that the city official or a designee may enter upon the Prope~o ertorm needed inspections.
i An... J!>',9C/
Signature License No. cate
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PIUNG LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SUAVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
#~ A/..e..
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
Z <7J"V. /1V
lYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. <t
Park Support F~e ,.,...,....."..".,....... Of:
SAC ......................................... $
Collective Street Fee ......... .... .... ...... ~
Sewer Tap ...................................It
$
Division 1 2 3 4
Permit Fee ................................,.. $
74.1r
Plan Check Fee .............,......,.,.",., $
State Surcharge .............,..,...,.,.,.,., $
Penalty ....,.,....,........................... $
Plumbing Permit Fee ......................, $
10 Z-~
7(,. <tV
Paid 7(;. cYU Receipt No. :Jrr-Jr
Issued
Date <;/U'".fl? BY~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee6&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.
......... $
9 Permit 7'e./APp;3;1t:q
ate ~h'l'T-
Pressure Reducer .......................... .t.
Meter Horn ................................... t
WalerMeler ................................. Of:
Sewer & Water Connection Fee ,.,."..,., <I'
WaterTowerFee ,.,.,.,.,.,.,.,.".."......or:
Water Tap ,.,.......,........................ ,If::
Builder's Deposit "...,.,...,................ $
Other ,.,.,.,.,.,.,.,.,.,.,.,.,...,..,...,...,. It,
Mechanical Permit Fee .................".. $
Sewer & Water Permit ...............,...... $
Total Due ...........,.......".."..". It-
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850