HomeMy WebLinkAboutBuilding Permit 99-0891
~ TIME
CITY OF PRIOR LAKE A.l(
INSPECTION NOTICE SCHEDULED
C.V~ 11... W7Jr'> rl ,)T
ADDRESS ;(.'t9
OWNER CONTR.
PHONE NO. PERMIT NO. qq. 8Q!
o FOOTING o PLUMBING RI o EXlGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~NSULATIO~ o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPE TION o MECH FINAL 0
COI't'lMENT$.: .
~1'" ~~{i
---
((.~
\
~
---
~
~IL )
- ----
~-
SPECTION BEFORE COVERING
Inspector:
Owner/Contr:
NEXT INSPECTION 24 HOURS IN ADVANCE.
ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
&~~
OJtt.TE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/
7- 2j'S
1. White
2. Pink
3. Yellow
File
City
Applicant
.ll. 2 , mJ
(7'";. ",. n \
Permit No. / I ~c [
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
,~ <}'1 C-e.J Gl,l'" oJood Crl- fJ €"
1. DATE
?/11/'11
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL OESCRj'TION
LOT (4
SN.!)
BLOCK Z
PO/~ ~7!:!-
PID
Z5-23"l-0$4-0
12. NO. OF STORIES
I
4. OWNER
W"-
5. ARCHITECT
(Name)
ev '<101"
(Name)
5"6&jq
(Address)
c.. ...,1...... ,,,,._,.,0
(Address)
~N~
(Tal. No.)
fA(L- Lj'l~ - (007
(Tel. No.)
13. TYPE.oF CONST~UCTION
loot " S/~'" "-
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
rffwV<. (J.t/.irS,"'""" ?f"V"I(..."".1u-<. Or ~ r.,S"r, 'fObAf '1"0
7: TYPE OF WORK Fireplace 0 Septic 0 Deck 0 - Re.roo~~<<.. Porch 0 SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0{ Finish Basement 0 16. PROJECT COSTNALUE
Chl.mney" Misc. / Z!..I)Ocl
18, PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No ) - 3 ()
I hereby certify that I have furnished :. ,;~., ,."".:~" 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
build' official can rev thiS P~llt lor !us~cause Furthermore, I hereby agree that the cily official or a designee may enter upon the property to per10rm ne~ed insjections.
X '>l,..,~ .)rl/~ "''' J"i "1/fC; /99
S"ignature . license No. . Dete
OCCUPANTS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS " ENERGY DATA "
PILING LOGS " PERCOLATION TESTS "
PLANS & SPECS " SETS
SURVEY " COPIES
PLOT PLAN "
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
USE OF BUIL~G
,1, c' .Ll,t-{(
SPACES ON PLAN
PERMIT VALUATION
.") , <;r'Y'). (' r
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. .................................. $
ler ') ,,-
Plan Check Fee ......................... .... $
State Surcharge ............................. $
Penalty...................... ................. $
Plumbing Permit Fee ....................... $
j, '2.."",
Mechanical Pennit Fee ..... ................ $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meier ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
~ tj;' )'~
Gas Fi la Pit......... ........... $
This C8ti'.l', i t'~ Y Building Permit When A~~oyed, C (-'
By . p~ 'C l Date 7-Z?--,I/
,
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 7'- ~
Paid "1 (, . ~"C Recel.pt N9-;3 )'-U 7')
Date '7 - 22:::'; f By fj!n
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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.
Issued
CilyPlanner
Date
Special Conditions ~ any
24 hour notice for all inspections 447.9850