HomeMy WebLinkAboutBuilding Permit 99-0973
CITY OF PRIOR LAKE
INSPECT/ON NOTICE
SCHEDULED
ADDRESS
/{c?',/'S kid ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDA nON 0 MECH RI
o FRAMING 'Z.@O WATER HOOKUP
o INSULATIQN ~. A 0 SEWER HOOKUP
1A FINAL ..,..:.,~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
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/' .~T1R
.~
DATE TIME
/J-'l-q~.
Jr;-J?7?
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RK SATISFACTORY, PROCEED
~;;'c:RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
1YL6?\
. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
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~\
DATE RECEIVED
B/q /9<9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SrTEADDRESS /~1-IC; JjjjAf k,
Permit No. qt:1-9'2.3
----,
1. DATE
~hlqq
r I
.ez.-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT
BLOCK
/l?E7& S A /UL)
PID .zS..(;}tJZ-I2';' - 0
12. NO. OF STORIES
ADDITION
- 4. OWNER
~OUI\I OS
13. TYPE OF CONSTRUCTION
5. ARCHITECT
~Namlu~
(Name)
(Tel. No.)
'/III) - /)1..1
(T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUilDER (Name) (Address) (Tel. No.) I 15. NUMBER OF OCCUPANTS OR SEATS
~CtxJ-.u.k. ~ij5-~Sf: '1<r?-~ I OCCUPANT~
7. TYPE OF WORK
Fireplace LJ
Alterations 0
Septic 0
Addition 0
DeckLl
Finish Attic 0
Ae-roofing 0 Porch LJ
Re'Sldjn~ Finish Basement 0
SEATS
New Construction 0
Chimney 0 Misc.
IS. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE
SQ. Ft. Width Depth Yes No
I hereby certify that I have fumished information on this application which is to the besI of my knowledge true and correct. I also certify that r am the owner or authorized agent for
the above mentioned party an tha aU con ruction will conform to all existing state and focal laws and will proceed in accordance with submitted plans. r am aware that the
:uilding offidal can p it r us ~ Furthermore. I hereb~ agree lt1at the city officia~ i-stee may .nter upon the property to perto"Vl7i1h<j' _ .J.
License No. ~
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS (]
SURVEY 0
SETS
COPIES
USE OF BUilDING ~S o/~
2SV"V.UV
PLOT PLAN
o
TYPE OF CONSTRUCTION, I II III IV V
Occupancy Group A B E F HIM R
Division t 2 3 4
S U
City,
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
7'-1. 75
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
lz-\
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
MeterHom ................................... $
Mechanical Permit Fee ..................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Du. .............................. $-76. C/?/
Paid 76. (,p/ ReceiP;~p. 6' ~Fl4s
Date e/9/~q By/(U--
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 r. requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to ""', '''' "',...."'. Before occupancy, a Certificate of Occupancy must be issued.
Sewer & Water Permit ...................... $
:7J{;1~:j;;,~i~~i;~itWS.t~1.f
r , f I
Certificate of Occupancy
Issued
CijyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850
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