HomeMy WebLinkAboutBuilding Permit 99-0246
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 1(j~l2-" 9- 4. f'
"'
ADDRESS 05~ L.j uJ;a~ ~
OWNER CONTR.
PHONE NO.
PERMIT NO.
<J9 -&7 0/'6
COMMENTS:
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
~~
,f~ ~ ~
~--
~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
he FINAL
tJ SITE INSPECTION
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK,~LL FOR REINSPECTION BEFORE COVERING
Inspector: ftJ -f I' Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
_.._-"~.,..~._~"---~-,...,.,-,~.._'-_.~---,._.,--,.._-"-"'-~-"-'."'-""
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.31~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
l-ZJ9Jqg
R-l5 t>
2.SITEA~ "\L '" n.. .
. - W\ K!.0 \~rllch
3. LEGAL DESCRIPTION
LOT SJ(L Y I:)~ Df 3 ~ I ~LOCK
ADDITION W ~ Ilews J'$ Mrtt/\.
PID d5- {OX" - ({J6--o
4. OWNER \ ~. _ ~~~
(l,r\lQn -Jl"TJ-U\
~ITECT (Name)
~ch
(Address)
(Tel. No.)
41./7- K~07
(Tel. No.)
6. BUILDER (Name) (Address)
Hcrizcn GJerbtS ~ lure In:\ustr'Ia.\ Y6\~.
(Tel. No.)
<i$'QO-"6900
7. TYPE OF WORK
New Construction 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
Fireplace c:J
Alterations 0
SeptiC c:J Deck c:J
Addition 0 Finish Attic 0
Chimney c:J Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1~'Oo
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Y'q-dLUc
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSl}iW.CTION
rc - root"
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7853, Ca~
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 mBntioned 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
ilding official can revoke this permit for just cause. Furti7;~ hereby agree that the city official or a designee may enter upon the property to perform ne7$7l?/
X ~ c7;26C j;J. /Q~ -1..;l.
Signature I License No. . Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING t1 ~ *1 tZ
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
c:J ENERGY DATA
c:J
PILING LOGS c:J
PLANS & SPECS c:J
SURVEY c:J
PERCOLATION TESTS c:J
SETS
COPIES
PLOT PLAN
c:J
Plan Check Fee ............................. $
-7Lf <It)
I . ct<;
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
S U
City:
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ --Je-, .m
Paid jt.,.CO Receipt NO.?, LlK::; I
Date 3/31/qq By (j.0AJ
. v
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 const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Perm~ ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certnlcate of Occupancy
Issued
City Planner
Dale
24 hour notice for all inspections 447-9850
Special Conditions ff any