HomeMy WebLinkAboutBuilding Permit 99-0043
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
4qq\ ~~ In: \\\.\=-.
3. LEGAL DESCRIPTION
"\FI
LOT
BLOCK =+' \
W~\Ot'-\~ ~\'1
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L ~ (Tel. No.)
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(Tel. No.) :zo I,
PID ~5. 0,:(9. on (- ()
ADDITION
(Address)
5. ARCHITECT
(Name)
6. BUILDER
(Name)
~~~ ~ ~\~t-\.
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc. ~
8. PROPERTY AREA OR ACRES
Sq. Ft.
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
~'i-o~
~_ C::Ol{~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
c:4- ~j' . {::o' .- ~~,
17. COMPLETION DATE
I hereby certify that I have fumiShe~inf ation 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 rty and t t construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can vet is pe f st cause. Furthermore. I hereby agree that the city official or a des~ee may enter upon the property to perform n1edB9 inspections.
X ~Z.\1~) \\ S\~B
Signature ~?'i ~ - '\"\. ZOO? License No. Dete
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING <
e~s A I
I
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 <!> 4
Permit Fee ,....................,............. $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
(.151 (0)
L 'tl. S i
l B .50
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......,....................,............, $
Collective Street Fee .., .. .. , ..,.. ,.. , .. , .., $
Sewer Tap ....,.......,...........,.......... $
$
Pressure Reducer ,..,......,..........,.... $
Meter Hom ............................,...... $
Water Meter ......,....,.."................. $
Sewer & Water Connection Fee ,.......... $
Water Tower Fee ........................'.. $
Water Tap ................................... $
Builder's Deposit ........,......,......,...., $
S U
City:
Plan Check Fee .......,..................... $
State Surcharge..............,.............. $
Penalty ,..,.............,..................... $
Plumbing Permit Fee ...................,... $
Mechanical Permit Fee ........,............ $
Sewer & Water Permit ...................... $
r Building Permit Wh1[1 App~~~
Date 1--1.2 7
Issued
This is to certify
signed by the
24 hour notice for all inspections 447-9850
Th. C.nl.r of lh. Lib Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT t6.\AN\~ \ c..,..S t--
APPLICATION RECEIVED I - :U - cr;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~'l L'Effic\A. ~~Ie.et-
Accepted ~ Accepted With Corrections
Denied ~ L
Reviewed By: 'Pj~ Date: 1- 2.'2.-'('/
Comments:
I. MIM''''~c:..\'",- "'i:ro.....~ ~
)L. (JprL.lio S~ c:O.rle.~ f.J2,]- Ilc:r'-l URG
Smoke ddtectors sh:::lll be
loc,ated in ell slt:el3ing
rooms, on each story, in
corridors to s~coping rooms,
and in vault areas more
than 24" SOOV9 corridors. which
lead to
~IQ(>piI'lO rOOfi'l'"
Smoke d~tectors shall be
'ocated in all sleeping
r09'!1s. on each Story, in
~om.dors to Sleeping rooms,
Ild IR vault 81 t:a~ more
tan 24" above corridors which
sad to '
sleeping rooms.
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction, Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
._~_'_"_"""""""____'_'"__~_'_.__'~~~~._h_'
~/'
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The ('tnter of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
,~
NAME OF APPLICANT
APPLICATION RECEIVED
I
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. t
i .
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i , . I
-! I ! I
,.-';
, \
I \
I j ,,' \'
Accepted
/
Accepted With Corrections
::;;~
Denied
[)111- In<A/I Date: ex/d-3/9i
51 S Y s.e~"L -oIL. 5Jhs~ Lb1
I rryfN'-dvS S~Ct -'o~ vJl ~VcJ
50 r DtJvJ Sd1ocL~ -Cie
Reviewed By:
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other"
ordinances of the jurisdiction shall not be valid,"
'.
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II~tweel'l,~ 8:00,8.,d ,9:,00 A.M. "for.' aUJl1s~ection",
, {tiFOFi'Al.i:"INSPE'CTi'otJS~447:.4230~~':~~"~~';:~
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- T
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
fc.-Il- ~q
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SCHEDULED
ADDRESS 4qclI
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OWNER
CONTR.
PHONE NO,
'19-43
PERMIT NO.
o FOOTING
o FRAMING A
o .JolSULATION
Jil"FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS: ~~~
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
~~
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,-
Inspector:
Owner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!