HomeMy WebLinkAboutBuilding 99-1062
:;- ~'1 C') ~oooo -0 0 )0- -0
'" :I: ~ C z_
~ 0 Ul Z"''''''' 0 c ~~
CIl 3: z
g ~ o 0 :::::jZUl~OO z m ;tl mO
0 " " 3: ~>C:3:~S m " m 0."
:"! " ~ Zr!;-C- Z Ul ~-o
t>l m Ul m Ul -I~>~ 9 Ul 0"
~ o > Z
-I -I ~~ ~ z-
t!'l -t - zO
l<::l > - en o 0
o Ul ~ 0"
S -I ." ~r z
co - > ~!;
~ <11 l' o 0
0 Z -I o~
." 0 > 0 mm
~ 0 > z ~
" r
r 0
~ -I ." -0 -0
~ :I: 0 " "
~ m " 0 0 000000
z " 0 0
~ m m m m 3:-oUl~3:-o
>< Z m m mr~>mr
-I 0 0 oC: -IOC:
~ Z ~ Ul :I:3: m:I:3: 0
a ~ -0 "'ll Ul
Ul m "'!!!"""!!! m 0 0
~ ~ -0 :::l 0 ZZ:I::I:-Z ;tl Z :I:
::! m (1) -I >QOO Q 3: -I m
::t
"" 0 () 0 r."OO " :::::j ;u 0
~ -I 0 Z -~~ - z ~ c:
5 ?r Zc:c: r
tIl ~-o-o 9 m
z m 0
C Po) ."
~ ",. 0
:I: "
m
~ 0 0 ~
c: 0
" < 000000
Ul m
51 z " Q."."om
)0- Z >;ii;iiO~
Ro 0 (;) l!!mm3:Q
~ < _-o-o-o~ \S
)0- ~!;!;!;o 0"
~ z >ooz:;; ~
~ 0 _mm-l_
!T1 "."" r ~
-1__ r ( i:
UlZ Z m
-I~ Q
DATE RECEIVED
6 / Z ro / qr
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~T~(p ~l~
,Je./SD
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. QCJ-/ObZ-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRES,R
4' l-\ \MIl--
3. LEGAL DESCRIPTION
2-
~SG
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
4-
H / LA./
PID 2S...,3/0-038- 0
13. TYPE OF CONSTRUCTION
ADDITION
4~WNER J../S/t
5. ARCHITECT
J::::/I/o/3
( 4~41
(Tel. No.)
rtlPL- tJ G 4a3~
(Tel. No.)
(Name)
(Address)
~ue ~
(Address)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
De
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
License No.
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
USE OF BUILDING
,e~s A /.e...
r
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I , ~ 00 . a:::>
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
BUILDING DEPARTMENT VALUATION
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~~ SC"')
'3B .LD~
.1S-
Plan Check Fee ............................. $
Issued
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter .......".-.~.......... $
Sewer&~iOnFee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 99. I;J Receipt No.
Date '1
uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee s requested. This document when
constitutes a temporary Certificar ~ dj~ jmPliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Cijy Planner ~ Date Special Conditions if any
ur Building ;:t,:it~~3e~~f
Sewer & Water Permit ...................... $
24 hour notice for all inspections 447-9850
ATTACHMENT A TO BUILDING PERMIT NO. qq- ;0"2-
PROPERTY OWNER ACKNOWLEDGMENT FOR NEW CONSTRUCTION
The Owner of property at /4",q.7 !3t..1I6tfj/IeO 7Je.. in the City of Prior
Lake has applied to the City for a Building Permit to construct new addition or deck.
Prior Lake City Code Section 4-1-7 (A) requires a Certificate of Survey, prepared by a
registered land surveyor, as part of the Building Permit application for all new
construction. The Owner has requested an exemption from the Certificate of Survey
requirements as provided for in Section 4-1-7 (D) and (E). In consideration of the City
accepting a marked site plan or survey in lieu of a new Certificate of Survey, the Owner
hereby agrees to waive any claims against the City and to hold the City harmless from
any claims or damages incurred if the structure is inaccurately placed on the site.
,~tJ2
DATE:
CITY OF PRIOR LAKE
~~~&MF~f--
~
ST ATE OF MINNESOTA)
) ss.
COUNTY OF )
day of
the
. NVVVV\NVVV\,,/\/\NVVI/\/VVVVVI,IV'.t',^^^^-
l ~. KELLY GRAU MEYER ,
i!>.tp..' ..~ NOTARY PUBLIC
\~ MINNESOTA
.. ~~ My commiSSion explflS 01.31.2000 .
, ~':;~""""""i,,.'",,,iW.w~.
HOLDHARM.DOC
White - Building
Canary - Engineering
Pink - Planning
Thr Crnlrr of Ihr l.ake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
""
'-.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
" .
Accepted
/
Accepted With Corrections
Denied
Q.~. ~ Date: ~f3Uh'l
5<:JtoadC<) (~ ofL. '
Reviewed By:
Comments:
liThe 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."
_.~.w;"",,,,,,,,,,,",,~___......-.,-~,,,,,,,,,,,=_...~-.-4"'''''~--' .',
qq-/OhZ-
White - Building
Canary - Engineering
Pink - Planning
Tht' Ctnter of the Like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/3/4<K~Lr:1N f./
0/2(0 /q1
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ Lfh '-17
I3LUb131120
.,.----,/-
//<-.
//6
Accepted
X-
./
Accepted With Corrections
A
Denied
Reviewed By: 62 ~-r
Comments:
Date: 8 - pO - Yr
I, R€!^J +t....e LWcct= (~J
"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."
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J~H!/il"? h\lle~~~ -\-~~\
TYPE OF WORK ~ck_
USE OF BUILDING S~ D
PERMIT NO. 99-/()(o~ DATE ISSUED 6-Sn - c:r 1
BUILDER J3"t'k.Q\~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
PLACE NO CONCRETE UNTIL ABOVE H
I FINAL
I fb I:l~f~.
~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850