HomeMy WebLinkAboutBuilding 01-0650
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DATE RECEIVED
~'~ p~ 8%1~llJrr1JA
CITY OF PRIOR LAKE ~~ } orfJ L wo. H.
TEMPg~~~~~~:~~~~TE OF ~rJl / ~. ~:o. ~,,=,
AND U~~~~~~~~~~~~ERMIT Permit No. to / ~&~ -C;- D
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
4 ~S~i
1. DATE
f.R-~h-6J~)
L ~I!
BUILDINQ JNFORMA TION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
PID ;)5--001;;-- o/d-o
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
lASt:.
14. FLOOR AREA APPORTIONMENT USE
5.
"2.
It?) ~ ~T3.~~-fRLtO/{;
5S '. \\C-cd-)li-e )J
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Chimney 0 Mise
8. PROPERTY AREA OR ACRES
Sq.Ft.
Yes
No
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 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
"'''''' ,"'" -.., . _'II 'j ""'" .. F",".~.,' "'.'" .,= ..,.. 0" off.'.'". d,,"~' ~,eo". "PO" "" _"'. ",..,,"" _'~.
X - 8~-<Q5.'58 f(l~(p~o;
License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION / (JOe> . (S)O PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
City:
Amount Brought Forward .................. $
Parik Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
~8. ?C)
'2 5". ~
.SO
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Building permi~hen Approved.
Date - L q.?ac(
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit............................ $
Mechanical Permit Fee ..................... $
Issued
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdinan and may proceed as req ed. 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.
city Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9B50
White - Building
Canary - Engineering
Pink - Planning
Tht' ernl.r of the' Lakr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT LJooJ {~ g~s
APPLICATION RECEIVED (p... '2 'f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections ;Z
Denied 7Jn d
Reviewed By: ~'r11I~~ Date: (, -2.'1- 2C<c> (
Comments:
I. ~u "cJ...,.. c.m.... Iou s l: r ...... A , r- ~r;:' ''''=-. a-. -t F.-.... P[o...:...
2. P"'OUt'cla.. ~'S~o..llC4..t..~ jUC~ ~.t.- a. (l ;"'s~cJ\'b\...~
S'. ~u &. s""" Ie... cl., k <. {,,'S O'"'-.....~ L... k ~ .r. t'^- h.. (I; {..., "31-.p..'iT
rDo",^,~ .
"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 L{:S~l c.olnr~
TYPE OF WORK w~ h~ P1CA.(!..~
USE OF BUILDING SFU
PERMIT NO. DATE ISSUED
BUILDER WoocQ. (~ 3.b~s ~(2- 3'38 ~(, Dc..
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FeO~ 1:':;."- :u..~
PLAeC-NS4> _
~
INSPECTOR
DATE
J
I
I
, FINAL
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850