HomeMy WebLinkAboutBuilding 99-1096
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
q /3/19
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"87 l<lis E PKW
LOT
3
BLOCK
PID zs -304-- 02./-0
2@
13. TY QF CONSTRUCTION
qtfz. (Tel. No.)
2.
(Tel. No.)
{prz...701.5/IS
(Tel. No.)
ADDITION
4. OWNER
(}
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-/09(p
1. DATE
q-s'-Ic,~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
5. ARCHITECT
(Address)
14. FLOOR A A APPORTIONMENT USE
'\
(Address)
Fireplace 0
Alterations 0
Septic 0 Deck 0
Addition 0 Finish Attic 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Re-rooling 0 Porch 0
Re-siding 0 Finish Basemefl1;:8(
Z t...e1/5L-~
10. CULVERT SIZE
Yes No
New Construction 0
9. PROPERTY DIMENSIONS
Width Depth
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 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
buildin . lal an revoke rmi' c se. F her re, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
ej-3- 17c~i
License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
USE OF BUILDING
"ee5 A/I<!-
.
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
if,OI;O
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
Cify:
137.'Zs-
Plan Check Fee ............................. $
State Surcharge............................. $
2.00
Penalty....................................... $
Plumbing Permit Fee .r.tJ../.P..?~.... $
~\Ib\l\1
~f
HJ.OO
Mechanical Permit Fee ..................... $
Sewer & Water Permit .. .................... $
............ $
uilding Permit When 7pr,wj
ate 1- -7
Issued
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ............ ...... .......... ....... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Paid
Date
that the r quest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee s requested. This document when
Plan r constit tes a emporary Certif'Zf of ~oning compliance and allows construction to commence. Before occupancy, a Certfficate of Occupancy must be issued.
' "' 54' 4
lanner Date Special Conditions ~ any
24 hour notice for all inspections 447-9850
ClC;-/09b
The ('(""rer of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
67/2t5q H(/N77/V~7VN
q /3 /99
The Building,. Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4087 ~HsPB6~ey ~/066 ;eo Nb
Accepted
Accepted With Corrections
><-
Denied g~ 0
Reviewed BYU;;(~ "7.;:;5---- Date:
Comments:
~~~~~hiAJ~ ~~.
1- 7-)7
l'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."
White - Building
Canary - Engineering
Pink - Planning
Thr Cenler of Ihe Lake Counlry
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
Date:
q -- 3-7'7'
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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CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2. Gold
3. Yellow
File
City
Applicant
Applicant:
Address:
PPNo. 99 -/22.5;
Phone: ~/;2 ~~ 1V' ~
The Cenler of the Like Counlry
.:50,
Quantity
(
Sub Krt.sf-?t:36R.RV 1<'/ Ldi,b
.
Building Permit # PID # 25"- 304- () L / - 0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Rough-ins
Water Heater
FEE SCHEDULE
Water Softner
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Sewage Ejector
Backflow Assembly (
Backflow Assem
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$ 3q6D
$ .50
GRAND TOTAL
$ '-It.CC
This permit is granted upon the express condition that said
contractor. shall comp in all respects with the ordinances
of the State Plumbin an he amendments thereof.
3&:405 .10/7/1'7 DATE
, I
A ITEST
Call for all i
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2. Gold
3. YeIJow
File
City
Applicant
PPNo.
q9-/09~
Thr Crnler or Ihr Lakr Couner}'
Applicant: G.Ii2cg I-/t,/NTl NC3/T00 Phone: 2 2~ - 2089
Address: _~7 R7~'I /2/0CiC
Signature: 7b~
Legal De~riPtion: Lot 3 Block 4- Sub 2.S - 304- - ()z. f - 0
Site Address: 4067 RrJS;:J8ERR-Y k::IDG6
Building Permit # CJ CJ -I () 10 PID # 25 -304- - 02../- 0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (bathroom sink) Stand Pipe (washing machine)
Laundry Tray (1 or 2 compartment sink) Sewage Ejector
Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAL
.--',...,'
O \N\ \ "_ e;"
yp.\ pS,-.. "I l
e\J\\.Et)\NG
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
-------
RECEIPT NO. DATE
ATTEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4~b Mo
NATURE OF WORK ,&
USE OF BUILDING
PERMIT NO. q1 ~ /0 '=tt;, DATE ISSUED 7-7-7j
CONTRACTOR lJo",j~ '
NOTE: THIS IS NOT A P RMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
____ I I
I~I I
- PLAC: UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
. .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGMEe
~ ..Jft <4
FINALS
g)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850