HomeMy WebLinkAboutBuilding 99-1353
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r::::---., nm: RFr.FIVFO __ CITY OF PRIOR LAKE
~:l r:~ ~~~ Q~ [g r. BUILDING PERMIT,
.. --i1t~MPORARY CERTIFICATE OF
NOV I 8 1999'11 i. ZONING COMPLIANCE
A~P'UTILlTY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUSTSc FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE 752'; J FI-7 f R L 17 fill tJ SHo te.e;..s
3. LEGAL DESCRIPTION
II
BLOCK
PJ2./0 R-
/
tf I t-l-
PID 2...5-/7Q-01/-O
LOT
ADDITION
4. OWNER
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
rj 9- /,'31'; 3
1. DATE
11-
T/i2.. L.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(H~ight) I (Width),
I
I2fSD
(Depth)
l
(Tel. No.)
B~) ,'" r,
13. TYPI;.,OF CONSTRUCTION
r'~l...m e~
14. FLOOR AREA APPORTIONMENT USE
) '. d '-
Ii '\.,-t C' _ (,."J C ./1. Iv
j;.)~ h
6. BUILDER
(Name)
L,,-, .l e./ t.-
(Address)
--
t./t^I/I;'
~'n'l..-e .
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
J-
)./1 A
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basemenw' 16. PROJECT COSTNALUE
Chimney 0 Misc. /" -j; ~ 5' J (), iJ V
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. I 3. 1 5' ~ Width Y . It. Yes No j,..../ t- \ l..G.;.. ,;~' ..;
I hereby certify that I have fumished information on this appiication which is to the best of my knowledge true and correct. I also certify that I am'lhe 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
building official.can revoke th~.i pe it for j~~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~. r- ~ tt%r I~ 9t,,;;-.1'117
7 ~ ~~ ~
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
t<'t .
(~ /11,'2
I
PERMIT VALUATION
t./a:o. dD
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee ................................... $
6'7, 2~
Plan Check Fee ............................. $
State Surcharge............................. $
2.00
Penalty......... .............. ........ ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
40 ,DO
, /i.-.
I 0/'
L~\7J\ [Iii
Sewer & Water Permit ...................... $
ilding Permit wren ~proved. 1"_
Date { - ~3 -'7,.
Issued
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
/2'l2~/
~j -, "-of;
L-..
Paid
Date
/'7 (--..~ /'---. .---)
(//-./. ~
- ..' ~ -.......)'.J )
...-- '-.'
The ('('ntrr of rht L.kt Counfry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
C L A' D l~ . D'! IV () (~ L II
/ II f./1C;
I i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
//)- 2 7 / /;:-:; / I~) L /-) (\/ N ,c.) t I (/<! E ,<.)-11'-~ .
Accepted
Accepted With Corrections ^
Denied ;j? ()
Reviewed Bye D/--* Date: J 1- 2-5-7/
Comments:
J. ~ ~ ~ ~~~ ~-tJ-
"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."
17 (7 - / 3 ::.;~
White - Building
Canary - Engineering
Pink - Planning
The Ct"n'er of the L.ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
c.S ,:'.- ;<;:? C L/ ";_ / ! ;\/ // c.. L /' I
./
,I I / /;. / (~:,:' I
/ !
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,,'-,......~ ~" "--")' /
i ,"',,' / I
l' ~'*'" t..___ . :
/~-'I'" .... "i i. .,...-\ ." "'''',' '"."'_:,/"'" ,.,/1, /'" (
r. " '~'- ,-- ,'- J , \ '. -~-; ;: / ~. .. . i-':" C.-.~-':
-.,.....,... "',
1.(::'/
i ~ "'"" .
Accepted
/
Accepted With Corrections
Denied
() ~.~ . Date:
~~~-oK-
it I cJ3/7!
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 vfolation 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 I SA ( \ F'H~ Lc..w,,",- ~~
NATURE OF WORK "&~ F-; lA..('~
USE OF BUILDING S FJJ
PERMIT NO. 1'1- {~~ DATE ISSUED 1\-J..~-'17
CONTRACTOR LA-V\d -pi c;
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
t ~::~~'{.~t~ i-rt~ D~rktUD I -} j
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
~.__. --.. . .... .IC
FRAMING .,Jk {f;;, } 7370 I
INSULATION J I
ELECTRICAL
PLUMBING
HEATING (if required) ... 1
~P" -'f1Jr:E~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
11"~1 . - ?,\tID I r
FINALS
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