HomeMy WebLinkAboutBuilding 99-0022
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DATE RECEIVED
r-
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
t-. ~7S'
I. White
2. Pink
3. Yellow
File
City
Applicant
. QC 2L
PermIt No. / '1 ^<,
1. DATE
/ ---:J- - 9'9
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
~ ~ BLOCK
KY\DfI:> H,li
PU'.
PID KYlG L H:
25"3/0 -..:' 41.
LOT
s-
ADDITION
(Address)
J."",h''cJ hi.
(Address)
6. BUILDER
(Name)
(Address)
~ .+-
7. TYPE OF WORK
New Construction 0
Fireplace jJ
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement;a
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Tel. No.)
'f9t -0 90Y
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
/Ij(). (!?C-
17. COMPLETION DATE
?
Yes No
10. CULVERT SIZE
I hereby certify that I have furnished 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
building offi . I c revok is p,rmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~ ~~
Signature License No. Dale
FOR ADMINISTRATIVE USE
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 ~,'(,)r<:J("). f)~ PLOT PLAN 0
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due.............................. $
Paid IJ7 ..lS Receipt No,
Date I ~S By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as r uested. This document when
. Ian er onstnutes a temporary Certificate of Zonin~ compliance and allows construction to commence. Before occupancy, a Certificate of ccupancy must be issued.
'.4'- t -txsiv
P nner Dale Special Conditions ff any
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1ZE:-s. A t1~
TYPE OF CONSTRUCTION: I II "' IV
Occupancy Group A B E F ~ I ~ S
Division 1 2~
Permit Fee ................................... $
U '1~ .10;-
~:2 S-
$
l,OO
~&O
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee .....,qIf.:t2tll1.--$
Mechanical Permit Fee ..................... $
<jtf-CC'Zl-
Sewer & Water Permit ...................... $
~~~~
-. ~\\I
\\, ~~ \
?? \\
"
Gas Fireplace Permit ....................... $
4-LJ, Co
ur Building Permit When Ap"
Date I - 1/ -
Certificate of Occupancy
Issued
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
/st .)S"
24 hour notice for all inspections 447-9850
~------,_.~---"---.,.~-------_..,--
Applicant:
Address:
Signature:
Legal Description: Lot
Site Address: ~c( 11\.4:-
Building Permit # PID # L5' 3!<::J -04z-o
NOTE: This permit will not be processed without complete information.
CITY OF PRIOR LAKE
PLUMBING PERMIT
L ?c( K
13 lAL .rel;- I. IJ
1. Blue File
2. Gold City
3. Yellow Applicant
PPNo. 7f-C;C) L 2,-
Phone: I./CjC -eye.,
.&( iq4 llV S-~37~
Thr ('("nler or Ihr Lake Counlry
Block
,5:
Sub
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
FIXTURE UNITS
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
$
$
$ 31.5'0
$ .50
$ 40.0 ()
GRAND TOTAL
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.
~as:~R~NO. /-It-1r: DATE
Ii. A TrEST
Call for all i4ections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 553721 Ph (612) 447-98501 FAX (612) 447-4245
An Equal Opportunity Employer
,. ..,. ,-..---. '.~ .,. -""~'.~ '~'''-'~'''' ._v_.. ~"", ,.___._. ___, "_"" ~._.~.-.. ...__. '_
White - Building
Canary - Engineering
Pink - Planning
Th. ('.n.., of Ih. L.k. Coun.ry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I I '/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
! '
1/
Accepted With Corrections
Accepted
Denied
~~
Date:
L -tL -qq
Reviewed By:
Comments:
L~
~/.Qv~~ ~.Q ~~ ~
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."
-~.._-.._-- _.__.._ .n, _ _~~u___ _ .. _. "'~__'" __ _,. _ ____....._....____.._
White - Building
Canary - Engineering
Pink ' Planning
The- Ctnfrr or Ihr Lakr Counrry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT gu l~ \Roc. ~
APPLICATION RECEIVED I -1 -'18
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
fL.{C/ 7fJ E/u-eb,'t-ct
~
l t-- .
Accepted
Accepted With Corrections )(
Denied
Reviewed By: 0 tt:.~)A
Comments:
I. t;...o ,.J.., t:... ... 'f' \c.. c ~ i '" < \" I \ '" h """ J" ,.d .
2.. ~ loc..s-e '--.A.. ~ C''-''- ,,~ ~ lA..........~ Cl "- j
Date: J - 1\ - 't 1
"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."
:t'~:lfAM~~rij NT I C;',;,:A e'ov E'it:7f.:fA S .;;!{ EJE'ifNtrtS:iti'N
:'~;iti("'("';"//::i,.',. '. .', "','" ',' ..,;,: ;:",\l!~:t:,:,:.., ..;.~ ,<.;:,ii~':;:;~"''''f;!l;~;';':ifl.
. P ',....,,,..' .. ....,.. NOTICE' ",," . ,. "';,';"',tf;'
;'>i,~~;" . ,
..~\;:.'ii',Thiscard'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:. , "
'<:,;':,'i6Wl)ere no serVice cabinet Is available, card shall be placed near main entrance~;':::;';.<::;':;.'@J;~ ':';2';';:"
}','''..'' . ;;;'''''):''(''. ' .,;, '. ',';,.. ,,' ,.'~:,: .,iM'~,,;,:; ,'.,
1:::~;;~;\LCall between 8:00 and 9:00 A.M.~for all inspections;::i;\",)';',:.i;::
..../.":'-J_..:~-~-_~_~,t,.<:~1.,.""._ ,:'---. - _. " . _._,~ ,_' ,.:_,.t _,'.,'. ._, ,,,,:...', ';'I",,::_.i_'-"~'~-"~:"~7 "_';;"
:,.'.\!\>.1('!I'~;':;i:'~' FOR ALL INSPECTIONS 447-4236 ,: , ." :i..,.;"'~'1'(',,,,.
'-