HomeMy WebLinkAboutBuilding 99-0162
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
3-j(--qq
/{15fJ
PID d~--047 -{J/S -0
DATE RECEIVED
MAR I I 1999
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
1L/-9t-(,
1. DATE
3. LEGAL DESCRIPTION
LOT /L I
ADDITION [5r HdaF7
---
BLOCK
Iv !iiSJU, tL'O cl
(A
I t/.7' f.. ,
~
(Name)
(Address)
6. BUILDER
(Name)
(Address)
~~ 7i77w/SOJ-i-,
(Tl'. No.) .I /
~~7 - ~J> ,(..
(Tel. No.)
(Tel. No.)
#7-;(7~J
7. TYPE OF WORK
New Construction 0
Fireplace R..,k( Septic 0 Deck 0
AlterationsJJ~' Addition 0 Finish Attic 0
Re-roofing 0 Porch 0
Re-sidin~ Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
q 1- /ft,c1..
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
..d ,;)." b-trf),
17. COMPLETION DATE
I hereby certify tha ~e furnished information on this app' ication 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 menf ed roperty and that all con on conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bUildingo.~jci /~. evoke th~~r j~C _ se. rthermore, I hereby agree that the city official or a designee may enter upon the property to perto ,2~eded inspections.
X l~r < -?-z-- ':<'3.5,-/- ,,;; /' 7f
Signatur License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDlts. .
AIR
I
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F H ~
Division 1 2 (!)4
Permit Fee ............................."..... $
S U
City:
'281.25'
18~.1~
Lo.ct)
Plan Check Fee ......................."..... $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
L.I O.C:>O
~~
~. rr,/
S
~
Sewer & Water Permit ...................... $
our Building Permit When ~r2(~'
Date J -I -
Issued
Side
000. 00
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due."............................ $
Paid
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance nd ay proceed as requested. This document when
signed bY the City Plan er onstitutes a temporary Certificate of Zoning o~lianoe and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
/' ''''~IZ ~
ity PI ner Date Special Conditions ff any
24 hour notice for all inspections 447-9850
Tht' Ct'n't'r of Iht' Lallt' Counlry
White - Building
Canary - Engineering
Pink - Planning
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
tV--
Accepted With Corrections
Denied
~~~
Date:
S -(2- ~l
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."
PR,IOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS --":I"I~~ ~~i~ ~ni~ (1 r
NATURE OF WORK Sh-ud~)\o.J,. ~oc~ ~\f\G..(~~
USE OF BUILDING S t= D
PERMIT NO. -3.S - /{a~ DATE ISSUED s-IS'-ii
CONTRACTOR rt",~ ~\"1C,.J..& 5\ll\&.QJS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
~/Z" : t2/-}: -;kh5
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING 0 6.. -
INSULATION No
ELECTRICAL
PLUMBING
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
I ,
----- ---'
)
BUILDING
ELECTRICAL
PLUMBING
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