HomeMy WebLinkAboutBuilding 99-0263
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~
DATE RECEIVED
APR2~
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. Lf'1- ?t.c::S
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 . , r\_
')?:[)5 fr r t'[)~ V\t
1. DATE
Y -2~lq
RlSD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
LOT"'r{t(+ 'P R LS hq BLOCK
ADDITION I'Y\ (' ef"'~ '( II rl'LU 1'-A s
12. NO. OF STORIES
PID cJS -CfcO ,0 I&:- 0
Pi20 I lA ) of Pot) 2-10 E I; nf J-iu R
153. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
4. OWNER (Name) (Address) (Tel. No.)
L ~~ /to S SpS F yU)t;. 7 ,f>! -;.
5. ARCHITECT (Name) (Address) ()'L,')l1r:3~ 3Z2-0 (Tel. No.)
-\-,0. 8'ft{ ~t
6. BUILDER (Name) (Address) (Tel. No.)
/~",u t 'Jt~ "J J!; A'!
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
-, :j 0 D
17. COMPLETION DATE
Fireplace.
Alterations 0
Septic 0
Addition 0
Deck"
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
10. CULVERT SIZE
9. PROPERTY DIMENSIONS
Width Depth
Yes No
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 mentione and that all c ction nform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offici n revoke this urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~-J- 99
License No. Date '
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION r;;(/oeo. (!)o
USE OF BUILDING
~s klK
,
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F /..~ I M (; S U
. Division 1 2(/ 4 ~:2---
Permit Fee ................................... $ .') S
City:
Plan Check Fee ............................. $
YC.4.l
t . nO
~'2.2S
~ O~;\
:-q(
0-/\
i"\~O
G~' v
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
iB.oo
Thi
By
our Building Permit \Yt)e~ i}tlp~~
Date ~. 0 (' (
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
Side
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 ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ............................. ...... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other .~~\o!~j..~\~............ $
Total Due .............................. $
Paid 2 5 - q 7 Receipt No.
-13 - 't C{
Date
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 request . This document when
signed b the City anner constitutes a temporary Certificate of ~g compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
4-g"
C Y Planner Date Special Conditions" any
24 hour notice for all inspections 447-9850
White - Building
Canary - Engineering
Pink - Planning
The Crnler of the Like Country
.4
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1...-..
l
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'~ I' '1"
, :
Accepted
/'
Accepted With Corrections
Denied
~~~
Date:
4- f ~C1~
Reviewed By:
Comments:
II ~~~14L-J~~~
2.) l~ }Acv~ ~. <;l.~~
3') h~ (\/\,~ V~\~ 2l9~+-~-
"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."
~.",~....,=.-"c-,...,,-..,..._.__._--_._--;- ".- --.-
QC(-Zrc3
White - Building
Canary - Engineering
Pink - Planning
Th. C.nl.. or Ih. Lak. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
YCtuY- t{)OJ/l"~
Lf-2-4!
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
S,::S05 PrDst POi ~'1-r
Accepted
Accepted With Corrections ~
Denied 1________
Reviewed By: ()2 f? f2..;;;e -
Comments:
(.~~.~(~
Date:
f/-~ -9T
"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."
FAX COVER SHEET
CITY OF PRIOR LAKE
16200 Eagle Creek A venue S. E.
Prior Lake, Minnesota 55372
(612) 447-4230 - Telephone (612) 447-4245 - Fax
DATE: 4. - (; - ~ I
TO: ~ul ~Ua.V\.s
TIME: /1:00
FAX #: ""0- 62>2
COMPANY:
FROM: ~ECLU~~ 91a.v..~ "&o.-~
SUBJECT: ~d:~~~,t
Message:
7~l,
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