HomeMy WebLinkAboutBuilding 99-0278
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DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
" '. TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
2. Pink
3. Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No. -.:J 9. Z 18
1. DATE
2. SITE ADDRES~ r ,}, . _ 11 ,'7)
~ 10 C(L'lUJJv:c>- \\.1 C
~ 'WctL{j
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
I~
ADDITION ~ ~~
II ~saf~t+
13. TYPE OF CONSTRUCTION
LOT
BLOCK
3
lit'
PID
1~-~I"o 18 -()
12. NO. OF STORIES
(Name)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (NaTe)
Jb\~" R o.U.Yfl(,A. t
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16.P
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
x
ave 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 agenl for
prope n t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
voke t . fo! just u Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf r leede . (jections.
License No. Oat
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
((Q5 HI tZ,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
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
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Plan Check Fee ............................. $
tQ.7'5
"/8 ~ 'J8_ qe .5Cj
1.50
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
-<;tl < 00
$
'. _~ ) c~ressure Reducer .......................... $
[~V-2 ~/----- MeterHorn................................... $
Water Meter ................................. $
............ $
~
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
...suild"r'~ nQl3esit ...T~~........... $
I- 2.-4 . ~ +-
Sewer & Water Permit ...................... $
Other ................... ...................... $ ~ .
..Gt:allJue..,.............................. $-/ 4- ~ tf.
Paid 12.4. S 4 Receipt No. 3SC:>2..-1
I~"" 0", 4- It, 7it. By 12-. tl.
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance nd may proceed as requested. This document when
signed b he City er constitutes a temporary cert~ ~~'23-f1Pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~y nner Date Special Conditions if any
Building Permit \?Il)enJPProv~
Date '-{-Z7 -7
24 hour notice for all inspections 447-9850
qC( -276
White - Building
Canary - Engineering
Pink - Planning
Tho Conlor 0' tho l.ko Country
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
Jo!-t...... ~.BU5TAoI
t(_ ~
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 X
Denied ~ 1t ~
Reviewed Bye . a "-y- .
Comments:
~~acl tLz u,f_k H~-~ ~~
Date: f-8 ~ 7'7
,
"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
The Center of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, """._.J
(' <) ; ,}' ! -'j "/
f
, ,
"'1
. ,""\
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
~
Accepted With Corrections
Denied
C:;YxAA) bk-~
Date:
L-/-J 2-~
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."
. ..._..._'-...._--~_...--c-._._.,._,._----__,.,...~_. ._._.....,.......~_____..._~,."..,.....,..
CITY OF PRIOR LAKE
Th. e.nlt, of Ih. Lak. Counlry
Applicant:
Address:
Signature:
Legal Description: Lot I Block 3 Sub
Site Address: SA /'1"'\6
Building Permit # t(lI- J '17 PID # f. 5 -G( Ol - o~ -0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
1. Blue File
2. Gold City
3. Yellow Applicant
# _~'(2 N
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
$ .50
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.
DATE
ArrEST
RE~NO.
Lt \
Call for all inspections 24 hours in advance.
pJ ~0~fl~dj~:t
y#J
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
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