HomeMy WebLinkAboutBuilding 99-0517
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DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
MAY a 0 ~ 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. ,I
'-I- ) b (1. '1
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq-5/7
1. DATE
S--/{)"1~
Pror L~(.. ~/sD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
6
rvlL-OeRA/5C,<;:;
4. WNER (Name)
!t1 ich c e.. '
5. ARCHITECT (Name)
12. NO. OF STORIES
2.. PID 25- 318- O.?D - 0
,oIJNDS
(Address)
"q <.( W}Je{-nC:S5
(Address) (Tel. No.)
LOT
BLOCK
ADDITION
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
SA fY\ 0
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Deck
Finish Attic 0 '\
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
17. COMPLETION DATE
I hereby certify that I have fumished 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 abov ntioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plan. am aware that the
buil' fficial can ke this rmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to 0 needed inspections.
X ~ ),-)D.cf'1
License No.
Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Front
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDING
!l-cS ~/R-.
,
SPACES ON PLAN
PERMIT VALUATION 3~. C{"'~
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM ~ S U
Division 1 2 Q4
City:
Permit Fee ................................... $
74.. 7~
'Ie .57
I,!::IV
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
wt. \ 11\C~~
'J\~'
Sewer & Water Permit...................... $
Gas Fireplace Permit ....................... $
This ~liC9Jli~Becomel Your Building Permit When Approv,ll.d.
By (jJ:- ~~ Date" -( 3-7 f
Certificate of Occupancy
Issued
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
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 ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ '.f{' ,
Paid T~~4.e8.4.............~~~.~i~~~0$ :;; ~ 'f
Date 5'.. 16 q 'f By
24 hour notice for all inspections 447-9850
The ('enter of the l.ake ('ountry
White - Building,
Canary - Engineering ~ .
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.~' ,~., I
/ :,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.;.:..
.;- L_ _~~_~..~
Accepted
Denied
/
Accepted With Corrections
Reviewed By: ~ ~
Comrr.ents:
~ ~~1 ~o l<C;u;1I ~_ Wl~
/~ ...~~.( fdfOP~ }~Bv1S ~ ~-(
---50 lkvl-Q-, $e-n/~~~"f2LIA~..
_~l&. ~le,,~ %V~ r~hrepr
Date:
5"[7 ~70
~~~~ ~:J!:r~
L~~~ StJy~ ~tvU1~~ Ii'
"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."
qq -5/7
The Ctnler of tht L.kt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/"1/ CH/lEt.- 0 () Y 1..-6
5~O/qc; f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~ 92-4- yYII-OERJVc5S 71<.A-1 L-
Accepted
Accepted With Corrections
, (
""
Denied
Reviewed By: ~kk
y
Date: )-IS -'l. 9
Comments:
_j2,Cln2 ~ ~l<
1-LaQ.~
"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."
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ LJt.~J..QJV\e9..S - 1~.
TYPE OF WORK .J2~~c-
USE OF BUILDING SF \)
PERMIT NO. g~ -511 DATE ISSUED r::;--Is-i?
BUILDER bc'j\~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING trL fLJ-1, I ff.Qit I 5)"- d '"'7 ~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
II~ I I I
I FINAL I I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
.