HomeMy WebLinkAboutBuilding Permit 99-0164
DATE RECEIVED
11118
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9C(-IfoL!
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
/S535' /'l/l1t't/Cl IkL.
3. LEGAL DESCRIPTION~ J
LOT
I BLOCK
IIU! Tr~~5
ADDITION
1. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
J
/( /
PID ;;':;--J~ 7- {YJ 1- ()
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
4. O~ER (Name)
Va VI ~ /--# r-iIN!Cl
5. ARCHITECT (Name)
(Address)
sftQer Yl/1'14!..
(Address)
6. BUILDER
(Name)
VI e. rR (' t<
7. TYPE OF WORK
New Construction 0
PI reola.CG ~(~'S/P1C.
. Fireplac~ Septic 0
Alterations ~' Addition 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Address)
&5e~ qt/O ~l2{)
IfcIS7/tv;" /~5i:-' rL IWtJ
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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
:Uil~,:c~iermit for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perf08t;;;,,~.
Signature License No. . Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BU!J-PING
Ke<:'.
/fIe.
J
TYPE OF CONSTRUCTION: I II III IV 6f)
Occupancy Group A B E F HIM (J.
Division 1 2 l) 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
SOIL TESTS
o
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~I"\. 0 Q
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
S U
Cify:
Amount Brought Forward .................. $~J (p 7 .() !
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
i1. is
~"i.8V
2S0
0:6 'l"\
'.tt;~
Pressure Reducer .......................... :1'.
Meter Horn ................................... :I'
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
:;:;k,:::.;~,~h'"li!:-
By Date S- (1- if
Certificate of Occupanri I
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ ~
Total Due .............................. $-1 1f7. OLf
Paid ~ - I Ie 7. Cfl Receipt No. .3lf7(/l
Issued '_L:i/; 9 J ) , )"
Date '?rl { -cr By' t<.A A
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 re; ested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
T
SCHEI)UlED
~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
to:~
OWNER
O~a IJ...
CONTR.
ADDRESS l 553 5
PHONE NO.
PERMIT NO.
](Pf{
qq- 'Sf
o FOOTING
o FOUNDATION
o FRAMING 11
~SULATIO
INAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,.
'-~~ G~J
C1o<;e-
v
-h)p,
~
,/
Jt qq.-!~I
I '1Q - 10lf
~ ------ /'
-----
--
TORY, PROCEED
o CORRECT TIO ND PROCEED
o COR-4C WO K, C LL FOR REINSPECT'ON BEFORE COVERING
Inspector\ /' Owner/Contr:
~
CODE
MENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTl
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White - Building
Canary - Engineering
Pink - Planning
Th. C.nl.r or lh. uk< Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CH~CKLlST
NAME OF APPLICANT \j l e.re..c..\::- ~l-~ p\.a..c-Q..
APPLICATION RECEIVED 3-1l-1i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
15535" 0 1I\.\.e ok \t.
\j'
Accepted ~
Accepted With Corrections
Denied ')/1
Reviewed BY:{~Ct3~ ~~
I -
Date: 5'-/2 -7 <{
Comments:
I. ~MU~'&...e_ iv\c::h.Jlo..h'C1\A v"."-c9...ll. ~r- 'S-\oIJ~ .&- c..k~~
2. Qa..\l ~ r-oub\... lVo.. e..-cl f\~ ,,^~\?.eu~\~Cl'A-
S. Al\ fT~W\i0 ~ C~l.e. s\o,?'S M\.IS~ \.b.Q. I '^~tQ.l\.Q.~ b~r-CL t"OUj lA,,^-
1',^,~rv~~Ol'\.. Do t'lnt- (00-0-- lo.e~,..e.. \~~"'~l~<JVl.-'I.
LI. Atl9l"O\1-ed. \MA..\~--oJ..<3-- T' e.~/ ~tN:"ct -
"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."