HomeMy WebLinkAboutBuilding Permit #99-0317
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 57/0
C av-tli'n al
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
IY~SULATION
fl. FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
D~TE
~oe
,I
e;~e.- T.....
TIME
'1: CO
Cfl- 51?
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR13ZCT 0 . ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CA 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~'2~
- 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
~77n
1. DATE
l\-q -gq
S$- . (1j~
;)5 - JCiq - nLf/-O
C'(lC~\ (<\r\/)o \l2..
3. LEGAL DESCRIPTION 3 ~
LOT I e - - BLff,K PID
ADDITION ~~ (-<-J~ I~ Add Y1 '
4. O~ER L(Na.~e) 0 ' \... (Address) 1;\ n,(TeL No.) 440 ~
,Y\\'y\ ~:jV""2afW\Q ~,n_S 070 0aCt\',"O\l 'f\~~L 4-~_~
5. ARCHITECT (Name) (Address) (~o.)
6. BUILDER
(Name)
(Addr~_ ~44-o-q~C1'3
L~k qQS -4 J yO
~fY)~
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-sidingO \i~r~
10. CULVERT SIZE
Yes No
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
'-1 G 'f :'J
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
Drl-3(i
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
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 abo..':(ll mentioned property and that all co truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
b~ qfficial can revoke this pe or just ca se. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X _ --\ ^,~\S\g a '\ ~ License No. \. \ -q ;:! ~
FOR ADMINISTRATIVE USE
..e:~~"MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
I,~ ,...,-, PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... 5'
Sewer Tap ................................... $
$
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
i6 ~I r<.
TYPE OF CONSTRUCTION: I II III IV C::f:)..
Occupancy Group A B E F t:+--j M -q{ S U
Division 1 2\)A
Permit Fee ................................... $ 5C{, ?~
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
.5"0
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... ~.
Meter Hom ................................... 5'
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $.__
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ .3S-.,.JS;
Paid ~."2. '5"" Receipt No. '~:3 7
Date 4/{(p/QC, By i:1lt J
in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance- and may proceed asl'requested. This document when
. I te~ certi~car l~llJi1omPliance and allows construction to commence. Before occupancy, a Certnicate of Occupancy must be issued.
~ D e Special Conditions ~ any
Sewer & Water Permit ...................... $
~ZZ'2:1~;:;~;:t;.1t";#-'?t
ce~:Z
Issued
24 hour notice for all inspections 447-9850
Td..
qq -3}1
White - Building
Canary - Engineering
Pink - Planning
Thr Ctnltr of Iht Lakt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, ~(t'V1 ~ 5u~wtU ~~S
u
Li-q-qCj
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~hich is proposed at:
v)7ln ~.~~f7C
Accepted
Accepted With Corrections
~
Denied /l
Reviewed By: ( V j)~ ~
V L - }/
f~ [;~vl /k ce~
Date:
<<-lr-c; 7
Comments:
eCtPO ~
.:..- - I
"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."
i ! I
White - Building
Canary - Engineering
Pink - Planning
The Ceonler of the L.ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
;#
NAME OF APPLICANT
APPLICATION RECEIVED
: j{
;' ( ,
i --
. ,
; \.
:.//;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.i 't.. \ I
;
; i(
Accepted
~
Accepted With Corrections
Reviewed By:
{).tJ1. ~
Date:
'-1 /{~-71
Denied
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."
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