HomeMy WebLinkAboutBldg Permit 00-0291
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
t2.,.k~u A.J
ADDRESS 1(,2 2- c.{
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
~ ~~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
^ ..
(~f~q,,, +t,t) ~:(L do t,
DATE
LlI..., loa
f I
(D ,.. .
TIME
txi ~ :;2 9(
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
.0
..
.k, ,'t "',.\ ."v,-,\: J
y
)( WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRE(ZRKI CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
...:./
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.,1 I
LJ Id::) lOr)
I '
DJelV6
Q.ATFRECEIVIiQ
all.
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
~...sITE ADDRESS
'r~
/(P 2. 2. 4-
3. LEGAL DESCRIPTION
5
C/lKDI NA '-
PrJJeI<. V I 6W
3
K-loeG
LOT
BLOCK
ADDITION
;.Ii;~NER
, ~..
(Name)
f1/\10SRSOAl
(Address)
Ik.OV
(Addressf
5. ARCHITECT
(Name)
_~R
~~t{~
(Name)
.i
(Address)
I
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0 Dec'
Addition 0 Finish Attie; u
_~ 121-1.5_
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
PUD
25 ~z99- 03(p- 0
ADON.
I.fLjo - ~ ?~tt
PID
If;;;;;, I
Re-roofin
Re-siding 0
10. CULVERT SIZE
Yes No
(Tel. No.)
(Tel. No.)
Porch 0
Finish Basemen~
1. White
2. Pink
3. Yel10w
File
City
Applicant
Permit No. j)()-oz,,11
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
L/I- ,h\ni~h
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
..",.--
ished 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
hat all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
q,;::j~t =00. F"'tl"~~,' h_.,~ ",,,... '" """",,,. _- ~y "',, "poo "" prop,"y to "';f:. ~
FOR ADMINISTRATIVE US~ .
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
Side
USE OF BUILDING
eRS A//L
- - /
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
S:cco.oo
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
7cl.1S"
Plan Check Fee ............................. $
State Surcharge ............................. $
L.SO
Penalty ....................................... $
Plumbing Permit Fee ....................... $
L/..o.()O
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
GaS~;ffi '~................., '--4/). Q 0
This' m"~ J., or -'luilding permit~e~pr~~d~ _
By ~ Date '1.' t.& ~ t!Jf1CKT
Certificate of Occupancy
Issued
City:
~o
61
Side
SOIL TESTS
o ENERGY DATA
o
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 Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
24 hour notice for all inspections 447-9850
/5&.25-
37tR" 1
Water Tap ............ ................ ....... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ..............................
Paid /~. z.. S-
Date~/"1./0v By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning(>rdirfance and may proceed requested. This document when
signe the City PI er const~utes a temporary Certificate of Zoning compliance ~ allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~'1.eO b ~ ~~ tL.eA~S &.", ~~1Li~
~y lanner Date " Special Condl ions ~ any
White - Building
Canary - Engineering
Pink ' - Planning
The Center of the' Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAMEOF APPLICANT Tr f\'-I A. '(\de.r&:of\
. f .
APPLICATION RECEIVED Llpc\ \ dO, dOOO
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J bd~Lj .~ rt..,/;pw Dri\f!:-
Accepted
~
Accepted With Corrections
Reviewed By:
Date:
L-/_ U---6t)
Denied
J
,
Comments: .
~~~ ~ ~ ~~ ~:E~
.r0~4 ~ I ~~_ ~ &,tA~.
"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 6rpf ~ny 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 I In'j &r\ckA ~OY\
APPLICATION RECEIVED A pf'\ \ d 5) d a (j(l
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/6;Jd4 grlVle_-,^, Dr\v~
Accepted
Accepted With Corrections X.
Denied /1, pi ~
Reviewed By~f~ r"
Comments:
" ~~ ~ ~ R'-v-.'. D.... ~
Date: tr. ZI!J . ~ C) tIP
"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."
II.
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS , lD'2.'2. '-{ R,.k-vie.vJ DNu-e..
NATURE OF WORK ~.........A :t:.",.~
USE OF BUILDING C; I="\)
PERMIT NO. On :"OdJ-Cf / DATE ISSUED l(.'Zb.'ltxJO
CONTRACTOR ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
..;:;.=~~ ':' --- -- ---
(
!
1
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING .(if required)
FIREPLACE
~ GAS LINE AIR TEST
(:h c<;!; 6);
U I IF
~.
t
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
=~= >-=.~- ,
t BUILDING
t ELECTRICAL
(-1
1 PLUMBING
~ HEATING
Vr
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical se.rvice cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
. where no service cabinet is available, card s~aU be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850