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CU' ~ Z ffi!;!;!;c 0 ~oOz=n "'l _mm-f_ ~ rn ;u....:;O r -i -f-- r i: (l)Z Z m -f~ Ii) CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT DATE RECEIVED M~~ - 9 2000 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 4-520 HUMf1/N~ /3/1<.0 3. LEGAL DESCRIPTION /z.. KNOB H//,L, (Name) USS ,:JINT 1. White 2. Pink 3. Yellow File Qty Applicant Permit No. 00-03(P~ BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) .;" (Depth),/ 3 .3120 PID 25 -.3'f'l- 027-0 LOT BLOCK ADDITION 13. TYPE OF CONSTRUCTION ck 14. FLOOR AREA APPORTIONMENT USE 4. OW (Address) reDO 5. ARCHITECT (Name) tX,(j f'TCcj'" 6. BUILDER (Name) (Address) (Address) 6'tv P tZ/V- Re-roofing 0 Porch 0 Re-siding 0 Finish Basement 0 7. TYPE OF WORK New Construction 0 Fireplace 0 Alterations 0 Septic 0 Addition 0 Deck Finish Attic 0 Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq.Ft. (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS 3<1 SEATS 16. PROJECT COSTNALUE 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No 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 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 buildin~, cial re~his permit for just use. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X Signature FOR ADMINISTRATIVE USE MATERIAL FILED WITH APPLICATION Back Side Side SOIL TESTS 0 ENERGY DATA 0 OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0 SPACES REO. PLANS & SPECS 0 SETS SPACES ON PLAN 1,800. CJ-o SURVEY 0 COPIES PERMIT VALUATION :II/?- ~ M91 PLOT PLAN 0 SETBACKS: Required Actual Front BUILDING DEPARTMENT VALUATION USE OF BUILDING ,ees I AI lit- , TYPE OF CONSTRUCTION: I II III IV V ::: ~.:...~~.~...~..~~.~.~.: ~:~ :t;" Plan Check Fee ............................. $ ~; ~~ I u~ State Surcharge ............................. $ . . City: 5(.. 15 '"SG. .a7 . To Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... $ Gas Fireplace Permit ....................... $ License No. Date Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ Pressure Reducer .......................... $ Meter Horn ................. .................. $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ ~tal DU~ Sll....................... $ Paid 'I, Receipt No. Issued 24 hour notice for all inspections 447-9850 00-03(05 The ('enter of the Like Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ~OC\ ~}\.)~~ () t- APPLICATION RECEIVED~~I oct \ ~orrr] The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 4f)Q. 0 \-hH'1\ I:i1 r r:~bI ~ Accepted With Corrections ~ Accepted Denied Reviewed By: Comments: ReAD ~ ::T~ Ju Date: silt) ItJO A.IJ 0 ALL ntt5*" PLAN S . I (\J Fa re.. m....~ T7 ON 1) ee- It.. f...I A,N {J - ~ c.::r- ON {Hc APp/2-0Ub7::J "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." to' OO~03~? The. Center of the Lake Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT \2. ()c\ \Ch ) ~::-)'~',(-\ \ () 1- IV APPLICATION RECEIVED I' \ {\. \ i :: Y'1 . I '~\ 00 (1 '--,":"" . / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: L.I')';) 0 l-h) f)\ h) I t~\h c ('J Accepted Accepted With Corrections v Denied Reviewed By: ~-i~...eA-t Date: (5"'- t 7 -et) Comments: ~~~~ ts $UhU-e4 ~ e~ .z;~~~ ~~ ~-fv~1O ~~'~Jtvv\e..e-b klt~/~ ~\ {A~~ ~ ~ >~ck ~J. e~~~- ~ ~~4- fJ(1vJ.1AtVVI. to~, "S~d ~ YO ~~.&<~ "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 SITE ADDRESS 4520 HUfV1.M/NGBliUJ Tit-I TYPE OF WORK IJG W ::DcC/~ USE OF BUILDING RES AIR. PERMIT NO. (JO . 03(P~ DATE ISSUED 5' / I () /00 BUILDER ,fCJ{j 76u5?..PIII Air- I , NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF BUILDING AND INSPECTION INSPECTOR DATE I FOOTING \ll/~ Lfrr. I 5//9/00 . PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I I FRAMINGKE"Q 13Efi>~E 'De(.l{.'B&5, I 6:;. 15~Cz) .1 FINAL I Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS 447-9850 , 'II . ,