HomeMy WebLinkAboutBldg Permit 00-0563
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
~ / o~/()O
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESj LJ S ry S-
/Lv
3. LEGAL DESCRIPTION
~
1. White
2. Pink
3. Yellow
File
C~.'..
A .. t
Permit No.
03
1. DATE
(Depth)
BLOCK :5
\;1-1\\
PID Q5:" - 31 0-0 ;;tq-O
13. TYPE OF CONSTRUCTION
LOT
~.
ADDITION
4. OWNER
Kf\.()b
(Name)
(Tel. No.)
"\ ~ - 4o~ -9-V
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
(
6. BUILD R
(Name)
(Address)
SE--Li=-
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Baseme~K
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
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 m tioned property and that all constructi . I conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 . ia can revoke' for just cau . Furt ermore, I hereby agree that the city official or a designee may enter upon the property to perform ne ed i spections.
X
License No.
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid /Z i1. Z-~
Date 7 /"Z-
est in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed requested. This document when
ttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING ~ *
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 h
Permit Fee .......... ........ ............. .... $ a.,. "2. c;-
City:
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Z.oc:>
40.00
~
Mechanical Permit Fee ..................... $
Sewer & Water Permtt ...................... $
............ $
e Yo r Building permit'ien ~proved.
Date - ,?t!J C/O
Issued
Date
24 hour notice for all inspections (952) 447-9850
Special Conditions ff any
Side
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
DO, 05~ ?
The ('("oler of Ihe take Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
po teO ClJ teio/
-7/ 5100
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4675
!<.{)S6WOOO /<.0.
Accepted
Accepted With Corrections
Denied
Reviewed By:
Comments:
Date:
"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."
The eeRier of Ihe L.ke Counlry
I (,Ii ~})
White' . - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
-~.
....., t L/
I
"I
" ",--
.I '
,/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i ~:~.""'"
~/ '.~^..'"
'.. L..-'/.
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
I
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 canc~1 the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
BIJ
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
Date: 7- 5'- 2dO'
Building Permit # PIn.
Site Address I C/5?S" ~~ar ..Q~~
Zoning:
Legal: L
B
Subdivision:
Existing Structure: YES or NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning 1-
building height?
Is the property located within the flood plain? Refer to Planning >4-
Does the alteration include any additional kitchens? Refer to Planning ~
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ~
Is the proposed use of the fmished space or Refer to Planning ~
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
PRIOR LAKE DEPARTMENT OF -'f-
. t BUILDING AND INSPECTION
...,
INSPECTION RECORD
SITE ADDRESS ~51') ~\.UOOJ) feR.
NATURE OF WORK ~~ Q ~J; -F,,^~~ ~
USE OF BUILDING ---5FO
PERMIT NO. no ...ot)1p~ DATE ISSUED
CONTRACTOR <f:;;;l,. / Pl\ONS*
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
r-.
ill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~---
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
- I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service 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 shall be placed near main entrance.
Call between 8:00 and 9:00. A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850