HomeMy WebLinkAboutBuilding Permit #99-0584
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED $- r-ol ILl
17 LlL/7 fj{~eu.J50(;{!f-
I
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9-5&>'-1
o FOOTING
o FOUNDATION
o FRAMING
~~TION PI<
T I ~ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~ALL FOR REINSPECTlON BEFORE COVERING
'08pectOC 'i>.\ ~ Owoe,/Con1rc
CALL 447-9850 FOR TH~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
QATE R~
OJ/&/kr
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
QQ-S8t.J
. 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
17L1y 7 ~ :~D
3. LEGAL DESCRIPTION
Z
tv 000 K-I D6 6
LOT
~r(
5
3~
c+
1. DATE
5)9/9C;
P2~rLq~ ~I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
<'E
12. NO. OF STORIES
BLOCK
PID
25"-.317 -tJ3t1- ()
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
~. \..\ .
5. ARCHITECT
(Name)
~)~
(Name)
(Address)
I -, Lf 4, Lfl.;.!:1P woDd. Ct- S.F;
(Address)
(Tel. No.)
I/q7~3/77
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck~
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 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 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~ ~fficial can revoke is permi just caus . Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf. orm needed inspections.
X ~ '-7 5'-/.;l-'1Cf
Signature
License No.
Date .
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
I
eE5 AlE-
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN
PERMIT VALUATION ? ~1'V">1. fC)~
PLANS & SPECS 0
SETS
COPIES
USE OF BUILDING
SURVEY 0
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV( 4;J
Occupancy Group A B E F HIM O' S U
Permit Fee ..........~~~~~~...1...~~... $ ~t?1. ~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
,t:; Co : 77
2.00
~~R~
\J)
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
nP8 co' m..e.~.~.. r' ..:.........e$rml.t When A~~ved. <] Water Tap ................................... $
II ~ ' Builder's Deposit ............................ $
B _ _ ~ 1/ ~ Date <"'- /- - C; Other ......................................... $ IL Ie /;, 1
Certificate of Occupa~ Total Due ........... ................... $ h)-I
Paid /~q7 ReceiptNo.~/5
Issued Date @;/ZO/qtq By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoninQ Ordina'nce and may proceed ~~est~. This document when
signed by the City ~ const~utes a temporary Certificate of Zoning compliance ~ allows co~truction to commende. Bekfe qccl!..~' a Certificate of Occupancy must be issued.
<r-e.A~' ~ L..-'7-~ ~. ~r~.
()"' - - C Planner Date - - Special Conditions n any
24 hour notice for all inspections 447-9850
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Th~ (-~nlrr or thr l.k~ Country
White - Building
Canary . Engineering.
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHI;CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ - / l~ /-L_j~ "'."1 , (' /~,~;" t~ i I. " f /
I It. f I " -...." .., '/ , ~, " ' lJ
,..----
Accepted
Accepted With Corrections
/
Denied
Reviewed By: ~-4.,L...~
Date: (~- 3 -'70
Comments:
t,L)~.t~f2~ ~ rull€- ~ ,,~l ~Cl~~
II ,. t/,
/~Q ~ !11A~ /'..AIL. <S~'te ~ fMN\, '1 n ')€'A/~ .
V\A~ U F<l ~ ~ ~ {A/~W~
/,p_<~r~.A/\<<<d/ ';:Y'f'1w~.
"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
C'f-
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS jT)ll LIt) k'.-rOj€ Wo~
TYPE OF WORK u-Prk ~ fo::::>t
USE OF BUILDING -.5 FfJ
PERMIT NO. q i -l)l3'1
BUILDER I{ a LL)~-<..Q.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
. DATE ISSUED 5" - ;}.c{ - c::z ,..
FOOTING I /:Ec:rOR I 9/~/:;; J
# ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
, I PI_ .11f1n4G I I J
FINAL
I ~JA 1~,
I~~{L. ~
Call between 8:00 and 9:00 A.M. for;(. Inspections
FOR ALL INSPECTIONS 447-9850