HomeMy WebLinkAboutBuilding Permit 99-0640
OAT:: TIME
CITY OF PRIOR LAKE , <ill ~ -.i'l "I ;Cb
INSPECTION NOTICE SCHEDULED
ADDRESS 5S(,,1 Cn>ssa..--.~ Ssr
OWNER CONTR,
PHONE NO, PERMIT NO, qq ~ (,,40
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING f\ 0 WATER HOOKUP
_~SULATIO 0 SEWER HOOKUP
~ ~~NAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: J eeL
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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HI?J
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n~RK SATIS ORY. PROCEED
lJ~~RRECT A TION ND PROCEED
o CORRECT W FOR REINSPECTlON BEFORE COVERING
Owner/Contr:
CODE
HE NEXT INSPECTION 24 HOURS IN ADVANCE.,
ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~1
QA T~ R~r:~IV~.D.
MAY 271900
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
5'::,(., ( c?..A~5.S ~l'l~ RA S;\ "StE
3. LEGAL DESCRIPTION
fG
BLOCK
.3
PID .zS-.302- ()$/- 0
13. TYPE OF CONSTRUCTION
LOT
ADDITION
4. OWNER
K~rJ'T
5. ARCHITECT
eA-I2DIA./Al--
~ame)
(!.<)'" Q,jto ~
.e,0dii,':;; 2 NO
(Name)
(Address)
~~ I e.~oS.Sblf>. Q... c;l SC
(Address)
6. BUILDER
(Name)
(Address)
"St:Lr
7. TYPE OF WORK
New Construction LJ
Septic LJ
Addition LJ
DecliA(
Finish Attic LJ
Re-roofing LJ Porch LJ
Re-siding LJ Finish Basement LJ
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Fireplace LJ
Alterations LJ
1. White
2. Pink
]. Yellow
File
City
Applicant
Permit No.
CJq- ~4o
t~;;1/q9
PUD
BUILDING INFORMATION
". SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Tel. No.)
~~Ml'l-<O\
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that 1 have fumished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for
the above mentioned property and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the
bUi'din~ffiCi I c,n re'fk6 ~is pe~ for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X -t A l_ A 5t;;nt,Q
- Signature License No. Date
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Water Tap ................................... $
Builder's Deposit ............................ $
Other .....,................................... $ /d<-i. ._1
Total Due .............................. $ (f"~
Pa;d /u e </ Rece;pl No. ~ ~ &.
Date 1,/1/"1" By d1A..-
st in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr~ requested. This document when
stttules a temporary certifir;Y;19nt compUance and allows construcfion 10 commence. Belore occupancy, a Ce"''''''e 01 Occupancy must be ;ssued.
n er I Special Conditions if any
Front
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDING
/i?es #4/.e..
,
SPACES ON PLAN
PERMIT VALUATION --3.,0-r.=.
/'
TYPE OF CONSTRUCTION, I II III IV-/
Occupancy Group A B E F AI M ~ S U
Division 1 UA C..... "='-
PerrnitFee ................................... ,'l: ~ _" z::o
Plan Check Fee .............................. ~.::: . ti '7
~{)
C;,yo
71. 7~
({e.. s;"f
t .&V
State Surcharge ............................. ~
Penalty ....................................... :t
Plumbing Permit Fee ....................... :t
Mechanical Permit Fee ..................... ~
~
Sewer & Water Permit ...................... $
~:;::a:~;~L~~:I~;~~'~e:;tWhen?pr~t
By ~~_ Date (p - -
Certificate of Occupa'
Issued
v
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS LJ SETS
_or'
SURVEY
PLOT PLAN
o COPIES
1"1
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
24 hour notice for all inspections 447-9850
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Thl' Cl'nln of lhl' Lib Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILOING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, '
--
The Building, Engineering. and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,
Accepted \/
Denied /\ j
Reviewed By: L L C/;, .J f1lD-J..J
~cJ0 ~
Accepted With Corrections
Date:
{Pfrl9/
Comments:
ok..
"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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Tht' ("t'ntl'fof Iftt' l.ktCounlry
White - Building
Canary - Engineering
Pink - Planning
.BUILDING PERMlLAPPLlCATION DEPARTMe:NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/CAN! CoNRA.O
5/2-7/qq
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5Sfo? c,iC055~/IIO.€.A .sf
56
Accepted
Accepted With Corrections ;>Z
Denied
Reviewed By:
(2 ftLl4-
cda(& ~ j) ~ /
Date:
(P--..2.' 77
Comments:
~ -ftL
"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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PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~~("J C\r'i'7SU-.~
TYPE OF WORK DP,... ~
USE OF BUILDING SF 0
PERMIT NO. 97-~ L(O . DATE ISSUED ~- ?-Lf
BUILDER K.aJ- C~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING A~LI-.., fA) I fft{ I '" -/ L{ - 'j <J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~~~ I I
~\-
I FINAL
f
I ~ l(, 11,~
Call between 8:00 and 9:00 A.M. for II i Spections
FOR ALL INSPECTIONS 4 7-9850
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