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HomeMy WebLinkAboutBuilding (Demo) Permit 09-0591 5" ~~ o )00000 'U I )0- -(') III ::z: 0 z_ o -n--n-n-n ~~ j s:: -1~~~OO 0 0 2 n o 0 Z m :u mo 0 ::0 ::0 3: m C co m ::0 m (')"n ~ :"'l ::0 " -r-s:l:z-t en m en m z -Oz z en ::f'U ~ (') > Z (I) :::!~>Q r:> 0::0 -t -t -i rif 0 :::! z- .... (;) en (') z 0 ("' zO S ~ ~ -t z o::U CllI 0 ....... ::f5: ~ (It (') 0 -t Z (')" -n ~ 0 mm ~ 0 .~ ::0 r- ~ -I r- -n 'U :.. ::z: 0 ::0 ~ m ::0 0 000000 Z ::0 (') ~ m m m I:'U(I)~I:'U >< m -t Z 0 mr-~)imr- ):::> ~ en (')C -t(')C I z ~ 'U ::z:1: m::z:1: 'U (') en cs en m -n!:!!::o::o::o!:!! m 0 (') 'U ::l (') zZ::z:::z:-z ::u z ::z: ::! ~ m (D -t )o-Ii)go Ii) 3: ~ m ~ 0 ~ (') (") r--n 0 ::0 :::j 0 ::f 0 z z~~ - z C ~ 0 ::l lD r- :; ~'U'U r:> m z m 0 N -n ~ .... 0 ::z: ::0 m ~ 0 0 CD C ::0 0 en < 000000 ~~) m :i! z ::0 Ii)-n-no~ )0- z >;u;uo Ao 0 Ii) ~mm3:1i) ~ ~ _'U'U'U~ ~ ~ Z ~s:s:s:c (') > (')(')z:;; 3 _mm-t_ !" ::O-n::o r- -4 -t-- r- i en~ z m -tr- Ii) CITY OF PRIOR LAKE DEMOLITION PERMIT Date Rec' d I PERMIT NO. Ol.. ~q I ADDRESS Ib 188 ZONlNG (office use) ~.J::A c.::il{J-c'E;T :S 6 LEGAL DESCRIPTION (office use only) . LOT BLOCK ADDITION Pill OWNER (Name) J..tni..-'1 ~ U";;;t:'5"'t;'o Mt::7Ho6.:r-'Sr CUldeN (phone) ::;-5. 2' -.:.1d77-2<99o (Address) /6 (50 A~CA.J)..t:A ('-:;;;1YJc"'C'"'$ ~t:- ilJ~ f;.. (..1~' C I :I", ...J CONTRACTOR (Company Name) (Contact Name) (Address) .: (phone) (Phone) Use of Building: 1-h.n1 E V A B M R S U 4 5 INTERNATIONAL BUILDING CODE Type of Construction: I IT III IV Occupancy G1:'oup: A B E F H I Division: 1 2 3 lZ! MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLrrION I hereby certify that I have furnished information on this application which is to the best of my lmowledge 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 building official can revoke this permit for just cause. Furthermore, I hereby agree t~ official or a designee may enter upon the property to perform needed inspections. c....,-- eLL 1'/'//09 . Signature Date Becomes Your Demolition t en AMJroved 111~~I~~7~T,l.1 ~.et) CA5l'f,bA S. C!...l~ ft-.j' VA-<) '- T Jt ~B S~ ~ Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested, " 9-7-t:J~ Date Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372 Site Restoration Proposal For Demolition Applicant: t-k <-'-1 Jf2.::1..~.J::5-~ UN~ rfi-(;7tJO 6'J..t., ('(1...( t rl! Address: J61B8 p\1;I~. A.e:...b\ S.~,[l'., ~t' Check boxes below: ;EJ Fill Excavation to grade ~ Sod or seed all bare soils )if Erosion control (see handout). Maintain erosion control until turf is established. ~' Cap sewe! below grade. * Mark location. Licensed contractor required. )!(. Cap water below grade. * Mark location. Licensed contractor required. ..~ Call City of Prior Lake Public Works Department (Call 952.447.9843 or 952.447.9844) for water meter removal. ,J / A t Cap gas line. * (By gas company) :El Disconnect electric at meter. (By electric company) IJ 1(\ l:J Pump and fill cesspool/septic tanle Certified contractor required. ,.J)I\ l:J Abandon well. Certified contractor required. Existing well ;Q. Remove existing structure foundation and footings, materials, and debris. ** ;a. Provide dust control by following means: (f) Water mist from a water supply (i.e. neighbors, water tank) 2. Enclosure 3. Other Comments: (provide surveyor draw site plan) A:n-p" c 1t~ *Capping of utilities must be inspected. * * Final inspection and approval of restored site required. Deposit will be returned after approved final inspection. ~_ -1~ Signature j' /7/09 Date J:\HANDOUTS\Demolition Restoration.doc PRIOR LAKE INSPECTION RECORD SITE ADDRESS ( (/) ( 9J B ~AIJ (~ ~. NATURE OF WORK ~<.., (O~ USE OF BUILDING ~Co PERMIT NO. ,. 5t:::t DATE ISSUED S -z CONTRACTOR r-k.~ 'tltCIV 'l1t ~ PHONE -7. (:;' 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 I I FOUNDATION (Prior to Backfill) I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER I WATER J.fi,;;Vl1C - CI'\:;? (if required) GAS LINE AIR TEST - 0 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS GRADING (Prior to Sodding) rlt-J-AL- =:.i iiii. Il'j 1_' h..~ i 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. FOR ALL INSPECTIONS (952) 447-9850