HomeMy WebLinkAboutBuilding Permit 94-0473
Qttrtificat! of OOcrnpanry
CITY OF PRIOR LAKE
~tpartmtnt of ~uilbing .Jn~ptttion
,p(Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior LaJce regulating building construction or use. For the following:
Use Classitication Single Family
Bldg. Permit No.
94-473
Occupancy Type
R3
Type Construction
v
Fire Zone
N/A
Zoning District
R
Legal Description
L7. B2. Carriage Hills 'ntird
Owner of Building Jeff & McDonna Blackwell Site Address 14604 Surrey Lane
ce4~.'tor's...N'""-;'~ ~'~-:E Builders Inc. 9523 Quaker Ln. Haple Grove MN
\ '.. Glay'StaB / Deb Garross 55369
-:; ,"'... ''-.. I
, , \. ,-. '''__.r C Planner
,...
Date:
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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D
OF PRIOR LAKE
ILDING PERMIT,
IFICATE OF ZONING COMPLIANCE
TV CONNECTION PERMIT /)A A
Permit No. ~R - ~
New Construction)lll
Chimney 0 Mise,
8, PROPERTY AREA OR ACRES 9, PROPERTY DIMENSIONS
Sq, Ft. Width Depth _yL
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
building o!!lcial can revoke this per ' If lust ~use:tfurthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections,
X' ~J??3 /n-/o -y~
Signature Uc:ense No. Dale
MATERIAL FILED WITH APPUCATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS' SETS
SURVEY ~OPIES
PLOT PLAN 0
1, DATE
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
3, LEGAL DESCRIPTION
7
ADDITION C A yt ;;? I A;) €..
4, OWNER (Name)
-:::S:~~r of /,4C DD IV ,V~
5, ARCHITECT (Name)
12, NO, OF STORIES
LOT
BLOCK ."-
1-/, LLS
(Address)
L c. Jl. wc..L l.
(Address)
1\ f
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Reroofing 0 Porch 0
Finish Basement 0
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Side
Front
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET ~ ~
USE OF BUILDING .
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
" I 1 J ,_
~ vC:X::;>. Gb
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV fJ
Occupancy Group A BEl H@M
OMsion 1 2~4
Permit Fee .....,............................. $
City:
Amount Brought Forward .. ..., .. .. .. .. .... $
Park Support Fee .....'........,....,..,.... $
SAC ..............,..,......'..,............. $
Collective Street Fee ........,....,......... $
SewerTap ................................,.. $
LicenseCheckFee ...................,...., $
Pressure Reducer ..................'......, $
Meter Hom.... ....,........,............ ..,.. $
Water Meter ........,..,.......,..,....,...., $
o Sewer & Water Connection Fee ,......,... $
o Water Tower Fee ............,......,....... $
7't7, 00
Sle>.~
'1 z. . cc>
Plan Checking Fee ......................... $
State Surcharge.......,.... ,.......... ..,... $
Penalty ........,.........,.................... $
Septic System ..........,.............,...... $
Other .........,......,............,........... $
Check if
Deferred
Subtotal..................,............ $
'~f>1, oS'"
Permit When Approved,
Date J 0 -n -qA.-
Issued
1. White
2, Pink
3, Yellow
File
City
Applicant
I :S€>7. ~
ls,SO. 00
~ro . 00
~s;-O.(!';)O
~.co
'1S"'. 00
qu:>.OO
ldZO. Gr?
J500.OO
B
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, document when
signed By the City Planner constitutes a temporary certificate of Zoning compliance and allows construction to commence, Before occupancy, a certificate of Occupancy must be issued,
city Planner
Dale Special Conditions n any
24 Hour notice for all Inspections 447-42309:00 a,m, . 10:00 a,m,
tt4 -\{1 ~
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,..'-:..h;"~:,i ''"..r:
~:.<t., .
q4 - t/73
~
Th. C.nl., of lh. L.k. Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 1 tL- t.J ~ j)'A.'-' .
APPLICATION RECEIVED fJ /0/11 /f'l
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Nt, 4'/ d~">iJ.'I!~X~
Accepted V Accepted With Corrections
Comments:
~~.~7~ '.n ::t3tiz:
~::=~ 7t::;r::J;~J ~ 4d/~.
. .N,
. :
"
"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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GREEN - FILE
YELLOW - APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE NO. f~-I?f
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT:
PHONE: lpo-l(CJ90
DATE: //- /LI-9V
BLDG. PERMIT 11 9.,., - (J l/ 13
SITE ADDRESS: /l/00L/ SUrY7e V L.o- PID# 0(."') -,,} /JIJ - 111J?-D
FILL ~ THE BLANKS r
1. Estimated length of water service L(~
. f t .Il(,
2. S1ze 0 wa er serv1ce~1nch(es).
ADDRESS:
SIGNATURE:
feet.
3.
Location of any couplings from structure
Type of sewer pipe. ABS PVC ~ Cast Iron
L//1 (
LV feet.
feet.
4 .
5.
Estimated length of sewer line
6. Clean out (if required) I located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY Jkj:"dtJu r DATE: ii/II/IN
===== =========~Jt===============================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID /~Vlfl
RECEIPT # 2'1?'J- L REC'O BY
4629 Dakota St. S,E" Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPlDYER
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2. Gold
3, Yellow
File
City
Applicant
Phone:
# qt./ - U!J-
7~~ -~712
Applicant:
Address:
Signature:
LegalD ription: Lot Block
Site Address: J1~(;~ ,t?ILYn~:~ tAl
Building Permit 1# q4-- 0'11. PIDl#o!S--3tJ() -- OtJt;- 0
NOTE: This permit will not be processed without complete information,
FIXTURE UNITS
Sub:
Unit
Quantity Type of Fixture Amount Total
2. Bath Tub with or without shower $ 6,00 It,(.o
I Dishwasher $ 6.00 ~~D
J Floor Drain $ 6,00 b, fjtJ
3 Lavatory (bathroom sink) $ 6,00 J~,!J/}
J Laundry Tray (1 or 2 compartment sink) $ 6,00 fL; . /) /)
2~ Shower Stall $ 6,00 I '1,00
2. Sinks: $ 6,00 I 7./)/7
Bar Sink $ 6.00
,~ Water Closet (toilet) $ 6,00 I tj. 0/)
Rough-ins $ 6.00
I Water Heater $ 6.00 tl f}f;
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6,00
Sewage Ejector $ 6,00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10,00
Lawn Sprinkler $25,00
Other $ 6,00
Minimum Fee $25,00
SURCHARGE ,50
GRAND TOTAL $ 4 ~ ,6/)
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the St~te Plumbing Code and the am7dments thereof,
'.j RECEIPT NO, /I 1~/91.J DATE
, ATTEST
4629 Dakota St. S,E" Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPWYER
White - Building
Canary - Engineering
Pink - Planning
Tho Conlo. of lho Lob Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ \!... r ..I
APPLICATION RECEIVED gj
'J-
Iii} Lv ~), L/ '
/O/I/I,y
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
f ~
Nt, A i/ d~ - l..A .J./
Accepted . " Accepted With Corrections
Denied
Reviewed By:
~
Date:
/O-I,}- 9<-1
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 cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
White - Building
Canary - Engineering
Pink - Planning
Th. C.ne., of lh. Lab Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~<L-t'-, ~ Jlu.
APPLICATION RECEIVED gj 1011/ /f'l
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Nt, 4Y cAi<"'! - ~ fL,.L.I
Accepted
Accepted With Corrections
x::J
(
Denied
Reviewed By: ~ M. ~ Date: 'O-17~,f
Comments: (() ~ ~ ~' C~ + ~)Y') ~i)
~ ~ ~ SI'7.-eS fY'"lbY -b .f.r~ 'h5;fLdlDh
(i) ~Ql..v h~Uh r-L~~Y(l!-~ ~~
(j.) M~ 8--~Oh ~~J ~ ~~~Uh
~
{!J ~ c.J1 ~ ~ fOtrJ-s ~ ~
4oo-l-(~
"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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Jl/1':tZf::'/
NATURE OF WORK 4Jf--_o- _
USE OF BUILDING I
PERMIT NO. tf'l-l/13 DATE ISSUED IlJllr/f/t
CONTRACTOR 11} ti- & ~ I Jlv '
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
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 I SEPTIC t{~ J L,
FRAMING
INSULATION (~ ilhu/Oti
ELECTRICAL
PLUMBING 'L~ .,1.. ,JAI
HEATING (if required)
FIREPLACE f" Ilhd/q,j
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD \.IL; IJ//;Rift'!
FINALS
GRADING (Prior to Sodding)
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 447-4230