HomeMy WebLinkAboutBuilding Permit 95-0008
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETYI
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.. I 2 1995
TEMPORARY
",
i!
CITY OF PRIOR LAKE
BUILDING PERMIT,
TIFICATE OF ZONING COMPLIANCE
I ITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. Cf5'- 0 ~
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" CN~VIGU TR.~, E
3. LEGAL DESCRIPTION
1. DATE
1/,2 r~s-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO. OF STORIES
LOT
ADDITION
4. OWNER
i'W\.
5. ARCHITECT
/ PID ,J..S-:1...1b - /)1)3- 0
J~ aJL~"/
c.V.I /)ii . t..../ 7t~
(Tel. No.)
'0 ~ 6~ '7/p
(Na e)
f.R,'GSe:.' ~
(Name)
6. BUILDER
(Name)
(Address)
$J'tY'1 €
_ (Address)
5.....ynt:-~
Fireplace CJ
Alterations CJ
Septic CJ
Addition CJ
Heating CJ Plumbing CJ
Finish Attic CJ Residing CJ
Reroofing CJ Porch CJ
Finish Basemenj)l(
9. PROPERTY DIMENSIONS
Width '2. LL Depth Z I
10. CULVERT SIZE
Yes No
x
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ YRCOLATION TESTS CJ
PLANS & SPECS.t6' SETS
SURVEY CJ COPIES
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE 0 ILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION '2 ,5~. DO
PLOT PLAN
CJ
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A BEl H ~ M
DMslon 1 2"f4
Permit Fee ................................... $ sq, 00
Plan Checking Fee ......................... $ ~S' \ 0
State Surcharge ............................. $ 1 . "1.5'"
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
City:
Amount Brought Forward .................. $ '=:7Cl. ~
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom......... .......................... $
Water Meter ................................. $
CJ Sewer & Water Connection Fee ........... $
CJ WaterTowerFee ........................... $
1 0,> 5'
Check if
Deferred
application and accompanying documents is in accordance with the City Zoning Ordi nee and may proceed as requested. This document when
emporary CertifICate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
J -2 5-7'J
Date Special Conditions ~ any
24 Hour notice for all inspections 447-42309:00 a.m. .10:00 a.m.
uildlng Permit When Approved.
Date J-';2 3-9~
,
Issued
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White - Building
Canary - Engineering
Pink - Planning
Tht Ctnltr of lht lib Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ,._.~~'. tu~
APPLICATION RECEIV;;;V I h;)/s-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/} . If- t'
4SL/L/- Y~,.-<..J,~iJi~ J~ c .
Accepted
Accepted With Corrections ?<-
Date:
1~~-1~
"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 ..rij6lf'-/ POYIdJ.JIM rr~
NATURE OF WORK Io~~ 6~
USE OF BUILDING
PERMIT NO. q -5, cJO 8 DATE ISSUED I, ~d ' '1s
CONTRACTOR ~.~ F~c>~
NOTE: THIS IS NO 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
~'/e b'~~~r J~?rY-.i ~b ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING fb 3 ,q-' 0))
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE f.fJ 'y 1:7'" 4.5 (~/lo' '15
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
GRADING (Prior to Sodding)
BUILDING . .,.~'''l~
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