HomeMy WebLinkAboutBuilding Permit 95-0314
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ci PRIO~!r:mi~@ ID;.=;:r~- CITY OF PRIOR LAKE
t ~ /! BUILDING PERMIT,
U t'll. ! JtlewlIMIliRY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. Sli;jD/RE~
3. LEGAL DESCRIPTION
LOT
J.....
PID :Is -0 k 9- dlJ-O
.
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
Permit No. q5"- 3N
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) 1 r (WIdth) f/ I (Depth) 2. 2.. I
12. NO. OF STORIES
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
7'-1(9- q
15. NUMBER OF OCC~TS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
30 C)C)C
17. COMPLETI N DATE
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Sa c.. tH' ,,,~~ Depth Yes No
I hereby certify that I have furn shed information on this application which is to the best of my knowledge true and correct. I also certify that am the owner or authorized agent for
the above ntioned prope nd that J construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 I can revoke I p mit f use. F ernlOre, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
ZZ'-'I..f 1-16~
Ucense No. Date
x
Front
Back
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
-Ald.J... QV\
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A BEl H@M
Division 1 ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 30 I OCXJ
City:
Permit Fee ................................... $
3~~l.15
?5Lo .54
15.00
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $
~~~. 3q
Check if
Deferred
i1ding Permit When Approved.
By
Certificate of Occupancy
Issued
Date
7-/ ~ --9$
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS ~ SETS
Side
00
SURVEY
PLOT PLAN
.t:f COPIES
a
Amount Brought FOlWard .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
License Check Fee ................. ........ $
Pressure Reducer ......... ......... ........ $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
o
o Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ... .......................... $
Paid .3
Date 1 h 19
24 Hour notice for all inspections 447-42309:00 a.m. . 10:00 a.m.
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ApPlicant:
Address:
Signature:
'""va1~: Lot z. Block -S~
SIte Address: 7g/ , -6<?7?'-Sub:
EIuucting P"""k # _ _ y. '/
NOTe, Th' " PlO #
' IS Ponn~ IYIN not be Processect Wiltrout ~ Informavo",
FIXTURe UNITS
CITy OF PRIOR LAKE
P. lilliS/NO PERIIIIT
II ~ ~J
2(11 ~
~
Phone:
1. Blue File
2. Gold aty
3. Yellow ApplicaJJt
# -f{[: /j~
J~
QUantity TyPe of Fixture Unit
AmOUnt 1
Bath TUb 'Nfth or 'NiIhout Shower Total
$ 6.00
DiShWasher
1=loor Drain $ 6.00
Lavatory (bathroom Sink) $ 6.00
$ 6.00
L.a_ry r",y (1 or 2 COnlpaI'tment .'nk) $ 6.00
ShoWer Stall $ 6.00
.1 Sinks:
Bar Sink $ 6.00
Water Closet (toilet) $ 6.00
$ 6.00
Rough-ins
Water Heater $ 6.00
Water Softner $ 6.00
Sland Pipe !washIng tnachlne) $ 6.00
$ 6.00
Sewage Ejector
$ 6.00
!lacknow Assemt"y (RPZ. Double ChOCk. PVe)
$25.00
Backflo'N Assembly Test $10.00
- laWn Sprinkler $25.00
Other
Minimum Fee $ 6.00
$25.00
GRANO TOTAL $ otS..J7J
n,;, penult', -... '""" the._ ....'Iion that"'d ~
"'."""'. "on """"'''. au -.. ";/h the d' .
of the State Plultlbing Code and the~ltlen entsO~~~:~ces
CBlPT NO. cr- DATE
.
- A'11'Bsl'
CaIl for all ins'PCcti ," 4 h .
4629 Do""", .. .... .. ""'on""
Sl S,!!" Pn.t l.oie. AI"'..... >372 I Ph, (612) 447-4230
AN !!QUAl. Ol>PoRTUNJry 1!Mp1.oY8R I PJ\>( (612) 447-4245
SURCHARGE
.50
~l1
." t
"'~'.~i"' . ':,j, <'. _,-'i>::::i:'~YJ,,(:;.,;)'I&,;"
White . Building
Canary . Engineering
Pink . Planning
The Cf'n.u of lhe L.ke COUnl1')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
../"
NAME OF APPLICANT /1' k 0 ./ t
APPLICATION RECEIVED '/ /;0 / 1::~
.in'
j
.. 1:f-"'~""
/
J '--t- -",i-I} if j
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ~ctivity which is proposed at:
.-,. ~
Lj/~1 L~~</ //?II,;'.~j//Lt-L /~#"dZ~)
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~. MIL8AFJ LE.EI~
Date: ~ /1 '3/i gqS-
Comments:
liThe 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. II
tl
White - Building
Canary - Engineering
Pink - Planning
Th. C.nl., or ,... Lak. Co.n'".
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
. r(.
NAME OF APPLICANT ~,;~<", Ly - f"~""'" J oJ.-+u_~
APPLICATION RECEIVED ?/JO/~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constructio"t(t!Vity which is proposed at:
1//3/ ~ aJII;/J,~
Accepted
Accepted With Corrections X
Denied
ReviewedBy: (11 ~~
Comments:
L ~VltIALJOU" t-.-:>+-""'-'2l"'~ ~o '
2. 7~t>..H~ lll\.frst~~~ tSlx. fn,,. _
~c:o [to ~.
Date: 7-l6~qS-
I./\....~ -- L -^-- ;1 f- {;..o.o-- ~ ..........A
~ 0
, ,^-c. ~A ,0.. .A
--..
liThe 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. II
~1
/'/.-.' ,
..1 .~..
;,7;:':~;; ;,'
....
White - Building
Canary - Engin....ing
Pink - Planning
r
Th. C.n'., of ,... LI" COln'ry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
. j(.
NAME OF APPLICANT 1.J ~./ .1.)0 - f" ~....., J "- + n ,./..
APPLICATION REC~IVED 7/;0/1/5"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constr~ction ,ct!vity which is proposed at:
Lf/JJ ~/ (~l,nAdIJAL
~
Accepted
Accepted With Corrections
Denied
v.~
/Jd/f/./
Date:
7 /;1 /9:7
, /
Reviewed By:
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 coeeor other
ordinances of the jurisdiction shall not be valid."
I
,
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1/1J~"l,'I1J~
NATURE OF WORK
USE OF BUILDING
PERMIT NO. qs 0/'/- . DATE ISSUED 7//f lis-
CONTRACTOR ~h'-~/V. f *o-J .
NOTE: THIS IS OT A PERMIT OR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNT L ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING v I?JhJlr
J '--
INSULATION ~I.rll.' f/2III/S"
ELECTRICAL
PLUMBING 1/ 'f/ll Its-
'" /'"
HEATING (if required) ~ /J . - 1//11 Ills-
FIREPLACE II r
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
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