HomeMy WebLinkAboutBuilding Permit 99-0967
DATE TIME
CITY OF PRIOR LAKE .,L
INSPECTION NOTICE SCHEDULED ~zh~ 2 :,30
ADDRESS /t:/684- r? AN /' ~ L/l./.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99- Y(P7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION (fJ
,:s:: FINAL pe:..c... T'
o SITE INSPECTIO
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: <<) .4.- ~ 0/.. Jk .-".' (7_ _~
.kA'I.A~.JL,.-.fy+f'u ~ tf--"7'
(;.() ..fL~;~ ~ __{!"./).. .-"' _LJ -
~ t ' I..__-+-II
.;l.e.u-e...- f (. , ". <:. , 'f" &t 4./J ~ ...u~
) .4V ~ 'J.-:, crI....- .
/(/ P4-cU.
"--
~dv~
J
~
-
Inspector:
/
o W~SATISFACTORY. PROCEED
~~~~CT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
h,
f
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
II
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
8 /h /qCj
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 /l
I'i l., ~L\ CAn!'o:; a.. IAYl-6, (\ E..
3, LEGAL DESCRIPTION
3
t!.A Jele./ A ~ b
LOT
BLOCK
5
H/U...5 3R.O
(Address)
1~t.~"I e..AnfH'_ kc. rt.t
1. White
2, Pmk
3. Yellow
File
City
Applicant
Permit No.
99-9bj
1. DATE
~-t>lr~ 9~
,e/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12, NO. OF STORIES
PID?~-30CJ - 033-{,)
ADDITION
4. OWNER (Name)
:..J~Df\lt. 1'11,- LA RV:lI...
ISo ARCHITECT
6, BUILDER
(Name)
(Address)
(Tel. No.)
ol't-yS 97t!-30/"Z-
(Tel, No,)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
(Address)
(Name)
S""I">"Ec
7. TYPE OF WORK
New Construction ["'J
AS 4&OV"-. (()W~ 'Ut.. J
Fireplace 0
Alterations 0
Septic ["'J Dec~
^AA:119~ .... Finish Attic 0
Ae-roofing 0 Porch 0
Ae-siding ["'J Finish Basement ["'J
SEATS
16. PROJECT COSTNALUE
13, TYPE OF CONSTRUCTION
(Tel. No.)
/P/:J.-lf<Io-49d.-/
14, FLOOR AREA APPORTIONMENT USE
Chimney 0 Misc.
18. PAOPEATY AREA OR ACRES 19. PROPEATY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation 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 ab ntioned 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
ing officia n ~~thlo~~ermore, I hereby agree that the city official or a designee may enter upon the property to perfo~~79~'
Signature License No. Date r
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Total Due .............................. . .1.1,.,0
Paid '? /. ~ I Receipt No. <"35f3h '7
Date e, /13 /'111'} BY.jtt:?' -
in the above application and accompanying documents is in accordance with the City Zoning 6rdinanbe and ~y proceed a~uested. This document when
utes a rary Ce~Pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Date Special Conditions if any
Front
..ok
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
USEOFBUILDING ~e:.s A/R..
PERMIT VALUATION
1.3d).fI'l
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
43.00
'2'1. 'IS"
.l..1:;
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
~
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Thi~9fon Becolie~uilding Permit.iYhen Api'!oved.
By~_A-;;C Date ~...t'2."''t''
I
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS
SURVEY
PLOT PLAN
D3ETS
~ \ COPIES
Amount Brought Forward .................. $
Par1c; Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
~-~'----~~
24 hour notice for all inspections 447.9850
_1 .,,4 J I n.
.~~x PR /O,!?,;
~ 'Y,
'I-. l'
iJ en
'7</ 9(,- 7
White . Building
Canary . Engineering
Pink . Planning
Tht' Ct'ntt'r of lht' Like Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSr:
NAME OF APPLICANT
APPLICATION RECEIVED
JEI<C/~/ C f'/c. CJJR Vf(...cC
8/0 jC;C;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/z/(p 8t/- (Y-IN 7C7~ LN IJ C'
/
Accepted
Accepted With Corrections
.
Denied-_
I /j ") 1
Reviewed B~;/ (/ l . ~^
Date:
,.,-)
L - ( ::: ~ r;1
Comments:
.
r,
I k:.-u-[ ~, <:
;) .JC 1<
I/T ,j C
J.
"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."
-......----_...- ...-.~ ......v- --, ..."'_.,_ .4
_.~._.
, I
..............~-
...-
.")
--,
'7
/ ./
ThrCrnlrr of Ihr Lab Counlry
White - Building
Canary . Engineering
Pink - Planning
f1U1LDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.'
-'
(' ~ 1-; /. Ice C
;.-
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, '/- Y / (
,,'/ ," f
,/ ':...
-
)\ I J..
I 'J '--
Accepted
/'
Accepted With Corrections
Denied
, Q 11)., ~ Date: K - 0"'-;'
Se.:Jbo.J60 ~ ofL-
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 anx 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."
ATTACHMENT A TO BUILDING PERMIT NO. qq- q(p{
PROPERTY OWNER ACKNOWLEDGMENT FOR NEW CONSTRUCTION
The Owner of property at /~e"" d,lfN77S11ie "N' N/5 in the City of Prior
Lake has applied to the City for a Building Permit to construct new addition or deck.
Prior Lake City Code Section 4-1-7 (A) requires a Certificate of Survey, prepared by a
registered land surveyor, as part of the Building Permit application for all new
construction. The Owner has requested an exemption from the Certificate of Survey
requirements as provided for in Section 4-1-7 (D) and (E). In consideration of the City
accepting a marked site plan or survey in lieu of a new Certificate of Survey, the Owner
hereby agrees to waive any claims against the City and to hold the City harmless from
any claims or damages incurred if the structure is inaccurately placed on the site.
OWNER(S):
fPMp (1, &p ~7!K (kA/~t
CITY OF.hRIO~}~A '
By: ~1fII;;!::::.,
Its 5 CJ t '-4Jt,J(,;;. et"iG ~
DATE: e,/13/9<7
STATE OF MINNESOTA)
) ss.
COUNTY OF )
The foregoing instrument was acknowledged for me this
A O"""ST ,I 99....!, by !<ol362-T P. ;-)".'71;.10/ INS
Official of the City of Prior Lake and7l1 ~ 4- (.11 vie:: Art.
owners. j
- /t
Notary Public / .
j 3 day of
, The Building
the
,~
.
KELLY GRAU MEYER I
NOTARY PUBLIC
MINNESOTA
Myoommlsslon expires 01-31-2000
. ",. :H."~v.I.
.
t@
. """,^A^
HOLDHARM:.DOC
I r
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS \"\Co 54 ~~ ,-,..~ t-J.G.
TYPE OF WORK DE-c."
USE OF BUILDING ~ Alp....
,
PERMIT NO. Cf'l" 'l(.g1 DATE ISSUED
BUILDER .j~~ c>1-'\~ l-1<:.v...."11,..~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I '~OR I ~ _I~:T; C;
PLACE NO CONCRETE UNTIL ABOt~ HAS BEEN SIGNED
J:Yn.llllllijft, I I
DEPARTMENT OF
BUILDING AND INSPECTION
~ ',t. (ere;
I FINAL tw~
I /ir-,
I '7 -.;( - 5''/
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
II I
._~__.__~'_._.~.,__._.~_.,_ __"__'__'u'_'_
i :1