HomeMy WebLinkAboutBuilding Permit 99-1025
II
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 5~ ~ I fY'\o....Nlj(" l2Mrl.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ~
FINAL 05(;
~SITE INSPECTIO
COMMENTS: J
I. J2AM
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
J1~1
~/
DATE TIME
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Cft - I () 5r5'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
WWORK SATISFACTORY, PROCEED
/0' CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ' Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~1
DATE RECEIVED
8/IB/~Cj
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT lS ISSUED (Please Print or Type and sign at bottom)
~ITEADDRESS I) '3 J?J I1JJ}/M
t'. Jr-.
fit:).
3. LEGAL DESCRIPTION
LOT
5"
L,L}K.6 510S
/
PID 25-07(') - OOt.-D
2ND AODN.
13. TYPE OF CONSTRUCTION
BLOCK
ADDITION
MANOte...
. .( OWNER
~ -J,loR 1111/J
5. ARCHITECT
(Name)
j,.f- J) ).I5E).J
(Address)
t; sKJ I1IJ!JtR.
(Address)
(Tel. No.)
<-1-<17 tN?
(Tel. No.)
(Name)
6. BUILDER
(Name)
(Address)
7. TYPE OF WORK
New Construction 0'
Fireplace 0' Septic LI De~
Alterations 0 Addition 0' Finish Attic 0'
Re.roofing 0' Porch 0'
Re-siding 0' Finish Basement 0'
Chimney 0' Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
11 O. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. CJC1~ /025
I ><EATE
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
Ie/SO
12. NO. OF STORIES
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
I hereby certify that I have furnished 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
buildin~l can revoke this permit f~s)cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
\~, ...,./~ 8. ~
~ ........ Signature License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 1<-4. SA-
Paid /ztf. f3 c./ Receipt ~o. .:3'-030
Date ~M-.q By r&f&--
t the est in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed J, requested. This document when
Planne . ~rary Ce'rJ~!J ljmPliance and allows oons1ruction to oommence. Befo,e ocoupency. a Cert'ioate of Occupency mus1 be issued.
l.umer D Ie SpecJ9.1 Conditions if any
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
.€E S /'lIE
PERMIT VALUATION
<:' ,",,",,,,on
,--
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
7</.1S"
4 9,- S"4
I .c;n
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
~1I1~1
~~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~::~Ire e Pe""~ ~>C~~;I~i~~.;e:ltWhen ~P'9'i~
By "7!-c Date 8 . '2. ""'r Y
--1" .
Certificate of Occupancy
Issued
v
Side
SOIL TESTS
a
0' ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0'
PLANS & SPECS 0
SURVEY 0'
SETS
COPIES
PLOT PLAN
a
Amount Brought Forward .................. <t
Park; Support Fee ........................... <t
SAC ......................................... <t
Collective Street Fee ............. .... ...... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Horn ................................... ~,
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
24 hour notice for all inspections 447-9850
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Tile Cenler of llle Like Counlry
White - Building
Canary . Engineering
Pink - Plann!ng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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Accepted
v'"
Accepted With Corrections
Denied
Reviewed By:
QI/l ~ Date g/asl'i'i
'Yi1?adCt1 ~ rJ/6 ..... u:..firne.Ll.# 18' [;un--,
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Comments:
.'
"The issuance\;or granting of a permit or approval of plans, specifications and
''computations ~all 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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11-1025
Thr Crnlrr of lhr Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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6/:;2 3/c;C;
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
53n/ Il./r-/NCK kU !;.D.
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Accepted
Accepted With Corrections X
';"
Denied . . .0 V/
Reviewed ~.. (;- '/
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Date: 8 2'(-7'!
, .
Comments:
I. ":-uJ ~t\.O t)..-r\c fir, r( cJ
"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 4, C)<;B f f'vlcll.A-r.,U
TYPE OF WORK ~ c Lc.
USE OF BUILDING c;r:;.D
PERMIT NO. q9 _ /D7~ DATE ISSUED 8-2.(1-7}'
BUILDER 1-ICv\.~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
(;;\ INSPECTOR DATE
I FOOTING f!l I 151-. I 9-/0-1/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
, fI1l" )Jt1G-
I FINAL
6.
I 7/13/~()
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
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