HomeMy WebLinkAboutBuilding Permit 96-0456
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DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
.-
~AND UTILITY CONNECTION PERMIT
JUL 2. 2.
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
442-\ r~ ~-r
1. DATE
N~ 'S -S~O - tJ1..3-0
c..PtlUZ-1 ~ 1--\ 11.-1.-$
PID ~ AP'D\-nO~
\4- \ L.-L- ~
3. LEGAL DESCRIPTION
4
LOT
q
BLOCK
.~~'P _ CAlZ-\Z-\~
ADDITION
4. OWNER (Name)
.~~ tzo P
5. ARCHITECT (Name)
1/Au:::. 6-~el.,...G.
(Address)
(Tel. N
44-2-\ fO)< J4uN"t" ~ H qlo z~9 I
(TeI1~!\')
-{?UV\(STN~ 101O".3(.;,4el
(Tel. No.)
(Address)
t It;1 ~ '2>10 ~
(Address)
6. BUILDER
"
(Name)
It
7. TYPE OF WORK Fireplace CJ Septic CJ
New Construction CJ Alterations CJ Addition CJ
Chimney CJ Misc. e. p" r-.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONSS" .si
Sq. Ft. '-I S-J S- Width Depth-::::::::-
Deck
Finish Attic CJ
Re-roofing CJ Porc
Re-siding CJ Finish Basement CJ
10. CULVERT SIZE
Yes
No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. fit; - J/,j~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
I
15. NUMBER OF OCCU~TS OR SEATS
OCCUPANTS ~
SEATS ~~
16. PROJ~T COSTNALUE
t, /)00.. -
17. COMPLETION DATE
DC;: 97'
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 menti nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildi can rev use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
Amount Brought Forward .................. $ ~ 5. =? .If 0
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap .........,.......................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........ ................... $
Water Tap ...... ............................. $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid ''5).1./ ()
/,
License No.
FOR ADMINISTRATIVE USE
I)
/(J ,
Side Side
SETBACKS: Required
Actual
Front
Back
~~PAlt~NT VALUATION
USE OF BUILDING
SCU'~.Q.\A ~k- ~ ~ ~t' \i
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F H I ~ S U
Division 1 2 (]::)
Permit Fee................................... $
City:
Plan Checking Fee ......................... $
.............
State Surcharge...........................~ $
1~~.Yz..
f~~;,~;t
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $ d.. S 3 I Lf ()
Thi
By
Certificate of Occupancy
Issued
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS 21' SETS
SURVEY
"Ii!f' COPIES
PLOT PLAN CJ
Date
uest in the above application and accompanying documents is in accordance with the Cily Zoning Ordinance and may proceed a equested. This document when
constitutes a temporary Ce)~~~mPliance and allows cons . n ~nce. Before occupancy. a Certificate 0 Occupancy must be issued.
ily Planner Date I Special Cond~ions W any
Th. C.nl.r of .1It Lak. Connll")'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT )J:AlJ. iff.J
APPLICATION RECEIVED '1/t-;/t.
The Building, Engineering, and Planning Departments have reviewed the building permit
apPlication,:? construction activity which is proposed at:
'-It.! 2J ~ oI1L.i- ~ t ~~Ja /;
Accepted
Accepted With Corrections ~
Denied
Reviewed B(? Q ~ <J....
Comments:
Date: 7-;25'-~'
I. ~ ~ ~~ ~(~.bA.} c.(M,\~
~. ~M^'f..tL &.~\e~\o~ s'^-.tJk ~ opJ.ab.J~ ~ -N.
~o p.cu- ()..~ {~ \~ct4 URL.
"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 1NSPECTION
SITE ADDRESS
NATURE OF WORK
INSPECTOR DATE
I FOOTING I, I "7-3' djv?
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC d>I
FRAMING ~oL=~~ 't-z. ;q~lt ~,9"'(1' ~~ fWb ~ g "f'~'1 I'V"''1 8'~''')
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
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