HomeMy WebLinkAboutBuilding Permit #00-0082
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
FEB I ,12lDl
. 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
53&/ /7t1t3L6WOOO DR/Ve
N~
3. LEGAL DESCRIPTION
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 0 () -0067
,t..DATE
R.l50
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
2-
/VOJe In SHtJee; O/iKS
,4. OWNEA'T~~{mt1{)L {~
5. ARCHITECT (Name)
PID z5...340 - 0 10 - 0
? 7H nOON
(Address) (Tel. NO.V .~
G~I AN~ ~,vt;L l40;!J~~q
(Address) (Tel. No.)
LOT
:z
BLOCK
ADDITION
&. BUILDER
(Name)
(Address)
ShI'fC
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0 Deck 0
~ition ~i;:;.sC 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Re-roofing 0 Porch 0
Re-siding 0 Finish Basemen9(
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
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
building offi' can revoke this perm' for' t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
4'4 z.--t7-DQ
/ ~~ ~
x
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Water Tower Fee . \.. ................ .~.~.:...... $
Water Tap ..........\..~:.......... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $-L./I:1 9.'7e;-
Paid /, 1..2,r Receipt. 6 Co "CJr'-f0
Issued Date 31 ( / () 0 By '. ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonin6 Orclnance and may procee s requested. This document when
s~.RY Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
,~~ 2-?~~~
v City Planner Date Special Conditions if any
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
l2es
,'1/~
PERMIT VALUATION
l.(.. e2CO
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 ................................... $
B7 . ?. c;-
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee .~.Q::,..~Z:-.. $
Mechanical Permit Fee ..................... $
2-.OD
'-IO.e>c9
~v
V
(fa .(5)0
ur Building Permit When ~p~ed.
. Date ~... I~.. ~~O~O
24 hour notice for all inspections 447-9850
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward . .. .. .. . .. .. .. .... $
Park Support Fee ........................... $
SAC . .. . . . .. . . .. . . .. . . .. . . .. . . .. . . . .. . .. . .... $
Collective Street Fee . .. . .. .. . .. .. .. .. . .. ... $
Sewer Tap ...................... ............. $
$
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
00 {X)02---
Tht Ctnltr of lht L.kt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
HOL I EIC)
2-/1"7/00
,
/61<R-V
f
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
53(0/ 1tt1I3L6VVOOD DR- N6
Accepted
Accepted With Corrections
~
Denied C2
Reviewed By. ~ .~
/
~_-tL_~ ~~~~ ~~
Date:
-"2 - (8 -?<~
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."
~
C(;v
The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/{ / / I "/C-- K"~/
I '". I...- f.-.. . I
2/17'/ (: {/
. I
/ E 1<' l<., V
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/::; :;? /;- I ,.i; / l< / c:.' -,' t V (, lr.!}; I'J '''':':'
....-../ ---.J c::> /, -/" \_' ,,-. \."j "'--'" ----,.
^ i-
t \J 1:--
~.
Accepted
v
Accepted With Corrections
Denied
Reviewed By: ~. ~~
(/
Comments:
~~~~~~D~
--~1~1 ~ ~ I ~V~S..
Date:
:&Z9? ~ 19{)
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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 53&( ,~~'(JLUnc('~ Qt-. \\Jl~
NATURE OF WORK ~~~ *- t::~ 1<:'1-1.
USE OF BUILDING S F'D
PERMIT NO. 00 - (JOB 7 DATE ISSUED 2 - 22 -~I..o'O
CONTRACTOR Molta-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~G
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
JRAMING
INSULATION
, ELECTRICAL
PLUMBING Wic..
HEATING (if required)) j,.1i;~~.
FIREPLACE
GAS LINE AIR TEST
'1/)~//o ,
9/~~Io)
I . /
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
--
h~
In .JI~ /; I
6"/~:)/~ · .
, ~~
I?r
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTIC\:" ~
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 (612) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~lJ2...
ADDRESS 53 I; I A-J ~
1:tJiJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
On-?d-'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIO&
~ FINAL (\l$/
o SITE INSPECTION
COMMENTS:
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
/
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ FOR REINSPECTION BEFORE COVERING
Inspector: ' M....... ( Owner/Contr:
CALL 447-9850 FcZTHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI