HomeMy WebLinkAboutBuilding Permit #00-0096
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ttIf 2 8 2lXXJ
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
-~'m~ BtA~, ~kP,-fu~ \
3. LEGAL DESCRIPTION
1. DATE
;l-;(~~
R/5D
LOT
BLOCK
I
PoN05
PID ?~-3~- 008-0
2 NO AD.D~.
(Tel. No.)
~ \. 4L1C-~1;).c,
P;
WIlD~N5~c.,
_ _,4. OWN5R _ L... (Name) (Address)
#'1J:1.LI' J:V}f1 ct .~ 4 ~r k kto
5. ARCHITECT (Name) (Address)
ADDITION
(Tel. No.)
-'~. BUILDER (Name) ,,,[J50sWebsJe r C +. ~~r1'~ 3 "73 3
7.I~~o~ }-b~r!X"r111 ~Pti~c. Deck~;crR~~;" Porch"
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
1 O. CULVERT SIZE
Width Depth
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. OO-()Q!J-ll'}
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) . (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
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 mentione pr erty 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 offici ca r vo this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
.J' '->> 61-1 20 ;2 -~ <6-if)
Signature license No. Date -
Amount Brought Forward .................. $
Park 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 ........,..,............................. $
Total Due .............................. $ /~ 7. 0 q
Paid /y 7.0 q ReceiP:(~; .3(0 "sO
Date 3/~/o6
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~~..CJO
I
USE OF BUILDING
12.65 A/E-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Permit Fee.............................,.,... $
<=t9.'7S-
~f
Z.SO
Plan Check Fee .......................,..,.. $
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~i~o~ecomes Y~ermit~~j\Per2V!d:.-
~~~~ ~-Jl-~
Certificate of Occupancy
Issued
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
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc as requested. This document whf
sig~e City la ner constitutes a temporary Certi>>te of Zoning compliance and allows construction to commence. Before occupancy, a Certifi ate of Occupancy must be issued.
1 (' . 'A,A "'7- 2...'" CO
, - City anner - Date Special Conditions if any
24 hour nOtice for all inspections 447-9850
Thr Crnlrr of Ihr Lab Country
White - Building
Canary - Engineering
Pink - Planning
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:
fl. 7 It- ~~ t~, L I i\~' L) L, f\ ~ E- _.-\-.~ A I L-
Accepted
~
Accepted With Corrections
Denied
Reviewed BY:~~
Date:
? - 2 -00
Comments:
Aw-~ ~ ~<:.J< ~<f'~ pw-- ~&
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."
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Tht ('tnltr of tht Lakt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1=R5D t--AR I ~I<.' ~ ~
2/26/00
, I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Iv; 7 ~3
BL-I NO I A~e:
\ :lc2. A L-
Accepted
Accepted With Corrections L-..._
Denied /~r)
Reviewed BY:(~~ --
Comments:
Date: "3 -I.. '2000
tJ ~ \)Q.c.k.. ~aJ-~
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."
d;~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS l~ /43
~o
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING >. 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~SULA TION rff\;\ 0 SEWER HOOKUP
, FINAL \t$J 0 PLUMBING FINAL
SITE INSPECTION 0 MECH FINAL
COMMENTS:~ ~~
Jj
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t1.A.e.JL ~ I
U
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TIME
Ar
6 -q c;
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)(WORK SATISFACTORY, PROCEED
I 0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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1/
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl