HomeMy WebLinkAboutBuilding Permit #00-0170
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DATE REQEIYEQ
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1;7;n/~O
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DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
hHlfr;or HlJ/I1fnirvJm:rJ I~ Ale,
3. LEGAL DESCRIPTION v
J BLOCK I
3IeIJ
LOT
ADDITION
KNOB
4. OWNER ~ (Name)
U ct lJ rei C-rGtf'L
5. ARCHITECT (Name)
6. BUILDER
(Name)
7.. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
II/~
Septic 0
Addition 0
fL J
5.5 ]7:1
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit NO.1J) -017 1)
R-/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID 25-3t.fCj - 001- 0
(Address)
'Ihol fI bf hJt,'tjb>>-b' 'ra..
(Address)
(Address)
DeckX
Finish Attic 0
13. TYPE OF CONSTRUCTION
(Tel. No.) '~~ {~\-~~~ 14. FLOOR AREA APPORTIONMENT USE
L/ OJ- '17 tf 0 \S'3'?>~j
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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 m tioned property and t at II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin off lal an rev~his pe r just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~ ,'11;)7 j I/lJ
Signature License No. I '"l);. -
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
./
IfJ3 S rl1 L
I
FOR ADMINISTRATIVE USE
Back
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 'I ACt:>. ~r"")
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
City:
SiP. 1 5"
]~~
. '10
, .An)!
JV:o 00
~,?,
~~~..t..:;I~i~.~~:When Approved~"
~ ~ Date .s - ~,. - (J l.,...'
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $14..5 L/-
Paid '14- .~ f Receipt No. 3-1/2- '5 '
Date ~/67J By ,
.~th reque in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed . s requested. This document when
. B ner c stitutes a temporary Certi t 0 oni com lianee and allows construction to commence. Before occupancy. a Certificat of Occupancy must be issued.
.
City Planner D Special Conditions if any
Issued
.:.
24 hour notice for all inspections 447-9850
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
o ENERGY DATA
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 ........... $
Water Tower Fee ........................... $
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The Center of the Lake 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:
".../..i."". (' 1/ ;' 11./;-' /' /"'."'.-,F I ' I' .1...."..,',.',,1 J,I ': , /.::-.~
~ " ...., J .~ ,I I' L~../ 1------::f-.-/ / I.., ...........
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Accepted
~
Accepted With Corrections
Denied
{f.r;;. J~
Date:
3L:J.Kloo
Reviewed By:
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."
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The Cenler of Ihe Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
0/1 V / 0 G~7 ~
.3/27IfJO
/ I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4-((;0/ #iJHJ-11 AlGt3leo 7Je- /tJ6
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Accepted
Accepted With Corrections Y
Denied /,~
Reviewed By: ~ '/ /{r
Comments:
LJ ~_ ~~ ~-P a-.J
Date:
3-:?o--~
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
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DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS L{f.pol HUUA~\~to.'t- el
TYPE OF WORK ~c ~ v
USE OF BUILDING srn
PERMIT NO. 00 - Q/W
BUILDER DcU.J ~cR _ r: t ~ {. ,...
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE, PERMIT IS BY SEPARATE DOCUMENT
. ' INSPECTOR~ J J DATE
FOOTING Y 1/?/W
PLACE NO CONCRETE UNTIL ABOVE Ii S BEEN tlGNED
~ ~.
DATE ISSUED
? - 21 - ""2o~r
FINAL
/ .
718/ If)!)
Call between 8:00 and 9:00 A.M. fof all Inspections
FOR ALL INSPECTIONS 447-9850
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u
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 4' 0 I
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATERHOOKUP
ANSULATION (F' 0 SEWER HOOKUP
FINAL f"\ 0 PLUMBING FINAL
o SITE INSPECTI - 0 MECH FINAL
COMMENTS: deck..--
J~~~
~
-~
OAT: TIME
~ - /70
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/hr1vORK SATISFACTORY, PROCEED
(0 v CORRECT ACTION AND\~ROCEED
o CORRECT ~ALL FbR REINSPECTION BEFORE COVERING
Inspector: ' ~ Owner/Contr:
/1
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl