HomeMy WebLinkAboutBuilding Permit #00-0208
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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 / 61J3 fa ~fJtJ
3. LEGAL DESCRIPTION
LOT ~ - 4 BLOCK:;)
ADDITION ~.\cl \ ~
~Ni7e; <
(Name) -
1. DATE
lj-3-c{J
PID ::J 5.- DD'-I-6 J3-()
/W~ J;~;;d 3[:
(Tel. No.) 4 '-4'1- \ f!fJ{
(Nal J (Address) 1.f~'7S IAHtfJl"!,.T &-
~#ace~f~fsePI~"7~J) LRe.~g~) p:;!s31-
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
ChimneyO Misc. r en .'~ ~ CJ~~
8. PROPERTY AREA OR A RES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
4. OWNER
~J. (Address)
-ere 'f'j/ CJ
(Address)
5. ARCHITECT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. -.f!O -0 20 I
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' formation 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 me~tio d property. at all c struction will conform to all existing state and local laws and wip proceed in accordance with submitted plans. I am aware that the
building official evoke this it for ju ause. F hermore, I hereby agree that the city official ~~si9nee may enter upon the property to per;>~e~d inspecti9rs.
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p ,.,-
License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION SOO. 0 0
USE OF BUILDING
/
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/
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 ................................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
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Plan Check Fee ............................. $
"21.00
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Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . .. . . . . . . . . . . . . . . . . . . . .. . . . .. . . . .. . . .. ... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
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Pressure Reducer .......................... $
Meter Horn....... .... ..... .... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $ .5
Total Due .............................. $35 . /
Paid ~S"'. I 5" Receipt No. ~71 W
Date . By ( / jt 1
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning dina e and may proceed as~. ue led. This document when
s' . Planner constitutes a temporary Ce~fic;ate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of ccu ancy must be issued.
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ity Planner Date Special Conditions if any
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
This
By .
Certificate o~ occulcy
Issued
24 hour notice for all inspections 447-9850
00 - 0 Z-OK
The Cenler of Ihe Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/ /J/V(3j/foES I _ - RAN DV'
4-/3/00r I
I I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
apPlicatiO/6030 a~i~ ~Co;;A/ at:
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Accepted .-/
Denied;:/('7/(/
Reviewed BY:(~..)4-r A
,/
Accepted With Corrections
JJo ~.)k
Date: 4, 7- '2{JCJ()
Comments:
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2. ~e.. \-hal'~ :1,,4. w,'~ l..J-'I-ll
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."
(fl) ,0 z, of
Tht Ctnttr of tht 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 propose9 at:
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j t:: /./. '." /.-. / /:.; I /" I
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Accepted
v
Accepted With Corrections
Denied
Reviewed By:/~J/~
, -
Date: L( - 7 ,. 6C>
Comments:
\JW~ ~ \tqv~$ W~d{.~.
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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
presum'ing to give authority to violate .or cancel the provisions of this code or other
ordinances of the jurisdiction shall no~ be valid."
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /.U)~{g .So~ __ A-V-.J<..
TYPE OF WORK 7yec;c.. ~~\ ~ LU el "-
USE OF BUILDING SF.fJ
PERMIT NO. ()7J - 0 Z 08 DATE ISSUED 'i- 7-?oCJO
BUILDER ~~ " i!~ 11'i'.)-
NOTE: THIS IS NtT A PEttMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL h<1 ~ rz...- z., <( . aV
Call between 8:00 and 9:00 A~. Yor all Inspections
FOR ALL INSPECTIONS 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
t~tl/~ i{~&t)
ADDRESS
lft,03(P
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
0- Zag'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
] SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ej~" ~ ~ vJ..L{
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04'RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~~ALL FO.R REINSPECTION BEFORE COVERING
Inspeelor: b\~ OWner/Contc
CALL 447-9850 FOR TH: NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS 1RE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
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