HomeMy WebLinkAboutBuilding Permit #00-0249
~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
ARt 12m
Permit No.
OO~Oz,4Cf
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
/ tf"$ 21
3. LEGAL DESCRIPTION
LOT t
ADDITION ~ tit If
:;:;'R . (Name)
n r;s?~
5. ARCHITECT (Name)
iufWMJZJ N,8
BLOCK 3
d~ AJJ;'f7eKl
1. DATE
tf /tZ /00
~ !LA1 65372.
PID .), S -33<1-010-0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2(:' 't", ...
12. NO. OF STORIES
(Address)
LYm &iJiAI ~ ,J&
(Address)
(Tel. No.)
~12.-'I63-q'7r
(Tel. No.)
13. TYPE OF CONSTRUCTION
'D~
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck ..
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. ~J t/70 Width ? fp Depth / ~ Yes ~
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 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 ~n re~oke . ermit ~or just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform~.e d. inspections.
X -zr~ ~~ ~~JcO
, Signature License No. ~t~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~~.~~
SURVEY
PLOT PLAN
o COPIES
o
USEOFBUILD~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
07 - 2..6'
6b.71
z. . 00
Plan Check Fee............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
This Apoocation l3ecomes Your Building Permit When ApEr.oved.
By ~ ~~ Date '/.....I7-()O
Certificate of Occupancy ...
Builder's Deposit ............................ $
Other......................................... $
Paid Tr~al Due ..,f(.~.........~~~~I~;~o$ ~ffB 1k:>
~ .~ .'
Date~ 7-0 By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina ce and may proceed as requested~ This document when
s' the lanner constitutes a temporary Certificate of Zoni~mpliance an~ow~ con7Lruc~r{o ;.o.m~~n<i(. ':' ,fore occupancy, a Certificate of Occupancy must be issued.
_ ~ 7-8...) V~~\
Planner Date ~ecial Conditions if any
~1}
A-' t41eJO
Pressure Reducer .......................... $
Meter Horn........... ..... .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
24 hour notice for all inspections 447-9850
00 .,O~
White - Building
Canary - Engineering
Pink - Planning
The Cenler of Ihe Lake Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT \ 0 C\ C'\
APPLICATION RECEIVED -A?'l \
'\ . olr~"t~r
. -
"d, aouo
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IE{:5d.1 2chlo frl NE
Accepted
Accepted With Corrections
K
Denied
r2/){(/(
- ,
Date: (.( -Ie" "2.000
Reviewed By:
Comments: .. -K t::-t'- 0
"
6tf fLA:~.
-ntC-lL ~t'\NOOWt J
~D
'NR>~O.,J
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. II
PRIOR LAKE
INSPECTION
RECORD
ILJ32,1 f<of3/~ Rei Ai,E,
NEW (7J~e-JC-
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. (JO -024-<1 DATE ISSUED .L{- /7- ()O
BUILDER TOO 0 FO~~"T1:;7<-.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE D UMENT
FOOTING OR ..,) ~;T7 ,...
PLACE NO CONCRETE UNTIL AB V HAS BEEriiIGJ:o"
-.f..BAMING
FINAL
~, I!t~ /6;
I '/ ~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
'/~ 3 e-/
SCHEDULED 1/~M/ 2/00
&:6 IN tCW, t-l, e,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
f}O - ~ 9
o FOOTING
o FOUNDATION
o FRAMING ([lJ
o INSULATION
FINAL
~ SITE INSPECT N
COMMENTS: ~
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
... ..1"'::.--------...--.----..
"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~LL FOR REINSPECTION BEFORE COVERING
Inspector: "~ ( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl