HomeMy WebLinkAboutBuilding Permit #00-0259
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Jf';.e-~~'
.....J PID .~S-- ~Y7-()lq-O
'9- r\{;A A{) D\)
, .
(Address) L l:" ~ (Tel. No.)
l:kj)A~ ,~f \. ,,3G:,I- 2 2... 'fr..;
Deck)( Re-roofing 0 Porch 0
Finish Atti!' 0 \ Re-siding 0 Finish Basement 0
DATE RECEIVED
APRI221J)
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
1111~
~'" ~ ..............--
3. LEGAL DESCRIPTION
LOT Y BLOCK ~
ADDITION~V\.Q~oJ\+ ~
4. OWNER 'l . (Name) 1"\. { (A~ress)
_ \l:1 ~~.s \~ve e>~1 . L '-.
5. ARCHITECT (Name) , (Address)
t::..-
6. BUILDER (Name)
\L}:',L~~
7. TYPE OF WORK Fireplace 0
New Construction 0 -D _ Altprations 0
Chimney 0 Misc. ~.<:.-~
8. PROPERTY AREA OR ACRES
Sq.Ft.
Septic 0
Addition 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes
1. White
2. Pink
3. Yellow
File
City
Applicant
1:;12-/ ~
I ·
Permit No.~ O"'OZ5C!
I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
No
I hereby ce 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 me 'oned 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 0 ficial n revoke this permit for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perf~~-;;;ed:;Zd i pections.
X 1{ /2- crO
Signature License No. e
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
5330
Paid S'S' ~ Receipt No. ~ 1 , 1 "
Date 4-! ~, ..Po By f2,-l) fd-
ThiSg'S rtify that the request in the above application and accompanying documents is in accordance with the City Zoning brdinance and may proceed as requested. This document when
sign by hm:er stitutes a temporary CertifiLJj oXS~Pliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
City Planner Date Special Conditions if any
24 hour notice for all inspections 447-9850
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
If 900, 00
USE OF B~NG A/I<
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
R S U
City:
Division 1 2 3 4
3l,oCJ
to, YO
,50
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
\ .n'~i)
~\()i
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This APeMcation ~ecomes Your Building Permit When Approved.
By ~ 9~~ Date "I-/7-(J()
Certificate of Occupancy
Issued
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
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 ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
n ~o "t~i
White - Building
Canary - Engineering
Pink - Planning
Thr Crnlrr of lhr Lakr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT '^ i ., \~ D<.weJ7) pfY\~,nt
APPLICATION RECEIVED Apn' \ \'d. 'I 8 (}00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
\ ~ \ \ Co ?heQ~OS\\- ~ €..nD.QWS
Accepted
.A'
Accepted With Corrections
Denied
Reviewed By: BauJlc (;;;01
Comments: K e;7tO J) EL-IL
1M F8 t2., nt. An 6~ 0 N
Date:
9-/?-tJO
Hl'rtJ D -0 u..T
P / Itf..J
ANI) AL L
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."
~
7/:; ()
White - Building
Canary - Engineering
Pink - Planning
Thl' Cl'nter of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT \!\ \ \ \ )(\f1\:J Dc:/ve \D p0\~ n:'
APPLICATION RECEIVED .A pn' · \d ') 8 ()00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
P ne c\~:;, C:\f\ t f\t\ €-.CtcJ () \!vs
\'1\\0
/
Accepted With Corrections
Accepted
Denied
Reviewed By:
Cl4{-1mr~
-o!fr;co-wJ Jo ~ ~
Date:
-4/;).0/ Dr;
"' I -
~~
.- 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. II
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITEADDRESS --17/(l.Q fNeo..sANI !VlEAOqI,)JS
TYPE OF WORK Ne.w r:uECAL-
USE OF BUILDING Ees #'//?
PERMIT NO. ()O - 025Q / DATE ISSUED '-1- /7- ()O
BUILDER WlLl.,l~S 'J)EV6UJ-IJ/rte;"J( - .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING ~ ft1:r. 'f-21-~()
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING ,Jot" ~
FINAL ~~ ~. 5/9 /~ t~ &r,4/olto
.Call b~~een 8:00 and 9:00 A.M. 'for all ~s~ectlons
FOR ALL INSPECTIONS 447-9850
. .-
l~~ TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED C?::ov
ADDRESS Illlto P '\ e,a. s;, n.t M~~
OWNER CONTR.
PHONE NO. PERMIT NO. &r z S9
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING @ o WATER HOOKUP o FIREPLACE RI
~SULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASUNE AIR TST
SITE INSPECTION o MECH FINAL 0
COMMENTS:
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"lz11WORK SATISFACTORY, PROCEED
/2; CORRECT ACTION AND PROCEED
o CORRECT WOR~K CALL FOR REINSPECTION BEFORE COVERING
Inspector: , Owner/Contr:
I I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ