HomeMy WebLinkAboutBuilding Permit #00-0260
~
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
... 13 TEMPORARY CERTIFICATE OF
WI' . ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
VQ -Ol~O
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 ^
~ ~lM.rl-..~ ~J
3. LEGAL DESCRIPTION
LOT 5 BLOCK
~ S+- A{)D)J
1. DATE
.... OWNER
&l\
5. ARCHITECT
(Name)
R\~
(Name)
l..j-Is - oJ
f ~-\eQ... f"'~~ J\ "hrJ ~<\~~o.
~ fl5-30V-O&>J- ()
I ~ PID 0< 0
If.1~ ~~
I
(Address)
J hcaS'5' <( i Iv'l. P4~ Ave.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
(Address)
(Tel. No.)
bld-Y'-IO - ~
(Tel. No.)
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
Chimney 0 Misc.
8. PROPERTY AREA O~ 9: PROPERTY DIMENSIONS 10. CULVERT SIZE
Sc: Ft. __ ( .... )Width Depth Yes No
I certify at I ha furnished inf ation 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 abov ro rty and t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buil' 0 revo pe it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfLj need. ~ inspections.
/\. -/<."'00
'-- License No. Date
Fireplace 0
Alterations 0
Septic 0
Addition 0
Dec~
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
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.
USE OF BUILDING
SPACES ON PLAN
PERMIT VALUATION
~3tJO(J
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee................................... $
Plan Check Fee............................. $
S U
7J../,75
4B.5'1
/. so
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . .. .. . .. . .. .. .. .. .. . .. .. .. .. .. .. .. .. . .... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
State Su rcharge ............................. $
Penalty ....................................... $
Pressure Reducer .......................... $
Mechanical Permit Fee ..................... $
V Meter Horn ................................... $
\.oW' 00 ~:r~:~t~;.;~~~~~~;:.::::::::::::
r'~, 6t1 Water Tower Fee ........................... $
/( tP,JtJ Water Tap ................................... $
?^r;I~8); :::~~~.~~.:::::.:::::::::::::::::::::::: _
J/#.no Paid T~;:.~.~....~:,~;.. $ ~~~
, Date 4"b, JtlV By
Tht7-.fy that the r est in the above application and accompanying documents is in accordance with the City Zoning ofdinanle and may proceed requested. This document when
sign ~~~ n_ ~ j"'Y V~ compliance and allows constAlclion to commence. Before occupancy. a Certificat of Occupancy must be issued.
Y City Planner Dale Special Conditions if any
Plumbing Permit Fee . .. . .. .. .. .. .. .. .. . .... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~ion ~ecomes Y~ur Building Permit When Approved.
By -" ~ ~~?i. Date '/-I'-!AOO
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
00 -OVf 0
The Center of the L.ke Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~cott e'\ ( Jt...
APPLICATION RECEIVED A f>r\ \ :) \:2 () 0 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'PrrCl\ LCA..L..,: /1N 5S3'h(
/~&SS S~mo~(n~ Av~_
I -
/
Accepted With Corrections
Accepted
Denied
Reviewed By: ~ :2~
Comments: ~~ ~~. ~ - o.J
~ ~ /JI~..
, , ./'
Date: Lj- /9,...." tJ
~~~
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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
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid. II
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'S-:,:'1', ""'" '. _~'e...~v','"I'!~:;..
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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
t..
, \
The Building, Engineering, and Planning Departments have reviewed the building permit
application ~or construction activity which is proposed at:
,~-
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-.......r'
, " {. ,,; ',,-
i l {__..i .-.1
f
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(,... c....,
Accepted
/
Accepted With Corrections
Denied
"'>,
Q_ V)).~ Date: L-flaJw
- ~/(~ 10 ~ O~cJ S;1e- plWtv<J
-
_.'*'~
Reviewed By:
Comments:
...
, at
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
SITE ADDRESS I to8S5 S (rv\ P~I ~s Au6:
TYPE OF WORK ~EW DC:::-LAL-
USE OF BUILDING /26SIr/,P
PERMIT NO. 00 -0 2~ . DATE ISSUED 1- /9 -2000
BUILDER .5:..D1 ( (2 IcE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE 'PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
-
FOOTING ~ ~, 1-~1-'*'
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
/?
FINAL ~ ciJ./; Idl
I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
. '.
CITY OF PRIOR LAKE
INSPECTION NOTICE
,SCHEDULED
ADDRESS
/ Co~ ss-
s~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING (@
o INSULATION
fA FINAL
o SITE INSPECTI
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:J)l::-L(.J-
~'-"'--
~-
~.---.......
DATE TIME
2Jl/DI
/0. 3~
o -a&O
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~_~ALL FOR REINSPECTION BEFORE COVERING
InspectDr: ~. ( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!