HomeMy WebLinkAboutBuilding Permit #00-0276
QATE R~EIVEQ CITY OF PRIOR LAKE
BUILDING PERMIT,
APR I A all) TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. ~ 0 ..02-70
I
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. ___.MIJIISS
{lP (0 OS
3. LEGAL DESCRIPTION
r~ BLOCK 2
W, lrlLlfN~
r (Name)
"IJIlV'I'L/SA ~
5. ARCHITECT (Name)
\'
1. DATE
. Otf - /3 -oC:.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
!?lLi ~
LA-KfL - J ~i\\\
12. NO. OF STORIES
ADDITION
\/r ff"Ol!
/ t;~Z1; NO LAh'L ~ \ rrel~oi;). ~'if~
(Address) (Tel. No.)
I \ \ '
PID .~~;5 - 3,~'- ()3).. 0': -
13. TYPE OF CONSTRUCTION
LOT
14. FLOOR AREA APPORTIONMENT USE
( (
(Tel. No.)
( f
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6. BUILDER
(Name)
"
(Address)
7.11'PIOFWORK
New ConstN"J...' LJ
Fireplace 0
Alterations 0
Septic 0
Addition 0
DeckJ(
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
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I h Y certiw 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
t ab ve orentioned 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
ildin O-,(Ci~. n revoke this permit for just caUSe. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .}j -- ~ 0'1-/3-00
\....0-' Signature License No. Date
I
SETB'ACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDIN21, II A.r"\
~ ttlL
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
14()oo,00
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee............................... .... $
R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .. . .. . .. . .. . . . . . . . . . .. . . .. . . .. . . .. . . .. ... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee............................. $
g7/~o
5iD.7f
;21 0 tJ
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Water Tower Fee ........................... $
Water Tap ....... ............................ $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ /4'-0'. '76:L
::: / 4U: ::"fTiL3' 3'
. . . . d . . d . h h C' Z ~O . I d tl .
st In the above apphcation and accompanYing ocuments IS In accor ance Wit t e Ity onlng rdlnflnCe an may procee as requested. ThiS document when
. ute a temporary Ce'2Ji'Jr 7~rJ.iaoce and allows conslrucllon to commence. Before OCCl4l"ncy, a Certillce 01 Occupancy must be Issued.
ate Special Conditions if any
~b~
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit...................... $
Gas Fireplace Permit ....................... $
This App~tion Bep>mes ..xour Building Permit W~9n Agproved.
By ~ ?7..e:.J~ Date 7-ZGJ-~
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-9850
O-J-7(P
The ('enter of the take Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT A rv1 '{ ~ - \ ~a. 0 ~~rr(1
APPLICATION RECEIVED ---Arll \ \ 1..-./ I do-o 0
Accepted
Accepted With Corrections
Denied
~ ,:/~D
Comments: Pelttl ;j)~ ;4/ /t-llJ' P -D ~'I
INFO t2-fP'-It-r-/otJ tJ,J ItpP;U;(}EJ)
Reviewed By:
Date:
-<I r- ~cJ -(;k) () 0
AlJIJALL
PLAN
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.1I
'0 - ;}1(:;
The Centef of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
i \ \
NAME OF APPLICANT /L\ r\i .\ \ I
- (
APPLICATION RECEIVED /\ "~)l' i \
1
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: !. ,.-.' \..../ \..._-)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
! ,.' J r, .,~) I "l..
I f-; (~, () /J:,;, i \ (') ( , L., ' ~e-,
C.A \
Accepted
~
Accepted With Corrections
Denied 1 /
Reviewed By: -L/~ Date: 4!d-'tJa)
Comments: J ~ ~ OIL,
.~ -to~ ~ ~~~
"The 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 /(QCo{)~ ~tSL/A10 L4/(.~ II2hII
TYPE OF WORK ArbW (7)~~Jt!-
USE OF BUILDING KeS~ 4/,e
PERMIT NO. fJ1) r 027(0 ' DATE ISSUED Lj- ZO -,ZO&o
BUILDER AtJOY i- LisA ()L.S{J,J
,
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 A Ctr. 5/ It:) /00
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING
FINAL
E:>'~a.vu 4 }Ie> ' 01
Call between 8:00 and 9:00 A.M. fckall inspections t .
FOR ALL INSPECTIONS 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
4- .fOol
4-:UO
ADDRESS
//;(,OS- BL-IND U9'KE ~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o 0 - 07-7(0
(
o FOOTING
o FOUNDATION
o FRAMING
-fl/NSULA TION
~~INAL ~
o 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
COMIVIENT8t \
~ I~ S ?(:U~
~l'\dv'l:ti OlAct 1
doE.
I) Jr.c,) <"~
d I'ell
,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION "ND PROCEED
o CORRECT WORK, (ALL FOR REINSPECTION BEFORE COVERING
Inspector. 'b ~V tJ.>>.lt Owner/Contr:
CALL 447.9850 FOR THJ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl