HomeMy WebLinkAboutPermit 99-0262
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CITY OF PRIOR LAKE ~: ~~: ~~~ d
3. Yellow Applicant
F!LUMBIN PERMIT # CU~L~2-
Applicant: '" C~ ~~ /' Phone: L/'-IV 0- rrfo.:J ~-
Address: ;e~ y/' (JJ,SI C'f,I/,-=
~ignature: ~ ()
\ Legal Des i i9r: Lot ) c Block ? Sub.t\
~ite Address: l'f1j 'U~ cL #III/j 11!1- MIf 1,1.)
Building Permit # C1Lf-l&;7 . PID#~S--,--)rfc-()3S'-O
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
tf~~
uern
~
Cenler of Ihe L.ke Counlry
Quantity
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
K
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
.., ..
)C
~
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;C
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 ok of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
,
$99.50
$39.50
$
$
$
$
.50
State Surcharge
GRAND TOTAL $
;~ . PAID WITH
i BUILDING PERMIT
l
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the 'amendments thereof.
RECEIPT NO. DATE
All bST
Call for all inspections 24 hours'in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer ·
.. _._- ._--,-.- -..---., .-.----..-."v----r.--r-""l5"".~r_"- .-----.--- -,--._~-
QA TE RECEIVED
f
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
1. White
2. Pink
3. Yellow
File
City
Applicant
APR 2, 1999
Permit No. q( - Ltc Z
g 'Jj(l
1. DATE
Lf If /99 /) r, l'. BUILDING INFORMATION \
~f )J-" ,.i 1\ I 1 ' ...:..... f( (,;. ""'41. SIZE OF STRUCTURE
,,"-.,1 ~ /2. ~ f O-'V IJA~ >)' .3 -; ) (Height) (Width) (Depth)
I 12, NO. OF STORIES
,~ PID J5 - J6~ -03S- 0
"211l1 Addn ·
13. TYPE OF CONSTRUCTION
r
(Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
L({V~ rrw ~~-
(Tel. No.)
t
.".
6:J~ <;;I'cf
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
~ ~~w Construc~ion 0 .. A1tE?;ations 0 Addition 0 Finish ~ttic 0 Re-siding 0 ~ ;:;a~ol"o,,; ~
ChimneyO Misc.0V1f' f<fY)V\-'1 FrI1. ~l/.e \ \v\(~t\ \ le\jt\
~ .. a. . '" _ .
'a. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
f I qereby certify that I bave fumished in~frm ion 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 m tion~(f'property a= construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
)::~~i~~ om n revokeJtr ~ J iicause. Furthermore, I hereby egree Ihal the city official or a designee may enler upon the property 10 peo/'liiR}~pections.
, .( / Signatur License No. ( f Date
\ tl '
"... '-.-' \./
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
~~.cJ ~ (V.U~
OCCUPANTS
SEATS
f.
~~~Cl.COSTNALUE
~.&e1
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
'1
USE OF BUILDING t<JS iJ, K
SpACE:S REQ.
SPACES ON PLAN
PERMIT'VALUATION J, 000 . ac>
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
1.
Front
Back Side Side
'It OFF STREET PARKING
SURVEY
o COPIES
PLOT PLAN 0
TYPE OF CONSTRUCTION: I II III ,( V )
Occupancy Group A B E F .....~ I 'fv1 '(B5 S U
Division 1 &-,4 :'::t./. 7 c
Permit Fee ................................... $ ~
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . .. . . . . .. . .. . . .. . . .. . . . .. . . .. . .. . . .. .. . .. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter................................. $
Sewer & Water Connection Fee. ........... $
Plan Check Fee ............................. $
State Su rcharge ............................. $
Penalty........ ~.............................. $
Plumbing Permit Fee ........................ $
. t:lJ
( I 0 . 00
(, ~ 0-- etC.
~:r
'...
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Gas Fire...~p I..e. ..pe:n ~ .. ..}l............... $ Waler Tap ... ................... .... ......... $
This f~p . ,dj"~CO~YOur Building Permit Wpen A~ved. Builder's Deposit ............................ $
By V' ZC;"". '--, Date (,/,? _LtJ Other......................................... $
/~ f'Qc ,/ Total Due .............................. $ -/.:>. a ~
,)t Ie 0 cupancy Paid ~7s . d S- Recaipt No. 3l. 1'6'7.;3
" - Date L( ~~- 99 By ~./cJ
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as req~~~ ~hi~document when
sig~by the E~ P anner constitutes a temporary Certi.. 'ficate ~f ZOning. compliance and allows construction to commence. Before occupallcy, a Certificate of Occupancy must be issued.
,~ \".t ...< ~
C) . C~ Planner Date Special Conditions if any
24 hour notice for all inspections 447-9850