HomeMy WebLinkAboutBuilding Permit #00-0350
;}~;Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. J) 0 or () 350
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
1. DATE
.56.:54-
t3()UNl1/ 57.
.3
HI Ll-S
t~' u'i Ifft)
l ',e./
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
17
BeooK:S V/t...,{..; is
12. NO. OF STORIES
LOT
BLOCK
PID 2~5-/~7..' Ot/(p-O
0771
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name) (Address)
~(.,/ N,k:.HAI'-1r1 t:;;;,fZ-
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Tel. No.) ,15. NUMBER OF OCCUPANTS OR SEATS
I.f I~/C ,.~) 7 j~\. ' OCCUPANTS
/.~ I L I r-'\--,.' .-, ~ j J_'
,:,' . / / '/./ /./ ,'-.,-, ~}tl (:X)',,,"I/"r' .Yi 'w. 81~ z.. 10J!:J,I-
. ,,1 . '... ',' t", , t.' - ....~, . ~..... SEATS
. Fireplace 0 Septic 0 Dec~ !1=t13-roofing 0 Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-sidling 0 Finish Basement 0 16. PROJECT COSTNALUE
:D~ lo.tJ ~(2.. ~ ~LCt-t
'W
9. PROPERTY DIMENSIONS
Width Depth
(Address)
:J (\ E?
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
10. CULVERT SIZE
17. COMPLETION DATE
Sq.Ft.
Yes
No
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 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 official can 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 V1A( /0.., 1"( I 1..J<"ri../"",---,/~"" 0._0,) r;J(.,.'
. Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
USE OF BUILDING
eES ~/K-
OFF STREET PARKING
SPACES REO.
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
SPACES ON PLAN
PERMIT VALUATION
$'7(;)Ot~O
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV (y)
Occupancy Group A B E F HIM @ S U
Permit Fee ..........~i~~~~~...1...~.~..~... $ S'/,OO
350 (0
,85
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap .... ...................... .... ..... $
$
Plan Check Fee............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn....... .... ..... .... .... .... ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ............. .............. $
Water Tap ................................... $
Builder's Deposit ............................ $
Mechanical Permit Fee ..................... $
Sewer & Water Permit...................... $
Gas Fireplace Permit ....................... $
This ~ication B~comes ~~i1ding Permit When Approved.
By ( c.? c...,.; "=F~ I-- Date 51 J I /0 0
. ' ,
Certificate of Occupancy
Other ......................................... $
Total Due .............................. $
Paid e 9. t:j S- Receip,
I~uoo ~~.
Date 00 By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin Ordin nce and may proce s requested. This document when
s!;r:"' ~nner constitutes a temporary Certi.ficate of Zoning comPlianl\an~ ~"~~ c:oRs~ruc~on t?~~enct Before occu ancy, a Certificate of Occuoancy must be i~ued.
., ~ K''"L2-.-c() v.~~;'VfJ ~~~
City Planner - Date . - pecial Conditions if any ~ ~ ~ l
24 hour notice for all inspections 447-9850
~
White - Building
Canary - Engineering
Pink - Planning
Thf' Cf'ntf'r of thf' LlIkf' Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT )0(.=>. K\ ,('\ \L hll1n~er
APPLICATION RECEIVED v'\, CUJ \ 0 +--'h i ~ 0 (j 0
I . ~. -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
553L( h(JUYl-hA ~tJ~
(,
v
Accepted
Accepted With Corrections X
/' -
Denied
Reviewed By:
comments:\).::1)EC-1L
~ ~ tt.Ctt-
2,) Ke.~ -:DEClL t+~~D-O~ ANI) ALL ,fit
,
'\.J~(2.rv\A:rt o~ 0 N TltlE~ ~P~Vb~ '\l~LAJJS,
~ =t.-.M
\-so\i~ '3:>-e.s. i31'-
Date:
5//I/~o
, f
~ P- ~Tt.lR.-~
t
I~
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
~
White - Building
Canary - Engineering
Pink - Planning
The ('enlef of Ihe like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ ~\l0- ~ ~mr~
APPLICATION RECEIVED \1\ ~ \ 0 +h J <f) 0-0 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
SSoLJ ~ ~U.J.-
Accepted IJJ'I/ Accepted With Corrections ~
Denied
.
Reviewed By:
Comments:
()~LK.. PEW'lMf\ :Su'-i~~, <:\0 ~ ~~
~~ ~~ J:v~t7Y"Io L~cJ~
Date: ~-l2-GK::)
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
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 55 Bti ~ tSOLANTY Sli
TYPE OF WORK NE L.0 J")G C ('-
USE OF BUILDING R-es. AI f?-
PERMIT NO. (){)-03!:::JU DATE ISSUED sl Ii / tJ()
BUILDER ~OE KLINt< HArt1rv{t:;~ . .
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.;J1r/ ~ 5//67dtJ
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S{GNED
I
FINAL ~/{ Ii1> I 6/?;/ /616
Call b~~en 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
DATE
7/~/(f()
/ )
BO u tJ71/ Q
I
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5 '031
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING <00 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
l('FINAL De~ 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS:
TIME
3:~
00- 036 0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(1 (- I
1lAJ\M '~!
~~~~
;>!.WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
:S::~O:ECT W~L. FOR REINS:::::::FORE COVEmNG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!