HomeMy WebLinkAboutBuilding Permit 00-0462
DATE RECEIVED
r,// /00
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
()() - 0 ~-z,-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITEADDRESS 5?~O L5XINGIUN e:r:
1. DATE
G-r'-ov
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
/ 0 BLOCK
;Y /(,.,J2t;:ZNIiSS
3
POI//) S
PID 25-.3/f; - 0'1-5-0
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
~~ lJ h (.~Ic~P.,c.-
5. ARCHITECT (Name)
(Address)
(Tel. No.)
'I? , - .)(;)t)c.
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
~y dl+'Ne;e..
7. TYPE OF WORK
New Construction 0
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck)(
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buil~1 can revo~e this ~~u~t cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X -- /-tV< ~. /"-J-ou
- SIgnature -- License No, - Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
~~ k/ fi!.-
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~,~ .00
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Penalty ....................................... $
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 .............................. $J2# 84-
Issued Paid i r2-4J~ ~+ Receipt No. .. m {q
Date (PIt c, I eJlO By (l.JJ ~ . '
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance ~nd may proceed as requested. This document when
s~ned y I,he CiI)( P anner constitutas a temporary Ca,,&1: 1~iance ap;;;;;;~()(l ~~ ~~cate 01 Occupancy must be issued,
Planner ~ate ~ - Special Cond.:ions if any ,
City:
Division 1 2 3 4
74. 75
'1a.Sj
/-50
Pennit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Plumbing Pennit Fee ..... .. .. .. .. .. .. . .. ... $
W
6/e!oV
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
24 hour notice for all inspections (952) 447.9850
Ob -o~~ L-
Thl' Cl'ntl'r of thl' Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\" t2dd \Ah.oJ-C ~Q4-
~ \ ~) ;;l,(J()O
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
S~3-JD L-~\~\\(ffi Cevr \
Accepted
Accepted With Corrections :>J..
Denied
Date:b -(p-~
Reviewed By:
Comments: I
I.R~ ~ d-ed: ~~
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){)(.~~~
Th~ C~nl~r of lh~ Lab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
"Toc1d \^)hW('-10~
-"\ \S+' 1'rT~
- J\,)~ } d., C,.(_1\J
APPLICATION RECEIVED
Accepted With Corrections
Denied
Reviewed By:
/f~) ~
Date:
~ (.,7-&0
Comments:
~~J f2-.fbV- ~ ~,
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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~a~O ~o,~~ (l.~-
TYPE OF WORK ~ 0 -.
USE OF BUILDING ~
PERMIT NO. (J7)'0 '1~z- DATE ISSUED G-I.o-~
BUILDER W~.~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING ft;r) fill ih
,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
.....,
FINAL - - (<<1 - 11:r1 o! 0)
Call between 8:00 and 9:00 A.M. for all inspections I
FOR ALL INSPECTIONS 447-9850
\
I
\
\
\
CITY OF PRIOR LAKE
INSPECTION NOTICE
. DATr
\t 2..0(01 A-... J :
b z. 3 0 ~(~\<),JCr.
TIME
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~o - ~2--
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION v_
~INAL ~J
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
COMMENTS:
'\ )C~ VI\SScS
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECY'fRl<.\::LL FOR REINSPECTION BEFORE COVERING
Inspector: K ' I~ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl