HomeMy WebLinkAboutBuilding Permit 00-0470
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1
I
. ,
.DA TE..f;U;CEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
JUN - 'l 2000
Permit No. -.OJ) - 047 Q
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
5:311 e/-f{e,RIAq6 Hlf.,l-
1. DATE
(o-O~-DO
Roll 0 N E R/bu
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
ADDITION
3. LEGAL DESCRIPTION
LOT ~ BLOCK
Noe77-1 SHoee; Ofir,c;
(Address)
~ ~ \\ ((At (\~~ <. ~..\\ ~
(Address)
12. NO. OF STORIES
I
PID z.5 -25~{)3- CL
57H
\\t. (P\a~~dto- \6~~
.(Tel. No.)
13. TYPE OF CONSTRUCTION
4. OWNER Q (~fe)
.:)(-'~ ~ Q!)\ \~ (
5. ARCHITECT (Name)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
J~~(fY ~\~( 5~)\ \~Y( i~~'\ \\.\\ ~c\ ~,iOI ...4l~~~~~
7. TYPE OF WORK Fireplace 0 Septic 0' oJ Deck)( Re-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
SEATS
16. PROJECT COSTNALUE
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify 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
the ~en~~.j m"th'7 and that all construction will contorm to all e~sting state and local laws and will proceed in accordance with submitted plans. I am aware that the
~Uildi 0 I, \~tsv~s pe~it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to ec;~rm6~e~ inODons.
- - Signature License No. Date
. I
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
1ZG:5 19/~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 3, C)OC. ()(')
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
Division 1 2 3 4
Permit Fee..... ..... .... ............. .... .... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . .. .. .. .. .. .. .. .. .. . .. .. .. .. .. .. .. .. . .... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee............................. $
I~.IS-
'/8.S't
1 ..SO
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
By cepe:~~~~~;::~i~;:..""te'"1-~
Certificate of Occupa4
~
(,1 ,~OO
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Other......................................... $
Total Due .............................. $ 1'2.t.f. 'B If-
Paid /u t:J4- Receipt 3""7 ~ .., ~
Issued ~p (, l/
Date c)(,I By -----
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdina e and may pr s requested. This document when
Signej,~ 1~~n_er .constitutes a temporary Certificate of Zoning compliance and allows co.ns~ction t~mmence. Before occupancy, a Certifi e of Occupancy must be issued.
~~ -':P~"i<-t.S>O ~ l~~
~ City Planner Dale - Special Conditions if any
24 hour notice for all inspections 447-9850
/~~-~ ~
C\) -OL;-10
The Center of the Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
r\...IFJ-( 1 ,,.., n. ( il. ,L,\ '\, '<\.") " ,.... ^.' ~\j c:
.1>;.,\ \ ',.~L'\ I. , , I L--.( ,(~ \ ~;\ \ '-
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Accepted ~
Accepted With Corrections
Denied
Reviewed By:
~.~
Date:
~ - ~ -&0
Comments:
~. \' ~ (\~k Av~'1
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
~
Ul~O/~10
Thr Crntrr of thr l..kr Country
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
c-e, \\. r~ ~ ~
0tJY'\L, ~NA 1 Q (7)(J
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
D 3 \ \ C JJ.niry' \ \ d _ 12..n0 ol ~ E
Accepted
Accepted With Corrections /
Denied
/21Z- fl
v f/
Date:~-=..Z -~
Reviewed By:
Comments:
~ ~ ~~~
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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS S3/J (1"rn'~ I-Idl R.oo..J.
TYPE OF WORK ~c ~
USE OF BUILDING S'FD
PERMIT NO. 00 ~O4-/() DATE ISSUED _/)-~ooo
BUILDER ~i-\-e.r- t! lJ9~- I'2B3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
..THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING k-;NSPECTOR tJI1;;:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~
FINAL
~
'11~ 1,,-0
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
?~UV
I1-T.
ADDRESS
53// ~//T6t G fI1~ CA
OWNER
CONTR.
PHONE NO.
PERMIT NO.
- o'f7 0
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
FINAL oe:i!t'
o SITE INSPECTION
o PLUMBING RI
o MECH RI
~ 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:
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.:::O:ECT WO~:LL FOR REINS::::/::~:FORE COVE~NG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl