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HomeMy WebLinkAboutBuilding Permit 00-0731 CITY OF PRIOR LAKE 1. White 2. Pink 3. Yellow File City Applicant Permit NO.j)O- 0731 DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 2. sq ADi~SS ~ G,u it 3. LEGAL DESCRIPTION <6 BLOCK-J PIDc<S-3b~-o08'-O ~(b ,j~ '-L ~f)DITl()N ~~me) U-UIc- 1. DATE BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) 12. NO. OF STORIES LOT Mtf- ~~#c (Address) (Tel. No.) 13. TYPE OF CONSTRUCTION All.. ,.6#7- 14. FLOOR AREA APPORTIONMENT USE ADDITION 5. ARCHITECT (Name) (Tel. No.) 6. BUILDER (Name) (Address) (Tel. No.) ~~2. -I/V7- c:>9J~ 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS o (.,t:. Wt- Mf;,J 7. TYPE OF WORK Fireplace 0 New Construction 0 Alterations 0 Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq.Ft. 3911 Ktm-aSr- S"'N P,l,. Septic 0 Addition 0 Deck 0 Finish Attic 0 Re-roofing 0 Porch 0 Re-sicling 0 Finish Basemen~ SEATS 16. PROJECT COSTNALUE 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Y.es 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 . WI con rm to all existing state a.nd local laws and will proceed in accordance with submitted plans. I am aware that the ust cause. Furth ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X -z..o U:;~. '? 0 '- 8" 'IS" -do License No. Date FOR ADMINISTRATIVE USE SETBACKS: Required Actual MATERIAL FILED WITH APPLICATION Front Back Side Side SOIL TESTS o ENERGY DATA o BUILDING DEPARTMENT VALUATION OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMITVALUATIO~,<<'O. CO PILING LOGS 0 PERCOLATION TESTS 0 USE OF BUILDING -R ~ ~ ~ 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 R S U Division 1 2 3 4 Permit Fee. ......... ......................... $ ~ 2 . Z. c,- City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ Plan Check Fee.. ........................... $ State Surcharge ............................. $ 1.00 Penally ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ LI D .or) ~DO Pressure Reducer .......................... $ Meter Horn.. . .... ......... .... .... .... ....... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Sewer & Water Permit ...................... $ .............$~ Issued Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other ..... ............ ..... ........ ........... $ ? Total Due .............................. $ t .3 .2. ~ .~ ...36ZJ#~ .0 Paid Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. City Planner Date Special Conditions if any 24 hour notice for all inspections (952) 447-9850 Residential Building Permit Checklist Basement Finish or Interior Alteration to Single Family Homes BY: Date: 8-/ "( ~ Building Permit # PID: Site Address "f7a4Po.Jt-,~ e.~. Legal: L B Zoning: Subdivision: Existing Structure: YES or NO I CONFORMS TO ZONING ORDINANCE YES NO YES NO Is this an expansion of the existing footprint or Refer to Planning I building height? ....... I "- "'- Is the property located within the flood plain? Refer to Planning '--- Does the alteration include any additional kitchens? Refer to Planning ~ Does the proposed alteration include any outside Refer to Planning ~ entrances other than patio doors? Is the proposed use of the finished space or Refer to Planning ~ alteration for anything other than a normal single family home (office, group home, day care, etc.)? THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERl\'IIT FILE TO MAINTAIN A RECORD OF THE REVIEW. L:\TEMPLA TE\AL TCHCK.DOC 00-0131 The Center of the Lake Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST APPLICATION RECEIVED NAME OF APPLICANT ~(')C~ (,re.-e. \=.. \.\om-e.~ o..!~ \5 I ;;JOQD The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: -4:1 3b ~()X'm~. ~ .r't- Accepted )>< Accepted With Corrections Denied ~ Date: e- (?-'?o:::o Reviewed By: Comments: ~f~ ~ ~ .J::''^~ ~o.<A 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." CITY OF PRIOR LAKE INSPECTION NOTICE DATE nME ADDRESS 1-t8fo SCHEDULED .3.1Z,.6~ 'It 1rA7U.P G15 C/f.. OWNER CONTR. PERMIT NO. 06.013/ PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RII o WATER IHOOKUP o SEWER IHOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: ~I-OJ b Pi ,-6 .~~ ~.II4-/ o CORRECT Inspector: Owner/Contr: 'NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTl