HomeMy WebLinkAboutBuilding Permit 00-0497
DATE RECEIVED
~//2./00
CITY OF f)RIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
- DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
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3. LEGAL DESCRIPTION
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~NER (Name)
1{~1 ~ 1Q;n/l1t/-"dIv/r
5. ARCHITECT (Name)
LOT
sf
S- PID 2.S:::.2Q4--043-o
t; ~ I rt I t:;;S ZML) R.olJN.
> (Address) ~ J (Tel. No.) lIYO .-
/7<//t/ A ,f'd9cU/a:Jury i'S39
(Address) - (Tel. No.)
leI
BLOCK
ADDITION
6. BUILDER (Name)
(Tel. No.)
(Address)
7. TYPE OF WORK Fireplace CJ
New Construction 0 Alterations 0
Chimney CJ Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Septic CJ
Addition 0
Decki\.
Finish Attic 0
REI-roofing CJ Porch CJ
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
I. White
2. Pink
3. Yellow
File
City
AppliClDt
Permit No..J) 0 ..04-97
BUILDING INFORMATION
11. SIZE OF STRUCTURE I
(Height) /" CNidth/ J?'- (Depth) /11'
12. NO. OF STORIES
13. "L)~~FNSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
~l sI/ f/.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PlOJECT C~TNALUE
I (11 {)(J ::;..-'
17. COMPLETION DATE
7-- 3/-00
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 ~..rY1("{ f4I1t.LNv .-b -/;2-00
-J Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. .. . .. .. .. .. . .. ... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ........... ............. ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
FOR ADMINIISTRA TIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN .J'
PERMIT VALUATION f(~?,O () tJ . ()7)
USE OF BUILDING
265 A/~
/
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H IRS U
Division 1 2 3 4
City:
Permit Fee ................................... $
~Z' 25
LJO,~~
/,00
J-~~
~\~'
Plan Checking Fee .. .. .. . .. .. .. . .. . .. .. . ... $
State Surcharge ............................. $
Penalty......... .............................. $
Septic System............................... $
Other ......................................... $
Subtotal ............................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS CJ
SETS
COPIES
SURVEY 0
PLOT PLAN CJ
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $.J 0.3. 1J
Paid J /) 3 11 Receipt No. 3 /~ f ~
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Date (.t i {/ Z,/()U. By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdina~ and may proceed a~ equested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate Occupancy must be issued.
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Certificate of Occupancy
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-4230
00- ok~1
White - Building
Canary - Engineering
Pink - Planning
The Center of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
t1Jjje~ JVDD ~ I AMt1 V
#0 I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
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Accepted With Corrections
Denied
Reviewed By: aJZA/t. 'e:: ~ Of Date: t. //3 / (J 0
f ,
Comments: ReAD "Dee-It.... ~J~rJDbU' ANt> A.Lt- Itt€"
J~FOt2-(VlAIIOtJ Of\} Tc-t~ APPR.1Jtl(7) :_~LA-NS,
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
DD~O~1
White - Building
Canary - Engineering
Pink - Planning
The Center of the L.ke Country
BUILDING PERMIT APPLICATUJN DEPARTMENT CHECKLIST
NAME OF APPLICANT
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APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I / /,-;.' /1 ..4 ;' / . ,/; /-" ,I L (/ "
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Accepted
Reviewed By:
Date:
Denied
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."
./
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PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS /7~/L/ I(/{)'GE tJ()oj) CT: SE
TYPE OF WORK NEw d.;;J e~
USE OF BUILDING ~t::;~ A.I e,
PERMIT NO. ()f)- 0 tjq1 I DATE ISSUED
BUILDER 7ODf) r TArAlI1r fIIil!e.Je. .:d:. "-/J../O -gS3~
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 /fJ1t fo ! 2-110"
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
- FRAMING REG. &F"otl€ J)EC.J{... Bc1. .p(A~~MeJT
I
Call between 8:00 and 9::00 A.M. for all n pections
FOR ALL INSPECTIONS ~ -9850
- '- /
1
1 '2111 tkJ
I
FINAL
*
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. ,
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
:SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
DATE
TIME
/ J Ie;-
()7) -o!/-CJ7
;
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECIH RI
o FRAMING IOWA TIER HOOKUP
e.'NSULA TION ~ - 0 SEWER HOOKUP
/!' FINAL D~ ~UMBING FINAL
o SITE~';'ION 0 M~
Cl)llftMENTS: r ~ ~
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~A~R.PR D
o CORREC CTION AND RO D
o CORR CALL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
Inspector
Owner/Contr:
CA 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
EQUIREMENTS hE FOJ.~ YOUR PERSONAL HEALTH & SAFETY!
/ INSNOTI