HomeMy WebLinkAboutBuilding Permit 00-0628
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DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
Y - 0 - 00 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1, White ~'Ie
2. Pink,
3. YeDow..;"~
Permit No.
()~~0
, DIRECnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
\~ F~~~~A
1. DATE
7 -/O-a:>
BUILDING I~MAnON
11. SIZE OF STRU<#IIIE
(Heiglt) (WidIhJ' (Depth)
3. LEGAL DESCRIPTION
LOT ~ \ _ B~OCK I ~I .as - rr~Q - f\:J'\ - 0
SO" ~ Ie+- at ~ 16~ '~<< '~~ l
ADDITION ~~ ~ ~ ~ ~ ~ ~ '_ A.:,f;Qt\.y.
4. O'!V~~ Name) (Address) (Tel. No.)
\~~t~~ ~~~ ,~~ ~~ RJt lJ"7..'31d.("
5. ARCHITECT (Name) (Address) (Tel. No.)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6, BUILDE", ^ _ _ (Name)
~ ~ ~c.rev.........
~^S~~
(Address) _ _d
~S'c.~'~ e..,,-
~L.
(Tel. No.)
1I140 - 51 M>
~qO-- 11,,~
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction LJ
Fireplace LJ
Alterations LJ
Septic LJ
Addition LJ
Deck"-
Finish Attic LJ
Re-roofing LJ Porch LJ
Re-siding LJ Finish Basement LJ
Chimney LJ Misc.
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 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 entioned 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
bui 0 I can ke thi~rmit for just cause. Furthermore, I hereby agree that the city Offici, ~ ..2!.s s19' nee may enter upon the property to perform needed inspections.
X ~!'~ _____ ~I '7-IO-GO
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLlCAnON
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS LJ PERCOLATION TESTS LJ
USE OFBUILDlNG R~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION .2000. O~
PLANS & SPECS LJ
SURVEY LJ
PLOT PLAN LJ
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 ................................... $
City:
Amount Brought Forward .. .. ... .. ... .. .... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .. .. .. .. ...... . .. .. .... $
Sewer Tap ..................... .............. $
$
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Plan Check Fee ........ ..... ................ $
State Su rcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Gd.~,
~
~
Issued
Water Tower Fee ............. .............. $
Water Tap .. .......... ....................... $
Builder's Deposit ............................ $
Other................. ........................ $
Total Due.............................. $
Paid J 0 ~./ , Receipt
Date 7. z,;. ttV
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr as requested. This document when
s' ner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
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City Planner Date Special Conditions if any
JP
'10.00
1-(.1
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:~+~:;~~&?
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24 hour notice for all inspections 447-9850
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The Center or.he Lake Country
6v- UkZtt
White · Building
Canary- eOgineering
Pink - .....nning
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BUILDING peRMIT APPLICATIQNDEfARTMeNT CI1ECKLISI
NAME OF APPLICANT \Joh~ Co~s.o~~.
APPLICATION RECEIVED Jti \ Y \ Q I ao..o...o
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5306 F\~,po"r\t ~(}nd
Accepted
Accepted With Corrections
Denied
Reviewed By: q", A~ Date: 7- t~.C9Q
Comments:
~~~ ~ ~ ~tTI1. A) Fa ~
~~ C11!)~ I e&WM ,
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
~ ~,
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J.5:?()fQ b'c;,^
TYPE OF WORK De~ ~
USE OF BUILDING SFf)
PERMIT NO. (}O.,'()(rj~ DATE ISSUED 7-/~- 2000
~UILDER Q~t;C:n..~ ___~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE' PERMIT IS BY SEPARATE DOCUMENT
DATE
I
FINAL SF- e8///~
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Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
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