HomeMy WebLinkAboutBuilding Permit 00-0756
DIRECTIONS
SPACES NUMBERED 1 I nnu I' MUST BE FIL.L.cLJ ,....
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SrrEADDRESS, .-=...._ljz.JJ;.-j V','(..-'"'tO/""c.. C.V ~v'~
~ f;.::......~..2-J
3. LEGAL DESC'IIr,TION )\
LOT "1 BLOCK L..f
(' --OJ:-I~L. (Y)) ~'('Ilgo
(Address) j
I/.,< t; '3 I/,~ r,,, ["V<J<..
(Address)
ADDITION
4. OWNER
--1:Ur k
5. ARCHITECT
6. BUILDER
~<~"EF0!7 ~( !CITY OF PRIOR LAKE
'" BUILDING PERMIT,
.1.. 1i~I\nPORARY CERTIFICATE OF
. 1111 ~ONING COMPLIANCE
. ANW "ILlTY CONNECTION PERMIT
1. DATE
1Jr)).rO '0
PL.-,
PID ~s-.m-~o~r-o
S-+-n A{)l) I\J
(Name)
~J...""'J'
(Name)
(Tel. No.)
4/.ftl-6~Y3
(Tel. No.)
(Name)
.J ~';)'-tI'1J
r.~.. ".r q,Y1- 77bJ..
/J.'1'-f'..:> 1Jt?;~>1'. c. V-L
Septic 0 Deck [1....00"""" Rs-roofing 0 Porch 0
Addition 0 Finish Attic 0 Rs-siding 0 Finish Basement 0
(Address)
7. TYPE OF WORK
kc-} (l".J~!. c...,~-,
Fireplace 0
Alterations 0
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Fl. Width Depth Yes No
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
building ial can revoke this permit for just cause. Furthermore, I hereby agree that the c~ official or a designee may enter upon the property to perform needed inspections.
X /1 ~O.a~7JL{) J~~
~ture ... license No. DIll
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
Front
Back
Side
Side
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
b 0."1/:;(,.,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
~'\MD
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN _ a. D<lO ,c.,.i SURVEY 0 COPIES
PERMIT VALUATION ~ PLOT PLAN 0
TYPE OF CONSTRUCTION, I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
Plan Check Fee ..................... ........ ,It
( 0 '2 . -:2. c::;-
<:[(').4fo
I. nO
Amount Brought Forward .................. $
Park Support Fee ........................... <;:
SAC ......................................... <l::
Collective Street Fee ....................... If
Sewer Tap ................................... $
$
City:
State Surcharge ............................. ,It
Penalty ....................................... ,'I:
Plumbing Permit Fee ....................... :t
Mechanical Permit Fee ..................... ~
~ v0 \uo
"J'l--I(.
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. If
Sewer & Water Connection Fee ........... $
Sewer & Water Permit ...................... $ Water Tower Fee ........................... <l::
..../ $ Water Tap ................................... $
ThIS lleaNo .~..~~:;iuil~,~~.;ennltJen~e;ved Builders Deposit ............................ $
By ~ _ ,;, Date ~ ..2C'cc..? Other ......................................... $
~:::eateOfOccupa7 :::: T0)i~~.......:~~;;~o$r
ThIS IS to certify lhat lhe request In lhe above appl~atlon and accompanYing documents IS In acemdanee With lhe City ZOning 6rnlnanet and may p,oceed: ~ed ThIS document when
signed by the City Planner constitutes a temporary Certificate of ZOnlng compliance and allows construction to commence Before occupancy. a CertifICate ~~:ncy must be Issued
City Planner
Date
Spec~1 Conditions if any
24 hour notice for all inspections (952) 447-9850
'JJ
~~
While . Building
Canary - Engineering
Pink - Planning
The ('fnln of Ihe I..ke eounl!'}'
.,".
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
_....lCLr<\f> .~
~?s{ I~ ~
m \ (' l-\fl L~ Urn::.J
Q:srol. \ Q crou
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I (r> ,<;,FS :-=:; \/ \ t J.-r X \ 0.. (J-.I r\f ('
Accepted
Accepted With Corrections
-./
.:_.1\;,
.
Comments:
I. (2w ~C
Denied ~r.
Reviewed By: (1. "[12.. _ k-
/ "'---::"
-i-L..., D..e-lc
Date:
e ')3'. )oor)
~....
j.{ c. c\ C
o
'.y
. ,
.t
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any vicUation of
'any-of the provisions of this code or of any other ordinance of the jurisdiction. Pel'tnits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS . J f. ~~<:: V,e frJH'<:L CO/'-V-l
TYPE OF WORK '7'1or l-
USE OF BUILDING ~ F'-"""
PERMIT NQ. ~6-1~" DATE ISSUED e - 2$'-206>0'
BUILDER j....=-~... M-l r 1.c.......J ~ <No d-II ') J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I~. I (j'!?J /tJ't)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
,~ I I
I FINAL
I 11 6 I S-/4)t}f
Call between 8:00 and 9:00 A.M. fO~ all inspections' .
FOR ALL INSPECTIONS 447-9850
'\
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
/ ~ 35 3
SCHEDULED f7'3 (I d I / ( ; r:rlJ_
J~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
fJ(J - 7s~
o FOOTING
o FOUNDATION @
o FRAMING
o INSULATION
1IlI FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATERHOO UP
o SEWER H UP
o PLUMB FINAL
o MECH AL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/-_..
(
\
.~
')7-dL )
COMMENTS: ~
A.
/
.,
')6] WORK SATISFACTORY, PROCEED
(OV CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ( Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI