HomeMy WebLinkAboutBuilding Permit 00-0780
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,~
CITY OF PRIOR LAKE
~ BUILDING PERMIT,
.,1 . r V1PORARY CERTIFICATE OF
ZONING COMPLIANCE
AI JTILlTY CONNECTION PERMIT
DIRECTIONS i
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITr ~DDRESS
I-fll'X'4
ClvJ...+nA 1/
La ^'
3. LEGAL DESCRIPTION
LOT (:,.., BLOCK
ADDITION r t:LtIi f.l.'}O .
4~~ (Name)
t:.o~ C- ~Q
5. ARCHITECT (Name)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00. 07P>O
.
1. DATE
<i{/lIJoO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
.;:)
\-h' U \
.f11--dS,3 ~
4 IW1cI n
13. TYPE OF CONSTRUCTION
(Name) y\ddrt~Sk _..
"3"1'-1'1 t6r~
Su-N\.'^-.t ~~ -r:~ (,<.l~lA-<-""-'^-t ,
7. TYPE OF WORK Fireplace 0 Septic 0 Dec~
New Construction 0 Alterations 0 Addition a Finish Attic 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 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 .R~i<=lol.rc. r~~iS Pl!nnit lor just ~e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pert07 needf inspection~.
X AL/ ~ 'll' \\ j '2-ClOc:J
Sic V E 1:;ignature - license No. \.. Date
(Tel. No.)
~ '" 0-\ <i>lS.<:l~
G,I<- '" I
(~\z.. Cl, t '1.SS'O
Ae-roofing 0 Porch)(
Re-siding 0 Finish Bas~eni: 0
(Address)
~{
(Address)
6. BUILDER
r-
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATF
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~-
USE OF BUILDING
~ A\K
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... $
I 71).2<""
8'1.2/
4,oC>
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
rtto
Mechanical Pennit Fee ..................... $
Issued
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 236.0{-1,
Oat. ~ ..3I.::J11?
230.~
3eu, 'L-
~
th t the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce s requested. This document when
lanner constitutes a temporary ee;:i; of Zoping complian~nd all~ construction to commenje. Before occ~". ancy, a Certinc of Occupancy must be issued.
:2.l/a') 'I-.P", ~~';.\JDv."'2~ _~ (" ~1-aA.<"_.
'City Planner Date Special on tIons if any
24 hour notice for all inspections (952) 447-9850
This is to certi
s.
_, "-~~:( PR/O/;>,:
f::: ~'~
u .'"
(JU- U7r6
White - Building
Canary - Engineering
Pink - Planning
'rhr {'filler of the L.kr (~ounl.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT :\l j) f"\ f\ eo _ \-\-c-,n'1S>_
APPLICATION RECEIVED . ~ I \ I
\ ~pmvC?_ ~n+
~OOO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
JjlJ~ 1/ (J-v 1\+ ('lA)+ La Y\iL
Accepted
Accepted With Corrections ,.~
Denied
Reviewed By: ~ ,fI!-~<-/.~
Date: ~/}..( /c;o
Comments:
.~~./~<:b ~ko ~~
(~ ~ ~4C\iO ~d~ A- :2~C;-~
MWIMLM ~~ L)~ ~."
"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 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."
~1
00-01~
Th~ C~nln of th. L.k. <.'ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ll 'C\'(\ E"_ \i-tJme..
APPLICATION RECEIVED (\ 1 ~ I \
\ ffiDmve. rY\cuU:-
I
dODO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Jj.l/ ~ 1/ CJ-v.J><4.- YIA J J- J rLl\L
Accepted
Accepted With Corrections
---;:.<
Denied
Date: 9 -b-200Cl
Reviewed
P'
Comments:
~~ <;......,6, ~\._\yt-O;;:: ~u~A.... Oc.J~ ~ houSD_
~~A1.~d,- ~
"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 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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS LI U f3c; no -. ~ :- - .L f: 1/'0..'
NATURE OF WORK' . D~r Ir~
USE OF BUILDING ~f:"1l
PERMIT NO. ()O.rF7PJO DATE ISSUED. t:! .~_?~
CONTRACTOR -5.1..JLHA .#
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
h~NSPECTOR
DATE
I 9/!/~
,
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
I) 1~.\l.M
4 10,0 I ~ -Ur)A.'4
. . I
SEWER I WATE~ I ~EPTIC
FRAMING ~~~"G
INSULATION "b.~1lA>'4
ELECTRICAL '
PLUMBING
II )02.1 j~
/I '};~.l I I f!JO
t1~A~"Ja {l'I. ..,.:tifed) No I-kal-
FIREPLACE
GAS LINE AIR TEST
BUILDING
ELECTRICAL
,~
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
I _
I J?;r,
I
I _
,I h
I )
?/?/ ;;J/
I I
I .
I rf/;;'lltJl
BEEN SIGNED
.
OCCUpy UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspectic-ns have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
\f'. 'V,,vl A_I
ADDRESS
44-& 4- tHDTrJtff U,J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
no -o-;xf)
o FOOTING fP)
o FRAMING
o INSULATION
FINAL p~
~OUNDATION
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SewER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOR~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
\
'u1vORK SATISFACTORY, PROCEED ------- ---------._________...
~CORRECT ACTION AND PROCEED-------------,
"
o CORRECT WOR~. LL FOR RE:NSPECTION BEFOR~OVERING
Inspector: -1./" T' Owner/Contr:'
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!