HomeMy WebLinkAboutBuilding Permit 00-0814
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
9.(p.oo
Permit No.
OO.o?Jlk"
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS /5/03 G.e.Ef:::JV OI1J;:::..S
3. LEGAL DESCRIPTION
/'7
1. DATE
T1<-
/2./
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
G~
RVkk(JYI
PID 7~"> ~/ZS - 0/7- ()
13. TYPE OF CONSTRUCTION
ADDITION
0/'1 r.s:
4. OWNER f-h It (Nam.)
k'eJ ,(!Jw~/
5. ARCHITECT I (Name
(Addr.ss)
15103
(Address)
(T.1. No.)
b(.U(l OakS Tr "I,!t;-13'1. 7
(Tel. No.)
tK.6'/77I J1II ~/2' 84(,. .3otlz.
'- . (T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
7. lYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
SepticCl
Addition 0
Decls,J(
Finish Anfc' 0 -
Re-roofing 0 Porch 0
Re-sidlng 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES
Sq. Ft.
I hereby
111. a
buil
x
19. PROPERlY DIMENSIONS "0. CULVERT SIZE
Width Depth Yes No
rtlfy 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
m 'oned operty 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
g ff I can r ke t . perm' or' ;;;e. Furthermore, I hereby agree that the city official ora designee may enter upon the property to pertorm q/~ns7;;
license No. , Date'
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.JeF.-S /-1/ /Z.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
,
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee .............. ..................... $
S U
City: Amount Brought Forward .................. $
#5V S/~ ,flM/ParkSupportF.. ........................... $
vGil!-I~/(Yr77P,J SAC ......................................... $
ee;iJJO 9".()() Collective Street Fee ....................... $
Sewer Tap ................................... $
.
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
48.e:n
<I.s~
.7<::
Pressure Reducer .......................... $
Sewer & Water Permit ...................... $
"~J......~;,~i~~.~..~il V'Jj.n Approv.d.
~ Oat. ...:r - ~ 1-"?f'C21..
Meter Horn ....... ...... ...................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder'~ep.osit .nrl......1t....l\,........ $-
Other'..~~. ~~f.~~ a!. -'
Total Du. .............................. $ PJ().76
Paid eO.7g R.C.iPt';,~M'I(P
Oat. q,/.3-07!; By ~
This is to certify that the request in the above application and accompanying documents is in accordance with the City zon~g Ordinance and may proceed Is requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction 10 commence. Before occupancy, a Certificate of Occupancy must be issued.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections (952) 447.9850
$~~
DO. 00/tV
Tht'(".,nleroflhpl..bCounlry
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~v K:K.EAJ
f
q./I.()()
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/57 03 ~/'2b6 AI O/tJt:- J I't:.-
Accepted Accepted With Corrections '<
Denied k
Reviewed By: Date: 7-//-~
Comments:
I. ~cl ~ ~rJC u.,_J.oJ-
"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
r7-
Oo...le-s. \ )--.,
1c..'X"\'-!'
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS l.5..t..o3 G,..Q.lLV\.
TYPE OF WORK /0", '\. t::Jeclc-
USE OF BUILDING <:)t=O
PERMIT NO. 00.08/4- DATE ISSUED 9 -1(-2.000
BUILDER 'R.v\<k~ ~I. {J<Jo- 13<({
.J I.J. (,12- 8u<--?04'Z-
NOTE: )"HIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I~:J/:-
''72.. - 59(,- ;;7tMJ
I FOOTING I P;:PECTOR I f 1/ y;:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I
I FINAL
A
/cYr; 1-tf/i?j.~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
rSITE INSPECTION
COMMENTS:
-
\
\
; .,Ill
~,-,,1
DATE TIME
SCHEDULED
'7.13.00 A f.
/5/03 Gea:;;;J CY1~S. --n2-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE.RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
2J ' 'td 'Zq '-l. "
-...
1
e.:
~ ....-
fal!.,) 7 "\
I
I ::Jdj~. ~ 'f-'
t.,.e.. .- .z;to:::(:1.J1lfr- ~
pter.--.
"
- , -'"
'?
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ t Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/(.15.00 ILT_
ADDRESS
/5/03 GKhF-N OI1K-5
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATlON _ ~
FINAL J?(3 ~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/':;"'--
rL( (I
\'-
'--- ---
] ,,//.,
'7'-z.-..( / 1
-/
..'"."._---*""'.:~~-.r-<"
~ WORK SATISFACTORY. PROCEED
/0 CORRECT ACTION AND PROCEED
fIT). Df)I4-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
,.....r
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~I
Owner/Contr:
\ .r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI