HomeMy WebLinkAboutBuilding Permit 00-0906
..l. 0" PRIOIi' <' rn ,~,j; " CITY OF PRIOR LAKE
&~~I D I ,: , BUILDING PERMIT,
.. . ~ Ii I TEMPORARY CERTIFICATE OF
\\ -".... ili i. ZONING COMPLIANCE
. ~ ~ UTILITY CONNECTION PERMIT
I DIRECTIONS ! I
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12 SITE A1L4G, <ic. q &o"f> ~l ("\(",('1
3. LEGAL DESCRIPTION
\6-l
L
2.
3,
1. DATE
~J/lJoo
RN'\d Nt=: Q~
BUlL
11. SIZE OF ST TURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK ---.3
\"-I'"\l"\h \-+;11
PID
~S-~I()-03b-O
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER (Name)
d"KR'1 :) ruC):::
15. ARCHITECT' (Name)
6, BUILDER (Name)
W", b wace. l-toMe.s
7. TYPE OF WORK
Fireplace 0
Alterations 0
(Address)
/'168"1 ~D5e""Doh Kl:>
(Address)
(Tel. No.) I
AJe" 9.0. 'to~ aJ~o
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
I
(Tat No.)'152o'i'i?-
/g58
,1-0.1< V I lie M N 5SCH?
(Address)
It:.D25 G-fC)vG/rQ.', \
Septic 0
Addition 0
Deck 0
Finish Attic CI
As-roofing 0 Porch LI
As-siding 0 Finish Basemen~
16. PROJECT COSTNALUE
New Construction 0
Chimney 0 Misc.
lB. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. 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
th~ lIDove ment;oned property ~nd ~at ." C ostructi n will conform to all existing state an~ 10ca,I !8WS and v.:ill P, roceed in accordance with submitted plans. I am ,aware that the
~U~g ~VOke thiS arm. JU cause urthermore, I hereby agree that the city offiCial or a deSignee may enter upon the property to perfTO\edC roi)ons.
- "-........ 7 Signa re LlCsnseNo. 0...
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
17. COMPLETION DATE
y
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12Ls. A J I~
. .
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ..................... .... .... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer&WaterPermll...................... $
FOR ADMINISTRATIVE USE
Back
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
2,ol!H'>
V
R S U
City:
lo2.'2.5
l. ,,(I
<.10.<90
~o
::z'Jn''&=,:-iJ~;':'-~-
BY~ ~"."'Date
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
D ENERGY DATA
PILING LOGS D PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
(!I 0
SURVEY
PLOT PLAN
COPIES
o
o
Amount Brought Forward .................. $
Park Support Fee .... .... ................... 'l::
SAC ......................................... $
Collective Street Fee ....................... t
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. t
Sewer & Water Connection Fee ........... 4:
Water Tower Fee ........................... It
Water Tap ................................... 'l::
Builder's Deposit ............................ $
Other ......................................... $
Pa;d 7D~"i{~'6D""""'~~~~;~~o$J~~-~q~;
Date 1()~J;;.5 By (~{J~
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~aJrequested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifi~~f 'Occupancy must be issued.
Issued
CijyPlanner
Date
24 hour notice for all inspections (952) 447-9850
Special Conditions if any
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
7~/9~(J Z-
(Please ~ or orint and sien at bottom)
ADDRESS
I. Blue File
2. Gold City
3, Yellow Applicant
()O_ () 9t? r,
I PERMIT NO...-.,- _ '.
tiI==..11
I +c, f;9 /UJ..I EW g 1'1,) 12<0
I ZONING (olliceuse)
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
'~A,.~c\{'-d:t(7(i PI~h,~& .t
22 /Du ~,'v\f ~~ (
(Address)
\f)yVl f.k, c l
~f.hJ.A
~
. SIGNATURE
,
1E'tl?:~Qs 2) <:/~ 9- t/oov
. --
~~ VI JJ< .s-S-o ~<I
(City) /:.." (Zip Code)
(Phone) ~"} '3~'{' - (;, ~O'{
~:~;J/19 /0 '/
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity I Type of Fixture
Bath Tub with or without shower I I Rough.ins
Dishwasher I I Water Heater
I Floor Drain I I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99,50
Residential, Additions & Alterations $39.50
Estimated Cost $ Building Penn it # ~ .,~' - 'ry
oo-o9iJb to
PLUMBINGPERMITFEE $~ .50 ~It}
STATE SURCHARGE ('
TOTAL PERMIT FEE
(Office Use Only)
I
This Application Becomes Your Building Permit When Approved
---
-
Building Official
P~ IRec~
Date I By ~ iAlf
Date ry / /1--v ~ /J:.fV'
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245 r
--
~~
00.OQ00
ThIPCiPnlrroflhlel..k"Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
S I () (1./;:::" I 6 F.JeR V
I I I
/0 . (/J' 00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4to 0CfROO:~_1Y()()n .e.J) Ai F:
. I
Accepted ~ Accepted With Corrections
Denied Cbl/2
Reviewed By: e:._ V ttJ-v ~
.."..
----
...,
Date:
I ~ - (0 - '2000
Comments:
,.....". -.-
(U +Jl. ~-\-r~^-I'~ -tU~
"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
SITE ADDRESS 1iL..~S ~\~rvD (j2J)
NATURE OF WORK ~LU x=--"'-'-.-A- F"^"'" ~
USE OF BUILDING JFD I
PERMIT NO. ()(). ()9'Il(o DATE ISSUED /0 -/D-?I""JO,j
CONTRACTOR ~-\-l yo ((" -
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT 402 - 0 2.L{O
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
l~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING ~~. gf,ltfz- ~~, \cl,'L \0
INSULATION U K\t Irl It, jo ........--- .
ELECTRICAL . f &-.1(//0?- \
PLUMBING PL 1..1. MINI,fW.. ~t'fJ, w,,'~ ~'f W/~oG~i2;. '7/.Jlolfl-- I
HEATING (if required) ~. 10 tL (J
cpc '.rtS
ok. -P6.,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~ It i GL~. #7& I/~ .yH~ l'6ut/r.
,
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
-
"11,/
//1/1'
I (y t--<j
rvV
;/Vy?
OCCUPY UNTil ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have beer. ,approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
IO~~'5
/0. v')
SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
DATE TIME
CITY OF PRIOR LAKE fO,l>
INSPECTION NOTICE SCHEDULED ;/'q)
ADDRESS /4C'oq a os... U/o,xJ Rd
OWNER CONTR.
PHONE NO. PERMIT NO. 00 -Oq{)(,
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP ,
o INSULATION @ 0 SEWER HOOKUP ~
,.8'FINAL . ,b-PLUMBING FINAL
o SITE INSPECTlO' B MECH FIN~
COMMENTS: ~
o EXIGRAOIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
,
U (55<-
,
't< u..
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Iif' ;()-J-S' OJ-. Owner/ContT:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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