HomeMy WebLinkAboutBuilding Permit 99-0688
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. Cfi- ~ B e>
DIRECTIONS
SPACES NUMBERED' THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12.SITEAjDjS3s-8 Lo/~ 4:,/ A/G"
3. LEGAL DESCRIPTION
1. DATE
d-JV,..e:;<j
Pk!llJe UJa5 .e/~D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
1ST
I
AOOIt../.
PID 2'>'-1[/5- "''''7-0
LOT
ADDITION
z.
BLOCK
N61.-S0NS
13. TYPE OF CONSTRUCTION
14. OWNER (Name)
L eL4;z.JD 5#1'11"'11..1
5. ARCHITECT (Name) .
(Address)
<,A7..,., I'E
(Address)
(Tel. No.)
447 44~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
A Gt..4-rJD
7. TYPE OF WORK
New Constructiorf)(
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yas 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 mentioned property~n ~t onstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building official can revok.?s i or i t cause. Furthe~~erebY agree that thn city official or a design.ee may enter upon the property to perform needed inspections.
X. ::z --c;" .'.- 1f,_/f...-9.9-
,. ~ Sig ure \00""'"" license No. :rfa:
S#7/ZJ-I
OCCUPANT~
Fireplace 0
Alterations 0
Septic 0
Addition 0
Dec~
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
r
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
BUILDING DEPARTMENT VALUATION
/l
USE OF BUILDING I!ft; A! f{
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
S'~. ~rl
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV~
Occupancy Group A B E F A I MAS U
. Division 1 2~ q: 71
PermIt Fee .................................... .'
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ..................... ........ q:
State Surcharge ............................. q:
Penalty ....................................... $.
~~
Pressure Reducer .......................... $
Meter Horn ... .... ......... ............ ....... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Plumbing Permit Fee ....................... q:
Mechanical Permit Fee ..................... q:
Sewer & Water Permit ...................... it
Gas Fireplace Permit ....................... $
ThiS~yq.~ Becobxour Building Permit Wl}en _Agp~~~
BY~' Date V -b 7
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ _ I
Total Due .............................. $ I olY .)<;lj
Paid \1..4. ~ ~ Receipt No. - ~ '5"~~ i
Date Ie bA- f ~fl By It.b l!-
est in the above application and accompanying documents is in accordance with the City Zoning Ordinance and lay proceed as requested. This document when
.:t?esAjmporary Cer1i(;;r~t:47comPliance and allows construction to commeooe. Before occupancy. a Certiticate at Occupancy must be issued.
nar ate Special Conditions i1any
Issued
v
24 hour notice for all inspections 447~9850
ATTAC.HMENT A TO BUILDING PERMIT NO. C1<?- &88
PROPERTY OWNER ACKNOWLEDGMENT FOR NEW DECK
CONSTRUCTION
The Owner of property at /435P3 /.0/5 ,qVE /VE _ in the City of Prior
Lake has applied to the City for a Building Permit to construct a new deck. Prior Lake
City Code Section 4-1-7 (A) requires a Certificate of Survey, prepared by a registered
'land surveyor, as part of the Building Permit application for all new construction. The
Owner has requested an exemption from the Certificate of Survey requirements as
provided for in Section 4-1-7 (D) and (E). In consideration of tl~e City accepting a
marked site plan or survey in lieu of a new Certificate of Survey, the Owner hereby
agrees to waive any claims against the City and to hold the City harmless from any
claims or dan1ages incurred if the structure is inaccurately placed on the site.
OWNER(S~ /0 ~-7
~0~.
DATE:d.J..u..,vl? Y9
CITY OF PIUOR L/'}f':: .
By: ~,-~
Its l.5<-.:J o;p f!)f1;C( C, /'tL
STATE OF MINNESOTA)
) S5.
COUNTY OF Sc.o-r-r )
"
'I'
The foregoing instrument wfl;a,ckns>w!(jd&ed f9r me this
JIAI'\.(. ,1991.., by IGob-<-r1 f.-tkf~
Official of the City of Prior Lake.and 1..Llhul <:;",,;It,
owners.
LIft.., day of
, The Building
. .
ilffj,; "EL'-~n~AU MEYER j
~p "c'l~miVPUBlIC
~. M)COmm,jji",~J~I'31'20c0
.VVVVVVVvJV\lVVVVV"J~ 1ft' r I J
the
-
IIOLDIIARM.DOC
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.,,"..
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS III '359, Y...-""" ~
TYPE OF WORK 7"'n.,.. t c::
USE OF BUILDING Sc::()
PERMIT NO. C, c,- L.('~
---
BUILDER ~ ,....... .' \. h
. .. ...........
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
-
DATE ISSUED
(9-7-77
INSPECTOR
DATE
, FINAL
J ).- 3O-rH
. I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
i/W/
"
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/L,joa/
ADDRESS
/ L/?,:;};
[().IS Ih-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t-(q-c;w
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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~~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~O~K. C~OR REINSPECTION BEFORE COVERING
Inspector: /~ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS tiRE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI