HomeMy WebLinkAboutBuilding Permit 04-0903
Sep 02 04 12:46p
Information Technoloc~
952 496 8489
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SCOTT COUNTY COMMUNITY DEVELOPMENT DIVISION
ENVIRONMENTAL HEALTH DEPARTMENT
GOVERNMENT CENTER A 104 ; 200 FOURTH AVENUE WEST . SHAKO PEE, MN 55379-1220
(952) 496.81n. Fax: (952) 496-8489. www.coscon.mn,us
APPROVAL FORM FOR CITY BUILDING PERMITS
The Scott County Environmental Health Dept. hereby approves the building permit request to
constructa A,Q&J\\lh (NO ',"~n.;\u. '''' ~ JJ 1~tO"ClCln'i)
,
in the City of r noY" L A.kR.
Property Address 3 ~ 7 7 Mil. r) c. \.v..t ( R &. S'
Property Owner Name R 0 ~ ~ r t B q T"l..
Property Owner Phone Number (Home) 9 S-z. -lI 0 3-0 79~ (Work)
Applicant Name (if different) S AM.c:
Applicant Phone Number (Home) (Work)
Parcel 10# (if available)
;l :\-<132. 00, -0
The Scott County Environmental Health Department reviews building permit applications in all
cities and townships in order to determine if the Individual Sewage Treatment System (ISTS or
septic system) needs to be replaced. The Department may also request that an altemate septic
system location be identified and protected from damage in order to assure that a replacement
location is available on the property when the current septic system needs to be replaced,
The Department's review of the building permit request is based on the policies and procedures
of the Department and the information available at the time of the approval. If the information
available to the Department was incorrect or misrepresented by the applicanVowner, the
property owner may be required to upgrade or replace their septic system.
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Enu, Health Dept.-Staff Signature Printed Name of Staff
9-/-olf
Date
County Use Only n f' n \ It / .. . L
/>lj>1CO<S<<-!t--"'^"l'- ."v~ -i'1v "'rv<-u<'''' ;-~rs
- A compliance inspecton was performed in order to obtain Env, Health approval Yes / No
....
- Does applicant have enough land for Alternate site (or did you require ~valuator to find one.l1--'
--
- At counter, did you speak with owner, contractor or? sp"lo. wI tllNl1lf 0'" .t'J k.1-\.fl
- Make a copy ,of this form for file, along with survey/plol plan, City pmt applic. & other pertinent info.
- Add notes on yellow sheet, or below, as needed.
H:\EnvHealthIEH File.\WordlSewerlFonns - Form Lette"IMI.CV\pp,oval Ionn Cily b1dg pml (nOlShakl.doc
An Equal Opportuniry/Safery Aware Employer
CITY 01' PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTII'ICATE 01' Z. '" I..I,G COMPLIANCE"
AND UTILITY CONNECTION PERMIT
Date JUc'd
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<Jot.~ite - Buildi'nq:)
Canary - Engineering
Pink - Planning
Thf ('rnl.. of Iht L.kt c.'aunt.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECI<U.SI
NAME OF APPLICANT
APPLICATION RECEIVED
R,006rtr BrvITi: / TO M BflA Tt:-"
I
91.I/.O+-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
39;77 M ArLSc..HAL...L ROAD
Accepted
.,-/
Accepted With Corrections
Denied
Reviewed By: ~
Comments: ~
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Date:
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"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."
~~
White . Building
Canary - En'lineAring
f """K ..:. PlanninS>
Tht' ("pnll'f of lht' l..k, Counlry
BUilDING PERMIT APPLICATION DEPARTMEf\lT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
{'( CE lei Lj(/ IT z= ITe 1'1
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
<J ~77 tl/\I,--CeHALL- 1< CAD
Accepted
j
Accepted With Corrections
Denied ,.---...
Reviewed By: ( C?- ~ h1. AYI"84" L..
Date:
r !-~/ (-fJ</
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Comments:
"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 .-3B"'? MA~'SC..~~ ~tf).
NATURE OF WORK 'A ~oiT/.".)
USE OF BUILDING S'. . o. .
PERMIT NO. 0 ~. OCl03 DATE ISSUED ~c.I
CONTRACTOR 10-.. ~;~~T. PHONE.!2.s..1'-O -/9lo
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PE,RIVIIT IS ~;.SEPARATE DOCUMENT
/A=>OL /1"1) ) tJ -r INSPECTOR DATE
, FOOTING t /)'f.../;"'! ~ 1.".6:r'-I
I I
E NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DEPARTMENT OF
BUILDING AND INSPECTION
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\O-t I'tI
I
HEATING (If required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
INALS
BUILDING
ELECTRICAL
IJ A
VI!) I
A
II -3
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet Is available, card shall be placed near main entrance.
~
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 313 7 7
OWNER
PHONE NO.
D FOOTING
D FOUNDATION
D'FRAMlNG
D INSULATION
JI:' FINAL
D SITE INSPECTION
COMMENTS:
(I L.c..e..
SCHEDULED II~
MAl~t... () U.
nilE
CONTR.
PERMIT NO.
l( - 1'03
D PLUMBING RI
D MECH RI
a WATER HOOKUP
a SEWER HOOKUP
[J PLUMBING ANAL
[J MECH FINAL
/.Jd~_
a EX/GRADlFILLING
[J COMPLAINT
a FIREPLACE RI
[J FIREPLACE FINAL
a GASLlNE AIR TST
[J
:,) n I
I~J J. r ()
.
\.
OWnerlContr:
C AL 50 FOR THE NEXT INSPECTION :u HOURS IN ADVANCE.
J ('f
CODE RBttUlREMENTS ARE FOR YOUR PERSONAL HEALTH '" SAFETY/
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