HomeMy WebLinkAboutBuilding Permit 01-0304
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
4-1/-01
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS tSSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
553(0 OVE!eLOOK:. O,ec.GC-
3. LEGAL DESCRIPTION
II
f1Al?DINI1G
/
R/D66
PID 25-335- 0/1-0
5TH /lOON.
13. TYPE OF CONSTRUCTION
LOT
BLOCK
ADDITION
4. OWNER \,: (Name) \ ) (Address)
. ~e., fu ~ 1),(\('("). ~ )('" \-Q.r
5. ARCHITECT (Name) "'-....J (Address)
I. White
2. Pink'
3. Yellow
File
City,,,
~
/'(;:&'~:,}
1. DATE
4 -q -0 I
BU
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
PUD
12. NO. OF STORIES
(Tel. No.)
Sc.N"\.Cl QSL-Y'-\()-3lj37
(Tel. No.)
6. BUILDER'
(Nama)
(Address)
D'-/
Ov.)y) e ("
7. TYPE OF WORK
New Construction LJ
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0 Re-roofing 0 Porch CJ
Finish Attic 0 Re-siding 0 Finish Basemenp(
.3 Jr<! Of) 1-1.':;
SEATS
16. PROJECT COSTNALUE
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Chimney 0 Misc.
8. 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
~U;ld;ng Oft;~~ !h;s Pp(":i7use. Furtheonore, I hereby agree that the c;ty offic;al or a des;gnee may enter upon the property to pertoLi ni~q ;/0;on8.
:;;:J * License No. Creta
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LJ
USE OF BUILDING
RE 6 "o/...e
OFF STREET PARKING PILING LOGS Ll PERCOLATION TESTS Ll
SPACES REO. PLANS & SPECS Ll SETS
SPACES ON PLAN SURVEY Ll COPIES
PERMIT VALUATION .~_,., .l)~ J PLOT PLAN Ll
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
DMsion 1 2 3 4 .-'"'7./1
'/'~. 7-5"
Permit Fee ................................... $
Plan Check Fee ............................. $
City:
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
I_50
4000
~
<<"
Mechanical Permit Fee .................. ... $
Amount Brought Forward .................. It
Park Support Fee ........................... $
SAC ......................................... It
Collective Street Fee .... ................... It
Sewer Tap ................................... It
.
Pressure Reducer .......................... $
Meter Horn ................ ................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... It
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... It
Total Due .............................. $ / / f~. 25
~. 393(, 0
Pa;d /11/.2S:-
Date 4'/3'0 I
.
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certific
Issued
CrtyPlanner
Date
24 hour notice for aU inspections 447-9850
Spec~1 Conditions if any
.
By:(l3
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
Date: 4- -11- 0/
Building Permit # I 6 ~!fD: Z5-.33S - 011- 0 Zoning: POD
Site Address S~~ Cll/-t) ~ ·
Legal: L I I
B
I
Subdivision: {!A1:!.01N'~l- bOGIE: 5TH
Existing StTucture:@r NO
CONFORMS TO ZONING
ORDINAL'l"CE
c~~
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
v
I Is the property located within the flood plain?
Does the alteration include any additional kitchens?
Refer to Planning
v'
Refer to Planning
v'
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
./
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
Refer to Planning
v'
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BU1LDlNG PERl 'lilT FILE TO
i'ilAINTAlN A RECORD OF THE REVlEW.
L:\TENfPLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS $30, .l')lNfL,Jc Cr,
NATURE OF WORK AJt4.J ".i5~.r,~
USE OF BUILDING SF-f)
PERMIT NO. ()(-()304- DATE ISSUED Cf-/z- Z=/
CONTRACTOR .r t I ] -".r ql.lO - 3Cf 3 7
NOTE: THIS IS NOT-~PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I_G
I
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING IA-. ,pJd-l M~
INSULATION ~ c?-f 7ka-J
ELECTRICAL
PLUMBING ~ dl~' 7/6,r
HEATING (if required) J1ff 7 ~a--'
~
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
"
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
h:r
P.11/1 Z-
,
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 st.3H be placed near main entrance.
OCCUpy UNTIL ABOVE
NOTICE
k/;r
f4y 't19fo
HAS BEEN SIGNED
!''h 16 u
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
ADDRESS
,~S30
DATE TIME
SCHEDULED fie;/; z- 1: 00
[)/~ ~.
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
()r-3oL.(
o FOOTING 0 PLUMBING RI
o FOUNDAT~O 0 MECHRI
o FRAMING 0 WATER HOOKUP
o INSULATI N ~J SEWER HOOKUP
'lS"FINAL ~ PLUMBING FINAL
Ir::l SITE INSPECTION ~ MECH FINAL
COMMENTS: L I ,
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNOTJ