HomeMy WebLinkAboutBuilding Permit 01-0493
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~~
DATE RECEIVED
5--tZ'O/
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
2, SITE ADDRESS
14 ';2,4(" tloV(" C+
3. LEGAL DESCRIPTION
(17
ADDITION /:('n hh
14. OWNER (Name)
/V\i4 -t ,,~
5, ARCHITECT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
OI-044~
.
1. DATE
'f-ICJ-O/
it
BUILDING INFORMATION
", SIZE OF STRUCTURE
(Hei!j,tll) (Wldlh) (Depth)
12. NO. OF STORIES
LOT
BLOCK
J-611
I
~M-7
PID .z."'-.%8~ ocx;,~o
Add.i.rlCY7
13, TYPE OF CONSTRUCTION
. "'t)cz..c..l wI St~..:rl
14, FLOOR AREA APPORTIONMENT USE
KJrvJ<-
(Address)
<,."'....1. II'" ll.p..u""
(Address)
(Name)
6. BUILDER
(Name)
(Address)
LL Q. b '-<<'.> "2..2> ') t" stt::
"0 me) L..o-\o-A.J.\\t. w<'V\
Deck~
Finish Allie n
(Tel. No.)
to"Il-O)"'I?>
(Tel. No.)
(Tel. No.)
1S'2. "ILI.aU'l..
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
JlW~
7, TYPE OF WORK
New Constrvcllon CJ
Fireplace 0
Alteralions 0
Septic 0
Addition [J
Re-roofing 0 Porch 0
Ae-sldlng n Finish Basement n
16, PROJECT COSTNALUE
'-tWO"'''
17, COMPLETION DATE
SEATS
ChImney a Misc. ________.~__._.
/8. PROPERTY AREA OR ACRES , /9, PROPERTY DIMENSIONS /10. CULVERT SIZE
Sq, Ft. ?J).?,?, ~ 'S'-~ ' Wldlh Deplh Yes No
hereby certify thai I have IUrnisl\ed in/ormation on this appllcalion which Is 101M besl of my knowledge true and correct. I also certify thai I am lhe owner or authorized agent for
e.bove men!foned property and that all construction will conform 10 all existing state and local laws and will proceed in accordance with submItted plans. I arn aware that the
I 'ng official can re'fke th~rmll for just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property 10 perform needed Inspections.
X ~\~"""'"\ "'"201\2.')0, :st....1,,/01
\ Signatura, License No. Date
"'-,J
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
WalerTowerFee ........................... $
WalerTap ..................................1 $
Builder's Deposil ............................ $
Other ......................................... $
PakJ TOlZ"j.~ii.h.....~~:~;~;~o$-fqi fif-
Date S-d-c;-oJ By M/
This is 10 certl!y that the request in the above aR)lication and accompanying documents is In accordance wiltllhe City Zoning Ordinance and ~ay proceed a~ested. This document when
signed by the City Pl8nner constitutes a temporary Certificate of Zoning compliance and aNows construclion 10 commence. Belore OCcupancy. a Certificate o~ncy must be issued.
Fronl
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
k!Es..IJ / R
/
TYPE OF CDNSmUCTlDN: I II III IV V
OccupancyGroup A B.E F HIM R S U
\.~.cm 1 234
Permll Fee .....~.~......,....... $..!:L.~~ .,.",.,
"". ~'", -Ie .......\:::.;-............... $ q??<,
~Slllll ~"-barge ........~~........... $ (,,1.2l
.......,~,.......$.~,~$ 2.00
City:
. Plumbing Permit Fee ....................... $
Mechanical Permll Fee ..................... of,
Sewer & WaterPermft ...................... $
~
6'';
tas OpIa
T A II
C ificale
................ $
Building Permit ~l;1{l, Approved. /
Dale !>-(.,e.-"?srJ
Issued
City Planner
Date
24 hour nolice for.1 inspections 447-9850
Special Conditions II' any
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS Cl ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY Cl COPIES
PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ........................................' $
Collective Slreet Fee .... ......... ,... ...... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
MeIer Horn ................ ............ ....... $
WalerMeler ...............................,. $
Sewer & Water Connection Fee ........... $
..
"
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ~ C-/-,
TYPE OF WORK .Jd;;r: L
USE OF BUILDING Sf-I"/
PERMIT NO. OI-c443 DATE ISSUED )-2'2-~
BUILDER JUrtO~_. ,5-, ~G;2- c/t,1-32R-
NOTE: THIS IS(/NOT A PERMitfOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I ~ECTOR I t, I Y' I~TE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S'IGNED
I~ I I
I FINAL
flAt'
~- f(:-Q1I1
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTiON NOTICE
SCHEDULED
DATE TIllE
:? -,t; 'C.)l/
ADDRESS
/1...11.4(. ~ Ctl1rr-r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION f/
p- FINAL ()#/L-
o SITE INSPECTION
o PLUMIIING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
--"'~.~---"".
/ ,
I /jf,-
~( ,.)')C
------
f_qq:J
,
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-........
~
,Lf 0., '\ ;.,
)
.-/
-~-'-'-
fiI WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: it ~
Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/