HomeMy WebLinkAboutBldg Permit 00-0396
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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
M~Y I 5 2rol
Permit No.
OO.039h
,
DIRECTIONS
SPACES NUMBI ,RED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDREsr
5"411 ~':;;Jt>l"""-A ST.
3. LEGAL OEseR PTION
LOT / I) BLOCK
( \A...r-f'11 r.tJd
1. DATE
5-/'5;- 0rJ
BUILDING INFORMATION
"-
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
S.t::.
(Name)
~Oi?RiL'-
(Name)
~'S
12; ('t~ '
(AQreSS)
~~
12. NO. OF STORIES
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
~D ~-t\r~ -()35-()
(Address)
(Tef. No.)
447-7<1"5. q
(Tel. No.)
13. TYP~ONSTRUCTION
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14. FLOOR AREA APPORTIONMENT USE
Foo;-e.
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
\'
"
OCCUPANTS
, ,
7. TYPE OF WOR (
New Construction "'J
Fireplace 0
Alterations 0
Septic 0
Addition 0
DeCk)(.
Finish Attic 0
Ae-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
18. PROPERTY AF EA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify tt !t 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 .( ned 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
building IC' n,. e ~;mit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ;{....Lj..r>i'f;- S -I 5:- o-c
, Signature License No. o.te
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Ree Jired
~ ctual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
IJ
USE OF BUILDIN l ~ @ .h ~
TYPE OF CONS' "AUCTION: I II III IV <<JJ
Occupancy GroulI A B E F HIM iii s U
Permit Fee ...... ...~~~~i~~..~...~..~.~... $ 3 L/, 75
2-2.5?
,~()
SPACES REQ.
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPAI :TMENT VALUATION
OFF STREET PARKING
PERMIT VALUATION
;r / OO(J . tJ()
SURVEY
PLOT PLAN
o COPIES
IJ
SPACES ON PLAN
City:
Amount Brought Forward .................. $
Park Support Fee ........ ................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................ $
State Surcharge ............................ $
Penalty .......... ............................ $
Pressure Reducer .......................... $
Plumbing Permit =ee ....................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... If:
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ _"57. f44-
Paid 67. 841-- Recei~3746 S"'
- ~~ .
Date S/c...q.lh By
This is to certify th It the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceedjs requested. This document when
sig~ bi' theF~ Planner constitutes a temporary Certificate of Zoning compliance and allows c~slruction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~~du-~.-. <;-2-+UO r/\,P~ 14W",^",~.~~<Ul 6\.u.11ev_~
-' City Planner Dale SpecJS.ICondllionsdany ~~ - ~_.
24 hour notice for all inspections 447-9850
~
Mechanical Perrr t Fee ..................... $
Sewer & Water P ~rmit ...................... $
Gas Fireplace Pe mit ....................... $
This ~lication J ,ecoO)eJ Y?ur Building Permit sj'l Aj?pJjOved.
By ..~...... ~.JU.A~ Date P7t/J
Certificate of Oce Jpancy
6b -6 )~~
Thl' Crnln ,f lhr L.kr C-"ounll')'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NA ME OF APPLICANT
V.
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(., (, .~, (' '.'.-
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Ap::>L1CATION RECEIVED
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Thl~ Building, Engineering, and Planning Departments have reviewed the building permit
aplllication for construction activity which is proposed at:
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ACI :epted
Accepted With Corrections
~
De lied
Re liewed By:
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Date:
,i)7-.-L{- ~(90
Co nments:
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f~(~ ~ _/~~~.LM. {:yrf9V' 'to 1~<udJN:.Q t>
"H e issuance or granting of a permit or approval of plans, specifications and
corl,lputations shall not be construed to be a permit for, or an approval of, any violation of
an~ of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pre suming to give authority to violate or cancel the provisions of this code or other
ore inances of the jurisdiction shall not be valid."
ordinances of the jurisdictio~ shall not be valid."
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PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 5&L/'1 &~SSAt/'OI2A f?r., 'S:E,
TYPE OF WORK NF w DEc.K- w!F5,..7it::.-N /?eat=""
USE OF BUILDING f!:.E5 A/~
PEI~MIT NO. tJ7) -tJ.S;lf DATE ISSUED 5// ?/dO
BU LDER ~8e:.7eT ~/C ' .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING trf.. I 6:1-. I 5I~/~ 1)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
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Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED, p~ s-'
CaSJ'-9.... d;/C(.. S~
ADDRESS
.s'b ?/9
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
ceJ-J'/6
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
~ MECH FJNAL 0
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Ii'WORK SATISFACTORY, PROCEED
h--cORRECT ACTION AND PROCEED
o CORRECT WOR! CALL FOR INSPECTION BEFORE COVERING
Inspector: ~ ........ Owner/Contr:
--............
~';
// /C":-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
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