HomeMy WebLinkAboutDemo Permit 04-0405
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CITY OF PRIOR LAKE
DEMOLITION PERMIT
1. White
2. Blue
3. Yellow
- File
- City
. Applwl
CITY'S COpy
DIRECTIONS
, DATE 3.d-q-o'/
Permit No. 04-.04-05
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BUILDING'INFORMATlON
7. SIZE OF STRUCTURE
SPACES NUM ~ERED 1 THRU 10 MUST BE FILLED IN
BEFORE PERMIT ISSUED
(Please print 01 type and sign at bottom).
e. NO. OF STORIES
2. SITE ADORE: ;S
FQjr!atuIU ShoreA' Tm,'1
PIDd5"- 93t.. 035"- <::)
9. TYPE OF CONSTRUCTiON
1S-d,30
3. LEGAL DESC RIPTION
5. ARCHITECT Name)
U()~:JS
6. CONTRACl'C R (Name)
(Address)
to. COMPLETiON DATE I <!:l.
Lei t. - :;(,,3 -0 19 ~O
-101.... ~
.j", 1\-1)';w j41,v fa (').. - rfer - D";;J.. 1 )
(iel. No.)
6/~t,S/MtJ/J 95Z. z.9Z-. 773S
[Tel. No.)
~- "t5~-1% -5113:~
[Tel. No.)
LOT BLOCK
ADDITION '5 . ec...;f-/ 0 IV 3 G
{:; (eG.L-tJ..v 'r:: ~et~C ';c,,",
4. OWNER (Na ne)
-20\:0 \/AL'-e'1 Vl6J D\L
(Address)
(Address)
I hereby cer .ify I have furnished information which is to the best of my knowledge true and correct. I also certify that I am the
owner or aul10rized 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 building official can revoke this permit for just cause.
FurthermorE. I)ere~y agree that the city official or a designee may enter upon the property to perform needed inspections.
X (;?77~ .. . l.{/~olc><(
o Signature Date
FOR ADMINISTRATIVE USE
METRO SAC IINIT DETERMINATION
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MATERIAL FILED WITH APPUCA TION r--.
o Site Restoration Plan
o Utility Abandonment Plan
o Sewer Abandonment
USE OF B~~
. )/f-.~,
SITE RESTORATION PLAN
Accepted by if;.. <k ~~
a Water Abandonment
Rejected by
o Electrical Abandonment
i Other
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Division
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2
IV <]) S
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CREDITS
Park Oed. Credit ................................................ $
SAC Credit ............................................._........... $
Sewer & Water Connec. Fee Credit .................. $
Water Tower Fee Credit .....................................$
Other .................................................................. $
TOTAL CREDITS ........................ $
TYPE OF COIISTRUCTION:
II
III
Occupancy GI ::>up A
... E
This applicatic n becomes your
demolition pal mit when approv.ed
By7JP'A:~ ~
Date ..5///0'1
, . I
Issued by
Date
This is to ce rtlly that the request in the above and accompanying documents is in accordance with the City Zoning Ordinance and
~maY procee ~ as requeste "
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. PIa r ~r
t;;-7 <J1-L
Date
Special Conditions jf any
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CITY'S COpy
c:White - Buil~
Canary -engineering
Pink - Planning
The (enler, f th..I...... Coun',.,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NA ME OF APPLICANT
AP?L1CATION RECEIVED
/.3/?L. 5/ n O~
5. 7. 04-
Th ~ Building, Engineering, and Planning Departments have reviewed the building permit
apl llication for construction activity which is proposed at:
jSZ,30 ':A/tZ.UiwAl G;lfo/285 ~/L-
Ac ~epted
Accepted With Corrections /'
De nied
,..
,..
Reviewed By: ~ - "', ~
Cc mments: t1Lt 'ifc.-t. ~
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Date: 5/7;;- ~
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"-+he issuance or granting of a permit or approval of plans, specifications and
cJmputations shall not be construed to be a permit for, or an approval of, any violation of
a,y of the provisions of this code or of any other ordinance of the jurisdiction. Permits
p 'esuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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CITY'S COpy
White - Building
Can::lIIY - Fnaineering
C"'Tnk :. Plann,"~
TIw(-..nlrr ,flh..I,.k..('ounl~'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
N.AME OF APPLICANT
APPLICATION RECEIVED
1.- // /
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Th 3 Building, Engineering, and Planning Departments have reviewed the building permit
apl llication for construction activity which is proposed at:
/
, '. ,r; ~;:' '.-
"
,
/,{ ,/~.,.' L-
Ac :epted
/"
Accepted With Corrections
,
De nied
Re viewed By:
~K-
Date:
5/7~if
Cc mments:
"The issuance or granting of a permit or approval of plans, specifications and
co l1putations 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
pn ~suming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
ADDRESS
15Z3() F/-1/IZUJti/iJ S?fOl1-b~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
04-- () 4-05'"
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
o EJfVJ () L I n 0 1--1
----...
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~\/yORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEEO
o CORRECT WORK, CAL R REINSPECTION BEFORE COVERING
Inspector.
OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY!
uaNO"
CITY~S COpy
- -'."4,.J- --
Th 5 drawing is neither a legally recorded map nor a II
SUI vey and is not intended to be used as one. This I ~
dri wing is a compilation of records, information, and :
da~a located in various city, county, and state offices, ;
an~ other sources affecting the area shown, and is to I?e
us,d for reference purposes only_ Scott County is notl!
re$ponsible for any inaccuracies herein contained. If I~
di~ crepeancies are found, please contact the Scott I'i,'
Co Jnty Surveyors Office.
"
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May 7, 2004
file:l/C:\J lOCUME-l \Lynda\LOCALS-l \Temp\l);DKJOB.htm
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5/7/2004
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