HomeMy WebLinkAboutBldg Permit 04-0819
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CEn IIFICATE OF ZONING COMPLIANCE
;'f~D UTILITY CONNECTION PERMIT
D1REcnONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE Flu.ED IN 7/':Ar'\ 10 / I
BEFORE PERMIT IS ISSUED (Plea8e PrInt or Type end sign at L . . ,.' " UU '-t
2. SITE ADDRESS ?J?J~4 kent St~.eet Sw
3. LEGAL DESCRIPTION
LOT
ADDITION
4.~~
5. ARCHITECT
BLOCK
P1D ZS. 103. 009. 0
~e~^
I(~~
a ~1re;) j.GVI L -4-<=,' fel. No.) (dj 7'j
n~r rw:s.Y.U o~W VJo2-t.jl/O'
(Addrees) (Tel. No.)
1. White
2 Pink
3. Yellow
FOe
City
Applicant
Permit No.
01-.08/9
BUILDING INFORIIAllON
11. SIZE OF STRUCTURE
~ (WIdIh)
(OepIh)
12. NO. OF STORIES 2-
13. ~ 9'f.. CONSTRUCTION
(OOT\ V\U\
14. FLOOR AREA-AeIitlRTlONMENT USE
~ (Name) K (Addrees) (Tel. No.) <<5/~2JSt-cfi~1
7.TYPEOF~ (?)Ja~o ~ H~~4 ~~~ ~~":{, Porch 0
New Construction 0 Alterations 0 Addition 0 Rnlsh Attic 0 Residing 0 Rnlsh Baa " , ,0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft WkIIh Depth Yes No
I hereby cerIIfy that I have furnished in". ,.,.,. ,'1lIl on 1ti8 ap,. . ~"".' Which Is 10 1he best of my knowledge true end o.....l I eIso cerIIfy that I am 1he owner or authorized agent for
the above mentioned p ".: ..... that aI o. "" JCtIon wi! .. '. 10 el8lCIsIIng sJate and IocaIIaw8 and wi. p. 0' ,J In accordance with submitted plans. I am aware that the
~bJ.~~ ~;. ,: . ..1 hereby agree that lhe city oIftd8J or a l;;t' 70 enter upon \he property to ~~1O '10::, ..
~' "'U'~ - lIcerweNo. D8I8
Amount Brought FOlWIII'CI .................. $
Park Support Fee ........................... $
SAC .......... ........ ....................... $
Collective Street Fee ....................... $
SewerTap ................................... $
Llcense Check Fee ......................... $
Preesure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Check If 0 Sewer & Water C, ,.1,.Fee ........... $
Deferred 0 Water Tower Fee ........................... $
Water Tap ................................... $
Other ..... ..................... ............... $
Other ......................................... $
Total Due .............................. $ ~". II II
.... '7(,.0" _~
Date 8.3.04- By
This is to certify that ths reqU88lln ths above appllcallon and 8. . . .", '''Vlg documenIs Is In 8CCOIllance will ths CIy ZoIWlg Ordinance and may proceed requested. ThIs document when
Ilgned Byths CIty PlaI'lnerCOllllftule88" ". ", .!CartlllcateofZonlng com,." ., and aIowsconstJUctlonto... ,1lC8. Befont occupancy, a c, :',: Ie ofOccupency must be issued.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
5kle
B8ck
5kle
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING /t:6f 11'/tr._
OFF ., I ncET PARKING
SPACES REa.
SPACES ON PlAN
PERMIT VALUATION
~/5()O.OO
TYPE OF CONSTRUcnON: I II IJIIV V
CIty:
Occupancy Group A BEl H R M
DIvilIlon 1 2 3 4
Permit Fee ................................... $
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty .. ............ ......................... $
Septic System ............................... $
Other .. .................. ............. ........ $
Subtotal ............................... $
This Apllcation Becomes Your Building Permit When Approved.
By
Date
Certificate of Occupancy
Issued
City Planner
08Ie SpeclaJ ConcItiOl1l W III1Y
24 Hour nolice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
18. ESTIMATED VALUE
57QO'ro
17. CdMPleTlON DATE
MATERIAL FILED WITH APPUCATlON
SOIL TESTS 0 ENERGY DATA (]
PIUNG LOGS 0 PERCOLATION TESTS (]
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J.x.3~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
/? /J
./~/OO ~
SCHEDULED
~5-
nME
; ...
~ ~~;.
CONTR.
PERMIT NO.
CJr- g'/7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
./'? ;11" /
(O~~/6' r~
"
- /' ~/
/ft J' e r;- / e-.
~RK SATISFACTORY, PROCEED
~ ~~RRECT ACTION AND PROCEED
o CORRECT~ REINSPECnON BEFORE COVERING
Inspector: Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
_T1