HomeMy WebLinkAboutBldg Permit 01-0259
05/17/99 MON 10:55 FAX 6124474245
CITY OF PRIOR LAKE
I4J 001
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
CATF r:lE~
4-4--01
~-
I. While
2. Pink
~ y.llow
Pile
Cily
Aprlle,nl
1. DATE
L..f~'o
Permit No..J) (-0 2f2!/
. DIReCTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLEO IN
BEFORE PERMIT IS ISSUED (Pleaso Print or Type ~nd sign al bOllom)
2. SITE ADDRESS
-~
3. LEGAL DESCRIPTION
C)
SAN!)
~L/\l..l.. "'(Y\d.\ r~_~_ Cl,
LOT,
BUILDING INr:ORMATION
11. SIZE OF STRUCTURE
(Helglll) (WIOlh) (O.pl")
12. NO. OF STORIES
SLOCK
PClliJ
PIC 25-Z14- OQ~:..D
3 Je.O -
13. TYPE OF CONSTRUCTION
n c \
\ I (') .'. "-I r\ '-'n "'_
14. FLOOR ~REA APPOFtt:!9NMENT USE
ADDITION
~. OWNER (Neme)
:an "
XY'L,;\ (\ 0 0 l.......~
5. ARCHITECf.J (Name)
(Address) (Tel. No,) "'-Sd--~-'
~ (-':-oe\~. f...J.. ~:~ \1iL~ ' k\~L\
(Moress) (Tel. No.)
6. BUILDER (Nem~) (Address) (Tel. No.F\,O~5- - 15. NUMBER OF OCCUPANTS OR SEATS
~ . '\..1.-Q.. ~() ~~ 'S CO';>%- OCCUPANTS
Cf\J~ \' c:' 0C).-. ~ 'R... RJ CY'm~ SEATS
7. TYPE OF WORK Fireplace 0 Soptlc 0 Deck 0 Re.r~o~g 0 Porch 0 '..
~:,:~;~.:::o _ "'.~~:~~ ^'."o~__ RoO' ':" 0 R'::"~~_ F1,., '"'.''' n , ~. P\R;'~C~~m
B. PROPI;RTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10, CULVERT SI7.E r-\f;. COMP',ETION DATE
Sq. Fl. . Width Deplh Yes No L-\ l ( t' ( () /.
1110rcby carllly \I181111(1V9 furnished InfonmaUon on Ihis RppllC~lIon which is II) Ihll best or my knowle(lge Irue end corree!. I also certify IhAllam Ihe owrle, or a~ItIOrized agp.n! IN
lne above menlloned propeny and Il1a\ all conslrucllon will conform 10 all exlsllng slale and 10c~llaws and will proceed in eecordanCl! with submlnp.c1 P~1nS. I em ewart) Ihallhe
bulldlnJl\Ol1lfjal Can ~evoke ~s pennlt lor lusl cause. Furthermore, I hereby sgree Ihallhe cily orlic.el or II Clcsi~~a mey enter upon Ihe propeny 10 Perform nee~dllnspecltons
X l /'V-...A U) \. ~u ~ ~r\<::\ ~ 1S: t.-J ';<1 C5 I
-. 5.gnllur. Litnn.. No, . . ~11'
seTBACKS: Requlrod
Aclual
FOR ADMINISTRATIVE USE
Amounll:lrOu9rll Forward .................. $
Park Support Fee ........................... $_.
SAC ............."......."..............,,, $
CollcclIvQ Streel Fee ..... .............."" $
Sewer Tap.... ..................... .......... $
$--
Pressure AeduC0r .......................... S
Meter Horn ...... .............. ............... $
WAler Meter ..""........ .............." ". $
Sewer & W~IOr Connection Fee "."...". $ _."
Weier Tower Fee ......................."" $..
Wl.ller Yap ................................... $
lJllilder's Deposil ............................ $
Olher .................. """ "............." $-." 0
Tolal Due .............................. $ ".0
Paid 7~. DO. 3133~
Oa\e ~ . !:i' () J By
This Is to certify rhallhe requeslln Ihs aboV1l application encl.~ecompanying documents is in accon:lance wlllllhe City Zoning OrdinAnce Md mey proceed . tOOuasled. This docurnen\ when
signed by the Clly Planner constltUles a I9mporery Cerllficate 01 Zoning comp1ancc aJld anows conslrucllon 10 Commence. Belore OCCupancy, e Cer1lIlC~I~ of Occupancy must be IS$IIoo.
Fronl
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STReeT PARKING
SPACES ~EO, __". _._
SPACES ON PLAN ___....._
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II la IV V
Occupaney Group A e. E F HIM R S U
Cily:
DIVI$ion , 2 3 4
Permll FOil ................................... $
14.75
Plan ChOCk Fee ............................. $
Slele Surchergo ............................. $.
1.2.S
Penalty....................................... $_..
" ~ J. ~\
~-'.
. Plumbing Permit Fee ....................... $
MeChanical Permit Fco ..................... $
Sewsr & Weier POrm11 ......... ............. $
:,'n:J:::' ,...~.:~:~~;~~. w,~ ~-';,
By,/!,Jf:Y _ Dele ~ r Y.-l--
CaniricalS or Oceupency
Issued
City PI'Mor
O:Jln
Sloe
MATERIAL FILED WITH APPLICATION
SOIL TESTS CI ENERGY DATA 0
PILING LOGS (j PERCOLATION TESTS 0
PLANS & specs 0
SURVEY r.I
PLOT PLAN 0
SETS
COr"'E;S
Speci~1 ConOlllon~ ,. Any
DATE TIME
CITY OF PRIOR LAKE 177:,;"";;'
INSPECTION NOTICE SCHEDULED ~(
~6sr ac4,tuOoj~7?1
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
;1 ((
ks/de
CONTR.
PERMIT NO.
tJ/- .,257
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 GASLINE AIR TST
o
/7 / /
Co/4-'t ~ I~ r~
./
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F 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 & SAFETY!
INSNOTl