HomeMy WebLinkAboutBuilding Permit 90-0232
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White - City
2. Yellow - ASsessor
3. Pink - Applicant
Permit No.
07 ,-? ....
r~ - ~I --:.. ci-..
1. DATE
DIR
SPA M ED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom
2. SITE ADDRESS
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
3. LEGAL DESCRIPTION
LOT
ADDITION
1/10
13. TYPE OF CONSTRUCTION
5. AR
;!ame~~<-/.. (Addre2/~
(Name) I \ (Address)
. (Tel. No.)
7-.1]6 "..
(Tel. No.)
14. FLOOR AREA APPORTIONMENT
USE
4.
6. BUILDER
(Name)
I'
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR
SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
7. TYPE OF WORK
New Construction~
Finish Basement 0
Fireplace 0 Septic 0 Heating 0 Plumbing 0 Reroofing 0
AlterationsD AdditionD Finish AtticD ResidingD
PorchD GarageD ChimneyD Misc.
9. PROPERTY DIMENSIONS 10. CULVERT SIZE
17. COMPLETION DATE
----
Width
Depth
Yes
No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I aiso certify that I am the owner or authorized 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 offi 'al can revoke this per' just caus . Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspec.
tions.
q~l--V- 10
Date
FOR ADMINISTRATIVE USE
Front
Back
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA $-
Side
PILING LOGS D PERCOLATION
TEST D
PLANS & SPECS fB- SETS
SURVEY !2t COPIES d--
SETBACKS: Required
Actual
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING~~ :~ ;....(:
PLOT PLAN 0
Amount Brought Forward. . . . . . . . . . . .. $ /. --:.. y:'
Park Oed. . . . . . . . . . . . . . . . . . . . . . . . . . . .. $ ;:)..., ,:-) -v"
Sac. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., $ G" '" c.... - '='~
Plumbing . . . . . . . . . . . . . . . . . . . . . . . . . . .. $
Sewer Tap. . .. . . . . .. . .. . . . . .. . .. . .. .. $
Sewer Hook-up....................... $ <,':: _~
Water Hook-up. . . . . . . . . . . . . . . . . . . . . .. $
Meter Horn. . . . . . . . . . . . . . . . . . . . . . . . . .. $
Water Meter. . . . . . . . . . . . . . . . . . . . . . . . .. $
Check if ~ewer & Water Connection Fee. . . . . .. $
Deferred -f"Water Tower Fee. . . . . . . . . . . . . . . . . . . .. $
Water Tap. . . . . . . . . . . . . . . . . . . . . . . . . . .. $
City Fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Other ................................ $
T'YlID /Cj/'~7'~
~I 0'105 ~ .. ~'~~~i'~t" ~~'.' i'5Q02 -~
)(} L
Date -1/4 C/D By 81/)11(L,
a r~est In the above application and accompanying documf'nts Is In accordance with the City Zoning Ordinance and may proceed es requested. This dOcu,
the f~~ ranner constltues a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Cerlllflcate of Occupancy
Vi y- '" 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 7 }:\20/ C;.
~<?
TYPE OF CONSTRUCTION; I II III IV.Y..-
Occupancy Group A BEl ~FrM
Division 1 ~ c-c
Permit Fee. . . . . . . . . . . . . . . . . . . . . . . . . .. $~ c~ '(', . O~
. ~. 9;:' ..--,
Plan Checking Fee. . . . . . . . . . . . . . . . . . . . $ -...:.- -. -- c"',
State Surcharge.. . .. .. . .. . .. . .. .. . ... $ L/ 6 - (, .:;:
Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $
Septic System. . . . . . . . . . . . . . . . . . . . . . . . $
Other '~~~'t~'t~'I'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'. : / (::-,L,' C? _ X'-C
City:
9'0....,,..,.
This Applic~9fi7Becomes Your Building Permit When
Approved .'J>'; _ " "'_,
By x:--/:: ~...<:.... Date 't. ~.. / - (. ''"'\
~ ----- -<
Certificate of Occupancy
Issued
This Is
ment
must
Special Conditions if any
24 Hour notice for all inspections
447-42309:00 a.m. . 10:00 a.m,
J
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT NO. fb - 3 7
NOTE: Sewer and Water
contractors must
be registered
with the city.
ADDRESS:
SIGNATURE:
~+
PHONE : (,/(/ 7 . ~ 5-) 7
DATE: y/ c)~- '7 ~
BLDG. PERMIT # 0,~__ d~;L
PIDtP- c,-" () 7 ~i ot/ (- D
APPLICANT:
FILL IN THE BLANKS
1. Estimated length of water service
<60
feet.
inch(es) .
4.
5.
Location of any couplings from structure
Type of sewer pipe. ABS PVC'/ Cast Iron
Ejd
feet.
Estimated length of sewer line
feet.
6. Clean out (if required), located at feet from
structure.
This ~.'~~,c_ation becomes your permit when app:ov~~ ~
BY ~. DATE: ')(-0 7- ?~
/" \.......
----------------------------------------------------------------
----------------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID 7- if - ,YrJ
RECEIPT # I 5- 9 (J;J-.-
v
~ /~' ~
AMOUNT PAID c--::J :'::> - __
e." (".'
REC'O BY 4/1/ ---....
;!"'--'~"
t
y
"
\
/1'1' ! I"
l'~
, (/~. .'-10
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 Fax (612) 447-4245
v"
CITY OF PRIOR LAKE
PLUMBING PERMIT
?o - r7
No.
Applicant:
Address: r::
/J/~
. " J
...-l,..-.,j ...;
.4 (< "
Phone:
Signature:
Legal descriptio
Sub:
Address: IS i J.' S~
,---.
Lot
Block
49' - c::? -7,f' - 6()/- C)
}:?; rf,; c- I*""vl-
/
Building Permit#
C; U - _~ ~ 3 .~
NOTE: This permit will not be processed without complete information,
FIXTURE UNITS
Quantity Type of Fixture Umt
Amount Total
I Bath Tub with or without Shower $4.00 LJ. ()O
I Dishwasher $4,00 J..j.O{)
I Floor Drain $4,00 )..1, 0 2>
.~ Lavatory (bathroom sink) $4.00 )(, DC>
\ Laundry Tray (1 or 2 compartment sink) $4,00 ).j,OO
Shower Stall ,
\ $4,00 jJ,OO
SINKS:
Combination Sink and Tray
I with or without disposal $4,00 4, 00
Bar Sink $4,00
, Water Closet (toilet) $4.00 f-. 0 C)
3 Rough-ins $4.00 J~.OO
I Water Heater $4.00 ,J../. 00
Water Softner $4,00
Stand Pipe (washing mach) $4.00
Sewage Ejector $4.00
Other $4.00
Lawn Sprinkler $20.00
TOTAL 5'- ()o
SURCHARGE .50
GRAND TOT ALst, s-V
,~
This permit,l}..granted upon the express conditions that said contractor, shall comply in all
respects with the ordinances of the state Plumbing Code and the amendments there of.
/c:J ~ /- YO
xi
Date
Attest
Call for all inspection 24 hours in advance.
(612) 447-4230 . 4629 Dakota Street S.E. . Prior Lake. Minnesota 55372