HomeMy WebLinkAboutBuilding Permit 92-0048
DATE TIME
CITY OF PRIOR LAKE
INSPECTION ~TICE (J.
PERMIT NO. 1:;; - t ~
CALLED-IN
SCHEDULED l ;) ~??7- 3 :00
COMPLETED
ADDRESS Lj) U 0 G f a.. l'~ UJOd~
OWNER
~ TELEPHONE NO.
LlI 0 FOOTING
l.L. 0 FRAMING
~ OINSULATI
COW
~ NAL
<( 0 FOUNDATION
:x: 0 DE MOL.
~ 0 FIRE PREVo
~
~ COMMENTS:
.....
~
o
CI)
~
ex:
:::>
~
ex:
o
l.L.
LlI
ex:
<(
~
~
~
9: ______.
~ ~CTORY'PROCEED
C 0 CORRECT WORK AND PROCEED
o 0 CORRECT WORK. CAL R REINSPECTION BEFORE COVERING
U 0 CORRECT UNSAF ONDI ION WITHIN HOURS. INSPECTOR WILL RETURN.
o STOP ORDER P TED. CA INSPECTO.
o INSPECTION aUIRED. LL TO AR GE ACCESS.
CONTR.
DPLUMBING RI
o MECHANICAL
o WATER HOOKUP
o METER SETfTURN ON
o SEWER HOOKUP
o SEPTIC INSTALL.
o SEPTIC MAl NT.
o PLUMBING FINAL
DSITE INSPECTION
o EXCAV.lGRADINGIFILLlNG
o LAKESHORE/WETLANDS
o COMPLAINT
o FOLLOW-UP
o SEPTIC FINAL
o FIREPLACE
o
o PHOTO TAKEN
Owner/Cont . 0
Inspector
447-4230
ytJllow CopylSite Norice
White Copy/lnsp<<tor'. File
OF PRIOR LAKE
UILDING PERMIT,
IFICATE OF ZONING COMPLIANCE
TY CONNECTION PERMIT Permit No. q:1-4 'X
I. While - City
2. Yellow - Assessor
3. Pink - Applicant
E
/I /q 2-.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
2..
6~~- 0.-/, /{/,C-
3. LEGAL DESCRIPTION
LOT BLOCK
ADDmO/O . (ofi...2... -~&Il-!l'0J~'".P
pm;) ~-- ('-.."7. (') - () M - .1.
4. OWNER. (Name)
~5~ 17 } 7 e I dJ) 'or J I
5. ARCHITECT (Name)
(Address) . ~
/UL~ e 5 a f1:U
(Address)
(Tel. No.)
LjVf,.J70
(Tel. No.)
13. TYPE OF CONSTRUCTION
woo./ rrn.dl So!.
14. FLOOR AREA APPORTIONMENT
USE
Width
Depth
Yes
No
15. NUMBER OF OCCUPANTS OR
SEATS
OCCUPANTS
SEATS
16. ES)JM}TED VALUE
'2S ~ CJ--O. ()-()
17. COMPLETION DATE
I - It'vlll - t:t ":J-
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK FlreplaceO SeptlcO HeatingO PlumbingO ReroofingO PorchO
New Construction 0 Alterations a--Addltion 0 Finish Attic 0 Residing 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
S . Ft.
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
I hereby certify that 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
tor the aboye mentioned property and thai 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 olllcial can revoke this permit fo t cau Furthermore. I hereby agree that the city olllclal or a designee may enter upon the property to perform needed inspec.
1Ions 7 ("" ~ / I.
I ?
X -, ~~L.~ MM-I R-'1;:L
Oate
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA ~
PILING LOGS 0 PERCOLATION
TEST 0
PLANS & SPECS ~ SETS
SURVEY 0 COPIES ;L
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET ~
USE OF BUILDING (' I y..c~ 1-:: iJ;r;;:" ~ L,
.:....... ';, ,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
~ -1 (')0
PLOT PLAN
Amount Brought Forward. . . . . . . . . . . .. s /(~. '7..:;'~
Park Oed. . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sac.................................. S
Plumbing .. . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sewer Tap . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sewer Hook-up. . . . . . . . . . . . . . . . . . . . . .. S
Water Hook-up. . . . . . . . . . . . . . . . . . . . . .. S
Meter Horn. . . . . . . . . . . . . . . . . . . . . . . . . .. S
Water Meter. . . . . . . . . . . . . . . . . . . . . . . . .. S
o Sewer & Water Connection Fee. . . . . .. S
OWater Tower Fee. ... . .. . .. ..... .... .. S
Water Tap. . . . . . . . . . . . . . . . . . . . . . . . . . . . S
City Fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Total Due. . . . . . .. . . . . . . . . . . . . .. s 1(. '7.. !::..-:t::
Paid /. Recel t If t.h /)
Date 0 'J.1/P 1,
TYPE OF CONSTRUCTION; IIIIIIIV ~
Occupancy Group A BEl Ht1tt.1
Division 1(?) (:J C
Permit Fee. . . . . . . . . . . . . . . . . . . . . . . . . .. s 74, " () C:J
Plan Checking Fee. . . . . . . . . . .. . . .. . . . . S c..'.Jy~ ..:.~ ~
State Surcharge. . . . . . . . . . . . . . . . . . . .. S .' .;:) C)
Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $
Septic System. . . . . . . . . . . . . . . . . . . . . . . . S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Subtotal. . . . . . . . . . . . . . . . . . . . . . . s 10> t Z ..s..~
City:
Becomes Your Building Permit When
Check if
Deferred
~ d6 ('::)
Date - ~ - 7 .::L
Certificate of Occupancy
Issued
This 1st
ment
must
rust In the above application and accompanying docum",nta lain accordance with the City Zoning Ordlnanca and may procMd a
the It Planner conetltuea a temporary Certificate 01 Zoning compliance and allows construction to commence. Belore occupancy. a
Special Conditions if any
24 Hour notice for all inspections 447-4230 9:00 S.m. . 10:00 a.m.
II BPAPCK"
BUILDING PERMIT APPLICATION CHECKLIST
NAME OF APPLICANT 44/~~L/U'~4~
APPLICATION RECEIVED ~ -/ r- ? ~
ENGINEERING
Approved
Reviewed by:
~enied
Approved with Corrections
Date:
Comments:
. ..'~.,
~
'"
PIANNING
Approved
v~
Denied
#-4
Approved With Corrections
L""7 J-L ,
Date: _5 r - 3y 2-.
Reviewed by:
Zoning:
Comments:
BUILDING
Approved
Approved with Corrections +
-" C'7" ,
Date: '----..,- 26, rf::::::.
~D ." ied
Reviewed by: _
.
Square Foot~:
)
----
Comments : ~~ -
'-kt:.>dRc.'c~
,Ocr>.. _
PERMIT ISSUED
4629 Dakota St. SE.. Prior Lake, Minnesota 55372 I Ph. (612) 447-4230 I Fax (612) 447-4245