HomeMy WebLinkAboutBuilding Permit 93-0378
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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1. White
2. Pink
3. Yellow
File
City
Applicant
CITY OF PRIOR LAKE
... BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT .il3 "'2 7
Permit No. -..;) 6
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 for
the above entioned property and that all construetion will conform to all existing state and local laws and wlli proceed in aocordance with submitted plans. I am aware that the
building cial can revoke tho . for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 0/'/93
Signature LicenSe No. ' . Date
Amount Brought Forward ...... .. .......... $ fa ~ 2. ~ ~t1
Park Support Fee ........................... $
SAC ......................................... $
Colieclive Street Fee ....................... $
SewerTap ................................... $
Ucense Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Cl Sewer & Water Connection Fee ........... $
Cl Water Tower Fee ........................... $
Water Tap ................ ............. ...... $
Other ......................................... $
Other ......................................... $
Total Due .............................. $
Paid
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3 S '10
1. DATE
/ If /73
LciI~ fh AJ s-S-J 7,;}.-
LOT
/0
.3
PI,D =i~ / /LJ-fJdx'J.. -e)
ADDITION
4. OWNER (Name)
It:. ~ ~j ~ r. Xhnj'-l1
5. ARCHITECT (Name)
(Tel. No.)
f. ''l. 'I ')- s--~-9J
(Tel. No.)
(Address)
. -'. ()
(Address)
6. BUILDER
S>/-I
(Name)
(Address) (Tel. No.)
Y~7-S--r9S
Septic Cl Heating Cl Plumbing Cl Reroofing Cl Porch Cl
Addition ~ Finish Attic Cl Resldingf Finish Basement Cl
Fireplace Cl
AIIerations Cl
7. TYPE OF WORK
New Construction Cl
Chimney Cl Mise,
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Side
Front
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET +
USE OF BUILDING ^~~...: Ls
TYPE OF CONSTRUCTION: I 11 III IV (iJ
Occupancy Group A BEl H ~ M
Division 1 2lf)4
Permit Fee ................................... $
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION .,
City:
Plan Checking Fee ..... .................... $
State Surcharge ............................. $
s~z. CO
Z4~ 30
Z,Z.So
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $ to !; z. 80
Check If
Deferred
mes Your Bu' ding Permit When Approved.
Date ..ll:1- q3
BUILDING INFORMAnON
11. SIZE OF STRUCTURE
(Height) (WI. ,,~) (Depth)
:.JI"7 lIP ;
12. NO. OF :rRIES
13. TYPE OF CONSTRUCTION
,-
01'01 (-". dfH
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
</S- (! lllJ
17. COMPLETION DATE
1-43/ 93
MATERIAL FILED WITH APPUCATION
SOIL TESTS Cl ENERGY DATA Cl
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS s'SETS Z.
SURVEY
Cl COPIES
PLOT PLAN Cl
~ B ~
This is to certify that the request in the above application and accompanying documents Is In accordance with the City Zoning Ordinance and may proceed as req ed. This document when
signed By the CiIy Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued,
Issued
City Planner
Date
Special Conditions ~ any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a,m,
/~ "'; ~'-I ,....,
. , / (
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~_dc '9~ ~~ ~-
// -)-93
APPLICATION RECEIVED
The City of Prior Lake ENGINEERING Department has reviewed the
building permit a~lication for construction activity located at
-)s;z)V ~~-<1~Jt'~..~
Comments:
t/ JZlied
by: .. 1f'&f1
!llJh(/
Accepted
with Corrections
Date / ~/v
Accepted
Reviewed
"The issuance or granting of a permit or approval of plans,
specifications and computations 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 presuming 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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, ,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.../) ~.'
NAME OF APPLICANT 7 11 ,4. h k .~
APPLICATION RECEIVED - // - 'j-- -93
The City of Prior Lake BUILDING Department has reviewed the
building permit~lication for con~truction activity located at
,qSJD ~~ (]~
--
Accepted Denied~ ~ Accepted With Corrections
Reviewed by:~fh _ ~ Date \1-'1-<13
Comments (l) ~o...<;.() n.ot-e ~ f ((J..,~ v.e.u" .f'AJ.. )
Co \lVu1'" t'V' ts
/
liThe issuance or granting of a permit or approval of plans,
specifications and computations 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 presuming 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
PLUMBING PERMIT
rJ 14-;~G. -~ rt-l
t.
...;>, - ...I '
File
City
Applicant:
Address:
Signature:
Legal Description: Lot Block
Site Address: J oS '-I 0 ~. 6 (I 55 c.v c .:.,.j C v'
Building Permit # CJ.3 ~ .=) '7 f PID #
NOTE: This permit will not be processed without complete information.
Sub:
FIXTURE UNITS
Unit
Quantity Type of Fixture Amount Total
I Bath Tub with or without shower $ 6.00
Dishwasher $ 6.00
Floor Drain $ 6.00
I Lavatory (bathroom sink) $ 6.00
Laundry Tray (1 or 2 compartment sink) $ 6.00
Shower Stall $ 6.00
Sinks: $ 6.00
Bar Sink $ 6.00
Water Closet (toilet) $ 6.00
Rough-ins $ 6.00
Water Heater $ 6.00
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6.00
Sewage Ejector $ 6.00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10.00
Lawn Sprinkler $25.00
Other $ 6.00 , ..
Minimum Fee ." $25.00 ....//
(
'-
SURCHARGE
.50
GRAND TOTAL $ c:{ ~, '5(;
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments the of.
f..~~Q.7Jq . NO..... . ATE
T 'ITEST
Call for all ins tions 24 hours in advance.
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
'4 ~~)_ ~~~ ~-h-;1/
The City of Prior Lake PLANNING Department has reviewed the
bUildin~permit~Plication for construction activity located at
-3:) Ljo lia-ALdA-~ ~1
Accepted
)(
Denied
tluJ6
Accepted
with Corrections
Date liZ/tis
I
~ ch~~ttA~
Reviewed by:
Comments:
~ -UAA- ff/15 ~~
"The issuance or granting of a permit or approval of plans,
specifications and computations 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 presuming to give authority to violate or
cancel the provisions of this code or other ordinances of the
jurisdiction shall not be valid."