HomeMy WebLinkAboutBuilding Permit 94-0090
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H CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETYl
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CITY OF PRIOR LAKE
BUILDING PERMIT,
PORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT . ~/.:' ). _ c ;-..
Permit No ~ \~ ( I.......)
D
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITI; ADDRI;SS
/ (/J ~l
t..1V
&-
1 I to t.tj
5l-V
~~GAL orPTION
ADDITION A- J \ . \ 1 ~
.~e)
"
(Name)
1. White
2. Pink
3. Yellow
File
City
Applicant
1. DATE
r/- Iv - f
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
:""llo. ...",
BLOCK
cd--
PID,;X;;;'- .:;;I47!, 6' , - 0.
13. TYPE OF CONSTRUCTION
(Address)
":><111 (,V I
(Address)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
IV hlZ . 4<.(D~t.,SY()
(Tel. No.)
6. BUILDER (Name)
0A-VI1 ~
(Address)
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
AdditiO~
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTI~j-TED VALUE
'I. 000 QS!.
17. COMPLETION DATE
Reroofing 0 Porch 0
Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
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 also certify that I am the owner or authorized agent for
the a ntioned 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
bu' Ing offici I can re cause. Fu reo I hereby agree that the city official or a designee may enter upon the property to perform ne ed ins ions.
...y' L
l
'l2
Ucense No.
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING W~ J ~.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II IIIIV(b
Occupancy Group A BEl ~
DivlSion~
Permit Fee ................................... $
City:
I ~ )? ou
70, z-~
4.08'
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
Check if
Deferred
/Fz.-. z.~
By
Certificate of Occupancy
Issued
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0
PLANS & SPECS 9'-
SURVEY ~
PERCOLATION TESTS 0
SETS
COPIES Z-
~~
~
~
Q
~
.:s;;:"L C>~
PLOT PLAN
o
Amount Brought Forward .................. $ I?fL, z <(
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o Water Tower Fee ........................... $
Date
in the above application and accompanying documents is in accordance w~h the City Zoning Ordinance and ay proceed as requested. This document when
utes a temporary C~rtificate of zon4' compliance and allows construction to commence, Before occupancy. a Certificate of Occupancy must be issued.
-:>"1. C:'
~- 7
Date Special Conditions rt any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT I~u", ~~
APPLICATION RECEIVED 4- c:,. - 9
The City of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
Accepted Accepted with Corrections +-
Reviewed by: Date 4. - z, - '9 ~
, ' ,
Comments: -1 l::)~~ \ ""' ':-..fii-C--+r...;:::.. I ~ ~:...)\~
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L.f-2!~Cj
"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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS JrhfJL ~ v('~
NATURE OF WORK _iIAflL_
USE OF BUILDING V
PERMIT NO. qJ/.-I/~ DATE ISSUED t./IU/flt/
CONTRACTOR Jr:~f _<~~ q, -/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING W. ItbJo/'2-
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING W. 1hJJ/r;ti
INSULATION if
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
GRADING (Prior to Sodding)
BUILDING . gJj IJI1#.r
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-4230