HomeMy WebLinkAboutBuilding Permit 94-0499
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Q J __ -4 QO
Permit No. l -Z.! { (
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
I s: ~-t.:=-
c::- L-, _
..Y\I~
~E-...
3. LEGAL DESCRIPTION
LOT I D ~ '/7- \ \ BLOCK
ADDITION /;;.J_~l'=" .",~~
1. DATE
-4~
PIDc:1~ 117- ()~""8'- ~
4. OWNER
(Name)
(Address)
(Tel. No.)
Septic 0
Addition 0
(Address)
- ~UKf-S..
Address)
o \ lA..-
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
5. ARCHITECT (Name~
~. ,....-b - I~
6~ILDER . (Na~
~ <" ~ - ~~~\
7. TYPE OF WORK Fireplace 0
New constructio~ Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
10. CULVERT SIZE
Yes No
-4.3:.~~
1. White
2. Pink
3. Yellow
File
City
Applicant
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF 3-0RIES
13. TYPE OF C
~~., ~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE ~......
;}.:1 C' 0 ~ ~
~OMPLE ON DATE
~ <- 's. 1-. lS' :s:-
on 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
on will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aw. are~. at the
urthermore, I hereby agree that the city official or a designee may enter upon the property to perf9r7 needed i'J.S!!ecti ns.
I -/~-t
Ucense No. f Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Side
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET e- :s:=::::::.-
USE OF BUILDING ~I,,",:::::" ~ ~ ~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl ~
DMsion 1 ~
Permit Fee................................... $
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION :2
City:
('
'J~-
&-1:~
i=S 4 ~~ o'l
Plan Checking Fee ......................... $
/,07'7, OD
, 7 D0# o:S:
, I 2-, ~
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Check if
Deferred
/W7-~
By
as Your Building Permit When Approved. I
Date 11- (- 0,./.....1.
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA -f1-
PERCOLATION TESTS 0
PILING LOGS 0
PLANS & SPECS 4-
SURVEY
SETS
""'t-
9- COPIES
PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee C~.~.\-............ $
SAC ..........~.~.~..~................ $
/<;11'7, ~s:
Collective Street Fee ....................... $
SewerTap ................................... $
License Check Fee ......................... $
..1-'
Pressure Reducer .......................... $
Meter Hom ................................... $
~
Water Meter .....7;;;.']..,'+.............. $
Sewer & Water Co"nile'Clion Fee ........... $
G~,;f
Water Tower Fee ......................... $
Water Tap .................................., $
Builder's Deposit ............................ $
Other ...................................~.. $
Total Due .... ..J, . 9.f/. f...f2.. .... $
Pai - 'J-t.: Recei t No. .
o
o
:3>~ _ ~~
r:~..b~
L-t:>.", _ ~~
~.~
I r~...M.~
-
24 Hour notice for all inspections 447.42309:00 a.m. .10:00 a.m.
Date I
st in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as uested. This document when
r constitutes a temporary Certificate of Zonin compliance and laI~ construction to commence. Before occupancy, a Certificate of cupancy must be issued.
1- -<-1 .1;.' t,Jt;-J,u&el01Cx.. /.-, ~ L ,., "~-k.cc:... ~("\).
City P1annet Date Special Conditions ~ any
q if - '/1 f
~______ c__ ~
The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
---
NAME OF APPLICANT Jo,^-,^- ~~ - P e\ \ ~
APPLICATION RECEIVED i b -'21-t:t '-1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
&'OCfG
/ 5"'0 ~ S i .
Accepted
Accepted With Corrections ~
-=s .
~.
Denied Id---..
Reviewed By: ~::J::::-.
11. A A 'I t
Comments: ~ _ _ :k:: (..,...JA~ ~w;.~ '''"'^<-
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"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."
The Center of the Like Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.f' "
, ".r
1<", 1 i '"
.-,.. ,
..
, .
_.' .
Accepted
Accepted With Corrections
~.
Denied
~
Date:
fl- ~r 9cf
Reviewed By:
"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,"
f1-'ir9
The Cenle' of Ihe Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
\\ \r:~),.\ ~
NAME OF APPLICANT ----.Jo \.', '^- ScrV'-. - . " € \ C< 'b(_ .
APPLICATION RECEIVED
I () .^-;Y-J - '1 ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(on 1 (p / (;0 fL,. S -/ .
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
~ .kJM t-<iJ2/l.u;, ~ !u.JA-.ar~~~t;
DJ(.d;N\~.JjJIWJ-R~1jf iJ.!11-r.d ~ tM!J.W
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~ b~~1 ~ )JW}ljJ/u;JoiJ~ ~~
"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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CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2 Gold
3. Yellow
File
City
Applicant
# ql./--Lfl
Applicant: P1~~I~4.- .fJ"':'..a" .,,4/ fi
Address: /,).j' ~ ;;l/....I,t',A ~ /J ".:-""" .s'iJ
Signature: .,J. 06'~
Legal Description: Lo(" Ii) ~ I J Block
Site Address: ~ L' 7t / 5~
Building Permit #
NOTE: This permit will not be pr
FIXTURE UNITS
Phone: F:ft'7 '/6- t:c'
Sub:
PID # ..33 - / I 7 -- vb f - D
Unit
Quantity Type of Fixture Amount Total
3 Bath Tub with or without shower $ 6.00 ./If, K-
i Dishwasher $ 6.00 (., . . ',)
/ Floor Drain $ 6.00 t... .,Iii
(, Lavatory (bathroom sink) $ 6.00 it. Iv
., Laundry Tray (1 or 2 compartment sink) $ 6.00 t,t.!
J Shower Stall $ 6.00 t,t';.,
;; Sinks: $ 6.00 /,./.#...
Bar Sink $ 6.00
..y' Water Closet (toilet) $ 6.00 ~y .,.J
.if Rough-ins $ 6.00 2'1.tv
/ Water Heater $ 6.00 (. , t.v
Water Softner $ 6.00
/ Stand Pipe (washing machine) $ 6.00 (,' , ~,:J
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 $ /~?:". ~t>
,
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 thereof.
. J. 7 RECEIPTNO.IJ.jJ.-?/IY DATE
ATfEST
,
Call for all inspect" ns 4 hours in advance.
4629 Dakota S1. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
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