HomeMy WebLinkAboutBuilding Permit 94-0515
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dlTV OF PRIOR LAKE
BUILDING PERMIT,
TIFICATE OF ZONING COMPLIANCE
ITV CONNECTION PERMIT
~~~y
AND
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
/y 7 /~ r:HE~',l;'Y ('(.>A '? I
3. LEGAL DESCRIPTION
Permit No.
1. DATE
1. White
2. Pink
3. Yellow
File
City
Applicant
91- S-l6U
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
PID lr- -,~ ,fl./ -00'/ - 0
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Address)
('t't'EA::~-V c.-- .<!./
(Address)
5. ARCHITECT
.IV ",t
6. BUILDER
(Name)
(Address)
tV'./!
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
(Tel. No.)
i.v
/
,-.-/
14. FLOOR AREA APPORTIONMENT USE
t'. .
(Tel. No.)
(Tel. No.)
Reroofing 0 Porch 0
Finish Baseme~'
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
/I.? 1:':' Po.,)
^- :::H -,_,
17. COMPLETION DATE
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 a 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 official ;an revoke th~s pero::t!!:1or Just cau~e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ...$.-:,,- d' <E r ~-.:-- / ~ M / / q y
. gnature Ucense No. ' Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Side
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
Division 1 2 3 4
City:
Permit Fee ................................... $
Plan Checking Fee ......................... $
State Surcharge ............................. $
5C/, 0()
35./0
1.'L~
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $ q(). <Y:;;'
Check if
Deferred
By
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
500 ~
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 1.3S
PERCOLATION TESTS 0
SETS
COPIES
'1().35
Date I.
This is to certify that the request in the above application and accompanying documents is in accordance wtth the City Zoning Ordinance and may proceed a
signed By the City ~PI constttutes a temporary Certificate of Zoning ~liance and allows construction to commence. Before occupancy, a Certificate
D. c.... ~ /(- '3 -r'L
c, lanner ( Date Special Conditions if any
24 Hour notice for all inspections 447-42309:00 a.m. '10:00 a.m.
qL/-~ 7 5~
Tho Con tor of tho L.ko Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
Jr r( .
NAME OF APPLICANT ~/ }ill A/A-( J -~
APPLICATION RECEIVED j ~/311 fY
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,<I 7/ L (liLT (:".J,b
Accepted~ Accepted With Corrections
Denied ,.
Reviewed By: (f. fl ~
Comments:
Date: / /- .3; - 'Ie(
1.~7!u~-r:.y( ~J
2. JJJJ, I-, '~V-U-M':/-;' ~ r~ u..~..9- ~ r?1(frvL~ ~
1: I ~}h\c-J .
3.
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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1'17/2- ~tu t, .J;;
NATURE OF WORK
USE OF BUILDING
PERMIT NO. f/~
CONTRACTOR - ' .JiA_-'l.;/i
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE ISSUED JIIL//ttJ
INSPECTOR
DATE
I FOOTING
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
WALLBOARD I .
FI
GRADING (Prior to Sodding)
BUILDING
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