HomeMy WebLinkAboutBuilding Permit 94-0529
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TIFICATE OF ZONING COMPLIANCE
ILlTY CONNECTION PERMIT
I. White
2, Pink
3. Yellow
File
City
Applicant
Permit No. 9 LJ. '!::>'"'2... ce
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
1. DATE
- \tJ '-7
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height)..,,' (Width), (Depth) , ~
,/1 '4
12, NO, OF STORIES
vA.
3, LEGAL DESCRIPTION
PID as- - ;;)S'S--Q;)~~
(Address)
(fel. No,)
\;J&
(Name)
(fel. No.)
(Address)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS .5
SEATS
16. ESTIMATED VALUE
S-c a~O.. 00
17. COMP ETION DATE
r',,:-
- dO -'-l~
6, BUILDER 0 (Name)
't)ur '
7, TYPE OF WORK Fireplace 0
New Construction-!Sl... Alterations 0
Chimney 0 Misc,
8, PROPERTY AREA OR ACRES
Sq, Ft. \0/ b~]
~ (fel. No,)
C. "':.<:S 'C\
\ (.. 1(-- I I
Reroofing 0 Porch 0
Finish Basement 0
9, PROPERTY DIMENSIONS
Width Y 5 Depth l J G
10, CULVERT SIZE
Yes 0cj)
rmation 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
nd th ' n will conform to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
. 0 ust cause. Fu re, I hereby agree that the ci):y official or a designee may enter upon the property to perfJm needed insp.ectio. ns,
#-7"3 y~ J -/G-S i..(
Ucense No, Date J
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Side
SOIL TESTS
MATERIAL FILED WITH APPLICATION
o ENERGY DATA
Front
Back
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS~ETS
SURVEY ~OPIES
PLOT PLAN 0
Water Tap ................................... $
Builder's Deposit ............................ $ (, SG() ,C)C)
,
Other ......................................... $
Total Due .............................. $ SP3 Ii.( . 112
Paid' ". ii) Recei t No, ' I( f
/' '-7
Date B ,: ~....L-
the above application and accompanying documents is in acoordance wnh the City Zoning Ordinance and may proceed requested, This document when
es a temporary Certicate of Zon~/~mpliance and allows construction to commence. Before occupancy, a Certificate f Occupancy must be issued,
/ -1?-7'L
Date Special Conditions ~ any
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OS~ILDING
.00
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Occupancy Group A BEl H~ M
Division 1 :e4
Permit Fee ................................... $
SSLJ . 00
'3~ a.} 0
4 o. aC)
Plan Checking Fee ........,................ $
State Surcharge ............................. $
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
Subtotal ............................... $~ b 4 . I D
pli' omes Y.'O}/~Uilding Permit When Approved, .
By .'~ Date 11-/7- eref
Check if
o
o
Deferred
Issued
24 Hour notice for all inspections 447-42309:00 a,m, . 10:00 a,m,
(050 . 00
~OO .00
~O.~O
Ll5. ~(")
<=15, co
'1 () C ,f')()
~ ()C) . ~ C"'I
9'f-.fL9
White - Building
Canary - Engineering
Pink - Planning
The Center of the Lak.e Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
I'
NAME OF APPLICANT {": .r i ./
...,.'" ;,.; f..t :
l I>,., ,,/
1"," '
APPLICATION RECEIVED /J iN/fl;.
. ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
j ! ; i " (
/ ,J :' / '. /.{'
/7
I:~,../
i ' ! ~ ! J:'
Accepted
(.../"
Accepted With Corrections
Denied
Reviewed By:
RJ
Date: )/, IS- Clef
Comments:
"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."
GREEN - FILE
YELLOW - APPLICANT
GOLD - CIT Y
CITY OF PRIOR LAKE NO. l/~-1J7
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: LC:..-t,_c:.C'')ide, j:rU1JbJ::)
ADDRESS: /:7L/UJ4, ZeN,"", ~'U~'(L
SIGNATURE: 0t"' /Y .r L./ 1- ....::...%'--'-'
SITE ADDRESS: ) u <;!n ttt:C;l-Lx-t'1f ClL/(
FILL IN THE BLANKS
PHONE: StJ4 - 7u (:.c>
DATE: /-/3-95
BLDG. PERMIT # 1/'1- OS'l.JI
PID# c{S' -~ 95" - o.(~ -0
1. Estimated length of water service
2. Size of water service / inch (es) .
I
3. Location of any couplings from structure
feet.
feet.
4. Type of sewer pipe. ABS PVC~ Cast Iron
5. Estimated length of sewer line ----- feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY ~ jto-).tJ.~"1 i~ ," DATE: J II 7Jrr-
====== ==========-=~==============================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID SS. ,rV JIt7/Q,';-
RECEIPT # ..;)S-33rL
AMOUNT PAID 3I,..!J~
REC' 0 BY/ l~ -i~ 1'/
j
4629 Dakota St. SE, Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLDYER
CITY OF PRIOR LAKE
PLUMBING PERMIT
~~
1. Blue File
2. Gold City
3. Yellow Applicant
# tfS- ~ t
Applicant:
Address:
Signature:
Legal Description:
Site Address: " ,/ ~
Building Permit # (/1./ -OIJ 1.., PID # oiS - :.LIT - d z.~- ~
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Phone:
"'p.c Ii'.:'
Sub:
Unit
Quantity Type of Fixture Amount Total
/ Bath Tub with or without shower $ 6.00 6.tA...1
/ Dishwasher $ 6.00 t . e.1J
/ Floor Drain $ 6.00 t _ IV
/ Lavatory (bathroom sink) $ 6,00 t . 11.:.'
/ Laundry Tray (1 or 2 compartment sink) $ 6.00 /.. . I'U
Shower Stall $ 6,00
J Sinks: $ 6,00 , _ ,,oJ
Bar Sink $ 6,00
J Water Closet (toilet) $ 6.00 t_IJ
,3 Rough-ins $ 6.00 ./ S' .tU
J Water Heater $ 6.00 I. '
<0 . trC.
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
tt t. ,J()
GRAND TOTAL $
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.
ulS:. 0"- RECEIPT NO. III 7/?r DATE
{)) - ATIEST
Call for all insp ti ns 24 hours in advance.
4629 Dakota St. S.E., Pri r Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPWYER
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The- ('("nfer of the L.ke Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT &1'~1Tj1~~ 13L~ lLu '
APPLICATION RECEIVED /I htJ-)tj/[
t ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
JjJ7f 't.L.Jkrd.-u
Accepted
Accepted With Corrections X
Denied
{2JJ~.
Date:
//- J1-? i
Reviewed By:
Comments:
l, 3~ ~~ i\-e.es
~ tA..5
2 . M.o. < \A. ~~ lA- Lros (C51 \ C<J2I\ t tC:) I u V\ L II
deu-eJopJ- ~/~
tu r-f' -($ e::, 4 b I.'s l... e~
"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."
13 rn,-( .2Pb -~,J).2.
') :.- ' .' ) ,.~
The Cenler of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 5'/1/) J ,u",i" !ilct1tJ-/,
APPLICATION RECEIVED II };1././91)..
, ,
,",
" ;
y",,(J .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J & !l1 ~ 'tiP i/lktJ{
Accepted v:!
(Iu
Accepted With Corrections
Denied
,~::.';-f-\l
Comments:
"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."