HomeMy WebLinkAboutBuilding Permit 94-0577
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETYI
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D .., nr::u '! CITY OF PRIOR LAKE
... ; i . BUILDING PERMIT,
TIFICATE OF ZONING COMPLIANCE
AND UT'l-ITY CONNECTION PERMIT
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
3. LEGAL DESCRIPTION
~ 12/~)/9'"
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. q4 - 677
1. DATE
LOT
J BLOCK J PID ..l.r- -.L if IJ - IL33- 0
11 c-c--lL""1 ;n.J t t,Ji <y I ~ I1J1 ~
12. NO. OF STORIES
~ '-
13. TYPE O~ CONSTRUCTION
'/cJ.
14. FLOOR AREA APPORTIONMENT USE
ADDITION
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Name)
7. TYPE F WORK
Septic 0
Addition 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Fireplace 0
Alterations 0
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS ;...
SEATS
16. ESTIMATED VALUE
3S-co.~
Reroofing 0 Porch 0
Finish Baseme~
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 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 can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform need inspections.
X f' . - /..., ('7.!
/1 u~~~
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Side
Front
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
t-~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
4
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS ~S 1-
SURVEY
o COPIES
tl3500.oo
J
TYPE OF CONSTRUCTION: I II III IV I!)
Occupancy Group A BEl H I} M
Division 1 2eJ 4
Permit Fee ................................... $
City:
(P3.00
110 . q~
\f 1 5
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $
loS". 70
Check if
Deferred
This
. g Permit When Approved.
Date 11..- 30 - q 'I
By
Issued
PLOT PLAN 0
Amount Brought Forward .................. $ / OS, 7b
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 ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total ue .............................. $
Paid I ()
Date
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
signed By the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate
City Planner
Date
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
QL/.SJ7
Special Conditions ~ any
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Q
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue
2. Gold
3. Yellow
File
City
Applicant
Phone:
c:--:
j-;.
# tI'I-i::# 0/110
i/{//.,r:J. ;-;1/
Applicant: ---7i{..~;~ <- 'c'!1 /,~ / 1/1./
Add t..! hI' ..., ),1 f' , .
ress: . Jj :/ ~I l" ". l- /.. 'F/fe'1-1 ") 1>1 j J
Signature: //--1;)'1. / / ( .'~.. ~.;
Legal DeSCrlpfion:' Lot ,3 Block 0 Sub: t)~..,...L,..{ul'/ taiJ:;d I..L
Site Address: if rot';';; I; >/l t1hc[{ I /.>f-) ,-' , {- ,
Building Permit # '/ l/ - ,577 PID #) ~ - .2-10 - J33 --()
NOTE: This permit will not be processed without complete information.
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 I I'"
. . -
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 $ .1.j-' J1)
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 amendm~nts thereof.
clSJ.. C RECEIPT NO. viJb/9( DATE
~ A~T
4629 Dakota St. S.E., Pnor Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
White - Building
Canary - Engineering
Pink - Planning
Tht ('rnltr of Ihe Like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (]1I ~L-1/' ,)1, <,~ /
APPLICATION RECEIV~r.L/.t ?I?y
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~ . (.
LIS t/3 '-fftJ~1.LI-,---JJu2Jc/.
Accepted
/
Accepted With Corrections
Denied
lM1.-t
~ a.
Date: t l.- '30 - q l-I
4k
~
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."