HomeMy WebLinkAboutBuilding Permit 99-0016
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I ~ -~ -tJD ./l IS-
ADDRESS lS'cff'/- I / )-.I/~ f- )1 uc
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9q-O/~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION '-
P<fINAL L. .
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
I. ~ ~ (ltn"3~
-
&- ~,~ I~/ ~.--,I
U . L/
o WORK SATISFACTORY, PROCEED
~RRECT CT. AND PROCEED
~ ~~RR CT W K C FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL~ 17-~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-.Y
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
'-'5. TEMPORARY CERTIFICATE OF
..- ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
\)c;k"
!IJr
2. SITE ADDRESS I
If?!J 't1~lf/
!JAil / '
3. LEGAL DESCRIPTION
LOT oil . BLOCK
.DDmo<< ..).,-/.~,j, h~
4. OWNER/,> . # (Na~e) 7 j e J
(/tAJC;f J<. ~~ I sill h.,
5. ARCHITECT (Name)
PID JS-1J..!:l3 - tJ /J -j-
(Address)
I C:;911 I1Jtf <;T Iii) I:.. S. ~ .
(Address)
(Tel. No.)
fo/;).-1I'I7-j':+9/
(Tel. No.)
Ai. ~LlfADI( le,itloEiJ - /JJI./lEV _fl/iV/f~+ WI)7<i:::XJV;;:7JitflJ~ LIUJA!I)RJI
tj.-IN'S(}LHldJ
7. TYPE OF WO?JK , Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Mi .
8. PROPERTY AREA OR ACRES
Sq.Ft.
Re-roofing 0 Porch 0
Re-siding 0 Finish Basemen~
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes
No
1. White
2. Pink
3. Yellow
File
Cily
Applicanl
Permit No. 't q A 00 , c..:.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO~F STORIES
~ra:r
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. 'ifOJECT COSm'ALUE
/TiS!)() ,00
17: COMPLETION DATE
I hereby certify that I have fumished 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 abo ntioor:..~'; >".pe nd at all co ructi ill conform to all existing state and local laws and will proceed in accordance with submitted p~a s. I am aware that the
build' offi I can't~v is pe it for jus" use urthermore, I hereby agree that the city official or a designee may enter upon the property to perto eedejJ inspections.
',/' \ b: ('\1
/ ~ ~ ignature .. License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION SL:r). 0(')
USE OF BUILDING
~6.~
I
AIZ-
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A B E F II I Mea:> S U
Division 1 2 (j 4
Permit Fee ................................... $ ::< ). 00
1 ~ . ~S-
.<;,0
City:
,,<(I
\ ,l.R
0f!.\\')
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ...............7:::.... $
Mechanical Permit Fee ............:........ $
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
35 Jb
Pressure Reducer .......................... $
Meter Horn .............................. ..... $
Water Meter ................................. $
Sewer & Water Connection FE1e ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
Gas Fi lac Pe 't ...;t;.... ............. $
Thi A' come uilding Permit Whe~ ~~8d.
B~ Date 1- IJ1 I...[
Certificate of Occupal
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid I - 7 - 't 9 Receipt No.
- ,-
Date ~b,)')
By
35./5
3l.{~/b
l. b tV
Thi~~, rtify that the requ t in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
sig(~ bYl.~ner ~~utes a ",mporary certif7t{;r~g compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
J:I City Planner Date Special Conditions W any
24 hour notice for all inspections 447-9850
Thr ("rntrr of thr L.kr Country
, ,
,.,.....,.....
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
1 ,
'- >
~ (_..~--l'.l~_:- '''~(..Il_.(y,
APPLICATION RECEIVED
.~l~
.~
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
1./
Accepted With Corrections
Denied
Date:
if ~b3
Reviewed By:
Comments:
+
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."
Th. e.nl.r 0' Ih. L.k. eounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT C. ~At (.!) C*ts '+oc:...-(Y\
APPLICATION RECEIVED .- 5 --
JA-N5 l~<11
t
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections Y--
Reviewed By:
f tK.yA Date: -H,-rJ
Denied
Comments:
/. Read #U D~~I'sA NJJ
"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."