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""TI" .... -l ....-- .... ~ (l)z Z m ....~ C) DATE RECEIVED CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2. Pink 3. Yellow File City Applicant WJG - 8 1999 Permit No. 9tf-9&75 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 5S~9 1. DATE 8-lo-C,CY 'PUO BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) 12. NO. OF STORIES ADDITION / /VOq6 PID z.s-3;36 - 0(:)2..- 0 13. TYPE OF CONSTRUCTION 5TH 4. OWNER (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE 6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS S AtvlS 7. TYPE OF WORK New Construction a Fireplace a Alterations a Septic a Addition a DecM..... Finish Attic a Re-roofing a Porch a Re-siding a Finish Basement a SEATS 16. PROJECT COSTNALUE Chimney a Misc. 8. PROPERTY AREA OR ACRES Sq. Ft. 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE 17. COMPLETION DATE Yes No 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 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 0 'cial 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 needed inspections. X C. / /,..., I ct C, License No. c> ( ""De/e FOR ADMINISTRATIVE USE Front Back Side Side MATERIAL FILED WITH APPLICATION SOIL TESTS a ENERGY DATA a PILING LOGS a PERCOLATION TESTS a SETBACKS: Required Actual USE OF BUILDING ~e5 rV~ OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION ? ()(')('). C!){) PLANS & SPECS a SURVEY a SETS COPIES BUILDING DEPARTMENT VALUATION PLOT PLAN a TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R S U City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ State Surcharge ............................. $ Penalty....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ (P2.7-s qO. l.l(p I . () 0 Division 1 2 3 4 Permit Fee ................................... $ Plan Check Fee ............................. $ Sewer & Water Permit...................... $ ~~f\ fb\\ / Pressure Reducer .......................... $ Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other......................................... $ Total Due.............................. $ Paid '7/ You Building Permit 1fiIYl~ -weov'tP:. C; Date () If - I Issued n the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee as requested. This document when ttutes a temporary Certificarl' '7'7omPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. '3, Idat Special Conditions rt any 24 hour notice for all inspections 447-9850 White - Building Canary - Engineering Pink - Planning The' Center or the L.kt Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted / Accepted With Corrections Reviewed By: Date: fS - /I-7r Denied Comments: I~ "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." ".-.- ~,~"~-"""'-"""'--"_'~'------"--"-"'-'~-'-'" ~ 9?-?r;5 White - Building Canary - Engineering Pink - Planning The CeoRlrr of the L.kt Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED Nrl.eK-/,4HY OU(3/lAi 6/~ /9q t . The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 5531 /!/C?H,.L/Of/\/76 6; SE: Accepted Accepted With Corrections .~ Denied 621~J Date: B ~(O--7 5 Reviewed By: Comments: l.eeaJ+k~~J "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." PRIOR LAKE INSPECTION RECORD SITE ADDRESS 55;Scr H l~ (Xt1\Nt- Q.~, TYPE OF WORK n.~c.~'- USE OF BUILDING SFD PERMIT NO. CJI-9~~ BUILDER ~~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF BUILDING AND INSPECTION .. DATE ISSUED 8- /0 -cr f INSPECTOR DATE I FOOTING~) Udf I 7-17-19 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED lu1f!I4 MJfJQ. I I I FINAL I I Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS 447-9850