HomeMy WebLinkAboutBuilding 99-1103
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DATE RECEIVED
9/7/99
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,
qlf- //03
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
/'7/20 P#6A911V/
.MOJOo~
/<../
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
I I'
12. NO. OF STORIES
3. LEGAL DESCRIPTION
LOT '7 BLOCK 'L-
ADDITION jC)JJ..f.AJ'Al;./r J.1 eAC<!),(,Q .;l ,:::!O
4. OWNER (Name)
C;~e
(Address)
PID 2.5 -3L/-7 - 0/8-0
tJ.. 0 D 1ft. (!)Iv
(Tel. No.)
13. TYPE OF CONSTRUCTION
F A:. If-.. fVl e t:J
14. FLOOR AREA APPORTIONMENT USE
I 4-0 If"
5. ARCHITECT (Name)
AM 'Pe cr" u,'( 4. <- JJ<.r It:;
6. BUILDER (Name)
(Address)
Wl ~ ('~/'~ I
(Address)
(Tel. No.)
7~S~
(Tel. No.)
"
w( LLlfl,y~
f}A ~ LO Pi'l.( ~N'T. LL c.
,/
([0, 't...) ~'t ~- LL-t c/-
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTSC;it.'"fC ~ ~ r-f
SEATS ~ ~<....
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck
Finish Attic 0
Re-roofing 0 Porch 0 ..1
Re-siding 0 Finish Basement)\
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. '3 0 'Z i.f
9. PROPERTY DIMENSIONS
Width ~" Depth ~ 4-
10. CULVERT SIZE
16. PROJECT COSTNALUE
J1 S, ~. O~
17. C PLETION DATE
Yes
() C.,.
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
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
s permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm nee ed inspections.
X' "?~nt.. <:l..i6y..
Signature License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
lees ;::1//2-
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
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 ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
Cj9,'15"
&8.e~
:;2.50
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
'if) .. a:?
I~
\\.J\\\~~ ~
~\q
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due.............................. $
Paid d tIJ. 0 Cj
By
Z 07. 0'1
.3c,,7.--1 s
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This
By
.. Permit qen N>~.
Date -It?
Issued
Date
uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed requested. This document when
constitutes a emporary Certifirre ofJ1l-omPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
a ner 1 ~ ate Special Conditions ij any
24 hour notice for all inspections 447-9850
99-//03
The Crnler of the Like Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
}/VItA/lAMS DBV.
q/7/91
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7/2-0 'Ph"t;..q,.5" ~ /VT /'18/1 DO tAl
Accepted
Accepted With Corrections
><
Denied A \ A
Reviewed By: W~~/'-J Date: 1-10 -'i'7
Comments:
,. ~ ~ Dedc ~ ~;~ ~i<3
"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."
White - Building
Canary - Engineering
Pink - Planning
Th~ ernler of the Lake 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:
V'
Denied j
Reviewed By: f4!i ~
,~ ~y:;f6c.:c(lCa
Accepted
Accepted With Corrections
Date:
9'- g-77
Comments:
~olC
"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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /11 2.0 \?h.on~eJ- Mpa&o't1..)?K. 1/\ .
NATURE OF WORK T)pc k.. ~ 1S:G:..9.0 ~ h'ut~L..
USE OF BUILDING 8J:::""A
PERMIT NO. 0 C; - 1(03 DATE ISSUED i-I()-9i
CONTRACTOR W;lli~ C2a.>J,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
! FOOTING Ded:: I j
i
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if requ'ired) .
"0.. y
10 t;"
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~D , r ]
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN iSIGNED
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 (612) 447-9850
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