HomeMy WebLinkAboutBuilding Permit 99-0409
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
'I -). 'f.q~
ADDRESS
6 gso /~ ST. S.IE.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
? <( - 901
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TI01'l /J 6:\
~ FINAL ~ \!Y
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 GASLINE AIR TST
o
COMMENTS:
~~
dJ?
(./
.~~
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/1l4
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
APR I 9 1009
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
h85"o HI iICffl-C,-r ""'it .5i?-
3. LEGAL DESCRIPTION
Jl-I
LOT
BLOCK J{
?~/O~ S(')(/TH
PID 2.5'- 017- 0 (,8 -- 0
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
\) Av e
5. ARCHITECT
(Name)
.51J.w. "p ~ fV
(Name)
(Address)
toss-V j.,'j/t'I'~f #{f- 4'~
(Address)
6. BUILDER
(Name)
(Address)
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
DeckY
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- L/Oq
1. DATE
..{-V-Cf1
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
/<-150
12. NO. OF STORIES /
(Tel. No.)
1/1/0- J:fl9
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
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 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 t~ermit 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- t--2- .-/. Jj - 21-79
r . , Signature License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Side
Back
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
I.Bo". dlO
USE OF BUILDING
J2;s /4U<
- ,
TYPE OF CONSTRUCTION: I II III IVCj
Occupancy Group A B E F ~ I M- 0
Division 1 {)/ 4
Permit Fee ................................... $
S U
City:
~,-7~
3~.6C(
.~D
,~ Qf
'0.1SJ
~Y)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Perm~ ...................... $
";/llJ~:;,~~;;t;.~~?
Certificate of ~
Side
SOIL TESTS
o
o ENERGY DATA
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Parik Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
:~';w::;0::::::::::~:=~o: q<ji~L/
Date5-3~7 By ~~~~
This is to certify that the r uest in the above application and accompanying documents IS in accordance with the City Zoning Ordinance and may proceed as request~ent when
signe~ t~ City P!ann r nst~utes a temporary Cert!fiIB-:e .5lt ~ni~~pliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
y ':P.I "'--4..1 A~ ~. ~~
City anner Date Special Conditions ff any
Issued
24 hour notice for all inspections 447-9850
i
! I
I
/
Th~ Crntrr of the L.kr Country
White . Building
Canary . Engineering .~
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
i
i
!
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'-l-~
\
Accepted
rV'
Accepted With Corrections
Denied
Reviewed By: ~ Vl~ Date: L1-2-~-tii1
com:<:;atl~~ <t70 ~.. fY~'j yJM~
5'" ~r~~~ r~ V~~~ ~~/k_~ 'G.
pr~1. ~<-
"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, Pen'nits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
QQ-t/07
Tho Con tor of Iho L.ko Coonlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
DAVE 5AMPSO'"
+/ IOj I qq
. ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
CPS50 RI~R.55( 51. 5.E.
AcceptedX _
Accepted With Corrections
Comments:
Denied (2
Reviewed By: ~~ - /
'--- )/ ~
I \ ~ +-k Dee k. ~('Q an,1-
Date:
t.(-2 q - qq
"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 (nSS() lLllc~~ S+-, ','-
TYPE OF WORK ~r\c.
USE OF BUILDING S~D
PERMIT NO. C(9 -<-JOq DATE ISSUED c/-').Cf -( 7-
BUILDER Da\l-e. ~""'vOs.CiY'..
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
/I INSPECTOR
1tJ;th
DATE
I FINAL
/ )It\.
I II / J 1 -1q,
j
J
I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850'