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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
5J~;da
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2,~'ADDRES' L/J SS WtlIOkllV't(;~ stre~t ~;D\ Lq ke..
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00,0 tHJO
S
.AIl 1\1 5 S :) -72.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Widlh) (Depth)
12. NO. OF STORIES
25-309- 003-0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
13. TYPE OF CONSTRUCTION
(Tel. No.)
l-!4 0 -q'.)b
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Y Lj 0 - (\ 3 b7
SEATS
16. PROJECT COSTNALUE
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
bU:Wial9FIn revoWhislerm~rjust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perlo) needpd inspections.
X i11v7/1!~~ . S" It/DO
..... . ' License No. ~!,I
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDING
ru;.s Itl i?-
f2/1oo,oo
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 () 4
Permit Fee ................................... $
@ S U
&'2,25
1tJ. .y6
f,ot)
City:
Plan Check Fee ............................. $
State Surcharge ........ ..................... $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This ~~~Uilding Permit When ~ed.
By 'f'; 'I- Date ~/8I ~d
Certificate of Occupancy
Issued
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .........................................$
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Date
he reque in the above application and accompanying documents is in accordance with the City Zoning Ordin nce and may proce
:erc ~poraryCe~/~mplianc~onto commence";:::'eO~ aCertific
City PI er ~e ~pecial Conditions n any
24 hour notice for all inspections 447-9850
lTh ,0400
White - Building
Canary - Engineering
Pink - Planning
The Cenler of lhe like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 8'f\{'lre.-w t'\o.. t-~Jn...
APPLICATION RECEIVED ~ \ Co +-\1) 8 0 D 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4ft)2$' WI)low"\N1'JOrJ S~
Accepted
Accepted With Corrections V
Denied
"=1~r-- Date: ~/IK ~tJ
/ .
'IJ ItrJ{) -Ou.T A./..SO ALL TH~
tHE Nr'f2tJtl6n r:'LAN 5,
Reviewed By:
Comments: 1CeA-1J
~
:peeK...
I AI F6 (2J'^~ ~(f o,.J {j,J
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."
'>'''';'''~-':~'''-J~~".~~.t::-'~'~~'1F-~"i'',\~.",.,~;prii(:';'lc'o/''-I'%.":~T.'i!.:~ -".~ .~...-:~"t'" ':'~~'~""-d' ~~'-'~-;,il~F;::',4,~~~-..:""'''.f~.':''l'7'~'~~I>t.?:,,-,~~,~~,~......,,,,;r,,..~._,.,.. "'1""'......... ~
t)1) .0400
White - Building
Canary - Engineering
Pink - Planning
Th. C.nl.r of Ih. Lak. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT An drew M <^. t ~jo..
APPLICATION RECEIVED ~0Jv1 \ (0 +-Y)) a 0 D 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4l_t=:;~ WI How'WoO(J S~
Accepted L
Accepted With Corrections
Reviewed By:
,~
Date:
~~?:/()()
Denied
Comments:
k:-
,
"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."
j
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".
. .
. " -- '. ,','
:,,_ _ ~.~~~.-"..L~';:~-::;-:c.:.;:~::;.;;.."~:
PRIOR LAKE
INSPECTION
SITE ADDRESS ~~ 92!:1 ~O 51R Eel
TYPE OF WORK NeW ~~
USE OF BUILDING ?es , /12-
PERMIT NO. 00 -./!fOO DATE ISSUED ,5,/ (g;& ()
BUILDER MtJl4E_ fVIATVJA
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
, FOOTING I R/-J. I s /2~ /00
_PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
.. I I
I FINAL
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
'~,;':';_\~-
,-.'. ,-.". ."' - "....., '-', .-~. -.. -, ..
. '-, .".
BURNSVILlE. MINNESOTA 55331
",<;::
JnOBE
EN'INeERING
~ COMPRNY, INC.
l 1000 [A!H 1-4 Sift STREH,
COHSUl.TIHG INOltfURS
PLANNeRS and LRND SURVEYORS
5'vAlSCT I!PI1Ie-S C't1A'1?
PROJECT NO. 8Z55, 00
BOOK Z 38
PAGE 5"
.,-;:::
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CERTIFICATE OF SURVEY
Legal. Description: L!27.5~ BU1C1( It' Slf4'A'.t2ARPLZ7PN 7lJ weSTl.luey PON'O~__
5IdtLLC&l1.!t1LT~~NN~771.
( q 7 I, 0) . DENOTES EXISTING ELEVATION
(172,0) DENOTES PROPOSED ELEVATION
_ INDICATES DIRECTION OF SURFACE DRAINAGE
172,:j~ = FINISHED GARAGE FLOOR ELEVATION
q b 1. 3/ = BASEMENt FLOOR ELEVATION
172/00 = TOP OF FOUNDATION ELEVATION
SCALE: 1" = 30'
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ON FNr;:. !/AWKS AVb</VE.
EUV ~ '766.4-G
;J
('7!:?/!~
Gin 1, 7 I
OlV1w/JGE ANt:>
VTlLl7Y EAGEmeNT
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I hereby
land as
RffJ/2U412v
I
certify that this is a true and correct representa~t~~
shown ~nd described hereon. As prepared by me
19 18 . '
~{J f fJt+-&
,
of a tract of
2(, rH day of
Minn. Reg. No. ,qo8h