HomeMy WebLinkAboutBuilding Permit 99-0639
/;,4/'6' 3cu
/ tf,f34z PeT E(3,c / /1./ &
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION . ITI
)If FINAL DCI5/C-.flV
/0' SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
</9 -&39
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~ ~::Z~/~
/~.Id
~WORKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~~
QATf RFr.FIVI=n.
S/Z-f4/97
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.
en - t:z3 q
I
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
'2. SITE AD/DR/~S~ 11'"\
?" , d-.. P~r"-~ r; Y't G rL\L
V
1. DATE
I
s:tAJ
s -;)k ~(jC(
Je../
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height} (Width) (Depth)
3. LEGAL DESCRIPTION
q
12. NO. OF STORIES
LOT
BLOCK
J1I~.:. n'lt/Ieo-I "" 1\10 S
s-
ADDITION
/oST
PID 25-308. tJz..5 - 0
.q,DLJN.
13. TYPE OF CONSTRUCTION
14.0~R
~G\JMI'.<"
5. ARCHITECT
(Name)
\\e.-\..e,-,
(Name)
(Address)
I bS"4d-.
(Address)
(Tel. No.)
Pe(e~r~^ e.c.ir suJ '-I40'.~:S''lg
\oJ (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTI'
7. TYPE OF WORK
New Construction LJ
Fireplace 0
Alterations LJ
Septic 0
Addition (]
Dec~
Finish Attic LJ
Ae-roofing LI Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 tor
the above mention arty and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
building official oke this p~rrrit for just ~use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ....... '*..i--....~ .s-- :1.1, -Y'l
~ /' 'Slgnature license No. Date
r ~
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
Front
Baok
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS a
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/Z~s n/-'L.
,
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PERMIT VALUATION
<" ~J. (!XJJ
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III I\CY.)
Occupancy Group A B E V I M (if' S U
Permit Fee ..........~~~~~~~,..1,.........~... ~ 14 - 7C;-
18 . Sf
/.ytJ
City:
Amount Brought Forward ,................. $
Park Support Fee ...,....................... $
SAC ......................................... $
Collective Street Fee ,...................... $
Sewer Tap .,.........................,.,..... $
$
Plan Check Fee ...,.,....,..."............. $
State Surcharge ...................,.....,... $
Penalty .........,..,.,..................,..... $
This
By
i1ding Permit When ~p~d~
Date ~/. Z. f----
(\ ~flJ)\
~\ql
\{,\ .Jt--
Pressure Reducer .,...,..,...,...,......... $
Meter Horn ....... ..............,.,.,., ,..,.,. $
Water Meter ...................,.,...,...,.,. $
Sewer & Water Connection Fee ..,...,.." $
Water Tower Fee ........................... !f.
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ................"... $
Sewer & Water Permit ..........,.........., $
Certificate of Occupancy
/'i~.o4
~S-"'l/
Dete c/"7 frq By 41/..<.---
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance and may proceed~ requested. This document when
sig . Plan r constitutes a temporary Certificat of onin compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
Water Tap ,.,.,...........................". ,It
Builder's Deposit .,.......................... $
Other ....,...".."..".....,.,...,........... $
Issued
Total Due "....................,....... $
Peid I ~..;. $4 Receipt No.
I.
Special Conditions it any
v
24 hour notice lor aU inspections 447-9850
.-...,,"~~~
':'.'.~
.",.
...., ,.,.,
~~
;
Thr ('t'nlt'rof tht' Lib Country
White - Building
Canary - Engineering
Pink . Planning
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
Denied ~ j
Reviewed By: - tJ{ ..;Jt7l./DtAJ _ Date:
Comments: oudkJ ~~ oIL
hi Lf/'l7
,
"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."
~~
99-639
Th.. ('C'nlC'T of the' I..kf Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPI.ICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT JAt1E.-S 116//l/6N
APPLICATION RECEIVED 6/ Z ~ /t:J9
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/&>8+2- P~6G,/G/N6 C-I/C
svJ
Accepted
Accepted With Corrections
x
Denied ? /7
RevieWedBY( ~.'I~~
- ., ,/
Date:
&-'2:---7/
I
Comments:
~r>.;-d J_ Lee ~~-"?--A
"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 .I (;g t.(/Z ~r<,,'f1'~ Cr---,
TYPE OF WORK 12.R.r/c
USE OF BUILDING ~ F D
PERMIT NO. 1/-(0 ~7
BUILDER -4 f',"/l-'UA.
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 t:,-;1 -7"P
INSPECTOR
DATE
I FOOTING f'N 1104, I &, -'l~9q
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
-l!r _Mill\;, I I
I FINAL
VIA /(/so/qt/1
'. I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
.
I
I
j
l