HomeMy WebLinkAboutBuilding Permit #00-0127
. 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
4l., 4 L' \-tOV\'\W"'\t '" ~ b~.--d
3. LEGAL DESCRIPTION
14- BLOCK cs-
t::: f\J..QB H , L.L- '2-N 0
4. OWNER. (Name) -:'\.. .
- \ h~c.~ T l.N\k=r--\:'1
5. ARCHITECT (Name)
DATE RECEIVED
.83Dl
LOT
ADDITION
6. BUILDER
(Name)
D6\{LL - \-\~\L
Fireplace 0
Alterations 0
Septic 0
Addition 0
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. /\
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
(JO-OIZ-7_
\';l:-l \
~ <3 00
\ . I
~l()V' lz:-~ \ ~~ e..
(Depth)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width)
12. NO. OF STORIES
PID 25 - 33OJ- O3fo-O
13. TYPE OF CONSTRUCTION
(Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
~~4~ ~~~\",&k,l""<!. \ (dt).- 'i~ ~q 1
, (Address) (Tel. No.)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
\. ./"
Dec~ . Re-roofing 0 Porch 0
Finish AttictJ ~ Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby C?le' at I have f mished 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 a ve p 0 an at 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 c I v e s permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform nelided in1pections.
X ~~~
( ~ "\ Signature License No. - Date
'V FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1265 Ale
I
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~ 0CXl. 00
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
~
Ll8.S'
, · ~O
Thi
By
V
\ ~~ \ rP
\ ~It]
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit...................... ...... $
Other......................................... $
Total Due .............................. $ /24. f!E;'"
,
Paid /24.~C;:- ReceiPt~~. 9~Cl,
Issued k"^-- V
T . . 'fyth th . h be I' ti d . d . . d . h h c~atze ~O~z!oOd By Is ~ .
hiS IS to certi at e request In tea ve app lca on an accompanYing ocuments IS In accor ance Wit t e Ity onlng rdlnance an may proceed s requested. ThiS document when
S~~he City ner constitutes a temporary Certificate of Zoning compliance a allows constructio to commence. ~~re occu9a~cy, ~~icate of ~ancy must be issued.
~ D"tc-J.,e.o ~~~
lanner Date Special Conditions if any
24 hour notice for all inspections 447-9850
o - ~ '7
The Cenler of Ihe Lak.. Counlry
White - Building
Canary - Enghjleering
Pink - Planriling
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
i...'
/'
(; f) f-~ I.... I"l// \
t' '-. I'
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APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.;4
~/j-'LL I! (
--r--, , ---,/' / / i ;,., I ,I
I'--:~ / -:; / L. /' /" ..
,,-) .n --,F:.."... ...J
-;-/.::-jr-/ I L-
Accepted ~
Accepted With Corrections
Denied
Reviewed By: ~ ~
Date:
3-Lt.{-CO
Comments:
~ro~ ~ ~~/X~~,
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.1I
0-' .u1
Thr Crntrr of thr Lakr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
DOU6!ttfiK:T'() 'j On
:~/ p;/oo
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4&+4- H/.JP1fVll Nrq a/eo /,eA I L--
Accepted X
Accepted With Corrections
Denied
Reviewed By:
Date: s-Cf- ~~
Comments:
I.~~ I4~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."
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~4q HUlMJM.l~~rc\l I~.
TYPE OF WORK ...I2ec~
USE OF BUILDING Sf:'.tl
PERMIT NO. fJO- 0/2-7 DATE ISSUED "3-9 -;2.oC>Q
,
BUILDER 101M "tnurl-u-~
NOTE: THIS IS NO ,fA PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING ~(c.. ~t?:r, lj-/7" V/1rtJ
PLACE NO CONCRET'E UNTIL ABOVE HAS BEEN SIGNED
I~
FINAL
/t!4 '
,
~ / ;?t,/tJO
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
pATE I _ TIME
SCHEDULED ~. z" /.lfJ q: Cf6
I
I-~rn-I~ bl vel
CONTR.
ADDRESS ~44
OWNER
PHONE NO.
PERMIT NO.
0-127
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING r(@ 0 WATER HOOKUP
~ ~~SULATION 0 SEWER HOOKUP
~ ~~NAL 0 PLUMBING FINAL
o SITE INSPECTION, 0 MECH FINAL
COMMENTS: s;::. p r J~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.:O:ECT WO~L~ FOR REINS::::/:n::FORE COVEmNG
'i
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ