HomeMy WebLinkAboutBuilding Permit 00-0409
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
51 n J 00
Permit No.
(JO.(Jtfo z-
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
y/,., L~ Sf --$1~.
3. LEGAL DESCRIPTION
1. DATE
S"-J7-tO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
to
I
(~~
PID
8~- 60S--(J06-0
BLOCK
o nk. (A ('A~
4. OWNER (Name)
rNAMe/~ iJ, ~A~
5. ARCHITECT (Name)
(Address)
f7f(,:i J ';-Q .:sr ~~ G -
(Address)
(Tel. No.)
Y"7-'~
(Tel. No.)
13. TYPE OF CONSTRUCTION
3 Sf::.ASON PCJRc.#
14. FLOOR AREA APPORTIONMENT USE
ADDITION
6. BUILDER
(Name)
(Address)
S'T~J $R4?~G..lp..
(Tel. No.)
'Vt;, J-rAJ LV,.;f-A,s JI
7. TYPE OF WORK
~7'7~/:J7 ;!--
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Fireplace 0
Alterations 0
Septic 0 Deck 0
Addition 'r!!' Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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
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 "'l(?ke.)pls pennit for just cause. Furthermore, I hereby agree that the dty official or a designee may enter upon the property 10 pe,:?!/,: nr;opeclJoos.
X -=:l, ~~ ~i1
~ ~ - Signature License No. Dete
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
k:.
Ii- / K-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 7~.~ 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
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 ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .. . .. .. .. .. .. . .. . . .. .. .. .. .. . .. . .. . .. .... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee............................. $
I 2 ". '1 S-
Ffl . OT
~a
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $~
J Total Due.............................. $
Paid ;::;;0 Cf.. 3'1 Receipt No.
Issued Date S1dKfov BY~
This is ~o ~at request i the above application and accompanying documents is in accordance with the City Zoning brdin~:le and may procee s re ested. This document when
signed the' la r con utes a temporary Certifj~f ~oninV~,~liance and allows construction to commence. Before occupancy, a Certificat f upancy must be issued.
./:' ,.) Jd.31Ud
. ~ h - City Planner · Date' SpeCial Condillons if any
24 hour notice for all inspections 447-9850
~
5'12-~joo
Mechanical Permit Fee ..................... ~
Sewer & Water Permit ...................... $
D 0 - aMP
White - Building
Canary - Engineering
Pink - Planning
The Cenler of the Lake Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
---
APPLICATION RECEIVED
~~
~~h
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NAME OF APPLICANT - r()J(\, AS
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
S~67
/6 ~.~ ~ h-e,~_A-
~E
Accepted
Accepted With Corrections
><'
Date: .5 - 2~. 2~
Comments:
eqo.oe. cJA. ~
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."
_____-...--.-."-.-..---.. ......,.' _.-..-~"........... ~- "'Y'"","',,,,,, ..-.--.
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00" oJoO
..
.,
Thf Cfntfr of tbf Ltikf Country
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPUCATION DEEARTMENT CHECKLIST
---
NAME OF APPLICANT
APPLICATION RECEIVED
-r~
:'-1\
~
~bh
1#l, QODO
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
566 7 15~ th ~tr~e-t.
~/
/"' /lL I
Reviewed By: ,l tJf.-//} ~~ Date: 5" .- d- 3--Q')
Comments: ~ ~I{.ce - OIL... :sreA-bae./fcrcY,
SE
.~
Accepted With Corrections
Denied
~
~I,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.1I
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS S8ts, 1 /50711 S, S~
NATURE OF WORK ADol I I 0 tV (RJ~H)
USE OF BUILDING ~6S It /IIL / / I
PERMIT NO. Of) "'04'oq DATE ISSUED s/zs/ao
CONTRACTOR vtJHN!FRAtJCI.5 WALS-/ PtlONE44:!-/.3C!2-
NOTE: THIS IS NOT A PERMIT FOR ANY dF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
...., INSPECTOR
{p- (I~~ /IJ ~~ ~.
(Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
, D~TE
?f2f/t7tJ
FRAMING
INSULATION
ELECTRICAL
6r
t!/-:;.
911fl/ov
1t?e//Jl>
/ I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
is '~cM4
~ ~ Of
~ ~
BUILDING
ELECTRICAL
==-
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service c;abinet prior to rough-in inspections
and maintained until all inspections have been appro.ved. 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
58~ 7 loG "TN .s /
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
f 0 INSULATION
FINAL O~
~ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: 0 ~
c,_'ose
~~\e
DATE TIME
s ,e.OI
jCJ, T"
Od-~o'l
I
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
/WORK SATISFACTORY, PROCEEO
o CORRECT ACTION AND PROCEED
o CORRECT WORK, 'ALL FOR REINSPECTION BEFORE COVERING
Inspector: n ~~.wm Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
\
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI