HomeMy WebLinkAboutBuilding Permit 00-0500
DATE RECEIVED
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRE~
3<6<:)'/
\N, \lowwcroeA
.s~e.J- ~ \J\J
3. LEGAL DESCRIPTION
LOT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00 -lJSfJO
1. DATE
'=> I sf (7)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID ~)S" -3{)~ -0 Id-O
OU
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Name)
(Address)
f\n&\(e~ el~\'-e(\
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
7. TYPE OF WORK
New Construction 0
Septic 0
Addition 0
Deck
Finish Attic 0
7(p3. J'd- I LlI (p
REi-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Fireplace 0
Alterations 0
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 ab ve 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
buil ng fficial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pe~ needed inspections.
X' If)11~1 DO
Signature License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
USE OF BUILDING ~5 ~
SPACES ON PLAN
PERMIT VALUATION
f2.0()O,IJO
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM ~ S U
Division 1 2 (!) 4 102
Permit Fee ................................... $ . 25
Lft), 1 fa
/.Ot)
City:
Plan Check Fee............................. $
State Surcharge ............................. $
Penalty ....................................... $
q\~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
ThiS~CO~~Uilding Permit When APPived.
By ~ Date" Iz.o 00
.
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
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 ........... $
Date
By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoni g Ordinance and may proceed requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
24 hour notice for all inspElCtions (952) 447-9850
Special Conditions if any
DO. 0500
The ("enter of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~()."u;1\ Uh~
APPLICATION RECEIVED :JZ~ \ S-t'h , f9...fJ7J()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
o'KC]7 W \\\cV-1 \krcrncl ~ ~W
Accepted
Accepted With Corrections
x
,
Denied
~ . '/ZOltJD
Reviewed By: -1~f.J Date:
Comments: K~D 'J) EC.t~ +{fAt~D"O~ A.~o ~ THlZ
1 tJ fOt<-W"A T/(),J O,u TH~ ~Pf(1.tJJ6D Tf=> LANCS ,
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."
DD-OSOO
The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATIIDN DEPARTMENT CHECKLIST
.--
NAME OF APPLICANT Gnn:::. (L)(.l.A.AJ 1"\
'_."-'~-". .. \ \:-- r'\
APPLICATION RECEIVED .',) \ )'(\e- \~
L\ \\ ~
..-~) /f\;' Tr~}
O( C. Vi (___
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'/(('/ 7 \/~ \ \ \. Ci \jJ \ ,\1 Ci{'(' 1 ~h~ '::.) y\J
Accepted
Accepted With Corrections
Denied
Q~
Date:
Reviewed By:
Comments:
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
SITE ADDRESS 389'7 lJ,LLOW WOOD Sf: :s ,W.
TYPE OF WORK l'(~uJ ~fl-
USE OF BUILDING ~e:S. A..IP-
PERMIT NO. 00. Q500 . DATE ISSUED t..ol 2-0 !tJo
BUILDER ANOi-GIAJ lJ'6fl;~ :SIC 7lo3-~''- - ILf l<.c
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
I FOOTING W1' I 4/~~1)1)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
___ J I
FINAL
Call between 8:00 and 9:00 A.M or all inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 3~7 W~lkWtA:~
~ I:T;,~
~
TIME
l : \S-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING ~
SULATION
FINAL
4tETE INSPECTIO
o PLUMBING RI
o MECH R~I
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
0-5()()
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
)QJvORK SATISFACTORY, PROCEED
( 0 CORRECT ACTION AND PROCEED
o CORRECT , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI