HomeMy WebLinkAboutBuilding Permit 00-0440
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
_as.
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITEi;7i~ PHEA~Nr M&rJ[)()W L-Al.
3. LEGAL DESCRIPTION
1. DATE
5-~,-,,2..dO(;
L/
~
PH15ASA/v ,
4. OWNER (Name)
()/(!,.~ fVA("'sH
5. ARCHITECT (Name) .
2. PID ZS--3'-t7- O!CJ-O
MEAOIjW 2ND AOf)A/.
(Addr~} fYl eH"!i.eJ w'S (Tel. No.)
/?fI? P/1PIJ..<iRAJT J./47- 39/4-
(Address) (Tel. No.)
(Name) (Address) f t. t.C (Tel. No.)
J III ~ m s peiJ~ It) f rn tltJ -_I
\,..,1 /PiA Wf~+!; {/JL~-f fI/(}hbs!lIJ 5f3/S
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Baseme~
ChimneyO Misc. .3 JeOOHS
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
Sq. Ft. Width Depth
LOT
BLOCK
ADDITION
6. BUILDER
Yes
1 O. CULVERT SIZE
No
1. White
2. Pink
3. Yellow
File .
Ci~'r~
~t
~""..... <
Penn It NO.-.f)O. MilO
Fe
BUILDING INFA~TION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
?--/ -",t:JfP(>
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
:Uildi cial revoke tho it r 'ust~ermore. I hereby agree that the city official or a designee may enter upon the property to pe:r-..:.e~'=~dO
License No. .' .' ......
f~ 14' .,
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
'*
~S ,4/~
,
Side
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $ 7'-1. 75"
City:
..3000. 00
Plan Check Fee ............................. $
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1.50
~o. 00
~
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS a PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .. .. .. .. ..... .. ... $
Park Support Fee ........................... $
SAC .........................................$
Collective Street Fee .. .. .. .. .. .. .. .. .. .. ... $
Sewer Tap .... .......................... ..... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
/
O~ {) ilO
Thr Crntrf of thr Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WAL5H# D/~K
~//2o/0()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Pf/6/}!5/if\/ I . /'1cr100W L- N.
I'I'/Ib
~
Accepted
Accepted With Corrections
Denied / --:) If( L
Reviewed By:~ r ~~ - --...,
Comments:
~~$~~~--A- fi'~~~ ~~
Date: ~--3o -::OG>~
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."
-~"rc:" ,', ~"~1<""'~ ~::'"~W"~:;~~~ .,:~'~~';.Y~'T' ::/"If;\ :}rl
. "",:"'-\(}n"'" ..f)., 44' . ,.', ,.c).. , .' "":. . """
." - ~; - ,; , . ';: ~ ',' ,-', -'" ,'.,,' ' , ,." , '-'. .-: '. , - ;' -
".., ,.-. ':, .'." ',.' "-" -', .'; ;,"-, .- ." .-,
.~>'t>:'''' ',-, :,' '~, , :'~" :<~ ".., <.:-,<.:", _.~":'''-:;'~__-._<_~ _'>:.~_l
./","Whlte:" · ~ttdlnl'::': :' ,
,','ca~-l~liig
.Pink . ., Plar)nlng ':'
.'- "S';, . ",-,>,:~' ',,':>.
>" .i
NAME OF APPl.IC.ANT
APPLICATION' RECEIVED .
I V At-S H, '1:)1(2 K
5 !2(f}!O() ,
I{ ,.... .
/7/ Ire
V
Accepted With Corrections
Accepted
Denied
Reviewed By:
~~
Date:
(PtL-cOO
Comments:
~~J~~)-~ 1 ,)~~
~ J ~Sk,~_ ~ ~Wl!
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
SITEADDRESS J1'\{~ ~~J- ~I~
NATURE OF WORK ~.a. _* ~
USE OF BUILDING ~PA
PERMIT NO. fjf)- O~"4'{) DATE ISSUED ~-:?o-?~"
CONTRACTOR W~ ~ PHt>>JE~ '147-?T..d
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
.11)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE .
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~. 41/9/~
f# ' 1 /;;-t/ If;
~ -" ,,/~1tJe
~ 1.!~'4 \ 7/J91~
,J/~ .\ t'/J'J/}/4e L -7/> 1/ n
. ~~ I ·
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
j/V(/
~
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shalt be placed near main entrance.
, ~'-{-04
I
/
,1/
SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
DATE TIllE
CITY OF PRIOR LAKE ~W(
INSPECTION NOnCE SCHEDULED
ADDRESS /71/6 (J~~Ik~ t A~4.; -
OWNER CONTR.
PHONE NO. PERMIT NO. 01J - t..!q ()
o FOOTING o PLUMBING Rl [) EXIGRADlFIWNG
o FOUNDATION o MECH RI o COMPLAINT
[) FRAMING o WATER HOOKUP [) FIREPLACE Rl
[) INSULATION o SEWER HOOKUP [) FIREPLACE FINAL
~NAL 0" [) PLUMBING FINAL [) GAS LINE AIR TST
o SITE INSPECTION [) MECH FINAL [)
COMMENTS:
~
~
/' /
( I
\. ~
~
----
~
-1[2k- ht )
/'
~
, WORK SATISFACTORY. PROCEED
[) CORRECT ACTION AND PROCEED
o CORRECT WO." 7'/#R REINSPECTlON BEFORE COVERING
Inspector: Jill r Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/NSNOTl