HomeMy WebLinkAboutBldg Permit 99-1304
~ CITY OF PRIOR LAKE
; BUILDING PERMIT,
tEMPORARY CERTIFICATE OF
) ZONING COMPLIANCE
~D 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 ADDRESS
1?/)l6 1- PlicA 54 tJr M~A fJOtAJ JAJJe
3. LEGAL DESCRIPTION
2-
'PH~A~/1/l1/ /'1~}7D()W
4. O,",NjR (Name), J \ . J (Address)
!S.ff..JJAJEnl t NAoMI lNMW SAMe
5. ARCHITECT (Name)
LOT
/2-
PID
25 -328 - tJZ.3- 0
13. TYPE OF CONSTRUCTION
BLOCK
ADDITION
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- /3c4-
"
1. DATE
No II, 3 1 J rf9
)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
1<-/
12. NO. OF STORIES
(Address)
(61:1) ~~~ -'i!~ Lf:L
(Tel. No.)
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction LI Alterations 0 Addition 0 Finish Attic LI Re-siding 0 Finish Basement)(
Chimney 0 Misc. / R~
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
_.::. .Sq. Ft. Width Depth Yes No
I hereby certify that I ave 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 mention 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 0 . ial revo~perrnY for j~st lfluse. Furt~, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~~"J~l/~ LU~~ }iLv.3.l!ln
Signature License No. Date/
6. BUILDER
(Address)
(Name)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ;:) o. z.G
Paid .35.2 c:;- Re1!;;ciPt. ,~3fr;'-fqO
Date /I / '-1-1 c; q By
in the above application and accompanying documents is in accordance with the City Zoning Urdina'nce J.d may procee s requested. This document whe~
nstitutes a te rary Certificat of in compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
I
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
/fY%) . ~
USE OF BUILDING
eE-s t!l.jg
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
3'</', l S-
Plan Check Fee ............................. $
State Surcharge............................. $
. g-D
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~
.1
Sewer & Water Permit ...................... $
Issued
Tr)iS' ce~the req
s' 8d b t'r;jJ1j lanner
. ,
City anner
v
24 hour notice for all inspections 447-9850
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA LI
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
LI
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Special Conditions H any
r7
(/ I. _ ; '.j Ir..4_
/ .' ',-..,' .......
The' Ctnler of 'he' Lakt Country
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,1:::''(:- /v/I I / h/ I (, I / I
/,
111/ .~) /(7 C\
, --j / /
I^li (, .( f2.. I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,. , It' ?... .A_ /:'//1' //"j'i/, ,-?- i.'jI' L"L J(' {J
/ .I '..' (_......,.- " '..".,1 .." ~', ., ,~-" ~.. f ~.-," .,
~
Accepted /
Denied 1 )
Reviewed By: _~. (?), :JP'1/OA.J
Comments:
Accepted With Corrections
Date:
J J- 5-9i
y
'.." t.
lIIii' -'
"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."
L,..
.
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ,~O B<--l QVuL~r...{ \V\-e.~ ~
NATURE OF WORK ~l"",,,<;,k \\~ ~~ ~~
USE OF BUILDING SPVl
PERMIT NO. Lti - ( <,()L\
. -
CONTRACTOR LJlJnt-l
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
/f-U _'Z 7
,
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
HEATING (if required)
....
~.
IMP!
?/~~~
/O-3{'-f/l
A
~
~/ft; /b z.,
r .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
pI-
, I
-f / 74/tJb
R1/~/ 0;;'
~
, /
. ? /.:; (/r.7h
,
BEEN SIGNED
HEATING
r
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
This card )nust be posted near an electrical service cabinet prior to rough-in inspections
and maintflined until all inspections have been approved. 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
DATE TIME
~~.
/7(J?~ 4~<:~_./ ~~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMIVIENT,,8: ~ ./
a~P-t/~'1' ~ j' ~ /'
/: /
;r/~/
~({
-'-~'.-.'-'~._-~~"~---~--,-
Y9- /Jt:)~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
JYhS//;2-~
,
/~/ ~
\ r___i6:1e // I"e/
----- ~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT,~~..; C~OR REINSPECTION BEFORE COVERING
Inspector: '~L.-----" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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