HomeMy WebLinkAboutBuilding 06-1105
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT . "1 "lO-OCo
I 0<. - '-x-
I PERMIT NO. t)0-/1 (J 51
Date Rec' d
I White
Pink
Yellow
File
City
Applicant
(~..~ ~"'~ m::tt~)
I ADDRESS
I~ D lfe... U\ \\JL
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) 'JOOt\-
mL)\~ O~ ~~'Ul ffi'? \\U'\Q
(Address)
(Phone) Cia!} ;}-} Dc?;. J690
BUILDER
(Company Name)
(Contact Name)
(Address)
,SArv\E
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlOn OAlteration OUtility ConnectIon
CODE: &h.R.C. DI.B.C.
Type of &struction: I
Occupancy Group: A B E
Division:
II III IV ~A (i)
F HI MRSU
I 2 3 4 5
o Mise
ORe-Siding OLower Level finIsh 0 fireplace
MDoc.,- lJJa , I
PROJECT COST IV ALUE <r.cJf I
(excluding land) ~
(j.;)
I DC:cJ .
I hereby certify that I have hJrnishcd mformatlOn un this application WhICh IS to the hest of my knowledge true and correct. 1 also certify that 1 am the owner or .1utlwnzcd agent fLn the
above-mentlllncd property and that all CllnstructlOn WIll Cllnfmm to all eXlStmg state and local laws and will proceed m accordance with submitted plans I am aware that the buildIng
ofti '..11 can revoke this {ermlt for 1St c. Ise Furthermore. I herehy agree that the CIty official or a designee may enter upon the propeny to pert()rm needed inSpectIons
19~c9[)~Olo
Date
x
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Contractor's License No.
$
$
$
$
$
$
I $
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Park Support Fee
SAC
# $
# $
$
$
# $
# $
I $
$
1'2..2.. .0" $ ~B.s~
I ~r- No 52,.'/1'-
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
~1.i~L/~
Tins lS to certify that the request 111 the above appltcatlOl1 and accompanymg documents is 111 accordance with the City loning Ordmance and may proceed as requested ThiS ctllcument
v..'hcn signed hy the City Planner constitutes J tempOral)' Certificate of Zonmg compliance and allows constrllCtIon to cummence Bt'fure occupancy. (l Certilicatl' of Occupancy mllst be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Bv.
~ .
Residential Building Permit Checklist
BJseme.!lt Fini.sh or Interior Alt.en.TIon to Single Family Homes
.[fD ~ Date/:J - de> Q (,
Building PermiT '4 . Pill:
Site Addre5s /L/~ 0HOL-R L-AJ
Zoning:
B
S ubdiYision:
le-.g'll: 1
Emnng Srruc-::ure: y~S or NO
CO~~ORyIS TO ZONI.'{G
o RD IN" __~'f CE
NO
YES
NO
Is chls an expansion of d:e e;-is-....ng :oarprL" or I Re1:e: ::0 Planr":":'""lg
build.irlg heigh!'? 'P
Is me prope::y lacatd Mrh""'l che flood ~laU::.? I Re:~er ~a Pl3J.~-ing I ~ I
Does l'le alte:ation include my additional k:tcie:::.s? I Ref:=:- ::0 Planning I ( I
~
Does the pro1=osed. alte:arion ir.clude any outSide Refe:r ~o Pl:l~-'~g
e:J.rr:mc~s othe: tb.an patio doors? fJ
Is me pro-posed !~e of ::he E::.isZle-i space or R~fe:- :0 PlaI1-~~ g
alte:3.rion for anychi::.g Ow."le: :b.:m 1 c.or:::al siI:.gle ~
~., ( ~- g:CUD hone, 6"1 C3.re~ .;;,T'_ '1,''''
r~ , v r: .a r'" Q
__'TIll. _.au:,- O._.c~. - . .....) .
THIS Cm:CXLlST MUST BE COM?LETED .~'fD I~CU.rDED m THI Bl:1LD[NG ?EB..i.'dIT mE TO
~L-\Jl'{TA1N A RECORD OF THE REVIEW.
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDIt,tG AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDIfi..G
PERMIT NO. 0 · DATE ISSUED -_0-
CONTRACTOR .... PHor4VJJ2- ".-,Sf/)
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I... ..._3 I
JK rl UleN (Prior to Backfill) I ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
uired)
FRAMING
INSULATION
ELECTRICAL
PLUMBING
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
I .
.. . - ~
rior to Soddin
BUILDING
ELECTRICAL
PtUMBIIJG
}-- ~yth
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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 shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850