HomeMy WebLinkAboutBuilding 02-0096
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White File
Pink City
Yellow Applicant
PERMIT NO. Al
WI' -OOCfb
I L{ 950 A
lJ 0 t:'~$.t'l. 'Tr cu I
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK I ADDITION /J1
OWNER
(Name)
(Phone)
PID
l-!cu) ,<;12-11 /t.; M
,I
(Address) I
~~~;~~R -rJ"J~~ 7,', j Ie-/" 6" h/_-h "'" }_
(Contact Name) "l"",,,- 6 \- Tet,,,,,j
,
ZONING (office use)
(2-
75~~ zjl./O .,- '111(:1 J
(Phone)
(Phone)
'5;- "<;1'8- '6~ S-Cl
/"5 J -;171..)- $1' 3 ).::J~
~? f3..'ltIM
(Address)
;L;;L
TYPE OF WORK
DPorch
ORe-Roofing
ORe-Siding
DDeck
o New Construction
M-ower Level Finish
o Fireplace
DAddition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
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 fo. e above-mentioned propertY. and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pI ware that ~ilding 0 cial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter the erty to perform n . . ns. '
0>0 d-G 3 J.S I
Contractor's License No.
X
Permit Valuation 2 1"00 .C>O
Permit Fee $ (/2 . -Z os-
Plan Check Fee $
State Surcharge $ I .00
Penalty $
Plumbing Permit Fee $ 6'D~
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
DUtility Connection
$
$
$
$
$
$
$
$
$
TOTAL DUE
mes Your Building Permit When Approved
Paid
Dat
lO
I - '"2.t3 - D L
Date
c..~ , -vb
3 L')
This is to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as 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.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
"'W -- -__.________-;___._~_..__._._. ----..,"-
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~?u~t- t-JI) O'i1--OlJ'lb
i:~: ~;y PE IT N '02-009/- I
J. yail.... "ppn..... __ co
I ~~-;;;s~ print ~~ at boatllb)
. \I.\~SO IW:~ --1(~, [ Nt
ZONING ((I1tia! UK)
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK
ADDITION ~Cl(
t IS-t
PID
OWNER
(Name) ~l \ la.'S o-rl
(Address) I~q 50
(ld81fP tta.r&1\
-r: .
'J':.::LJ.. \ ( tL II
(Phone)
q52-~-"f'o-qM I
APPUCANT \ I
(Name) ~ciY'lrtX 11~r\
(Address) 14QSD ~cLl~ -({a.~LMF:
(1fcldress)
(Phone)
~ t" O{ L~~lf'
q~ - 440-4&""4 (
f'.1N
(City) (Zip Cocie)
(Phone) ~S) - -t.fO - q r=rl
1- 3.) -02-
DATE
(Contact Person)
APPLICANT SIGNA TURE'-.
APPLICANT PLEASE COMPLETE BELOW
QUBOtity Type of Fixture Qualltity Type of Fixture
Bath Tub with or without shower Rough.ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backtlow Assembly
Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial &. Multi-family 1 % of jab cost with a $39.50 minimum
Residential, New One &. Two.Family S99.S0
Residential, Additions &. AlteTlltions $39,50
Estimated Cost $
Building Permit # j Z - () 0 90
,f\J\.........l
r \0\1' Ii.'.,....,..
5 pp..: G pC'i"..d
- 6\J\\..O\N
~
PLUMBING PERMIT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEE .$
(Om\:e UJe Ollly)
Bulldln8 Omtlll
Pllte
This Application Becomes Your BuildlnK Permit When Approved
14 hour notice far .11 inspections (951) 447.9850, fu (951) 447....145
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1<-11 w Asf>PAJ.O~~ CJ'.-r-
NATURE OF WORK ~~ h'1,../'9A
.
USE OF BUILDING SFLJ
PERMIT NO. 02 -t2?l((p DATE ISSUED /.2e;!;-<::L
CONTRACTOR -Zie~~.c/'-- ~. PHONE /'5/-'Z i1-eri?1
NOTE: THIS IS NOT A ERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
r=-~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
W/e
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FIN
-
- -... .
g)
BUILDING
ELECTRICAL
PLUMBING
HEATING
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850