HomeMy WebLinkAboutBuilding 02-0113
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
~;t1l' CAADU,,:Al..., Klj)L~
1'../\ \ L
LEGAL DESCRIPTION (office use only)
LOT
BLOCK -z...- ADDITION
~~\~
OvrNER D
(Name) '~c-wt A-~ T .
(Address) ,
White File I PERMIT NO.
Pink City 0 7 II?
Yellow Applicant L.. - .:>
I<f: - lv1/J ~ 12-
ZONING (office use)
rub.
~ADO
PID Z ') -
-Os/-G
(Phone) 1<)2- - ~ 4'1 .. 4? t I 0
'S"537<-
BUILDER
(Name) ~~
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
DDeck
OPorch
DAddition
ORe-Roofing
ORe-Siding
D New Construction
\6'Lower Level Finish
o Misc.
PROJECT COST IV ALUE (excluding land) $
o Fireplace
DAlteration
OUtility Connection
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 at the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the pro ~.. ons.
Permit Valuation A- c1?G:C? - -
Permit Fee $ f>l. 2~
Plan Check Fee $
State Surcharge $ '"2,. . c:A:?
Penalty $
Plumbing Permit Fee $ 40.-
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ ~-
-eIJ
Contractor's License No.
'2- -I) .- (\ 2-
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other G i.-I&- . ~?P $ LOO
TOTAL DUE $ f'70.2e?
Paid
Date
(~c9. 2-..,-
-z. C; / C? 2--
. f
I ~;ceiPt No. rJ"\~ z.D"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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: ./? J'"\ itl-- Date: /- /
r'-1} '\j 2. . ~ (02-
Building Permit # 02 r'i I 3
Site Address
PID:
Zoning:
Legal: L
B
Subdivision:
Existing StrDcmrGor NO
I CONFORMS TO ZONING
ORDINANCE
10S I
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? 'f
Is the property located within the flood plain? Refer to Planning y
Does the alteration include any additional kitchens? Refer to Planning y
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? 'yO
Is the proposed use of the fInished space or Refer to Planning
alteration for anything other than a normal single y
family home (offIce, group home, day care, etc,)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO
2. Gold City . /)..-. -/{3
3. Yellow Applicant V l- _ h
ZONING (office use)
sell\
~12-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OVfNE~
(Name) (~
(Phone) 152-'1L(? -(0 It V
SZ)'?>1Z-
APPLICANT
(Name) ~
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNAT
DATE
Z. -5-D2-
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
J Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
{IT"
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
en Approved
I P,;d
Date
I :~eiPt No
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~;w ~J~icant I PERMIT NOO Z -((.3
ZONING (office use)
~ \ \ C~2j)\~^t-
\.1Xr€" IPA \ 1,.
~\
1J C;S-;~7 2
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z~-~
--0
OVfNE~
(Name) How1~
(Address) 5'-lt C
P.
(Phone) q5'2. -4~1-(O (to
R bIZ ~'/li1tJ ~12-
APPLICANT ~'.J"....r
(Name) ?11 vrU?
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
2 "5" .-() 2-
APPLICANT SIGNATUR
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL 016 +\~~ FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential. Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
$
$
$
\"'\.
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office lise Only)
I ::ce;p'NO
I Paid
Date
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Sit ( CAP-P//V'-PT<- ~(O<3E-- ~
NATURE OF WORK Lo__6'L le-v6L- Fl~s~
USE OF BUILDING \~~ A/tL ,
PERMIT NO. ()7- --;' s DATE ISSUED Lk/c9L
CONTRACTOR lIOMAc;;. 5uL.L.lvtA('i
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~i~iJI) i :
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
..8EWIiR I VjJtr:Sn J~ r;::PTIt.
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
.3. t, ~~
. IJ,
'. r
COVER NO WORK UNTIL ABOVE HAS BEEN SIGN,ED
~O~ I I
FINALS
I
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEf\
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections ~aYe 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