HomeMy WebLinkAboutBuilding 02-0179
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Z.;ZS -02-
/5071
/tPPR~ oof /1
Date Rec' d
I. White File I PERMIT NO
2. Pink City . 02 -O/7a
3. YeHow Applicant --I-
(1!!A- / t--
ZONING (office use)
eL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
s/cY8 ~
S~~
(Address)
(Phone)
4'-ro'-S-+(:f
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
ORe-Siding
o Misc.
o New Construction
'rfr--ower Level Finish
-z...-. l!A1 ~ .
o Fireplace
PROJECT COST IV ALUE (excluding land) $
o Porch
ORe-Roofing
OAddition
OAlteration
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 that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;t:ln thepropertyp~ ;)._ ~ ~_ tJ?
~ Signature Contractor's License No. Date
Permit Valuation Z, () 00 . () 0
Permit Fee $ r,Z . Z~
Plan Check Fee $ .
State Surcharge $ /.00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
es Your Building Permit When Approved
'2. -25""" -0<...-
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other L:::7 .- ___ .It '-' $
TOTAL DUE $ ~~. Z5
Paid
Date
+.cr
f. Z-5 ~C 'Z--'
I ~~1t-.
r
4-'1 ~
This is to certify that the request io the above application and accompanyiog documents is io accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoniog 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:~.B Date:2.~~oL
Building Permit # PID: Zoning:
Site Address I So 71 I4p~~~~ (1)-
Legal: L
B
Subdivision:
Existing Structure: YES or NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? 0'<
Is the property located within the flood plain? Refer to Planning o~
Does the alteration include any additional kitchens? Refer to Planning crk;-
Does the proposed alteration include any outside Refer to Planning ~lc.
entrances other than patio doors?
Is the proposed use of the finished space or Refer to Planning t11i
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED Al'lD INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L\TE:NfPLA TE\AL TCHCK.DOC
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
//- /1 'v'L--
~. ~~~~ ~~~y I PERMIT NO. (}2 '/#7-1
3 Yellow Applicant , ,
ADDRESS
J'3>-{) 71 /7P f? I7l,O (J J ;q
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
- 003- ()
I OWNER
(Name)
(Address)
(Phone)
APPLICANT . L'.'
(Name) ;/f9-JJtrA-. I _C..- /,..,..----)-- .-"
Address) I
/r'-lOr
(A fl s) (City)
~-- j ///"
Contact Person) S, //h.,-~ .:~/ L-//7~,~'-~""'~ (Phone)
PPLICANT SIGNATURE /~~.,>.' -- ~ ~-",-"-,-
Quantity
PPLICANT PLEASE COMPLETE BEL
Type
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
/ / - r).. - Cl ''"'}--
ype of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
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
Building Permit # 02 -/482_
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
-.3 q ~;;()
.50
400U
(Office Use Only)
This AppHcati~n ?Il.o ommes Your Building Permit When Approved
etJ~~ /1- /7 ' d 1.--/
Building Official Date
Paid 40 . 0 ()
Date
/ l / 2 . 117.-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J $"'0 L I Appclos~ ~ 'TF.
NATURE OF WORK L.or.cJ4:rlsvH Q f)"d","-, t-, (2 ') Roo\M..s
USE OF BUILDING ~
PERMIT NO. 0 2"-0177 DATE ISSUED 2-?S' -0"2-
CONTRACTOR . ~~ PHONE
NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~OU~ I I
1.EeU.rIilA~ fPrlor to Backfill) I I
PLA~ - NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~'L-.'! w..~ I ~E""IC -
FRAMING VW'/ /r- , )
INSULATION vw- 11- (j
ELECTRICAL
PLUMBING fW jl-()
HEATING (if required) 1W II'"'/~
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
mg)
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 ~een 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