HomeMy WebLinkAboutBuilding 02-0262
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
3- 21-0 Z--
/ '-13 &:; /
j)PVE c;;r
Date Rec' d
I. White File I PERMIT NO ~
2, Pink City . ()'? -OZ /_
J, Yellow Applicant , V _ U' ~
ZONING (office use)
.tel
LEGAL DESCRIPTION (office use only)
LOT /1BLOCK
I ADDITION ,K'll/ tJo lI/l.L- STH
PID~6 <3&8 - Or7-0
OWNER
(Name)
(Phone)
(Address)
~~;~)ER fAOCL ~VO ~D 5"10 V
(Contact Name) s: a 1l<,~
(Address) ) l1 Sb-f \!o\te- (.3c 0 _ ~. f ~ Of2- la~
(Phone) crf2 - 't<?b'- ~cf3 3
(Phone)C IZ-G36- 6 Y-/3 c:
nlt,.J c; s-~) /2
TYPE OF WORK
ORe-Siding
o Misc.
o New Construction
~ower Level Finish
- -5'$".
ODeck
OPorch
DAddition
DUtility Connection
ORe-Roofing
o Fireplace
DAlteration
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 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
ent on the pr9ferty t~ p:rJ9rm needed, inspections. . /'
X (!Utl,A' I~~ LA..,D <;' if) tf ~- 2/- 0 L-
Signature Contractor's License No. Date
Permit Valuation 3, t10 O. 00
Permit Fee $ '7L/ 7 S
Plan Check Fee $
State Surcharge $ /. s;- 0
Penalty $
Plumbing Permit Fee $ 4-() " 0 0
Mechanical Permit Fee $
Sewer & Water Permit Fee $
-
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other ~e:TE/~ $ ).00
TOTAL DUE $ //17. LC;-
1~1Ii
4-/52-4-
Paid
Date
'r; --
/ . ~~
~., - 'V' -~' "'2--
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
/',7'
Base
t()
Residential Building Permit Checklist
ent Finish or Interior Alteration to Single Family Homes
<(
Building Permit # 0
Site Address / L/3 to /
Legal: L / 7 B I
Existing structure:~r NO
Date: 3-;Z /- 0 L
'C/
BY:
PID: 25-.3~fj-O/7-Ci Zoning:
DOVe ~/.
~I
Subdivision:
):'ll/ d/5 III {-f.-,-- 5-ff--
CONFORMS TO ZONING
ORDINANCE
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ~
Is the property located within the flood plain? Refer to Planning ./
Does the alteration include any additional kitchens? Refer to Planning
~
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? -/
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single i
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AL'ID INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TE.MPLA TE\AL TCHCKDOC
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPL~E PERM1T 'y/-'- ~ _
I P/~€- ~ oz--ozk' "
j) ^V c. /1 N- C:-7~ _
V '- L.. -;-; - ;,.
LEGAL DESCRIPTION (office use only)
LOT 'BLOCK / ADDITION
OWNER 7J
(Name) r'flt LlL
(Address) /'13(0
~ # ()D p-rjr;-rlY\./
10' &,
N.; ~ -
APPLICANT 1/' _
(Name) ILl Gf?- eo 4- h /?Svp L-I1 erZ-
(Address) /'klS-1 /nfl/^-' //VL \~/G3--,
. (Address)
(Contact Person)
APPLICANT SIGNATURE
ZONING (office use)
IZ/
(Phone) y9h-Y63-;;
(Phone) 9,s7.,-Y4/)- S~W
jJ~O~ LlJr-<r- SS3-''L
(City) (Zip Code)
(Phone) 'f?i;2--Cfl/ j> - Sc,:u2
DATE ~'/Pl
INPUT
OW
AL TERA nONS
FUEL
OUTPUT
DNEW CO
FURNACE MAKE AND MODEL
A PLICANT PLEASE COMPLETE B
RucnON D REPLACEMENT
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
REA TING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL 1J1/l~c,. 3 60 ~rJ
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial & Multi-Family
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ;L<-t~ -
$39.50
$39.50
$39.50
Building Penn it #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
$
$
$
~ q~S-{)
.50
~().J()D
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS / ~ -3 ~ / 00 V (3 C!-OV~
NATURE OF WORK L-OtUf5Je- L-eV'ez.-...-
USE OF BUILDING e6S /I/?
PERMIT NO. 02-' 0 Z-{P 2- DATE ISSUED .:5 - 2/- aZ-
CONTRACTOR !<'AV().t'A2.f77>V P~V6& PHONE L/9t. - CJtJ33
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
t m I
I 1 ~ 11 TIl11I HI. I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
"
~- }.rs- .
S -L~ -())
~/J-~ -0 ~
T
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~ - U I d
BUILDING f;) f7/ If-.J/f
ELECTRICAL I
PLUMBING j
HEATING V
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTIGE
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