HomeMy WebLinkAboutBuilding 02-0422
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CITY OF PRIOR LAKE BUILDING PERM T,
TEMPORARY CERTIFICATE OF ZONING COMP A
AND UTILITY CONNECTION PERMIT
Lj-1-0d-
I PERMIT NOl9J. - DL-j J-;LI
White File
Pink City
YeHow Applicant
~(/y
LEGAL DESCRIPTION (office use only)
LOT/6 BLOCK
ADDITION
OWNER
(Name)
vJ
,-
PID;lJ -
(Phone)
(Address)
ZONING (office use)
~\
- 0
(Address)
tf9 :>
(Phone)~J-I- -rot ."" YYo /)
(Phone) ~ /.2 - ,J 6 f - ? ~/ .2
/7l IV 5'5) ;).J-
/.JDm~.f'
. If
~()()
TYPE OF WORK.
Aa1fe"w Construction
o Alteration
DDeck
o Porch
ORe-Roofing
o Misc.
DLower Level Finish
PROJECT COST IV ALUE (excluding land) $
o Fireplace
QAddition
ORe-Siding
DUtility 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
enter upon the property to perform n ded inspections.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
/Y5r
Contractor's License No.
$
$
$
$
$
$
$
$
#
#
Park Support Fee
SAC
#
#
Water Meter Size / ; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
lbb .. t!>D
, .00
3S'.SO
CJ; . {)O
Builder's Deposit
Other
Date
$
$
$
$
$
$
$
$
$
-
TOTAL DUE
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
'""~--~~ '-I;l:t,(CYL <~~ t4~~r~~hlv1(
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
,l-!/Z/fl!lt,i/ Dd -0 Lf oJ d-
The- Ct>nlt"r or the tlke Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Ul;?~t1/J1/rll ~~
APPLICATION RECEIVED i-LJ-tJ;;--/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whic is proposed at:
11
,I
Accepted
Y-
Accepted With Corrections
Denied ~O L
Reviewed BV./r.:z~
Comments:
Date:
4' -/7-0<-
~etL ~ M.a.,- '^ J? G,
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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10/24/01 WED 11:22 FAX 8124474245
CITY OF PRIOR LAKE
~OOl
Date R"'d
em OF PRlOR LAKE PLUMBING PERl\IIT
1 ~;Dlrssi:s:;;;:r~ ~c,. ~W
~. ~T:... ~~'<Mi I PERMIT NO. d-LJ ~~ I
II WNlNG,_~ I
LEGA.L DESCRIPTION (g/Jia: UIII! acl~)
LOT k::,BLOClC. LJ ADDITION ~~ (Jcu t-
pm
O'WNER
(Name)
(Conraa Person)
(l'hone) bSJ-LfU -l/'jDO
\M ,"" $} 2'2-
(Phone)~~-'fs)-ISt.
IVW\.. . SS1:J.~
(City) (Zip Cod.c:~
(phone) t~ l-'is;;. -/51:,5
DATE t:"".:2-
(Address)
(Ad.d.ress)
Type 0 lat.
I
FEE SCBE:DULE
Induslrial. Commerchd .t Multi-ramlly I'Y. at jab cast ....ith a 539.50 minimum Residential, l'le.... One &. T..g.F~il,. S99.,O
(lelidenlial. Additions /k. Alte18lions 539.50
Esrimllted Cl:Ist S
Buildlng Panni! ~
PLUMBING PERMlT FEE
ST ^ TE. SUllCHAllGE
TOTAL PERMIT FEE
S
5
S
.50
,
&u1~PA!D "
~alO:i\'("::":
eeJpt No.
- ,
lomu UI! OalY)
Tbit Applic3uiun Becomes Yuur BundinE Pcrmil When AppTowed
Paid
BIIIldlDt aISle-i..
Date
By
Dlle
:11 hOUf IJotiC6 far 1111 ihl~tiMl. f9IIi:Z~ ,",1_Q::;'c;.;;. er.. ,Og1 Loi-:.....,.....
2/l d L9v I gSI9gS 'oNlVG: g l 'IS/OS: g l GO ,VO '90 (]Dl)
WOH3
.-"
~ . ....
TI,~ . ~c..,"
GoOLJa . <::n'"f
C!~y OF PRIO~ LAKE
SEWER AND tJATER P~RMIT
NO.~
NOTE:
Sewer and Water
contractors mus~
be re~istered
vith the city.
ADDRESS:
PHoNE:tJ~1f~l~
DATi: : ~ 'I O:;:J-
S ;: G ~T >. ,!,T";P.:=: :
g!...DG. :?~?..."'!!T ;;
4 -
~!LL IN Tn~ BL~KS
:E:sti!!12,tec length of ~ater service <30 feet-.
Size of vater service / 1nc~(es). aMtA
Loca~ion of any co~?lin~s from s~=uc~ure~feet.
~~pe of sewer pipe. ABS____ PVC~ Cast Iron
3(J
~s~i~ated length of sewer line
fee~ ~JII1..
a.t ~fest
from
1 .
2 .
3 .
5.
6.
Clean out
st="".lc-.::.u:::e.
(if
re~irec.) I
located
~===_=~~=~~~====~===~~3_____~____~__~__=~=~==~~~===~____;~=~~~~~
T~~5 application becomes yo~r permit ~hen approved.
B";
DAT::::
~~~=~~~;;;--~~~==~~~=~-=Q~~~~~~~==========:=~~~~~~~~~~~~==~=~=~==
FE~S:
S
s
$
:35.00
.50
35.50
Sewer and ~ater line connection pe~it.
Surcharge
TOTAL
· rc~ fo= ei~her sewe= 0= water inc~vicu211y is 520.00 plus
S .50 su:rc:harge.
* Se~e:r and yater pe=rnits issued for nev construction must be
:reco=ded on the building permit ca~d at the time of issuance
to i~su:re tha~ no cuclic:ate se~e= and ~2ter pe~its a:re
-I ~ a.
_ssue_.
R~~'=''':'"':l'''' .:l
_10"...___. =-
REC'D BY
GI! IifR!~'
.~~".
-l~
, , - )
D~'!'~ ?A::::D
AMOUNT ?_~!D
· ~-rr -=:~'='~-=: ""':."~':::: ~:' S.::;.. 7'-:C'''' 'I_:!.\:~, ~!~-::,~":,r'l ~.:''':-: I ?''''L '~1:' ~- ~:3lJ I F..1X (~~:" ~~ ---!:~~
GIG d L9vlg8l9gS 'oNlvG:gl 'lS/lS:g[ GO ,VO '90 (3nl)
WOB~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~';::n ~!~ I PERMIT NO. J _ / - --::! ,I
J, Yellow Applicant , .:.:X C- / <./'IG:.,(,
,
ZONING (office use)
15294 JEFFERS PASS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name)_ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) _651-633-2561
(Address)
2700 NORTH F AIRVIEW A VENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/5/02
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL 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 HEATN GLO ST-TRC
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
"
"-'t, f ."-
bWlLD" ,.
.\., ~Id\~ ,'.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
i1j'! J 8
,-"..1\ "
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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PRIOR LAKE
INSPECTION RECORD
I CSe.~ -\-k Mo.,'V\. file
DEP'.RTMENT OF
BUILDING AND INSPECTION
SITEADDRESS JS:A94 ~rr~r:s RCl,~
NATURE OF WORK PJ.e0
USE OF BUILDING S~A
PERMIT NO. {J';'- {')I.(,;);}- DATE ISSUED 4-/7-cJL
CONTRACTOR ~JeVl,~W1aV\^- ~.e~ PHONE &'12 - "5'(01 -?t, 12>-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTO
FOOTING
~
DATE
c -tu ...va...
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~
SEWER I WATER I
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
~
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING C 0
ELECTRICAL
PLUMBING ~
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
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.
g ,- (cr .. cTZ-
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~ - '''0'2..-
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850