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" -. ~ z >oOz=r; ~ 0 _mm-l_ t- ~ !11 ::0"'::0 r- -4 -1-_ r- i enZ z m -I~ Cl "- ~ CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT LEGAL DESCRIPTION (office use only) LOT. BLOCK ADDITION (Address) Lj-;;LS' O(~ I. White File I PERMIT NO I 2 Pink City . 07, 0 ~ 1/1 c' J. Yellow Applicant . V TI-:.J. P"'/'or L4k-e; M N 5~ 37:2 8 L Vd/ Date Rec' d ZONING (office use) K~ PID 5-:3 84- BUILDER (Name) (r"'nfr'~ I-fr,J34'~..J (Contact Name) Toe . ~/fl f1 ;rft:i. (Address) . (Phone) f/<;l -9 56~ 7P<S (Phone) 1~).- r]6~7R?? (Phone) 'It'). -~ o~ --6;; 1/ C) S TYPE OF WORK ORe-Siding o New Construction ~ower Level Finish o Misc. DDeck o Fireplace DPorch ORe-Roofing OAddition o Alteration OUtility Connection 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 enter upo e ro orm inspections. Permit Valuation Permit Fee Plan Check Fee State Surcharge Penalty Plumbing Permit Fee Mechanical Permit Fee Sewer & Water Permit Fee Gas Fireplace Permit Fee ~ $ $ $ $ $ $ $ $ .)0 C/a . (:)0 qo.oo omes Your Building Permit When Approved {5 -g -(J L- Date d. C(]767]7 Contractor's License No. ~- ;)~ --6,) Date Park Support Fee SAC # # Water Meter Size 5/8"; 1"; Pressure Reducer Sewer/Water Connection Fee Water Tower Fee Builder's Deposit Other 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 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 PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS -1!:l~ :&k:oklM~ lS"lvce NATURE OF WORK e..'u.J Lo~(~ ~'^-\~ ( USE OF BUILDING S FCl..- PERMIT NO. 02 -0 t.fCl5' DATE ISSUED ,.r:;--{., -(~YZ CONTRACTOR C~ ~s PHONE -rS-"2.-cqo]-t,2C({) NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT - I I ~II . .PLACE NO CONCRET UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS INSPECTOR DATE FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED l~~ ) 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 fhf ("fnlff of lhf Lakf Countr) White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT (~ APPLICATION RECEIVED Lj -;).5 ,-0;;;'- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Itf:J7D ~kJm~ p)ud Y- Accepted Accepted With Corrections Denied Reviewed By: Comments: "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." Residential Building Permit Checklist Basement Finish or Interior Alteration to Single Family Homes By:f f;l Date: 7- ~ .5 - ()~ Building Permit # /{ ',. PID:c9.S-3>i1- O~d-uZoning: I( ~ Site Address /.?/:J.9o 'I...MJ-t;// 1tPJ,1Jt 6/ v'J..... Subdivision (:-llUuc/JlUi.:/p2ur' Legal: L J d- . B / , E.:risting Structure: Y'ES or NO CONFORlvIS TO ZONING Y~S NO ORDIN.Al~CE Is this an expansion of the existing footprint or Refer to Planning building height? ore.. Is the propert'j located wit.\in the flood plain? I Refer to Planning I s(e Does the alteration include any additional kitchens? I Refer w Planning I DK Does the proposed alteration include any outside Refer to Plannmg ok entrances othe: than patio doors? Is the proposed use of the finished. space or Refer to Plar..r..L.':.g e>k. alteration for anything aIDe: than a normal single family home (office, group home, day care, etc.)? YES NO THIS CBEC1G.1ST MUST BE COMPLETED .~'fD INCL1JDED IN THE BU1LDING PER;.'YIIT Fll.E TO t'il-UNTA.lN A RECORD OF THE REVIEW. L\TE;y[PLJ... TE\-\.L TCHCZ.DOC