HomeMy WebLinkAboutBuilding 04-0123
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO ~
2 Pink City . O^ LI' - /
3 Yellow Applicant , ~
~. J
~) {Jlld.- ~
ZONING (office use)
(J L~ J!)
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK I ADDITIONI-?111 ~..e4t j)~
PID;;{S- L/O~- OOq-O
OWNER
(N ame)
\1 ~CiNl/IY1I ('
Y~:, b)oGh hi n
(Phone)
CJ5J.. . 11'1(;' -b/LJj
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
o Misc. \ (Z..C
o New Construction
~'ower Level Finish
ODeck
DPorch
ORe-Roofing
ORe-Siding
TYPE OF WORK
o Fireplace
DAddition
o Alteration
DUtility 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 upon the property to per~orm n7wnspe,.c, tions.
X "i~l / L C C- .:3 -J-()'1
Signature Contractor's License No. Date
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Permit Valuation
-
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other eJec $ l,t7d ./
TOTAL DUE $ 1/8/15
o
---
\ Paid
Date
1/A;~1~
I~~~.
Lj& tfl 3
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 ;2/J If-
Date: 3- 7~)Y
-:;;T () LI ;;Z
/I? ,; Zoning: j;- ," ./}
~)i'-tt5 N-{O v~
Building Permit # C!?f-- f"Z.3
Site Address
Pill:
Legal: L B
Existing SlructueNO
CONFOR1vIS TO ZONING
o RD IN" AJ.'{ CE
Subdivision:
NO
YES NO
Is this an expansion of the existing footprwt or Refe: to Planning
building height? -
Is the property located within the flood plain? \ Refe: to Planning I
..---
Does the alteration indude 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
alter:lTIon for anything other than a normal single ~
family home (office, group home, day care, e~c.)?
THIS CHECKLIST MUST BE COMl'LETED ..\l'fD I1'!CLUDED IN THE BtnLDING PERMIT F1l.E TO
LYWNTAIN A RECORD OF THE REVTEW,
T .\'j";:'7I,rPT .l. Tc:\A LTrFCZ.DOC
PRIOR LAKE
INSPECTION RECORD
6IJ f?. B lit -f.P IrI-s 7Y
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED · ,-0
CONTRACTOR " .... /".u. , .~HONE I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~.
~II
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
~~ / 30
3 -:So .,()i.-/
'-.Jo,Oi-/
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I I
FINALS
-~
I
r
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.
FOR ALL INSPEC.....~ONS (952) 447-9~50