HomeMy WebLinkAboutBuilding 04-0071
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I, White File I PERMIT NO
2 Pink City . -t1) /1__
3. Yellow Applicant , ~~
7/1
(!., I /'2.
Nb
ZONING (office use)
Jet
/ 4+ 7~ N/~ItT//v"-cj/}L<5
LEGAL DESCRIPTION (office use only)
LOT 2- BLOCK 3 ADDITION
j::.tJOt$ HILL- 4-71-1
PID 2.5. 3toZ. 028. 0
OWNER
(Name)
/?otf
S~, !\R{b Jf}
(Address)
(Phone)
952-233-tJf3g-
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
o Porch
ORe-Roofing
ORe-Siding
o New Construction
~ower Level Finish
o Misc.
PROJECT COST IV ALUE (excluding land) $
o Fireplace
DAddition
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 th . 'n official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~ter upon the p perfo ~ e ~ns ? 1/7 /z q/!
Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ J~O
Penalty $
Plumbing Permit Fee $ 0
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ ~{j ,,0 0
~"~dmg~/~!;;~
Building Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $ '~
/1 J.b'roer Fee # $ --- i--
""- V'
Builder's Deposit $
Other ele<:-. Drmf- $ / . {' ()
TOTAL DUE , $
Paid
Date
J~ ~. ,?{<)
. -/7 -Otj
- - -/
I Receipt N3X7 ~ ~
By ~ .
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 ..:;Jteration to Single Family Homes
BY:~.
~
Date: . " ,..
/"?-c)~/'
Building Permit #
Site Address
Pill:
,
J /-/L/7 c ?;nijin" g, :. It &"/vl C (W, ~ ;; -
I 7< 7 / .,IL C 7 ..~
· ,j ~ /11-/.
Subdivision: K~ ~ r--=-
Legal: L Z B
.5
Existing structu~r NO
I CONFORlvIS TO ZONlliG
o RD IN ~t\J.~ CE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refe: to Planning
building height?
t-Ja
Is the properry located within the flood plain? , Refer to Planning I
t.JCl
Does the alteration include any additional kitchens? I Refer to Planning I
f'Jo
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ~()
Is the proposed use of the finished space or Rde: to Planning
altenrion for anything orh.er than a normal single tJO
family home (office, group home, day care, e~c.)?
Tms CHECKLiST MUST BE COMPLETED A.'ffi INCLUDED IN THE BUlLDING PERi'dIT FILE TO
MAlNTA1N A RECORD OF THE REvIEW.
T .\r=',fClT .\ n:\,..\.LTC":HCZ..sCC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 1+'t'79 j)/'-f/-b-hAl'1(J,k a~
NATURE OF WORK t.
USE OF BUILDING Sr::
PERMIT NO. ~~-J&-~D ~-I-I_~f/ ~
CONTRACTOR 4. PHONE ~ S"" Oi3a
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
___ I
ill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRA
INSULATION
. ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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 lNSPECT10NS (952) 447-9850