HomeMy WebLinkAboutBuilding 02-0682
DATE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1/-1J.-03
ADDRESS
(73CQ
f,i~l W1f7J cL c:.,,(
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'2 - '~L
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSlt/OTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
{p....5" - 02-
I. White File I PERMIT NO 2J
2. Pink City . ()Z."O /_/1
3. Yellow Applicant , ~r:l...._
'13&9
fit-
LEGAL DESCRIPTION (office use only)
~
PID ;d .tJ:
LOT
ADDITION
OWNER .
(Name) :&:d~
~~
(Phone) 4 ~ 1- , I :5 7
({Zt.- (fr/2) e/z - /tJtfl
(Address)
Q..,.T .s~
BUILDER
(Name) Nit
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
~J
ORe-Roofing
o New Construction
o Porch
OLower Level Finish
o Fireplace
DAddition
o Alteration
PROJECT COST IV ALUE (excluding land) $
ZONING (office use)
Ix I
ORe-Siding
OUtility Connection
I, "5'00 .0 Co
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 needed inspections.
#
#
X
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ () .00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
(P-3-DL
Date
$
$
$
$
$
$
$
$
$
. ~S-
Your Building Permit When Approved
Paid
Date
/d~.e~
~-/_O
I~
t, - 7-ClZ-
Date
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
White - Building
Canary - Engineering
Pink . Planning
The ("tRier of tht' L.kf Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
Q .
~TC/tP ajC!-'f7~
&-~-d-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ~. .ty 'rhich is proposed at:
1~369 1f,(i962 u/otJd {}/f-
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
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."
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO I
2. Gold City . 6 z. -0'- f, -?
] . Yellow Applicant . t...--
ZONING (office use)
1 '3lo,. ~ ,
Jl.Q
;
LEGAL DESCRIPTION (office use only)
LOT q BLOCK l( ADDITION LJ
PID 2b-::n.i-6r/-o
OWNER
(Name)
(Phone) 4 C.{7-/( ~
c~ U (,'2. - ~(2 -(4 'f7
(Address)
APPLICANT c->
(Name) -.:>c. .. ~
(Phone)
(Address)
(Address)
(City)
( Zip Code)
(Contact Person)
-- _.------~---
-LICANT SIGNATURE
(Phone)
DATE
2-
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
X Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
$
$
$
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
ffrlO c1
I!//prt-
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
~f. 5""0
.50
qO. a:?
b -b. 07.-
Date
I Paid
Date
I ::ceiPI No
omes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
OEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /73ft79 Je/OG6WOOO cr:
NATURE OF WORK K/rcH~ iP..B'7QOcL--
USE OF BUILDING Je6S /I/~
PERMIT NO. 02- - () 0 &2- DATE ISSUED t;; -(0 - 02-
CONTRACTOR ~~T7: PHONE 447- //37
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ I I
~II
. NCRE;E UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
-
FRAMING
INSULATION ""-
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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