HomeMy WebLinkAboutBuilding 04-0151
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3./7.04-
I. White File
2. Pink City
3, YeHow Applicant
PERMIT NO. 04.0/5/
ADDRESS
(~Y;-7 &tl'{~1,/i( IT/lll f\J2
ZONING (office use)
/l!/S D
LEGAL DESCRIPTION (office use only)
LOT 2- BLOCK +- ADDITION
/tC.A/ 0 6 HILr'-'
PID 2.5". 3/0. 035.0
OWNER ,
(Name) ~ H I tVt\.l\.
'.
L-ISA. I~:)/t' U-Ll(A,lt~L
(Phone) ~Sl-lf-(jJ,--"I+;~{)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
OPorch
TYPE OF WORK
ORe-Roofing
ORe-Siding
o New Construction
}(Lower Level Finish
3 ~S.
ODeck
o Fireplace
OAddition
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
OUtiIity 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 buildmg 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 inspecngns L') ~----
X , ?J~7/ol
Signature 'I..- / / , Ir ntractor's License No ate
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
3 000. 00
7~.7S
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ /5(0. ZS
I ~;?J-: ~ z~ "1
I.SO
Water Meter Size 5/8"; 1";
Pressure Reducer
+-'0.00
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
4(J.tJV
TOTAL DUE
I Paid
Date
-t.~
~/7.
Building Official
J/;?~r
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 10 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 (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
..
..
Residential Building Permit Cheeklist
Basement Fm.i:sh or Interior Alteration to Single Family Homes
BY:~
,...
N0
Date:
3/17/oLf
BuildinO' Permit #
1:1
Site Address /L/ ~ 17
L~~:L 2- B ~
PlD:
Zoning:
3/u.e 6/12-./ 7lG1 /~
Subdivisfon: K~ 1/4
EDsting str'acmre@r NO
CONFORLv!S TO ZONING Y'KS NO
ORDIN".AJ.'{ CE
YES NO
Is this an e."tp31lSion of the e.~g footprint or Reier to Plamring
building height'? tJO
Is the pI'OpCTjlccated within the flood plain? I Refer to Plamring I ~O
Does the alte:"'..rion include any additional ki!cho.s? I Refer to PlaI:ning I rJO I
Does the oro1;osed alteration indude any outside' Refe:- to Pla.Tl~i-rl g
. . .
emranc:s other than patio doors? "';0
Is the proposed use of the finished spac: or Re::e: to Pla'T"T'~g
alteration for anything othe:- than 3. nor:nal single NO
family home (ace:, gro~ hC!:le. 6y e~e. e!c.)?
Tms c.;~CXl.lS7 )11:57 BE COMPLETED .~'fD ll'iCUJDED IN Th--:E Bll1D[~G PSR'v!I7 FT~.E TO
)(A.IN7All"f A RECORD OF Th--:E REVTIW.
..
..
..
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDIN~
PERMIT NO. ()
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~j I
PLACE NO CONCRETE UNTIL ABOVE H.AS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
]
I
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
r 1
FINALS
<f~ ~f'
]
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 INSPECTIONS (952) 447-9850