HomeMy WebLinkAboutBuilding 05-0899
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(Please triM: or .!riat lIIld sip at bottom)
ADDRESS
/7390 ~r-~e~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CEJRTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
I PERMIT NO. ()5~~q 8 CJ91
~
L White File
2. Pin, City
) V.h.. Applicant
bf'...
SfE-
I LEGAl. DF.sClllPTION (....... ~~l
LOT E;LOCK ADDI110N
Date Rec'd
9. /t-. 05-
[m~~~'~(__,
O~30J
PIr' 2~. 4-00.
OWNEil /
(Name) _~qrr'l
l (Addres:l) L 7390
(Phone) (95:<) 331 .2 S39 _
S12
~C_(Phone)
(Phone)
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( (; /), ') 'J,-C3 ~~~ CD I
.3 ~,4( €.;__
353 rr~
I hereby ~itifY lita: J hav~ funished information on Ihis application whid is 10 lhe belt of my knowledle bU~ and correct. I also certifY thai I am the own~-r orluthtliz.:d apt for Ih:
abo~.men"~ prcperty an( t1v,t aU COIISbUClion will COlIform 10 aU ~xi51inl stale and local laws and will~:d in accordal1Ct: with sublfill.ed plans. I im a'vate II:ar the buildinJ
official can rrvoke Ihis pmnit I'or j'Jst cause. Fu::1hennore. I hereby asree It 6lth~ city official or i ~sisn~ Olay ente' upon th~ property to J.morm needed tnspccti~rls.
X ~,--= =::::c, 6?t??c;3 7/3(j2C) / 911&/~5
..- . _ Signat\lJ'e Contractor's License :"10. Dale ._.____
f-I~ cJl.,-,,(e.-
:Ue€I'~elct? bf'_
~~;:Name).n-/791 Ptf~'Se-- J?~iIo)fS
(ContactN.me) ~h~'-- F. bl~ '
(Addresl) *022.. t::!J ~ ~ SIl9~Ojle('
. I "
TYPE OF 'WORK [] New COns~OIl DDedc OPorch ORe-Roofing DRe-Siding OLowtr Level F nish 0 Firq>l;lCf
[]Addition ~l\Iferation DUtili~1 Connection 0 Misc.
3 ZS- 0
CODE: OU.C. [II.B.C. PR.OJECT COST/VALUE $ --=-r-------
Type of i::on::tJ:111ction: I D m IV V A B (uclwlin.land)
Occupar:cy Gl'DlIlp: A BEll HIM R. S U
DivisiOl: 1 2 3 4 5
Permit'
Permit F
Plan ChI'
State Sur
Penalty
P1umbin
Meehan:
Sewer &
Gas Fire
11 2 500.0 0
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..
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..
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tFee :~
it Fee "
,I
:?ennit :t"ee :;
ennit Fl!e ,.
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aluath
:!e
ck Fe~
chargf!
J PCi111i
call'enn
Wafer
plare ?
~s Your Buildlrll Pnmit When ApprD':],d
q,(q-dS
Date
Park Support Fee
SAC
Water Meter Sil:
Pressure Reducer
Sewer/Water Con
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE a
#
1#
e 5/:3"; I";
nection Fee 1#
#
~~ 9. dO. 0:';-
$
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'7~. vU
ct 7/. qJ~
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~- ---.-.----'
I Paid
Date
ThIS is to ,mifY thaI the requ"SI b 1M a~ application and accompanyinS documents is in accordanc~ with th~ City ZoninS Ordinan~ and rnay ~ aI; requ,'Slt~. Ibis documenl
=:"d~'~_C;"_~_' '_00 cm_<<z.,.._~- -- g:J ~~;r:~c.._"o:~='
Plaouing Director Date Specia CODditionJ, if my 0._____
24 hOllr ootic~ for all inspections (~2) 447-98!1O. fax (~1) 447-4145
16200 Eaglll Creek Avenue Prior Lake, WI 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
t'f30/~
I. Blue File I PERMIT NO ~
i ~:~w ~~~Iicanl . 00; 0 9- 74
ZONING (office us~)
/7390 LJeE:/2R6t-O ,L)~
LEGAL DESCRIPTION (office use only)
LOT /2BLOCK.::l ADDITION
PID 2S: ~ rJ5S.lD
~ 2.z::J -3 .3 t.j- 7~1f
EWNER
~"~ .-!.. ~n r Lt;trc it ~f .
~ddress) I 3 ~ '" __t h ;C~\ J... ( 0 ^ ; d t
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
">PLICANT SIGNATURE
(Phone)
(Contact Person)
DATE
APPLICANT PLEASE COMPLETE BELOW
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
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) y Other Mdt/6 Wltfl'/9t.- 7V
I
FEE SCHEDULE
Industrial. Commercial & Multi-family I % of job cost with a $39.50 minimum
t/WIiJL.-LeV'f:;t"
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
3'1. 50
.50
4'0. tTU
(Office Use Only)
'his Application Becomes Your Building Permit When Approved
Date
Paid 4-<;~ C/l:)
Date ~ :Jf; i OS-
Receip No. ~SZ-
By
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
--
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /7390 12eBlR.&D tJ/(,.,
TYPE OF WORK /JLTex..
USE OF BUILDING ~ ~/",
PERMIT NO. tJ5.CJfJtl9 DATE ISSUED 9./ti.tJs-
BUILDER F/,v~ PIfAS-E; PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
1- I I
PLACE NO CONCRETE UNTIL ABOV~ BEEN S~~
I FRAMING I 7l& I la!~ ~
I F~NAL
.
FOR ALL INSPECTIONS (952) 447-9850