HomeMy WebLinkAboutBuilding 04-0160
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
"' t.f 5 5fo
at bottom)
s u.~i( LIJ N E
LEGAL DESCRIPTION (office use only)
LOT..3 BLOCK 3
ADDITION
~~e~R levr1 d-lOvi
~i
(Address)
BUILDER ~ t
I (Company Name) t:t ~ g e.
(Contact Name) - 9 f: c
(Address) 1<6 c: 0 J Norm EV Ie. Irs()Y}
Date Rec' d
3. IB.fJ4-
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. o~. 0/'-'0 ,
Lrke (YlN
ZONING (office use)
.J .3 /u:)
PID
(Phone) q5?--~-5~33
COhs-fr-u ch a-n
(Phone) d.1~- 4'6Q- "~fo/o
Stlrv-le
N 5
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
ORe-Siding Lower Level FinIsh
4 /l.M5 .
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
x
I hereby certity that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also cerufy that I am the owner or authOrIzed agent for the
above-mentlOned property and that all construction w' onform to all existing state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
urther or, I hereby agree at the CIty offiCial or a deSIgnee may enter upon the property to perform needed mspectlllns
3/J <0 I D4
Date
Permit Valuation 3, () 0 O. 0 0
Permit Fee $ 71-.7S-
Plan Check Fee $ -
State Surcharge $ /.57)
Penalty $
Plumbing Permit~e e.tI $ 4-0.00
Jl....
Mechanical PermifFee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ -
This Application Becomes Your Building Permit When Approved
~nk~ SLt!/Q~
Contractor's LIcense No
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ //~.2S
Paid
Date
Receipt No.
By
ThIS IS to certify that the request In the above applicatllln and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
isslIed
Planning Director
Special Conditions, if any
Date
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
B:J..sement Finish or Interior Altenrion to Single FJm.i1y Rome.s
BY: ~ ~ Date:.5, 1.f,O-t-
Building PermiI: # O?--. 01(,0 Pill: z,!:,. ~ 00. ()f~. d Zoning:
S i!e Address
Legal: 1
3
B
::J
Subdivision:
~~ m<..A...--f" =7 IU:1
E.Iisting Srrucrure: Q:'!o
CONFOfuyIS TO ZONillG 1'1:S NO
ORDlliAi'{CE
YES
l'iO
Is ilirs an expanSIon of me ex.isGng foocprillt or R~ fer ~o ? la..1'J..;,-::w.-"lg
buildL.-:.g heig.b.t? V
Is the properrj lecated witi'..m me dead pbin? I Refer to PlaTh-D...J.g I y
I
Does ul.e alteration inc:ude my additional k:cc~ens? I Refe: to Planning I ;C I
I
Does G.l.e proposed alteration include any outside Refer to Planning
e:1~J.ces othe:- than patio doors? y
Is the proposed use of tb.e .th"J.isned space or , Refe: to P!annmg
llte::lcon for anyrhir:g ache:- m3.J.J. a :10r::1:11 single f
.--, ( .-- nO"G"le, d.:..y c::!:"e. e::c.)?
"'':'"--11"'" ,.., - Q gTOU'J
l"-1.-'.._/ ,.o,....e orrlC~,
THJS CHECKLIST ~IUST BE COl'yLPLETED _-I..i'il) !:'fCLFDED IN THE Bl:1LDli'iG ?ER:'yIlT FILE TO
-'t L-Ul'IT.-UN A RE CORD 0 F THE RE V1E'iV_
. --::C,-:;; ~ --::. .~.::. -:-.==-:C.:.=.,,:::(,=
PRIOR LAKE
INSPECTION RECORD
5i.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ - On -' }
~IL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
J
J
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATIN
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
J
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