HomeMy WebLinkAboutBuilding 02-1086
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
, 9-3-()Z-
I White File I PERMIT NO
2 Pink City . 0' 7 _/OtJ,l-
J. Yellow Applicaot . V W
ZONING (office use)
,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
f-LU
PIDa5-0(~- 0(/-0
OWNER
(Name)
(Phone)
(Address)
BUILDER fx. ~ -
(Name) ~\.. e '<') E .. -~ AC
(Contact Name) I~" \;.._ ~ lA l ~
(Address)
(Phone) (fj). -4t{L- 3i7u
(Phone)
'-..,.
TYPE OF WORK
o New Construction
DDeck
o Porch
ORe-Roofing
ORe-Siding
DLower Level Finish
o Fireplace
DAddition
DAlteration
DUti1lIY Cunnecrlon
Misc.
/>/f7PrA/'1 A:6H(.IPb ""j
PROJECT COST /V ALUE (excluding land) $
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 aq::ordance with
submitted plans I am aware that the bUlldmg offiCIal can revoke thIS permIt for just cause Furthermore, I hereby agree that the CIty official or a \Ignee may
enter upon the prope to perfor~ded inspections
,/ ' -- (t't~~C)
X ~ ~ ~
Signature Contractor's License No ate \
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
1.00
Park Support Fee # $
I
SAC # $ /
Water Meter Size5/S"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTALDUE~ ti ~4' ,;02- $ G:> 5. "L';-
Permit Valuation
Permit Fee
Plan Check Fee
"Z- t:'Oe;). -
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Paid
Date
~!;f-~
I Receipt N~~ :J'/
By 9
This is to certify that the request in the above application and accompanying documents is in accordance wilh 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 muSI 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
~t
White - Building
Canary - Engineering
Pink . Planning
The {"('nlt'r flf Iht' I.akt Counff1"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT V3I.-td~!- Fo}~''(/ 4J
APPLICATION RECEIVED 9 - 3-0~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~;'j-~ !7-/l/JU,;tJ
Accepted
Accepted With Corrections
Denied
t2o~
/ZEM ~~.
Date:
r!Jn
Reviewed By:
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
1~&5d-
I't/ a
/t--
'?~ 0dA (j)-/6fb
~ ~~~ ~:~y I PERMIT NO.;a, 1 ., J/.r"'"Y11
3 Yellow Applicant U ~ __,.~,
I
(Please
ADDRESS
ZONING (office use)
RI
LEGAL DESCRIPTION (office use only)
LOT / I BLOCK
ADDITION
PID
OWNER 6. 'J J
(Name) U I d e./rs
Ute:/,
(Phone)
(Address)
A
'v),,"
Quantity Type of Fixture (Quantity Type of Fixture
1- Bath Tub with or without shower \ 7 Rough-ins
- Dishwasher \ / Water Heater
- Floor Drain \ / Water Softner
2- Lavatory (Bathroom Sink) \ / Stand Pipe (Washing Machine)
- Laundry Tray (lor 2 compartment sink \/ Sewage Ejector
- Shower Stall y Backtlow Assembly
- Sinks f\ Backtlow Assembly Test
- Bar Sink f \ Lawn Sprinkler
2- Water Closet (Toilet) J \ Other
,
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
ResidentiaL Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~ q ,)()
.50
L.IOJO()
(Office Use Only)
Building Official
Date
Paid L(O r uU
Date q _ /3-0a.
This Application Becomes Your Building Permit When Approved
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
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
-
SITE ADDRESS (b~5Z A,..;AlA (f2A( '-
NATURE OF WORK '2 ~ f3A r/--r f2&n.of?6L-
USE OF BUILDING ~
PERMIT NO. 02 -IO~ DATE ISSUED er/5ioz.
CONTRACTOR Bv,.../Jt!M &c>~ PHONE 1~2- - -'ler z . ~ f 70
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ I I
~I~r to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
ATER I
l)-\"'/-O~I-1 f)-en.
FRAMING
INSULATION
ELECTRICAL
PLUMBING u. ~ Pi>.. tt it
HEATING (if required)
{ 1 ~ (04
. i...{ __ G> \....
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
N
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL 'k VE 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850