HomeMy WebLinkAboutBuilding 02-1119
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4--, /. O~;-
at bottom)
/5Z&~
;::/1/ k~'V rry
/{7--S
~;~~e ~:~y I PERMIT NO. 02 . I/Iq
Yellow Applicant , I
-
U
ZONING (office use)
R-l
LEGAL DESCRIPTION (office use only)
LOT 5 BLOCK 4- ADDITION li/t;N'fI'1/~/'-/ I rr
PID Z.:5 3'7", () J S-, (~
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
vV I IV U~v'U?)j:_)
/ft1?6J-
(Phone) C;5 1 - &-'75- 87/y' fl-
(Phone)
o Fireplace
B
S U
ORe-Siding ower Level Finish
PROJECT COST ;;~~-
(excluding land)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtihty Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
I hereby certity that 1 have hlrnished mformation on this application which IS to the best of my knowledge true and correct. I also certify that 1 am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:""" '''t~ ,",'Z!)"'''mm', , ""'" "'"' "''' ", '" om..,"" ,,,"''' m" ,c'" "'CC ", """'~, m ","",m c''''''4~'f: [J 5:
Stgnature Contractor's License No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Date
Buildlnu Onicial
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 $ / 3('. 2~(
ThiS IS to certify that the request m the above application and accompanymg documents is in accordance with the City Zoning Ordinance and m y I lcee as quesled. ThiS documenl
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupa cy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Sin Ie Family Homes
BY: ~ Date:
PID:
Zoning:
Building Permit # O?--II/tl
Site Address (
Legal: L B
Existing structur@NO
I CONFORMS TO ZONING
. ORDINANCE
Subdivision:
C~I
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ---
Is the property located within the flood plain? Refer to Planning ---
Does the alteration include any additional kitchens? Refer to Planning -
Does the proposed alteration include any outside Refer to Planning -------
entrances other than patio doors?
Is the proposed use of the finished space or Refer to Planning ~-
alteration for anything other than a normal single
family home (office, group home, day care, etc,)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK,DOC
02-04-2005 09:26AM
r1ATTHEW DAN I ELS, I ~,jC .
423 3017 P.01
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Slue File
:. Vul~ C~...
> Y.llow Appli..nl
I PER1\UT No;J- I J a
I
ZONING (offia\l$c)
(Please: r:ypc or prine and $i~ at bottom)
I ADDRESS
15U~ ~'n..AJaJ
~hk &-b, NW'
LEGAL DESCRlPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone) q6~ -~q5' - g~J.j1'8'
1
(Address)
APPLICANT
(Name) N1t'l.~PW ~ie.le. J rll!.. .
(Address) .5"2.'30 <!.a Y"~ I J c::>R J W a... y
(Address)
(Contact Person) ..ili..nie.1 E..
APPLICANT SIGNATURE
(Phone)
~5J - 42..!S -...3'1o~
R ^"",p rYJ~u.rrt.
(City)
S.5b"g
(Zip Code)
(phone)" {.,Sf - J-I'2i3 - ~"1ao
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Draip Water $oftner
I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
J Bar Sink I Lawn Sprinkler
1 Water Closet (Toilet) - Other
I
DATE ~L/.I, .~. ~~
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi-family 1 % of job cost with a 539.50 minimum
Estimated Cost $
Residential. New One & Two-Family $99.50
Rcsid.:ntial. Additio,ns & ~atiOns $39.50
Building Pennit # 8lJ1iO,1'?- ~
, 'I(,J p~
~q.SO '"11M".
.50 .
10 .aD ~ '-t..ttW '
$
$
$
PLUMBING PERMIT FEE
ST A IE SURCHARGE
I TOTAL PERMIT FEE
(Office Use Only)
This Application Become!! Your Building Permit When Approved
Paid
Receipt No.
"
Da~EB 2
By
Building Official
Ollte
24 hour notice for all inspections (95:2) 447-9850, fu (952) 447-4245
,
TOTAL P,01
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /SZ(p(p ;C/!//C:W/lV /-IE76H,S (!.:/.
NATURE OF WORK L OWUL..- U~
USE OF BUILDING .ec;S /9//C:- :
PERMIT NO. (J 2 - ///9 DATE ISSUED tp_ /0 _ () Z-
CONTRACTOR /'V,</L'i!c, /U~ PHONE _I) - &'1'<17
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
=--1 ',f 1
PLACE NO CONCRETE 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 '-
FINALS
1
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