HomeMy WebLinkAboutBuilding 05-0443
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
5. /7 os-
or
ADDRESS
}/ q I
'rz{, N w
ZONING (oIlice use)
)2rsO
'" WIrite I'il. [ ]
2" Pink City PERMIT NO. ()~ 044-3
3 Yellow AppIico.. _ _
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
}
Sill.
BUILDER
(Company Name)
(Contact Name)
(Address)
PID 25.37/. 02-8. ()
(Phone) g 'j'L -1---"J--~ ~.3 J q I ~
.
(Phone)
(Phone)
TYPE OF WORK o New Construction ODedc OPordl ORe-Roofing ORe-Siding wet'Level FiRlsh o Fireplace
OAddirion OAtterarion OUriJity Connection o Misc,
CODE: ~ Dr.B.c. PR.OJECf COST IV ALUE S J1Jl nOQ
Type of ion: I n m IV V A B (excludin.land)
Ocaapancy Group: A B E F H r M R. S U
Dirision: I 2 3 4 5 I
I hereby certiIY tbat I Mve ~ information on this applicalion which is to the best of my knowledae true and romer, I also m1i/)' tbat J am tM owner Of authllflZl'd IlIC11t filr the
aboYe-menlJ propmy and that aU construction will conform to aU existina state and local laws and will ~ in acturdancc with submitted plans, I am aware that the buiIdinJ
official cm r e th" permit filr jUJt au "Furth , I hereby aglft that the city oftIciaJ or a desipee may enter upon the property to pnform nmlL'd UlSpl.'Ctions.
6- i~ -Of)
x
Permit Valuation
Permit Fee
Plan Checlc Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Pemut Fee
Sewer &: Water Pemut Fee
Gas Fireplace Permit Fee
.3
$
$
$
$
$
$
$
S
.50
Oz)
T~~lication ~s YOlU BuildUtJ Permit When Approyed
~ ~ S~~S-
Buildin2 Official ' Date
Conlractor's License No.
Dale
Park Support Fee #
SAC # S
Water Meter Size SI8"; I"; $
Pressure Reducer S
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
~~ S
TOTALDIJE ~ s. 'H.es- s /6 c,. 2> S- 'j
fPaid /.54:. ~f r~o. ~~ 7. :
_Date cP. /CJ.t"'r I ..~ ~ _
nus IS to c:ertilY that the request in the a~ appliclltion and accompanying documents is in l<<OrdlInce wilb the City Zoning Ordinance and may fII'<<eed as reqllC.'Stcd. This dllCllmmt
when sianed by the City Planner constitutes a temporary Certificate of Zooin, compliance and allows constnaction to commence" Before occupancy, a CertiflCtte of Occupancy must be
issued
PIaoiiIiii DinlCtii
Date =- SpOClif CoadItiOJll, if my
24 hour notice for 11/ Inspections (~2) 447-98!1O. fu (~2) 447-424S
16200 Eagle Creek Avenue Prior Lake. MN 55372
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
jtJ..3/ OS-
I. Blue File I PERMIT NO {)5.~" .
2. Gold City
3. Yellow Applicant
ZONING (office use)
w.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) r:.ol (-ee.Yl-t4e'~
(Address) '3IQ \ ~ c::. CJ J,
(Phone)(:7CS2- )~- ~/4'
.W
(Contact Person) "
APPLICANT SIGNATURE
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
I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum Residential, New One & Two-Family $99.50
E,'ima'ed Co,, $ '2\V i t2 pD Boilding pe:::;",i~, AddiHo", & Alte"Ho", $39(; Y
pfllD f;1L--
B{)/~O
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
'3g.~
.50
40.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
~
DatejO "/ ( 0 .---
I ..) / )
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DEPARTMENT OF
BUILDING- AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO_ DATE ISSUED
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT F R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
~] l J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
~
BUILDING
ElECT~ICAl
PLUMBING
HEATING
00 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 unl/l 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