HomeMy WebLinkAboutBuilding 03-1191
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
2 Pink
3. Yellow
File
City
Applicant
8"dv9-0'3
I PERMIT NO. ():S.- I It! / I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
.@~,"
(Address)
.,~}..,j5z- S/Y7-A57Z
~C~
LOT
BLOCK
ADDITION
PID
-- ()9yO/~-()
(Phone)
(Phone)
95Z-ljl/7-8~7 z
;;/'Z-- 9U,- 9678
/It
TYPE OF WORK
o New Construction
ODeck DPorch ORe-Roofing
o Fireplace DAddition ~teration
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
OLower Level Finish
DUtility Connection
o Misc,
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- ed property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware at the b 'ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the 0 erty to perfo needed nspections.
8r-/8'-03
X
Contractor's License No,
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter
State Surcharge $ Pressure Reducer
Penalty $ City SAC and WAC
Plumbing Permit Fee $ 0,00 Water Tower Fee
Mechanical Permit Fee $ 10,00 Builder's Deposit
Sewer & Water Permit Fee $ . Other
\
Gas Fireplace Permit Fee $ TOTAL DUE
'<':C;';
This Application Becomes Your Building Permit When Approved
~ 7~ 9/s~3
Building Official
Date
#
#
".
,
#
#
Q.5.Q.3
This is to certify that the request in the application and accompanying documents is in accordance with 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 must be
issued.
Ci. 'J- D/j
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
The ('enler or the I.ab Countr)'
~\^Ihit~ - Bu~
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT --1l Mid. ~!f
APPLICATION RECEIVED ~ -" ex 9-. 15 \3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propose~lt: , f
1t6 dO- ~F emu- OR-cuJJ G6v
Accepted
Accepted With Corrections
~
Denied
Reviewed By: ~ i~ Date: 1/'S-;6'3
Comments: R~ af(/ J /,12, C.
~ cy "'-<> JLiJ .
"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."
The ("enter of Ihe l..kr Counll1"
White - Building
Canary - Engineering
C~ink - Plann~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
x
Accepted With Corrections
Denied
Reviewed By: ~
Comments:
Date: Q, t;- - 00
"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. Blue File I PERMIT NO
2 Gold City . :) - II al
3 Yell a\\! Applicant , "'
fA ~ ch 1'\ "
r
ZONING (office use)
(Please
ADDRESS
/(P5~ () IY'\
~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
/Jr.
V ~f f I' Vl--j
(Phone)
(Address)
APPLICANT SIGNATURE
~Ot:t
APPLICANT
(Name)
(Address)
(Contact Person)
APPLICANT PLEASE
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
OMPLETE BELOW
Quantity
Type of Fixture
Quantity
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum
,~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Residential, New One & Two-Family $99,5y
Residential, Additions & Alterations $39.50\
, ,jv'-'
<~/
\(\ '\
t\\'~ ,( )
~tJ\ /
Estimated Cost $
Building Permit #
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
Date,/ ,- / 6/ J) 'Q
111 Ii--
By
Building Official
, i
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
o ~
~
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
[,. FOOTING :r~f),v.J> P\O- 'ikl.ll53 ~ :
-..
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING f'vf '1- JJ1d) ~
HEATING (if re
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE AS 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