HomeMy WebLinkAboutBuilding 02-1569
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/2 w (, -02-
/ '1.2 S-S- ~ a V'e-Y1 C (j <-A rT #13..
LEGAL DESCRIPTION (office use only)
LOT 25""BLOCK / ADDITION
OWNER ,
(Name) .Ma r i 0 .,. Jill . la-rOt I/o
(Address)
CO"",...
Date Rec' d
~i~i~e ~:~y I PERMIT NO. ()? _ I' C I-a I
Yellow Applicant f.., ~ ~ ~ '
ZONING (office use)
e/
t.- Sm
PID2S- 3'- - Oz:5"'O
(Phone) 9~ c J.. - YSlS- -~9.s-?
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ORe-Siding
~ower Level Finish
o Misc.
Z eMS.
PROJECT COST IV ALUE (excluding land) $
ODeck
OPorch
ORe-Roofing
o Fireplace
OAddition
OAlteration
OUtility Connection
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 accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
X ~ IV 2..t::-; } . Contractor's License No. Date
Permit Valuation 2, 0 () O. DO
Permit Fee $ C,Z. z.S"
Plan Check Fee $ -
State Surcharge $ /.00
Penalty $
Plumbing Permit Fee $ 40.00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ 40.00
This Application Becomes Your Building Permit When Approved
~ -TJJf-/
Building Official
~ ~ L---
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~ /2..10.02.- $ /~3_ ZE)
/~/?~L--
/ Date
This is to certify that the request in the above 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
iSSU~ ~
Planning Director
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
Date: 12. (p . {.I 2-.
PID: 2S<lCe8 -t:eS---O
~Ve-/t/ (!7,
Zoning:
tel
Building Permit #
Site Address /4355
Legal: L ZS- B I
Existing structur~ NO
I CONFORMS TO ZONING
ORDINANCE
Subdivision:
KNOB /,jll/& 6!1!
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning 'I
building height?
Is the property located within the flood plain? Refer to Planning )G
Does the alteration include any additional kitchens? Refer to Planning r-
Does the proposed alteration include any outside. Refer to Planning
entrances other than patio doors? y
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 .-\.i'ill INCLUDED IN THE BUILDING PER!'fIlT FILE TO
MAlNTA.IN A RECORD OF THE REVIEW.
.
L:\TE~1PLA TEVU TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
DEP"RTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /4355 ~/lVbN ~O()/G--/
NATURE OF WORK :d:,~ ~ VEZ___
USE OF BUILDING :s /1//2-
PERMIT NO. 02-/$(09 DATE ISSUED /2-. q. oz-
CONTRACTOR -r/l,e,qL.-t-Cl~ /7/1/0/0 PHONE 445 - 495f!J
,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
...- I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ;t;Au ~,j
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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 roughwin 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