HomeMy WebLinkAboutBuilding 02-1281
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
It> -~ 1/-0 J...
a 2 -(} / (p "
I. White File I PERMIT NO
2 Pink City ..11-1 _I' '") 0 I
3. Yellow Applicant , l/ t7'- t7'-O
/50Zf; /1 PP/1 L- 005/1 /7ert I L- ;11 C
ZONING (office use)
/2 / sD
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK 2- ADDITION 3/20 rlOO/\/ro ,,(;?;qJ'P K/L.J(;j6 PID ?S-342_- 0/& --0
OWNER
(Name)
(Phone)
7~1-4LfI - 18S""L-
NO &(/r;TT c, /)/1 vC
,
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
~ower Level Finish
DDeck
o Porch
DAddition
ORe-Roofing
ORe-Siding
o Fireplace
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
DUtility 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 pia . I 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 th to form needed inspections.
X
Permit Valuation r
Permit Fee $
Plan Check Fee $
State Surcharge $ I. 0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
#
#
4-od -D'L
Date
$
$
$
$
$
$
$
$
$
Other
6L 6C772/Cr7 L-
TOTAL DUE
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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Bup~ing Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
I
(#-
..
BY:
'I
..
Date:
/6- L( -- () ;;r-------
Building Permit #-
Site Address
PI]:
/' 5{)<-~ f /f?//;J () Iv cSCc
--r Zoning:
( t~
f)<5j)
Legal: L B
E.risting S tructur@- NO
Subdivision:
CONFORlvIS TO ZONING
ORDlliAl'fCE
NO
YES NO
Is this an expansion of cb.e exisnng footprint or Refe, co Planning
building height? V
Is the urouert'! located within the flood olain? I Refer to Planning I
.I. '" ..; '" ~
Does the alteration include any additional kitchens? I Refer to Planni.1""1g I V
Does the proposed alteration include any outsIde Refer to Planning
entranc~s othe:- than patio doors? /
Is the proposed use of the fii"lished spac~ or Refe, to Planning
alteration for anything othe:- than a normal single /--~
family home (oruce, group home, day care, etc.)?
Tms CHECKLIST MUST BE COMPLETED Ai'ffi Ii'!CLTJDED Ii'! THE BU1LDli'!G PERl'tI1T FILE TO
tYL..IJi'!T..iJi'! A RECORD OF THE REVIEW.
LIE::V1?L..J... E_.lJ:.. TC:~C(.DOC
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
/0- tf- 02-
~. ~~~ ~~;:y I PERMIT NO. 01.. - (Z// I
3, Yellow Applicant , ,
/SO 2-r
ZONING (office use)
~~----...I
LEGAL DESCRIPTION (office use only)
LOT (y BLOCK ~DDITION
OWNER
(N ame)
IV {; t-l-e;i$,
.
0/1 ve;
(Phone)
15"2 -W7-IY'J7
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
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
Bar Sink Lawn Sprinkler
Water Closet (Toilet) 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 # ,
!I Ie ,w~
.50
$
$
$
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
hen Approved Paid
24 hour notice for all inspections (952) 447-9 , fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /5lJ;JB 12;ni!(/cJOc,~
NATURE OF WORK Lf..-, - f I
USE OF BUILDING ::Jr
PERMIT NO. t)~- Id.-F! I DATE ISSUED 16~ L-;-O d--
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
lJl. ~.. . . ...~liT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I L .-,. I
~ to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
f(-2)~02
If - z,~,dl
Vl;y?
/1- 2-1- en.
J/~ }..J.- 6L
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 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