HomeMy WebLinkAboutBuilding 02-1526
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
In( L( ((p 2-
ADDRESS
ctD
White File i PERMIT NO
Pink City . OZ'ls ? L
Yellow Applicant _ """
1ufttS3)~ Sr S~
5D
LEGAL DESCRIPTION (office use only)
LOT I BLOCK
ADDITION
OWNER
(Name)
(Address)
ZONING (office use)
'"
PID
-001
.J. ~6
S~
J(.0~ a-L- (Phone) --9) 2 -- y~ 7,- () Zr4 7
BUILDER
(Name) <;..S ap
(Contact Name)
(Address)
- L"f2.-tq-, 6
(Phone) -k12 ~ t..l (~7 '" ~ ")
<14)1(;. ~ . :>>
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
ODeck
OPorch
(}dAddition
ORe-Roofing
ORe-Siding
o Fireplace
OAlteration
DUtility Connection
)1"4 PROJECT COST IV ALUE (excluding land) $
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~erform needed in. spections,
X 0--'-tuld."-_L~U\Lk \() <:1-02
Signature Contractor's License No, Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
x
Sewer & Water Permit Fee.Y
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
dO.DO
O().()D
3C;-. 5"0
.f!:)D
This Application Becomes Your Building Permit When Approved
~~
Building Official
/ ~!IJ1,~ Z--
Date
Park Support Fee #
SAC #
Water Meter Si ",
,
Pressure Reducer
City SAC and WAC #
Water Tower Fee #
Builder's Deposit
Other
$
$
$
$.
$
$
$
$
--
~S~,tJO
"/S-tJO
.
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
;."d. .. <2 II '" tI'tI' L ~
\ I, 15 . C!J.., ~ ~ V'()A...L
Date Special Condition. if any
24 hour notice for all inspections (952) 447-9850, fax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building Pennit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted is 30 Percent.
Property Address
'-/034 Roa.noke Sfree.,f SE J
,
PrIor- Lo..l:=e. /vIN 55372
J
Lot Area / ! O'/B Sq. Feet x 30% = .............. 3/329
************************************************************************
HOUSE
LENGTH
5'7-
/2.0
27
x
x
x
WIDTH
24
5,0
24
=
SQ. FEET
02.'/8
t;o.O
(oL/B
ATTACHED GARAGE
=
TOTAL PRINCIPLE STRUCTURE......................
I <:J5~
DETACHED BLDGS
( Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS....................... 0
DRIVEW A YIP A VED AREAS
'27. I
x
1~
= Lo5/
(Driveway-paved or not)
(SidewalklParking Areas)
x
x
TOTAL PAVED AREAS......................................... t.P5/
P A TIOS/PORCHES/DECKS ZL.j x ~ = q{p
(Open Decks Yo" min. opening between X =
boards, with a pervious surface below,
are not considered to be impervious)
X =
TOTAL DECKS........................................................ 9 fR
OTHER
x
x
=
TOTAL OTHER....................................................... 0
TOTAL IMPERVIOUS SURFACE
UNDER/OVER
Prepared By Mrf/
I 2,703
LA t.J Dee... I r:, 2 Co
Date 10 /25/02-
, F
Phone # (95~) L/frfI- 43ZB
Company Ja.c:.obSon Gf:..9/11ter~ J- 5(/rl/~ors
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
ADDRESS
403
~: ~:n ~I~ [ PERMIT NO.
3, Yellow Applicant _
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
c~k s,r
(Phone) ~/2 -Cfe -;'7J
(Address)
APPLICANT C _.. I
(Name) ~
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
CANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$49.50 minimum
$149.50
$64.50
$49.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$49.50
$49.50
Estimated Cost $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Paid
Receipt No.
Buildinl! Official
Date
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
~. ~~~I~w ~\:~. l PERMIT NO~ - / 5~
J, Gold Applocant [/, ,
,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
So viti, ~" s r
bI2-Y/f'-}b33
J'h,J ,!:>,?)37;;>
(Zip Code)
(Contact Person)
(Phone)
DATE
bn - '1/ r-}J.,S ?
tJ?;J ~7)372
(Zip Code)
"/Z -t.j) i-l63 _1
Jj- 2;'-0 L
(Address)
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Size of water service I" inches.
Location of any couplings from struetHre ~ feet. ..f-r--c>""", w.b o,f- Sf-r~r
Type of sewer pipe. 0 ABC .flpvc 0 Cast Iron
Estimated length of sewer lin~ feet.
Clean out (if required) located at ---1-2L feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family I % of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17,50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
u--\-
.50 ,2!)\jr(\1
pt&~ I
$
$
$
Receipt No.
Building Official
Date
Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE PLUMBING PERMIT
fik Wr1~2-152l.t
Date Rec'd
1. Blue File I PERMIT NO
2, Gnld City .
3. Yellow Applicant _
ADDRESS
~ost
Roo.......... o\<...e.....
S-\-
ZONING (office use)
R\SD
LEGAL DESCRIPTION (office use only)
LOT 4 BLOCK
ADDITION
~
PID
OWNER~
(Name) J
(Address)
(Phone) u{2- fit -7C??
APPLICANT
(Name) S'6 ....... t
(Address)
(Phone)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavato Bathroom Sink)
Laund Tra (lor 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet
e of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum
Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49,50
Estimated Cost $
Building Permit #
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildinl! Official
Date
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
White - Building
Canary - Engineering
Pink - Planning
--
rhe ("f'nlt'r nr the t.kr Counlr).'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT aLl;? ~.
APPLICATION RECEIVED /6- '1-0(9... ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which ~~oposed at: ,
S/(J3t.j JY()a/Ll)!~ s;
Accepted
Accepted With Corrections
o
/'
Denied
Reviewed By:
~ ~ Date: 1t!IP/(J"l...---
fbu( tLU ~ ~_~,
.. -- .b.-
Comments:
liThe 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."
""~""'"
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pUB SUO!IB::>!!!::>eds 'SUBld !O IE^OJddE JO I!WJed E !O 6U!IUEJ6 JO e::>uBnSS! 1341."
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. ":.~;1 ,4,'"
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'~""." ", 'L'" \,0....".." -,.',-'" /,' --.:io'rlt. ..."......., 'I.' . >,. ;'. .
.J
White - Building
Canary - Engineering
Pink . - Planning
, ~(' ('enfn or Ihe 1.1"(' ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (ZU;Uy ~d_
APPLICATION RECEIVED / 0- LI-O~
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is roposed at:
r
I 3
Accepted
)(
'-
Accepted With Gorrections
Denied
Reviewed By:
IYJ9B
Date:
) I--)lf ---e; ?
Comments: See Reverse Side for Additionallnformationl.
t- 1^tl1
See Attachmentst{l')' ~ading Plan, 2) Erosion Control Measures
liThe 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."
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 10.31 ~ ~~b'
NATURE OF WORK /Jbw ~NOI'f (~iJ ~t/()j<.J5" t'6~~tfIGAtYrJC'
USE OF BUILDING SF I),.
PERMIT NO. -- / s;. DATE ISSUED I 5 a 2.-
CONTRACTOR U4 e PHONE I,/Z ~ f?f!dP
NOTE: THIS IS NOT A ERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPA~~TE DOCUMENT
~q.1'1j'. e f; : /~rJ'o( INSPECTOR DATE
FOOTING it"'w -, 1-).) / ).. , L.
I FOUNDATION (Prior to Backfill) ~Vi~ ly/q/pv~ \fvt I t ),..-I55-{t.
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DEPARTMENT OF
BUILDING AND INSPECTION
SEWER I WATER I SEPTIC
FRAMING
INSULATION""~
ELECTRICAL
PLUMBING .t,.
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
<?OVER NO WORK UN,llL ABOVE HAS BEEN SIGNED
I ~#;~ f/-/ju I I
I FINALS
GRADING (Prior to Sodding)
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