HomeMy WebLinkAboutBuilding 03-1553
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2 Pink City
3. Y cllow Applicant
11- dh -().]
I PERMIT NO. 03'" 155f
ZONING (office use)
L
LEGAL DESCRIPTION (office use only)
LOT L-{10CK 3 ADDITION
0-
03-0
0""
(Natne} 5('--011 ~ 1)<",_ 4 t''\o''',^- ~ f'O..^(.I:';i
(Phone)
152 - '-li/O -'f?';;"I;)..
(~)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
power Level Finish
DDeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
o Alteration
OUtility Connection
o Misc.
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 uilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property}o p m nee d inspections.
<-;;> . .
x
Permit Valuation 00
Permit Fee $ s;-
Plan Check Fee $
State Surcharge $ 0
Penalty $
Plumbing Permit Fee $ " ao
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace 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 $
Other $
TOTAL DUE (/A-~ ,IZ..3.tU $ //&7.2$
This Application Becomes Your Building Permit When Approved
~~ ~
Building Official ;;;t I ga?e
I ~;ceiPt No. ';;;:-7 (
I Paid ((VJ.l.,~
Date rz. /;r ! 0 ~
f
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 (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: ~ ~~
Building Permit #
Site Address
Pill:
Date: //- c::;& -tJ 25
/S-LjO.:{ ~:d ~
Subdivision: tJ~ ~
Legal: L '-/9 B-3
Existing structureS'or NO
I CONFORl'VIS TO ZONlNC
ORDIN".AJ.,{CE
TIS
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? tJO
Is the property located within the flood plain? I Refer to Planning
NO
Does the alteration include any additional kitchens? Refer to Planning I jJO
Does the proposed alteration include any outside Refer to Planning
entrances othe: than patio doors? ~O
Is the proposed use of the finished space or Refer to Planning
alteration for anything orne: than a normal single ~tJ
family home (office, group home, day care, e!c.)?
THIS CHECKL1ST MUST BE COMPLETED ...\.ND INCLUDED IN Tm: BtrILDING PERl'l!1T Fll.E TO
MA1NTAlN A RECORD OF THE REVlEW.
T .\T'=~"rPT .l- TI\ALTr.FCZ.DOC
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
:3 . (8.05
;::-/{ c: tV {;5. /55-3
~. :::'n ~~;y I PERMIT NO. (!S (;/r;J71
3 Y cHow Applicant .
ADDRESS
/5402-
ZONING (office use)
tfI/ 000 0 (jet::-
Ie)
LEGAL DESCRIPTION (office use only)
LOT4-%LOCK 3 ADDITION W/L-DS S()U'TH
PIDZ5 3 e !.:-. 1(;3 0
I OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name) ~". / i/; j/
/
OE77;V/l/r/ ~ St6/i
(Phone)
4cf(J . &2/L-
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
DATE
)~lv< · r
APPLICANT SIGNATURE
APPLICANT PL
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL
j
'Y-'
j SE COMPLETE BELOW
D REPLACEMENT D AL TERA TIONS
FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
DGravity
D Mechanical
Air Conditioning
Yent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit # (15'. t// f/j
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.3 C; ')"0
$
$
$
.50
40. vU
(Office llse Only)
Date
Paid
~}.' (/u'
Date-, (0 C"-
--J (/ "'
Receipt NO.4&64<2
By
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /f-.&/O;J.. LLJt:KJd .LJ~!:::-
NATURE OF WORK L..
USE OF BUILDING :2 E
PERMIT NO. 0 3~ _ I~~ ~ DATE I~SUED 1:1 -1- ~
CONTRACTOR S:.C~ F~aA/C.1 S PHONE ~?I"-~/:>"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
~i
. PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
I()' /0. t;"
10 o. I~ '-- 1)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~_ ____w.
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTrce
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