HomeMy WebLinkAboutBuilding 04-1104
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
If) i 25, () 1---
at bottom)
ADDRESS
$/22 WYjJlJ~
1 White File I R I L I
P;nk C;ty PE M T NO. () ~ i II (J'f--
3 Yellow Applicant , '
~T s6
ZONING (office use)
le-IJ .0
LEGAL DESCRIPTION (office use only)
LOT /5BLOCK .:3 ADDITION W/L,of5}UVeSf ~tJNO.f 2-,Jf.)
PID
3-:rr. osf: 0
OWNER
(Name)
gv(.JA+~~t tJtf1UJfPJJ~V
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
o Fireplace
B
S U
ORe-Siding Lower Level Finish
I fUYj.
PROJECT COST /V ALUE $
(excluding land)
TYPE OF WORK 0 New Construction oDeck oPorch ORe-Roofing
oAddition o Alteration oUtility Connection 0 Misc.
CODE: 0.R.C. OI.B.C.
Type of <E;nstruction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
I hereby certifY that I have fi.1rmshed mformation on this appIical10n which IS to the best of my knowledge true and correct. I also cerufY that I am the owner or authonzed agent for the
above.menuoned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
\ "fficial can ,revoke thl~ permIt for Just,cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectlOns
I X /{':1 (i?tl,.:>f (i!'!f.:U (f..J./ h (O/Z.Y<<
'. / Signature Contractor's License No. ' Date
Permit Valuation /1 () 00.00
Permit Fee $ 3+.15
Plan Check Fee $
State Surcharge $ .50
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~
Building OIlicial
Itl/zs/or
I Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other ~~ M1--- $ I. 00
TOTAL DUE $3~. 2.5
Paid
Date
Receipt No.
By
Thts IS to certifY that the request m the above appIicauon and accompanying documents tS m accordance with the City Zoning Ordinance and may proceed as requested. Thts document
when signed by the City Planner constItutes a temporary Certificate of Zoning complIance and allows construction to commence. Before occupancy. a Certtficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
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
/2 '---/' ,. nl' ,
BY: ~ ~v
,
Date: 10 /2- S~ (I
Building Permit #
Site Address 5/2 z..
Pill: Zoning:
wyJJO ~ 0/~ S'.E:" ~
Subdivision:
Legal: L B
E~tingS~cmr~rNO
I CONFORJ.\'IS TO ZONING
ORDmA.1'l"CE
YES
NO
I 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 I rJO
Does the alteration include any additional kitchens? I Refer to Planning I jJa
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ~O
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single tJO
family home (office, group home, day care, etc.)?
THIS CHECKLIST :VIUST BE COMPLETED ...\..l'l1) INCLUDED IN THE BlJ1LDING PER;vfIT mE TO
MAiNTA1N A RECORD OF THE REVIEW.
~
L\TE~fPLA TE\AL TCHCZ.DOC
PRIOR LAKE
INSPECTION -RECORD
z &J t'IJD HAIM.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .!SJ
NATURE OF WORK
USE OF BUILDING
PERMIT NO. CJ4- ~ / / ()4- DATE ISSUED
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, S.&"
INSPECTOR
DATE
E UNTIL ABOVE HAS BEEN SIGNED
OUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
EATING
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