HomeMy WebLinkAboutBuilding 04-0961
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
5~/2-
/1/'7 tlt.& tv 0 (J D
Date Rec' d
White
Pink
Yellow
I PERMIT NO. t"Lf-Cf6/1
File
City
Applicant
LJI€-
ZONING (office use)
/2./
LEGAL DESCRIPTION (office use only)
LOT fJ? BLOCK I ADDITION 7/7'9/1ooAl 7ZI A/O/Z%H S'ftt1d CJ414-' PID zs:.s~. oo~. 0
OWNER
(Name)
WIUG;trr;
'?
f11A Ie Y
(Phone) 9~~ - '1~5 -Cjt;s-~
(Address)
EtJ~ t::.7Z-
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection 0 Misc.
CODE: ~.R.C. DI.B.c.
Type of ct;;"nstmction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
ower Level Finish 0 Fireplace
B
S U
PROJECT COST/VALUE $
(excluding land)
I hereby certify that I have furmshed Information on this application which IS to the best of my knowledge true and COlTect. I also certIfy that I am the owner or authorIZed agent for the
above-mentiOned properry and that all construction will conform to all exislIng state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can e )ke this permIt l' Just cause Furt ore, I hereby agree that the Clry official or a deSIgnee may enter upon the propelTy to perform needed inspections.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee UlMer $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
3CJt!JO I
7q~ ?q-
/';:yO
;?--
This Application Becomes Your Building Permit When Approved
~~~~ 9P:>/dr
Buildll1~ Ufficial Date '
Contractor's License No.
9-1-0~
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other eL6 ('A?z.4 C~l.-- $ /.{lO
.--
TOTAL DUE $ ///7'0(5
1-7;~t/ I :~ceiPtN;(:~/l~ I
Paid
Date
ThlS 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 constllutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
I issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basement Finish or Interior .eVten.rion to Single Family Homes
BY: ~~ ~p
Leg~1: L Ie
B
I
Date: 9~ ;?~ -{j Lf
Pill: ZonIDa-;
c5/jld (2~z6 /a~;~ I12c
Subdivision: 7!:f--.Mf ~ f-l. ~()~
Building Permit #:
Site Address
EIisting sCrucrur@r NO
CONFORLyIS TO ZONlliG y~S NO
ORDINA1'i"CE
liS
Is this 3.J.'1. ex-pansion of the exi~WJ.g fooq;rw! or R~fe: to Pl2.r.u.-ring
building height? t-JO
Is u'le properrj located wiwin lfJ.e flood plain? I Refer to Plar..ning I t---JO
Does ,.he alteration include any additional kitchens? I Refer m Planning I
~ 0
Does c.he proposed alte:ation include any outside Refer :0 PlaI1.ning
e:ltrJnces ocher man patio doors? 00
Is tb.e Foposed use of the fi.~shed space or Refe:- to Pl~.JJ.ll~g
aIte:J.rion for 3.J.'1.ything OG1e:- than 3. normal sl:;.gie tJO I
f3.l--:til~1 home (office, grOU? home, d2.Y. C2.r,e, e~c.)?
NO
TillS CRIC-eL1ST MUST BE CO(v!PUTED _.i...'fD !i'{CLTJDED Ii'{ THE BtnLDfNG PE~'dIT i'ILE TO
""L-Vl'iT_.lJN A RECORD OF' THE REYTEW.
- .---::7"Ic:r -" -:;. .:.; -'-~~,---:- ~(~c
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~ tj/~ - #1>>'~ e-ood. .ok
NATURE OF WORK ~ '-
USE OF BUILDING
PERMIT NO.
CONTRACTOR
NOTE: THIS IS NOT A ERMIT FOR A Y OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~ I
-'1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
L/- (l,-()
;.1t/1
Lt-; tVI
LJ -1/
SIGNED
OCCUpy UNTIL ABOVE HAS BEEN
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