HomeMy WebLinkAboutBuilding 03-1564
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
f2-~ ~e-
~.
QCJ--)> f be.rr-~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(N ame)
~s~~
37'1
(Address)
BUILDER
(Name) OW!\e..J
(Contact Name)
(Address)
~~~e-)
(7~e.
&0
~. ~i~i~e ~:~y I PERMIT NO. 0"2-{ L", 11
3. Yellow Applicant .;/ _ ~(p :I
ZONING (office use)
~ r;or We
.s-? y)~
(Phone)
(2j
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ODeck
OPorch
ORe-Roofing
ORe-Siding
~Lower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
o Alteration
OUtility Connection
o Misc.
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I aiso certifY that I alp 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
exnter upon the prope~ perf\L~eded inspections.
~~ \#-))/03
Signature Contractor's License No. Date
"
Permit Valuation 1:( 2.()(!) 0, 00
Permit Fee $ (p Z ' 7...-5
Plan Check Fee $ -
State Surcharge $ 1,00
Penalty $
Plumbing Permit Fee $ L/O.DO
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~
Building Official
/ ;;-h ~.7
/ ate
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other ~tUn--- $ /.00
TOTAL DUE ~.- .~ ft.-. 3. 03 $1()~25
o (;, Z-
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:~
1~
Date: /ifP /03
Building Permit #
Site Address 37 Cj 3
Legal: L B
Pill: Zoning:
~~~fV ;eJ,
Subdivision:
Existing structure:~~r NO
YES
NO
I CONFORlVIS TO ZOl'lING
o RD IN AJ.'{ CE
YES
NO
Is this an expansion of the existing footprint or Refer to Planning
building height? Nt)
Is the property located within the flood plain? \ Refer to Planning I Alo
Does the alteration include any additional kitchens? Refer to Planning \ Ne;
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? AJo
Is the proposed use of the finished. space or Refer to Planning
alteration for anything other than a normal single yd
family home (office, grou~ home, day care, etc.)?
THIS cm:CKl.IST MUST BE COMPLETED ..\u'ffi INCLUDED IN THE BU1LDING PERl'llIT FILE TO
M.AlNT...IJN .-\ RECORD OF THE REVIEW.
T .\iT-~'"flJT .l, TF\A LTC-iCZ-DOC
PRIOR LAKE
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 379.1
NATURE OF WORK
USE OF BUILDING -:JF> J), .
PERMIT NO. D'5- r:: =-DATE ISSUED lZ.t~
CONTRACTOR ~ S'nl1l.lJ PHO -rn-f1o~1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
- I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
,jr. --- -
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if re
- G~
We
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 b'een 'approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-Sn50