HomeMy WebLinkAboutBuilding 02-1609
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have mished 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 Ii the ove-men property and that all construction will conform to all existing state and local laws and will proceed in accordance with
ware Jk:t th Ullding offiCial can revoke thiS permit for just cause Furthermore, I hereby agree that the City offiCIal or a designee may
"p'~n ::rmsp 'ons -
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\,' Contractor's License No ~
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-----
Permit Valuation )j)OO I Park Support Fee # $
Permit Fee $ G/1.. ,). ~ I SAC # $
Plan Check Fee $ I Water Meter Size 5/8"; I"; $
State Surcharge $ t.oO I Pressure Reducer $
Penalty $ I City SAC and WAC # $
Plumbing Permit Fee $ L.{ 0,00 I Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other e/e6. Perm; r $ I r i..?O
Gas Fireplace Permit Fee $ I TOTAL DUE ('AvtA:::/O rz.... 2-(, ~ l) I 04-. Z5
//)" a"'--- , ,.., ~jn
~rn'ftl::.. Yow BWIding p=it Wh~ App~d Paid / "1' ,:> I Receipt No. W,"-J -//1-
Date /ffy/ By _\/l -~:f 7 -() -
12-13"0l.. /
BUildif1g Official Date
This is 10 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
~h7Mn 'gned b/tEycty Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
Issue
II 12-- J.. '1 -OL
· 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: (It,;( ~ Date lfA - ,;( 3--Qif-/
Building Permit # 011 ;(C,01
Site Address .30//
Legal: L 12-. B I
Pill: Zoning:
hiy';C? / I T;-.
Subdivision: tA./-ev1S J11tfVl
Existing S tructure:~r NO
c9
CONFORLvIS TO ZONlliG
ORDINAl'{CE
Is this an expansion of the existing footprint or
building height?
YES
Refe: to Planning
Is the properrf located within the flood plain?
Refe: to Planning
Does the alteration include any additional kitchens?
Refer to Planning
Does the proposed alteration include any ot:tside
entrances othe: than patio doors?
Refer to Planning
Is the proposed use of the finished. space or
alte:ation for anything othe: than a normal single
, family home (office, group home, day care, etc.)')
Ref::, to Planning
2- Ylel
NO
NO
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THIS CHECKLIST MUST BE COMPLETED .-\.ND INCLUDED IN Till BtrILDING PERi'yl1T F1l.E TO
l'iWNTAlN A RECORD OF Till REVIEW.
T\T::"7\,f:JT .I. TI\.-\ LTC':;:CZ.DCC
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
3;;'1/ h)A'-!z<//
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/r-
I~ ~ r,;;J '3 --u .,,~
I. Blue File I PERMIT NO
2, Gold City . 6" ""I' oq
3. Yellow Applicant V lJ I
I
ZONING (office use)
R~
LEGAL DESCRIPTION (office use only)
I LOT
BLOCK
ADDITION
PID2 S- -3g'.'J - 0 J.J--j 0
OWNER
(Name)
I!rA If'
I '
<:~' /
--.-/ I r u t{;:J
C)-L,'- I J'L "7 / /, ...:1../
(Phone) 10;( - 7"7 - --/0."/"-.
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address) / /' ( (:~~~:)
f // (7;4 ~~
APPLICANT SIGNATURE ..:.{.. W ,7 .--:\/\ . DATE
I'" ( "
Lv ill cr Lt; 1/ C APPLICANT P'L'EASE CnMPLETE BELOW
Quantity Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
(Zip Code)
(Contact Person)
III /')
c-?
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations -$39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit # ,.,..,-
~ Jq, S-Oso,K "}~
$ 40flll, (~\v J \
1\ -
paid;\cl/ Vv
I Date~ll_ &3 () 0-
Receipt No.
I
By (JJ/
J
Estimated Cost $
(Office Use Only)
Thi~~~lic~iecomes Your Building Permit When Approved
/ f'l1/tt I~ It-,~ J 'CJ 2-
Building Official Date
24 hour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS JG 1/ Foxro.I I ~y
NATURE OF WORK L,L, ('.-'liS "'-
USE OF BUILDING 5. F.
PERMIT NO. 02 -/htJ9 DATE ISSUED /}..-1.1'02.
CONTRACTOR ty/~ 1fr()Up PHONE qQ - 4L-/7 - t.(()2/
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
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
I5<IRlr~: ":"...
I.-.a blttt 'LIft TI9T
~.
~
~
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.[1...-.111 Ja I'.I_. l_ 1_.:IJ:..m
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.
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FOR ALL INSPECTIONS (952) 447-9850