HomeMy WebLinkAboutBuilding Permit 08-0126
:t
~
::!
5'
UI
81
~ ~
;u ~
m t/J
o >
-l -l
> -
o l/l
-\ ..,
. ')
o 0
Z -\
> 0
z ~
o .:<
." ."
;U ;U
o 0
o 0
m m
m m
C C
8
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
~
f:;
~
~
~
~
Ro
~
~
~
Z
l/l
."
m
o
-I
o
Z
N
"..
:z:
o
c
~
en
Z
>
c
<
>
Z
o
!'1
~
::J
CD
::t
()
o
~
:"'!
Occupancy Group:
Division:
A
----,
',./
~
~
n>
-i~
f/
\\~
B
E A H
(' IJ/ 2
M R
4 5
~) D'.
.~ L
I~' P
(~. t'
~
'-..l
J
~
~
-....j
~
""
~
...
o
o
i:
i:
m
z
-i
en
DDDDDD
en"TIZ"TI"TI"TI
:::jzen~OO
~>Ci:iS
Zr'">ZOZ
t/J -I^>C)
." - '" -I
m 0 -
o z 0
-l Z
(5
z
."
:z:
o
z
m
z
p
~
m
;U
>
C
C
~
m
en
(I)
-0
Z_
~~
mO
0."
:!"
0:xJ
Z-
zO
0"
=!~
0;;0:;
mm
en
o
:z:
m
C
c:
r-
m
c
-::::....
~~ ~
o-~
...
-f
i
m
I hereby certify that I have hlfnlshd mt(lrmation on this application which IS to the best of my knowledge true and CO!Tect. I also certify that I am the owner ()I autho!lzed agent f(rr thc
above-mentIOned property and that all cnnstruction will conform to all eXIstmg state and local laws and will proceed in accordance with submItted plans_ I am aware that the buildmg
(ltlicial can rcvo till ermlt for JlI.'it cause Furthc ore, I reby agree that the Clty official or a desIgnee may enter upon the pro petty to perform needed mspcctlons
---
x
(/
Signature
Permit Fee
Permit Valuation
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
\ Mechanical Permit Fee
\ Sewer & Water Permit Fee
l Gas Fireplace Permit Fee
I
3
.I
$O()f!).DO
$ l?~, 2~
$ 57. 3(p
$ I. CSO
$
$ 5'0, () ()
$
$
$
This Application Becomes Your Building Pennit When Approved
~~
Sui/dill!! Ofticial
~/'-f%'L
. Date
,-
~
:lto
~
(0
000000
3I:"cn:::e:l:"
mr~>mr
oC: -IOC:
:I~ m:I!:
"TI~~~~~
zZ::J:::J:-z
>ClOO Cl
r"TIOO ~
-"'''' -
Zc:c:
~."."
DDDDDD
C)"TI"TIO[l!
>:ii:ii0~
~mm3l:C)
!....".".,,~
~>>>c
>OOZ:;;
_mm-l_
;U"TI;U r-
-1-- r-
enZ Z
-l~ C)
S U
(excluding land)
... .L.....'-'.Tr;\;.;-:l"t::t'~r:r .... ~,un -l'
Contractor's License No.
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
t Q7. ( ,
~
#
#
#
#
~
~
'1J
m
"
3:
:::j
Z
9
f?
n .~
o
Z .~
~~
%
\
~
o~J..c"o~
Date
$
$
$
$
$
$
$
$
$ Ir7.11
Receipt No. S S~je
By ~
ThIS IS to certify that the request in the above application and accompanymg 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 Zonmg compliance and allllws construction to commence. Before occupancy. a Cernficate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-985ll. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
~~
Date:
3('2.k (of
'Lou\u~;.
Building Fermlt #
Site Address ~ or Z.S;
Fl.D~
~jJ~
Subdivision:
Legal: L
B
Existing Strul:tur~r NO
CONFORMS TO ZONING
ORDINANCE
I
Is this an expansion of the existing footprint or
building height?
Is the property located within the flood plain?
Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
eYES ')
NO
YES NO
Refer to Planning
fJO
Refer to Planning tJO
Refer to Planning NO
Refer to Planning
}JtJ
Refer to Planning
(JO
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\ALTCHCK.DOC
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please tyoe or \lrint and sign at bottom)
A1.J1.J1tESS ~ q ,< ~- C 4tll.\.. ~ tll.r Po.. t. h NW
P (' \' () \" l-~ \:: ~ t \V\ A/
While File
Pink (11y
Yellow Appli,~nt
SiZe/a ~
PERMIT NO. ()'1 - OIl{? l
ZONING (office use)
LEGAL DESCRIPTION (onlee use only)
LOT
BLOCK
ADDITION
PID
OWNER " D '\./
(Name) (lAf l ~ ex. 1 ex V\. ~
So,J~ \AOV
(Phone) (q-..r~) l.(S? -G It; 0
(Address)
BUILDER \-,.., L I ..
(Company Name) ~ {\"::("o5 C~SC('u.c..t:\~Y\
(Contact Name) A\$;(.)( \:..r \ "'-~ ~<;~ V\
(Address)
5\', Q ,
(Phone)
(Phone) jj;:, l~) G ~.r -~S 60
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding ~ower Level Finrsh 0 Fireplace
OAdditlOn OAlteration OUtility Connection
CODE:~.R.C. OLB.C. o Mise.
Type of onstmction: I II III IV V A B
Occupancy Group: A B E @ H I M R S U
Division: 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby eertity that I have hlrmshed mt'JrmatlOn on thIS application which IS to the best of my knowledge true and correct. I also certify that I am the owner or authllllzed agent I'Jr tbe
above-mentlllned property and that all construction w1l1 cont(,rm to all existmg state and local laws and will proceed m accordance with submItted plans I am aware that thc blllldmg
~"ccc' c'" ,.ccc "cc wmcc::a:.uc.cc. " "d;.OC'. " "", "CO, ,"d,. "''' "mc'," "" """",, m" em" """" ,", """rt'; ,,, ""'0< m "n"~ '~"':;~ _ 0 \l
( / Signature / Contractor's License No. Date
I SOt1)~. 00 $ I
Permit Valuation Park Support Fee # I
Permit Fee I $ 1?Ff, 2~ SAC # $ I
Plan Check Fee I $ 57, 3~ i Water Meter Size 5/8"; 1"; $ J
State Surcharge I $ I. CSo I Pressure Reducer $ I
Penalty $ I Sewer/Water Connection Fee # $ J
Plumbing Permit Fee $ 5'0, (J () I Water Tower Fee # $ !
Mechanical Permit Fee $ I Builder's Deposit $ J
I
I Sewer & Water Permit Fee i $ I Other i $ I
I
\ Gas Fireplace Permit Fee $ I TOTAL DUE 1$1'17.// I
This Application Becomes Your Building Pennit When Approved I Paid I ~7. f I ReceiPt No. 5' S-S'J'4> I
~ ~~ .5/2.fo/OL I Date ~.'2L.!"~ By ~ I
Buildll1!! Omcial . Date
ThiS IS to certify that the request in the above applicatIon and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed a~ reqllested ThiS document
when signed by the City Planner commutes a temporary Cellificate of Zonmg compliance and allows construction to commence. Before occupancy. a Certlhcate "fOccupancy must be
issued
Planning Director
Date Special Conditi"ns, if any
24 hOIlI. notice for all illspections (%2) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372