HomeMy WebLinkAboutBldg 08-0049, Plmbg 07-0049
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ADDRESS
I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
Yellow
~i f 2--/ 0 ~
I PERMIT NO. 08.- (X] l.j? I
File
City
Applicant
~ltS
ZONING (office use)
A~~
5W
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
Pro
ADDITION
OWNER
(N ame)
(Phone)
(Address)
~C~~~~: Name) S~e.-\\~ C~~~~~}
(Contact Name) ~"-l ~ ,S~~-e..r
(Address) ~~q ~ ~\.Il V/L "\VL.
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility Connection
CODE: Mi.R.C. OLB.C.
Type of &;stntction: I II III IV V A B
Occupancy Group: A B E HIM R S U
Division: 2 3 4 5
I hereby certify that 1 have turnished Information on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner Of authorized agent for the
abovc-mentlllned property and that all nmstructllln Will contilrm to all eXlstmg state and local laws and WIll proceed in accordance with submItted plans I am aware that the buildmg
official can revoke thiS p.' It for Just cause Furthermore, I hereby agree that the City official Of a deSignee may enter upon the propel1y to perform needed Inspections
Z/'2;iU ~
ate
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(Phone) bS j- (\ '" "? -) S" rt C\
(Phone)
-t--
$""50,"-- ~
VV\,,....J
ORe-Siding OLower Level Fintsh 0 Fireplace
o Mise
t-JGW p~ \"0
U~
PROJECT COST IV ALUE $
(excluding land)
'Zo~ i 11- 4'-
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 i $
Other $
TOTAL DUE $ '7(:, t () 0
This Application Becomes Your Building Permit When Approved
~..4l1L
c9!i;J-/o7
, Datc
I paidtii~ 00
Date ';;-/01
I ~~ceiPt N~ S-I 5" g-
13uildlllg Uftlclal
ThiS 1S to certify that the request in the above application and accompanYlllg documents is 111 accordance with the City Zoning Ordinance and mllY proceed as requested ThiS document
when signed by the City Planner constitutes a temporalY Certificate of Zonmg compliance and allows construction to commence Before llccupancy, a Certificate ()f Occupancy must be
i.ssucd
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File I PERMIT NO. l/
2. Gold City
J Yellow Applicant O'} - 0 0 c4
ADDRESS ZONING (office use)
/67 d
S ,t-U..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICAN1o~ /J /;LJ
(Name) L~ _ /?- /
.
(Address) '3 / '7 p~ S'7
(Address)
(Contact Person) /5.df .~
APPLICANT SIGNATURE ~~
(Phone) c; ~ / .- .t../ cP -; - I ,..;;t ~
F~ s~c;~L/
~ (Zip Code)
(Phone) ~ /;Z - CJ cP,- - 'f b ~ 6
DATE .:2- t:> - o~
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
a Lavatory (Bathroom Sink) / Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
~ Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
/ Water Closet (Toilet) Other G-'-' .~ 5~
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family
Residential, Additions & Alterations
~
Estimated Cost $ b t?OcJ
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~O.oO
.50
fR() .c;6
Paid
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave" S,E., Prior Lake, MN 55372-1714
PRIOR LAKE
INSPECTION RECORD
DEPARTMEtr r OF
BU~LDING A~jD INSPECTION
SITE ADDRESS
NATURE OF WORK -". Patte J~
USE OF BUILDING
PERMIT NO. DATE ISSUED ~
CONTRACTOR SHA.rP~7f!... Q./tT. PH NE4t ,. f
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
IlIeel'lf~G ,_,
I r8YfJRATI&U (PI iar tv D"'~lffill) C I
PLACE NO CONCRETE UNTIL Pi,BOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
v{-SoJ.
;uo.!.
:4
~
GAS LINE AIR TEST MoVtO~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
, I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be pos~ed near an electrical service: cabinet prior to rough-in inspections
and maintained until all inspeotions have been approved. On buildings and additions
where no servi'ce cabinet is available, card shall be placed near main entrance. .
FOR ALL INSPECTIONS (952) 447-9850