HomeMy WebLinkAboutBuilding Permit 09-0020
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Dlte Rec' d
1Lftr/CfJ
I White
Pink
Yellow
File
City
Applicant
I PERMIT NOoC1J. 00z..0 I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID2. . 2-$!$ o~ (.0
OWNER
(Name) T j" OI/Y1 t'( .s 1- E: fa fr7 -e
JOh17$Dr1
(Phone) t 5-/ - 5- g-7.- 0 '-1/8
(Address)
BUILDER f- 11 tJ r fh enl1 R e c; OL.l,c.e >
(Company Name)
(Contact Name) f:ul
(Address) or'" h~ rvr Ave
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition ~lteration OUtility ConnectIon
CODE: bG.R.C. DI.B.c. !Si:Misc
Type ofl;;'~ction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
ht"~
PROJECT COST IV ALUE $ 21 ~ .
(excluding land)
"0 S- t (-
) ~:.?
I hereby certify that 1 have hlrnished mt(lrmatlon on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authorIze,l 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 buildmg
olTtcial ca evoke thIS perml~lSt cau Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed mspectlOns
X t~ 2()2-7J 3/'1 /l-Z3-t?8'
Signature Contractor's License No. Date
#
#
-
Permit Valuation 2-1~~- Park Support Fee
Permit Fee $ .$"~ SAC
Plan Check Fee $ 8 Water Meter Size 5/8"; 1";
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ 5"0, - Water Tower Fee
Mechanical Permit Fee $ - Builder's Deposit
572-
Sewer & Water Permit Fee $ - Other
Gas Fireplace Permit Fee $ 'br I#C. . TOTAL DUE
Paid
Date
-
-
#
#
-
-
-
-
~8
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. TillS document
when signed by the City Planner constitutes, tern orary Certificate of Zonmg complIance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
issued
/-9--P'?
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
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT GR~ REo ~9S5
l7-(
C>~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
~ ~ c:::::::::'-^-> ~ \
/ ~?!orrections
Reviewed By: ~rr Date:
I
~^'1/l-c:1 c..- ~ (~ ~
~~ c;;:~ A-r-
Denied
,z-hl loa
r I
-fJ,A-r/Vr7'l-[.-J
'-c- 7C /h. b:5'
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
~-BUild~
anary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
- -~,
NAME OF APPLICANT
APPLICATION RECEIVED
;,,_,,_::-~'~'_l--t"C":\ ;-. '~\.,\ ~/"'-\ I,', ,_,,'{' __!~_, t'-,:. ". 'C'>'_' /"~ ,.
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"'-fl~:."-
,',:-.c-:"...- /~,-~.:-~::) ...____-----.c-". "',.....) ;~- . ('... '''1
\
Accepted
Accepted With/Corrections
i'~"\\ / /
, ! I f
/ J.' '--1"-
-h .! I
-.....--.,..r/' I
Denied
Reviewed By:
Comments:
/-
/'
Date:
I
I
I
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"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
x
.
Accepted With Corrections
Denied
#~-
Date:
1-1-(;7 'I
Reviewed By:
Comments:
'I.
tt"<<,,"
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PERMIT
Date Rec'd
! Z 1. ['1
~. ~~:n ~!~y I PERMIT NO. 0 0, OO? J\
3. Yellow Applicant L, ~YJ
ADDRESS
(p?:tJQ
Con rOl
~
NS
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
~:;~f~i jr)p C~(p;. ~:fk,11c.tt I ~~><PhOne) 95;;),-'1 33 I~'if .
(Address) 43ttf2- 6 ~ctkl Ot.Ll<.-J J2.J I-kfJl,,/l S /Ylt1553<f :5
\ (Addre~) (City) (Zip Code)
(Contact Person) 'J D Ct.-.rt..A" (Phone)
APPLICANT SIGNATURE
DATE
j-
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION !lrREPLACEMENT ~ AL TERA TIONS"
FURNACE MAKE AND MODELl nLn€- TJPICIlXJIt9;fYA FUEL t;;/
FLUE SIZE RETURN OPENINGS INPUT IDb . <fDO OUTPUT 1~") 0tY.:)
. ,
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
SWarm Air Plants o Steam Units and Fireplaces Cannot Encroach
DGravity D Hot Water into Required Side Yard Setbacks.
o Mechanical D Radiation
)dAir Conditioning o Special Devices Fireplaces with Box Additions or
jaY ent. System o Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99,50
$64,50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39,50
$39.50
Estimated Cost $ ~Cll> -
Building Permit #
!- l~ ) D
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
r ~. ~,..
; ~.1
,~ ~,. . ..
(Office Use Only)
Bui/din!! Official
Date
P~
Date.; z.. J., CJ
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
A+{-,,'( ~ "" J. '\.
I. DIu. 1'11..
2. C.old elly
3. Vel/ow AI'f'IIC<III
PERMIT NO.
N~
LEGAL DESCRIPTION (office u~c only)
LOT BLOCK
ADDITION
PIP
OWNER
(Name)
~So^
'?;;IJO (0(\ ro
(Phone)
/J11r
(Address)
stree...t" IV IE
Pr?ur l't ke.. MV
APPLICANT J d ~
(Name)~e,l 01\. 5~ (w.JIJ~ CON\p~y
(Address) -:3y lo k,l~<..r- ~~ Ai .
(Address)
l ~ IV\. ~t:) (OVV"\..
b?---
(Contact Person)
(Phone)
7lo'3J{7~~07-q~
IVY! %"WI
(Zip Code)
7 b 3-Lf75 - 6 L.. G("
21
(Phone)
p ) jMO<A+h.
(City)
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
Ol... Bath Tub with or without shower Rough-ins
A Dishwasher J Water Heater 1J ~ Cc-\.Ilof\
Floor Drain I Water Softner
L.I Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks ."... D;-5~oS4L. Backflow Assembly Test
Bar Sink Lawn Sprinkler
~ Water Closet (Toilet) I Other -r::c.e... r{q k..er-
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi--fdmily l% of job cost with a $39.50 minimum Residential, New One &. Two-Family S99.50
Residential. Addiltons & Alterations $39.50
Estimated Cost slC,.,J 00()
Building Permit #
fJ () Fee- - ~((.A.ktJ w ~~~.e.-
~ .50 buJtJ..~ perMH-a.lr~ ,
$ J;SSv-eJ:-fo ~kU1'\..
PLUMBING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
(OfJiC( U,c Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Bulldln!! Onicial
Date
SUI
Dllte
24 hour notice for lllJ inspcctlon~ (952) 447-9850, fax (952) 447-4245
16200 EI1~lc Creek Ave., S.t" Prior LAke, MN SS372-1714
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS tb '3t9t"') L:oJ'-l~1 ~e&\
NATURE OF WORK r<..e-~~N\~'" ~ L-::" or f'\~ P4"'\-A- _6
USE OF BUILDING ~,..s A/.2...
PERMIT NO. (Jr. oozo DATE ISSUED
CONTRACTOR G~ N~l"~ {Z~ PHONE C\~"t... ~,~ ..,~ \"2-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
r -~
-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
FOOTING
r--- -
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ~
.
We.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1~wM-P tk /X I I
F ALS
()
r""" ===--------- - --
BUILDING
ELECTRICAL
PLUMBING f'\.lU"'4.\"~
S- 2.7 ()c
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,
FOR ALL INSPECTIONS (952) 447-9850