HomeMy WebLinkAboutBldg Permit 09-0462, Plmbg 09-0312
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(p r /. () J
Please
ADDRESS
4~ 51 .t:1 nUYl woocl ~V
1. Blue File I PERMIT NO :::l
; ~~:~)W~~~licanl . OCl. 03/ ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
~=~N~Vt)Yilll ~lciQnl~
(Address) L1 ;=J t1 ,(
(Phone)
~:~~f~~}f\q-~
(Address) 0~ l)O Hw4 .\3 ",(J.
(Address)
!yY)"
(Phone) q_\~ -11 aT - JgJT
bUYn\1Il Ue/ 5563=J
(City) (Zip Code)
(Contact Person)
(Phone)
DATE
t;;;.!aqJf:\Cj
.
Quanti
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture Quanti
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavato Bathroom Sink)
Laund Tra (lor 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $49.50 minimum
Residential. New One & Two-Family $149.50
Residential. Additions & Alterations $49.50
Estimated Cost $
Building Permit #
(Office Use Only)
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
L/q..60
.50
50- UO
Buildin!!: Official
Date
Paid 50,00
Dattp, I r 0 /
Rec 'p N057f74-
B
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LtZS7
(; 'AAlt-.l wc.oD
e
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
pm
OWNER
(Name) ~
(Address)
~ Mi.f
AJt3J()I,JeP
.
'C
- BUILDER ~W ~&J
(Company Name)
(Contact Name) ~' \
(Address) t7f7(P Q..Jt.it.t:"'fO..( LIVe
Date Rec' d
1 z,. (i J
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. q - 'I' 2--
ZONING (office usc)
(Phone)
~ r2 '5~~'6~~'1
LI1rc.e
(Phone)
(Phone)
rL ~-S-7? Z-
~ / 2 -'5t::.3-C,C6/f'
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAdditIon ~Alteration OUtility ConnectIon
o Misc~fl",.tDm\...
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group:
Division:
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
B
OLower Level Finish
o Fireplace
eL 1.1- J.. e{
A
R
5
-p, bOo
B
S
PROJECT COST IV ALUE
(excluding land)
$
U
have hlrmshed Infllfmatlon on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authof!zed agent ftlr the
erty 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
s permIt for Just cause Furthermore, I hereby agree that the CIty officialllf a designee may enter upon the property to perform needed InspectIOns
x
Signature
Permit Valuation
7
Permit Fee
$
$
$
$
$ "
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
'7-2 -~f
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 2'f{~. l(L
.
I ~;ce1to. ~ ?O~
Paid ~
Date y I a i
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 Cllnstltutes a temporary Certificate of Zoning complIance and allows Cllnstruction to commence. Before occupancy, a Certlficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake. MN 55372