HomeMy WebLinkAboutBuilding Permit 09-0288
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5 Zfl_ o{
File
City
Applicant
I PERMIT NO. 09. oz88
I White
Pink
Yellow
(Please
ADDRESS
Zo;/
n at bottom)
~ !C/; ( LOG/ ,-1- M;r- I/I/f,ve .~ d-
ZONING (omce use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) '~e~\1r-.
Ar~~l ~,,'--\ -:::.t e '^-
P +-PI ~
(Phone) Cj S 2 - LfLJ 7. I' 't 0
(Address)
BUILDER I t\
(Company Name) h",-'I5~.tl ~5.e~~-"---~
(Contact Name) R~t-r)-~L ~- \ -\:-t"_iA..
Due Dt d.v-.
tD '''V\..() c -......v..---/'
(
(Phone)
(Phone)
c;,S/ 224-7000
& (z- Z<'fK' '13(') Z-
~: h'~- ~
ORe-Siding ~ower Level Finish
.3 /oL~ 5
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddinon OAlteration o Utility ConnectIon
o Fireplace
CODE: OI.R.C. OI.B.C. o Misc.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ 'Z- 7- OC-.JL)
Occupancy Group: A B E F H I M R S U I
Division: I 2 3 4 5 (excluding land)
x
I hereby certify that I have furnIShed mfmmatllln 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 t'lr the
above-mentIOned pro ,. and that all constructIon WIll conform to all extstmg state and local laws and will proceed in accordance with submttted plans I am aware that the buildmg
official can revok ' is ermll for Just cause Furthermore, I hereby agree that the City official or a deSIgnee may enter upon the propel1y to perform needed mspectIons
5. t 10Y
Signature
?oY'ee ()77/
Contractor's License No.
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
.3 0 0 (. . c/lJ
$
$
$
$
$ SV. (jQ
$
I $
$ 50.00
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permtt Fee
TOTAL DUE
(!;Iu.Gi:)
This Application Becomes Your Building Permit When Approved
13uildlll!! OfIicial
Date
Date
$
$
$
$
$
$
$
$
$
.5
ThIS IS to certify that the request in the above appltcatlOn and accompanymg documents 15 in accordance With the City Zoning Ordinance and may proceed as requested TillS document
when signed by the City Planner constitutes a temporary CertIficate of Zonmg compltance and allows constructIOn to commence Before occupancy, a CertIficate of Occupancy must be
lsslI(...'d
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
CITY OF PRIOR LAIne PLUMBING PERMIT
Date Rec'd
I. OIu. Fil.
2. G<>ld Cil}'
3. Yellow AppliNlll
~ERMIT NO. 0'1. ozee
J
ZONING (ol11e<! us~)
15291 Fox Tail Ct NW
LEGAL DESCRIPTION (office use only)
OWNER
(Name) Kevin and Kristen Ptak
(Address) 15291 Fox Tail Ct NW
_J
j
LOT BLOCK
ADDITION
PID
.__ (phone)
APPLICANT
(Name) Larson Plumbing, Inc.
(Phone) 763-427-7680
A_1J9o_yer, M N
(City)
55304
(Zip Code)
(Address)
3095 162nd Lane NW
(Address)
(Contact Person)
._... (phone)
763-427-7680
h ~;;~'1--
APPLICANT SIGNATURE
DATE
Quantitv- Tyue of Fixture Ouantitv ~--'"'--.~
"'yue of Fixture
Bath Tub with or without shower .~ough-ins
r~._n~
Dishwasher Watel' Heater
Floor Drain Water Softener n. ...-..
Lavato!): (Bathroom Sink) Stand Pioe (W~hi~lg Machine)
", Laundry Trav (1 or 2 comp'~~ment sink Sewage Ejector
Shower 8tall J~.~.ckf]ow Assembly
Sinks Backflow Assemblv Test
/ --.--- ,..
Bar Sink ___Lawn Sprinkler
Water Closet (Toilet) Other _......~
APPLIC NT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family t% orjob cost with a S49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ Lloo. (J 0
Building Permit if _.._~_...
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT Il'EE $
.'-/ q . :5 0 PAID WITH
.50 BUILDING PERMIT
SO.OrJ
(Office Use Only)
This Application Becomes Your Building Permit When Approved
BuildIng Officl~l
Dille
Dat(." 5", (;7
By
24 hour notice for alllnspcctlolls (952) 447-9850, fax (952) 447-4245
4646 Dakota Slrcet S,E,. Prior Lake. MiulIesola 55372
Residential Building Permit Checklist
BasementFinish or Interior A:lterationto Single Family-Homes
BY: ~ Date: S 29. oJ
Building Permit # 0'1 02 (38 PID: Zoning:
Site Address / S2 q / ?'OX 771/ L- G -r
Legal: L B
Emting Structure~ NO
Subdivision:
CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ~
Is the property located within the flood plain? Refer to Planning y
Does the alteration include any additional kitchens? Refer to Planning )C
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? >f.
Is the proposed use of the finished space or Refer to Planning '(
alteration for anything other than a normal single
family home (office, 2fOUP home, day care, etc.)?
Tms CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLATE\ALTCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
~ ~/",.,
DEPAR'fMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
-.. I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~
--- --
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
l- -
I
:-~. ._~ - --
3UILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
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