HomeMy WebLinkAboutBuilding Permit 09-0245
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I PERMIT NO. 0Cf ;' 245 I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
ADDRESS
I
}J i-1OlJ
D
Ne
Date Rec' d
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER!il
(Name) 'A-r'I
[;)),.n4,.}
f /iktt~,J
(Phone)
(Address)
UILDER
Company Name)
Contact Name)
Phone)QSQ - ff~f 'ss,/I
(Phone) &iJ- - '-1/'1- 'II '/~-
,
~l~iAJ """- JVJ0 S~2D
S /)-12:-
ORe-Siding OLower Level Finish
o Fireplace
TYPE OF WORK 0 N~w cons;r ion ODeck OPorch ORe-Roofing
OAddition Alteration OUtility ConnectIOn
CODE: NT.R.C. DI.B.C. 0 Misc.
Type of ~tmction: I II III IV V A B
Occupancy Group: A B E F HIM R S V
Division: I 2 3 4 5
PROJECT COST/VALVE $
(excluding land)
I hereby certify that I have furnIshed mformatlon on this applicatIOn which IS to the best of my knowledge true and COlTect. I also certIfy that I am the owner or authOrIzed agent fClr the
abov'-mentloned property and that al construction will conform to all eXlStmg state and local laws and will proceed in accordance with submitted lans. I am aware that the buildmg
offic' I can revoke thIS permIt ~ . Just ause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propel1y to perform ne ded mspectlons
2337 ~-/~.-(j
Contractor's License No.
/'
Park Support Fee
#
#
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
,..
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Date
$
$
$
$
$
$
$
$
$
ThiS IS to certIfy that t 1e I' lest In the above applrcatlOn and accompanymg documents IS in accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner conSlltutes a temporary Certificate of Zonmg complrance and allows constructIon to commence. Before occupancy, a CertIficate of Occupancy must be
issued
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
2. Gold City
3. Yellow Applicanl
5.7.()/
P1Ve:- tv) tJ~O~~-
PERMIT NO. q, 0 Z1Je;
I ~;:;;;S; -... "on" bottom)
LJ9gbq JnClJ)', -\-D)~ ~\ NtJ
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
[ OWNER
(N ame)
(Address)
(Phone)
APPLICANT ~' ~ ~
(Name)' 'if) l/'.
(Adme,,) ~ 5~~ ~~_ ,~+ ~~
(Address)
.' ~one) -x.~'+~-l;?-
,.,Si\ tin. () ( k \ (J70
(City) (Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATU
DATE
Quantity Tvpe of Fixture Quantity Type of Fixture
I Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
J Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Eiector
I Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
.J Water Closet (Toilet) Other
~
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $49.50 minimum
Residential, New One & Two-Famil
eSldential, Additions & Alterations
$149.50
$49.50~
Estimated Cost $ ....... ~ L,OO'-
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
lJ-Ci ' 9l
.50
5:). Di)
(Office Use Only)
Buildin2 Official
Date
Paid.5CJ, dV
Da~
g No. 5 777
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
D
PRIOR LAKE
INSPECTION
RECORD
l-IlfO' "'I'INllDv A!-O.
. 1'1"17
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. . () . .
BUILDER ~ PHONE # ",. 55JB
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
~ Pi-- VtseJ
,.PLACE NO CONCRETE UNTIL ABOVE HAS BEE
FRAMING
I FINAL
fP
I*J~
FOR ALL INSPECTIONS (952) 447-9850