HomeMy WebLinkAboutBuilding Permit 09-0037 DATE TI1AE
CITY OF PRIOR LAKE � n
INSPECTION NOTICE SCHEDULED �c
ADORESS ( ' 1� � � 5 � c �Cf(!�l'1^G.�j �� ,
OWNER CONTR.
PHONE NO. PERMtT NO. ��" �O 3�
❑ FOOTING ❑ PLUMBING RI O FJC/GRAD/FtLUNG
❑ FOUNDATION ❑ MECH RI � COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE Rl
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
�EiNAL ❑ PLUMSING FINAL O GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAI ❑
COMMENTS: L . L • �:y��c, (,�
�
�WORK SATISFACTORY, PROCEEO
❑ CORRE AC 10 ND PROCEED
❑ CORR CT W K, ALL FOR REINSPECTION BEFORE COVERING
Inspecto OwnedContr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUtREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
Lvswon
oF PR/�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� �_. ; :. � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � _ � + �Q
� °.�"' =�;. � AND UTILITY CONNECTION PERMIT �
V ` d7
��n'NES��P I Whice File pERMIT NO. e
2 Pmk City � � ��
3 Yellow Apphcxnt
Please e or rint and si at bottom)
� ADDRESS � �^ �� P ����� � I � �� ZONING (o�ice use)
!� �
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
� nva� � �" � /�� S ��o`�' ' 0" �{o ' � �
(Phone)
(Address) r��� �� �C..i�����5 � UI�.— � ��
BUII.,DER �� � �
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Consuuction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding Lower Level Fimsh ❑ Fireplace
❑Addition ❑Alterarion ❑Utility Connection
CODE: .C. ❑I.B.C. O Misc. ✓ ' e�M'
Type of onstruction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished �nformat�on on this apphcation which is to the best of my knowledge true and correct I aiso cert�fy that I am the owner or authorized agent for th
above-menhoned property and th t all construction will conform to all exisnng state and local laws and will proceed m accordance with subm�tted plans I awa that i dmg
� o icia e t is permit for ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ms cnons
x
Z Z �
Signature Contractor's License No. D te
Permit Valuation 3��� .— Park Support Fee # $
Permit Fee $ 4� s' SAC # $
Plan Check Fee $ � Water Meter Size 5/8"; 1"; $
State Surcharge $ � C�� Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ ��. �' Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit ee $ TOTAL DLTE $ � Z(p � Z S
Tlus Applic ' es our Building Pernut When Ap roved Paid .Z ReCei t NO. S
Date Z p B •
Z Z 9
BuOd�n � Otlici�l Date
This is to certify tha t re e m the ove applicanon and accompanymg documents is m accordance with the City Zonmg Ordinance and may proceed as requested This document
when signed by th ry P r temporary Certificate of Zonmg compha ce and allows construcnon to commence Before occupancy, a Ceruficate of Occupancy must be
issued
2 Z. d
Planning Director Date Special Condi6ons, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Sueet Prior Lake, MN 55372
4 r Date Rec'd
� �� CITY OF PRIOR LAKE PLUMBING PERMIT
� x
� �
� �. Blue File
z �ma c,�. PERMIT NO. �. 3
3. Yellow Appltcant
ease or ' t and si at bottom
ADDRESS � � �' � ' , p � r �� �,�� �n _ � �� s ZONING (o�ce �)
. ,
�ni � `,,:�� . �..
LEGAL DESCRIPTION (oflE'ice use only)
LOT BLOCK ADDTTION PID
OWNER " hr � � ,�
(Name) 1 l � � I W (Phone
(Address) '� �� � U 1 `���
� APPLIC , �
(Name) (Phone)
� ��
(Address)
(A� �� (City) (Zip Code)
(Contact Person) �� � J
(Phone)
APPLICANT SIGNATURE DATE v
APPLICANT PLEASE COMPLETE BELOW
uanti T e of Fizture Quanti T e of Fixture
Bath Tub with or without shower Rou h-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E'ector
( Shower Stall Backflow Assembl
1 Sinks Backflow Assembl Test
( Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum ResidenYial, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
Estimated Cost $ Building Permit #
PLUMBING PERMIT FEE $ �-'S'�
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ S� - - -/ ,! ,/���
(Oftice Use Only) � w pV� -"— v`
This App i Beco�es Your Building Permit When Approved Paid Rec ipt No.
Date By
u din cial Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-0245
4646 Dakota Street S.E., Prior Lake, Miunesota 55372
P R I Q R `.. DEPART�IIENT OF
A K E BUIL�IING AND INSPE TIO
C N
I-N PE
TI N
RE RD
0
SITE ADDRESS ��� t 5 W l�-r�.N�SS �t' .
NATURE OF WORK �,,ati.�-; � L.,� v�i. �'c,�t� �
USE OF BUILDING � �4
PERMtT NO. �� • 3? DATE ISSUED � z a
CONTRACTOR Tc�+.{ Ao��►�t B�r�k.� PHONE q5z• 22�► • 383 J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTI�NS BEL�W
THE PERMIT IS BY SEPARATE DOCUMENT
�� ��
rior to Backfill)
PLAGE NO CONCRETE UNTIL AB4VE HAS BEEN SIGNED
ROUGH - INS
Ff�Al1�IN�
INSU{.ATIt�N '
ELE�TR#CAL.
Pi.UMBINC
H T��IC if r+� ujred
GQYER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
o Soddin
� BUILDlNG � 2 ir
ELECTRICAL
PLUMBING G /8 2 3 �
HEATING � , <<
DO NOT OCCUPY UNTIL ABOVE HA� BEEN SIGNED
NOTIGE
This card mu�t be posted near an ekcwical service cabi�et prior to rough-in inspections
and malntsined ur�til �11 in:pections have bea� approved. t�n buildings and additio�s
where no service cabinet is avallsble, card shall be plac�d �ear main entrance.
FOR AI.L INSPECTIONS (952) 447-9850