HomeMy WebLinkAboutBuilding Permit 10-0707 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS ) l Li
OWNER CONTR.
PHONE NO. PERMIT NO. / 0 — _
❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI
❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL
JZ_FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST
❑ SITE INSPECTION ❑ MECH FINAL ❑
COMMENTS:
17-\‘ (04 , e- g
/
`J�1 WORK SATISFACTORY, PROCEED
❑ CORRECT • - TION AND PROCEED
❑ CORREC • K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner /Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
`l P x „ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
k , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE g, 2_3, i 0
7 AND UTILITY CONNECTION PERMIT
MlArNESO�P I. white Fil PERMIT NO.
2. Pink City I 0
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS i 9 S � / / N � ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 2, 5, 4-4-6 00, O
OWNER
(Name) 62,9 /0/4/ NJ/ I-01/0 C%Y (Phone) 673 . 6 O 06
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck ['Porch DRe-Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace
['Addition DAlteration ['Utility Connection 2_ RPIS
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that l have furnished information 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 for the
above - mentioned pro 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
official can revoke t s permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins do s.
X ( —� 3 f
Signature Contractor's License No. Date
Permit Valuation 2 ) Park Support Fee # $
'60. V DU. 0
Permit Fee $ Z5 SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ S 0 0 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 5 ¢ 3 U Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 5.-, 612 TOTAL DUE $ / 760: 26
This Application Becomes Your Building Permit When Approved Paid / 76 - ZS ceipt No.
Date a Z 3 / U
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist .
Basement Finish or Interior -Alteration to Single Family Homes
BY: dio; Date: 8. 23- / O
Building Permit T /0. 107 PM: Zoning:
Site Address /61- 5/ »/,1
Legal: L B Subdivision:
Existing 5 cructu : YES or ! "O
C Or FORMS TO ZONL G YES NO
ORDL�iA`i CE
J I YES I NO
Ls this an expansion of the e:usdng footprint or Refer to Pla mg
building height? - V
. Is the property located within the flood piain? Refer to Plannirg ✓
Does the alteration include any additional'. Refer to Plazning
Does the proposed alteration include any outside Refer to Plarn.=ng
enhances other than patio door?
Is the proposed use of the i fished space or Refer to Planning
aiterat on for anything other than a normal single
family home (office, rot': hcire, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERfIIT FILE TO
NLJNTAIN A RECORD OF THE REVIEW.
PRIOR LAKE pp,
J AND IN SPECTION
INSPECTION RECORD
SITE ADDRESS / 5 /E Wi' y
NATURE OF WORK tow (1/ �
USE OF BUILDING y2&S
PERMIT NO. 1?) - 10 7 DATE ISSUED ). 2.3. / 0
CONTRACTOR L✓ 0V0L.P PHONE 573. Eoe5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
Ommur 1
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH-INS
MENNWNMEMONIIM
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required) 7
FIREPLACE '41
GAS LINE AIR TEST Fl
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
_ 1
FINALS
MENUMMEMENNWIft
BUILDING tk J V
ELECTRICAL
l
PLUMBING
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