HomeMy WebLinkAboutBuilding Permit 03-1410
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
D FRAMING
o INSULATION
Ii' FINAL
~ SITE INSPECTION
CONTR.
PERMIT NO.
~ -/t/lO
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
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COMMENTS:
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~WORK SATISFACTORY, PROCEED
o gprmECT ACTION AND PROCEED
b/CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
01~
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
r
INSNOTJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
Date Rec' d
/0.2-1.03
I. White File I PERMIT NO
2. Pink City ()I ? _ IAI?'.
J. Yellow Applicant '-J I~ V
/ ~g4-
/fVO~t5 ~OG6 //U.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
ZONING (office use)
..e./...f'LJ
PID?S-: 26(" .fJ2:?- 0
(Phone)
/~U/ ~~h/ru
/3T'I'C- ~ J}/
/'1/7 ,lf1cfn'7U C/'ck
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/Ii 'c-I-() f't'p. I
(Phone) q~z---t./c.f5- 3(; ti9
(Phone) I~(z-- 2- o'Z _. (", U-"2-
S5'3r"
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
)(o6~;;;,
o Misc.
DDeck
o Porch
ORe-Roofing
o Fireplace
DAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
OUtility Connection
I hereby certify that I 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 property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware th e buil' official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~teruponthepropertyto rmne ~. /t1h/h~
Signature ~ Contractor's License No. 'bate '
Permit Valuation /, 000.00
Permit Fee $ :5~. 75'
Plan Check Fee $
I State Surcharge $ # .5V
Penalty $
Plumbing Permit Fee I $ 4o.oV
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~
Building Official
/O~I/03
Date
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
City SAC and WAC
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
#
#
$
$
$
$
$
$
$
$
$ 75 2.-5
I Paid
I Date
"7 =>, 2..-5.
/ () /~ 1 /if:J
I ,
Receipt No. ~11.f
By ~~~ ~
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
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE PLUMBING PERMII
Date Rec'd
/0.30,03
~. ~~ ~:~ PERMIT NO. O?-I'L,/O
J. Yellow Applicant .J. -r-
(Please type or print and sign at bottom)
. ADDRESS
j4ft:,e4- Ifl'Uo~ .e;LJc;6 ~
. ZONING (office use) .
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID "2--5: 2-8"'. oa 0
OWNER
(Name)
(Phone)
(Address)
It -.
APPLICANT I . \) ( I,
(Name) ;- \M12/\ Cc~V' .l( \kW\ VJI (\ J
\ c, l q <t (2 () c.oS 0",
,..
(Address)
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/',
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(Phone) q~:J -,?7 () - (hG-- ,)-
l AiLeu', t<- 5"50 cfL/
(City) (Zip Code)
(Address)
(ContactPenlon) Je.< ":,(?\'" 5; 1..""" -J+
APPLICANT SIGNATURE ~/,~-yl . -\Lr-au~
U
(Phone)
5--1W1 ~
DATE
/o/~()J 03
,
,
......,
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Quantity
I
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Co", $ Boitding Penn. # {)J - J ftO ~ 1
PLUMBINGPERMITFEE $ ~ pf1IDO f0-
STATE SURCHARGE $ ~ .50 (J V
TOTAL PERMIT FEE $"./ / v_~
(Office Use Only) "'./
This Application Becomes Your Building Permit When Approved Paid ~ Rece~ ~
Oa10. ]0. r)) By fjJPJ
1-
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
.T'
;
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS / ~f!J~ pV?JL6 ~t/c96 7?L-<--
NATURE OF WORK ?()WeC- (/0/~7/ $A-77t'
USE OF BUILDING /Ck;f /-1'/1'--
PERMIT NO. 03 -/4-/6 ' DATE ISSUED /0,2-1 03
CONTRACTOR ;fjP2U COUtJ/"lt4 PHONE t,/2-. 7-02-. (02-/2-
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
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
" I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
_ /7
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~
,k-li-03
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.
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FOR ALL INSPECTIONS (952) 447-9850