HomeMy WebLinkAboutBUILDING PERMIT #02-1541
DATE nUE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I (J - (5-ci~ -r: ct:Y
= ADDRESS ~ {i Fax ~'l
OWNER CONTR.
~ 2 - I s-l/ I
PHONE NO. PERMIT NO.
D FOOTING o PLUMBING RI D EXIGRADIFILLING
D FOUNDATION D MECH RI D COMPLAINT
D FRAMING o WATER HOOKUP o FIREPLACE RI
D INSULATION D SEWER HOOKUP o FIREPLACE FINAL
~~NAL L.. (... r:;/fIi~ o PLUMBING FINAL D GASLlNE AIR TST
D SITE INSPECTION D MECH FINAL 0
COMMENTS:
/'
~RK SATISFACTORY, PROCEED
o CORR~CT ACT ON AND PROCEED
o CORR R ,CALL FOR REINSPECTION BEFORE COVERING
Inspector l' Owner/Contr:
CA~Lw7-~ FOR. THE-NEXT INRPEcnON 24 HOURS IN ADVANCE.
V , - . ..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .t SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
oz.--o()(p 4-
(Please type or print and sign at bottom)
ADDRESS
:3&/7
Pox
~/L-
LEGAL DESCRIPTION (office use only)
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
PERMITNOOol_/~LjI
- - I
/ /c.-J1f9 1'-
LOT q BLOCK
ADDITION
/11 ~/V-f /7/'1 tVJV ;? NO
PID 25-Z<?)S- 001-0
I
OWNER
(Name)
L3tJL5 e-/~.oF0/21
(Address)
S~n6
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Consttuction
~ower Level Finish
DMisc.
ZONING (office use)
.e2-
(Phone) 515'-- 441'" ;J-gs t,
(Phone)
(Phone)
DDeck
DPorch
ORe-Roofing
o Fireplace
OAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
DUtility Connection
I hereby certifY that I have furnished information on this application which is to the best of my knowledge ttue and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all consttuction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. ram aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
:teruponth~7?::fpons. / ;)-/-; !;}Db?--
Signature Contractor's License No. Date
Permit Valuation ....3f)tJ & , tJO
Permit Fee $ 7~
Plan Check Fee $
State Surcharge $ j,5D
Penalty $
Plumbing Permit Fee $ 4~,()()
Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~
Building Official
/d/~ 2,..-
, Date
I Park Support Fee #
I SAC #
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC #
I Water Tower Fee #
I Builder's Deposit
I Other ei-t;e::;)?,J tJrtL-
I TOTAL DUE
Paid
Date
. .-"
J/fl" 't~
1d--=3-~
$
$
$
$
$
$
$
$ 1.00 .-
$ 1/5,75
~;ce~>(h
U
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
is~ ~~~
Planning Director
I~Aa:- p~,,- ~nd:i~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
II Ita III
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File PERMIT NO I
2, Gold City ./1, ",1 _ jeL/
3. Yellow Applicant C/O< ~ .
(Please type or print and sign at bottom)
ADDRESS
.::;? ~) / 110/
, v
------ "I .-1
j a /-:~/L/
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
f ~ '^ .'>c.-'
7- _!,
PID(),.5 -;"::+ 5 UC.J, -()
OWNER
(Name)
/1 .
:/)6 h
f)~ c-x;f; r -;--
(Phone)
L/{/ ~ - l-.)-?~~j
. (Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
I
~/I(~ii
(Phone)
APPLICANT 'SIGNA.. TURE
DATE
I). /'3/';;)0-0 "
Quantity
,1 '{ \
I DLVv Ii.
II e\)
~
I
I
I
I
I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I Type of Fixture
Bath Tub with or without shower I Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
Residential, New One & Two-Family $99'50~
Residential, Additions & A,,1terations, $39.51. "
Building Permit # a 0 '..--
,I) /""
PLUMBING PERMIT FEE $ ;Y. P-, '.Aft, ut
STATE SURCHARGE $$ .50 I, ", ,! /; G .N>";I'
TOTAL PERMIT FEE u /vi r
Paid fJ
Date, ?/Y
0/ ) <--
Receipt No.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
BY!y/
U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
II IIII Iii
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 3 &,/'i h)' Ta; I T y
NATURE OF WORK /- L-
USE OF BUILDING .~ r=-
PERMIT NO. D,.:}- IS-'ll ,., Df\TE ISSUED /d- 3'-00-
CONTRACTOR ~6 /,)1 'erj +0 r I" PHONE L!tJ;- .ajJ:;~
- \./
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
./
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING n;1/ '~.- ~O ~O)
INSULATION j/J/fI >/ )/{) -()]
ELECTRICAL
PLUMBING rvr/ 1- t-1) -();.
HEATING (if required) rvy/ ?,.. ~()- cJ>
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
./II'; I
(
~
'-\.?
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
I 0 -IS-
This card must be posted near an electrical service cab.,inet 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.
Ii 1lI lIT
FOR ALL INSPECTIONS (952) 447-9850