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HomeMy WebLinkAboutBuilding Permit 09.1021 _ _) O _ n 40 OO2 o a zg n 0 D 00 § O Em�� o$ § � ° 7 7 c m ›c m m m § k. \ m § § K§B k / \� I } 0 D. n z - 0 -4 o \ 0 § k \ il (-- 4. 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Pink City oct ,. / o z_ 3 Yellow Applicant 1 (Please type or print and sign at bottom) ADDRESS ZONING (office use) 4()H 0 13\ (C 6krts --- tv I S t LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER , c �� -� (Name) \ L( t Uu,(-e o i n (Phone) ! (Address) BUILDER I ,, ,, p (Company Name) S Cvw y - (Phone) S _ ' t� (Contact Name) (Phone) (Address) TYPE OF WORK ❑ New Construction ❑Deck ❑Porch DRe-Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace DAddition ❑Alteration ['Utility Connection 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 HI MR S U (excluding land) Division: 1 2 3 4 5 1 1 hereby certify that I have furnished inform en 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 roperty and that all co i . - uction 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 r vo thi permit forjust c. ..e Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X , If 10 -----— /7/ li O lgnature Contractor License No. Dat Permit Valuation O0 Park Support Fee # $ Permit Fee $ 692.-2-5 SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ \ - . Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ S®. s Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee .. $ TOTAL DUE $ . _ 2_S This I 1 1 a ' : g uilding Permit ■ en • pproved Paid LF�A►I Recei • t N., V '/ p I Date 2 RI B /!SJ k 1 l rr O . inc 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 1 --- -- co t . t s ,,- - u i ef • IX il U I ( \ • +60/ F.____-- ........_... _ - • - 1 tx:i " CI La V 0 _..1,1 im i yr --- . ( i . _ .. . . .. _ , A - ,T --4 --- ,J ..... 2 2 g cr.3 ca p 1 '" 1 Z .. 0 Vi 03 i-, • III c ti 1 ) _..0) t CO —, .c .— , ,..0 .„/ 5. < — , Tc; - ti c:3-4 al A <,.... j ce Lu clo , rit.c tr , Z 6 Ce rm E romft i t 5 t , i s 42 • 144 i / ) I A LLI u j ts= -0 t.F _ W \J\ ~...:— CI " ch. -r• ce - cc 1 2 ko _ CG I x • , 2' o 0 . . - c - .5 6 ; - (\'‘ La- °3 m () "g 1 0 g k•A \C \ \ ''-' CI) LANs ' , CL> , - VI ... Z 8 j g cp 73 , ., --- - J- A ....- •• g -- ..- c,...) 5 CO 0 0 0 0 o — — Lou_ W < < V.. If .-.. . - 0 .... 0 . , ......- ...t. ) :4‘ I . :.-- .ta --- '1 - -- r — • -7---t—T---7-17--- t C i RIO Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT NE S�� 1. Blue File pERMIT NO 2. Gold City /'17 (6zi 3. Yellow Applicant C.,� (Please type or print and sign at bottom) ADDRESS ZONING (office use) /991 )/0 hie i it -71-0„--i; l SF p,a 14 , 5 2 ) �/Y LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICANT / (Name) J ctS ©✓L e L Z 2l (Phone) (7 IC) S 2 ct 3 c)6 (Address) tine e/ci 4 Yf e t 1 s I l Sc f i^e r ,4-4 ,5cr 3 7 2_ (AddrtSs) (City) (Zip Code) (Contact Person) J u Y `''. (Phone) - APPLICANT SIGNATURE AiIIIIII" ealima C DATE /2 — 17 — APIIINIIIIW L, - -/ APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture (' Bath Tub with or without shower Rough -ins Dishwasher Water Heater Floor Drain Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly t Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler [ Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi- family 1% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ nQ ,✓ STATE SURCHARGE $ .50 I P- ►l[ 0 -- TOTAL PERMIT FEE $ (Office Use Only) This Appr , iii) : I , es Your Bttiring Permit n Approved Paid Receipt No. 4 1*W Z II 0 Date By Buildine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECQRD SITE ADDRESS NATURE OF WORK F=11'Istit Lt USE OF OF BUILDING R Az- PERMIT NO. '( &zl DATE ISSUED i (Ir I ac( CONTRACTOR I PHONE ‘7■ ' 4 ;2 2 ) --- - 41 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE 0.11111111111111P !R'O Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS BUILDING ELECTRICAL 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