HomeMy WebLinkAboutBuilding Permit 10.104 J
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
g.' l TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 3 2 . 10
AND UTILITY CONNECTION PERMIT
-i, NN S 50
1. white pile PERMIT NO. �j
2. pill city /a , ! O¢
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
17 U L I (o Stone \36.0d-- &i rcil-e. sto
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER -
(Name) \l V(.S k b CSC .. A M cd son (Phone) ` ..52 g'_[ - 1 - T
(Address) 1 l V4(U S wleb6c'c Q1 c l e 5 W ' . n o� L_l {� l MN r�537c -
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. ❑ Misr:
Type of Construction: I II III IV V A B `�/ e
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ on
Division: 1 2 3 4 5 (excluding land)
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 that the building
official can revoke this permit for just, - use. Furthermore • I ereby agree that the city official or a designee may enter upon the property to perform needed
X 1 1. Ill F t11 A 30- 0
Signature Contractor's License No. ate
Permit Valuation 3 00 06 Park Support Fee # $
Permit Fee $ / 7 / 75 SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ ! • S73 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ -50 CO Water Tower Fee # $
Y
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ /Z co. 15
This Appli . ' I • ' • • mes Your Building Permit When Approved Paid /2. (, , 2.5 Rec . t No. 6
lit 3.2..14 Date ,3, Z,/ v By
B) ding 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 S.E., Prior Lake, Minnesota 55372
Residential Building Permit Checklist
Basement Finish or Interior _Iteration to Single Family Homes .
BY: 1111-- Date: 3, 2 ,/ 0
Building Permit T :/0 . /0' -- PO: Zoning:
Site Address / 7 v i-; S O AJ6a 'rte
Legal: L B Subdivision:
Existing Structure: I NO
CON TO ZONEN.G C
ORDL`t.N CE L
YES NO
Is this an expansion of the existing footprint or Refer to Plarr;rg
building height? -
Is the property located within the flood plain? Refer to Planning ,...
Does the alteration include any additional kitchens? Refer. to Playing
Does the proposed alteration include any outside' Refer to Planning
. entrances other than patio doors?
Is the pro use of the finished .space or Refer to Planning ✓
alterazon for anything other than a normal single
• family home (oEce, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED .iYD INCLUDED IN THE BUILDING ?ERLQT FILE TO
MAINTAIN A RECORD OF THE REVTEW.
PKIUK LAKE BUILDING i 1 11/1C11 1 Vr
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 044 S7aN R - Cill�
NATURE OF WORK R lT
USE OF BUILDING S
PERMIT NO. 1 # D- E ISSUED 3, 2. 10
CONTRACTOR M477SOM PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELO
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING ep (o I , $��a
INSULATION
ELECTRICAL
PLUMBING
1
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1 1
FINALS
BUILDING ye4
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