HomeMy WebLinkAboutBuilding Permit 11.0052 J
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/ " CCITY OF PRIOR LAKE BUILDING PERMIT', Date Rec'd
� " TEMPORARY CERTIFICATE OF ZONING COMPLIANCE + q l
0 �" AND UTILITY CONNECTION PERMIT t
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A'NES °
`. white File PERMIT NO. g ( 0051
2. Pink City
3. Yellow Applicant •
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5 1 r Cow y / A; 1 R (5 D
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25 . 0 55, 0 Z5 .
OWNER
(Name) ger5 Y gos e /S (Phone) ° V 3 09 v
(Address) 5; 614W ` Cvi/e -/
BUILDER /� /r
(Company Name) &) V f Per1Y�Tede4 U- L (Phone)
(Contact Name) 3 "A oft (Phone)( 866 9
(Address) g(( Cu,, h, Le.( r EJe,a P/.fri 'of r t , I'04 , (/' -
TYPE OF WORK ❑ New Construction ['Deck DPorch ❑Re- Roofing ❑Re- Siding DLower Level Finish ❑ Fireplace
DAddition VAlteration ❑Utility Connection
CODE: 6.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B � d`
Occupancy Group: A B E F HI MR S U PROJECT CST /VALUE $ b�
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 pro. • .. that , 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 p 14't for ju - ause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
, (9 s 01 1lle(1
,,,-, a re Contractor's License No. Date
Permit Valuation — Park Support Fee # $
Permit Fee $ --7 7- � 5-C) SAC # $
�
Plan Check Fee $ q , 35 Water Meter Size 5/8 "; 1 "; $
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State Surcharge $ O Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ ' 5 4 5 O Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ t ; .
(Aka) 1 12 loi l I
This A' i atie,i Becomes Your Building Permit When Ap . roved Paid 1 33 4—, Rece t No. 6 0.6 2,3
Date 1 By
By ,
Building 1 i .. 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.
r 1'..-02 / f
I .nning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
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p RI Date Rec'd
Af X9 :'' CITY OF PRIOR LAKE PLUMBING PERMIT
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4,411000
1. Blue File PERMIT NO. I I 0052
2. told City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5Z C.44 7 c T Y L_ - i j / 553
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Na Y,��c`7 (Phone) ,-) 2_- —2062,
(Address), 2:7 4 c,4, c co. "r KR 4_ E '/2, 2A frg 0 53
APPLICANT I %
(Name) U 4 -- 7 G- cir me-- (Phone) — 7‘3 -7-5 " b *I DC
(Address) 2 ) 5) L--' 4LP1 - .7 - 2-.N. 44J / 55 ( 1 2---7
(Address) (City) ,� (Z / i i p Code)
(Contact Person) ��el`'' A 7.. P...._ - 73 -2 .$� c - 1C.b
APPLICANT SIGNATURE � 4 ! DATE 2_
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
) 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 rations $49.50
The Minnesota Statutes §326B w ist $ Z Building Permit #
"SURCHARGE" has been changed For one
year effective PLUMBING PERMIT FEE $ 7 i 50
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .g.. oo :St I �/
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ 5'4 ` e 5 6 ' 4.1 1�
Ap 1 '171 e
is 2i, beginning July 1, 2010 0 /�
This Application Becomes Your Building Permit When Approved Paid 5 R eceipt o. / 1
Date Z -� By
Building Official Date •
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
FEB-16-2g11 17 : 27 FROM: AIR MECIty,ii,Ct 3 %1
4 / 5 MRLirvzs6 J 9545 F : ErE
woo a)ieliolidjorilto
CITY OF PRIOR LAKE Date Reed
.11EATING/Allt R
CONDITIONING/FIREPLACE PFMIT
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RIVITT NO. 006
:t. Yeltve App',4411 _
(flew type _print and sign at bottom)
ADDRZSS
I ZONING ;cr; bie)
d 1
I LEGAL DESCRIPTION (office u only)
I LOT BLOCK ADDITION PID
_
(mono 95.9,
(Addrcs) 5, ..___C itu -
_
AprucAls„.. , ,. im ...L_
Nao j_
m . 4.L.,(_U , a
(Phone) _
(Address ii. ()A s 1 - ft .. ° 1.. 2
--- . _
(A&-es) — (Airy) I (Zip Ctsde)
1 (COxItagt Person) __sle.- ir, (Phoze) t- Xit -,?-) - CI -- _F.._._______
AEPLICANT SIGNA r E _ cyt Ce/f l
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APPLICANT PLEASE COMPLETE BELOW
ONKW CONSTRUCTjON 0 REPLACEMENT ''' ALTERATIONS
FURNACE MAKE AND MODEL .. FUEL .
FLUE SIZE RETURN OPENINGS , _ INPUT OUTPUT Air P 1
—
TYPE OF SYSTEM
Vtratin lants
alrivity
ID Mechaniml
DAir Couditioning
ent. System
F T REP LA CE MAKE AND MODEL BEATING OR POWER PLANT
0 Stealt
0 Hot Wax:
0 Radia$on
in Special emices
0 Other Devices, PLEASE NOTE: Air Conditioner
0
)nits and Fireplaces Cannot Encroach
into Requfred Side Yard Setbacks.
Fireplaces with Box Additions or
Dv
Cantilevers to the Outside of Buildings
bac.4.- ‘,...0 ofic... Ilelpaire a Bu ilding Permit
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FEE SCHEDULE
Trictustrial. Commercial & Multi 1 t h ofjob cost Residential, Ons Fireplace . Sti93o
S49.50 minimum
Iter-ideothl, T-Tcatirg & A'C (New Construction) $149,50 Residential, i & Alterations
RAsidential. Heating Only (New Construction) say) 1Rtesidentiat, AC Only S
Estimated Cost $ PAiif NM # Th e m innesota Stalin es § :l263. 148
5' LIRCHARGE" has been einingcd ror one
HBATING PERMIREIILDINaPEEIBILT___ year enzetive
STATE SURCHARGE $_. _ lady J. 20!t.,, eniti Am :AO, 1011,
TOTAL PERMIT PEE S Tlie miniffirtin stirettarre rot a "toyed fee pe
(One Tin *My) is S.c, bezionin.g.kty
Mt; Application Becomes Your Building Permit When Approved Fold Receipt N.
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sadine offid.Ri ryo? ,
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24 henr mike for an inspections (952) 447-985D. fa. 447-4245 + ' o
°Ind -
44 DAI.ota Street &E., Prier Lake., Minnesota 55372
Jt
PRIOR LAKE BU DUNG AND`INSPECTION
I N RECORD
N PE O
I T C
S
SITE ADDRESS 52:7 4-- R-
l
NATURE OF WORK A- z--. ∎ ��+
USE OF BUILDING A �` s
PERMIT NO. l 1. U V DATE ISSUED i z
CONTRACTOR PHONE (2(Z - - C to`i �
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING 1 1
l FOUNDATION (Prior to Backfill) 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH — INS
/ER / WATER / SEPTIC
FRAMING
E
INSULATION 31et
ELECTRICAL r
PLUMBING �r.
HEATING (if required)
441EPLACE
--GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1
FINALS
BUILDING k
ELECTRICAL
PLUMBING
HEATING E.
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