HomeMy WebLinkAboutBuilding Permit 11.1236 )§
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04 PR OF PRIOR LAKE BUILDING PERMIT, Date Reed
_ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ( 4 1
Z. AND UTILITY CONNECTION PERMIT
4> A,r'
krvEs°
`. White pie PERMIT NO. / J / . 3
2. not City
3. Yellow Appiicast
(Plase type or print and sign at bottom)
ADDRESS ZONING office tae)
b3 SZ ( S4 N E ) o, Lo !2 /SD
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25 It- ' • OG 7. 6
(.,9utos&fyiGkd l • C: Om
OWNER � k
C 1.3 -, f�1 c tie ii. L v t ') Ke. C B (Phone)
((Na 2 3 7 9
(Address) (a 3 S Z Coy, roy Si- 106 , 1 (. c{ 1 rt ke , Al rJ S 5 3 - 7 Z
BUILDER
(Company Name) ALT 0. Oti oti y i G 1 c/ V; i.e \ L L C (Phone) &) /- 3 r) 6- c 7 .S 1/
(Contact Name) /14' ke y Q v e / � + (Phone) �3 4 (,1 L 3 )' I.- S 7 S y
(Address) 1 (S �ti 1 2 ) ) 4 ti i' AV L" , ' t Yl e , ti (,L L/ Z /C/
TYPE OF WORK ❑ New Construction []leek ['Porch DRe- Roofing DRe-Siding .own Level Finish ❑ Fireplace
['Addition DAheration []Utility Connection 1 /Z -OO/ - 7
CODE: EJLR.C. QLB.C. 0 Misc: NG F• P.
Type of Construction I II MP/ V AB
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ L 1, (Y 0 0
Division 1 2 3 4 5 (excluding land)
I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. I ahu certify that I am the owner or authorized agent for the
above property and that all construction will conform to all existing state and local laws and will proceed in submi plans that the building
official can revoke ,s penyit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X - 4 - - -_ BC (,)- .cNq I I — RI J
Signature Contractor's License No. Date
Permit Valuation 0 66 ` U 0 Park Support Fee # $
Permit Fee $ / 3 75 SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I "; $
State Surcharge $ S6 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
P l u m b i n g P e r m i t F e e $ 5 7. 5z Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE ctr c 1/, /5-, / / $ e 9 7.5
This Application Becomes Your Building Permit When Approved Paid e C/ . ?" . • A, No. ( Lf 6. cS
Date p., (5 `(
Budding Official Date
This is to certify that the request in the above application and accoaapanying docwncnts 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 ei Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Caeduoas, if any
24 boar 'Mice for all iaspectioas (952) 4479850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Residential Building Permit Checklist
B sement Finish or Interior Alteration to Single Family Homes
BY: Date: // /S (/
Building Permit T / 1 Zj ‘ PID: Zoning:
Site Address
13 ,8Z a1fIJv/
Legal: L B Subdivision:
Existing Structure: Or NO
C O 'TORRMMS TO ZONING YES `i O
ORDNANCE
YES No
Is this an expansion of the existing footprint or Refer to Planning
building height?
Is the property located within the flood plain? Refer to Planning
Does the alteration include any additional kitchens? Refer to Planning
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? f
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single •
family home (office, roue home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MINT AIN A RECORD OF THE REVIEW.
T •177A,fPT .� T=IALTCHC K.DOC
. PRrp Date Rec'd
CITY OF PRIOR LAKE PLUMIBING PERMIT
A
j�'NESo�
Blue I. B Pile PERMIT NO. I
. Blue city
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
(1, S8 a Conroy a. , NE , Prior Lemke,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
((Na ('t.Y1() iC r 1 {' 1Le, Clutoske, (Phone)
(Address) 10 Cove co t' Sk NE E , Poor Lad e
APPLICANT — � / '
(Name) 6 a, 14 _ _L, (P ( hone) 17 / 5 " / `� 9 1 _3 _
(Address) 101 Par. F obe(s 5o. 3
(Address) q (City) (Zip Code)
(Contact Person) 1 h (`�YY�Qt S �UC ,t (Phone) '/ �5- 71 1 n '3
r ` - _ y 0 i
APPLICANT SIGNATURE w 1 - - DATE _
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 & T .:- amily $149. i
Residential, Additions = Alterations $49.50
The Minnesota Statutes $ 326B.148 Est $ Building Permit # /�/i p :
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
July I, 2010. until June 30, 2011 STATE SURCHARGE $ .50
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ � �
is i5, beginning July. l, 2010 +�
This Application Becomes Your Building Permit When Approved Paid _ Receipt No.
Date
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
'DEPARTMENT OF
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS (038 2 CO &/e S T .
NATURE OF WORK LOWF Lev
USE OF BUILDING `� /i//2-
PERMIT NO. 1/ /23 DATE ISSUED /1. /S. 1/
CONTRACTOR nail f f A/D nnA/ PHONE 6/2. 394. 5754- -
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1 1.1111.1 I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING M�1ME-
INSULATION
ELECTRICAL MIIIIIIIMIll
PLUMBING MENEM
HEATING (if required) 111111MEEM
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
t I I
FINALS
BUILDING D6 /212a) h/
ELECTRICAL
PLUMBING
4 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