HomeMy WebLinkAboutBuilding Permit 12.356 J F.
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� rR�o CITY OF PRIOR CATS Date Recd BUILDING PERMIT,
OF ZONING COMPLIANCE
E.. ' x
o �' TEMPORARY CERTIFICATE • 3 Z-
a 7 AND UTILITY CONNECTION PERMIT
U I. white Pile PERMIT NO. ' Z _ 2.5"-le .
2 Pink City
��ANES��� 3 Yellow Applicant
(Please ■ e or . rint and si: at bottom) ZONING (office use)
ADDRESS
1 i-,1L✓ -17,a,
LEGAL DESCRIPTION (office use only)
LOT BLOCKS ADDITION
' ZI) PID
OWNER (Phone)
(Name)
(Address)
BUILDER � 2"' ' � - 9 �
I (Company Name) LA D • ot,'1� (Phone) ` -
L "1 IA- - PEQ►� T. - SJP (Phone)
(Contact Name) 1 I l M .
6 Z,
(Address) n0'2.! F 64 Pd 1 t-r T RD . SE / PR - Lt41� I " `'a
( New Construction ❑Deck ['Porch ['Re-Roofing ❑Re- Siding Lower Level Finish Fireplace
TYPE OF WORK ❑
['Addition ['Alteration ❑Utility Connection
❑ Misc.
CODE: Y4kR.C. ❑I.B.C. B L cxx
Type of Construction: I II III IV V A PROJECT COST /VALUE $
A B E F H I M S U (excluding land)
Occupancy Group: u 2 3 4 5
Division:
ruction will conform to all existing state and local laws and will ee in n c co property ith submitted itt needed plans. I am aware that the building
I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
official anr � epth property ai<�i hat
Just all
ca -
er more, I hereby agree that the city official or a designee _ 2 `
�/ 'L • -7 c ' Date
X - C ontrac tor's License No.
Signature
Park Support Fee # UIIIIIIII
Permit Valuation 3 O o e' o
Permit Fee 1111116Fana 121111111111111111111111111111112111111111111.
Plan Check Fee '
Water Meter Size 5/8", 1 ",
$ Pressure Reducer IIIIIIIIIII
Penalty UIIIIIIIIIIIIII Sewer /Water Connection Fee # IIIIIIIIIIIIIIII
Water Tower Fee #
Plumbing Permit Fee ' 67) Builder's Deposit
Mechanical Permit Fee Other
Sewer & Water Permit Fee $ v
Gas Fireplace Permit Fee IIIIIMMIll TOTAL DUE
= - Q .t No.
This Application Becomes Your Building Permit When Approved al-
Date - Li. (L---- 17'
Buildin_ 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
Date Special Conditions, if any
Planning Director
24 hour notice for all inspections (952) 447 -9850, fax (952) 447424•
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
6L ------_ Date: > . .s' Z BY:/
q
/ PID: Zoning:
Building Permit # / ?sue
Site Address / 6 , `e , en - - Z (4s1
Legal: L B `7 T Subdivision:
Existing Structure: YES or NO ,
r NO
CONFORMS TO ZONING YES/
ORD I NA NCE =�
YES NO
Is this an expansion of the existing footprint or
Refer to Planning
building height? om'
Is the property located within the flood plain? Refer to Planning
Does the alteration include any additional kitchens? Refer to Planning
/
Planning
Does the proposed alteration include any outside Refer to Plann �,
entrances other than patio doors?
Is the proposed use of the finished space or
Refer to Planning
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L: \TEMPLATE\ALTCHCK.D O C
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Date .Reed
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A, CITY OF PRIOR LAKE PLUMBING PERMIT
Iftv .1'0.7 V4
rt'ir i
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y
1 'Nit* A ppilcinl
(Pleastypo OtrInt and sign At hOttotn) - .„
I ADDRESS ZONING (office ure)
Ae__ 4- 4
.. ,..
.. ...
LEGAL DESCRIPTION (oo;cc me only)
LOT nLOCK 5 ADDITIDN- p11)
._. ,
. . .
..... . _
owis ,,_ ,
1
(Narrio_.__&41 kiwi) Ji Of
— (Phone) / - t i t / 0
jAed.res9__ lie J-I. 8 4 4A- p.f_d_ALP I
- ,
..._
r 7 i c
.1.) M CC )-) 00 i C ed (-ID , (Phone) ( 3 5 Z - 75 40
7/ .., 0
(Addr ti eGs) 6 7.Q b s N W , OA A
—_-----
(Address) (Ci i (Zip Code)
(Contact .I?erson) ..,.):"/ i ,C) SI f (-- (Phone)
APPLICANT SIGNATURE .. (-- a __...-_ DA.TE 2*.•_ •
.'447-ter-1;-"i ::/_. 12 _ ., .
APPLICANT PLEASf.: COMPLETE BELOW
. . ...._ ......_
quantity Type of Fixture I unnlit Type of Fixture
Bath 'rub wilb or without shower Ron !h-ips
.... _ _
Dishwasher Writer Heater
_ -
,
Floor Drain Water Softener
— - • - .-. _ _____ _
-. Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
.
Lalindry Tray ( I or 2 compartinent siiik Sewa:,e Eector
..._
i _ Shower Stall Backllow Assorrilq___
.___. Sinks Backflow Asscrnbl Test _ _
Bar Siial; . _.. ,_ , _ 1.awnSprinkJer i
1 _ Water ClOset (Toilet) _ Other
..._
FEE SCHEDULE
InchlEtrial, Commorainl & M010-Thntily 1% ofjob cost with A SOO() minimum Resiclentin!, New One & Two-Fniuily $149.50
Rceicichliol, Additions & Alleracions $49 50
rile Mianonal Stott (es 11326a,14 8 . – l ilt S —..,_________ auficiina Permit t1 ,...,. N._ i
"SURC1 has Int.to ehunsed for o
yam. aril:ONG PLUMBING PERMIT FEE $ MA
kil) :•
,Inly 1, 20i0. ontll ;Imo) 30, 2011. STATE SURCHARGE $ no
, iiiii WITH 1 6
. ID
.
The minimum tArclin rgt rar A "NO No" ovvroll TOTAL PERWIIT FEE $
fog. heoloaaig July 1, :Iii a
. . BUILDING PERli.41 l
Thlo Application Becomes Your Building Permit When Approved
iluilrlIto ()Metal -- --_,- .
Don — . Paid
__. .. R No, ' ---
By —
24 dour nude(' for all Inapoutlunk (n) 447.9850, lex (952) 447.4245
454 boUota Strout S.K. , Prior bolo, MInnoioto 55372
, ,. _
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1
PRIOR LA K E DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /"4' 84 doe p4sr
NATURE OF WORK daiivei4 L6VE V
USE OF BUILDING ger *lit
PERMIT NO. DATE ISSUED •
CONTRACTOR PHONE 0
NOTE: THIS IS NOT A PE MIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
4 0111/141 1 111.
1 �
1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING PP))
j (.
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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