HomeMy WebLinkAboutBuilding Permit 12.1231 Cd i CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE `0. l9 /2—
IP IP AND UTILITY CONNECTION PERMIT
Hesot'' 1. white File PERMIT NO. /Z , /23 1
�. 2. Pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
K.0
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID Z Z:52 , OO' b
OWNER pQ I
(Name) , `i G ►'�¢./` -�- �,` L .. 4 A .......1 (Phone) D7' ??R - '4 5. 3
(Address) (5 - 1 o r. s (.. - e 1 6v t.:),...) 4dC
BUILDER
(Company Name) 4 :" • O" 4■ ■ C�'� (Phone) Cp(a S 4/0 7 I o%
(Contact Name) 3 — R— L` -°tiso.•• (Phone)
(Address) 343 ?9 C� notz, '41 Tr i. S
TYPE OF WORK 0 New Construction ❑Deck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish ❑Fireplace
❑Addition pAlteration ['Utility Connection
CODE: [ R.C. DLB.C. 0 Misc. ��
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ R5 —
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
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- mennone 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
offici can this p it for dust cause- Furthermore, I hereby agree that the city official or a designee may enter upon the property to pei tom needed inspections
X
( CC-c,4 if IC ^ is - r Z-
Signature Contractor's License No. Date
Permit Valuation 2-5; .- Park Support Fee # $
Permit Fee $ 41 Z ../ 5- SAC # $
Plan Check Fee $ 2.408 21 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ (. •C".`") Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ - 4 .5° Water Tower Fee # $
Mechanical Permit Fee $ S4, s° Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 5-41.5-1 TOTAL DUE S s , . O 4- $ S O3 .6 4
Cit< e �--
This Appl' , . do : ecomes Your Building Permit Wh - Ap , oved Paid $ 51, 04 Receipt No. ('p1 i..3'
Date I o/-� / By P
Ihv
_
..� .1,,..... 0 - l Z
if ilding 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
•
4 PRI0 CITY OF PRIOR LAKE Date Rec'd
' � HEATING /AIR CONDITIONING/FIREPLACE PERMIT q 41 1NNESDl- t' 1. Pink File PERMIT NO
een
2. Ye city �� j���
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
(7s7 TS(akc V to (43
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
(Name) AN V G A 9ci� ■' � t (Phone) -1 � 4 r7 / (P d,
,
(Address) 4 ' eA 111\ A ,......■ .s•Ns? - 2.•
/ �/� (Ad. ess) (City) (Zip Code)
(Contact Person) 1 r t ! . . / , (Phone) (ore- 3� 6) IS ,
APPLICANT SIGNATURE ii 'Z,...._ DATE
A ' PLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT SLALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
[Went. System 0 Other Devices Cantilevers to the Outside of Buildings
R • quire a !, ilding ' ermit. ,
FIREPLACE MAKE AND MODEL h..,, ; t Ot L. A ; � u +" i/"llli_leiri
FEE SCHEDULE a /L1'
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
The Minnesota Statutes § 326B.148 Thst o st $ Building Permit # 1,
"SURCHARGE" has been extended ,n,� d'
until June 30, 2013, HEATING PERMIT FEE $ w`�'
The minimum surcharge for a STATE SURCHARGE $ .50 (t CI l ty
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ ref cJ L(r*4 1` .. /0
i u■ ley
This Al • ation Becomes Your Building Permit When Approved Paid tv l Receipt No.
/ Building Official ` Date (ts D ater ' -c/-0---- By fi / .... e . _
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
P R I R LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 5 76 7 / Vi W.
NATURE OF WORK / 1.
USE OF BUILDING
PERMIT NO. AFF D ATE ISSUED /! , l
CONTRACTOR ✓� � PHONE (,/2.94/08
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
11111111=111111aS
I ldt FRAMING -r p Gw40 ' 'Ted e+` wir " j-( R- is I(
INSULATION (4- Ii11t��IL
ELECTRICAL
PLUMBING VISub �(� (I(6 4
HEATING (if required) } (q7
UMW 11 Pe /4 (
C,AS Li N) � -� %
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
BUILDING C i
ELECTRICAL
PLUMBING
'HEATING
DO NOT OCCUPY UNTIL ABOV/ 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