HomeMy WebLinkAboutBuilding Permit 13. 0227 n_
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of CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
( / PR; N\ \ TEM PORARY CERTIFICATE OF ZONING COMPLIANCE 3_2_513
3 AND UTILITY CONNECTION PERMIT
464,NESOth I. White File
2 Pink City PERMIT NO. /,_?, Z Z 7
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS (o
_
/ 7 O 5 Z DA/ /5/2-//9/e_. / /C _� (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 2-S , 415 003 _ O
OWNER '
(Name) 73&)q-...0 ‘ '' , /9 O A i-,OA , (Phone)
(Address)
BUILDER
(Company Name) CU /c� — 70 /` COO (Phone) 6/Z- 75 2.3
(Contact Name) l01166; 7 / 't / C-- _ – ( n) 8 2J' - / ( 0
(Address) 5/* 3Lc/G- "eir. UAZ, .1---0/ S /)#9 C.- 55 6
TYPE OF WORK ❑ New Construction DDeck ❑Porch DRe- Roofing ❑Re- Siding Lower Level Finish _❑ Fireplace
DAddition ❑Alteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that t have banished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above - mentioned property and that at - tion 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 pe it fo st eau urthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
' X /.% / 396 3/s//3
Signature Contractor's License No. D td e
Permit Valuation 3 0 U U 0 0 Park Support Fee # $
Permit Fee $ , i 75 SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I"; $
State Surcharge $ /— 7 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 5 ¢ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit `' $
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $ Sly - SZT TOTAL DUE $ /
This Application Becomes Your Building Permit When Approved Paid / • Z - I R deipt Nob Pv
Date j Z 5 , t;
15' .
Building 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
PRIOR LAKE Zi
INSPECTION RECORD
SITE ADDRESS /7O52. srew ,,,5o/, ie I /!C7
NATURE OF WORK h. WE1. LE1/6
USE OF BUILDIN 4.111
PERMIT NO. • DATE ISSUED
CONTRACTOR CO/VS en di., dO &t . PHONE /_ 8'77_ 21.4 .116/
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
WINIMIRMNSianarag
I�-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING 6 OA
INSULATION
ELECTRICAL
PLUMBING
HEATING
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
LATH
FINALS
BUILDING J /�
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
4r DateRec'd
a. CITY OF PRIOR LAKE PLUMBING PERMIT 3 15 I3
v 4
44s...0.
Blue File
2. Gold City PERMIT NO. 13 z Z7
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
f D Z _q + +r i ce - C1 rc l
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) ??rpld 4 ' Ov► ', (Phone)
(Address)
APPLICANT
(Name) o i 5 \LA y , . Cam (Phone) tQ 1 2— 7 s lQ 9-?
(Address) 'I 7 3 7 L e Ce vtk-cf it-A 1-I 5100'31
(Address) (City) (Zip Code)
(Contact Person) CCv1 N\--e Ub CCut.Pf-- (Phone)
APPLICANT SIGNA • : ;' A / v DATE _31_2413
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 $49.50
Estimated Cost $ Building Permit # o
PLUMBING PERMIT FEE $
STATE SURCHARGE $ .50 •�
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
pRj CITY OF PRIOR LAKE Date Re 'd
HEATING /AIR CONDITIONING /FIREPLACE PERMIT 3 //
,!"_.;.:::''' ;
sitNNEso 1. Pink File ' 3
2 Green City PERMIT NO . / J�
. ZZ /
3. Yellow Applicant ,
(Please type or print and sign at bottom)
ADDRESS • ZONING (office use)
•
rI /0 Y
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) M I . 0 it- (Phoned /� / '
(Address) 1 )705-0., S*obricv 1k fKiJ7 / OW 55371
APPLICANT C)5, _�" c —9c).7
(Name) _ In MI/Mi.- �� 9 'y /f `!r ime) T�
(Address) 1 ' 4 ( Li 1d I Irk _ cL
(Addres () �j� (Zip Code)
(Contact Person) • � City ir . �� (Phone) ► (xa lay' '
APPLICANT SIGNATURE M.1 : DATE ,c)-1 a
AP's' CANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
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
jecihtYanical ❑ Hot Water into Required Side Yard Setbacks.
❑ Radiation
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
['Vent. System 0 Other Devic s Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL / - riz - Ji( - I L; 1.971e /p1-r
EESCHEI. )
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
"SURCHARGE" has been extended Cost $ Buildin_ Permit #
until June 30, 2013, ` 0 PM WITH
� �J
The minimum surcharge for a HEATING PERMIT FEE $ r i BUILDING PFRIVIIT
"fixed fee" permit is $5.00 STATE SURCHARGE $51
TOTAL PERMIT FEE $
(Office Use Only) : ...---110,4, "
This Application Becomes Your Building Permit When Approved Paidn Mill Receipt Nol 1
1 ' ` BY
Building Official Date r ' C
24 hour notice for all inspections (952) 447 -9850, ax (952) 447 -4245 d '
4646 Dakota Street S.E., Prior Lake, Minnesota 55372