HomeMy WebLinkAboutBuilding Permit 12. 1313 J�
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cct PR /O�,
� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT l v • ' 0—' r
1. White File /Z / 3 / 'S
2. Pink City pERMIT NO . .�7
3. Yellow Applicant �l
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5325 5tf i E . 7X--4 1 t- t 12-)69
LEGAL DESCRIPTION (office use only) G �
LOT BLOCK ADDITION PID 2 5. 040. ( Z _ _ 0
OWNER �- / per,
(Name) 6 / !) f�Yt/✓i . (LL- (Phone) /11 7 — 3S -1
(Address) c j p5- 5- /(a 1W t (,_ Pr_
BUILDER
(Company Name) .e (Phone) 0 57-47 5 -' e3 3/ f
(Contact Name) /it/ YV 9l i e-- (Phone)
(Address) 6 T S F P--0 (2 a
TYPE OF WORK New Construction ❑Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ID Fireplace
Addition ['Alteration ['Utility Connection
CODE: I.R.C. ❑I.B.C. ❑ Misc:
Type of onstruction: I II III I V A B /"� rte'
Occupancy Group: A B E F HI M R S O PROJECT COST /VALUE $./ // � ' ?� s
Division: 1 2 3 4 5 (excluding land)
L_
I hereby certify that I have hed 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 - mention d property , . at all construction ' conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
offic' . . e .ke this p - . or ju cause. Furth re, I hereby agree that the city official or a designee may ent upon the property to perform needed ' spections.
% ,� Nell /9 lo.�. / /z
Signature Contractor's License No. Date
Permit Valuation M 6ec —
Park Support Fee # $
.
Permit Fee $ 3z4. Z5 SAC # $
Plan Check Fee $ Z (0, --no Water Meter Size 5/8 "; 1 "; $
State Surcharge $ al • 5Q Pressure Reducer $
Penalty $ I Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 5 51
T h i s / lie. do com.. our Building Permit When A proved Paid • 7 i Receipt o 7 3
Date 1 (-� I 1 �— By
■• �'' � ' ► I/ /q /Z
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 const to temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
�� —' —/° \
Planning ' ector ate \` Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -424
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
•
) _j P RIO
f-:
White - Building
Canary - Engineering
�'INNESOc Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted Accepted With Corrections ______X_____
Denied
Reviewed By: / ffr Date: / /� / -? �«
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
O� PRIp�
,.11!
e or
White - Building
�, �P Canary - Engineering
"NESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted Accepted With Corrections
Denied
/-4 / /-
Reviewed By: Date: 1
Comments: } - 7t o vN.90 �,.�
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
prit, r
'
\
PERMIT TRACKING FORM ry
Address: J` ._-> =-5 // (72- Description: �� � N
Application Received: r6 • 0 - ( 2—
Building Department
Dat Days Elapsed
Initial Review Conducted ( ( i-/ - -
Applicant Called with Corrections -er-
Corrections Received
Corrections Reviewed
Final Review
Applicant Called
Planning '� a" _ ` , � : � r'
Date Days Elapsed
Date Reviewed
Initial Review Completed 1 l !tA (-Z,,
Corrections Received
Corrections Reviewed
Final Review
Applicant Called
Engineering Department
V'
Date Days Elapsed
Date Received
Initial Review Completed 11 ( trz-
Corrections Received
Corrections Reviewed
Final Review
Applicant Called
Initial Review Time Correction Review Time
Initial Application Date Final Corrections Received:
Applicant Called W /Corrections: Final Applicant Call Date:
Total Days Elapsed: Total Days Elapsed:
pat
Q-
,
� 9 a
4.07-1
Date Received Date Reviewed Permit #
PERMIT REQUIREMENT REPLY DATE
Date: Date:
Request: Reply:
Accept n
Decline n
Date: Date:
Request: Reply:
Accept
Declinen
Date: Date:
Request: Reply:
Accept n
Decline
Date: Date:
Request: Reply:
Accept
n , .
Duildiug1TL n.iing /Engineering Permit Complete Permit Issued U
J:\BUILDING\FORMS\PERMIT INFO REQUEST.doc
PRIOR LA DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 532.5 �r-�a-F - I I=.4<` ---
NATURE OF WORK A4..,AI cam A-UI 1TZ
USE OF BUILDING J�
PERMIT NO. ( - 2 1 3 DATE ISSUED (1 /1111Z-
CONTRACTOR PHONE ► -6) 4fs ® S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1
FOUNDATION (Prior to Backfill) 1 4ie 1?-1S/1,4„
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER /WATE=Ef10..._
FRAMING £ f/g //3/7
3
INSULATION
ELECTRICAL
P?LUMB1NG
, AT4NG (if required)
FIREPLACE
GAS -LIN A1R TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS E
GRADING -r-ior to Sodding)
BUILDING s-- lT
ELECTRICAL
AaLUMBING
7: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