HomeMy WebLinkAboutBuilding Permit 12. 0910 & 12. 0784 - ,
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o f PR / CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
F ;
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 8. 13.1 7--
..
AND UTILITY CONNECTION PERMIT
� j
arlit'1VESO .C� I. white File PERMIT NO .
3 Pink Cp / L q1
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 1 ZONING (office use)
A iL k i
1 53-7 WI" Ws r qr ..
y
V
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNS
(Name) i € it 56/0 (Phone) C r 5)-- ,.,5 L / (�j •
� 9
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck EPorch ❑Re- Roofing ❑Re- Siding Lower Level Finish ❑ Fireplace
['Addition ❑Alteration ['Utility Connection / v
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. •
Type of Construction: I II 11I IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR 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 1 am the owner or authorized agent for the
above - mentioned property and that .•1 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aw re that the building
official • revoke this ermit f• s cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neede - nspectio .
/ r � _ - S /3
Vomit - rA. _ `
II Signature Contractor's License No. Date
Permit Valuation / d 00 , 00 Park Support Fee # $
Permit Fee $ 7,1"- SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $
i 5D Pressure Reducer $
Penalty $ 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 $ / 2 7E54 TOTAL DUE $ 35 Z�
' 5 . . . . -
This Application Becomes Your Building Permit When Approved Paid L R ipt No. (, /.
Date a" ., /), r+ 2,---- B .
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
� c3. PR /pp
CITY OF PRIOR LAKE Date Rec'd
B HEATING /AIR CONDITIONING/FIREPLACE PERMIT
1 VNES C:
1 . Pink File PERMIT NO .
2. Green Cipl 0....._ 7 t.
3. Yellow Applicant ddJ
(Please type or print and sign at bottom)
ADDRESS / � v � � ZONING (office
/C Z - �/ L..l1G) 5 (- /J ' �j use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER , 1 �, ,
(Name) I ti.?)"" Jet' (Phone) c,- eSc, C./ 100 .
(Address) 1 ii 1 lit `J S Pie 1 A4 ()
APPLICANT nn 1
(Name) 1 t Wt 5 l tDL 0 11 (Phone) (O51 -L/73 _ 33
(Address) 2 7 t A t O- 11 i L 1..) A,J is a P 3sL v t w_7: IA, Nl 531 (3
(Address) (City) /r (Zip Code)
(Contact Person) ) G i /J ` (Phone) l0 - (p 30-- 33 J5
APPLICANT SIGNATURE 1 Lab. DATE ________b__3_/_.tj...
APPLIC ' ` PLEA' OMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Wane Air Plants ❑ Steam PLEASE NOTE:
❑ Gravity ❑ Hot Water Air Conditioner Units
❑ Mechanical ❑ Radiation Cannot Encroach into
❑Air Conditioning ❑ Special Devices Required Side Yard
[Went. System Other Devices Setbacks
FIREPLACE MAKE AND MODEL / / 1 `/ J ` 6G0 C9,2 el - (v/ - 5 3 - t )
FEE SCHEDULE
Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
Residential, Heating & A/C (New Construction) $99.50 Residential, Additions & Alterations $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $39.50
Estimated Cost $ Building Per it #
HEATING PERMIT FEE $ r " '' 6 -- LI - ro
STATE SURCHARGE $ .5y'
TOTAL PERMIT FEE $ 511 5 -
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid / � � Receipt No. i 1 �/1 j/
` ( p 1.� u0
Date p / o , By
Building Official Date d ��f
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
PRIOR LAKE BUIL DEPARTMENT OF AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /527/ / S
NATURE OF WORK 40 4
USE OF BUILDING f- .
PERMIT NO. �II� D. E I SUED
CONTRACTOR r -��I�I > _ 741P PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPE TIONS BELO
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
ONORMNP I I 1
I 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING WG -11Z
INSULATION /
ELECTRICAL
HEATING (if required) fki -z
FIREPLACE
GAS LINE AIR TEST e v5-1/7,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
BUILDING
ELECTRICAL
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