HomeMy WebLinkAboutBuilding Permit 03-0403
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
PERMIT NO. 03 - ,-/()3
B rboCl11e-rc- /3/vJ
LEGAL DESCRIPTION (office use only)
LOT 'f BLOCK :J.. ADDITION ~JM U~
ZONING (office use)
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PIDd5-SJLj- !)~f-<1
OWNER
(N ame)
vaSON 1-Ie:3/V~
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~
'152- /1-3~ -2. 7cro
f
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
TYPE OF WORK
(Phone)
(Phone)
o New Construction
)QLower Level Finish
OAddition
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-mentioned 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;'er upon the pro~ p~eeded inspections.
I _
l,'
o Misc.
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o Deck
OPorch
ORe-Roofing
o Fireplace
OAlteration
PROJECT COST/VALUE (excluding land) $
Contractor's License No.
$
$
$
$
$
$
$
$
?...aJo (Jt)
7'1. 1~
#
Park Support Fee
#
SAC
Water Meter
Size 5/8"; 1";
I ' ,5'""0
Pressure Reducer
'10 , otJ
Gty SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
e/eL. ft.fJ/J (,
TOTAL DUE
Paid
Date
!H1//7 ~ d>:J--
4-7-fj\l)
Receipt N o.tltJ~ 51
By qs:.;
I ]fUlica~ jomes Your Builmng p;;; ;~ved
BUiIi~:: Date
ORe-Siding
OUtility Connection
<//:/..:. L3 l
,!.,d
$
$
$
$
$
$
$
$ ill 00
$ If '7., as-
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
~sued. ~~
Planning Director
~ Lu~ LrVf:1
Date Special Conditions, if any
24 hour notice for all inspections (952) 447~9850, tax (952) 447~4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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Legal: L
t;
Subdivision:
Existing structure:~r NO
CONFORlVIS TO ZONING
ORDIN.Al~CE
,--~
(YEV
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
v-
Is the property located iiVithin the flood plain?
Refer to Planning
~
Does the alteration include any additional kitchens?
Refer to Planning
v
V-
Does the proposed alteration include any outside'
entrances other than patio doors?
Refer to Planning
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, e!c.)?
Refer to Planning
/
THIS L..t1~CKl.IST MUST BE COMPLETED A.l.'fD INCLUDED IN THE BlJ1LDING PERMIT FILE TO
MAlNT .-\IN .-\. RE CO RD 0 F THE REV1KW.
T .\ I ,...\,roT .j, TI=\ALTrHCK.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I #4l/3 Kr(Jo/tt."ftf:rt!.. e I~
NATURE OF WORK '-.L-
USE OF BUILDING SF--
PERMIT NO. /.13..- - 'I tJ 3 C~ATE ISSUED y- 7- ~
CONTRACTO~6"t'J6.I iII~~a- PHONE.olJ3- ").790
NOTE: THIS IS NOT A PERMIT F1>R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUilDING AND INSPECTION
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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. JU ,
~(-/I'~
v
./if)!1-/!r:J
t17 J-te3
n~.~
r;-I ~ ItJ..3
FRAMING
INSULATION
~ ELECTRICAL
PLUMBING
. HEATING (if required)
fW._
"'"
~
AM:-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
I
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/
t
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
f~
'1- ~
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
DATE TIME
CITY OF PRIOR LAKE (J Sl.
INSPECTION NOTICE SCHEDULED r -<.-J
ADDRESS --Ill "3 <{""3 ~ ~
OWNER CONTR.
PHONE NO.
PERMIT NO.
~-'l.D7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,iJ FINAL
&SITE INSPECTION
o PI-UMBING RI
o MECH RI
o W~TER HOOKUP
o SI:wER HOOKUP
o PI.UMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~
~ORK SATISFACTORY, PROCEE~D
o CORRECT ACTION AND PROCEE:D
o CORRECT~K, CAnR REINSPECTION BEFORE COVERING
Inspector. _/}J I / Owner/Conlr:
CALL ~850 !Ol-mE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ltEQU~S ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI