HomeMy WebLinkAboutBuilding Permit 03-1527
CITY OF PRIOR LA][(E BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CC~NNECTION PERMIT
Date Rec'd
I. White File
2 Pink City
3. Yellow Applicant
PERMIT NO. 03"-15;;)~
(Please type or print and sign at bottom)
ADDRESS
/1/57~
K05~ WOod f2d
ZONING (office use)
R-/
LEGAL DESCRIPTION (office use only)
LOT q BLOCK / ADDITION
~~,b ~
OWNER n L / - . AA _
(Name) ~ fe-f..,-A,J 23f L-e~ LB Y If I 1q&0
(Address) 14S12- 1-o:5a.wotJf) ~ to b
PID;{5 - 31D- ()CJi - b
(Phone)
;J III (){L ~C-b hI,.J
c)S-3 7'~
BUILDER (() , \ r
(Name) GtAI.\fl1?-- Lj ~ l~O)..J \ VC-
(Contact Name) . (Dj LrA-1'2iL
(Address) 114.Q 6LMt5fl>~B ~B
(Phone) ~/cz- 9 b 4- 8lq 4
(Phone) SAm ~
-Sr- Lo v( ~ P J\t4L yY},.J _ss4f to
TYPE OF WORK
o New Construction
~ower Level Finish
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
o Alteration
DUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
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 win conform to all existing state and local laws and will proceed in accordance with
submitted I . I a e that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
:terup e rope orm needed inspections 51 [;1 /I It? ~ 3
\..5ignature Contractor's License No. Date
Permit Valuation ~tOO Park Support Fee # $
Permit Fee $ 74 .7S SAC # $
I Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ I. ~O Pressure Reducer $
Penalty $ City SAC and WAC # $
Plumbing Permit Fee $ '-{O, 0 0 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
~
Gas Fireplace Permit Fee $ TOTAL DUE $ lito /~}-J
.-/
This Application Becomes Your Building Permit When Approved Paid I {& J ~S Receipt No. lj~.8qi
~~ 41 z43 Date J /- .I r;- V By (j
" .
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 1(952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or Interior AJteration to Single Family Homes
BY: ~ lSl~
Date:
/(_ 1'7~03
Building Permit #
Site Address I t/ 0 ~! 2-
Legal: L '1 B. I
Pill:
/L/57;;( - ;p~~~~ ;ed
r. 11 ~J#'A
Subdivision: /)~ ~
Existing Si:ructure~r NO
CONFORlVIS TO ZONll'fG
ORDIN.Al~CE
TIS
NO
I
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
tJo
Is the property located within the flood plain?
Refer to PlarmiT'lg
f'Jc
r~
Does the alteration include any additional ki1:chens?
Refer to Planning
Does the proposed alteration include any outside'
entranc~s othe: than patio doors?
Refer to Planning
No
Is the proposed use of the finished spac~ or
alteration for anything oilier than a nonnal single
family home (offic~, group hom~, day care, e~c.)?
Refer to Planning
No
THIS l..t1~CKl.IST MUST BE COMPLETED .-\.ND INCLUDED IN THE BU1LDING PE.R1vllT FILE TO
L'tWNT AlN .-\ RE CO RD 0 F THE REV1E\V.
T '\TI=-:'vf1JT ,j, TF\ALTC':HCZ.DOC
CITY OF PRIOR LAKE
9524474245
P.01/01
Date Rec'd
ell i OF PRIOR LAKE PLUMBING PERMIT
1%./5.D3
(['lease tYPe or J)rint and si~ at bottom)
ADDRESS
/L/S7~ Q~QnL
1,lllue Flit . PERMIT NO~.CSZ7
2. OoJd Cil)'
3. Vdlow "/lplleAftl
-ZONING (olfice use)
LEGAL DESCRi.t' lION (onlee use only)
LOT . BLOCK
ADDITION
PID~ lOf.JJ
(phone) q~ ~- d,15 - 73;j~
OWNER
(Name)
(Address)
&~&~~ d X~ 7Ji~
(j'
/1-/S-7~ Q~Wt/?i~ a~
I ~
APPLICANT:;) l/i~ ~ A I (-- );} / ~ /R
(Name) n::7J'~Gt!.-- f~~c, .w. . (phone) L
(Address) y "611 - y"tLt2-e-Io. (J~.bdL _ _~G~sld-3
/) 5':ddress) . -r/2,;/ I I' '-0 - -(City) ( (Zip Code)
(ContactPerson) ~~, . (phone) 0/J--Bf.,; ~~ --;S-S /
APPLICANT SIGNATURE ~J~~~l~, DATE /a. - / / -IJS'
( .,".~........--
J
I
APPLICANT PLEASE COMPLE IE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (ror2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
TyPe oCFiJ;tare
Quantity
I
Rough..ins
Water Heater
Water Softner
. Stand Pipe (W ashing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly"Teit-
Lawn Sprinkler
Other '
FEE SCHEDULE
Industrial, C~cial & Multi-family I % of job cost with a $39.50 mi.nimum Residential. New On~ &. Two.Family $99.50
__________. Residential, Additions & Alterations $39.~Q .AIIID
Estimated Cost $ Building Permit # 03. 1.t:Jl, 7peol1VI?
PLUMBING PERMIT FEE $ _ 3 9,5 () ~
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ t/tJ, 00
/
(Offiee U5C Only)
BuUdhl~ Official
Date
1!Js:1J3
This Application Becomes Your Building Permit When Approved Paid
24 hour noti~e {or aU Inspections (952) 447-9850. Cax (952) 447-4245
16200 Eagle Cre~kAve., S.E., lPrJor Lakey MN 5S.372~1714
TOTAL P.01
PRIOR LAKE Dt:.fJARTMENTOF
~ BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 1"15 ., J.. 'R (') :s~~J /!J
NATURE OF WORK "'_ J.J, PUJ.'J"S/t
USE OF BUILDING ~. _ .
PERMIT NO. t; '3" I ~ ().. 7 DATE ISSUED /1- /7- a
. CONTRACTOR a/ARM. !CJ~.N~~~N~ .'1( i?1y
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
1/1;(/
'M'
1- ?-rJG(
}
I
-Y
..,
J1//
~'
COVER NO WORK UNTIL A:BOVE HAS BEEN SIGNED
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
1,// /1?J
/ VII/'
I
3--)LI r64
I
/
'J(f
SIGNED
'"
M)
l/l~/
OCCUpy UNTIL ABOVE HAS BEEN
NOT~CE
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 shaU be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
ILl (7') 1:7
'>oJ I~ ~ I~'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o ~ULA TION I J
.P'FINAL Vlv (
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~-
/ / II~I
( / J UJL
\ ~
~
DATE TIME
:?...1 r~t,(
ad
S-/97
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-~
1]' / '\
T /U )
/
-------
I WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~/1~ FOR REINSPECTION BEFORE COVERING
Inspector: J t!I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!