HomeMy WebLinkAboutBuilding Permit 13. 0237 /04 r..l
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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TEMPORARY CERTIFICATE OF ZONING COMPLLArCE 3 2_7,13
AND UTILITY CONNECTION PERMIT
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rMNES�S P1 � VV/ 13 _ o / 3
White File Pink City PERMIT NO. , 2 7
2. 3. Yellow Applicant
(Please type or print and sip at bottom)
ADDRESS IL-k _) pp .'2_' S t O F c_--t ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT L BLOCK \ ADDITION J c -F E I?- s i l'�1=V t t= lZ C t PID
OWNER
(Name) ; '1 A T p.s. 1"1 "I -14 U t"► E—S (Phone)
(Address) - 12-C l VvASI-4 lt 16it,'J RvE s _s 20t a.0 t1-.14\ 1 SS43
BflLDER
(Company Name) M k-'r- t -Aer -1 y -F U 1 ES (Phone)
(Contact Name) S U E - 81 \. 1 (Phone)
(Address) 1'2 t LA./ r k S I-} It J C —1 p., vs_ S S't— ? r) 1 1=Q 1 IN) .N. r-1 t-.A SSA 39
TYPE OF WORK , New Construction giDeck ❑Porch ❑Re- Roofing ❑Re- Siding wer Level Finish ❑ Fireplace
DAddition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI M R S U PROJECT COST /VALUE $ . i U 0 U
Division: 1 2 3 4 5 (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 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 enter upon the property to perform needed inspections.
Xc _.,1 - =L. BC-- J 1 5 4 ( 13
Signature Contractor's License No. Date
Permit Valuation 3 / 000 U 0 Park Support Fee # $
Permit Fee $ rj 4. 75 SAC # $
Plan Check Fee $ _ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ / Ci Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $
54- c e) Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 54- t6 D TOTAL DUE $ /20, 7 �
,
This Application Becomes Your Building Permit When Approved Paid / c . ?s Receip o. C" Y `i Z-
Date i- ,fO. /3 By
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 S.E., Prior Lake, Minnesota 55372
I
I
r Rt 0 CITY OF PRIOR LAKE Date Recd
°° h HEATING /AIR CONDITIONING/FIREPLACE PERMIT 1:Q/
41111.?1(t' I.hrJ Fik
2. ors riry PERMIT NO. /3 _ 404 3 7 '
J. Yellow Applmexe /
(Please type or print and sign at bottom)
ADDRESS ZONING (ottire um}
t { 1C-- 1C1� �� , __
PAID WITH
LEGAJ, DESCRIPTION (oflicc use only)
BUILDING PERMIT
LOT BLOCK ADDITION `` PID
(N ) 2t\ (t\ TO O 11�.t l', (Phone) .
(Address) 11 13)1D PcLi x s \ A L `+ iv,,,) \ D r A(Jt- 4 r r 5 J
1
APPLICANT n
(Name) nt 0 = ‘ i0 n � ) (Phone) G C� I " m i� I Cio
(Address) t� U v t✓ H fk,r r') i.,3 3J 1 , sv I k e. I , „ 15s7,:2,--,
/ {Address (City} � (Zip Code)
(Contact Person) R- N N - r (. D Ct- \t- C (Phone) � • � - 1 1.0
APPLICANT SIGNATURE v � ► � , t ' 1 , ti '. 1 i DATE C " '
APPLICANT PLEASE COMPLETE BELOW
CA* EW CONSTRUCTION ❑ REPLACEMENT El i
ALTERATIONS
FURNACE MAKE A D MODEL NO ho' oin.54,L*6V( ?Sfl- FUEL tk
FLUE SIZE RETURN OPENINGS INPUT SC) 1v OUTPUT jt&(,)
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
DGravity ❑ Hot Water into Required Side Yard Setbacks.
� Mechanical ❑ Radiation Fire laces with Box Additions or
... Air Conditioning ❑ Special Devices p
ant. System p Over Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
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 549.50
Residential, Heating Only (New Constniction) $64.50 Residential, AC Only $49.50
Estimated Cost $ lQ L i e j O Building Permit #
The Minnesota Statutes §:12611. WI{
HEATING PERMIT FEE $ \ 49 • 5 - year St'RC�i has been changed kw one
year effecti +C
STATE SURCHARGE $ ,c,og -16-" July 1, 2010, until .lent 30, 2011.
TOTAL PERMIT FEE $ / c1-f , 5 The minimum surcharge fora "Med fcr" permit
(Office Use Only) Is ‘5, beginning duly 1, 2010
This Application Becomes Your Building Permit When Approved Paid PAID o.
Date BUILDINGPFPMIT
Bultdtne Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
o ., P Rio � Date Rec'd
4, ; CITY OF PRIOR LAKE PLUMBING PERMIT
f ' 'l 13-0/4 3
4-
I. Blue File
2. Odd Gtilr [ PERMITNO. 2 ,
' 6 !J�
3. Yellow Applic�mi 1
(Please type or print and nip at bottom)
ADDRESS ZO NING wee use)
PAID VtilTILI ' AhTk -
LEGAL DESCRIPTION (oflice we only) BUILDING PERMIT
LOT BLOCK ADDITION PM
( (Na ) _" i\, --- q)- (i n (Phone)
(Address) . 10 - Y11 / 2 1'ct V-s ck- CAT LAIAlff kijiAt 1 rn 56"
APPLICANT A �
(Name) Q/0 ` ,1,1(I n (Phone) C la) . W -, V:IAD
(Address) d DAD 4 t» .L4) , u,x (N\ ' 0 V-7 1Y‘, 3 j �'
(Add ss) (City) (Zip Code) •
1 7 (Contact Person) �; I _ $ £A flh , 1 / (Phone) C * .I Cg 91
i
APPLICANT SIGNATURE 411011111t, ' f I C_ ■AX I DATE 114 t3
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower , R -ins
i Dishwasher F r Heater
l _ 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
l . -1-& Bar Sink
Lawn. Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi- family I% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes § 32613.148 -1st $ lk" t C 1 � t Building Permit #
"SURCHARGE" has been changed for one `y ice, Ss
-D
effective PLUMBING PERMIT FEE $ ll.f 1;J
July I, 2010, until June 30, 2011. STATE SURCHARGE $ ; & -
The minimum surcharge fora "Rued fee" permit TOTAL PERMIT FEE $
as $5, beginning July 1, 2010 1 J ` t sr) •
This Application Becomes Your Building Permit When Approved Paid PAIe'H
Date RUILDIIG PERMIT
Building Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372