HomeMy WebLinkAboutBldg Permit 04-0029 & 03-1094
CITY OF PRIOR LAI(E BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY COINNECTION PERMIT
/. 2,,0.04--
(Please type or print and sign at bottom)
. ADDRESS
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. ():I... 002..-'1
5723 C/eOSSrlNO/r2A S I
s6
ZONING (office use)
pvo
LEGAL DESCRIPTION (office use only)
LOTISBLOCK / ADDITION (!AIU:J/A/I1L- /24lj~ 3M.D
PID zs: 3/'. OIS. 0
OWNER
(N ame)
ne/1v'71I~1
, ,
SA/'16
D~L,
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
~ower Level Finish
I ,e/Jl)'1
o Misc.
<
C!A't ,e,,/~
fS:1 -II/)- J 4111
(Phone)
(Phone)
(Phone)
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
o Addition
o Alteration
OUtility Connection
PROJECT COSTlY 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 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 P9n the.prope. rty to p~ inspections. . /
X /, If) r 1 / -<~ cJ -- 0 ~
. I Sign re Contractor's License No. Date
I Permit Valuation ~ 000.00
Permit Fee $ , 34.'75
Plan Check Fee $
State Surcharge $ . .!::> U
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
~;Z:BuilWngP;j~:r:;d
. Building Official I Dati f
Park Support Fee # $
SAC # $
Vvater Meter Size 5/8"; I"; $
I Pressure Reducer $
City SAC and WAC # $
\Vater Tower Fee # $
Builder's Deposit $
Other ~eA"l4~ $ /. 0 t)
TOTAL DUE $ 3~. 2.5
I)
Paid .3~. Z,S- I ReceiPf,}4o. /;(, ~~z"
Date / ~O.. a4-- I By .
G~
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LA](E BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CO'NNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. P3 -/6 q '/'
(Please type or print and sign at bottom)
ADDRESS
S1~3
d )/ tJ ~ 5' fiJUtl r~
ZONING (office use)
PUn
LEGAL DESCRIPTION (office use only) /l_ /' )j 'I
LOTJ~BLOCK I ADDITION ~a:f? ffl d~
V
grd.
PIDdS-- 3)~- 015-{)
OWNER
(N ame)
J~J I1tzdrr~
(Phone)
./frb -/~ifO
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ODeck
OPorch
ORe-Roofing
ORe-Siding
o Lower Level Finish
o Misc. eqrc,~5 w/'A/do tJ
o Fireplace
o Addition
o Alteration
OUtility Connection
PROJECT COSTlY 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 will conform to all existing state and 10ca1laws 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
enjitr opo the P'r t,,~~~ inspections. , /
X ~~/Y177.,fi g/cOj03
/' Signantt; Contractor's License No. ' 'Date
/
Permit Valuation
City SAC and WAC
'Water Tower Fee
lBuilder's Deposit
Other
#
#
$
$
$
$
$
$
$
$
$
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
~s-oo" ----
/Lj- '7 S-
I, :35
Park Support Fee
#
SAC
'Water Meter
#
Size 5/8"; I";
Pressure Reducer
This Application Becomes Your Building Permit When Approved
11t~~ ...t~ ~/~A:r
Building Offici~.1 ' Date'
I Paid
I Date
'7(0.
<6' - d--lJ'- 0'3
.?t,. ~cJ
Receirt No. if,?; ~3
By t;;
V
TOTAL DUE
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 5923 CAeOSS/1 NOerJ ~ I ·
NATURE OF WORK L-OW~~ ~EV6L-
USE OF BUILDING /CA5S /1~'e.
PERMIT NO. 04.0029 'DATE ISSUED I" 2. o. 04-
CONTRACTOR ~~/A/7V~ PHONE
"-
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
/5;-
~,
c?/I d! () 'f
rl-I/;1. / tI 0/
/
HEATING (if required)
E
~
;< //:Wt} if
. , ,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
"'~1i
r'Y;t~<>. ~
BUILDING
ELECTRICAL
/'7
lM//
,
~- A J.-o'1
,/?
~EATING J/Vf~ ~(r'lJ-az,\
DO NOT OCCUpy UNTIL A~BOVE 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 INSPECTIC)NS (952) 447..9850
~
)
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~~ L/~SS&i~~tf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PL.UMBING RI
o ME:CH RI
o WATER HOOKUP
o SEWER HOOKUP
o PL.UMBING FINAL
o MECH FINAL
COMMENTS:
--
-----
___':lI...........
~
/ /'J.,
\ C!~
~
,,,..,- }
f111
DATE TIME
4- ). 3c:)t.(
L-{ - J-q /-g -/O?o/
I
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.4' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~_r~OR REII~SPECTION BEFORE COVERING
Inspector: I r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!