HomeMy WebLinkAboutBuilding Permit 04-0048
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/4'fpIZ
~JEf\/()O.o
Date Rec' d
Z~ Zro4-
I. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. 04- . 004ei
I
~O..
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(N ame)
PID 25: 3/0.01 2..
j
I
I
(Phone)
(Address)
(Address)
3
(Phone) qtlLj- }Jfitl
(Phone)
--~
TYPE OF WORK
o Deck
OPorch
ORe-Siding
o Misc.
o New Construction
~wer Level Finish
IfR~..
ORe-Roofing
PROJECT COSTlY ALUE (excluding land) $
o Fireplace
DAddition
DUtility Connection
o Alteration
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 ware tha the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
:' th~ prope 'pero neoded inspections a D ~ lB315 cf( . ;;? - Of
Permit Valuation
l ()OO.OO
$ 34--.7S
$
$ . S7J
$
+0. ()
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
~-d.-()1
Date
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Vvater Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
\Vater Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7525
Bpaid
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
16200 Eagle Creek Avenue Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~\~
I OWNER
(Name)
(Address)
(phone)
I PERMIT NO.I)L/_ WI
I ZONING coma:us<J I
I
I
PID
I. Blue File
2. Gold City
3 _ Yellow Applicant
ADDRESS \L\ 1_\ () (t d \
\D L- ~ \ CY~(l. WOO Ro..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
APPLICANT c:. '- 6) \.. .
(Name) ..)c..lle.t"~ t \umo\~
(Address) '1<\QO Adr\Cl.(\ CiVl\O.. St.
(Address)
(Contact Person) -'5 Q. t ~ <Sc.,hexw
APPLICANT SIGNATURE
(phone) q S ';l- '4 41-lo 1 ~ l{
~r\ Dr lo.~ SS 51 Z-
(City) (Zip Code)
(phone) (0 1"2...1 Y ,- 30~ 3
DATE ~?'/o4
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
\ Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
\ Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry 'fray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
\ Water Closet (Toilet) Other
FEE SClIEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
^.5OBLf~ ~
(Office Use Only)
This Application Becomes Your Building Permit When APpr~
Building Official Date
Paid
Receipt No.
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS / 4 & /2- /,2"aJ E:W 000 J!,O ·
NATURE OF WORK L() W67e, 6BV E f-" / 6'i.1f1l yooVV'
USE OF BUILDING IZ65 41 /t:... /
PERMIT NO. 04-, tXJ4-e [)ATE ISSUED 2 , 2- 04-
CONTRACTOR /'1# ...s7J97E-WI.o~ PHONE q94. ~11-
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
OUGH - INS
-
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if re uired)
~
~/'V
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
[ I
FINALS
--- :!:::::~..:::::::: -~ ~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
"S~/€
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet priol' 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
INSPECTION NOTICE
SCHEDULED
3-13-at--
ADDRESS J'Ito t 7 / ~~
OWNER CON1R.
PERMIT NO.
'1-00 c.Lg
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING, RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING, FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
./
~
I
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owne rICo ntr:
FOR THE NEXT INSPE:CTION 24 HOURS IN ADVANCE.
co
UlREMENTS ARE FOR YOUJ~ PERSONAL HEALTH & SAFETY!
lN$1ion