HomeMy WebLinkAboutBuilding Permit 04-0132
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO.Ot/_j :3~J
(Please type or print and sign at bottom)
ADDRESS
14t,41
R05eW()od
Rood
AlE'
PraD(' Lak
ZONING (office use)
R I S-fJ
LEGAL DESCRIPTION (office use only)
LOT/3 BLOCK.3 ADDITION r)J~h
fj// J
PIDdS-3IO.- oa'3~
OWNER
(N ame)
Patti
14-b~1
a.nd
R05ewocd
fJo.ncy tUff;
/2.d JJ E
(Phone)
qS"J - 4-4s - 408/
(Address)
P 1""0r'
La..tt
BUILDER
(N ame)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ODeck
o Porch
ORe-Roofing
ORe-Siding
~Lower Level Finish
o Misc. I, 12 .(,.. C..6 Ot;~. ·
o Fireplace o Addition o Alteration OUtility Connection
PROJECT COST IV ALUE (excluding land) $ ~ZOOO . f) 0
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 P1form needed inspections.
X 'fJ(}A1t!u ~, ~' .~t:JA.<:A 111:kJ04-
J Signature Contractor's License No. Date
v
Permit Valuation f:;!dCJtJ,tJO Park Support Fee # $
Permit Fee $ 'Z. z,~ SAC # $
Plan Check Fee $ 'Water Meter Size 5/8"; I"; $
State Surcharge $ I.()() Pressure Reducer $
Penalty $ City SAC and WAC # $
Plumbing Permit Fee ()tv /J't,r $ 4t)~ tJ(J 'Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other e/~ $ 1--00
""
Gas Fireplace Permit Fee $ TOTAL DUE $ /Ol/~:;6
_. -~ . ,d/
This Application Becomes Your Building Permit When Approved Paid~/r?~' d-6 . J Receipt No, ~ &J 'f I;C.)
2f~ :#Jl~ ..3//1 !d <( Date '-~ - J I - ()'-/ By d
,
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or In1:erior A.lteration to Single Family Homes
BY:
~~
Date: 3-: /'/- () 'I
Building Permit #
Site Address
Pill:
/~/6L;/1-
#0 4R wo~;dg:Rol
Legal: L
B
Subdivision:
Existing strucrure:~ NO
CONFORLvIS TO ZOI'f[NG
ORDmi\i~CE
Y""E S
NO
YES
NO
Is this an expansion of the existing footprint or
building height?
Refe: to Pla.n:n.iJ."1.g
Is the properrf located within the flood plain?
Refer to Pla.r..n:ing
tJa
~O
~Q
Does the alteration include any additional kitchens?
Refer to Planning
Does the proposed alteration include any outside'
entrances other than patio doors?
Refer to Planning
~D
Is the proposed use or the finished. space or
alteration for anything ou.1.eT than a normal single
family home (office, groU"9 home, day care, e~c.)?
Refer to Planning
jo
Tms L.tiLC:-G...IST MUST BE COMPL.ETED .-\J.'fD INCLUDED IN THE BU1LD{NG PE.RJ.'YllT Fll.E TO
~L-\1NT .-\.IN A R.E CORD 0 F THE RE VTE\V.
., '--::'-:\/pr j, --::".j. ~ ~l~~-:- r.:: :-: c; c
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I..!I-L tll & s e.. WOd d ~J
NATURE OF WORK ~.'-
USE OF BUILDING SF
PERMIT NO. 011- - ~ ~ DATE ISSUED ~"'1-0tf
CONTRACTOR l'AJ,I,,) ~ r+ ; PHONE 'IqS-. l{(J..lL
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
>i"')
PLACE NO CONCRE".~E UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
tif;
I
I
I
VI
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
- .' ~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
///# 4,. ~-tX-r
. I
V1/!/ t-f ~G -()~/
t/l/' l.1. -G ~Otl
UNTIL ABOVE 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 INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
.I L({,I{ (
OWNER
PHONE NO.
o FOOTING
o FOUNDA liON
o FRAMING
o INSULA liON I
P""FINAL V, (...; r
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED If-{, V't(
~l{,lntJcL4t 1
CONTR.
PERMIT NO.
Lf-( J1-
o I)LUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TSl
o
~- ."- ---. ~---.
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I ~ / A)C A If- AL9
( / /1(. ( ,/'l- :- { ./
\ ~l..-~ ~
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---- -----
/'
~K SATISFACTORY, PROCEI:D
o CORRECT ACTION AND PROCEED
o CORRECT jOY1 ~R REINSPECTION BEFORE COVERING
Inspector: 1 V Owner/Contr:
CALL ~7 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTl