HomeMy WebLinkAboutBuilding Permit 04-0081
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
z.., I q ,14--
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. O~, 0 O~ /
(Please type or print and si2Il at bottom)
ADDRESS
45~9 I-ItI'1nINQ d//UJ ./~.
ZONING (office use)
Je/
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ5.3~ ()03.0
OWNER
(Name)
(Phone)
(Address)
BUILDER ~ 1/
(Name) ~iSJ, ~/!1.tS ~G
(Contact Name) J1~.f.J. J-Itt/);rt...
(Address) f: O. 130> 4~ ,4.1-'~, At! ..ss-.nz.
(Phone) --t2 ~)4W- 70".)
(Phone)
o Misc. /.(ll:L. ~
o New Construction
~ower Level Finish
Z~S.
o Deck
OPorch
ORe-Roofing
ORe-Siding
TYPE OF WORK
o Fireplace
OAddition
o Alteration
OUtility Connection
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 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
enterupon'thep~ nee~ns.
X ~/ ~ .... ~2DIB'Itt -19 ~~ o'{
r Signature Contractor's License No. . Date
Pc.uuit Valuation z,.1 00 0.00 Park Support Fee # $
Permit Fee $ (, Z. ZS' SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ 1.00 Pressure Reducer $
Penalty $ City SAC and WAC # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Firepla<;yrrpi;s.-.., $ +6.00 TOTAL DUE $ 103. z.,S
/J
This Application Becomes Your Building Permit When Al'l'&'" led Paid /()3. Zr ~f' ~t'>7 4~
~ ~ ~1 /0 'f Date J '..04- By .
Building Official Date
'l1is 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
'hen 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
med.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
1:
. - ... . - -
.
.
L
Residential Building Pel.wit Cheeklist
Basement FInish or Interior AluntioD to Single Family Homes
BY:
~
~ Date: e?!I?J,,/
Zoning~
~
PID:
~~
S abdivisioD:
Building Pe~~ #
Site Address 4 5t:?~
LepJ: L B
E::dsting sauctur@r NO
CONFORi\'fS TO ZONIl'iG
o RD IN'..A..i.'f C.E
'YES
NO
Is this an .....~~on of the e:cL~g fOv~~t or
bm1ding height?
YES
Refer to P~g
NO
Is the ~"~~"/locmd within the flood plain?
Refer to Pl~ I , II : II g
NO
tJD
~o
Does the al~..tion include my additional ~hen.s?
Rete:- to P~g
Does the }l1.\Jl'Iosed alte::uion include any outside'
enLuw.ces othe:' than patio doors?
Refer to P~g
tJo
Is the lJ4 \o/~osed use of the finished spac: or
alte:':1tion for anything other than a n\Jl~ single
family home (acc:, gro~ home. day c:u-e. etc.)?
Refe:- to PI~g
NO
THIS \...~CXl.1ST ){UST BE COMPL.ETED .~'fD INCltJDED IN THE BtllD~G PER-yIIT mE TO
)l-UNTAIN A RECORD OF U11. R!'YTI:\v.
,.
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,.
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PRIOR LAKE DEPARTMENT OF
<BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~5B9' !If/I1r!I/tIq6//GO I~.
NATURE OF WORK LOW (5',e t-,{5V 6 L-
USE OF BUILDING /865' rl / ~
PERMIT NO. 0 4-. O~ 6/ I DATE ISSUED z. /q, 0 ~
CONTRACTOR /-#1/V/.sH /!()1"1&-;.$ PHONE ~. 7()~.:3
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
wr/
t/0;Y
HuMb;.,,, $t~k ~ ~- U-oiJ
~ ~ !
HEATING (if required) ,.> I . 3 -t'{ -()"f
FIREPLACE yVy'/ '3,..I/f-o~
GAS LINE AIR TEST ~ '::,-Cf-d4
. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FRAMING
INSULATION
ELECTRICAL
WIL,
1. - ( cJ -(}l.-/
3- (rj -dy
,
FINALS
BUILDING
ELECTRICAL
rf"b
1
5:/~
HEATING fJ
DO NOT OCCUPY 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 It,LL !NSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~f-ol
OWNER
LI"87 I-Iu.. ~ . b'r~ \I ~ ,
coJm.
ADDRESS
PHONE NO.
PERMIT NO.
'f -60st
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
jZ.EINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~K SATISFACTORY, PROCEED
o CORRECT AC N AND PROCEED
o CORRECT K, CALL FOR REINSPECTION BEFORE COVERING
CALL
~ Owner/Contr:
- 8.;;;FO~E NEXT INSPECTION 24 HOURS IN ADVANCE.
QUI~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Inspector:
CODE
/NSNOTl