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HomeMy WebLinkAboutBuilding Permit #13-1184 oF PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd � ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ! �) ��� � � �TIL NNECTION PERMIT � '�i � 1'���' '" f � wn��e FJe PERMIT NO . / _� 2 Pmk Cny /� / y1� ; Yeilow Apphcanl / 1 (•=—/ Piease or rint and si n at bottom) ADDRESS ZONING (ot�'ice use) Ccr� � �--c s'd'�C' (�' � � '� � l,7 � LEGAL DESCRII'TION (ofl'ice use oniy) LOT BLOCK ADDITION PID �- �� I�� • O/ S_� OWNER (� /J (' (Name) �1Ge.0 � �e�1 q C/�d�/h.Q.� (Phone) (Address) / �, v �d �-a�e S/`� c� 2 ,S": �. BUILDER (Company Name) ` ce �lJ � � � �S ! J` c! e "��'v�(i �.�L r (Phone) �l�' �f6 �SO C � (Contact Name) ��c .�./'�� /�'+ (Phone) (Address) lc�G �� .�, f - ,�, �.V � ' TYPE OF WORK ❑ New Const wn ❑Deck ❑Porrh ❑Re-Roofing ❑Re-Sidmg ❑Lower Levei F�msh ❑ Fireplace ❑Add�UOn �Alteration ❑Util�ty Connea�on � � M�sc �A'[ � T//v'V LY's CODE: R.C. ❑I.B.C. � Type of C struction: I II III IV V A B pROJECT COST/VALUE $�� �C�� Occupancy Group: A B E F H I M R S U I (excluding land) � Division: t 2 3 4 5 , I hereby certity that I have himtshed mfrnmation un this appLcauon wh�ch is to the best uf my knowledge nue and currect [ also ceiufy that t am the uwnec o� authurizcA agent for thc ( above-menuoned piope�ty and that ail construct�on w�ll conform to atl exishng stare and local laws and will proceed m accordance with tiubm�ttcd planti I am aware that the buildmg ufficial can revoke Ui�s peimit foi �ust cause Fur , hereby agree that the aty offiaal or a designee may enter upon the propetty to priform necded mspcctiuns , X t�C� � /L� �-�-�� �gnamre Contractor's Luense No Date Permit Valuarion 5 0 � Park Support Fee # $ Permit Fee $ O SAC # $ Plan Check Fee $ • Water Meter Size 5/8"; I"; $ State Surcharge $ 2 0 � Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ _ S - b Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Perrnit Fee $ TOTAL DUE L�`� �4�. �..; $ � e This Appl' ion Be Y uTlding Perntit Whe Appr ed Paid et t NO. Date � ' r � z 3 C a���id�„a � This is to certify th the ieqi �st m[he above ap}�Lcaoon and accumpanymg doc ments �s i accordance wrth the City Zomng Ordinancc anii may prucecA ati �equcsted Thil ducument when s�gned by iry P 1 ner c nstitutes a temporary Certificate oP Zomng mpl�ance nd allows construcaon to commence BeFore uccupancy, a Cciuticatc of Occupancy must bc tssucd Z3 r_� lamm�g Director D te Special Conditions, if any 24 hour noticc for a►i inspcctions (9SZ} J47-9850, far (952) 417-d245 4646 Dakota Street Prior Lake, MN 55372 04 pRtp� Date Rec'd � CITY OF PRIOR LAKE PLUMBING PERMIT � �2- .�� �3 � � �� I. Blue F�le pERMIT NO . 2 Gold City � I� • I I 3. Yellow Ar�hcant lease or ' t and si at bottom ADDRESS ZONING (o�e�e use) LEGAL DESCRIPTION (ofl6ce use oniy) LOT BLOCK ADDITION PID OWNER (Name) ��r ����� �. � (Phone) (Address) �, W ,�1�,_ �� APPLICANT (Name) � '� : a 't� Q � � r� �� = � A (Phone) �� 2 ` Z I "L — �{ la �3 (� (Address) \��� � ���-'�-- Llr� \ t`cur �-�n �lr� ,S"S � �-�. (Address) (City) (Zip Code) (Conta.ct Person) �� � i��� � 1 r12� (Phone) k.S� 2 � 2 � 2 l-'�"� � APPLICANT SIGNATURE ' DATE Z- O 5 I APPLICANT PLEASE COMPLETE BELOW Quanti T e of Fixture uanti T e of Fixture Bath Tub with or without shower Rou h-ins Dishwasher Water Heater Floor Drain Water Softener Lavato Bathroorn Sink Stand Pi e Washin Machine Laund Tra 1 or 2 com artment sink Sewa e E'ector Shower Stall Backflow Assembl Sinks Backflow Assembl Test Bar Sink Lawn S rinkler Water Closet Toilet Other The Minnesota Statutes § 326B.148 "SURCHARGE" has been extended FEE SCHEDULE The rninimum surcharge for a ob cost with a$49.50 minimum Residential, New One & - amily $149.50 Residential, Additio i Alterations $49.50 "fixed fee" permit is ��.(10 Building Permit # � � � � � PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 `j� TOTAL PERMIT FEE $ � L� �/ , (OfYce Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By BuildinE O�cial Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS � NATURE OF WORK � USE OF BUILDING �'�p� PERMIT NO. DATE ISSUED / ♦ CONTRACTOR PHONE r INSTALL EROS ON OL AND MAINTAIN CLEAN STRE S AT ALL TIMES INSPECTOR DATE . �� ER PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING �z � , INSULATION : � , ( �-; l; ELECTRICAL PLUMBING l� HEATING z �L�� T COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED HOUSEWRAP LATH FINALS B�UILDING � 3 � E�_ECTRICAL P�UMBING � 3t I'� HEATING 3� � y 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 ALL INSPECTIONS (952) 447-9850 • � � � v� � • . . • • . .. . • - . . ' ; • • . , . ; _ , . � � i I, , • - . , ^ , - - ., ... ' ��t - ., , %' f � fi �� �p+ A -�1=1�0�.1� L`?� IST��I�. 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