HomeMy WebLinkAboutBuilding Permit 03-0905
(Please ~ or orint and sign at bottom)
ADDRESS
/7254-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'1. ~.oy
I. White File I PERMIT NO I
2. P;,k C;'y . /'J? - 090' r-
3. Yellow Applicant V.-l ~
t:Je:az.,c1 C. L.-O PK-.
S"e-
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK / ADDITION p(;;;f;/vP I ~
OWNER
(Name)
(Address)
EDWII\J
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
2NP
PID 2.!S. 377-,06(',0
I ZONlN;;Of!iceuse) I
Cor /) Q..C; 5>
(phone)
't9--Q3 V-l/?..ti~
(Phone)
(Phone)
o New Construction
\..{ower Level Finish
fl-L :3 le/'S.
ODeck
ORe.Roofing
ORe.Siding
OUtility Connection
I hereby certify that I have furnisbed 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 confonn to all existing state and local laws and will proceed in accordance with
SUb~~rans. I am aware that the building official can revoke this permit for jusr cause. Furthermore, I bereby agree that the city official or a designee may
;tl:1 the ,.-t~- Pf~::ededinspectio.. (/7 h 3
SignatUre Contractor's License No. ' .Date
I Permit VaIuation
I Pennit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$ I, () 0
$ 1/7 7.5
I ReceiftNo. -rqt.9(,
BU'
OPorch
o Fireplace
OAddition
OAlteration
PROJECTCOST/VALUE (excluding land) $
$
$
$
$
$
$
$
$
.3 00 0, 0 0
.
1<1.7)
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
Pressure Reducer
#
#
-
1.57)
City SAC and WAC
#
I Water Tower Fee
I Builder's Deposit
I Other ~1Ut:!/TZ-
I TOTAL DUE
4-d.O{)
#
-
I Paid //7 zq
I Date' "? e.o"?
:J/i1ca7Jr=YourBuildingp~~7ved
BUil~ 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 sign by the i Planner constitutes a temporary Certificate of Zoning compliance and allows construction to h_"__.____. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
7-r---() :3
o..o(u)
~w... (-evr I
Date Special Conditions, if any
24 hour notice for all '-', ..~_..J (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~d6ur
.
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: (UA.. ~ Date: 7 1'. oJ
Building Permit # 0 y- C/qo 5'
Site Address 172 S 1-
Legal: L (p B /
Existing Structure: ~ or NO
CONFORlVIS TO ZONING
ORDINANCE
PID: 25. 372 .0 or.. cJ
Zoning:
t:/I
L/~f3--0
Subdivision:
P /e.- .
P6De.F1e;:u::> 2 ~
~3
NO
Is this an expansion of the e:tisting footprint or
building height?
YES
Refer to Planning
NO
~
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside'
entrances other than patio doors?
Refer to Planning
~
~
~
Refer to Planning
Refer to Planning
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
Refer to Planning
L---
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERJ'IUT mE TO
"'lAINT A1N A RECORD OF THE REY1EW.
.
L:\TEMPU. TE\Al TeHCK.DOC
PRIOR LAKE QIiPARTMENTOF
-BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /7l ~ l..( O..~; f', d r1 f),... <;.e .
NATURE OF WORK t.d.... F;>'1./S ~
USE OF BUILDING 5:.. F. /-1-
PERMIT NO. O"?-.O'/05 DATE ISSUED 7- ?,-Q~
CONTRACTOR ()w,."........ PHONE q~.2. - 'f]'{- 42,1K'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
OATE
,- I
, U I ,....-. "J I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
11 IITI . ..
1/lIP
M
fIVrl _
!lit""
q. /)..-03
q-!)---v>
Q-r003
q'l)r:.'"7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
l I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
M
uZ
~
#-ff
OCCUPY UNTIL ABOVE HAS BEEN
NOTICE
)
?~/oo/
~//.v"'y'
?/;/"'Y
7//?r
SIGNED
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
OATE nIlE
CITY OF PRIOR LAKE ... / /, /
INSPECTION NOTICE SCHEDULED Z,//d7
ADDRESS /?"Z S-r/ AerIJWr! J1
OWNER
CONTR.
PHONE NO,
PERMIT NO.
Os - 9c:7~
o FOOTING
o FOUNDATION
[] FRAMING
~SULATION
~FINAL
[] SITE INSPECTION
o PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH RNAL
o EXlGRADlFILLING
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLlNE AIR TST
[]
C~MEIiTS:
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~ WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HlULTH '" SAFETY!
"""""