HomeMy WebLinkAboutBuilding Permit 04-0046
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0'"
Lf~ I
(Please tvo~ or orint and sign at bottom)
ADDRESS
I~;&d 12~lm-,
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LEGAL DESCRIPTION (office use only) . I /1 .
LOP3BLOCK / ADDITION ~~
OWNER /( I 0 I
(Name) J u...rlu n u. r l G/v
j
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
~er Level Finish
ODeck
OPorch
ORe-Roofing
DAlteration
o Fireplace
DAddition
o Misc.
PROJECT COST IV ALUE (excluding land) $
I I
ZONING (offi" use)
KI
PlOd S- 31 J-- 033-0
#
#
#
#
q:S-J- 'f'lD-3IiJj
ORe-Siding
DUtility Connection
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
~terup~~rfoe~~;:;s (/30 /0'-/
----v' t Signature Contractor's License No. I r/ate
$
$
$
$
$
$
$
$
$
--
Permit Valuation
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I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty I $
I Plumbing perrnj'f'JeP/I.A mit,/"I $
I Mechanical Peririli Fee I $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
6?-. 7~
-
/,"0
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---
This Application Becomes Your Building Permit When Approved
~i~~P -f~~ti
Paid /03- rI J
Date (- ,d,f) ~D4
1/)3 .J5
ReceiPt No. U'J'i'I'1 l
Bv tA I
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This is (0 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 lmerior A.lter::!tion to Single Family Homes
r::2 ~
BY:~
Mf>
Building Permir ~
Sire Address /?3~"
Leg::!!: L 5'3 B I
Pill:
E.risIing Structure: 1:"ES or NO
CONFORlvIS TO ZONING
ORDINA.!.~CE
Is this 3.L"l expansion of tte e7i:lung footpru:.: cr
building height?
I Is che property located within che flood ;Jlain?
I Does the alteration include any additional k::chens?
Does the proposed alteration indl!.de any outside
enrr-~ces ache:- chan ;Jatia doors?
Is the proposed use of the fiTJ.ished S1Jac~ or
alte::rc:on for anything Qeb.e: t..b.an .1 normal sl::g1e
tar:rily home (office, grau'9 harne, day c::..r~, e~c.)?
Date:
(-
30 Ol/
/73;2G z~~~~d) ~
Subdivision: /j~ dJ'd-
:r:~ s
NO
YES
NO
Refe: to PlarJITJ..-rg
Refer to Planning
ND
tJO
tJC
Refer to Planning
Refer to Plann.:ing
tJo
Refer to Pl=-,g
tJo
THIS CRECCL1ST MUST BE COMPUTED ..\.:m INCl.UDED IN T:-rr BU1LDIT'iG PERMIT FU..E TO
i'fL.lJi'fT..\..Ei ..I.. RECORD OF T1:fE REVIEW.
~ '-::'-:"Jrcr .'.. --:;-', .:. ~ -~"'~\"~ '"":CC
PRIOR LAKE
INSPECTiON RECORD .,
13 ~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING f
PERMIT NO. lL!-- pATj: ISSUED t- ~D -~ rHJI'
CONTRACTOR It PHONE V"D- ~ ,- 0
NOTE: THIS IS NOT A R IT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
.i/>i'
I
Backfill) I I
PLACE NO CONCRETE UNT!L ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
A
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)..:;Jo-04
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M
2-7-0-()L/
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
, , ,
.1Ai:< Y, "I' j4
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
ft#-
~
~
OCCUPY UNTIL ABOVE HAS BEEN
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.
/ I /
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7R~~Y
# .
SIGNED
"
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED ~~~
L/ee/'-hid a-
ADDRESS
/' /S..2~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~INAL
o SITE INSPECTION
COMMENT~
.~~~~,r
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R/v~ .4'./_.:.
- /'
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CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
XPLUMBING FINAL
:;A"" MECH FINAL
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .
Owner/Contr:
CALL 447-9850 FOR THE NEj(T INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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