HomeMy WebLinkAboutBuilding Permit 04-0210
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
(Please type or print and si2ll at bottom)
ADDRESS
/5317 @'1~0f ~OG6;t1N
LEGAL DESCRIPTION (office use only)
LOTJ7 BLOCK.3 ADDITION
OWNER
(Name) C.,........J<. C:,...."'''^
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
w,,-os s ()(/,-,1
o New Construction
)'I!!eCk
o Fireplace
(Phone)
ad-
(Phone)
(Phone)
DPorch
ORe-Roofing
DAlteration
Date Rec'd
f, /. 04-
I PERMITNO.O~_ Oz-/O I
ZONING (offi" use)
,e./
PID z.:;: 3fJz... 09/. 0
9<5"-z-.. 2.<-<0- .!>2."Z..~
t(z. z. f,2.. '1/98
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
enter u~ they. "y';'<.) to perform needed inspections.
X~i..l1. d") ~- ,,~
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
DLower Level Finish
DAddition
PROJECT COST IV ALUE (excluding land) $
-_/
_.
'fLjOOO.OQ
$ /0 $, {JO
$ ~" . ~S
$ 2. <90
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~
Building Official
~WI~1
Park Support Fee
SAC
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
Paid r / I /%
Date d-:J-~LI
# $ I
# $ I
$ I
$ I
# $ I
# $ I
$ I
$ I
$ /7/.1U
I ReceiPt No. t./ b l(Lr1
I By 0-------
o
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, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
D~ck ,-\.dJi[iOll~ [0 Sillgi~ Famil~ Hom~s
~ ~./ ~.
BY~~
Date cf/ I/d i
BuilJingPermit =-
Site Address /531?
Legal: L '3? B 3
PID: Zoning:
?P--o.~' d2,../~ _ .
if ~ ---~ I t drJ n .
Subdivision: ~ ~
Existing StruC1ure@or 'iO
CONFOR.\lS TO ZO~'iD"G
ORDI?'-iA~CE
~YES
;\0
Y,rd Setbacks: ,'{OT .-\.PPUCABLE
MEETS CODE
R~quin:':mt:nt
Proposed
. Sldey"rd
(25' if ::lbutting J. stree~. 30' If abutting a street in
C "rdin,,! R.id~e)
. Side Yard
to.
to.
t-f?l
331
l{ (., /
. Re"r Y "rd
25'
. T o"vnhous~s
ivfust be consistcm wIth
"pproved pl:l1l for
development
f'J A.
AN) PROPOSED DECK NOT CilEETL'iG THE ABOVE CRlTERlA Cin;ST BE REFERRED TO THE
PLI..'{NINC DEPARTMENT. ALSO, ANY DECK ON A LOT WiTH A SUSPECTED BLUFF, OR A~
OTHER LN\JSUA.L CffiCUCiISTA,'<CE ",ruST BE REFERRED TO THE PLI..'<i'fL.NG DEPART[y[L'lT.
Tills CHECKLiST ML:ST BE COMPLETED A.I'ID ll'iCLlJDED u'i THE BUlLDll'IC PER-VUT FILE TO
MAu'il'Al.!'i A RECORD OF THE REVlEW_
r LE~/[P~...I,.T:::"[;EC:',~:,~:-iC~(.D(;<
..
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
/5$L7 61ftfj4S I!!!I.IUIG
USE OF BUILDING ~ _..
PERMIT NO. 01-_ (J~'() Df\ E ISSUED ~ ()iIf-
BUILDER 6Jl;UI'1M PHONE # ~~. 3U~
NOTE: THIS IS N6TA PER~IT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING I tfj:;OR I ~- ';;'~EO V
, PLACE NO CONCRETE UNTIL AsOVE HAS BEEN SIGN-ED
~ I I
SITE ADDRESS
TYPE OF WORK
, FINAL
f~
119-1
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS /CJ '> /7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA~~
::ll!'aNAL .
o SITE IN EC 10 .
COMMENTS:
DATE TIME
SCHEDULED
~-1'oY
/ _, .J .... It.....JlJ"
-~ "~--y
CONTR.
PERMIT NO.
t..{ -"Jl 0
o PLUMBING 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 GASLlNE AIR TST
o
4KSATISFACTORV, PROCEED
o CORRECT N AND PROCEED
o CORREC , ALL FOR REINSPECTION BEFORE COVERING
\
Inspector:
7
5 I FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.
Owner/Contr:
CODE REQUI lMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'''''"'"