HomeMy WebLinkAboutBuilding Permit 04-0265
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
Yellow
File
C'ity
Applicant
I PERMIT NO. oq..... d&S1
(Please type or nrint and sism at bottom)
ADDRESS
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4p~-~ qrY
OWNER ~ 14 Ycd- ~ ~
(Name). '/' /ftIJ. 'it'M
4tuI/flfl:j~d!t ~~
e Ncril (JI/t../
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LEGAL DESCRIPTION (office use only)
LOT /q BLOCK
/ ADDITION
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PID~')-q~ - 0/9-(;
ZONING (office use)
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(Phone) r:1fJ5:~- :1:J.6 -/& r/-6
(Address) , ~ //!LI./
BUILDER
(Company Name)
(Contact Name)
tJ
(Phone)
(Phone)
(Address)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing
DAddition DAlteration DUtility Connection 0 Misc.
CODE: MI.R.C. DI.B,C,
Type of l,"nstruction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding j:3Lower Level Finish
PROJECT COSTlV ALUE $
(excluding land)
o Fireplace
x
I hereby certify thai I have furnished mformation 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 [0 all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the buildmg
otTIcia! can re e th's ermit for JUS use Furthermore, I her ee that t ecity official or a designee may enter upon the property to perform needed mspcclions.
, . ."~ " -;I-/~--tJc,L
Signature
Contractor's License No,
Permit Valuation
Permit Fee
h-c:9t!KJ, 6 d
$ 7<1.75
$
$ /.S-eJ
$
$ I/tJ ~
$
$
$
TOTAL DUE
Park Support Fee
#
#
SAC
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
State Surcharge
Penalty
Plumbing Permit Feejl.vlJfr.
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee ~O
pplication Becomes Your Building Pennit When Approved
- ---
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L/" I/::;-OCI
~
1i1.t~ /01
Paid
Date
~
Buildinl! Otlicial
Date
$ I
$ I
$ I
$ I
$ I
$ I
$ I
$ --I
$ / I tp ~C7-5 I
Receiot No.L-I(~ Ii &;.:-/ I
By ,/' I
~
ThiS IS to certify that the requesl 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 al1ow$ construction to commence Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Special Conditions. if any
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
~~
Date:
+ /s-o?/
Building Permit iF
Site Address
Pill: Zoning:
Legal: L /9
B
/
SUbd!w~L/q ~6~cj2
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Existing strucrure:~r NO
CON"FOR.yIS TO ZONlliG
ORDINAl'fCE
'{ES
NO
TIS
NO
Is r.bis a.""1 expansion of tte ex:i~.....ng footprint or
building heigh!?
Ref:::: to Pl.anr~i.g
I Is the proPer:-f located "iiliin the flood plain?
I Does ,,'le alteration include anyadditionallc!cnens?
Does ,,'te pmposed alte:-ation include any outside
encrmces othe: than patio doors?
Refer to Pla-wing
iJ()
tJ()
t--lu
No
Jo
Refer to Planning
Refer co PlaTh.-ring
Is the pro1Josed use of me fjrTisiled. spac: ar
alt::"'lnoT: for 3.."1.ythi..,g Qc.b.e: man 1 l1oG:.al single
famil~( home (office, grOU? hooe, d2.Y C2.n~, e~G.)?
R~fe:- to Planning
THIS CHECKLIST ;y!1IST BE COMPLETED ..I.l'fD INCLUDED IN nIT BtnLDING PER'II1T Fll.E TO
ylAli'lTA1N A RECORD 01' THE REVIEW.
. -:7\,(;:Jf..!. -:;",..:.! -'~"''';I~'~ ,"":(,(--:
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~ /.J1I.1f .D ~eI' ~, e IJ t:l: ~
NATURE OF WORK L.J;, .
USE OF BUILDlN~~ . . .
PERMIT NO. n, - DATE ISSUED y. I.s-"'~ .
CONTRACTOR ~Y5~~ PHONE>>" -",- 'I'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
V/IP
till( /
(,/ - J. Jroft
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l.+ n-()bl
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT-
7/1/0,/
t /~f(a '/
6/ yfi/
h /Y-PY
.
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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.
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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 piaced near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
S-~~y
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
_~llULATION
~AL
o SITE INSPECTION
COMMENTS:
~:9:~~.o; /
DATE TIME
SCHEDULED ;7~~~
P~dC7
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
./1
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORKSATISFAC~U"I:I:LJ
o CORRECT ACTION AND PROCEED
o CORRECT Wl$VR REINSPECTION BEFORE COVERING
Inspector: r 7"'---- OWner/Con!r:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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