HomeMy WebLinkAboutBuilding Permit 04-0318
DATE TIME
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CONlR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/~~C'.s
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
/DimE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS'
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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WORK SATISFACTORY, PRocEED
o CORRECT ACTION AND PROCEED
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o CORRECT WO~K, :AL~R REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Oi PR/O",
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Ar'J\'NESO't"
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
"f,2-2-.04-
White
Pink
Yellow
File
City
Applicant
I PERMIT NO'04. 03/81
(Please ~~ or print and sim at bottom)
ADDRESS ,?
/ (p 90~
5/npK.-l/VS
(;./ /t:-
sw
ZONING (office use)
leI
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zS. 308. 03"'.0
~=R /lhrf &fl,;t// ~S'tP1
(Address)
(Phone)
tJ5'/-L/c//J- /,?29~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck o Porch ORe-Roofing ORe-Siding adT ower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc. /"'"
CODE: E'I.R.C. DI.B,C.
Type of &nstntction:
Occupancy Group: A B
Division:
III IV
H I
2 3
A
I hereby certify that 1 have lrnished information on thYa iicalion which is to the best of my knuwledge true and correct I also certify that I am the owner or allthonzt'd agent for the
and co u ion >V'ill ooform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thai the building
m JUS "m;~ I h",by ,,,,eo thot t: nty offici,! m, de"gn" m,y ent" upon the pmpcrty to p"fo,m o"dcd m~2?d ;0.-/
Contractor's License No I~e I
I
E
II
F
I
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
$
$
$
$
$
$
$
$
$ / / (P. Z5"
Permit Valuation 3,000.00
Permit Fee $ 74. '15
Plan Check Fee $
State Surcharge $ /.5'0
Penalty $
Plumbing Permit Fee ~ $ +-0, 0 0
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Builder's Deposit
Other
TOTAL DUE
g::,t:o:wuildmgpe#:~~~ed
Paid
Date
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4-,2-l..()4-"
I,
I Recei))vNo.
By /L-
a
tf-""~(," -/
8uildinu Otlicinl
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 signt'd by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isslled
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
c;? .
BY:~
.
~
Date: i/N-) Y
Building Permit #
Site Address / t 943
Pill:
~
Legal: L
B
E.Iisting Structur~r NO
CONFORJ.vIS TO ZONING
ORDINANCE
Is this an e.."qlansion of the existing footprint or
building height?
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?
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day C:!l'e, etc,)?
~
Zoning:
<).W.
Subdivision:
YES
NO
YES
Refer to Pllllllling
NO
Refer to Planning
~~
t-Ja
No
Refer to Pllllllling
Refer to Pllllllling
tJo
Refer to Pllllllling
yJo
THIS CHEClO..IST MUST BE COMPLETED A.l'lD INCLUDED IN THE BL"1LDING PERl"nT mE TO
MAINTAIN A RECORD OF THE REVIEW.
.
L:\TEvJ:PL"'. TE\Al TCHCZ.DOC
PRIOR LAKE
INSPECTION RECORD
~~ ~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING JI1E
PERMIT NO. f'JtfI-, ATE ISSUED ""-
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
r I
-, I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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/
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FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
INSPECTOR
DATE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I j
FINALS
g)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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BEEN SIGNED
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OCCUpy UNTIL ABOVE HAS
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