HomeMy WebLinkAboutBuilding Permit 04-0547
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
While
Pink
Yellow
File
City
Applicant
I PERMIT NO. 04-. 05411
/
ZONING (office use)
(Please ~ or print and silitll at bottom)
ADDRESS
/ b 7 ;2'J I/Au.kd
iAJ.
LEGAL DESCRIPTION (office use only)
3ADDITION (I) ~P&-'l1r1v.t
A/ot/idX..
Date Rec' d
to r" 1 -() '-I
~15D
LOT II BLOCK
~vl- PID dS-?3g--CJ~O
OWNER
(Name)
\ ~7c"17 ~
(Phone) CY;;z-;;l~~rt7.3
J hereby certify that I have furnished information on this application which is to tht' best of my knowledge true and COlTeet I also certify that I am the uwner or authonzed agent for the
above menlloned plOperry and that all co trUC!1O ill conform to all eXisting state and local1aws and Will proceed In accOldance with submmcd plans I am aware that the bUlldmg
:fiO"p ~t/1Sl Fun" ".' hmby ""e th" th,oly off""l 0" de",oee m,y ente, upon the pmp'ny to p,,'o,m o";':~~;:~q
./ 17 "'~lgnature Contractor's License No Date
/
Permit Valuation
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing
DAddition DAlteration DUtility Connection 0 Misc.
CODE: ~.R.C. DI.B.C.
Type 0' C~truction: I II III
Occupancy Group: A B E F H
Division: 1 2
DRe.Siding ~ower Level Finish
IV~h-."
dJ~'?SU
PROJECT COST IV ALUE $
(excluding land)
'7000.00
$ 9(. 2-S
$ -
$ Z.OO
$
I
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee!!y n I.LJ,J(! :f-
I Mechanical Permit Fee I $
I Sewer & Water Permit Fee I $
I Gas Fireplace Permit Fee Ai 0 I $
Park Support Fee
#
SAC
#
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
~.oo
TOTALDUEtf'~
0_ 7. 64-
-
This Application Becomes Your Building Permit When Approved
~~
h
I Paid 1:/ I.::J.'.::J.S
I Date. C,/Y-)D<I
I Receipt No. ~h 9 r'l
By .P-r' .
BuildlllgOtlicial
1/7/0'/
, Date
o Fireplace
$
$
$
$
$
$
$
I $
1$12-7.2S
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 .~igned by the City Planner constitutes a temporary CertifIcate of Zoning compliance and allows construction to commence Before occupancy, a CertIfIcate of Occupancy mllst be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Aveoue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
...
4_ .
BY:~
1~ /-' Date:
Building Permit ;;
Site Address
Pill:
I &,"ld-.9 ~rY4ctv {..i-/
Legal: L
B
Subdivision:
Existing scructure@Jr NO
CONFORlvIS TO ZONING
ORDIl'L~~CE
YES
NO
Y1:S
NO
Is this an ex-pansion of the exiSTIng footprwt or
building heigbt?
Refer ~a Pl2.lJIling
I Is the propert"jlocated within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances othe: than patio doors?
Refer to Planning
fJo
N()
No
Refer to Planning
Refer ra Planning
Is the proposed. use or ilie fi.:.-llsn.ed. space or
alter-J.nm: for anything ow.1.a than a i10rnal single
~ .1' ( ~- ,~ '0
rarm y nome ornee, groU"9 nome, ....ay c::rre, ~!c.).
Refer "CO Planring
tJo
,fJo
THIS CRECJa.lST MUST BE COMPLETED ..lu'iD ['iCLUDED IN Till B8lLDIT'iG PERvllT FILE TO
iYWl'!TAIN A RECORD OF THE REVIEW.
~ ,~7,/r~T j,~' j, ~ -,~,:"-=\-,~ -:nc
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I'''~' tulNdstJI' ~
NATURE OF WORK LL
USE OF BUILDING ~F
PERMIT NO. -'> ~- 54? . Di-E ISSUED (P - 7-0" ; ".,.,.
CONTRACTOR~1I5T~ . /UJyJ PHONE~r- /,,,,..,
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 j
II) I I j
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
plUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
;#:4
7//~)~
0//7/or'
7//y'/oy
'7//c(/"1'
SIGNED
-
#?f
~
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.
,
FOR ALL INSPECTIONS (952) 447-9850
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/.bZ29 ~;.d\o/ ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
COMMENTS:
~
/O'.uer
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Tille
c!5</-~~7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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( C-t' O.J t:.
~ORK SATISF~ROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL "7-9850 F0R THE NFl(T INSPEC:TION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS /h.?..z9
V/....~~d,--
OWNER
CONTR.
PHONE NO.
PERMIT NO.
,A(PLUMBING Rl
~MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
~FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS: /
- ~t7r ..,L~e/
DATE TIME
v~..6'y
k
1!7L/ -sL/7
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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A,- S,h {('. /.. /.
#/:..A.r~ G~ J-,.. /4r/"V'.,,~/J.VL-
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6ft~1/'
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
I~~pector: ~ Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/