HomeMy WebLinkAboutBuilding Permit 04-0604
m~ PlllO<!'
... '"
/0. .,
~ ~
U '"
""lYNESO,\t>
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5. 2ft;, 04-
White
Pink
Yellow
File
City
Applicanl
I PERMIT NO. 0 t!--. o(po4
Please e or tint and si
ADDRESS
at bottom
LA-J .
LEGAL DESCRIPTION (office use only)
..., .-. \I \' <N /W"\ ',^ \
LOT _l BLOCK 5 ADDITION .J.Sl.A.N,SJ VI fi<AJ r\4/ ~"
ZONING (office use)
1:./50
PIDz.5": /4-3. tJ~(P. ()
OWNER
(Name)
"(Address)
~L.\ LA:
S'l40
(Phone)
kJ
-~~..
I
(Phone) c26J-,lr--ft0r
(Phone) 65/-tl X--(?o-o-
(Address)
TYPE OF WORK 0 New Construction lLFbeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlter~n '\ DUtility Connection D Misc. (?a2.60L.A IS ~ 'S\l'l..J..lC.."\..)ljL
CODE: C8fr.R.C. OLB.C. PROJECT COST/VALUE $ 13, 0Cfj .
Type offo~stmction: I II III IV V A B (excluding land)
Occupancy Gronp: A B E F HIM R S U
Division: 1 2 3 4 5
~
I hereby certify that I have nlrnished informalion on this application which is to the best of my knowledge true and correct. I also certify that I am the owncr or authonzed agcnt for the
above-mentiOned erty and that aU construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
offIcia 0 e thi ermit f JU c~e. Furthermore, I hereby agree that the city official ora designee may enter, upon the property to perform neede mspectio s
r% 1IC>3kA-
Contractor's License No.
Permit Valuation tJOD.oO
Permit Fee $ /03.00
Plan Check Fee $ 4. (" . 'ts-
State Surcharge $ 1... 0 0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & W 3ter Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
#
#
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Mui
This Application Becomes Your Building Permit When Approved
r
~F--
"Zr..
~
Buildll1!!.Otlicial
.5/~J6i
. Date'
$
$
$
$
$
$
$
$
ThiS IS to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and proceed as requested. ThiS document
when signed by the City Planner constitutes a temporal)' Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
b/IT/6'I
1o!/~~ ~t'Os~!:uJ.
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
Tht (-..nIt. of Ih.. L.kt (.ounln
qhite - Building)
anary - I=.ngrneenng
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
J< 15S 6 Y c.,ON5Tf2-
5. 20. 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
157QO 51<YL/Nb
Accepted
Accepted With Corrections
AVE.. N.vJ.
/
Denied
Reviewed By: ~ ~~
Comments: (7....<< r
~~p~---z;z;;:~ ~
,
.
=;: L &..
~
Date:
t
V
f
6 ;/~t/
,
r~'dP
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
~~
".
White - Building
Canary - Engineering
r Pink - PlanmnQ"')
The ("foil" of Ih..I,..... ('ounll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
1/
l..
i L_ .
NAME OF APPLICANT
APPLICATION RECEIVED
/
"y
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'-.'
T V C- .
, \) .
. "
Accepted
./'
Accepted With Corrections
Denied
Reviewed By:~h. g
Comments: U
a.~
Date:
blrf1tif
I
~01J( d... a..o ..sIvnlJn dY\ ~ cL-, ~IJ>_I/IJ ~
bl(~
"
.
/
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
'"
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ls,QO SI'-YLi~ AVE'. tJ,W.
TYPE OF WORK pe;2.cIlu.....~ SHJ(/Jc S'T/lkciU~E.
USE OF BUILDING $", . p. .
PERMIT NO. OtfJ)C:.,()4- DATE ISSUED 5/ Z-8(o'f
BUILDER K"S'~6/.L" &,.15;-. /JJ~. PHONE #f#SI-77S-/3ZZ.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FINAL
r9-il INSPECTOR
I FOOTING t.>'C- UJ 'I [10 .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
DATE
~
FOR ALL INSPECTIONS (952) 447-9850
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED 7- ~.J-olj
S:~ [W
ADDRESS -1 c;7 ~ L)
OWNER
PHONE NO.
PERMIT NO.
t) -l./~ .JC
o FOOTING
o FOUNDATION
o FRAMING
~I SULATlON
INAL
SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT L FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNO"