HomeMy WebLinkAboutBuilding Permit 00-0842
nA TF RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
r. /9'O()
Permit No. (J O. 0 a~z-
Cl rc..k.
BUilDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PE~MIT ISI SUED (Please Print or Type and sign at bottom)
3. LEGAL DESCRIPTION
)"z,
12. NO. OF STORIES
LOT
BLOCK
I
'/l1.- ,e,( 0
PID
25-335-012-- ()
5771
13. TYPE OF CONSTRUCTION
(Name)
5~
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(AdClress)
(Tel. No.)
6. BUILDER
(Name)
oW /I e.e....
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Fireplace [j
Alterations [j
Septic [j Deck [j Re.roofing [j Porch [j
Addition [j Finish Attic [j Re.siding [j Finish Basement [j
BR777/t!.OOI'1
9. PROPERTY DIMENSIONS 10. CULVERT SIZE
SEATS
16. PROJECTCOSTNALUE
Chimney [j Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
17. COMPLETION DATE
Width
Depth
Yes
No
I hereby certify that I have fumished 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
buildin official can revok this permit for just use. Fu hermore, I hereby agree that the city official or a designee may enter upon the property to perto ne d i actions.
X
UcenseNo.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA [j
PILING LOGS 0 PERCOLATION TESTS [j
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
e6S 1'9/.e.
/
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
',000
PLOT PLAN
Ll
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
3 c/o I~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
.~o
#.rrO
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid
-le5. ZS
e-f3f.-
Certifi
Issued
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 pr 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.
City Planner
Date
Special Condilions ff any
24 hour notice for all inspections (952) 447-9850
Thr ("rntrr of thr Lakr Count!')
Applicant:
Address:
Signature:
Legal Description: Lot I z.- Block I Sub
Site Address: 554-{) OIle/e..t-Ot'Jy trl IlL
Building Permit # tJ 0.0 '042-. PID#?~'3~ - ()n-l)
NOTE: This permit will not be processed without complete information.
CITY OF PRIOR LAKE
PLUMBIN.G PERMIT PPNo. OO-OBn...-
~ 0 ~0-4, zu.)ewL Phone: 447-2-/(, (,
654-0 Or/~u;o~ ('AL
1. Blue
2. Gold
3. Yellow
File
City
Applicant
FIXTURE UNITS
Quantity Type of Fixture Quantity Type of Fixture
I Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
I Lavatory (bathroom sink) Stand Pipe (washing machine)
Laundry Tray (1 or 2 compartment sink) Sewage Ejector
Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet (toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
:?1.~-V
$~n
$
$
$ .50
GRAND TOTAL
$ qO. on
r PAID WITH
8Ull..D1NG PERMIT
\
This permit is granted upon the express condition that said
contractor. shall compJ i II espects with the ordinances
of the State Plumbin e amendments thereof.
"'19. ()(/ DATE
ATIEST
Call for all in ections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS S5Ao O\J6ll.u:?D 1<. C; i2- S'. E:--
NATURE OF WORK FIN~ ~1;t-lil~",- '6f'..D ~
USE OF BUILDING _ H
PERMIT NO. c)o - 912.- DATE ISSUED '\ I Ft IC> 0
CONTRACTOR J C> \. c..€- 'SCrVW z6N Mc-H
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
....... I
_II
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
~,/I,(1fJj
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~ I I
FINALS
BUiLDING
~TRICAl
PLUMBING
HEATING
DO NOT
,
:5
fI(~fi.."
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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.
Call between 8:00 and 9:00 A..M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
6S7'o
CJU 67LL<JCJ f<
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING @)
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
>ii'
DATE TIME
.3/1 Z/M II, C) c
L/.2-.
Cl1 ~ (")? ';/~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSlVOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/