HomeMy WebLinkAboutBuilding Permit 04-0067
(Please'!ype or print and sign at bottom)
ADDRESS
+a55
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3, Yellow Applicant
W/ND5(JNq
C/ Ie.. eL-E;
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LEGAL DESCRIPTION (olliee use only)
LOT ZBLOCK 2..- ADDITION W/ND50Nd ON 7716 LAJ:::.6
.
OWNER
(Name)
-~~
~~
(Phone)
(Address)
4oSs. k!'Nf) ~Nr-.
"IE:
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
G t..L<-r-_
(Phone)
(Phone)
o New Construction
~ower Level Finish
ODeek
OPorch
ORe-Roofing
Date Rec' d
I PERMIT NOoL?9'_
0'71
I
J8tFireplace
OAddition
DAlteration
I I
ZONING (office use)
PUSD
PROJECT COSTlY ALUE (excluding land) $
PID Z:::>. G3b_ OO!:::>. 0
Ci~L-l.f..n-l{5l{4
[ ]Re-Siding
[ ]Utility Connection
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certi fy that I am the owner or
authorized agent for th above_men~' n,ed property and that all construction will confonn to all existing state and local laws and will pI JCeed in accordance with
submitted plans. m are t~t Juilding official can revoke this pennit for just cause. Furthermore, I hereby agree that the city dficial or a designee may
;ter upon the y-~y~ erfr-ffi e ;,:reetions -z. Is / t> L{
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
i/O, - I I Water Tower Fee
b//J, - 8'-11 )l(),JJ'~er's Deposit
'I I Other e'-'6eTlU ~ l.-
I TOTAL DUE
, .,r-
/' IV, "'~
_~-/ /~{j'f
$
$
$
$
$
$
$
$
qOOV -
&''7 - d.--S'
d,60
This Application Becomes Your Building Pennit When Approved
I Paid
I Date
Building Official
Date
#
#
#
#
I
I
/.00 ~I
I: /7o,;;J-S I
I Receipt N ( .
Byg---
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 signed by the City Planner constitutes a .......t'v.""') Certificate of Zoning compliance and allows construction to commence. Before occupancy, a eer ificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
"'_n._."__,_____.__ --._._._._-i--"___._._.___...._..~,________._.______._~_
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(qstJ 'N~- '-I Nt
Residential Building Permit Checklist
B,aSjerrt Finish or Interior AlteratiOn, to Single Family Eames
{!/J r+ Date: ,:J ~ /1-() Lj
BY:
Buildinz Permit #A't/T"-/~7 ,p"ID: d Zonm .
~ vT "'"' - ,l/J/"~~ S' 0 ",' /.>i-' g-
Site Address .!./()5 S ~..Am /-:)
Legal: L
B
Subdivision:
E~tingStrucrur~rNo
CONFORLVIS TO ZONING
ORDINAl~CE
G
'1"0
YES
NO
Is this 3.i"1 ex~ansion of the e:v...isring faotpr.u:.t OT
buiiding height?
Refe: ~o Pl2.I'.l..."T....."'1g
Ref::r to Planning
v'"
I 1/ I
Lta~:,;~ ,~,- J
',V/U- 1V<>'r ~ ~
.~.~
......-
I is the pt"oper.y located within the flood plair:)
Does the alteration include any additional kitchens?
Refe: to PlarJling
Does L~e proposed alrerarion include any oc.tside
e::ttr-illces om::r than paco doors?
Refer to Plar.w.:ng
Is the pro1Josed use of the Bris6.ed spac~ or
alte:-:;,ricn far anythi.."1g ou1e:" tb.an 1 nOTInal single
farr.t.il~l home (of:5.c~, g:rou~ bame, day C2.[.e, ,e~c.)?
Refe-: to P:a...~1'J.g
.,.-/
THIS CHECKLlST :VlUST BE COMPLETED ..I.:m INCU"DED IN TRE BG1LDli'iG PERl'lIlT FlL, TO
:VL-UNT..lJi'i A RECORD OF TRE REVIEW.
- '.-::7,..I"",=T .J. -:;".J. - -~...~,~,~ ~.I~,C
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS lit! sS" W,. ~ cl>> Uq,
NATURE OF WORK L /,.. -
USEOFBUILD~N SF' .
PERMIT NO. - .... DATE ISSUED .;J.-/)-04
CONTRACTOR O~Yb"''''''' PHONE till.,. 'Irq';
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTION~ BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
OAT;
,--
I
I I
NTIL ABOVE HAS BEEN SIGHED
ROUGH. INS
'it
\
;../-/1'
FRAMING
INSULATION
ELECTRICAL I
PLUMBING I
HEATING (if required) I
FIREPLACE I
GAS LINE AIR TEST II; tV' t
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNIfD
I I
FINALS
BUjLD1NG
ELECTRICAL
PLUMBING
HEATING
DO NOT
((1~
&f-tL
v
OCCUPY UNTIL ABOVE HAS BEEN SI~NED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in irlspections
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
-----------,._--~-~-~--
------.-----.--~__..u__...
OATE TIlle
CITY OF PRIOR LAKE C:H~.d(
INSPECTION NOTICE SCHEDULED
ADDRESS ~t;" w,w!l~ 0.,1'"
-....l
OWNER CONTR.
PHONE NO. PERMIT NO. ~- OO~
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RJ
j('NSULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
~RK SATISFACTORY, PROCEED
o CORRECT ON AND PROCEED
, ALL FOR REINSPECTION BEFORE COVERING
Inspector: JL Owner/Contr:
CAL: J;-9 ~o F~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~MENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
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