HomeMy WebLinkAboutBuilding Permit 01-0012
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1/+10/
1_ White File I PERMIT N"". r; I
2 Pi" C;'y "'"' 0 _ 00/7
3. Yellow Applicant ~
(Please ~ or print and si2l1 at bottom)
ADDRESS
4-(,5& PIIK-~NOOO
DR.
5.6.
I ZON~G ,office use) I
LEGAL DESCRIPTION (office use only)
LOT V; BLOCK 4- ADDITION
WaOOR.J066 6Sfhlt::.-S.3~ PIDZS- 3{7- 027-0
-..,{ qqk" - e:n~
...-.., _ l;;""~_. I
(Phone) t.l.YO -117lt I
mY\ ~5~~
\k~ }--Cl~?
'(Name) ~ D~
---
(Address) V\(95(o \Al'l. U ~ \)cSb-
BUILDER
(Name)
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck
~ower Level Finish 0 Fireplace
OPorch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
OUtility Connection
o Misc.
3 g.M~.
PROJECT COST/VALUE (exc1udingland) $
I hereby certify that I have furnished 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 r--r~-~J 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;t~_;; tor\~ons
~HA~lf. __
P'
Contractor's License No.
DC
I Permit Fee $ 83.2S I Park Support Fee # $
I Plan Check Fee $ I SAC # $
I State Surcharge $ \.50 I Water Meter Size 5/8"; 1". $
,
I Penalty $ I Pressure Reducer $
I Plumbing Permit Fee $ 4-0.00 I Sewer/Water Connection Fee # $
Mechanical Permit Fee $ I Water Tower Fee # $
Sewer & Water Permit Fee $ I Builder's Deposit $
I Gas Fireplace Permit Fee $ I Other $
I TOTAL DUE ~ /2.'1. 75
~k Your Building Permit When Approved /9.01 $
1- 0"1 - 0 I I Paid IZ,.Ik IS- I ~;cer~ .3105 'f
I BuildijJ{ Official Date I Date I.IO.O!
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 ._...y_......) Certificate of Zoning compliance and allows construction to __u_u_.._.!. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
]..-zg-o /
I, Blue File I PERMIT NO I
2. Gold Ci<y . 01- 00/2-
3. Yellow Applicant
(Please.!,VDe or orint and sim at bottom)
ADDRESS +65 b ,P' /llCK--WOO 0 OR- -5 (:;
ZONING (office use)
U
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(phone)
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
iliijl:-. -
--~ I--.~~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
(Phone)
~'"
Quantity
Type of Fixture
j.
~
1.
Rough-ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Pennit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Building Official
Date
I Paid
I Date
~~~\1
Cl.\.l.
By
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD l1.
SITE ADDRESS 4~C/,., QlLt~J}. O~- ~~
NATURE OF WORK ~'O--.~ "., )L,
USE OF BUILDING _ <;F="D
PERMIT NO. 1)/-0012-- DATE ISSUED 1 - tZ)9- 01 .
CONTRACTOR --PLek- PHONE ifC/O - 87, / ."...
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BE~
THE PERMIT IS BY SEPARATE DOCUMENT '--""
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
A
FRAMING Iq, 3/1/~1
INSULATION dJ. ~/} /{J I
ELECTRICAL
PLUMBING Ifff. ,1/7 /!} /
HEATING (if required) ~ :3/7/0 I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
l I I
" FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
z;)
5/1/ Inl
. .
OCCUpy UNTIL ABOVE
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.
s- /~ /oj
12M 5~?);/
HAS BEEN SIGNED
KI:J.
Call between 8:00 and 9:00A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
'-I {,. 5"' h
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION", ,
-erFlNAL c-.t.. ,
o SITE INSPECTION
COMMENTS:
DATE nME
SCHEDULED ~iJ4J t9:W
() cukt /xyd:l
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
lSLneo,
*'
it;~
i.
o.
i - J::J......,
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
F=1J1Jo/ .
~RK SATISFACTORY, PROCEED
o CORRECT ACTIf'N AND PROCEED
o CORRECT '?f'f', . CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
1-=1