HomeMy WebLinkAboutBuilding Permit 03-0346
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
5'10)..
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LEGAL DESCRIPTION (office use only)
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LOT BLOCK ADDITION
OWNER
(Name)
(Address)
BUILDER I
(Name)_ b.ll.. d.,,-M-.
(Contact Name)
~'H"u.
(Address)
91'4.
~..Ia
I. While File
2. Pink City
3. Yellow Applicant
(Phone)
Date Rec' d
3 -~-o"3
I PERMIT NO. (J] -034& I
ZONING (office use)
1(,'j-/
PID;:JCj'- '-IOO-OOd.:-6
(Phone)
(Phone) 9S;J- 9L}-7:!tJl
~/) Ib 0 VL.... JlYI~ (1.1-.
ub.v///", 111/1/ <.:w'/V
TYPE OF WORK
o Misc.
o New Construction
}i!1...ower Level Finish
oDeck
oPorch
oAddition
oRe.Roofing
oRe.Siding
PROJECT COST IV ALUE (excluding land) $ /1/ Wb
DUtility Connection
o Fireplace
DAlteration
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 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo~ ~ro~~ P:f"JI' needed inspecti~ns,
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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
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
.5/100 f!!!
74 ?..
J 5.2
+-0.00
, jJf1ati7lE~ourBuildingp;~~7-~;d
Building Official Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
/ I tv . -z.:::,
.j-. '7-() 7
# $
# $
$
$
# $
# $
$
$
$ I/f.,. z5'
/
I ReceifjJ:o. -I-..:? 'I'f"L
Bv /. .
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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 '~"'I"~''''/ Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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
.
Residential Building Permit Checklist
Ill' 1 BOmL-. Finish or Interior Alteration to Single Family Homes
1M ,~ Date: 3-;)0-03
BY:
Building Petmit ;:
Site Address S-4o 2.
Pill:
D-e,('(;A2
Zonin"; -
$L/~~~,!~cR ~
SubdlV1slOn. r/", / Cl ffI~
Oee({tterd -{ '{ - \.
Legal: L 2. B (
Existing Structure: ~ or NO
CONFORlvIS TO ZONJNG
ORDINANCE
@
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
~
Is the property located within the flood plain?
Refer to Planning
v--
!./'
Does the alteration include any additional kitchens'?
Refer to Planning
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
!./
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
Refer to Planning
~
THIS CHECJa.IST MUST BE: COMPLETED AND INCLUDED IN THE BUlLDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVlEW.
T ,\TP,fPT "TF\ALTCFrCZ.DOC
~RIOR LAKE
INSPECTION RECORD
SITE ADDRESS .-3 +'~ ~. [)e~" F' ,. e. I J d i "
NATURE OF WORK "L ,Fi"J.J It
USE OF BUILDING ~ F .
PERMIT NO. ~ - 034-(P DATE ISSUED 3. 25 -03
CONTRACTOR 1ll' N.~-t:.OA; PHONE-"'~ .."or
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- .
DEPARTMENT OF l\A o;~ FeI
BUILDING AND IN~ I e
INSPECTOR
DATE
~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
#// /a?
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.
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS
51"'0..2
DATE
.2bds"
. . .
d"'t!!~/'/ 0;r
T1III!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
PHONE NO.
CONTR.
PERMIT NO.
a?-...?j/6
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..a.-AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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;(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK';~;/7 REI~PECTlON BEFORE COVERING
Inspector. /~ Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .. SAFETY!
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