HomeMy WebLinkAboutBuilding Permit 03-0095
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ADDRESS
/4337
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1, White File
2 Pink City
J. Yellow Applicant
Date Rec'd
/- z1-a3
I PERMIT NO. (J5 -()09SI
!y IUJVK-fr7 gC:(5 .t>c.- vLJ .
LEGAL DESCRIPTION (office use only)
LOT 4-BLOCK Z-ADDITION l"7e-r'tl;JOW V IcSk/
OWNER
(Name)
(Address)
ZONING (office use)
KL
PID 2S - 3f# - cXoyj - 0
(Phone)
/1F7 1./
~~;~~R ~~ kfi,~t~a( Mu'&./t,:;
(Contact Name) //'OvtL~ ~/1a"vZ,rc;vt
(Address) c:17- ~ Z-4<'tcl d 44"Aft/./1 A.
TYPE OF WORK
o Misc.
b"/2-Yt!6-8E"f"f
(Phone)
(Phone)
.:> .>.:?a5"
o New Construction
~ .ower Level Finish
TJ ..er?J.
ODeck
ORe-Roofing
ORe-Siding
OUtility 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 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
;t~~rmneededinSpeCtions. dari30Q ~c?? -OJ
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
$
$
$
$
$
$
$
$
I. 7/1JO~ $ /1 (p. 2-S
I Receipt No.J/~' kl)
By ~~
OPorch
o Fireplace
OAddition
OAlteration
PROJECTCOST/YALUE (exc1udingland) $
~IJ.;ll<.llUII.;;
Contractor's License No.
.--,
~
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
000.00
74. J7E:
Water Meter
Size 5/8"; 1";
/.SO
Pressure Reducer
#
City SAC and WAC
Water Tower Fee
4-0. 00
#
Builder's Deposit
Other
comes Your Building Permit When Approved
I.;'~();J
TOTAL DUE t'~
. .~./
Paid /71 /1 w / <T.7
Date" '1-:2 X'-3
Buildi g Official
Date
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 proceed as requested. This document
~~:/i!l1' cQ!Estimtes a temporary C'rtifi'a;'~~;:~O;lim" md allows 'Q:O:; 'oZ':::" o;::~~ a c:::~~a;ustb'
pranning 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
FEB-03-2003 16:02
CITY OF PRIOR LAKE
9524474245
P.03
CITY OF PRIOR LAKE PLUMBING PERM!' W ~ ~ ~ H~ ~I
W FEB Oil 2003 J
LOT
LEGAL DESCRIPTION (o!l;c< os< only)
ADDITION
BLOCK
\4'-. ,,--,
RrnnK m,.l'f"
, Din !',I.
t Qohl Ci,y
J y,11o)v,. ....".i~"1
I PEF:m~ "-I
(1.:5 -0 09'S 1
(lIlell~ tvue or Drm[ lJ\dsi~ ltbDttom)
ADDRESS
/4-337 LJ/Z.--(}l)Kfl67c:-& IS G.- v'D ,
OWNER
(Name)
(Address)
I APPUCAL,,-
I (Name)
I
(Address)
\1"" K\p;r-
\ \\ Or) Lh\c"
(A~s)
(Contact Person) ~ IY\
I APPUCANT SIGNATURE ~ II /.._J-~_
,
I
I
I
I
I
I
I
l
Quantity
Y..
'X.
v.
PI IJiY\b o.J
Au f''\
ZONING (oJO;<< ",,'
PIO
(Phone)
R\url
(pho"e) -(Cj~) 7q? - ir:Klf
\< \C.G~-Ir,t'\ 'Cl::4A.\ ",,',,'-1 3 I
(City)\J' (Zip Code)
(Phone) J Cl"/\d.S..::l ~ R if1)?
'- -
DATE 2J.dr-:").
APPLICANT PLEASE COMPLETE BELOW
Type of l<hture
Bath Tub WiTh or witnoul shower
Disnwasner
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compartment sink
Shower Stall
Sinks
Bar Sink
I Water Closet (Toilet)
Quantity
I Type of Fixture
I Rough.ins
Water Heater
Water Softner
Stand Pipe (Washing MaChine)
Sewase Ejector
I Backllow Assembly
I Backtlow Assembly Test
I. Lawn Sprinkler
! Ollier
FEE SCHEDULE
Industrial, Coml'l",en:inl & Multi-family 1% ofjnb cost with a $39.50 l'J'\i..,imum Residcntia), 'New On~ &. Two-Family $99.50
Resid;:ntja~. Adaition5 &. AUerahOT'lS S39.50
E.tim.tedCos! $ BuildingPermil# 03-009.5" PAl f)
PLUMBING PERMIT FEE $ \ / ev 'L.~
STATE SURCHARGE $ V .50
TOTAL PERMIT FEE $ /" " .
(omC't: I.Jn Ollly) '"
Thi, Applka'Od come. Yo..r BuildinK Perlllit When Approved I p~ ~ipt No. /J /if I
~I g om,,;., 2 - ~t. -05 I Oz - (" -0 >' _.!::..:L-t f (./#1
N hour ....i., for allln'peet;... ('S~) 4479850, fox ('52) ..7-42.( }J /. "\
16200 E'Cle Creek Avo., S.t., Pri.r Lake, MN 55372.\71. L--/
TOTRL P.03
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: /111/4 fL' Date: 1-). 7
Building Permit #
Site Address
Pill:
Zoning:
Legal: L
L(
Subdivision:
(tJ t'<<che-v I/i ~ l1/
2..
B
Existing Structure: @r NO
~--.........
~
CONFORlv!S TO ZONING
ORDINA1~CE
Is this an e:'tpansion of the existing footprint or
building height?
YES
Refer to Planning
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
enlI1lIlces other than patio doors?
Refer to Planning
Refer to Planning
Refer to Planning
Is the proposed use of the finished space or
alteration for anything other than a normal single
famiiy home (office, group home, day c:u-e, etc.)?
Refer to Planning
NO
NO
~
~
~
~
~
Tms CHECKLIST MUST BE COMPLETED ..\.ND INCLUDED IN THE BUILDrNG PER1vIIT mE TO
i'iWNTAIN A RECORD OF THE REVIEW.
.
L:lTEMPLA. TE\AL TCECK.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~ J, ~".,." BI",cJ .
NATURE OF WORK L.'. rir;'~;;
USE OF BUILDING~F. ..
PERMIT NO. - DATE ISSUED ,- Z ~
CONTRACTOR I.,s PHONE~'l. · ~",
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
l- I J
I I J
PLACE NO CONCRETE UNTil ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING fA. 1 / (' ~r tnJI1.4
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
7U-
2-/ IP-> tD.~
~
~/ i ~ /0'<.
."- -.- --
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
~ff/)
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
DATE TIME
..-?/~S-'
/L/S-? 7 g~c)cJJ-/?t~Fe 4%/
SCHEDULED
CllY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
a?-7>S-
o FOOTING 0 PLUMBING RI 0 EXlGRADIFILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~NAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL ~D ,
COMMENTS:~(,'- ~~<.I //):?e i\ L
?;c;/~er/ /-;1.9/ cLL-L-
/2~4
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.-----
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( (//()J~
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gRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO EINSPECTION BEFORE COVERING
Inspector:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1_0"
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