HomeMy WebLinkAboutBuilding Permit 04-0092
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. White File I PERMIT NO 0-'"")1
; ~;;'~w ;;:;';li"", - '0'1-00 7 0'1-
35(Yj
(Please typ~ or print and silW at bottom)
ADDRESS ZONING (office",,)
Fo X feu / T r--.
LEGAL DESCRIPTION (office use only)
LOTI () BLOCK d- ADDITION W ibivJ.A1/u~ /5-f-.
OWNER
(Name)
~epf/eN
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
RI
PlD .;<5' ?7t. ^ 0/4"-,0
7 ;(e- D AM I GIC.
I
(Phone)
q >z..-Y'~o - 3.6z.~
(Phone)
(Phone)
o New Construction
ODeck
DPorch
ORe-Roofing
DMisc.
/.R..~
~wer Level Finish
~.
PROJECT COST IV ALUE (excluding land) $
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 local1aws 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
;terupo~~~n~a.~n~ ' -z-I-z- $ / ~ if
~ ' Signature / Contractor's License No. Date
<#:3000, t!J 0
$ 7Lf. 7'5
$
$
$
$ I..!O -
$
$
$ J-{O.--
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee o IP/V e..i--
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
I
Gas Fireplace Permit Fe(Jop(+-.
o Fireplace
OAddition
DAlteration
Park Support Fee
#
SAC
#
/,50
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
vi e.c....
#
#
z::;Jec~uilding~~;;;Ved
Building OfficiiI I Date
I Paid
I Date
- --
1'0 '/ '(/./
:)- d-7~ c.-r
Receipt No. t../ 5 i 7-1
By J'
ORe-Siding
DUtility Connection
$
$
$
$
$
$
$
$
$
I,()Q
15'1-'/5
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 temporary 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
Basement Finish or Interior Alteration to Single Family Bomes
BY:~~
Building Permit if
Site Address
Pill:
Legal: L I tJ B d-
Existing Strllctur@or NO
CONFORJ.v!S TO ZONING
ORDINA1'fCE
Is this an expansion of the existing footprint or
building height?
I Is the property located within the flood plain?
I Does the alteration include any additional kitchens?
Does the proposed alteration include any outside
entrances other than patio doors?
Is the proposed use of the finished space or
altention for anytbng other than a nonna! single
family home (offic" groun home, day care, e:c.)?
Date: d- 025-01
Zoning:
350'f'- 1-0)( 1-c::k1 -JA.
Subdivision: ~ _. . ;.f't-
YES
NO
YES
Refe: to Planning
NO
Refe: to Planning
/...Ill
r-J6
rJc)
Refer to Planning
Refer to Planning
,J~
Refe: to Planning
tJ()
THIS CHECKLIST MUST BE COIl-IPLETED ..>..zm fNCLUDED IN THE BU1LD[NG PERMlT FILE TO
iYL-IlNT.-VN A RECORD OF THE REVIEW.
r '\~~/rPr ~ T:=\A.LTr:HC-c.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS .3 so 9 Eo)( f(J. ; I TV'
NATURE OF WORK J- L
USE OF BUILDING j F D
PERMIT NO. 0 II .;l. DATE ISSUED ;1." S". V
CONTRACTORS~.~ Tr~I'.~V PHONE 1/'<<1' !It.~'
NOTE: THIS IS Ne:rrA PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I I
PLACE NO CONCRE E UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING firE!> I 5-7/
INSULATION I I
ELECTRICAL I I
PLUMBING I I
HEATING (if required) I '~
FIREPLACE ~.
GAS LINE AIR TEST ~ v-}
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
,1
ff;r--
. -
cJ-//c.f /05'
- .
~ " c}//'I/oS
I I3:v rl//<I105'
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 cabinetls available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
DATE Tille
CITY OF PRIOR LAKE ;frfts 5:40
INSPECTION NOTICE SCHEDULED
ADDRESS ,..g,)O 9 ~nk1
OWNER CONTR.
PHONE NO. PERMIT NO. t) r{ -9z.-.
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNDATION D MECH RI D COMPLAINT
D FRAMING o WATER HOOKUP o FIREPLACE RJ
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: L,e. F;;V'f/:..S'
/I
fy~
...-/) ,..
~
'flwoRK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR ;"CALL FOR REINSPECTION BEFORE COVERING
{.?-
Inspector: ,~ Owner/Contr.
CALL 447-9850 ;~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/ItSNOTJ