HomeMy WebLinkAboutBuilding Permit 03-1523
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
;~i~i:' ~:~ I PERMIT NO.t?3-- )S:J....'r1
3. Yellow Applicant ~
(Please tv{l~ or print and sim at bottom)
ADDRESS
/5 3(",0
~Iocaf rZt~de JvJ
I I
ZONING (off",u,,>
1(1
LEGAL DESCRIPTION (ollice use only)
LOTO<~LOCK I ADDITION !I.J~ $oiiI1---
PIW!5'-3 fJ - 0;)3-0
OWNER
(Name) MI<':'I-1I'\t:-L b~N'TR'f
(Phone) "tSZ - '/D3-"17'-17
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
~Lower Level Finish
ODeck
DPorch
o Fireplace
OAddition
ORe-Roofing
DAlteration
ORe-Siding
DUtility Connection
o Misc.
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 local laws and will proceed in accordance with
submitted plans. I am e ~th UlldlOg offiCIal can revoke thIS permit for Just cause Furthermore, I hereby agree that the CIty OffiCIal or a deSIgnee may
enter upon n ded mspectlons
X 1 1/-14-03
Signa Contractor's License No Date
I Permit Valuation 3000,- I Park Support Fee # $ I
I Permit Fee $ I t../;7 ':J I SAC # $ I
I Plan Check Fee $ /, So I Water Meter Size 5/8"; 1 "; $ I
I State Surcharge $ I Pressure Reducer $ I
I Penalty $ I City SAC and WAC # $ I
I Plumbing Permit Fee $ 4/0.- I Water Tower Fee # $ I
I Mechanical Permit Fee $ I Builder's Deposit $ I
\ Sewer & Water Permit Fee $ I Other $ 1-
I Gas Fireplace Permit Fee $ L/f}.- I TOTAL DUE $ /-7 &. d3 I
.r- 'u:7{ a1
This Application Becomes Your Building Permit When Approved I Paid /0 (0 , '.:I'V Receipt No. I
~ ~ -11/-1';1.0'1 I Date Ij-/4--? Bv c.,
t1 -....
Building Official
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
€w~
....'I\'NE.O~"
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please tvpe or mint and sim at bottom)
ADDRESS
i ~L ~::Ii~"' iPERMIT NO. 03 -/5.{3
/5 3 ~ C,
~tJjca -I ~
ZONING (office u,,)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name) Ml~ ~--rR'f
(Phone) 15"L-l(O) - <11'-/ 7
(Address)
. APPLICANT
(Name'
(Phone)
(Address)
(Address)
(City)
(Zip Code)
~::~::::7:;GNATURE '1J1JJktf
I (/
APPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture Quantity I
Bath Tub with or without shower i Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I Other
(Phone)
DATE
/I - 1'1-03
Type of Fixture
I
1
I
I
I
I
I
I
I
I
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 Permit #
~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
:r-
.50 61Jd ~
Building Official
Date
I Paid
I Date
/J~ 1/..}
r
/I-IL/./?
Receipt No.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E" Prior Lake, MN 55372-1714
BY~
U
Residential Building Permit Checklist
Basement Finish or Interior ."-Iteration to Single Family Homes
BY:~ ~ Date: 11-11/-03
Building Permit # Pill:
Site Address /5 5 ~ to ~J /S:3 t 0
Legal: L B Subdivision:
ZODing:
tJd6ct'd ~
Existing struc!Ure~ or NO
CONFORLYIS TO ZONING
ORDINAl'rCE
YES
NO
Is this an expansion of the existing foocprillt or
building height?
YES
Refer to Planning
NO
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?
Refer to Planning
,Jo
r-JO
r<!:l
Refer to Planning
Refer to Planning
tJo
Is the proposed use of the finished space or
alteration for anything other than a norma! single
family home (office, group home, day care, etc.)~
Ref"" to Planning
Nll
THIS CHEClUlST ~IUST BE COMPLETED Ai'ID INCLUDED IN THE BU1LDING PERlvlIT FILE TO
~WNTA.lN A RECORD OF THE REVIEW.
r .\TI''vrur ,TC'IALTCECZ.DOC
PRIOR LAKE
INSPECTION RECORD
I3tJh ('~a + a; v
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
/5.3i. ?
NATURE OF WORK '- L
USE OF BUILDING ...5 r::
PERMIT NO. 03__. ATE I SUED ~~ .",~?
CONTRACTOR PHONE '1'OJ- V 1T
NOTE: THIS IS OT A PERMIT FOR ANY OF HE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
,__ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
-
FRAMING (( f; J - 2. ~ ~
INSULATION
ELECTRICAL I
PLUMBING I
HEATING (if required) I
FIREPLACE I _
GAS LINE AIR TEST XV
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
j/Y(/
J1i/
J't(/
OCCUpy UNTIL ABOVE HAS
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.
].. , ). 'r -1J!:"
BUILDING
ELECTRICAL
PLUMBING
I HEATING
DO NOT
2..- - f--{"' -0{'
l~ j.S"-~
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447.9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
I ~ 3(, ~
{};o ~ Lr{-r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION / L
Ii! FINAL L-.'
'b SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
--- ~-
(/" U O-:;e-- r; 2 ')
'" ~
----- ------
DATE TIME
2--).F...(/5
6....
3 -/~~ ~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~R~~L FOR REINSPECTION BEFORE COVERING
Inspector: V VY Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
uaNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <l SAFETY/