HomeMy WebLinkAboutBuilding Permit 15. 0026 5 0 0 n 000000 v 0 a 20
n 0 e 0 0 0 . 0 13
gzu) 00 Z m �0 SC/
O r q XI X 7 3 - rr■ s � z ■ ■ -I -a
m m m ■ § o ■ ■
§ t 2 §oqo P �§
t. ■ . k § / cn xi
j k
\ o > > o m m
m
§ r 0
-n 'V
% 2 § § 000000
X § m m E -00 * R -oo
% \ E ? m o o % . ■ dx . m 0 ak) C
2 m m tft § F > 0000 3 Z '
§ g o 0 r-n O O ,, q �' o
z r
§ z F. m r 'V -0 P §
X
X XIm
2 o fl A
m . x0000 •.
§ t §
,_ % Cnrnm� 0 V
\ z § 002
§ - a r
z 2
a
t -
. -Ir o
(4--
PR1p,P • CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd 'TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ! _ 7 /6—
r.)
r x AND UTILITY CONNECTION PERMIT
U Isj
��NNE50�P I. white File
2. Pink City PERMIT NO. /5 L
3 Yellow Applicant I
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
,gn i 7. f/ ' A Id
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 'ZS ,.302, . 67;7
0
OWNER / �, SSS>
(Name) SCC / /40(11 �/td sOe (Phone) 9 --.7. - 1 / 3
(Address) v2 5-7 60.66-stT 'Fre:m 1 A) . t4).
BUILDER i t � T'1 " 3 f�l �S'3cf
(Company Name) 1—VOci �ok ''tS AC ' (Phone) el/?- 3 Af
(Contact Name) 27)--e '`t H i tS Ke-e75 la (Phone) tp/,- 3 C? 6 8-39
(Address) 4//q 7 Le c:)e,- /3./Lt _ST ett.k.x9e �4Li< 5-s--3 7 E
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing ['Re-Siding ower Level Finish ❑Fireplaces
['Addition ❑Alteration ❑Utility Connection 4- S N'0/ • P .
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
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-me oned 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 c evoke this permit for just cause. Fut • I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X r /' � /2/e9/3 ,/5--
Sil. ature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ G-7 2. SAC # $
Plan Check Fee $ �__ Water Meter Size 5/8"; 1"; $
State Surcharge $ sU 0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ ✓L',-! ' Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE / $
22 /� ..
This Application Becomes Your Building Permit When Approved Paid /1,j�1K R-, -ipt No. ,4,c,
Date /,. /S,: /l 1 .
Building Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina e 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
4646 Dakota Street Prior Lake,MN 55372
PRIp Date Rec'd
Eir CITY OF PRIOR LAKE PLUMBING PERMIT z o is-
are
l" d it
2.Gold City PERMIT NOS/''
7-72:47
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
a S 61 ° k\-- � � � L
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICATp
(Name) CAZ-E Nva L‘3,0 % C (Phone) CA
(Address) —1 te.(c) k' \\ '��.£N/ l 6—
(Address)
(Address) (City) (Zip Code)
(Contact Person) I O N (Phone) Q‘5 szAtts Cl
APPLICANT SIGNATURE c � �\ , DATE ( `��- 1 C
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity _ Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit# i ne lviinnesota Statures 9 5Zbi.i,14b
"SURCHARGE"has been extended
PLUMBING PERMIT FEE $ The minimum surcharge for a
STATE SURCHARGE $ "fixed fee" permit is $5,00
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ' • eipt R
AA 1 I. i
Date 111111 ,
Buildine Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 a/ /
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
•
PRIOR LAKc DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 2-057 W00
NATURE OF WORT-77. Wtir- 1.--t1/61---
USE
OF BUILDING /2,�3‘471 . —
PERMIT NO. /5. Z(o DATE ISSUED • 1. /3_ t''"--_
CONTRACTOR a pq� 16^ K PHONE Ga iz . 361. CFI,
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
1=611,111191.11111
I)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING f5j i/ Jg- -"
INSULATION
ELECTRICAL —
PLUMBING Vi 5vc.-
HEATING 1J —
F
lgifiLi.... _
I1111111R __
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
HiliginiiMilli IIIIIIIIIIMaiI
FINALS
BUILDING �.i —
ELECTRICAL
PLUMBING- —
HEAT —
DO NOT 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