HomeMy WebLinkAboutBuilding Permit 13. 0319 J
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OI PR!0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE T:(q(,/ 3
AND UTILITY CONNECTION PERMIT
y'A Jyggol" 1. white File PERMIT NO. /3. 3
2. Pink City19
3 Yellow Applicant
(Please type or print and sign at bottom)
,AliPPRZO ZONING(office use)
/C. i tag eir,'q terve �E
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
ER '
OWNS ,-Mrd (e`nt41 6/.z ,q 3 7- /7)
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ❑Re-Roofing ORe-Siding ower Level Finish 0 Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: DI.R.C. DI.B.C. 0 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-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 ust cause Fu therm ,I hereby agree that the city official or a designee may enter upon the property to perform needed mspec ons.
Contractor's License No. wa'i
Permit Valuation 3, 000 , 06 Park Support Fee # $
Permit Fee $ 74/ 7S- SAC # $
Plan Check Fee $ — Water Meter Size 5/8"; 1"; $
State Surcharge $ (� ? Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ / , Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ -- TOTAL DUE
This Application Becomes Your Building Permit When Approved Paid 7(e_ (" ipt No.6a 6 Z
Date '
Building Official 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
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 /-57-
4646
s f4646 Dakota Street Prior Lake,MN 55372 _p g-_�sr
01 pRi00 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT /3
4r ote
I.Blue File
2.Geld Airy 2 PERMIT NO. Z_(y
•
7
3.Yellow Applicant V
or riot and sign at bottom)
ADDRESS ZONING(office use)
/
431 o U ('I Ue.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION pID
OWNER
Cek(Name) OL iGsvt e._,1 (Phon4 � 3() - / _,
� �
(Address) /4 3(0 (i r� 1-49 tic ct
APPLIeCANT `4/e S p/v4(4)- (Phone) 2 "�•0
7P
(address)) /0 5z( 11„ L -
(Address)
L(Address) (City) (Zip Code)
Contact Person) J U 7 / (Phone)
LICANT SIGNATURE u. DATE
r
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#
PLUMBING PERMIT FEE $ (6'.l
STATE SURCHARGE $
TOTAL PERMIT FEE $ Arele
(Office Use Only)
This Application Becomes Your Building Permit When Approved Receipt No. 6 p55,4_
T
it a1 Date Da L:\i I3 By \�
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /t310 VterOAM &AVE _
NATURE OF WORK i
USE OF BUILDI 1116
PERMIT NO. DATE ISSUED
CONTRACTOR at /4$i/ PHONE 12. z ribl 7
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL was
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
M111.111111111111111
FRAMING U
INSULATION i
7gX/64 417'
ELECTRICAL /
PLUMBING .;11,�
HEATING /r� ; ✓ /
111111111111111
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
LATH
FINALS
111111111111111.1.11.1110)
BUILDING �,..ti,c� 30 1/�
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspection*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