HomeMy WebLinkAboutBuilding Permit 04-1007
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1_ While File
2. !>ink City
3 Yellow Applicant
I PERMIT NO'()Lf_ /()OI71
ZONING (ollice use)
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PID~"-:?9;--03l/J
(Please tuN! or orint and sia at bottom)
ADDRESS
3'S'1S' ~~P:dfY RIo,,'!:. i!J::J,
PRlcJ
LA~f
AI.}
SS371-
LEGAL DESCRIPTION (office use only)
LOT Zo BLOCK t. ADDITION
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OWNER
(Name) ~f-'-
Date Rec' d
(Phone)
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(c'rl_ ') 308, - 8$"</-1
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(Address) "3B1r
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BUll.DER
(Company Name)
(Contact Name)
(Address)
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(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding )8D:.ower Level Finish Jil'Fireplace
DAddition DAlteration DUtility Connection D Misc.
CODE: Or.R.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
r
E
II
F
I
nrrvvA
H r M R
2 3 4 5
/~ DOO
that I have furnished i formation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzcd agent for the
nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
se_ Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
10 - ~- O</-
Signature
Contractor's License No.
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee t?w,ver $
I Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fet::"~, $
,
/#
3~t7. G-O
711" 7.5-
I Park Support Fee
SAC
Water Meter
Size 5/8"; 1";
/,SP
Pressure Reducer
Sewer/Water Connection Fee
#
#
l/~ .--
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
/51o.~
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Date
$
$
$
$
$
$
$
$
$
/5t., ;)...5
This Application Becomes Your Building Pennit When Approved
$~ /t7/d/
Paid
Date
ReceiPt No.l..I 'lq ,y-/
Bv 4'
U
Building Official
r:Tate ~
, ThIS is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proc<.-ed as requested. This document
when signed by the City Planner constitutes a .~......_.~., 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 ..\...Iteration to Single Family Homes
BY~~ Date: j{)- S-Oc(
Pill: 3<:f?~ ~G;onj:?: V;
S,bd""',., fi >>4?..., So~(
Building Pmmt #
Site Address
Legal: L ..;70
B .:z
E.risring Structu;@ NO
COl'U'ORlYIS TO ZO~l:NG
ORDlliAl'{CE
YES
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
Refer to Planning
;1~
;1/0
;1/0
;1Iv
/0
I Is the property located within the flood plain?
Does the alteration include any additional kitchens?
Refer to Planning
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
Is the proposed use of the finished space or
alt=tion for anything other than a normal single
. family home (oalce, ~au'P heme, day care, e~c.)?
Refer to Planning
THIS Cm:CKLlST ,)!1JST BE COM:?LETED .-\..'fl) INCLUDED IN THE BUlLDlNG ?ERMlT FliE TO
)WNT.-\.lN .-\. RECORD 0, THE REv1EW.
i ,"~':'./llJT j, 7'='...\, T -;--:-....;r-( "":Cc::
PRIOR LAKE
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3?7S"" ~~V Itf&,. ~
NATURE OF WORK - ....<'.11.. "~d .L...J.. / ~iI~M
USE OF BUILDING .s r
PERMIT NO. 04: . /00'1 9ATE ISSUED
CONTRACTOR ~~,~ ( '-cSCJ/ht.l."'- PHONE~/~ ~~11)"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
L l
)1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
I
I
I
UNTIL ABOVE
NOTICE
g]
vi.
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/ /
HAS BEEN SIGNED
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS r87C)
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'i;(FINAL
IiJ'SITE INSPECTION
COMMENTS:
DATE
SCHEDULED ~
~~/~
CONTR.
TIME
PERMIT NO.
L/ - (ot) 7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-
~ \),
(l \V ~t, ) "'''-. \ '.
^
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE ~~LL FOR REINSPECTION BEFORE COVERING
-.i ~ ~/ Owner/Contr:
.. ~ FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.,
CODE QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOn