HomeMy WebLinkAboutBuilding Permit 01-0305
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
lj- /J.-() I
1. While File
2. Pink City
). Yellow Applicant
I PERMIT NO. QI-b30S I
I ~NU13fficeu,,) I
(Please !VP~ or Drint and sil!D at bottom)
ADDRESS
,)~~ {9"trlo()k Dr~/~ r E.
LEGA~J 9.ESCRIPTION (office use only)
LOT/'BLOCK ( ADDITION/lfi~d
A J ~JL S7E
?/
V
PIOd5 '-"33S-()J4-~
OWNER -.-J. r::- C I I
(Name) I "'-,....~ r. e."'If.o1"'t5
(Phone) .3,,).,.- 'f'f7-Hol
(Address)
s. '" <.
BUILDER
(Name)
~{!
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck
~ower Level Finish 0 Fireplace
OPorch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
OUtility Connection
. 0 Misc.
PROJECT COST/VALUE (exc1udingland) $ jcJ1Jd>t>.
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 loca11aws 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
~ter~erfJ:n/t~ ,., j l2bo\
Signature ~ Contractor's License No. ~Date
3~.~
I Permit Fee 1$ 71.7"1 I Park Support Fee # $
I Plan Check Fee 1$ I I SAC # $
I State Surcharge $ !.~ I Water Meter Size 5/8"; I". $
,
I Penalty $ I Pressure Reducer $
I Plumbing Permit Fee $ 4-0.00 I Sewer/Water Connection Fee # $
I Mechanical Permit Fee $ I Water Tower Fee # $
I Sewer & Water Permit Fee $ I Builder's Deposit $
I Gas Fireplace Permit Fee $ lather ~ $ /. ao
1/ lit;. 25
me, Your Buildin~it When Approved I TOTAL DUE -I--j? ~d7 $
- rl.. .2:.0/ ' A
I Paid /rJ. ~~ 1~~~37.S/rJ
BuildillOfficial Dare , I Date ~-/PI-o I
This is to certify that the request in the above application and accompanying documc;"nts 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 notiee fnr all in'pectinn, (952) 447-98S0, fax (952) 447-4245
.
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
Date: c( /2 - 2::>0/
By:(j;)jJ
Building Permit # ".' ~
Site Address ~V' Oft-<<-J
Legal: L4 B ~
Existing structure:~r NO
CONFORJ."VIS TO ZONING
ORDINANCE
,
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
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
Zoning:
SUbdivision:~~
&
NO
YES
Refer to Planning
NO
:><
Refer to Planning
K
>::;
J>L-
Refer to Planning
Refer to Planning
Refer to Planning
x
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PEAAIIT mE TO
MAINTAIN A RECORD OF THE REVIEW.
.
LlTEMPLA TE\AL TCHCK.DOC
.'
PRIOR LAKE DEPARTMENT OF
.' BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~ ~l:)(o Q~ (1 t'.
NATURE OF WORK Le......u- L..~ ~~..J::" ~
USE OF BUILDING :;JF.D
PERMIT NO. . ()J~0305 DATE ISSUED 'l.(-(?.~(
CONTRACTOR (~~~ 't62- <'(<{'l- 8e(j (
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
...
I
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
..~ V O~
~O~
'K\)~
1>U(
,
s) ~\'tl'
IA.
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
--
1.{
I-l
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
" FINALS
)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
;)J;
I
I
/ I
~/zr/GS
~7
OCCUPY UNTIL. ABOVE HAS
NOTICE
This card must be posted near an electrical ~lU'Vicft 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.
'-.
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
,~
nME
ADDRESS S55~ Ou.v /OaC
OWNER
CONTR.
PHONE NO.
PERMIT NO.
01-0 ?l'Ic;
[J FOOTING
[J FOUNDATION
[J FRAMING
o INSULATION
[J FINAL
o SITE INSPECTION
[J PLUMBING RI
o MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAOIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
[J
COMMENTS:
O(~ ~~Q
/'
/WORK SATISFACTORY. PROCEED
o CORRECT irlON AND PROCEED
o CORR CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr.
C L 447 ~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO';/e ~UlREME/V1S ARE FOR YOUR PERSONAL HEALTH" SAFETYI
~ ~TJ