HomeMy WebLinkAboutBuilding Permit 01-0499
CITY OF P LAKE BUILDING PERMIT,
TEMPO CERTIFI TE OF ZONING COMPLIANCE
AND UTILITY CO NECTION PERMIT
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~!VDeOrOIintandsi at bottom)
DRESS
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,
Date Rec' d
1. White File
2. Pink City
J. Yellow Applicant
0/ -() 4f!1J
ZONING (ollice use)
t<150
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LEGAL DESCRIPTION (office use only)
LOT I BLOCK 3 ADDITION WfWFEJJ/;.$ P()Nn~ 2@
OWNER
(Name)
(Address)
PID 2S-~ - 01,0-0
(Phone)
~~,ER L- SII ,e'WHJ,4,/ ~(H/'~;-r
(Contact Name)
(Address)
~E OF WORK
o New Construction
o Misc.
~ower Level Finish
PROJECTCOST/VALUE (excluding land) $
(Phone) ---M-7 - 0077
(Phone)
ODed
OPorch
OAddition
ORe-Roofing
ORe-Siding
pt(fireplace
OAlleIlltion
OUtility Connection
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
;rerupon~~<~inspectiOnS_ ~z4 ZL%'/
~ Contractor's License No. _
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I SmreSuoch~ge $
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $ q 0 . {} ()
./'I /)
r ~?2' ,,. .Y7s Your Building Permit When Approved
Lf6 - (/1r:f S:-2-'./-?~
Bu' ~cia1 Dare
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2 ~C)d
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I P~k Support Fee # $
I SAC # $
IWaterMeter Size 5/8"; 1"; $
I Pressure Reducer $
I Sewer /W ater Connection Fee # $
I WarerTowerFee # $
I Builder's Deposit $
I Other $
I TOTALDUE ~ S:W-O/ $ /t;,'1. 25
I Receirl~ .3'1,,70
Bv /Jf!Jf~
I
I Paid
I Date
/t, '1. z,~
F ~/ '" I
,~ j 4:;..
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
J~n-li-Ol 05:38pm From-WAUSAU
F-711
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U!OAL DESCJli '1l0N C.............." l .J
LOT / BLOd; 3 ADDmON U}~ PU71 ~ 9- ,.J-"~'I1J:;S - ;?3? -ocrD-O
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(PbImI!) .
. Al'PIlCANT
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(PhoIlc)
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[ZIp CaUl
(Caaact Pmgn)
(Pbc:nIc:)
= OATE
AlTUCANT pI "ASE COMPLETE BELOW
pW CON511tUC"nON ClIEPUCRMENT 0 Al.TERAll0NS
FURNACB M-U(AND MODEL FUEl. AlA-I. C~
FLUESIZI! _,5'" UTtlPOPBNINGS R' DIPUT:?2 000 OUlPUT A.J.:.a.
, TYP! OF ...It....~ ~TlNG 01. POW!a PLANT
. C1Wum. Air ,....11 0 SIIlIIII
3r~dmUD' ~5.~~...
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JlIQPiACE~ ~ANDMODBL .J.k...l-il..A-oc: 6C~5;-I-:() R. f:
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pr ....C1l' ,d,'.. ;I. I~:
APPUCANT 51' iNA.nnu;:
Air CcI8IIIIiIlIlG' thIiD
c-c...U 1'" ill..
R&quind Side Ywd
~
nl S.. ~~I..I J1.I
l~afjal""ll 1laicIcnIaI.O'r......
539.50 lIIi11lll\1llll
aOSl~ Had" &ItIC (I\J- Col\llrllQilllll DUO
llcori~""ll". K_.. Onl)' (\'I... ~etlo1I) 564 SO
60::.
isa-4 Cost S .-'2.oQ-) -
Ind.Slliol. Comm.,. iol ~ .....lli-'IIIlII~
~aI, Adcli""". & AIIInliIlllI
Il&:sidcIIllaI,ACClIIlY
SlUG
SlUO
S31l.SO
8liilding hnDit /I
HEATING PDMlT PEl S
STAn StmCHA&GE S
TOTAL PJUIlT BE $
_sit
BUl PAID WITH
...... 'LDING PER~r'.
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Residential Building Permit Checklist
();) _ Basement Finish or Interior Alteration to Single Family Homes
Bi! f7 { Date: 5~ z4 -0/
,
Building Petmit #
Site Address
PID: 25-338. 02.0~OZoning: Ie/SO
Legal: L
1
.3
Subdivision: tvlWG"Rtt/6SS' P()I\lDS" 2"'~
B
Existing Structure: @>r NO
CONFORlvIS TO ZONING
ORDINA1~CE
YES
Is this an expansion of the existing footprint or
building height?
YES
Refer to Plarrnmg
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 Plarrnmg
Refer to Plarrnmg
Refer to Plarrnmg
Is the proposed use of the finished space or
alteration for anything other than a nonnal single
family home (office, group home, day care, etc.)?
Refer to Plarrnmg
NO
NO
;(
x
)(
x
I-
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERl....lIT mE TO
i'tlAlNTAIN A RECORD OF THE REVlEW.
.
L:lTElvlPLA TE\Al TCHC<.DOC
B5/24/2BB1 14:32 612-447-BB77
1-Ei'+EN a:N;TRtx:TION
PAGE B1
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
. .
SITE ADDRESS SOle> W"~'TI7'~ Cd-.
NATURE OF WORK t",':II..Je,J- l \-7-v-~ ~
USE OF BUILDING :3 'F n
PERMIT NO. Qj- o4-qq DATE ISSUED '5'-'2 c.(--za:,/
CONTRACTOR L" f-4.. ."- PHONE t./'I7-t?o"'"?)
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT .
"
INSPECTOR
DATE
,..... I ~
I I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
\
W>\ ".A_J /V
. rJ, ./. S
1 J'l" ~~ J~J \)\
JI ~yr,~ )lj \l \ .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
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 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.
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS (952) 447-9850