HomeMy WebLinkAboutBuilding Permit 15. 687 0J
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of PR4�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE-
AND
OMPLIANCE-AND UTILITY CONNECTION PERMIT • ��ls
4"/NNESY'P
I. White File G
2. Pink City PERMIT NO. `5v ,C�
7 .
3 Yellow Applicant
(Please type or print and sign at bottom)
�)ADDRESSLori �j � ZONING(office use)
\Lii b L s t' ?S'�.r L y� , �/y�•� k&c:0
&PI9l it V
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID _. ((7 0/ea. 0
OWNER
(Name) So-
r% at- A n,., rvl(..41%:c st v... (Phone) 612- 3?-7 - 8'16
(Address) l 4 ilCI V Lar; Re, 5E. P f:fir L4 Vt-e.
BUILDER (
(Company Name) jj Wil`-� a,...s a..a gins Cvfori. fie.w•ole,iL(,t- (Phone) Gs!- IL "6 7? 3
(Contact Name) .,o c G.)'tk t Ci w► 3 (Phone) 61? - D ll7 ")4C, 3
(Address) i 731 Do.^.- c-,-, Cf. /I'D P 1` x+11 7sil 4 S-P '1
TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
Ig4ddition ['Alteration ['Utility Connection
CODE: R.C. ❑I.B.C. ID Misc.
Type of onstruction: I II III IV V A B
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ /S� I/Cia
(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 proper 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 th rmit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform necde rasp•ctions
Signature Contractor's License No. Date
Permit Valuation s'QQQ . Park Support Fee # $
Permit Fee $ / /7-
/ /l. —7> SAC # $
Plan Check Fee $ -/c0 •5-� Water Meter Size 5/8"; 1"; $
State Surcharge $ 7c0 .5-÷..
Z . s-40 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ a Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $ y/
Gas Fireplace Permit Fee $ TOTAL DUE As— $ A 4'11
L6 / OYGLS Z/ .
This Application Becomes Your Building Permit When Approved Paid e0_4-'7 Receipt No. 3? `
Date .1. . (S By j.+,t-..,/
49-tt�tG/�..,0 7/C !3—'
Building Official I ate
This is to certify tat the re,is; in e bove application and accompanying docu ents.s in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed b e City P . cr st utes a temporary Certificate of Zoning co plian e and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
slued.
al !��.■► i ka 1
Planning Dire • Datt Special Conditions,if any
24 our notice for all inspections(952)447-9850
646 Dakota Street Prior Lake,MN 55372
Dec. 3. 2015 3: 13PM No. 2593 P. 1 DA
4R7p, bate Reed.4°:::-'7.'---i CITY OF PRIOR LAKE PL ING PERMIT
'"k#1rssC-6'` 'Goin M
;: Pl�l�`tIVII'T lrlOr.
S.Mow AopW'lu
_Rime 't�Z4ist$IntandiKLI_
bOt[ »�-
ADDRESS LO1tT11WC(omccu.
/IMO ler; C2,c)i
LEGAL DES TION((Accuse only)
LOT BLOCK ADDITION PM
• OWNER.
(Name)` _ (Phone)qui -
dross) l }?
dsi
(Address)31&5 ``e-Tr rklv& ; .'k —6R(:)0 t= ek. '.. 55/
.I �.
(Address) (city) (Zip Code)
(Contact Fuson) c �to (Emco) '6 5)-77E-15-9-/
APPLICANT SIGNATURE /` /` %J a'r DATE
/`
APPLICANT PLEASE COMPLETE Dr—LOW
t cant[ j i e of Mare $ anti T i'a of ' Cure
Bath Tab with,or without shower Rou:,1-ins
Dishwasher Water Heater
Floor Drain Water Softener
yatox athroom Sinit) _ I Stand Pipe(Washing IV,I.achbte)
Laundry Tray(1 or 2 compartment sink Sewage B„jector
Shower Stall . Baektlow Assembly
r
Sins Baokfow Assembly Test
Bar Sink Lawn ' '..
Water Closet(Toilet) _ Other
ME SUI1LDULB
Industrial,Cotnnoercial es Multi-fenny 1%of j ob cost with a$49,50 minimum Raaidential,Now One&Two-lisensly $149.50
Residential,Additions do Alterations S49.50 •
1
The Minnesoin Statutes$3261145 ..�est $ Bttildtog Permit#
"SURCHARGE"has been changed for ono PLUMBING]PBIiMIT FEL $
year effective
July 1.2010,until June 30,2011. . STATE SURCHARGE . $
The rehlimnni surcharge tar a"axed tee"permit TOTAL PEST FEE $ `. r
Is A.5.beshisbahly tam tedefii 0
This Application Becomes Your Building Permit When Approved Paid 'v. ..,
Date By
....4% ,,,.
, ,.
Badding Oftitisl Data —
' 24 hour notice for nit inspections(952)447.9tt50,laic(952)447-4245
- 4646 Dakota Street 9.17.,Prior Lake,Minnesota 55372
•
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ' i idG
NATURE OF WORK / � VI PAW V*
USE OF BUILDING _
PERMIT NO. LG]_ :yDATE ISSUED
CONTRACTOR nJjrirrAj � ,� i4;1 PHONE (.�'�. i/ . mi
INSTALL EROSION CONRTOL A D MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
1
1)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING p..� o�� c(r-
INSULATION D�- � c0-"'
ELECTRICAL
1111111111111111.
.101111.0
10.1.111111
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
VMS
FINALS
BUILDING °1'7
• ELECTRICAL
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