HomeMy WebLinkAboutBuilding Permit 11. 0084 S 0 0 0 C? 0000 ❑❑ 13 0 > zC)
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O� PRI.6CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
4 ,; '
.1 :11;::
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2 ,7 / i
AND UTILITY CONNECTION PERMIT
M,NNES��P I. White File
2pink City PERMIT NO. f/ D Q U
.
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5056 - ?:),iveiyi-b---- l.....A/.. ,g. t
LEGAL DESCRIPTION(office use only)
LOT 6 BLOCK Z ADDITION D 41, EL6) 8 R` PID 25-. 3 99:
0/7 6
OWNER
(Name) l��✓"��j Q)6d (Phone)
(Address) cpc3 AA-)I-y -,l g '�
(....A-) ,
BUILDER ��
(Company Name) OkgEg-113 '' ..A-.4-1.8`e_J (Phone)
23 z 9 YL)- .. (3
(Contact Name) at. � � v )
A . 1 (Phone)
(Address) I 07c76 ,-''yl't -`�cf (ku L l/"`)DOgv u
TYPE OF WORK ❑New Construction ['Deck Porch DRe-Roofing ❑Re-Siding )4
ower Level Finish ❑Fireplace
DAddition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑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 .• ke .s pe mit for cause. Furthermore,I hereby agree that the city official or a desii nee may enter upon the property to perform need•It1 (spect ins.
x j - 2C)S CJ'I c9 9
Signature Contractor's License No. Date
Permit Valuation 2 I 0 U 0. 0 0 Park Support Fee # $
Permit Fee $ (o Z. 2-5- SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ / (j 0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 54-. 5Z) Water Tower Fee # $,
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 53Z- Se) TOTAL DUE $ /7Z . 2....5-
This Application Becomes Your Building Permit When Approved Paid riZ_ ZS— R eipt No. G 2.47
Date Z, LS,ft
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
4646 Dakota Street Prior Lake,MN 55372
�., PR%%�
CITY OF PRIOR LAKE Date Rec'd
IN
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
NNESo,Se.
2.1. Finkn Filty U e PERMIT NO. ' „, '
GreeCi
3.Yellow Applicant /r I
(Please type or print and sign at bottom)
ADDRESS ` b ')o/�� j, ZONING(office
ti J )5 0 )6 f`-� `� pJ use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER e,'t bi3 (Phone)
(Name) t�
(Address) ,v /1.3 i---)5 ())1JL$ &'
APPLICANT l j i o -3 3 `i
(Name) Fio.,0 � H (Phone) ��
(Address) 00 r A l41-v(.0:W /N-05,-
1.), ()-, 'S .\k, ` - V'` 1:J
, (Address) (City) (Zip Code)
\
(Contact Person) �J 0 CA 1 _ ''4 (Phone)
-
APPLICANT SIGNATURE � DATE 0011
AP' ICANT PLE COMPLETE BELOW
❑NEW CONSTRUCTION ❑REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants ❑Steam PLEASE NOTE:
❑Gravity ❑Hot Water Air Conditioner Units
❑Mechanical ❑Radiation Cannot Encroach into
❑Air Conditioning ❑Special Devices Required Side Yard
[Went.System ❑Other Devices Setbacks
FIREPLACE MAKE AND MODEL _14,?/r)-'A)--G-� (SL -5�I —!Y l
FEE SCHEDULE
Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace $9910
$39.50 minimum
Residential,Heating&A/C(New Construction) $99.50 Residential,Additions&Alterations $39.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $39.50
Estimated Cost$ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ 5.. .1
AILD PMD
PERMIT FEE $ NG PFRM�T'
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
.UO.ZU11 U3...ift ZW1 r/C101.C.U1 .C/JJVID/VO,V YJ.E.G.C.V.A.Jft,./ .=-1-S/mr-,. // /
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Date Reed
CITY OF PRIOR LAKE PLUMBING PERMIT
. _
i Iti.le rat PERMIT NO. 1 I 64.4il
1 1 elti etty
1 YrIXI/kv AM$A0' 0 I
(Pte 4be type or print and sign at bottom)
I ADDRESS ZONING(ann.uci
k-9C.)rt. .S C4::
...— ,
LEGAL DESCRIPTION(orrice wearily)
LOT BLOCK ADDITION PID
OWNER
(Name) — (Phone)
(Address)
,------.
APPLICANT l'%-4 f. , ,
(Name) 1 tilstcr C,r0 ‘erto (phone) 61) 90 - W.c ?'
(Address) ...;3 I '4) 1 ' ,Jam r
(Address) ( lY) (Zip Code)
(Contact Person) _ , -feLIC 1,-"'a?046rd (phone) 6/ .) 76) —q6 -CV
APPLICANT SIGNATURE ( ,t .'"*":7--- -.,:;,,..- 2_,,... DATE ____________
APPLICANT PLEASE COMPLETE BELOW
QuantityType of FutureQuantity Type of Fixture
—Bath Tab with or without shower Rough in
Dishwasher ___ Water floater
Floor Drain Water Softer
I Lavatory(BathroonT.Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly ----
Sinks Backflow Assembly Test
1 ---T—Bar Sink Lawn Sprinkler
L _ai Water Closet(Toilet) Other
FEE SCHEDULE
Intlisirial,Commercial&Multi-family 1%of job cost with a S39.50 minimum Residential,New One&Two-Family S9950
Residential,AtItlitiong&Alterations $39.50
Estimated Cost S Building Permit#
PLUMBING PERMIT FEE $ PAID WITH
STATE SURCHARGE S ;l:, JILDING PERMIT
TOTAL PERMIT FEE
(Office Ilse Only) _
This Application Becomes Your Building Permit When Approved Paid Receipt No,
Date By
Building otrivinl Date
24 hour notice for all Intpcctions(9M)4474850,fox(952)447-4245
16200 Eagle Creek Ave.,S.E,,Prior Lake,MN 55372-1714
Residential Building Permit Checklist
B-a emeut-Finish or Interior Alteration to Single-Family-Homes
BY: -,///// Date: 2- , 7,
Building Permit# // op ND: Zoning:
Site Address
Legal: L B Subdivision:
Existing Structure: YES r NO
CONFORMS TO ZONING YES NO
ORDINANCE
YES ( NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ✓
Is the property located within the flood plain? Refer to Planning ,-
Does the alteration include any additional kitchens? Refer to Planning
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ✓
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single ✓
family home(office,group home,day care,etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
•
•
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PR
DEPARMO �ui1A?�,
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E BUILD
INGTANDENT 01 NFINSPECTION
INSPECTION
RECORD
SITE ADDRESS 5056 ookl sCI) i-N.
NATURE OF WORK 0 Re,
USE OF BUILDING Al if
PERMIT NO. . 00 i ' DATE ISSUED Z . 7. /
CONTRACTOR 77/'15&.�/n6 2c/iLdt;R„s PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS B
THE PERMIT IS BY SEPARATE DOCUMENT ELOW
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING I I I II MEM
FMION11111
INSULATION IIIIIIIOMIIIRIEMMIIIIIIIMII
ELECTRICAL 111111.11111111111.11111.1111111
PLUMBING 1111111_■
1111111111111111
HEATING (if required) —
FIREPLACE 0 n � -
GAS LINE AIR TESTAE) R. II1.111.1111111111
I ■
1111111...
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
111111111111111111111111111111111111111111111111111111111111111
FINALS
. 2 II I. I. I= NmmmlIllMIIIMMIMMIIIIMMMIII
BUILDING guaiffikaimmim 1111.1111111111
ELECTRICAL
1111111111111111
PLUMBING
111.111111111111
HEATING111111111111111
.
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTIC
This card must be posted near an electrical ervice cabinet prior to rou h-i
and maintained until all inspections have been approved. On buildings entrance.
9 n Inadand adddctions
where no service cabinet is available, card shall be placed near manent ance itions
FOR ALL INSPECTIONS (952) 447-9850