HomeMy WebLinkAboutBldg Permit 03-1374
(Please .!YO!:: or print and sien at bottom)
ADDRESS 1""':
Y7 0']...10
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2 Pink
J, Yellow
File
City
Applicant
I PERMIT NO. D3 ~ 1314 I
PID ;(~- L/oJ.- O/3-J
(10'2-) 3",l\ - 13'31
r;~vff ~G{\-\-IS 'TlZA\v
LEGAL DESCRIPTION (office use only)
LO/3 BLOCK / ADDITION rL'-Z~
OWNER
(Name)
::fs. f2..E<.M"(
SAt1E:..
(Address)
BUILDER . L .
(Name) NON€..
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
~fJ~
\CoO L.eo €:-
(Phone)
Date Rec'd
3- /CJ"00
ZONING (o"",use) I
ORe-Siding
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 local laws and will proceed in accordance with
submitted plans. I am awqfe tha e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter p the property to to: - needed inspections.
X _
" \ J U Signature
Permit Valuation
Permit Fee
Plan Check Pee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
1 Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
(Phone)
(Phone)
o New Construction
~wer Level Finish
ODeck
ORe-Roofing
OPorch
OAddition
OAlteration
o Fireplace
PROJECT COST IV ALUE (excluding land) $
Contractor's License No.
$
$
$
$
$
$
$
$
~ "?tJf)O . (J 0
?'f, 75
#
Park Support Fee
#
SAC
,.cd
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE /fJuHTYI () In ^....
lfiIlIA.".! I. .u...>
#
I{o.oo
#
This Application Becomes Your Building Permit When Approved
~~
/IJI/a la,7
, Dafe
Paid
Date
//(,.ZS-
/2-.3.07
I ~~ci:ft. 1'-6> 057<>
Building Official
Date
$
$
$
$
$
$
$
$
I
z,~
$ I' (P
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 consuuction 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
/
/
rJ3 - ('SlY
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: e~' 1~P
Date: 10 -9 ~3
Legal: L / 3 B
I
PID:~Qd-" ~iJJ.g:~~ .
Subdivision:T~ CLu.J ~~
Building Permit ;;
Site Address
Existing structure:~r NO
CONFOR.LvIS TO ZONING
ORDINA1.'{CE
YES
NO
Is this an expansion of the existing footpr'wt or
building height?
YES
Refer to Planni..'lg
NO
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 Planning
tJo
NO
rJO
Refer to Planning
Refer to Planning
NO
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office, grOUD home, day care, erc.)ry
Refer to Planning
tJo
Tms CHECKLIST ~n;ST BE COMPLETED .~'ffi INCLUDED IN THE BU1LDING PERM1T FILE TO
~WNT..>JN A RECORD OF THE REVTEW.
r '\'T1=:\,rwf j, T='\ALTfHCZ.DOC
PRIOR LAKE
INSPECTION RECORD
5t;~' 81J~ JJ-I-s TV'
NATURE OF WORK ~ j;'1jI ; ~ It
USE OF BUILDINGC) F J:t - .
PERMIT NO. Q !a- I a ., If ~~SUED IO~ ~,,~ JJ
CONTRACTOR ~~mJI PHON'-/J. 3"~-)~~/
NOTE: THIS IS N"'6T A PERMi'r FO"R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
,
INSPECTOR
DATE
I
I I
ETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
- ......
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1/1/1/
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1 -2-7-d((
I -,i.. '7~ ()L/
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I j
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
#- &/:7/:5-
// // )'~.y'
PP7- _ .?/-;/6~ "
~ 6/;7/~j~
.
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
~~~
S@0 ,k'~#~ ~/
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
---..OS -/JY
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/ .
/:30c;/
(-52 //
/"(
(~~ ':;{ ~
~RKSATISF:CTO~'~~E:D ~ e~
/0 'CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING
Inspector:
~;
Owner/Cont~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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