HomeMy WebLinkAboutBuilding Permit 16. 0096 )
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of Palo CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �/ G 1 I
AND UTILITY CONNECTION PERMIT /6
U �
'ylp�Eso4t' 1. White File PERMIT NO./6 6
2. Pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZO G(office use)
%g463 Est C-T NW
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER �- ' "
(Name) L,htN tl. ZAcIA-P-2.1m°kJ (Phone) 21 —119- l 3 9
(Address) 1.4463 E•uu.Ar eT N1nJ
BUILDER _
(Company Name) 1 L t4 R1- Ip
-t51 t"4 (Phone) 9S 2- C, 1-3 511
(Contact Name) S stnnes GA%/Uz kff' (Phone) 501-714-9 3 C5 I' 725
(Address) 1,223'1 (J t t .e--r tikvE. S. r 130-12-"vsv t u..Ej /vy1\I S S 3 31
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing [Me-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ['Alteration DUtility Connection n�—,,
CODE: R.C. ❑I.B.C. 1Misc. W 1)14144414,t- LCHt12S
Type of C nstruction: I II III IV V AB g 7--114 . O GI
Occupancy roup: ABE F HI MR SU PROJECT COST/VALUE $ i
(excluding land)
Division: 1 2 3 4 5
I hereby certify that I have tumished 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 can oke th' ermit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X $C 6 56510 l /26/I 6
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
386 . 00
Permit Fee $ 55S. 30 SAC # $
Plan Check Fee $ 361 • 08
Water Meter Size 5/8"; 1"; $
State Surcharge $ t l .0 0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ .57) ,5U Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUFF S 2 --/O ../6 $ k. OS
eripation Beci es Your Building Permit When Approved Pa C� gp ®2 Receipt No. 0 3
� Date t`2 (o By
'61116Buil ng 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
4646 Dakota Street Prior Lake.MN 55372
/Ct//ei t / &r'f ar/ _
0 CITY OF PRIOR LAKE PLUMBING PERMIT Date Rec'd
I. Blue File
2.GoldAiry I PERMIT NO. / I
3. Yellow Applicant
(Please type or print and sign at bottom) vP
ADDRESS
/ 6;
ZONING(office,ase)
644 W NW
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT -
(Name)LICANT4-2._. 1944,9 i7 9 Z.4- (Phone) �--2.16—9/11Y
'
(Address) Z "f'e fr .� �'''e- / 6t v,1(2 —S71'1)
(Address) ��
// (City) (Zip Code)
�-k(Contact Person) ....C44..4,Ye..._
(Phone)
APPLICANT SIGNATURE ----- f=‘ ------
DATE 1 6
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet(Toilet) Other
FEE Industrial,Commercial&Multi-family 1%of job cost with$49.50 minimum LE
Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit#
`s iie Minnesota stat qe § 2:26B.1 €8
PLUMBING PERMIT FEE $ ..�� ��-'� h it 'RGF has beer extended
STATE SURCHARGE $ i he i�zas�irrlLnn sued aar �_'for a
(Office Use Only) TOTALfixed fee"permit is
PERMIT FEE $ 50,S-0 / '
This Application Becomes Your Building Permit When Approved Paid
Receipt No.
t9WITH
Building Official Date �.J�,;
Date � PERMIT
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
• •
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS mg(fa 'fit lav C
NATURE OF WORK W eeter Ds
USE OF BUILDING ��'` �� ��
PERMIT NO. .. DATE ISSUED 2�p�i;j
CONTRACTOR N*A at1F-4—lidat PHONE f• Cpl •271- 133 3 I
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ''
ALL TIMES
I $ r4 t J �/ INSPECTOR OrDATE
allOMIPSFOOPMFAimmovMPIPiresoNflOpe
R
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
L . I I
FINALS
C3UILDING )
aq ) .3/4/C
ELECTRICAL
PLUMBING CO C
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.
FOR ALL INSPECTIONS (952) 447-9850