HomeMy WebLinkAboutBldg Permit 04-0128
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please'!yp~ or print and sign at bottom)
ADDRESS
OWNER
(Name)
~
(Address)
BUILDER
(Name)
(Contact Name)
d8toS
~ ;tM~
m.~Ln-
~,
S. c.v.
(Phone)
(Phone)
(Address)
3;'// C/ aL...
d...;~
TYPE OF WORK
DMisc.
o New Construction
~ower Level Finish
Date Rec'd
). While File I PERMIT NO O'L-/ I
2 Piok Ci<y . -,- r-,O
3. Yellow Applicant I C7-O
(Phone)
p~~
DDeck
DPorch
ORe. Roofing
o Fireplace
DAddition
DAlteration
I I
ZONING (office use)
K'/ 5'0
~UJ JJd
LEGAL DESCRIPTION (office use only) ( / <'
LOTh BLOCK =3'7 ADDITION 0 ?J~tul~~
6-41:&9
PROJECTCOST/VALUE (excluding land) $
PID d!J- /33-(JS9-:5
9.5".;) - oJ:;J~ - ':;>1::: q q
~ /..2 - "'d'~ - s-& ?.:;
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ORe-Siding
Dutility 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 aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the y......y....) to per rm needed inspections.
X ~r~:E
Signature
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
Gas Fireplace Permit Fee
gOOO.OO
74.7<;
$
$
$
$
ulA-W~) '-r-~4Md'
$
Jh1. $
I,"!;O
This Application Becomes Your Building Permit When Approved
~ . 'If. ,{J:"- sA tJa '/"ted Y
Building Official bat;
Ar. ::JO;)f" "17:12
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
--
t'/&,aJ-J
;,).,- /tJ - '-I
3//.o./6s-
/
Date
# $ I
# $ I
$ I
$ I
# $ I
# $ I
$ I
$ I
$ 7fol(~S- J
.' ./ /'
I Receipt No. ';ic; <--//0
B (...,' ,
o ~
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
16200 Eagle Creek Avenue Prior Lake. MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
~. . 0;'
BY:~~
Date:
Y- -/ cJ --() <;
tJ/l~ (d--S
Building Permit #
Site Address
Pill: Zonina;
~ J> 6i7- - ~1~ l)ud
Subdivision: ~ - "--1 A ~,
Legal: L t, B 371
Existing StTucture@or NO
CONFORlvIS TO ZONJNG
ORDJNA1'{CE
YES
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
I Is the property located within the flood plain?
I Does the alteration include any additional klIchens?
Does the proposed alteration include any outside
entrances othe: than patio doors?
Refer to Planning
NO
rlo
No
Refer to Planning
Refer to Planning
t--}()
Is the proposed use of the finished space or
alteration for anything othe: than a normal single
family home (office, group home, day care, e;c_)O
Rek to Planning
~o
THIS CHECKLlST MUST BE COMPLETED ..\.ND INCLUDED IN THE BUILDING PERMIT FILE TO
i'tWNTAlN A RECORD OF THE REVIEW.
T .\TMrPT ,"",ALTCHCZ_DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~ ~~S. (!~"... ~
NATURE OF WORK L. L .
USE OF BUILDING 5 F
PERMIT NO. Ia. r DATE ISSUED :9" /~ .
CONTRACTOR IV r J1IjAJS~ PHON~/__' ~,_
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
- l'
Jlf/JP
. /,/VY/
.
?-u-()'{
4 r( -04
FRAMING
I INSULATION
ELECTRICAL
HSATING (if required)
-
J/J/p'
L-t r !-a4
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
I HEATING
DO NOT
Y'/J/
~
tll/(/
YJ//
OCCUPY UNTIL ABOVE HAS BEEN
. . -
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.
t; . 4 -dl.f
(0- u. -{{If
G({"tJt-\
SIGNED
FOR ALL INSPECTIONS (952) 447.9850
DATE TIME
,..~-._.. .~l'RIOR LAKE "-i/-~
INSPECTION NonCE SCHEDULED
ADDRESS :l>r~ ~ (<1 '- RJ
OWNER CONTR.
PHONE NO. PERMIT NO. L(-/L<iI'
o FOOTING a PLUMBING RI o EXIGRADIFILLING
a FOUNDATION a MECH RI a COMPLAINT
a FRAMING a WATER HOOKUP o FIREPLACE RI
a INSULATION L.-r L- a SEWER HOOKUP o FIREPLACE FINAL
~NAL < a PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
~
/ ~t0x
~
------........
r/ "
r!~
)
~
-------
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W?~K, :~R REINSPECTION BEFORE COVERING
Inspector: f/ vr Owner/Contr:
,
CALL ~7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH of SAFETYI
INS1<<JTI