HomeMy WebLinkAboutBldg Permit 04-0136
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~~rint and Si~ bottom)
I ADDRESS
3, 5 \'p,DU"- III
Date Rec'd
I. White
2. Pink
3. Yellow
[PERMITNOOL/"~ /30 I
I
File
City
Applicant
S\,l...,)
ZONING (office use)
;e
LEGAL DESCRIPTION (office use only) ') ,
LOT BLOCK /- ~ ADDITION ~-f ~
PID;(l5~ 1'7:;)- 06f-
I OWNER ;
:::::s) ~~~~ ~ ~~Cf-
+rL . Sw
(Phone) q~d.~L{q7
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o New Construction
'!fLower Level Finish
ODeck
OPorcb
OAddition
DUtility Connection
ORe-Roofing
o Fireplace
DAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $ {D, 00 0
I hereby certify that I have furnished information on this application which is to the best of my knowledge tnle and correct. I also certify that I am the owner or
authorized agent fOf 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 pennit for just cause. Furthennore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
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. Si a e
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
-z.o"
-
This Application Becomes Your Building Permit When Approved
~ ~ 3j;~/t'J<(
Building Official Date
?,_s-o,+
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter SizeS/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other pJeI $ j.-
TOTAL DUE $ /30,')-S
I Paid
Date
13v.'~
=3--/d-~ '
-11-6 "1
I ~~cei~ N o~ it '
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) 447-98S0, fax (952) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
Easement Finish or Interior Alteration to Single Family Homes
BY: ~ ~~
Dale: 3'- I J ~.C)!I
Building Permi! ;;
Si!e Address
Pill:
ZonIDC"
o ~.
350 S- ~':) jYU~-(fJ!
Subdivision:
J^-.J
Legal: L
B
Existing Scructure~r NO
I COl'fFORlvIS TO ZONING
ORDINAJ.'l"CE
YES
NO
YES
NO
Is this an eX;lansion of the e:--.:S'i.ng foolprwt or Refer to Plaw.iJ.i.g
building height? ~1)
Is me PToperty located wlChin the flood plam? I Refer to Plamring I
Nb
Does the alteration include any acditional lGlchens? I Refer to Planning I ~O
Does ll].e proposed alteration include any outside Refer 10 Planning
entrances other than patio doors? No
Is the proposed use of the f.Jrished space or Rd~e:- to Planrjng
alte:3.rion for anything ou."1er G1a..'1 3. normal single 1J
family home (ofiic~, grau'9 home, day C2.r.e, e~c.)? 0
THIS CHECKLIST MUST BE COi'l!:PLETED .~'fD INCLUDED IN THE BU1LD!NG PERl'dIT FILE TO
.YL-\.1NVJN A RECORD OF THE REVIEW.
-,---:-7,;(":)f .i -:;. -"" ' --~.::!-..~-;(~c
PRIOR LAKE
INSPECTION RECORD
\. :t:f.s-~.s- -<;'prl.LGI!J. Tv
/-.1-
DEPARTMENT OF
RUllDlNG AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED 3 - 'J'.
CONTRACTOR ~ IJ PHONE 'Ye) . I/At/?
NOTE: THIS IS NOT A PERMIT FOR NY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
r-.- I
~I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
M
/At
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.----- : --
f _----.d-
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical servjce cabinet prior to rough-in inspections
and maintained until all inspections have bill!n approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOP ALL INSPECTIONS (952) 447-9850
~_________"______._____,._~_~^.,,__._....__..___..____"__,___,.____n_
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
3S0S- S~uc e
/
OWNER
CONTR.
or:- /J"C
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
-t!I'1!fNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
~H FINAL
CO....M~: ~ ' __
tb/ec q! 4/ ~~
~/ / ~
.~ v~6#~S' /7- /
;" ~
~C'c~. h ""/
DATE TIME
~~-
~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
c;~o~ S-
f
~~
-
61/;[A
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@"~ h;';-~
-""'_~ ~~,AA~";
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/