HomeMy WebLinkAboutBldg Permit 04-0700
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec....
G.2./.04-
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 04-_ 0700 I
(Please type or print and sign at bottom)
ADDRESS
H 77()
/'1"(~;hL L..k L UI\V~.
ZONING (office use)
CI
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID z.S-: qZ.8. DOz... ()
OWNER -
(Name) g~ ..,'
(Address)
~ t--i 5C
(Phone)
BUILDER
(Company Name) Ou~
(Contact Name) -:::re.~
-tv f3J
LuK
/
(Phone) .-3/.3 - 48/-'l'-I1-':'
(Phone)
(Address) /4050 w. llL/i'k T...u_
L4.N...."-~. /1..c,
CC2/.5
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
;grAddition DAlteration DUtility Connection 0 Misc.
CODE: OI.R.C. \ll3LB.C.
Type of Constroctioili
Occupancy Group: A B
Division:
I
E
II
F
1
illIVVA
II I M R
2 3 4 5
~~
PROJECT COST IV ALUE $
(excluding land)
)~."DO. aD
I hereby certifY that I have h.trnished 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 property to perform necded Inspections
x t /). / /17-1
Signature Contractor's License No. Date
,
Permit Valuation ~.. /<; tlt1t),6lJ Park Support Fee # $
Permit Fee $ 'x ,t:;; 2S SAC # $
Plan Check Fee $ /72. </1 ! Water Meter Size 5/8"; I"; $
State Surcharge $ 7.'5""0 I Pressure Reducer $
Penalty $ I Sewer/Water Connection Fee # $
Plumbing Permit Fee $ I Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $ I
Gas Fireplace Permit Fee $ I TOTAL DUE $ Lfl{5:/lD J
-f~/~ (!
This Application Becomes Your Building Pennit When Approved Paid Receipt )$6. -+77_70
~ . 6/..t~~ '-I Date ? 13.04- By /1
~ 0
Buddin.!!. Otlicial Date
ThiS IS to certify that the request in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requcstcd This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
"""d 0-. ~'N 1../ .z..}J.(l
~ PlanningDirfctor ~ Special Conditions, if any
\j 24 hOllr notice for a' inspectfons (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~
o~~
ThO' ('..nl.., or lh.. I..k.. ('ounlry
(j(!'iw. . BuildinQ)
Canary . t:nglnel!ring
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
roo 2/'()4-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4770
Jl1 V.5Tl C!.-- L-A 1<.6 D tC / V 6"
,
Accepted
Accepted With Corrections
/
Denied
~~~
~
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~ ~~.:eLJ Date: ~/~F~Y
~
~07..J ~O _-nD -u ~- {j ~
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Reviewed By:
Comments:
.
/
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
,/
....
, .
,
":;:.
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS .-'!f7 ~tJ ~ yrrlG Uf~ ,()It;,.,
TYPE OF WORK hJT~$..,TI .IfT,;'" 7J.-~
USE OF BUILDING U. ~ /.I.~ ·
PERMIT NO. ()4. 0 700 DATE ISSUED .2/1/6'1
BUILDER ~G /:fas lfUlC PHONE#!!O-"'~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL I I
FO~~CTIONS (952) 447-9850
&Ba?-/
)'f77IJ fA-<ra-JJ. ~_ _
U CONTR. ..
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-
--/I..au,~_A k:.}/ld ~~J-
r I /
_ ~. '\.c...~~_
---LJ L1tl () /
l J t9-;W) ~ -\- c \..0
DATE TIME
4- 07eo
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
,f2-e ~
,
/'
~RK SATISFACTORY, PROCEED
o CORRE/'m' ION AND PROCEED
o CORRrCT K, CALL FOR REINSPECTION BEFORE COVERING
Inspecto4. . Owner/Contr:
CAU ~7'9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
H<SNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED ~)o~~
TIME
ADDRESS fL/77t? f{~5t.c- Lk
OWNER
CONTR.
PHONE NO.
~OOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
if-7tiJt!1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
I. R....J. I'd I.,.,..l ~ t_.
t>..J)~
, .
P.u.' AJ. ~tt...e.~.~
~~Jc
o WORK SATISFACTORY, PROCEED
)(CORRECT liON AND PROCEED
o CORRE W K. CALL FOR REINSPECTION BEFORE COVERING
Inspeclo,
Owner/Contr:
,
CA 44 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
------
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
U<SNOn
nME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
M~.;t;::_> Lk
CONTR.
J'1170
ADDRESS
OWNER
LJ-
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~'N>>I""..!jl A
- ,
~oi L I-- C b. //1 ~
,
o WORK SATISFACTORY, PROCEED
o CORRECT ION AND PROCEED
kRRE RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
7.;650 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lN$NOTI