HomeMy WebLinkAboutBldg Permit 04-0846
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8, It; .04-
While
Pink
Yellow
File
City
Applicanl
I PERMIT NO.{)tf- 9L/6
(Please type or. mnt and silnl at bottom)
ADDRE~ J
It rL / lIiduM (j),/,,_
~KU ~)
55:'V?_
ZONING (office use)
PU<::;D
LEGAL DE ,CRIPTION (office use only)
LOT1 B "OCK /.j ADDITION
0~d 1?/1r~
PIDdS-:i35- 0310-0
OWNER
(Name)
0~
,
7)t'~4Js"
(Phone)
153.-~-~~~
~-.?;g,~
(Address)
BUILDER
(Company Jo, ame)
(Contact Na ne)
(Address)
(Phone)
(Phone)
TYPE OF ~ 'QRK 0 New Construction DDeck DPorch o Re-Roofmg ORe-Siding ~Lower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: ~. LC. DI.B.C.
Type of ODS mction: I II III IV V A B
Occupancy G ,oup: A B E F H I M R S U
Division: 1 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
nished information on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner or authof!Zcd agent for the
d that al uClion will conform to all existing stale and local laws and will proceed in accordance with submitted plans I am aware that the buildlOg
it for Jl rthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed I . pectin s
Gas Fireplace Permit Fee J; (J.
II
yt 5CJeJO r 0 "
$ ?.Y. 7s-
$
$ /..50
$
$ /(0.11"
$
$
$
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit JiM-- - $ (. ,Jc)
Other $
TOTAL DUE $ 1/7. 25
x
L
Signature
Permit Valuat ,on
Permit Fee
Plan Check F, 'e
State Surcharl ;e
Penalty
Plumbing Per nit FeeO WVe..-r
Mechanical P ~rmit Fee
Sewer & Watl 'r Permit Fee
This Applicat on Becomes Your Building Permit When Approved
~~iti~f-/ ~dO{
Paid
Date
117. Z-5
~.jB.fJ4-
I Receipt WlI, .,.77,5Y
By ...-1h(... ^
/
ThiS is to certify t\hat 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 t~e City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence, Before llccupancy, a Certificate Df Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Baseme:n Finish or Interior .-IJter:!tion to Sin.,le Family Homes
" .
i
I
i
IsY:
~
~ Date:
Building Pennie ;#
She Address
Pill:
Legul: L B
E.risting structure~or NO
CONFORlvIS TO ZONlliG
ORDIN.~~CE
I
~s this all ex-pansion of the existing foo!jlrwt or
~uild.ing heigh!?
I [s me property located Wltb.li:1 the flood plain?
I Does the alteration include any additional :mchens?
l:Joes me proposed alteration include any outside
~t:ra."lces othe:- man patio doors?
:s the proposed use of the f~shed. spac:: or
i.lter-3.rion for anything atb.er tfJ.an a nOCJ.2.1 single
:J1Tlily home (offic~, grau~ heme, day C:.lr~, c~c.)'?
15- /~-oV
Zoning:
W~CUJ Rrd StA
Subdivision: J-e-
Y"ES
NO
YES
NO
R~r~: ~o Pla.-mL."1.g
tJc
Refe:- to Planning
NCJ
r-Jo
Refer co Planning
Refer CO Plarming
)'-10
Rer'e:- (Q PlarlIllng
Alo
THIS CHECKLlST MUST BE COMPLETED A.:m !NCU;DED IN Till BClLDING PERMIT FILE TO
,L.lJl'!TAIN A RECORD OF THE REVTEW.
C'~T . -. . - -_..~.. ~ -.
; ., , -"II:~ ..;. - - -, .' _,( ..l_
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
r
~. . .
SITEJIDDRESS "-YI 1A~1"-' ~
NATUI ~E OF WORK' l.IJ ~
USE qF BUILDING ~. F: t> ,
PERMIT NO. ()f. O~ DATE ISSUED 1JfJ8/.4/
CONT RACTOR "[iiJA :f)E1I1 U~ PHONE-'-/& -IIJ. -~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
.
~
~
~
DATE
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fD7hf!'
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
f/1vY"
BUII.DING
ELE CTRICAL
PLU MBING
I HEATING
!
iDO NOT
/P'7-
ft'~~
OCCUPY UNTIL ABOVE HAS
NOTICE
/ .
O,//a/oJ---
It/( /oJ.
~A",~,'-
<5'Pt'ftS
BEEN SIGNED
,This card must be posted near an elcc':rical 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
ADDRESS
/~J (;. /
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,.l!H'INAL
o SITE INSPECTION
DATE TIME
SCHEDULED >(~~~~--
7 7~
~::~~ Cr
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o ?'" rf"9'h
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
CO~MENW.; ___ /" J
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~OR~FACTORY,PROCEED
/0' CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /~
Owner/Contr:
r
CAU._ 447-985" FO~. TH'S NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOn