HomeMy WebLinkAboutBldg Permit 04-0684
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White
Pink
Yellow
File
City
Applicant
I PERMIT NO.O+. o,,~1
(Please type or II rint and siltD at bottom)
ADDRESS
2q//3
dotftV"lT
77ZA / '-
ZONING (omce use)
{!./
LEGAL DEi ;CRIPTION (office use only)
LOT /hLOCK
/ ADDITION
71-f-€ /IV I ,-Of .s () (./777
PID zs: ~82.. 014-.0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(CompanyN,me) ~4!"'?'" 0/..,.",017 //t:,...nLr. (Phone) ?S?/- ~33-"'9'l$"
(Contact Nalle) /70"" "P'A//1~' / A/..ce- ~'o6<,,"k //1I~'lYJ t7h"h (Phone) hf/ - '/.:1:$-//9. ~
(Address) 67/S' ..P~~::1she A-/iHL
TYPE OF "ORK M New Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
IQAdditlon DAlteration DUtility Connection 0 MISC.
CODE: ~I.L.C. DI.B.c.
Type of &nsfutction:
Occupancy G: oup: A B
Division:
I
E
II
F
I
III IV
H I
211)
(DAGi)
M<i)SU
4 5
PROJECT COST IV ALUE $
(excluding land)
~ .'
300CtlD. ,(jp,.]K
I hcrcby certify th t I have fiJrnished 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 lroperty 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
Iltlicial 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 needed Inspections
X ~"...../~
/ ,/
Signature
Contractor's License No.
6-.3'1:'$/
Date
"
I Permit Valuat on ... COO. OClO,Otll Park Support Fee # $ A~o.O<l I
I Permit Fee $ z...t'S3.S0 I SAC # $ 1"3'50.00 I
I Plan Check Fe e $ I 4,,1.(.7tz I Water Meter Size S/8"&:) $ 3oo.C!)o I
I State Surchaq e $ I 'SO. 00 Pressure Reducer $ 70 dJO I
I Penalty $ Sewer/Water Connection Fee # $ l 2..e> 0 . fO 0 I
I Plumbing Per nit Fee $ ~t)Q. Qo Water Tower Fee # $ 700.00 I
I Mechanical P ~rmit Fee $ 100.00 Builder's Deposit $ \"500 . 00 I
I Sewer & Watl 'f Permit Fee $ 3S. S;O Other $ I
I Gas Fireplace Permit Fee $ t40.00 TOTAL DUE utu,ro 1.91.04-- $/0. //3.76 j
This Applicat on Becomes Your Building Pennit When Approved Paid IU.IU71 Recei~o. ~/If~ij'
~~ -0 ;J.e/Ot[ Date itJ~dtJ4--' By 4.,
(/
Blli1IIlH!Otlicinl Date f
ThiS IS to certify l13t th{' 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: .1' City Planner constItutes a temporary Certificate of Zoning compliance and allow~ construction to commence Before llccupancy, a CertIficate Dr Occupancy must be
i'~ ~ (J/Z,Z/Ot/ ~ oJ-/. ~~~.
Planning Director
. Date'
24 hour notice for all inspections (952) 447.9850. fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 5S372
Special Conditions, if any
5~~
~itp; - B~JiI~
Canary - Engineering
Pink - Planning
Thf Crnlr of lhr L.h Counlrl
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJ,MEOFAPPLlCANT .ll'J.ubr dJ~ ,~
AF'PLlCATION RECEIVED ~- IS"":t..j
The Building, Engineering, and Planning Departments have reviewed the building permit
ap ::>Iication for construction activity which is proposed at:
,:;JC)I? ~/;(/d Ir-
/'
Ac ~epted
Accepted With Corrections
Denied
Re viewed By:
Co mments:
~l-~
~~ /LL/ ....Ar.
Date: h/~ y / () 4
~.
"n e issuance or granting of a permit or approval of plans, specifications and
cornputations shall not be construed to be a permit for, or an approval of, any violation of
an~' of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pre suming to give authority to violate or cancel the provisions of this code or other
ore inances of the jurisdiction shall not be valid."
Job Address ~ K, ~.,;~ ...,.;;t
Heeting Contractor s,~ f"\t..L-'-'.
Name of rester ~
L{,/]. '" 1 C'f"?"
q, . \
6
l."t
(~I
Date
Percent O.
Percent CO
Percent CO.
Stack remp.
Combustion air is adequately supplied per
UMC Sac. 606 ~ ;1\-
1:/7 . ~t?_
Input
~
~~
u.~
While "Building
Canary - Engineering
""-;"".mC - ......annmg::,
TI1~ ('('nl.. of Ih(' I..kr ('ounlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
i'-'
/'
'{ /
. (..
I
r l
--~_...-
N, ~ME OF APPLICANT
,
,. J
AI'PLlCATION RECEIVED /1- /!J- i/
Tile Building, Engineering, and Planning Departments have reviewed the building permit
allplication for construction activity which is proposed at: .
;r/)j.... r / j. ~
r /,' "/"":'." _,.'/ f.l. ( , r
A, :cepted
~.
Accepted With Corrections
D 3nied
R 3viewed By:
C Jmments:
~
.
-;J.L' ILl.-
Date: 1o/cJ,8/o<f
"1he issuance or granting of a permit or approval of plans, specifications and
cilmputations shall not be construed to be a permit for, or an approval of, any violation of
a ,y of the provisions of this code or of any other ordinance of the jurisdiction. Permits
p 'esuming to give authority to violate or cancel the provisions of this code or other
o 'dinances of the jurisdiction shall not be valid."
Thr ernl. r or lhr I..kl (.ounlry
White . I;!uilding
c ~."!"ry - I:ngineerin!t>
Pink . I"lanl1lng
.BUILDING PERMIT .APPLlCATION DEPARTMENT CHECKLI~T
N,~MEOFAPPLlCANT /J1.Ahr: aJ~( lJ~lA~
APPLICATION RECEIVED -.0- /5"';Lj
Tt e Building, Engineering, and Planning Departments have reviewed the building permit
a~ plication for construction activity which is proposed at:
/;;9/f( ~h(aT T;-
Ac cepted
tX
"
Accepted With Corrections
DEnied
RE viewed By:
,~
Date:
o -2'1-C/1./
, f
Cc mments: See Reverse Side for Additional Information! .
Oriveway Must HaVA A Concrete Aooroach
See A.ttachments: 1) Grading Plan, 2) F.rosion C.ontrol Mplfsur"~
"Tt e issuance or granting of a permit or approval of plans, specifications and
cor nputations shall not be construed to be a permit for, or an approval of, any violation of
an'" of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pr~ suming to give authority to violate or cancel the provisioQs of this code or other
ore inances of the jurisdiction shall not be valid."
09'13.'99 lIO:>' 11 :53 EX 612HT42-15
CITY OF PRIOR L<KE
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TUlO. - A"lleAIIT
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CIT~ OF PRIOR LAKE
S8~ER AND ~ATER ?EF~IT
NOTE:
Sewer and Wdter
contractors ~ust
be registered
with the City.
\PPLICANT, L10Ycf Ci-CCHtlh'n-r FHONE:.7S'.,J-;J)'/- S;~<jO
\DDRESS:_I{I,I7~ ()a""1l;lU:!.('m~r;"TE: //-/~ -01
>IGNATURE: ~ ~d BLOG. PERMIT #
,IT;;: ADDRESS: ,;l 'jIg &6rJ::f' .,..&J PTD#
FILL IN THE BLANKS
1. Estimat~d length of wat~r service
LiD
feet.
2. Size of water service
/
inch(es) _
2. Location of. any couplings from structure
f@.et.
~. Type of seWer pipe. ABS PVC~ cast 1ron____
5. Estimated lengt~ of sewer line f't7 feet.
6. Clean out (if required). located at
structure.
feet
!rorn
~~--~=~-------~===~==~~-~=~:~~~===~=;;~=======~:==~~========;~=~~~~
This application becomes yo~r permit when approved.
BY
DATE:
=~=____======._M~~=~~Z~~======~=~~===========~=~==~==============~
FEES:
$
s
$
35.00
.50
35.50
Sewer and water line connectio~ permit.
Sur'charge
'i'OT1\L
* Fee for either sew..r or ',fatel' individually ].5 $t.l.~o plus
~ .50 surcharge.
*
sewer and water permits issued for new construction must be
rec~-lie<iy'.. ~:..,..btti;ldlln~ permit ca:d at the tIme of issuanc..
~o i!h$d"er.t~at fl<Il dupllcate sewer and water permits are
J.ss~d.'---'
DATE F''''I!D
><ECETPT,~
Nnv 1 Ii 2004
AMOUNT PiUD
RECID BY
:. "
. v i' ,." J. ~~ __
,l., q~' f
--~f~'.' .
~i~~'~':
4629 Dakota St. S.E.. Pm' Lake, MlnnG~ota 55372 ! Ph. (612) 4474230' Fax '6,2) 447.424:
AA e:Ql1~L OPPOIfTL'NITY P.-v:'1DVFJ,
1 'd
2605 1>22 256
~u, ~''''e"x3 pJ:;o Il
dl>l' 10 1>0 51 ^oloJ
_.
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE )\DDRESS 2.'1/8 &dOlfT 71lA1t.
NATU~E OF WORK /JE..w OJl.J'ST/h.J..cn;~
USE OF BUILDING 'S.F:D.
PERtv IT NO. (';4-. o~f14- DATE ISSUED ~O" .
CON1RACTOR IttElt.l'OJ ~N If'/tt". PHONE~l./z8-lhU
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
lNSPECTOr:-~ DATE
I FOOTING /J)~ I &'1/. L/tJ-),q-~ t.-1
I FOUNDATION (Prior to Backfill) I ~ I ///~I /'
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH ~ IN~...~ . ,.
SEWER/WATER/SEPTIC A /"~~;'. ////~;1.f
FRAiMING !f1j )2/2J)
INSULATION . pvj) . I-~..j, /
ELECTRICAL
PL~MBING
HE :TING (if required)
FIR PLACE
GAS L:INE AIR TEST ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
/<1/A "-/c. I ~ 11m-As-
FINALS
-
r/)
/
) ?"/...? A
(;;.:1 tflv
'~
GR, ~DING (Prior to Sodding)
BU~LDING~~ +" 8-1-0<
ELF.CTRICAL Ii
PLUMBING
HE, ~TING
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.
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FOR ALL INSPECTIONS (952) 447-9850
_._._--------'._"-_.._._-~.--,._.-
,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'11/~ Robc,+.f-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
fl-aNAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
5;rl,W4/ t. rJ (.
DATE nME
~'51-or z,:JO
n1-trly'\ r"/l",,-
{ji,i.A
)(~LLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
S/-;-r
kORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
In.pector:~~ Owner/Cont~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
"s"'>n
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
2?lg
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~NllULA TION
~~AL
o SITE INSPECTION
COMMENTS:
DATE TillE
SCHEDULED 8-'2J~
UJ-
CONTR.
PERMIT NO.
L{-~e'-/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MEcH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
g ~IRTST
J. FilA60 _~ llMlf
(JJc-
I
+0
.....,
I'
doc;.p
II) ( ,
) ~\-~ ~.~
WORK SATISFACTORY
CTION AND PROCEED
K, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
NEXT INSPECTION 24 HOURS IN ADVANCE,
uaNOn