HomeMy WebLinkAboutBldg Permit 04-0227
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2, Pink City
3, Yellow Applicant
Date Rec' d
PERMIT NO.C!Lj....;}d- 7
(Please type or print and si~ at bv..v...)
ADDRESS . ~~ ~ 5 W 'i\~SCI' /,V 5f:.
!
Prvo/ ~~~ MAr
ZONING (office use)
If ISfJ
LEGAL DESCRIPTION (office use only) r/J, d "
LOT/OLBLOCK8 ADDITION (j/~?o-rdo;2JV PIrb25-33&'-031-D
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
;::on l--=op:/;::0spections. W~ L)
//" G/ Si~re Contractor's License No. ' Date'
//
I Permit ~ation
I Permit 'Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee'tIt.J 0 t,OAJ ~
I Mechanical Permit Feel $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit FrtoAJfr $
OWNER
(Name)
tb:l'
2 I'm b"^~~l
(Phone)
q5t
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
OPorch
ORe-Roofing
o New Construction
~ower Level Finish
o Misc. 1.f2..0. C,06S S~..:;
o Fireplace
OAddition
o Alteration
PROJECT COST IV ALUE (excluding land) $
~tJ.oo
71../, 75
.
Park Support Fee
#
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 5/ J6-')"~5'
I Date L/ - 1_ -I'J L/
, - ~
By
----
Receipt N o. t..I~ Lf.<C) ~
~.
1,50
#
lfo, --
#
t:..- I tp ~-
t-I tJ.----
This Application Becomes Your Building Permit When Approved
~ca~ JA,df
"/1.{0
5~l.( ,
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
$
/ 'OD L
.I 51"()!;
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 (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
t/r-d--~7
Residential Building Pel wit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:~
,..
~ Date: Lf- (, -()~
Building Permit # PID:
Site Address
Zoning: .
10 /!~5 tt/~i1S?U ~
Legal: L B
Existing structur~r NO
Subdivision:
CONFORivIS TO ZONlliG
ORD IN' AL'l" CE
YES
NO
Is this an expansion of the existing footprint or
building height?
YES
Refer to Plamring
NO
Does the alteration include any additional kiTchens?
Refer to Planning
vJo
,NO
No
Is the property located within the flood plain?
Refer to Plamring
Does the proposed alteration include any outside.
entrances other than patio doors?
Refer to Planning
NO
Is the proposed use of the finished space or
alteration for anything other than a nonnal single
family home (office, group horne, day care, etc.)?
Refer to Planning
N!\
THIS CHECKLIST MUST BE COMl'LETED A.I.'fD INCLUDED IN THE BU1LDING PERtvlIT FILE TO
M.AlNTA1N A RECORD OF THE REVIEW.
T .\TI=~/f1JT.l, TF\ALTr:FCZ.DOC
PRIOR LAKE
INSPECTION RECORD
~~ t,.J-I
NATURE OF WORK L. .1.. .
USE OF BUILD1NG
PERMIT NO. U'!~_ a~. pATE ISSUED !/-,--L/
CONTRACTOR rslII ~V PHONE -
NOTE: THIS IS NOT A PERMIT FOR ANY 04= THE INSPECTIONS BELO
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
INSPE"'....... DATE
~T; ~ t"~S. /~ R'-L //J!J,tl 11~ ),..).-0(;1
__~_ i
I I
PLACE NO CONCRET UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING 4t,l.! f"'~/7 ,r(-t"M ~II ~ dA."d ~h<t,. d411~h-
. INSULATION / r~r- 1I/.t..S:J~
&LECTRICAL I "////h5-'
pLUMBING /K~ rPJ~-.t--
HEATING (if required) j/~Jj{, , 1///'1 /~
FIREPLACE #PI- ~//,rc;S-
GAS LINE AIR TEST ~ ,~R~~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
A
IIf/Y
, ,
y /(-',?~', ~
7/';~-
~ rtJ/~~f
. ,
HAS BEEN SIGNED
~:
OCCUPY UNTIL ABOVE
NOTICE
This card must be posted near aft 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. -
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
7h~.-
,
4f'7zS- ~.k~r' ~~
t!J.y.. .2 .2.7
,
PERMIT NO. C!><.S- - ...3'9J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COM-NlENT)3:
fldY/~G/f
h-l-d~C~
,
SCHEDULED
CONTR.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~~UMBING FINAL
~ McCH FINAL
.,.-
hi.-" /
,
0;[
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
..,.....l!lf1fIREPLACE FINAL
o GASLlNE AIR TST
o
/'
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. "'Tr'; ~...:..- ,~~/-P.fL. ~~ V:j?
/'
/UI<--
~
~./7,c.
~K SATISFACTORY. PROCEED
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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI