HomeMy WebLinkAboutBldg Permit 05-0018
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
While
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Yellow
File
City
Applicant
I PERMIT NO. 05 00/8
S6
tfltJff /"IV 77U--
LEGAL OJ iSCRIPTION (office use only)
L0139ILOCK I ADDITION 771'1t!&-)l--(YU;;J'( p/'tJl4C--
Date Rec'd
/.5.05'"
ZONING (office use)
Pl/[}
PID 2~ 4-02-.0-19. 0
OWNER
(Name)
Jv.J
(Phone)
(Pn - f.,()O - (.,0 J,(,
c.(...6/~,Jf/l..
(Address)
BUILDER
(Company] ,ame)
(Contact N, me)
(Address)
(Phone)
(Phone)
TYPE OF 1 VORK. 0 New Construction DDeck DPorch ORe-Roofing
DAddition DAlteration DUtiJity Connection D Misc.
ORe-Siding JifLower Level Finish
Z~.
PROJECT COST IV ALUE $
(excluding land)
CODE: OJ R.C. OI.B.C.
Type of Con :truction:
Occupancy ( troup: A B
Division:
IIIIVVA
H J M R
2 3 4 5
B
S U
J
E
II
F
I
D Fireplace
I hereby certify t lilt 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 authonzcd agent for the
above-menlwoee property and that all construction will conform to all existing state and local laws and will proceed in accordance with subrniued plans. I am aware that the buildmg
:""'] "n '"'01 '7:;Z lost? F"~e,] h": '",ee thot th, dry offi,',] m, d"'gnee ro" em" upon tho pWP"'" tn p"fonn needed ;n7;/tJ J
Signature Contractor's License No, I Date
I Permit Valua :ion Z, 000. W
I Permit Fee $ f;z"Z5"
I Plan Check F ee $
I State Surcha] ge $ /.00
I Penalty $
I Plumbing Pe :!:ee ~ $ ~"(JO
,,'" .
I Mechanicall 'e it Fee $
I Sewer & Wa er Permit Fee $
I Gas Fireplac: Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other a~<!../
TOTAL DUE
$
$
$
$
$
$
$
$ /." 0
$ 104-.25
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Bui dllll!.Otlici,ll Onte
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Receipt ,No. ff(P~
By AfP/A-... ~
/
Paid
Date
This IS to certify Ithal the request in the above applicalum and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as reqtK'sted. This document
when signed by 11e City Planner constllutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, 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
Basement Finish or Interior Alteration to Single Family Homes
~y:~
Auilding Permit #
~ ite Address l' '76 !J
~ Date: 1/6/~ '-(
Pill:
Legal: L
B
~
~:
Zoning:
] .xisting structure~r NO
CONFOR1VIS TO ZONING
ORDINANCE
YES
NO
I
I.s this an e;'Cpansion of the e;tisting footprint or
bl cilcling height?
YES
Refer to Planning
NO
I I.s the property located within the flood plain?
IDles the alteration include any additional kitchens?
D leS the proposed alteration include any outside
ell trances other than patio doors?
Refer to Planning
tJ()
Nt)
tJ()
Refer to Planning
Refer to Planning
tJtJ
Is the proposed use of the finished space or
all :ration for anything other than a normal single
. faJniiy home (office, group home, day care. etc.)?
Refer to Planning
f-lo
T11S cmCKl.1ST :VIUST BE COMPLETED AND INCLUDED IN THE BL'LDING PERI'rlIT FILE TO
:Vir lNTA1N A RECORD OF THE REVIEW.
.
L:\1FMPLA. TE\AL TCHC<.DOC
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4920 (J'LvFfC .IIE.IG/-t/J /l2/l/L
NATUFE OF WORK L ()Wt;;k U/'VU-.-
USE OF BUILDING I25J 11//G
PERMIT NO. 05.0016 'DATEISSUED /.5.0S-
CONTF1ACTOR (?LB /s It/~ PHONE &IZ. (pDQ. (p 03 <0
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
..... I
I I
fl LACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAM ING
INSUL ATION
ELEc'rRICAL
PLUM BING
HEATING (if required)
f1~//
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t4d
I~
. ,
lilt! los-
11/~/c6---
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I J
FINALS
BUlL ING
ELEC' "RICAL
PLUM BING
HEATI r-.lG
90 NOT
. I
ff~
//t1/
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OCCUpy UNTIL ABOVE HAS
NOTICE
..7'IYL~J
,2/fk~
.;;. /~1/5
upr~r
BEEN SIGNED
Th is card must be posted near an electrical service cabinet prior to rough-in inspections
an d maintained until all inspections have been approved. On buildings and additions
wl,ere no service cabinet is available, card shall be placed near main entrance.
I
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE SC:~
ADDRESS <f'V8 Jf%
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
~CH FINAL
C~J:NT~: ___ /
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DATE TIME
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o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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"'ORKSATISF~~
/;};;ORRECT ACTION AND PROCEED
o CORRECT Wo;",WR RElNSPECTlON BEFORE COVERING
Inspector: r pi---- Owner/Conlr:
gALL 441-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
IHSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!