HomeMy WebLinkAboutBldg Permit 05-0642
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
7-{; -cD
I White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO.05~ 0 t/Ot.j.
(Please type o[IPrint and sign at bottom)
ADDRESS
HLlJ'
f)anA
I/i-P'll InJ\:
ZONlNx (office use)
~/
LEGAL DESCRIPTION (office use only)
LOT to ~LOCK CR ADDITION
OWNER .
(Name) frfvl1 +- '-: ~'"
(Address)
~/U
')I~J-P I
PID3?&, - O/?-()
(Phone) -9'\"01 Lj/{7 O'?.f'1
BUILDER i
(Companyij"ame):o...v,A'rHLUf:rh (OV1(J-:
(Contact N<jme) K~.~\ . -rf-oV'l5
(Address) !..:J 1/ 10 K-'m...-,c'( A vi'.
-rb/
(Phone) 3Q L/ti>Cf. j-W
(Phone) -'iLJ)')'~ 1CJID}
l-)(')Y-.!!
LtJ\. te..uL/I of'
I
mAl
TYPE OF \fIORK. 0 New Construction DDeck o Porch ORe-Roofmg ORe-Siding tw'iower Level Finish 0 Fireplace
! DAddition DAlteration o Utility Connection ~
CODE~'iR.C. OLB.C, DMisc.
~"
Type of 0 qtnIction: I II III IV V A B PROJECT COST IV ALUE $ ~'I-OOV
Occupancy roup: A B E F H I M R S U (excluding land) J
Division: 1 2 3 4 5
( hereby certifY t~at I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
abovc.menttonedl property and that all construction will conform to all existing state and local laws and will proceed in accordance with submmed plans. I am aware that the buildmg
offiCial can revokt, thiS permit for Just <;ause Furthermore, I hereby agree that the City offiCial or a deSIgnee may enter upon the property to perform needed mspectwm
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X L'\...t. . .~ r;ttp' ~ ;:) O~d.(,a..J_ .:::il.. I Y 'r1~D ~-
"sIgnature Contractor's License No, ate
Permit Valuation ~ ppc) ,~ e Park Support Fee # $
Permit Fee / $ .:1.5- SAC # $
6"z,
Plan Check Flee $ Water Meter Size 5/8'.; I"; $
State Surcharge $ I. DO Pressure Reducer $
Penalty S Sewer/Water Connection Fee # $
Plumbing Permit Fee $ .1/ tJ. ~ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Wa~er Permit Fee $ Other $
Gas Fireplace Permit Fee $ ~, t:X' TOTAL DUE ~ 7. 7. ,r- $
d~Ar~
l3tli'ldinl! Ol7ficial
r~~-s~
Paid
Date
~//..., -~
/ '7 ..:?.P(. ':> ~
. 7-9--:)
/+3.25
Receipt No qq7~6
By ~
This Applica.ion Becomes Your Building Permit When Approved
ThiS IS to certify that the reqm:st III the ab~)vc applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed ;IS requested This document
when signed by rhe City Planner constItutes a tcmpOl'ary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate of Occupancy mllst bc
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
Ba5eme:lt Fini5h or Inre:-ior Altention to Sin"le Family Home5
" .
BY /# rP' /?
/''t. "17- e"'~b-
Building Permit # .
Site Addre5s C; I/d-/
L~saj: L b B...L
Dare: 7 0-S-
p;:;~ Zoning: ,e/
Subdivision: ~h cl..s4r
Existing scruc:ur@ NO
CON-PORlvIS TO ZONlliG
o RD Il'-L~'i CE
'{ES
NO
YES
NO
Is this an ~X?ar:sic:a. of d::.e ;:xi~l..o.Ug :oOtpr1I:.t or
building height?
Refe: ~a Pl ~T"T"I'i1g
/10
/10
;f/o
Ii,
~
I' is tile property loc,,":ed ;vir"i~ che flood p lam)
I' Does the alreration ir:c:ude any additional k;;cne::!.S?
Does the proposed. alte::rc:cn include any oursicic.
er:rr:mc~s othe:- man patio doors?
Ref~ to Planning
Rerer to Planning
Refe: ~o Plar.n:ng
Is tte proposed. use or":he Enisb.ed spac~ or
alte:-::.icn for ar.)'1.:i::.g oth.e:- :hm J. ::.oc:al .single
fa..--:ril~, haec (or.::ce, g!QU-P aone, day C2I:.~:=.)?
Refe: :0 Plar:rr'~""g
THIS CliECXl.1S,}I1:ST BE COM:pUTED A.i'iD INCLUDED IN T:-IT B81l.DING PERl,!lT F1l.E TO
i'tL-Ill'fTA.E'1 A RECORD OF THE REVIEW,
PRIOR LAKE
INSPECTION RECORD
SIT~ADDRESS Y~I A~/ ~'e""~ ~I
NAl1URE OF WORK ~~ / X"~
USEf OF BUILDING
PERMIT NO. as~... OAT): ISSUED _.
CO~TRACTOR.Sct · ~ PHON~/..,t.~3
NOtE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
,
,......
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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ffif!-
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'////-
FR MING
IN ULATION
EL CTRICAL
PL MBING
HE TING (if required)
FI EPLACE
GAS LINE AIR TEST
cf~zt:r
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i}c As-:'
tf:ft~~
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i-~9~S
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BU LDING
ELIi:CTRICAL
PL~MBING
HE~TING
DO NOT
J .
/O/~/c:5
?/&.~r
/O/2u'/or
/o/)'P-/OS-
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
~ .
~
#~4/
#~
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,
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
4C/2/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
\:l !!!cSULATION
~~~AL
o SITE INSPECTION
DATE TIME
SCHEDULED /~~r--
~/'1L) ~c...; /r/
CONTR.
PERMIT NO.
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
[] ~R HOOKUP
~2l!.M.BING FINAL
~ECH FINAL
COMMENTt
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ORK SATISFACTORY. PRU~I:I:U
o RRECT ACTION AND PROCEED
R REINSPECTlON BEFORE COVERING
Inspector:
/'
&(c..
Owner/Contr:
/J ,- 6'c/:2
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE R1
..Q-1'IREPLACE FINAL
""""0 GASLINE AIR TST
o
, .
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PLI
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----
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl