HomeMy WebLinkAboutBldg Permit 05-0680
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please tvDe or orint and siRn at bottom)
ADDRESS
While
Pink
3 Yellow
File
City
Applicant
I PERMITNOtl~ oro80 I
$1f3:2
~
LEGAL DESCRIPTION (office use only)
LOT /4-BLOCK
( ADDITION
D61?12-A~O
OWNER ()
(Name) ,jGfl1'l (1'r"1l-1'-",-
(Address) :5l./q~ DU-r-;,<. j..!
Co......, ie
BUILDER (\
(Company Name) t.:>I'-L...O;:::' LDN.\TI7.LL(T'(l)'.,J
(Contact Name) "D...1.;:; G. jl l. i:S
(Address)
i5YO r/rlLL..lL<:,u L-A.".)f-;
Date Rec'd
7. /5, oS
ZONING (office use)
122-
qT1f
PID zS, 4-00. 014-.0
(Phone)
o,:j"'r) .- 4l.1 "1 - :;r1'.tO
I.v'-
(Phone)
(Phone)
i'r')..l
'1 5";,). ../~;.- --;":l.. '.h_
'15':;" - .J./J. - 5' ;;;>'2- ~
L.':. _":llj
L H- A(,b",
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding .~ower Level Finish 0 Fireplace
DAddition DAlteration DUtility ConnectIOn ~
CODE: DI.R.C. DI.B.C.
Type of Consttuction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V
HIM
234
DMisc.
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hlrnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or ,1llthoIlzed agent for the
aboVl'.mentJoned 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 buildmg
official c~ke this permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propel1y to perform needed mspeellons. _
X LA'" ~ ~ ,-/Y,OS
Signature
Permit Valuation 3,000.00
Permit Fee $ f 4-. 75
Plan Check Fee $
State Surcharge $ ;.50
Penalty $
Plumbing Permit Fee ~ $ tit? -
Mechanical Permit Fee $
Sewer & Watd Permit Fee $
Gas Fireplace PermIt Fee $ -
This ApplicatiQD Becomes Your Building Pennit When Approved
l3uildill_!!.Oflidal
Date
Contractor's License No.
Park Support Fee #
SAC #
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE orW~D 7. /5, 05
Paid
Date
,t //,. 2-.5
91 -:?/ir
I Receipt~o.
By //
(J- .
Date
$
$
$
$
$
$
$
$
$ /1 t? 2 5"
<P"/tj..fiV
ThIS IS to certify that the request in the above applicatlon and accompanying documents is in accordance with the City Zoning Ordinance ilnd may proceed as requested ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and alhlws construction to commence Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notict' for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~: ~:~ I PERMIT NO. OC j Il:lk)
).Yellow Applicant / \O~
(Please '!v'pe Qr 'Print and sil&Il at bottom)
ADDRESS
...F' '7..? d- ~r,e;e r / /"hIJ C /,,() Ct..~
ZONING (olliee use)
. LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
Pro
OWNER
(Name)
(Address)
J,c/f>-RY .PfiTR/C/<::
.<,i/-?~ PEE.R//E~J)
(Phone)
~/P~~
APPLICANT / /
(Name) L/./.&"J / J/llE ?A8G //V~. (Phone) 9S-c2' 9'P'j'. 6Ut:J'7
(Address) ;;7.3'5 S-I/~,qy /JAA:: Rei CJ/~R7'J- J.rj/~
(Address) (Cily) (Zip Code)
(Contact Person) .JEFF ,4/2/./0 (phone) c'b/..:1,9,.y~591l9
APPLICANT SIGNATUREA,-Y4~ DATE 'i? o9oc
V ~PPLICANT PLEASE COMPLETE BELOW
Quantity I Type of Fixture I Quantity
Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink I I Sewage Ejector
I Shower Stall I I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet (Toilet) Other
Type of Fixture
/
/
I
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Twn-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $"3.~/1::JoO Building Penn it # S ~ ~80 \ ~(
PLUMBING PERMIT FEE $ n ~ . j 0 / fl rJv
ST A TiE SURCHARGE $ 5 lJ-J \' t;jJ/
TOTAL PERMIT FEE $ . >/ f)&;.--\S~
.... / '-'< r;~? r'V-
lie ti _ eeomeSYOUrBUildiDg:;t/1;1oved :::; ~ ~ II ::~e;t~)o,rr-f>\L
uildlng omc~ (Il('te - -[ () C; V'-1 rr-
24 hour Dolice for all inspections (952) 447-9850, f81 (952) 447-4245
16200 Eagle C,eek Ave., S.E., Prior Lake, MN 55372-1714
PRIOR LAKE
IN!SPECTION RECORD
SITE ADDRESS 5+32 D6E'A!FI6l-O elite,.
N~UREOFWORK ~Ae ~e;L-
USE OF BUILDING S A~
PERMIT NO. tJ.5. 0" DAtE ISSUED Z15. OS-
CONTRACTOR ~ PHONE4U. ZZA-Z-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILGlNG AND INSPECTION
INSPECTOR
DATE
I I
I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRA ING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
.
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILQING
ELECTRICAL
PLUMiBING
HEATING
DO NOT
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-
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.
FOR All INSPECTIONS (952) 447-9850
ADDRESS
, \: r:!2
DATE TIME
SCHEDULED /t1g~.r-
17 / (
&erT/~ /d CJ.-
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o JIlSULA TION
'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~ ~R HOOKUP
~..:.':':'.BING FINAL
~CH FINAL
o EXlGRAD/FILLlNG
o COMPlAINT
o FIREPlACE RI
o FIREPlACE FINAL
o GASLINE AIR TST
o
COMb'I;NTS:;
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rORKSATISF~KU<..totolJ ~
o CORRECT ACTION AND PROCEED
o CORRECT WOR~:;.~: 7R REINSPECTION BEFORE COVERING
Inspector: ~ OWner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSNOrl