HomeMy WebLinkAboutBldg Permit 04-0618
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTI~N (office use only) IJ I
L04 BLOCK d.. ADDITION .x:f./!W1~:- ~
rJ ~
OWNER ~
(Name) :J~)
(Address) 552\
(Please type or print and sign at bottom)
ADDRESS
6" 5' ~I
Date Rec' d
1. White File
2. Pink City
3 Yellow Applicant
I PERMIT NO. ()If- G/~
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~tLu
ZONING (office use)
RJ S,Q
PID d5 - / fa S'. {J;)-f--Q
<;. \....J e,..V\,s. Cl ...........
<..a 5+
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
qsz-t.../L)O-5l../)(P
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L A-r.~
l~e-;r:zu...J
sE
?.I.~<).J-
C:vcjt
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding Ii1'Lower Level Finish 0 Fireplace
OAddition o Alteration DUtiJity Connection 0 Misc. r'\
CODE: &aI.R.C. OI.B.C.
Type of &nstmction: I
Occupancy Group: A B E
Division:
II
F
I
III IV (V'\ ~ Q
H J.... "M"' w S U
2 W 4 5
PROJECT COST IV ALUE $
(excluding land)
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 authonzed agent for the
above-mentIOned pro nd that all constru . n will conform to all exisltng state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revo is per it cat I ermore, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections.
x
I
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty I $
I Plumbing Permit Fee 13u OLultkJr
I Mechanical Permit Fee f $
I Sewer & Water Permit Fee $
I
Gas Fireplace Permit'Rll !JWIYC:J-
I
Contractor's License No.
"'-2./-0,-/
Date
/. .
ill !$fJtJO, 01)
79: 7r
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
....
Water Meter
Size 5/8"; I";
J , ~"
Pressure Reducer
Sewer/Water Connection Fee
#
#
Llo- -
~
Water Tower Fee
Builder's Deposit
LfO.-
~
C' / e C-- {!Irn1A.u.-UIJ1...
TOTAL DUE
Other
/6 ~ ";)-5
Receipt No. (../~ f~!:
~
This Application Becomes Your Building Permit When Approved
~~
~f~,fty
Paid
Date
l6-~'oS-
& '~J-(1
By
Building Ollicinl
t...J
ThiS IS to certifY that the requcst in the above applicalJon and accompanYing documents is in accordance with the City Zoning Ordinance and may procced as requested. This document
when signed by the City Planner conslJtutes a temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CCrltfiCale of 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
...4? r- ~ r; ~ ,
BY:~~
Date:
c; ~ ;;;2/-0c/
Building Permit #
Site Address
Pill:
Zoning:
.s 5.;2/ i-04
Leg'll: L B
Subdivision:
~
~'
.
Existing Structure: x:"ES or NO
CON'"FORlvIS TO ZONING
ORDmAl~CE
Y'"ES
NO
'YES
NO
Is this an e:tpansion of the e;j~i.illg footprillt ar
building height?
Refer to PlanLJ.L.'1.g
Is me property located within the flood plain?
Refer to Planning
,Jv
fJo
,.10
Does me altention include any additional kitchens?
Refer co PlaImmg
Does l~e pro-posed alteration include any outside
entrances othe: than patio doors?
Refer to Pl;1"''''';TJ.g
Nd
Is the proposed. use of the fi.Tl.ished. space or
alte:-3.tion for anything Ow.1e:' If}an a uormal single
,.. .... 1 ( ,..- ~. \ '7
car:llly nou:e OElee, group nome, d.ay care, e:c.).
Rde, to Pla:nmng
tJo
THIS CR:ECXLlST MUST BE COMPLETED AJ.'fD INCLUDED IN Tm: BU11.DING PERi'lIlT Fll.E TO
~l.lJNTAlN .-\ RECORD OF THE REVITW.
- '--:-:""I-:::T :.. :-:-",":' i --,-"1"--7('; '~(~c
PRIOR LAKE DEPARTMENT OF
, , BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS S~ ~I t~s-f HtJri 3-0~ CLi V'
NATURE OF WORK L L.
USE OF BUILDING 5 F . J
PERMIT NO. 011- ~/1r DATE ISSUED ~ ..~'-O..,
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
/4t:/f
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// //6/09"
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/~6~~
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FRAMING e.~>~ W(v1~
INSl;JlATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTil ABOVE HAS BEEN SIGNED
I I 1
FINALS
#FI ,
,H~
BUilDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
/J
//Vf/
1I-~-rJ:i
-
YV)/ / ..'
///]/
v
UNTIL ABOVE HAS BEEN
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.
If" ~-c6
{tr <6' tfIj
SIGNED
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.iI' k'-C:O -
ADDRESS
SS'1..(
1-10",,. ~ C' ,~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4.- Clfj
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~REPLACE FINAL
~ ASLlNE AIR TST
COMMENTS:___
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--- --
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR ED
o CORRECT WO 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/
INSNOTI