HomeMy WebLinkAboutBldg Permit 05-0921
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I PERMIT NO. OG", 0 rz I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1 White
2. Pink
3 Yel\ow
File
City
Applicant
(Please type or print and si~ at bottom)
ADDRESS
J 4-J[p '1 () /t~ A-h nq uk. CI
~
LEGAL DESCRIPTION (office use only)
LOT J BLOCK 3 ADDITION
,snDh J JJ 4f!1
PID 25~ 3&'2.. () z. 7. 0
Date Rec' d
ZONING (office use)
IGI
O~R ~ ~
(Name) "'e-.n:ho ~ }a~ -L~k.kef
(Address) JLJLjIJ 7 ~hhn~cJc fr ,JE
BUILDER I r' . I ~.
(Company Name)-E J JJ/)~ -I-f11YJli5 I (Phone) 9E:J. - gjs ~!(J./Yj
(Contact Nam,) ~~l~ J.riIv.m d" 100Mn ~Ii-I<hp (Phone)
(Address) J ~) _ _ _t_lj jyt <.<) ~ d-DVf3f.!..liJSYJII-t llJ,J ..5ZX3o {,
(Phone)
TYPE OF WORK. 0 New Construction ODeck o Porch ORe-Roofing ORe-Siding ~Lower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc. 1"
CODE: DJ.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
J
E
PROJECT COST IV ALUE $
(excluding land)
45; D()O
I hereby certifY that I have fitrnished 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
above-mentIOned property and that III construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:~;;;k~: :er1 fOT' . cause;;;;er'0.i;;/ agree that the Ctty official or a deSignee::1;~e~pon the property to perform needed m;e~t:_D S-
. L J' ~re Contractor's License No. Date
oJ'
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
$
$
$
$
$
$
$
$
'J. akJ ~
,'" 7{"
$V
I
Water Meter
Size 5/8"; I";
Park Support Fee
SAC
#
#
Pressure Reducer
Sewer/Water Connection Fee
#
#
~o.oo
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE {!Ru@ 9 'Z--1. o~
_o~
I Paid /11.7 ".+'?
I Date ~- :J -/j /F
I
Receipt No.
By
Date
$
$
$
$
$
$
$
$
$
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CT
ThIS IS to certifY that thc requcst in the above applicatIon and accompanying documents is in accordance with the City Zoning Ordinance and may procecd 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 mllst be
issued it:fd Lo~ /e<A( 1-/-a..daA-
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
09-29-200508:17AM
t'1ATTHEGJ DAN I ELS I I ~jC .
423 3017 P.01
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(P1Js.e tYPe or print 3111 sien at bocrot:n)
AD'DRESS I
14~Io'1i ~J T; JI rvt 1-;) ~ N.E.
I !U~
LEGAL DESCRIPTION (office use only)
. I
I. Blue File PEn~~. IT ~ q~1i
:. Cold Ci'y n.
J. YellOw Applic'Ol
ZONING (oflk~ use)
L4H
!
o VINER
(Ni.me)
)r,Al~~J~D ~;)
I
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1/
UJ-L-, ~,~
I
PUp
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(Phone) 9S.a. ~ - "884
.50&37
BLOCK
ADDITION
(AcJd~ss) l./d), bULJ ~~
I I~
Af1PLICANT '
(N'ame)~p.I"".
(Address) '52-~ ~ a.rrou~t;e1
i J (Address)
I
(Cbnract Person) L 'JkH'l i el
AJPLICANT SI~NA TURE
I
I N{l .
(Phone)
R.n.-'e.YYlourrr.. MN
(City)
bn"J. 42=t... ..~~r")
WOj
~
(Zip Code)
J
E. ~Y'I' (Phon~)" (.,5'"J. .o.I~''-~''W6
1/ ...' 1L '-1t .~LA, ~ J' "u- DATE "4.1r.;$, ;ldo~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
BathTub with or without shower
lDishwasher
lliloor DraiJ'l
I I).,avatory (Bathroom Sink)
laundry Tray (1 or 2 compartment sink
Shower Stall
I Sinks
~ar Sink
Water Closet (Toilet)
I
Type of Fixture
ruantity
i
i I
I
I
I
J
Rough-ins :
Water Heater :
Water Softner !
Stand Pipe (Wa.$hing Machine)
Sewage Ejector I
Backflow Assembly
Backflow Assetpbly Test
Lawn Sprinkler:
. ! Other .
I
J
I
I
,
Residential, New One &1 Two-Family S99.50
Residential, Additlj &j ~lions $39.50
Building Permit # rJlt()/~() ~
i '''G p,'f Ij
I PLUMBING PERMIT FEE $ '-$9.6l>: ~~4t~
I STATE St1RCHARGE $ .50 I .' I
I TOTAL PER.J.mT FEE $ i'IJ . ~~..A1-. ~.
~~~i ~ ~,.
IThi' .{ppli"'tl~n Boco.." YOdr Building Permit Who. Approved i~.' If (C;~ U . I~ I lilt. . ceipt No.
D~t~ 1~#..tt,teU(;T 0 6 2005 ~,JIIF;J, y
Buildine Official .. ~ I! II
2. h.., ..ti<o f., 'II inspocti.", (952) "'7~' ..g&"'-"--4~.. r I
I
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimate.d Cost $
TOTAL P.01
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 111"1(, 7 (I,,,,,t'''4.1<-
NATURE OF WORK ,-,t-. ~1t1S1i'"
USE OF BUILDING 5. F. '0-
PERMIT NO. Os. 0 '12/ DATE ISSUED tf z I. CIS
CONTRACTOR 14I...cl ~ ~~.L PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDIN~ AND INSPECTION
INSPECTOR
DATE
I fi.8ITHU~ I
r.yUB............ \~ 1r18f .. lIIackfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
8~-.. _... ... .re" , v~.. ..v
fu/t
//1/11
~
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
JiiIR~PLA8E
r' -tA ~ · I t.1Iii I Iii Ii 'f::.
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to- j I r(})
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70/ r/~s
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
- flIIIIIlT 11 HU,ng)
BUILDiNG
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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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
ADDRE~~q L, 1
O~,
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
-:Iii{ FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~
N;~ -7J~~
CONTR.
PERMIT NO. C; - Cj 2....1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
L , \ -~ F'.....,J\.
~ +0 ~~ {2L,
- \..
~RK SATISFACTORY, PROCEED
o CORRECT CTION AND PROCEED
o CORRE , ALL FOR REINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
CAL 44L~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
./
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon