HomeMy WebLinkAboutBldg Permit 05-0823
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please me or print and si2D at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only) Q .#
La"! BLOCK ~ ADDITION r~
OWNER
(Name)
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/4"5ltll ~Ol'~ La..;f<
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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Date Rec' d
i'" t9t1~~
I PERMIT NO. tJ 5- f ~3
I. While File
2. Pink City
3 Yellow Applicant
I2i.t:' tit/-
ZONING (office use)
PuJ>D
PID C;U 5"""- tY 90
(Phone) 9S--;l 0/"1 S- oys/
~ "4.~
(Phone)
(Phone)
~t</
95"01 f{Y:2. C)~i'/
{,1:2.. $"9 "8'3'}
>53 ?i'
ORe-Siding ~ower Level Finish
o Misc.
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
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I hereby certify that I have filmished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorIzed agent for the
above-mentIOned 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 building
official c evoke this permit for just cause. F rthe re, I hereby agree that the city official or a designee may enter upon the property to perform needed mspections.
J
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
OAddition OAlteration OUtility Connection
CODE: ldI.R.C. DI.B.C.
Type o~nstmction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Signa~re
di)t:J{), /' _
~~~-
$ I,t:e I
$ I
$ zt/J, ----'" I
$
$
$
This Application Becomes Your Building Permit When Approved
~~ P/Z~,4~
Buildinj! Otlicial
Date
;l1J /'101"3>
Contractor's License No.
Park Support Fee
SAC
#
#
----1- ~ <I-.S-
Date
$
$
$
$
$
$
$
$
$ /03. zS
Receipt NV fll?7
BVtf"
ThIS is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed 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 must be
issued
Planning Director
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE ~ I. VS, flS-
Paid
Date
/03. 2-5"'" _
8. zs: &If
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
Residential Building Permit Che\:klist
Basement Finish or Interior ...:iJteration to Single Family Homes .
BY: ~ 'M-I-
Date: t~ ~ 1(- !(
~~~~r~:wt/~3~l_ Jl~~
Legal: L B Subdivision:
Zoning:
E.Ii.sting StTucture@)r NO
CONFORLvIS TO ZO~ThG
ORD IN" AL'1 CE
Y"ES
NO
YES
NO
Is this an expansion of che e:cisting foo~:,.;"'t or
bUl1ding height?
Rete: to Plamri...'"1g
Is the proPert"f located within the flood plain?
Refe: to Planning
}.it)
jJO
fit)
Does the alteration include any additional kitchens'?
Refer to Planning
Does the proposed alteration include any outside.
entranc~ othe:' than patio doors?
ReIe: to Planning
/J(j
Is the proposed use oI the finished. spac~ or
alteration for anything aIDe: than a normal single
family home (offic~. grou~ home, day cue. etc.)"
Rete: to Pla-n-nmg
IJo
THIS CHECKLlST MUST BE COMJlLETED .-\J.'fD INCLUDED IN THE BmLDlNG PERi'v!lT FILE TO
i'llAlNT.-\.IN .-\. RECORD OF THE REVIEW.
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PEAAul
9. C, ,05-
OS . /~
~. ~': ~:~ PERMIT NO. /Jr-. 0 ". L~
3. Yellow Applicant v.:J. (J~
(Please tvoe or Drint and sia at bottom)
ADDRESS
/4-3(P I sl/t);e6 ~G
. ZONING (office we) .
LEGAL DESCRlr .l.lON (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(phone)
. (Address)
APPLICANT SA} PI 0 /''\ -,rC r~..... ~J ~"'Ilt.l"" f,>r
(Name) I-\- 7'AJ ~ (Phone) .Jo Ir "''- 'f /J. -nr n,
(Address) 'S'''t ~ 1 \('(f'1-. S.J c:;~ ~ ~4 .-Z7.V
(AaesS) (City) , (Zip Code)
(Contact Person) t. ')tt>r r:;; - _ IJ ~ (phone)
APPLlCANTSIGNATIlRE f) G.... ~ DATE..r::-!LC '~vJ~.).:'4<;;'
APPLIC6T PLEASE ~OMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
L L c.....
".J
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEESCBEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ ~
/
Paid ~
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
~K10 ~~
~tJjV
./
./" .50
Estimated Cost $
Building Permit #
(Omce Use Only)
This Application Becomes Your Building Permit When Approved
~.
t
Date
Recei~
By
Building Omcial
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
P R I 0 R LA KE DIi,PARTMENT OF
Il .EfUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS &t, I ~.h~~e ~
NATURE OF WORK ~
USE OF BUILDING . S F -
PERMIT NO. . ~ DATE I$SUED $- iJ,J- S'
CONTRACTOR C ~us-rr PHONE 8"'-- (J~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~
I
I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
F "NG
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
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~
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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BEEN SIGNED
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BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
)U/f-
//A
v ,
OCCUPY UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections hav. 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
INSPECnON NOTICE
SCHEDULED
ADDRESS
/~~/
J~.."c.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o I!!lULA TlON
",...8"'RNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~
// P'l7./
DATE TIME
~~
~
s-- ?-2J
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
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BEFORE COVERING
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSIIfOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &I SAFETY!