HomeMy WebLinkAboutBldg Permit 05-0224
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. as- -~Lf I
(Please type or print and si~ at bottom)
ADDRESS
4 &'11-
TJlvif
4-e'fl ~I
--P2L
ZONING (office use)
PU/J
LEGAL DESCRIPTION (office use only)
LOTS ,{LOCK I ADDITION
OWNER
(N ame)
j.,,.J
~ ~ ~r {J~ PIJb7~-4/C)J- c::b/-d
/
(j-t,,- I J,J CA
M~~ &dW1- ;J/L/
J
(Phone)
(q,l..- 'Of) - ~;Jfa
(Address)
Itfc2~9-
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding )QLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
CODE: ~I.R.C. OI.B.C.
Type of &nstmction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE $
(excluding land)
I hcreby certify that f have filrnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owncr or authonzcd agcnt for the
abovc,menl1oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am awarc that the building
:'flcial can reVOke~e;Z Just cause Irtherm~erebY agree that the City official or a designee may enter upon the property to perform necdcyh?A J
Signature Contractor's License No. Date
,
I Permit Valuation ",300 l) .oe Park Support Fee # $
I Permit Fee $ 74, 7~ SAC # $
I Plan Check Fee $ Water Meter Size 5/8"; 1"; $
I State Surcharge $ (. S"a Pressure Reducer $
I Penalty $ Sewer/Water Connection Fee # $
I Plumbing Permit Fee (!f),uf y- $ Lla,,, D Water Tower Fee # $
I Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $ ./
Gas Fireplace Permit Fee JlO $ TOTAL DUE $ .11t/; /;)-5
......... i/:!fO~'?-
This Application Becomes Your Building Pennit When Approved Paid //~'c7.5 ReceiPt No.
~~ *~fc;~ Date .~- A'l- l) By ~
Buildlllg Ollicinl
ThIS tS to certifY that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requestcd. 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
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
Ba,seme.:::n Finish or Interior AltGr:J.rion to SinQ'le Family Eomes
~ .
BY:~
f"
9-~f-.
Date: 3 - ;;? C; -() S-
Building Permit # .
Site Address
Pill:
<<5~d
~g:~ ~
Legal: L
B
Subdivision:
E.ri.sting scrucru~r NO
CONFORl'YIS TO ZONING
o RD lli ..:\J.~ CE
Y"ES
NO
I
Is this an expansion of d:.e e7.i~...ng footpr.nr or
building hei~ht?
YES
NO
Refe:- to Pl~T1-n"~g
~o
Is me proper":,,! located within me flood plain?
Refer m Pla'nT,,.i-ng
Does the altention indude any additional kitchens?
Refer to Pl~-n'"~g
fVo
PC)
No
Does the proposed alteration include any outside
entranc~s other tb.a:I:4 patio doors?
Refe:- to Pl.'~"'~~g
Is the proposed use of me Brishe:i spac:: or
alteration for anyrbng othe: than a uor:r..al single
famil~l hon:e (offic:, grau'9 hOwe, day C3I~, e~c.)?
Rder to Pla.rm:ng
tJt}
THIS CHECKL1ST:YlUST BE COMPLETED .~'fD Ii'1CUJDED Ii'1 TH:E BlJ1LDli'1G PERiYllT mE TO
MAlNT.-\.IN A RECORD OF' nIT REVIEW.
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I./B2z.. 1:htfF ~~t.c~ ~ \l^"c.....
NATURE OF WORK ~ER.. ~-R-M~"
USE OF BUILDING . -. S.F; " · __
PERMIT NO. ~,,(}..;i/ DATE ISSUED ..,(~C\ ~
CONTRACTOR "')D~ 6LE{3NerL PHONE~.fc,OO-"o',
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
1/
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?/(~~S-
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y/r/Os/
~/(//c5
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FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if re uired)
COVE.R NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
i / /
//2Pp..s-
#..)6/o~ -
,~/2~oS-
t// z#d5
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
I,'
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"f
'.
~A TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED. ?J
4f?.2- /5~////A~ Tr/
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENT,S: .."....., I
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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C/A:
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~ORKS~ PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL F REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl