HomeMy WebLinkAboutBldg Permit 04-1038
DATE RECEIVED CITY OF PRIOR LAKE
10. II. 0 +- BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. PiDIt
3. Yellow
File
City
Applicant
Permit No.
M. 103B
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3046 Knollridge Drive N.W.
1. DATE
10-11-04
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
~
12. NO. OF STORIES
LOT
BLOCK
z
PID z6.3ft10. OO5.Q
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER (Name)
Jonathan & Lorie Orman
5. ARCHITECT (Name)
(Address)
3046 Knollridge Drive N.W.
(Address)
(Tel. No.)
952-226-3690
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name) (Address) (Tel. No.)
Lauer Mechanical Maintenance, Inc. DBA Lauer Construction
9309 Lyndale Avenue South Bloomington, MN 55420 952-881-290i
7. TYPE OF WORK Fireplace LJ Septic LJ Deck LJ Re-rooflngl Porch LJ
New Construction LJ Alterations LJ Addition LJ Finish Attic a Re-slding LJ Finish Basement LJ
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
SEATS
16. PROJECT COSTNALUE
$4,800.00
17. COMPLETION DATE
Yes No
11-30-04
I h certify that I have fumished 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
th abov mentioned property and tha all construction will w..;~.... to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bui 'ng 0 I can rev It r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X J 4052 10-11-04
License No.
Oate
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA LJ
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS LJ SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z" 500. 0 c)
SURVEY
PLOT PLAN
a COPIES
LJ
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee .......... ................. $
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builde(s Deposit ............................ $
Other......................................... $
Total Due .............................. $
Paid 10, If. 0 4- RecelptNp. "?81t7
Issued ~ I
Date 1eo ~W By 11. _
This is to certify that the request in the above application and accompanying cIocuments is in accordance with the City Zoning Ordinance and may . ..., , J requested. This cIocument when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Balore occupancy, a Certiflca f Occupancy must be issued.
'IV;. 00
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
City Planner
Date
Special Conditions K eny
24 hour notice for all inspections 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TillE
t'~~-
, ,.
ADDRESS JO~6 k'..Pt~/~~'~~
-t
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
...&"'FfNAL
o SITE INSPECTION
COMMENTS:
/J /)
/~O() F
.-"'I ./
r'~V'~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~cT-/a.?~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ .~ /
G~ /e-.~
'"
~./
/-:/ /.p
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & &4~iH ,,'I
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