HomeMy WebLinkAboutBldg Permit 04-1163
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 PERMITN06~_/I&3
(Please tyoe or orint and siltll at bottom)
ADDRESS 50fdJ c.. 04..-1( POlf) +- Dr.,5 E.
fV",oY L-AK~. fhI0"5"'}.37g
LEGAL DESCRIPTION. (office use only) 111 .
LOT I BLOCK Q ADDITION I~JJze4J
OWNER l'"'\ I jJ I
(Name) ua n Ie.. n R + h e<d-J)
E u4K Fo, n-t-
(Address)
5c/c. Q
BUILDER
(Company Name)
(Contact Name)
(Address)
ZONING (office use)
JO~
PIDd5-qo/- rJ[}.f-6
WAjYle-,Y'
br C) e..
(Phone) q SJ- - Li 4 () -L/ g 7n
J
r II c:J r LA K €-.
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck o Porch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
I hereby cenify that I have furnished information on this application which is to the best of my knowledge Ime and correct I also certify that I am the owner or authorized agent for the
above-mentIOned propClty and that al1 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
otTIcial can revoke chis permit for Just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections
X 4\ ~e W~ Contractor s License No. 11- 'r2.e-()Y
J/
~VOOO.OO
$ d'7.2S
$
$
$
$
$
$
I
I
I
I
I
I
I
I
Gas Fireplace Permit Fee A)I) l $ I
f-rafYl~ ,~OMlt/ f-or/ViJvJ
This Application Becomes Your Building penni{ When Approved
~~
CODE: lIiZh.R.C. DI.B.C.
Type of &nstmction:
Occupancy Group: A B
Division:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permir Fee(t()V+ y-
Mechanical Permit Fee
Sewer & Water Permit Fee
Bl1ildin~ Otlicial
I
E
II
F
I
IIlrvVA
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
2....." <:>
Ljo, -
II/rr:I6'f
'Date
Park Support Fee
#
$
$
$
$
$
$
$
$
$ /d--Il- d,~
SAC
#
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other Jl/ t>
TOTAL DUE
Paid
Date
----
/ ;)Ji_ 01:':;)
/r (::T - 0 ~
Receipt No.i.t'fU,/-'J
Bv Or
U'
ThIS IS to CtTtify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pwceed as requested This documenl
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
Basement Finish or Inlerior Alteration to Srngle Family Homes
~
f2.-.. . . ~ (JA.
BY: ~ ~.-
Building Permit ;;
Site Address
Pill:
Date: /1- 1-5 - tJ Lj
50&0 zLg'Oak PI I?y);'~
Legal: L (
B
OL
Subdivision: ~r,t7 lOt::!-
Existing StTucture@r NO
CONFORlvIS TO ZONING
ORDlliAl'{CE
Y~S
NO
YES
NO
Is this an ex:panslon of the exi~W1g footpru:c or
building heighl"
Refer ~o Pl8.I1J1.ir.J.g
I Is the properlY localed wilbin the flood illain?
I Does the altention include any acditional kilchens?
Does the proposed alte:-ation a:clude any outside
entrances ather than patio doors?
Refer to Planning
t-Ja
00
NO
Refer co Plam:ing
Refer co Plaw"ling
t-Jo
Is the proposed use of the fi..nished 5pac~ or
alte:-:lnon for anythLJ.g ou.~c ch.an 2. lloG:2.1 5ingle
family hame (office, grau? harne, day c;J,r~, ~::c.)?
Refer to PlaImmg
00
THIS CR:ECKLlST MUST BE COMPLETED A.'IllINCl.UDED IN THE BL'lLDING PERvllT FILE TO
ItL.\li'lTA1N A RECORD OF THE REVIEW.
~ ,-:7,/,~T J. -::',j, - -,~~~.:;(-.: -::(~:C
PRIOR LAKE
INSPECTION. RECORD
SITEADDRESS ~'-O EAf:r f;A/l. "jr~'- :DiP. Sr.
NATURE OF WORK l. 1L-,j.J/~'"
USE OF BUILDJ.f:'J~ .s.1:": .
PERMIT NO. (1 '1/ II w3 OAT ISSUED JJ /l'z{L1/
CONTRACTOR ~''11. HON~"~
NOTE: THIS IS NOT A iSERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (If required)
FIREPLACE _:... - ... ~I ~I'~-
.
GAS LINE AIR TEST
.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
;jj
/ffr.
ic;;' .
~
,H~~
/C~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
.
)?P'?
1#-4/
#a--
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
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SIGNED
This card must be posted near an electrical servll;:8 cabinet prior to rough-in Inspections
and maintained until all Inspections have ~een 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
ADDRESS \'Of-D
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~ I~LATION
~NAL
o SITE INSPECTION
-POMMEN.TTp: : ,(
ff -e.:;-/h W?,
SCHEDULED
P o.:,d.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
r )!tl;iECH FINAL
rZ-/
r~4~L *~/
,
/LJrZ 6',k9 /':"~/
-J
;
- $er:k.
.-:,
/7 'h? (
./
f-rh4 (
~
Olf
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/1- fi
TIME:
c7/- //~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLINE AIR TST
o
2/; h.r
-
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di
/
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./
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r: ~/d
( ~;:r--e It Ie
'-. -. ...---
..,a:::woRK SATISF,,", u" .;.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~EINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
pie ~/I ti tJlj-/163
(Please"!vpe or print and silm at bottom)
ADDRESS
;;;:, ~::y I PERMIT NO.Ail _ /.,.;nO
). Yellow Applicant U-/ ~ V
$000
E- ChIc Pi- Dd"-
LEGAL DESCRIPTION (office use only) / /) _. JJ.'_ II
LOT ( BLOCK :J.. ADDITION ~c..f / tJ n
u
~V:e~Rra_+h /f?c:N 9- Drvnd
!d2C;ItJ&~
I
(Phone)
<Address)
APPLICA~ _
(NameL~./YM~
(Phone)
(Address)
(Address)
(City)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE.
ZONING (officeus<l
PID,;2S-L/Oj-6}/-Q
1/ t/tJ- LI /70
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
~ . itioning
V/"" \ OVent. Syste
~REPLACE MAKE AND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
../
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Industrial, Commercial & Multi-Family
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3t1-S6
.50
Lit!,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I pai'Z;O, --
I Daj"", -~ -0 Lj
Building Official
Date
24 hour notice fur all inspections (952) 447-9850, fax (952) 447-4'1Af
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
ReCei'2/~ t? 3 ~
By
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