HomeMy WebLinkAboutBldg Permit 05-0038
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
While
Pink
Yellow
File
City
Applicant
I PERMIT NO. o.s. 0 ():5 8 I
/63&5 CrlGL65 ,€-IoGiE: ;1/111
LEGAL DESCRIPTION (office use only)
LOT33BLOCK .:3 ADDITION
f/V/L-05 .soU71f
PID.-?S 382. 087. ()
OWNER II 1
(Name) __if1'VI (eo..
+\-a.lliKat
(Phone) 4!JZ .440 -/1/{9
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Date Rec' d
1./0.05"
ZONING (office use)
12/
TYPE OF WORK D New Construction DDeck DPorch ORe-Roofing ORe-Siding j)(Lower Level Finish 0 Fireplace
DAddition OAlteration DUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECTCOST/VALUE S
(excludiug land)
I
E
II
F
1
1IlIVVA
HIM R
2 3 4 5
J hereby certify that I have furnished mformation on this application which is to the best of my knowledge tme and correct I also certify that I am the owner Dr 3uthonzcd agent for the
above-mentIOned propt'lty 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 buildmg
:"C,'] (" 1k;/,,,'mit fa, J"" ,,'so FM", I h"'by '.", thot th, "ty offici,!", ""'gn" m,y en", opon the pmpeny to p"fo,m n"d'/:;0"":o5
..... -- - Signature Contractor's License No. Date
$
$
$
$
$
$
$
$
$ /43. '7S
I ReC/"iD 4rC,,j'..f
By ;:
, -
Permit Valuation 2, 00 '" _ C 0
Permit Fee $ 62,75
Plan Check Fee $ -
State Surcharge $ /.00
Penalty $
Plumbing Permit Fee 61{ (<J#l1/. $ 4--0. C'li
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ 4'-O_(lU
~y ,UJP"17<- .
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1 ";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
This Application Becomes Your Building Pennit When Approved
Paid /43. II
Date /_ j(). <'';-
BlIildin~ Otlicial
Date
/
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
issLled
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
FROM :FARMINGTON PLG & HTG
'.'~- -.. "
FAX NO. :6514637835
Feb. 02 2005 03:50PM P1
s~\
"""_".10""
CITY OF PRIOR tAKE PLUMBINC PERMIT
Date Rec'd
5' ~8'
""' r.., I PERMIT NO
I Gol4 C"r .
J 'hllaw "'w1LY1
(P~ut wee or DMlaad siJm al bottom)
ADDRESS
ZONING (0"'''' ",'
1 CO?, InC:;
E",,,-.le.,>
'~
K,Jd~
LEGAL DESCRIPTION (olllee.... .Illy)
LOT BLOCK
ADDmON
PlD
OWNER /l
(Name) H ,uQ~etsl
H,",-\bk<>-~
(AddIess) I C;::z, 1.",(, . ~\ f'., K,~.o:..-
APPUCANT \
(N&IIIC) FM r ~ " ~~'""- P ( \A '^" lQ.1.>1g ~
(Addftss)a.ID3'-1 C:hinqi>vo&"l.. 19u'l:
(~)
(CaalIa PCIIOII) J, '^'" J f),. '"
APPUCANTSlONATUilB '"'.J) ~ ~'L
(Phone)
\+~_ (phone) 1,,51- LJ/o?,-7B;)..4
:t=Tj.~(' -h"..., ~<;Q'~U
(Olt) (ZIp Code)
,
(J'IIoae)
DATE
ri. - rl.. -(Y-..
APPLICANT PLEASE COMPLETE BELOW
QlAIllltJ ~ of ~re QualltJ J TJpe of fuCare
BGlI Tub wltII or WltboUt IbOWCI' ' RDu.....
~ WII#tHe.rer
~Iiilu WIlCrSolbicr
1 ~(B1IbrooaI Sink) I ~ PilMI (WuhinJl Machin.)
Liiiudry 1'n., (I or i COmllU1menl8ink Sow&ie BleCcor - ,
shower Stall Bicktiow AuerDblv
SfftJcs oacld1ow AJSelI\bly Test
Oar Sink lAwn Sll1inllcr -
I WiUJr CIOId (Toilet) Other _
CC'"r"'~ Lc. JI, "'~"saJ.~";"J J "~~ o>.rt K.
IadluIrIII.C", '. ..1AMullWaalllJl"'afj4bc..Urldll S39.JO-1.~- RaIdeadaI."'ewOllcA 14hw,~50
rcaw.Iol. AddIlIanaA ~$.~:
Ilstimlled.. t ....-:._ JI!II1dIn& I'cJnDU ~41~
PLUMBING PBRMlT PEE S
STATESURCHAROB S
TOTAL PUM1T ra S
(011ooo Vol 00Irl
nJI AppUeaIlA 1IecoIa.. V..r IIlIlIdlae PaaIl WIIea Apprond - 1'814
. DIll!
I"" UIIIdd
Do..
U PIr ..Ia r.. .1 I..,...... (951) ~MISO, ,.. (95J) ",..u.
I
I
I
I
I
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1
I
I
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDIN
PERMIT NO.
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BEL
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
1---
I
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.
rt{?
)
I
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I
V
I I
y/?/c€
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (If required)
FIREPLACE
GAS LINE AIR TEST
.
0' (V I/z,--
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/)"
Ii tJ} I
. I
I
-V
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
)
I /9/6~
I '
This card must be posted near an electrical servlca 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 shail be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE I~
INSPECTION NOTICE SCHEDULED
ADDRESS }5"3&'S 'Z~l,.("'" R.L~
OWNER CONTR.
PHONE NO. PERMIT NO. t;" - ao5~
o FOOTING o PLUMBING RI o EXIGRAO/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
....a1iINAL o PLUMBING FINAL o GAsLINE AIR TsT
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
OJ~ ~ ~:'lf'
/'
rORK SATISFACTORY, PROCEED
o C:uRRE ~TION AND PROCEED
o COR C RK, CALL FOR REINSPECTION BEFORE COVERING
Ins r: Owner/Cont':
CAl.l~~O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
If'lS/lOTJ