HomeMy WebLinkAboutBldg Permit 05-0424
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS /I
/ h 7 Lj 9 /~ nnel/ 7 VIA I
,
LEGAL DESCRIPTION (office use only) ;...x:J
LOT3 BLOCK J ADDmON~/VIl/tJ-/ c9
~=e~RFh~~ h-/ J+eYJ
(Address) J h 7 Lj CJ A rJ #'1 &L ~,,-\ I s: E
BUILDER.- t /
(Name) y I ~ Ct'~", p ~
(Contact Name) &A ~
(Address) ~O I e 71 ~~
I
/]u-. I j.,rJ
~-/~-IJE
I. White File
2 Pink City
3. Yellow Applicant
PERMIT NO/J'7_ If;}." if I
~E
ZONING (office use)
R.J
PID OI)/1-(/tJ ~-O
(Phone) 9~~-lfIf7 -S"3 ~J-
I
(Phone) t::jS-J-, yY"Y"" ~).:l ~
(Phone) t / ;)..- ? 2. Y - :l. -:s :1 9
./
sf.
'IS Il:II," J /Jq ,/.ph
,
(1Misc.13~J )" ~::~J~e/iniSh
",
ODeck o Porch ORe-Roofing ORe-Siding
o Fireplace DAddition ~lteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ J;l. () t) ()
I
TYPE OF WORK
o New Construction
I hereby certifY that I have furnished 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 can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon ~roperty~err needed inspections.
X A1aA11 ~ / 7 q *1 J-=--II-OS-
/ Signature Contractols License No. Date
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
Plurnbing Permit Fee(~AJI-v $
MeChanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
/t7?V, ~
~~'
~,.2'/
.ro
'-10.
.
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This Application Becomes Your Building Permit When Approved
~/~
Building Official
S~L/GS-
,
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
I Water Tower Fee # $
Builder's Deposit $
Other $
I TOTAL DUE ~ .5.l.:l.0S $ /O~.5ft?
I Paid
I Date
/tJ~. ~(11
~.U~r
Receipt No. 'f<13/(,
By /.
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
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
05/02/2005 08:32
9527585942
WELTER BLAYLOCK
PAGE 01
Date Ree'd
c~ I i OF PRIOR LAKE PLUMBING PEnu I
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~: :: ~ I PERMIT NO.A~ ~..""""-
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f~ t'ftIII !JNlIIlIIt..... "'.om)
IADDRESS
ULP14-t1 AvlnC\ IVai' J Sf-
ZONING (..,mc~ ~l
I LEGAL DBSCRIYl10N (0_ \IIIE oaJy)
,
I
I LOT BLOCK ADDITION
PID
OWNER n oJ
(Name) ~e(G\ I ..L f'-I)...f~ 'fe,\(:1-\e"v}
I (Add.rtssL1.1.-PI 4 ~ I\vl n Cl T reM I S E..
Wel
1509 E Hi way 13
(~'1nit, li~ mn
;.,,1 c..~__ ~cX~
. I
. 'PPLlCANTSIONATtJRE 1\ M~&
APPLICANT PLEASE coMPI..I'D Bnow
type offtdllre ~
88th Tub with' Or without shower
Oitbwesher
Floor Drain
laYarory (Bath. . " . J Sink)
Laundry tray ( I or 2 com,.nmeGt sink
Shower Stali ..
Sinks
ear Sink
Water Closet (toilet)
APFUCANT
(N ame)
(AddreJ$)
(ContaCt P ~...ort)
Q...dCy
I
I
I
J
(pbonc) L-fLl, ~ 'S? 22-
'5~ - 5<t~ I
(Phooe)
(Ciry) (Zip Code)
(Pboae) -Li I ~ C7d \ LP1 '5 I
Lf~()-'- OS
...;;,r.- DATE
Type of fldare
Roush-ins
w..... Heater
'Water Softncr
Sa.nd Pipe (W....ma Machine)
s.wap Ejector
Beektlow Assembly
Backf10w Aasembfy Test
Lawn Sprinkler
Otber
li'EESCHEDVLE
Inc.lulluiaJ. Commeceial &. Mulli-fan'il; ."/. of job CCJ6C with a $39. SO minimum
Dmc(' l)~ 0".,)
Reside"''', ~_ One & Two-Family S~5()
RetidentiaJ. Additions &\ AltCt1ltions S39.S0
Estimated Cost S
Buildinl Pennit *'
PtUMBlNG PERMIT FEE S
STATESURCHA~OE $
TOTAL PDlMIT nE $
.50
Paid
Receipt No.
This ;\pplie.Uon Becomes 'tour Buildhll rermit When Approved
Date
By
....lid..., Ornel.'
0.,..
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /t ?~" 4~ 7;., Z
NATURE OF WORK ~N".~;;"'" ~M~de. f
USE OF BUILDING ..s ~4f1
PERMIT NO. -". DATE ~S~ED
CONTRACTOR ~~ " PHONE~.I.~.~
NOTE: THIS IS NOT A PE IT 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
.....
FRAMING fA1/ ~ ,- (" 06'
INSULATION ~ I
ELECTRICAL I
PLUMBING Y1/V / ~
HEATING (if required) M
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
~
~
~
{'
i ~
.p'2e~S----
?//r//oS-
~f/lJ~
7ftJ~0-
BEEN SIGNED
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 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
._.,_,_".,"<c_.~<.~.,.___......,.~__~,......_____'_. -
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/L 77/94~~__
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
;;4/as--
~/
t:::'-:s- - Y.2~
./
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
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IS FACTORY, PROCEED
CORRECT ACTION AND PROCEED
o CORRECT WOR'] ~Y~EINSPECTION BEFORE COVERING
Inspector: F~~ner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSliOTJ
White - Building
Canary - Engineering
Pink - Planning
BUII.DING peRMIT APPLICATION DEPARTMENT CHE.CKLlST
NAME OF APPLICANT 'f) Ie.- tl( EVJU IJd I 1/3 kLy-S;
. O-Id--~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~/}q~ HIt//f/Ct fr-
- / F.
Accepted
Accepted With Corrections
x
Denied
Reviewed By:
~f~
Date: ~~~-
I' c..
Comments:
A~J~ ~qd ~~~~/
~cI;v 1/
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."