HomeMy WebLinkAboutBldg Permit 05-0335
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2 Pink
3 Yellow
File
City
Applicant
(Please type or print and si~ at bottom)
ADDRESS
,~ /4B f-ll\\M-OVe 6..\J"e.. ~{:.~ ?....~,," l.~~..... ~U ~ 'l. :>.,~
LEGAL DESCRIPTION (office use only)
K(2a)r4 ~ I <-...2 .~........, G ~
.-
LOT C) BLOCK '-, ADDITION
Date Rec' d
PERMIT NO. a- S3..s-
ZONING (office use)
PID '2)"- I :31~:J.-, U
OWNER
(Name)'Ro~U" 1:> 4- "8,,"\(H~ \<.. ~ ~ c.t'\.
t-I, cr~~- Y1<i-~l 'Z.. i
(Phone) l.C' ~::5l -'"3'3S--/-z..t;~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ORe-Siding MLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc. r' <I- /;/"(5'.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
III IV VA
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
1
I hereby certify that I have htrnished 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 exisl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke this permit for Just cause Flllthermore. I hereby agree that the City official or a designee may enter upon the property to perform needed mspectllJUs.
x
~~
Signature
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee? . '.0 $
u'-I tJti/Nei<-
Mechanical Permit Fee' I $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
1",0 DO. D ()
0725
2., uO
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
4-() . 0 0
TOTAL DUE
jj:1"11--: Y~'Bmlmngp.nnn4 -: ;;"
lIuildll1g Otliclal Date
I Paid lLC1<1'J....~
I Date . t /:L1 t2 ~
t../-- Z-G, - 0 S-
Date
# $
# $
$
$
# $
# $
$
$
$ 12q 25
-
ReceirllJfW3 :s
By A
Thts 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
IL""(A~ Lo~~ !-evJ-! I-I~ V1~
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
.c
Residential Building Pel.wit Checklist
Basement Finish or Interior Alteration to Single Family Homes
~:fLe!lk.M Date: 4Af-d,
BY:
Building Permit # Pill:
Site Address !CJ(4Y Allvv.d~
Zoning:
Legal: L
B
Subdivision:
E.xisting structure:~or NO
CONFORiVlS TO ZONmG
o RD IN".A.L'T CE
\3
NO
I
Is this an expansion of the e:tisring foo,tl1.:.u.t or
building height'?
YES
Refer to Planning
NO
~
Is the propert'f located within the flood plain?
Refer to Planning
~
~
Does the alteration include any additional kitchens?
Refer to Planning
Does the proposed alteration inc1ude any outside
entrances other than patio doors?
Refer to Planning
~
Is the proposed use of the finished space or
alteration for anything other than a normal single
family home (office. group home. day c:rre. etc.)?
Refer to Plarmir.g
~
THIS I..r.u:.CKI.lST ~IUST BE COMPLETED ,~'fD Ii'!CLUDED Ii'! THE BllLnr~G PER"YrIT mE TO
.'irAlNTAlN A RECORD OF THE REVTEW,
.
..
- ""~-,,,,-,~--'"--",,,",,,-"~" ,:::.....,=--,:.~. - -..-... -- - -
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS . Ct?t.fJ Fj LM1 o62-G-
NATURE OF WORK ' . L" L..-. fc N: l~
USE OF BUILDING ~ A-/I2- / /
PERMIT NO. 07-~~) DATE ISSUED 4!z-t (oJ.;
CONTRACTOR (4~ HJr~---N PHONE~~~~),t2c7.?,
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
,
rior to Backfill) I ,.
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
_, S~PTIC /' I'
FRAMING~r~.sJ tvd: /tit ~/2-1"5 pdf
INSULATI(5N ~?'
ELECTRICAL I
PLUMBING /1'1',
HEATING (if required) %?"
;? r
Qf(oS-
-V6'/'3!~
f/d/of
,s/6~f
<51'/,,-{
IIU _ AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
___ (Prior to Sodding)
BUILD.I~G
ELECTAICAL
PLUMBING
HEATING
DO NOT
j/4
hi I 6/t/or
jV~~ b;,lL?;(O~
y~ b/13/~s
.
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
. ;-
b/13/os
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
6;;~ ~IME
/6/rr /J~c;~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDA nON
o FRAMING
o J!jSULATION
....a""'"FINAL
o SITE INSPECTION
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
~ECH FINAL
c:/5 - - s: $-.5
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COU~TS:/ J ,,/"; /' /
~~cn-t~9/ hh-r / dg"'G
_/ .I'
~t(;-;-...6" k-9 hh./
~ -'~ p
/k~J, ~k~/
/
, "\P-rc ~-~
/'
t:eJ~
.
/1 / /
~r~C~v'j
r-;; /
~h7/
0;/
/ /
~~ /o.s-
,
C!J<<
./
cY<-
------.~-.. ----
/ ~ ~ ....-, '\
\ r?~r~,/Z' /e.- / )
~ORKS~y.PROCEED ~
o CORRECT ACTION AND PROCEED
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!
INSI<<JTI
".,...,....,._,.."..~"'.".....__,.M__~'...,._.._,..~~.,___.._..._"_._~_+__,__.,,,_._._,,~.,".,,-_,...~._.,..._~..,, ~N"____~__'__.'__"___"""'._'_'"__~.~~"'"''''__''''~__'''''~ _.~.._.,......~~e"__