HomeMy WebLinkAboutBldg Permit 01-0901
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO.
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I /0 "'l.3 7 - ",..(..D '>'" &~
;?e. ?R/(")R LAke;
,
LEGAL DESCRIPTION (office use only)
LOT / ~ BLOCK
ADDITION
PIDa 5" --
OWNER
(Name) ,~7E-~ ~/~Lqx
(Phone) ~-) L -~""7 - 3A57:\
(Address)
BUILDER
(Name) L)4u/L>
(Contact Name) "
(Address)
/,
(Phone)
(Phone) #7- 8~Z..o
L. ~e~/r?)V
TYPE OF WORK
~ New Construction
~Lower Level Finish
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
JlIAddition
OUtility Connection
o Misc.
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 aw e 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 the property rform needed inspections.
x
Contractor's License No.
~/~
Date
-
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
# $
# $
$
$
# $
# $
$
$
.zj.,O $ . Z5
I r:;~g6
Permit Fee
$
$
$ 2..
$
$ 4 . (')0
$
$
$
Park Support Fee
SAC
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
8.2,{- 2a:>j
I Paid
Date
/~'f. ? r:~
. . Z~ --c) I
. Cling Permit When Approved
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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
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I. Blue File I PERMIT NO
2. Gold City ./)J_ 0/1/
3. Yellow Applicant . Uf' LV
ADDRESS ZONING (office use)
t D
LEGAL DESCRIPTION (office use only)
LOT/fBLOCK ADDITION
(Address)
d~W \~ ) \ 0 X
iP cr 3 ') t'\J ~
Se.l=-I PJ."",~.~
&5<il J \;rldk-~<t LJ. ff .tA
(Address)
(Phone)
95 f) _l{<j, -31 s::o
f ~~ (<'1;/
rfIA --:-}'37 )
OWNER
(Name)
----.
\t
APPLICANT
(Name)
(Phone)
q'fJ- V</l
,1?,.j. S-S1J)..
(City)
fO ;)-r;;;-
(Address)
l.A4~
(Contact Person)
(Phone)
l./)
(Zip Code)
3" Lf73)
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APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
J Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
'1 Water Closet (Toilet) Other
.
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
B(J/~~~ WITH
P€F;."vtJr
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
-------
Receipt No.
--
Date
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
By(d)
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
Date: $- 2( - ~/
Building Permit # PID: Zoning:
Site Address U-'.3'7 LUc -(~ , r T r--
Legal: L 18 B l Subdivision:0(/J.J~~ ~~
Existing Structure: YES or NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning V
building height?
-
Is the property located within the flood plain? Refer to Planning V
Does the alteration include any additional kitchens? Refer to Planning l/"""'
./
Does the proposed alteration include any outside Refer to Planning /
entrances other than patio doors?
Is the proposed use of the finished space or Refer to Planning /'
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1<-1 -gry ft/1t-!/elZAl666 -rJ2,/:Jlv
NATURE OF WORK Lo~ Le~,^,'!l.~
USE OF BUILDIN~ ' .
PERMIT NO. ~O _ L DATE ISSUED e-2.I-:;C/
CONTRACTOR ~bc.,t-LA PHONE t./f{1-892~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
r.-
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
r--~-
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
FIREPLACE . /4 , 0 I
GAS LINE AIR TEST , f( '5J" /
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
- -- -~-
~ -----
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-In Inspections
and maintained until all inspections have been &;Iproved. On buildings and additions
where no service cabinet Is available, card snaU be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
ft/~6/
I'
.~'/~r/te~J ~/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/6~J?
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
iii' FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
01'- ;?o/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.-/
r-" / ~ /'
/;?7~ I C-/(c
{
,;(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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