HomeMy WebLinkAboutBldg Permit 01-1133
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
5741 C&JfJ/tAJO~
sr S6"
LEGAL DESCRIPTION (office use only)
LOTZ9BLOCK.3 ADDITION ~/"'/1"t- /21.0616 /J-I-
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Name) Q"IU;J]t',J jl/{J/J(;, lJ;;;tj)fJl J )N(
(Contact Name) I oi1iI?t1J ff'VYvl.j
(Address) I-WS-<-- .At~~ ltv" ~ ./.YIv~
Date Rec' d
/o...g..o I
PID 2.-~ .2tJQ- tJG?O' 0
(Phone) .!ID.- /1i/7~tc.(f77
(Phone) aLl.- G?''L- 2~"tj-3~M...
~J?6/
TYPE OF WORK o New Construction o Deck o Porch ORe-Roofing ORe-Siding
~ower Level Finish o Fireplace OAddition OAlteration OUtility Connection
o Misc. 3~5 PROJECTCOST/VALUE (excluding land) $
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
;ter up/~arform~eeded inspections. /r.Ja)ct
~' , Signature Contractor's License No. ' bate
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE ('~ ID-II-O I
//C,.2-.5
/0- z,~
3,()()O.OO
$ 70/. 7 ~
$
$ I.GD
$
$ +0.00
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ //(,. 25
Water Meter
Size 5/8"; I";
#
#
Rece~'Pt ~'f3-t)
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
/()~1-o/
I Paid
I Date
Date
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
The Center of the L.kf Counlf,'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT C:OU I\JT7<-Y LI V I Nq BLoIZS.
APPLICATION RECEIVED I 0 - f3 - 0 J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
b /4-7 ~JeOSSANDI2A SI. S~
Accepted
V-
Accepted With Corrections
Denied (dlLiIl
Reviewed By: . 7./)r ~ ~..k---
v #
Date: /~-f-o(
Comments:
~~ L~ {~J. -~]~~~~ Lct4-
"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."
PRIOR LAKE DEPARTMENT OF
, BUILDING AND INSPECTION
INSPECTION RECORD
SITEADDRESS 5'7<-1'1 ~~~~_ 5)\-.
NATURE OF WORK LOu.:l-E!r-L<W..G._ Q ~'^-~
USE OF BUILDING
PERMIT NO. ()/-//33 DATEISSUED /tJ-'1-o1 .
CONTRACTOR Q.()J",hA le~il~ (&ia.",-' PHONE (,12- 2"'-!"alD
NOTE: THIS IS NOT A'PERMiT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
-
~~.
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
I}I;-f~ ./ ~/i/:/
I ..
(/ I Ill) I
J)~~J
'/~
...,
.fA- ' II /1/0 I
II ItA/sir"
I -.
~. f()/ d-14 /
I .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I j
FINALS
h
/A
I P~f
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 b,een approved. On buildings and atfditions
where no service cabinet is available, card shall be placed near main entrance.
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
. .
1/)// i1 'Z--
I I
t / ') d /k?.
I//J/I v-
. I
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~k 2..- 1: 00
ADDRESS
5' "f ?
~
PHONE NO.
CONTR. 1..... L, DI -/ ( 33
PERMIT NO. ;::-.P. l:) ( - I 2...30
OWNER
o FOOTING
o FOUNDATION
o FRAMING '$J
o INSULATION
FINAL
~ SITE INSPE ION
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP @ 0 FIREPLACE RI
o SEWER HOOKUP ~ FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
COMMENTS: L. L,
(1fl~
~
"C4fp
,/ -
~.1
-+-1J1 ~I /33
~
~
. ,
~ -b+- [)(-/~30
.hAL. f?~.
)l::JNORK SATISFACTORY, PROCEED
(0 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
In.peel"" ~ Owne,/Conk
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I/iSNOTI