HomeMy WebLinkAboutBldg Permit 05-0984
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05 ~ (Jj 84{
(Please type or print and siltn at bottom)
ADDRESS
Ib010
,(JOll"lr~ ob
It\).
LEGAL DESCRIPTION (office use only)
LOTcQ BLOCK 3 ADDITION rr7cllZiu:Wtd. ~ Pst'
OWNER
(Name)
ZONING (office use)
Is-!- PID 3~o- dIg
R(.t.",-c11 ~v.:....
160)0 .uo~IJt\.JOO~
(Phone) ~. W(J. L/11a.
I (Address)
BUILDER
(Company Name)
(Contact Name)
(Address) 'L/J.1~
R1)
~-l 1:) ~ Co~ ~\;~(/h4. -"
f..r,...-I
R"" 1-,evj .!r ,JE-
(Phone) ~/J' '1JCf. 33~/
(Phone) '(~. ~E)3 .,6lfS
ORe-Siding ~Lower Level Finish
o Misc.
PROJECT COST IV ALUE $
(excluding land)
~ Fireplace
:ld'oco
.
<.,.
-
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
CODE: M.R.C. DI.B.C.
Type of l:'~stmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
I hcreby ccrtify that I ha e . trni hed mformation on this application which is to the best of my knowledge true and COlTect. I also certIfy that I am thNlwncr or authonzcd agcnt for the
" nd hat all construction will conform to all existing state and local laws and will proceed in accordance with submittcd plans I am awarc that the buildmg
mi or Just causc Furthermore, I hereby agree that the Ctty official or a designee may enter upon the property to perform necdcd mspccttons.
) "\ ~ ,,2C:> '~<f?J., /6 . S' QS
"-Signature Contractor's License No. Date
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
~$
./ '$
$
$
$
l{ 000.'-
S1/d,?
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
:J . 00
L/(J -
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
'-/0. --
TOTAL DUE
$
$
$
$
$
$
$
$
$/u 9.20-
b~BuildlD'P;/;;;"d
Recei't~ o. 5lM7/
By Y
r
Buildlllj! Otlicial
Paid
Date
/11 9. 2- 5"
10 . ~.~
Thts IS to certify that the requcst in the above applicatIon and accompanying documents is in accordance with the City Zoning Ordinancc and may proceed as requested. This document
when signed by the City Planner constttutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Ccrl1ticatc of Occupancy must be
issued
Planning Director
Date
Date
24 hour noticc for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basement Finish or Interior Altcn.tion to Single Family Homes
,...,
Bv.
.I. .
~
~
Date: I {7 .~il- 5"
Building Permit #
Site Address
Pill:
j/ m:tbxxdoni?d
/t{)'10
Lesa1: L
B
Subdivision:
E.risting SQ1lc:ure~r NO
CONFORLvIS TO ZONlNG
ORDlli.Al,{CE
Y""ES
NO
YES
NO
Is Lbis an exp2.IlSlon or d::.e e;,i~~g fOOcprillt or
building height?
Rere:: to Pl:m""'-;-:g
Does the alteration includ.e any additional k:tche:::.s?
Refe: to Pl3II!lmg
tJ~
tJO
,Ja
Is me property located. w"itirin che flood plain?
Refe: to Plar..n:ing
Does the proposed. alte:-anon include any outSide
entrmc~s othe: than pano doors?
Refer to Planning
Is the proposed l.,l,Se of the Enished. space or
alte:-anon for anyrhing othe; than a nar:nal single
f"......J.' ;'1'1 'l1o"""e (oFc- rrr-r"'U"" ;..,o,-a ,..;..,v c..,.,.,. c"'c )'J
..W0.4........ 4' ..LJ.- .._.....,.,:-..J"I ""'" ~.I,.J,""'~" -.-, -- . .
Rde: to Planrung
}JtJ
,Jo
THIS CRECKL1ST :VlUST BE CO(';[PLETED A.I.'fD INCLUDED IN TID: BU1LD[NG PERJ.'IGT mE TO
MAINTAIN A RECORD OF THI REVT:EW.
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS II, 070 t1Iorl:-lJ WO()c/ l!..J
NATURE OF WORK /.-..J. .
USE OF BUILDING .s t=
PERMIT NO. LJ~- t'f~ f- DATE ISSUED 10. S- S- ~C~
CONTRACTOR ~I Os PHoN6/.t. '1lq-J;) 01
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
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
tJc..
- ,
. .
It:Jjz9)
, /
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
Ph ·
fP
t7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
.
~
~
4
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/P'Yo6,
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DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical seryic.e cabinet prior to rough-in inspections
and maintained until all inspections have tJeEm approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
DATE
tboM
/bo70 ~rl/~t:XIl /2d'
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMr.,ENT$; " .
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.H)'f///~C c h;#/~/
~~/., O/{
,
TIME
S--~7'
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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/ ~
/ / ~,/ '\
( c~t' 6.5€- /iI' /'e )
~~FACTORy.PROCEED ~
~ ~ORRECT AC t tV" AND PROOEED-'.
o CORRECT WORK, C LL F EINSP- CTION BEFORE COVERING
Inspector:
Owner/Contr:
-.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl