HomeMy WebLinkAboutBldg Permit 01-0099
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I PERMIT NO"JI_ 0 0 qq I
if . .,
I ZONING (office use)
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2 Pink
J. Yellow
File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS
!/L30 l-EX/Ncq77J/U C/ .
~6
LEGAL DESCRIPTION (office use only)
LOTIQBLOCK 3 ADDITION WILD6I<N655 PONDS
OWNER
(N ame)
Date Rec' d
z -1.1J;~ /
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. ;
"
PID 25-3/B- 045-6
7000 WM6ATCJeA-!--'!
s,e:, 1'1 6" ffu".. e..- f7 tc ~ .... c..
(Phone) (,JQri;.. 7GJ - Y77- SCa'
7 [J. - rJAo - S"rJo
(Address)
BUILDER
(N ame)
(Address)
(Phone)
ODeck
OPorch
ORe-Roofing
TYPE OF WORK 0 New Construction
)!fLower Level Finish
2. Je/'1S.
o Mise,
o Fireplace
OAddition
OAlteration
PROJECT COST /V ALUE (excluding land) $
ORe-Siding
OUtility Connection
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 the property to perform need ins~tions.
X -~---c~ - ~ :J ---.<;-0 I
Signature Contractor's License No. Date
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
$ (Oc{~/~
R.eceiPiJtJJ1 310.7 c:) I
By ~'~ I
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter
I Pressure Reducer
Sewer/Water Connection Fee
n
, :j:!vater Tower Fee
){{ ~~~ ,\Builder's Deposit
( l , tV\lfbther
~
#
"2. 25
#
#
1.00
Size 5/8"; I";
4{) . 00
#
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eu;;,c-neJ e.I'1J
P61V'?/T
(~ilding:;:~;~;:~'d
.-/~~cial Date
TOTAL DUE
/44-.25
. Z-27~"-Ol
Paid
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
Date:
Building Permit #
Site Address 5230
Legal: L / 0 B
Pill: 25-3/8-M6- () Zoning: ;:;150
LEXIAltq70tJ (!;T s6
3 Subdivision: NIL.t)6JelJ6SS PaND.:5
Existing Structure: YES or NO
~
CONFORMS TO ZONING c:::::v NO
ORDINANCE
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? V
Is the property located within the flood plain? Refer to Planning V
Does the alteration include any additional kitchens? Refer to Planning r/
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? V-
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single V
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED Aj~D INCLUDED IN THE BUILDING PERMIT FILE TO
MAINT AlN A RECORD OF THE REVIEW.
L\TEMPLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 5~ 00 L~,* Q..-\-.
NATURE OF WORK ~~""'--!- ~"",4 (-'?)~
USE OF BUILDING S~fi.
PERMIT NO. Q/- UOGf!! DATE ISSUED '2-tS--t3bof
CONTRACTOR _LJ~J~ PHONEJ'3- Y71-500fJ
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
;h.
3/z/01
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j/ ;r/ D/
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'3 ) d/ 0 I
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
th
~
h
,j~.
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
- /" .
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7 ft~~~
((.I'I/o{;,
i' /ufr6
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspection~
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shaU be placed near main entrance.
~
~
~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS ~l' ..LeX> A ~ L
. -
CQl\IIMr,HTS: ..--
E/~rfr/cGt/ /-;~~I
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
_ r
%4' L'r
~/ /'
/-;-~., /
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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-------
~ _ /' ".--r /
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DATE
~~
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C/~
TIME
~/- 7"7
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/ /
?//e' ~2-
....
Z'~
o;{
?)
~RKSATIS
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl