HomeMy WebLinkAboutBldg Permit 01-1279
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at b~..u~)
ADDRESS
!It,SLJ9
7) I.,rfc h
I. White File I PERMIT NO f I
2. Pink City . 01- /'17
3. Yellow Applicant ;-
It-~
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION c?~ ~4 ~k fJ~
, /
OWNER
(Name)
",/ ok
~fA, .1(_- W11
(Address)
BUILDER
(Name}
(Contact Name)
J) (7\5 J./O/1" t e'f ~;V
~~ 6.e I,," ~.V
(Address) , ~ 0 tJ I..( :r~ d,; c /~( Lei-
TYPE OF WORK
o Misc.
ZONING (office use)
(<ISO
PID';<s - CJ9CI- () I J--J
(Phone) 1s-).-'!t{7- f'~/
(phone) (pI), -7 Sl- 7 Nfc d{
(Phone) ~),-9~'I-'f~77 If'
6)337
8 UPN> VI /4. /A~ I
.
o New Construction
o Deck
ORe-Roofing
ORe-Siding
DLower Level Finish
o Fireplace DAddition ~teration DUtility Connection
-~:~
PROJECTCOST/VALUE (exc1udingland) $ r ~ vv
o Porch
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 t'.ut'...~J and that all construction will conform to all existing state and local laws and will proceed in accordance with
sUbmitt~ans. 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 ut A7lt~~eeded i~spectiOns. 51 yo 1/- ~ -l) I
I . Signature Contractor's License No, Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fir..:tace Permit Fee
f } /l A
~'SA c B~dingpermitWhenAPproved
_ ,~ /1-8-01
Building 0 cial Date
$
$
$
$
$
$
$
$
2.QQOd"JrJ
u'l. . 2..<'"
I Park Support Fee
I SAC
Water Meter Size S/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid"11lO'3; ~ '7
I Date 1l-tJ- I
# $
# $
$
$
# $
# $
$
$
$ Lo3...;;)S
Receipt lio. LI O( U oJ......
By ~
iJ
. 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
, .~C)
40 .0tJ
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
White - Building
Canary - Engineering
Pink - Planning
Th. C.nt.r or th. toke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
. ~~~ )~ 12e..1Q.A}-
((-e - Of
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
ap~~,;~:r con~ti~XVity ~ proposed at
Accepted
Accepted With Corrections X
::::::ed ~~~~ -
Date: Jj - B ~(
Comments:
~ ~kk~ ~c)7~ ~n__l-
"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."
~
l[
~{J.-1q
CITY or PRIOR LAKE PLUMBING PI.RMlT _ -
. ---.........- ~zONINO (olke \lIII)
....
(PIc:~~Jlr I.Innt m4,j
ADDRESS
I,r
J tJJs4 i VufCA
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y
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.....
LEGAL DE~'CRlPT .
...' tON (office UJe oul)') -"------
: LOT DLOcx.,ADIJ!TION &~~ ~ f)~
/1 i ~':~~,. w (,-ft;_ V -
I
dAddres~) 16)'If{ M~ kf ~.Y~
--
-'-
PIDd 5_ - ()!l3 -0 /;Z --(.)
{Phone)
Ii APPLICAN'f/_. -~~-_.. .
I' (NameL ~f). _ _
.x (Addr~ss) J-~f-' !9 It ~ ~If.._
(Address)
.x' (Contact r~I''':~n) ~--tL fJ(J -ut:..-.- .-..' (phon~) '--
A APPLICANT SIGNATURE _.._~ I"; r ).I"~ DATE
V "
APPLICANT PLEASE COMPLETE 'BELOW
Type or Fixture Quantity
Bath Tub with or wiffiOut shower
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
II Laundry Tray (lor 2 compartment sink --
I Shower Sta.I~.
, Sinks
Bar Sink
Water Closet (Toilet)
(PhOn" fS) '[3:J ~5;
1/H1.~"
(C~.
~rjC(.7
(Zip Code)
-lfL--L:i/o/
Quantity
Type of Fixture
/
k-
I
I
Rough-ins
Water Heater
Wilter Softner
Stand Pipe (W.shin~ Machine)
Sewage Eje~tor
Ba,k{tow- Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
FEE SCHEDULE
Industrial. Commercial &. Multi-familv 1% gfjob COil wid\ II $39.50 minimum
. ,
II
Residential, New One & Two-family $99.50
Residential, Additions & Alterations $39,~C
ESlhl1atl!d COSl S
Building Penn it #
PLUMBfNG PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
, eu/! ~,qID 'A
....4J/~ VII/;
G J:J(,
(Om~e Use Only)
This Application Becomes Vour Bulldinl Permit When Approved
'........
Date
I Pall:!
I
:Dail-Ih-;i
I Receipt No.
BllildiJ'l& UllICI.1
ay Q6--
-'2/
14 hour notice for all InspectionS (952) 447-9850. fDx (952) 447-iZ45
..
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
,
SITE ADDRESS U./)~7 [)u~c.~~
NATURE OF WORK ~ ~
USE OF BUILDING
PERMIT NO. CJI 1'd-71.. DATE ISSUED II-rJ-O (
CONTRACTOR "~p'<, ~ PHONEy/2-75-1-78Cf("
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.--..
:A '
a, ,
"\,
\
FRAMI
INSULATION
ELECTRICAL
PLUMBING 1)NOCr2--0f2&Jrv::J Ith.o/O/rZ+
HEATING (if required) (dffv ~
~
A
4
111-:>7/p/
I(P ?/f1 /
I
-
l/ /t!?7/o1
)//~?~/
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/1
BUILDING 1!2r,
ELECTRICAL
PLUMBING Ii
HEATING aJ,x-~~ -~~~h.'
. DO NOT OCCU~V UNT{L ABoVE HAS
NOTICE
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.
/l./ liltJI
/Z/Iiflal
_ I :iI, '-I ~l
, f
BEEN SIGNED
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
DATE TIME
fzlt'"! /fJ1 'I: '! 0
, ,
ADDRESS -'1P S- 'f C}
~~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATIW 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULA TIO Af)E SEWER HOOKUP
~FINAL ~PLUMBING FINAL
b SITE INSPECTION ~ MEC'N nN:8:C
COMMENTS: ~,
~/-/~?'
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'~~ "', ~'~>i'l'.;;~~:','
A
(l~
'~
,>I WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~,
J
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Inspector:
Owner/Contr:
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!