HomeMy WebLinkAboutBldg Permit 05-1008
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIftCATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
Date Rec'd
(P1eae type or print and sip at bottom)
I ADDRESS $ .s- ~ '7
(/t055alUd r~
I. WIrite File I ./15 ~
2. Pink City PERMIT NO. (/ - 100
) Yellow Appli.... _
I I Z~Gp-, I
LEGAL DESCRIPTION (ofJ"JCe use only)
--
LOT } BLOCK.5 ADDITION
~cJ 'RJ
wi Plod 5- 3t/.) ~ (JL(b
OWNE~ \
(Name) 0" 1'\
La <'- ') () Y\
(Phone)
qs.;<
Ll !/O -3t~5
(Address)
/VLlJ
BUll.DEB.
(Company Name)
(Contact Name)
(Address)
(phone)
(Phone)
TYPE OF won 0 New Construction OOeclt OPorch ORe.Roofing DRe-Siding
OAddition OAlteration DUtility Connection 0 Misc.
Lower Level Finish
o Fireplace
400(j ;---
. CODE: OI.R.C. OI.B.C.
Type of COastmctiOll: I
Occopanc:y Group: A B E
Dh'ilion:
n mIVVAB
F HI MRSU
1 2 3 4 5
PROJECT COST IV ALUE S
(excludin,land)
x
have furnished information on this application which is to the best of my knowledte true and correct. I also certifY that I am the owner Ill' authorized allCllt for the
and that a constrUrnon wiD conform to all exlstilllltate and local laws and wiI1 proceed in acconIance with submllted plans. 1 a awaR t the buUdin.
p", for . use. FurthCl1llOl'e, 1 hereby qrft lhat the city ollldal or a dcsiplee may enter upon the property to perform nRdi j ()'
tuJe Contractor's License No.
IfYlf~
Dale
Park Support Fee # S
SAC # S
Water Meter SizeS/S"; I"; S
Pressure Reducer S
~evWa~Conn<<tionFee # S
Water Tower Fee ## S
Builder's Deposit S
Other CU S
TOTALDUE ~ //)./1. e,r $
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer &. Wa~ Permit Fee
Gu Fireplace Permit Fee () I
a"O
comes Your BalIdlnl Permit When AptII'Oft4
thIS is to cenil)< that the request in the above application Ind accompanyina documents is in ac:c:ordance with the CIty ZooID. Ordinance and may proceed as requested. This document
when lilned by the City Planner constitutcs a temporuy Cmilkate of Zonina compliance and aUows constrUCtion to commence. Rem lXC1Ipanc:y, a emirate of Occ:upancy must be
issued (2-rtld
PlamWJa Director Date ~ia1 ~t if BY
24 hon notice for.n Inspeetiolll (9!l2) 447-9850, fax (9!l2) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Residential Building Permit Checklist
~ ;Eeme.:J.t Finish or Interior }Jt. cration to Single Family Homes .
.' /0-/0- oS
Date:
BY:
Building Permit # .
Site Address
..7 S-6 '7
:!l~ t:hl4tV>t ~ Zonmg:
Lesa1: L
B
Subdivision:
Emting Srrucmre: Y"ES or NO
~9
I CONFORl"\iIS TO ZOl'lTh.1 .G
o RD lli A.i'i CE
NO
YES
NO
Is this an expansion or tile existing footprint or Refer to Pla.mn...'"lg ~
building height?
Is the ptopc:rt"j located within the flood plain? I Refer to Pla.nn:ing I /
Does the alteration include my additional kitchens'? Refer to Pla.nn:ing I /
Does the proposed alteration include any outside. Refer to Planning /'
entranc:s other than patio doors?
Is the proposed. use of the finished. space or Refe: to Pla.rJIJ.mg /'
alteration far anything other than a normal single
family home (orne:, grou'9 aome, day care, etc.)?
THIS cm:CK1.1ST MUST BE COMPLETED AJ.'fD INCLUDED IN rrlI BtnLDlNG PERl'YIIT FILE TO
L'lL-\.INTA1N A RECORD OF THE REVIEW.
PRIOR LAKE
INSPECTION RECORD
"() '1 (j SA-veL
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED
CONTRACTOR ~ PHONE 0 '
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if re
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS -.0
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 approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
-.....-.--. '.
ADDRESS
ss-O?
SCHEDUlED ~
C~....r--S~~ d",....~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
,-~-/cPor
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ~R HOOKUP
~PLllMBING FINAL
~H FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME~TS~ I ~ ~ ~
U~ p2~ / ~~ ( / ~f/", r-
./ kA"/ 6>'Z/ h4~ / ~~
, ,
~/
fi~c /1 t
~ /
/~.~./
/'
~tl-
~ /
.~#~/
dk
.~RK SATISFACTORY,
/0 ~ECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR R SPECTION BEFORE COVERING
Inspector:
r/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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