HomeMy WebLinkAboutBldg Permit 04-0116
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
:3 .~o4-
I. White File I PERMIT NO
2. Pink City . 0 III _ 0 11'-
3. Yellow Applicant V'" r ~
(Please type or print and siJm. at bottom)
ADDRESS
3/52. L50d~-r t;1I!.A/L- A/W
LEGAL DESCRIPTION (office use only)
LOT 4- BLOCK Z ADDITION /V1'-.oS S oV7J:I
OWNE~
(Name) j on,-
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
+\-a"U\ '\ "
6
o New Construction
~ower Level Finish
.:J 1!P1's.
ZONING (office use)
/el
PID ZS. 38Z. ~. (')
(Phone)
q~ - J./~""-ta:~3
(Phone)
(Phone)
ODeck
OPorch
OAddition
OAlteration
ORe-Roofing
PROJECT COST IV ALUE (excluding land) $
o Fireplace
ORe-Siding
OUtility COIl11ection
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 th 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 propel1o pe~o needed inspections.
X _ - :2, -,J- Ot-/
~ I. igna~ Contractor's License No. - Date '
'I
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
3,000.00
$ ..,.,.,. 75
$
$ I. .sO
$
$ 4--0. 0 0
$
$
$ 4--0. 00
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee #
I SAC #
I Water Meter Size 5/8"; 1";
I Pressure Reducer
City SAC and WAC #
Water Tower Fee #
Builder's Deposit
I Other ~ 4A-i..-'
I TOTAL DUE
I Paid
I Date
.-/
,~//. QI.::J
, ,~-- (j- 01./
Receipt No. c..i ~ l.{/ d--'
Be- .
$
$
$
$
$
$
$
$ /. 00
$ /57- Z-S
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
16200 Eagle Creek Avenue Prior Lake, MN 55372
."..~
PRIOR LAKE DEPARTMENT OF
. - . 'BUilDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3/52. l3 0/$ tA T / /ZP7/ L-
NATURE OF WORK LaJAlEJe... ~ l..-
USE OF BUILDING ~ s ff/ /G
PERMIT NO. 04-. 0 / Lfp , DATE ISSUED .3. 1'. 0 4-
CONTRACTOR f-I ()!9 N ~ PHONE 4-ZI::J. to () e.3
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~~J,/ //ti fkJ~c(
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/~
r.. '
'tY/,fft,/
. ~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
(f~
l.4/(~
~
kJ
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
Tltis 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~/1;j~
TillE
ADDRESS ~ ~(""~~ It..
OWNER CONTR.
PHONE NO.
PERMIT NO.
J:}-01/~
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION ,..,..
..J4 ~INAL c.. .Lt.-",
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
ok
"1G
c:~- ~J> z
~RK SATISFACTORY, PROCEED
o CORRECT ION AND PROCEED
o CORRE , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY/
fNSNOTl
DATE nilE
CITY OF PRIOR LAKE I:fl. -oc..(
INSPECTION NOTICE SCHEDULED
ADDRESS 3/t;,4 ~
OWNER CONTR.
PHONE NO. PERMIT NO. 4-f&,
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH Rl o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL ~ G~INE AIR TST
o SITE INSPECTION o MECH FINAL
COMMENTS: L L ~ L
I. HI! :IN$.~~ CAN;~M ~ ~~(
?IU~ .(~~
2S )'
2. t1Jt t;r ~.p. \" ~~ .
~. I~t;~
~JL. Wc.$v ~ vJ-
~. ~..&... t-e:t:~. ~ ~,;_l~
.l.op e ~
~t ~~
I
r>\( ~ ~ ~>-'
I.~ 1ti? ~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
)( CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I/fS/tOn