HomeMy WebLinkAboutBldg Permit 06-0227
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Address)
B,lJILDER
(~y,N~)
(o)Q'taCt Name)
(Address)
~ ~;:.?es
'/hiT /KAz:)
Z/~ ~~.AL
Date Rec' d
1-. 3. O(P
I. White File I PERMIT NO /'} 1
2, Pink City . ~/-. () Z'" ,
3 Ye\low Applicant (fI ~ .
ZONING (office use)
pm z~ +JO. fJl 0 . u
(Phone)
(Phofte) QSZ-7i"r-4T /79
(Phone)
~/Vr
ORe-Siding ~ower Level Finish
. 3~5.
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
OAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V
HIM
234
A
R
5
o Fireplace
o Misc.
B
S U
PROJECT COST /V ALUE S
(excluding land)
ave furnished information on this application which is to the best of my knowledge true and correct. I also cettify that I am the owncr or authonzcd agent for the
abovc.menl1oned Il erty 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
;cial can revo t s perm;z..7Furthermore. 1 hereby agree that the City official or a designee may enter upon the property to perform necdc;~~
~ Contractor's License No. · . D$.. '
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
3. 01) lJ. c/l..L
. 7'-1. 7S-
I. .rV
~,tIlJ
4--0. t'V
~~_P~"WhmApprov'"
~o"
Building Otlicial
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /Sb.2..5:J
.
Paid Receipt No.
Date By
ThiS IS to certify that the rcquest in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requestcd. This documcnt
when signcd by the City Planner conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Ccrtificate of Occupancy must be
issucd
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
v~ 3' 0'1'-\
CITY OF PRIOR LAKE PLUMBING PEAAul
Date Rec'd
5' . J. () Y
I. Blue File PERMIT NO
~. ~:~w ~:Iicant . ()(, .0 zz. 7
(Please tvDe or Drint and si2l1 at bottom)
ADDRESS ZONING (ofticeuse)
I q Q q()
\>\1 eaSLiCAA
R (An
LEGAL DESCRu" lION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
A. 0.4.., \crr.(
-->
>>0 lMe~
(Phone)
(Address) ~ll' i l\t='..
VV" V\
APPLICANT L
(Name) furlf\'1.'v1}~,^- PllAUlAb j 1
(Address) _~ LO~ (.1 C. h.,' r-P e~
(Address)
(Contact Person) d: '^^ 1 Do.. V\ ,
APPLICANT SIGNATURE ~~.L ~.
C~j1JQ \--I, (Phone) ~S\- lllD3- {~u
A v t2-- tz:tf lI\Il,' t\ "1 b",,- M i'\ 55 O~ 4
(City) J (Zip Code)
(Phone)
DATE
h~v~\ p {q ~r Ji4
FEtS~n~DULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
, Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
\ Bar Sink
I Water Closet (Toilet)
Cc:> \M1Y\C2.-4~ J.a>'-UtZ tr
Type of Fixture
Quantity
Rough-ins
Water Heater
Water Softner
, Stand Pipe (Washing Machine)
I Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
~4~
Building Offidal
Estimated Cost $ Building Penn it # v/11 D
PLUMBING PERMIT FEE $$ :2,C\. Scc\e1.so 1 I fL J O,/)..
STATE SURCHARGE l:J 1 F-'"
TOTAL PERMIT FEE $ U [r). I) l/
~~:-:1J(
T
Residential, New One & -Family $99.~.
Residential, Addition Alterations $39.50 ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
.
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
..' .. .
4
.
Residential Bufiding Pel.wit Che1:klist
Basement FInish or Interior Altention to Single Family Hom~
BY: ~ ~ Date:~r;3jd4>
Building Permit # pro: Zo.ai:ng:
Site Address 1'(9 9 () ~~" , ~ ~:
'..
L~: L B Subdivision:
E.mting strucme:@rNO
CONFORJ.vIS TO ZONING
o RD lliA.J.'{ CE
~
Is tbis an ....~-..sion or the ~....sting fo",,:,..':"'r or
building heig..."t?
Yl:S
ReI~ to P~g
Is the iI""',:,e:t'f located within the flood plain?
Re:~ to P~g
Does the al~..rion include my additional kitc~e:lS?
ReI~ to Plamring
Does the iI..",,:,osd alte::uion inciude my outside'
enrranc:s other than patio doors?
Refe:' to P~g
Is the :;4 \'/~os.:d use of the furisb.ed spac: or
altc':1tion for anych:ing othe:- than a aor:nal si:n~le
. family home (oce:. grotI;' ho!::e. 6y e~:. e:c.)?
Re:fe:' to PI~g
NO
NO
Vi)
1Ja
JJtJ
100
Na
Tms L.b..l:.CK!.lST :'Yft:ST BE COMPLETED ...\..:.'fD fi'{ClUDED IN T:-n: BtllD[;,(G PER.'YUT fT~E TO
)l-\.lNTA1N A RECORD OF r.dI REVIEW.
~
~
"
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PRIOR LAKE
.-
INSPECTION RECORD
I~() PIleNJlIlVr IJIA/ U-.
NATURE OF WORK - ,~6, -
USE OF BUILDINCi M&l ~
PERMIT NO. 0' . fLZ,-,;-f ATE ISSUED tI'-. ~
CONTRACTOR r~ PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
,
SITE ADDRESS
INSPECTOR
DATE
~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
~
~
~
~
~
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
-'
tip r/b9
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~11J/66
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L~/7 /"6
<I!?bC,
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/7
IM/
YlI};)
M
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~/ ~/O"
J
J
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~,~
ADDRESS
[4 qQ () P~s~.-r
PHONE NO.
CONTR.
PERMITNO.QI- ~I s. ~a
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
SFINAL
4fi SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ~R HOOKUP
'PLUMBING FINAL
~MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
----
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I / 1
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"---
...::::::::::::
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O!>e- flG )
----
~.SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~:. ~FOR REINSPECTION BEFORE COVERING
Inspector: V ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl