HomeMy WebLinkAboutBldg Permit 05-1103
(Please type or print and si~n at bottom)
ADDRESS
29/8
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
11,2, 05
1 White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 05". //03
BO!Jt!A-T
/,cA/L-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
PID z.s: 382..-. ()/4-. 0
ADDITION
OWNER
(Name)
--3d 6
(;}4,tg-
Ke d e Y
~t>bc+j
(Phone)
(ol~ '8'/7, l(olO
(Address)
j BUILDER
(Company Name)
(Contact Name)
(Address)
-ri<A-/ ,
ZONING (office use)
I'Gj
(Phone) ______
(Phone) ~
(
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding Mowe.:.~e:=~~sh
OAddition OAlteration OUtility Connection /' ., IC."/~
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Fireplace
o Misc.
I II III IV V A B PROJECT COST IV ALUE $
E F H I M R S U
I 2 3 4 5 (excluding land) c::/
I hereby certify that I have hlrnlShed informatIOn on this applicatIOn which IS to the best of my knowledge true and correct. I also certIfy that I am the owner o;-;;uthonzed agent for the
above-mentIOned property and that all construction WIll conform to all exislIng state and local laws and will proceed in accordance with submItted plans. I am aware that the building
~IiCial can revoke this permIt for JU causeiJJ;::' I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform nee;t,In;tloO'5-
ignarure oj Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
"
$
$
$
$
$
$
I $
I $
1,00 0.00
~7.25
#
#
Park Support Fee
SAC
2,00
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
4-0. 00
Water Tower Fee
Builder's Deposit
Other
+0.00
TOTAL DUE
/
Be mes Your Building Permit When Approved
Paid
Date
/6r- 9. Z~
.I/. Z ~OF----.-
/')
Recei/t~o.
(J'~
Date
$
$
$
$
$
$
$
$
$ /IbCJ. 25
,
5l:JJstl
/
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. TillS document
when signed by the City Planner constItutes a temporary Certiticate of Zonmg compliance and allows construction to commence. Before occupancy. a CertIficate Df Occupancy must be
isslled
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 2918 D06f!/1-T //M-/L-
NATURE OF WORK L-ovvEJe.- U::V6l..-
USE OF BUILDING /Z6f rl/'/C
PERMIT NO. CJr. 1103 DATE ISSUED /1 z~ o~
CONTRACTOR ~-UeV PHONE
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
I'll ,
~
p#
,
J
V
.
J /.-" /
1/ <.. /
11/+
I
I
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUilDING
ELECTRICAL
PLUMBING
HEATING
_II
V1IV
.f)
V ,If/' ()
V\tY
Yo' J/Uv
/
I,
~y
DO NOT 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~-2-~
ADDRESS
)i IS! (lxhu.{f
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-IIO)
o FOOTING
o FOUNDATION
o FRAMING
o INSULATlONj I
;t FINAL t~ V r
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
~~
/ /
( ///'\r...
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,
--
-~
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----
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT v;'~' 9109R REINSPECTION BEFORE COVERING
Inspector: II il! Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl