HomeMy WebLinkAboutBuilding Permit 05-0052
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
. /"7 (,'c-
/. -'~
I. White File I PERMIT NO I
2 Pink City . 0 c.;-. 0 0 c::; 2-
3 Yellow Applicant -'-
ZONING (office use)
K2-
LEGAL DESCRIPTION (office use only)
LOT '7 BLOCK 2 ADDITION 06b/!/rlt-.-:z..,O
Lt T11
,
PID 25. 3{30. CZ5"'. ()
OWNER
(N ame)
... \G\S6V\
(Phone)
952- Zlb -5blb
K';..~
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
rower Level Finish
~f ;tJt17 s.
DDeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
DUtility Connection
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 that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon operty to erfor. ne ed inspections.
x
Contractor's License No.
Permit Fee
o (1 (1. 0 0
67. 2}1
Park Support Fee
SAC
2.00
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
4-0. 00
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
#
#
l J '7 /ZoD5
I Date'
$
$
$
$
$
$
$
$
$
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~~~-~
Building Official
(/(~5
Date
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
~
r
~
Date: / / /J/~.s-
Pill: Zoning:
~dJ~' ,.11
Subdivision: ~ttd(
~!t:6-
Building Permit #
Site Address /7 d & S-
Legal: L 7 B ~
Existing Structure: YES or NO
I CONFORMS TO ZONING
o RD IN"Al,{ CE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? NO
Is the property located within the flood plain? I Refer to Planning I ~O
Does the alteration include any additional kitchens? I Refer- to Planning I flD
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? tJ()
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single NO
family home (office, group home, day care, etc.)?
THIS CHECKLlST :vruST BE COMPLETED AND INCLUDED IN THE BLlLDING PERMIT mE TO
MAlNT.-\.lN A RECORD OF THE REVIEW.
L\TE?vIPLA.. TE\..i.l.. TeHeZ.DOC
=~ . CIT~'OF PRIOR LAKE
. I. 1ft ~r nITInIHNC.'~l~~,-,f';. ;LRi\>IIT
Date Rec'd
2. 1-. (.is-
i ~:'n ~!~ I PERMIT NO. /; c- () 05 J I
3. Yellow Applicant . lJ-) . s
ZONING (office use)
/2 2-
,ilZ &5 n/9/2J/jrl EL-O L-;J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
pm 2~.::..;;: ]' cJb. (J l J ~- ()
OWNER
(Name)
J}-tJ' 0 tJ lvi/Lit) Ai
(Phone)
(Address)
APPLICANT
(Name)
:111'50 IV K4 le-/l' J
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE
~PPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential. Heating & A/C (New Construction)
Residential. Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
.50
po vJ/Ui
(ji/O
Estimated Cost $
Building Permit #
~
STATE SURCHARGE $./
TOTAL PERMIT FEE /
HEATING PERMIT FEE
$
(Office lIse Only)
Building Official
Date
r. Or
By
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDIN.G AND INSPECTION
SITE ADDRESS /7 Z & 5' /l-1/1/CJ /-/ ~/ EZ-D LV
NATURE OF WORK L()tA/E/Z (Gl/~
USE OF BUILDING /2~5 /l / IC-
PERMIT NO. OS 0052- DATE ISSUED I- /-1 os
CONTRACTOR K//2 TV AI PHONE 'ZZ{o. ~ zro
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
fIIIII'III'
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
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