HomeMy WebLinkAboutBuilding Permit 05-1000
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I ~/t{ ZI
CA~TL, E-6.A-7E
LEGAL DESCRIPTION (office use only)
IADDITION
Date Rec' d
I White
Pink
Yellow
I PERMIT NO. tP5"- ItmOI
fit-lOlL UjU, /11((/
'''is- 3 ra-
File
City
Applicant
vV
ZONING (office use)
Ra..
LOT
OCK
PID3R~- 0
OWNER ,<7
(Name) \lLO~ 1-
ilJll- ~ \'f2-
(Phone) q5 2- - "2 'S J> -&<(-02
~(
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding r\H'ower Level Finish 0 Fireplace
DAddition DAlteration DUtility ConnectIOn ..)'1-
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III
H
2
IV V
I M
3 4
o Misc.
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$
x
I hereby certity that I have hlrnished mlilrmation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoflzed agent lin the
above-mentIOned property and that all construction will conform to all eXlSl1ng state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
official can evoke thIS permit for JU cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed IllspectlOns.
itl /:l!cK
Date
Signature
Permit Valuation 'lOOt). --
Permit Fee $ 81,;}5
Plan Check Fee $
State Surcharge $ .;). "Z>
Penalty $
Plumbing Permit FentJAr!'r $ 41).-
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee N~ $
es Your Building Permit When Approved
10-7-0<;
D~tc
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other e Ie< - $ l.cD
TOTAL DUE $ I ~/a..5
I
Paid
Date
".,.-
/i~~5-
I ~~CCiP' Nof-:of/
ThIS IS to certify that the request m the above apphcal10n and accompanymg documents IS m accordance WIth the City loning Ordinance and may proceed as requested. TIllS d<lcument
when signed by the City Planner wnstItutes a temporary Certificate of Zonmg compliance and al1<1ws construction to wmmence. Berme occupancy, a CertIficate <If Occupancy must be
issued
f2~q(.J
1-!--CN1\-J O.)-r
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
5..;_"
Residential Building Permit Che~klist
B:lsemell.t Finish or Imerior AJtention 1:0 Single Family Homes
Bv.
, '".
DaTe: )() -- 7-!J-
Building Permit #
Site Address
Pill:
{2L;~1 /e-<jQ Ie
~~f
/ //L/d /
Legal: L~ B I
Subdivision:
E.:risting 5cruc:ure: @r NO
CO~fFOR.l.yIS TO ZONING
o RD lliA..:.'i' CE
NO
YES
NO
Is ctus an e;;-''02I;.Sion or' c.t:e exi~.....ng fOO~Ul: or Re:r""e:- ~o ~l'Jn~":~O"
. . ..l."~-"'::r /---
building height'?
~
Is me proper:-jloc3.!d wirbi:J. u.1e t100d plain? I Refe:- to P lar'~'T1 g I ~.. I
Does tb.e alreration induce any additional ki!ehe:::1S? I Rete:- ~a Plarmmg I I
///"
Does the oro1josed alterltion ir:ciude anv outSide Rer~:- to PlaT'!~~g
. . .
e:: traIl c e5 othe:- man patio doors? /
Is c.t:e proposed. llSe or dle drrisned spac:= or R~:e:" :0 ?LJr~'~z
.'
alte:-:J.r:on for anyrbing o!he:- u.1an 1 ::on:z.l single ---'
f.!..-rnily c.o-r::e ( ocee, g::-ou'9 c.oce. dz.:r c:rre, e:e.)'7
THIS CHECXL1ST .'vIlIST BE CO~LPLETED ACID INCLLlJED TI'I Tl-i--:E BL1LD[NG P~R.l'i!lT mE TO
MAfl'ITA1N A RECORD OF THE REVITW.
PRIOR LAKE
INSPECTION RECORD
11111. I (t
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. t)~ ~ 9j.E ISSUED _.
CONTRACTOR - -0- .. = ~"l.; /.,. PHONE~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
=--.-J 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 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.
r:'n" AI. ..............___._