HomeMy WebLinkAboutBuilding Permit 05-1164
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please
ADDRESS
1 White
Pink
Yellow
File
City
Applicant
PERMIT NO.
?5.J-!:) ,3
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK tf ADDITION
{/f~{{l1(/}L
Lpl ht.:i 1'1 ( l
5-1-
PID ~.5'-3 'l{,-03
-L1
~'::e~R .\(> 1/1 (-I{ r;.-
(Ph~~( YV1-()7d~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection
Lower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C. o Misc. , ~
Type of Construction: I II III IV V A B PROJECT COST IV ALUE .$
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished mformation on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner Of authorized agent for the
ab"ve-menl1oned prop'lTty and that all onstmctlOn will conform to all eXIstIng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildIng
1 . . .
"ninal can rev~}l}[s perml:pJu - ause Furthermore, I hereby agree that the CIty offiCIal or a deSIgnee may enter upon the propelty to perform needed InspectIOns
X ./;Y' ;(<.:;"tA~ // -...J-7-. ./c.-jOJ--
Signature
Contractor's License No.
Date
Permit Valuation
6~.-
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Permit Fee
State Surcharge
Penalty
Plumbing Permit Fee C> WJ/c.
Mechanical Permit Fee
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Plan Check Fee
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
l- -
TOTAL DUE
Your Building Permit When Approved
/ r),3-Us
Date
ThIS IS to certIfy that the request In the above apphcatlOn and accompanY1l1g documents is In accordance with the City Zoning OrdInance and may proceed as requested TIllS document
when signed by the City Planner constllutes a temporary CertIficate of ZonIng complIance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
R..-rC(c!
Residential Building Permit Checklist
Basement Finish or Imer:or Altcf:tTIon to Single Family Homes
BY (/J. fJ= Da!e //-,;) J--{J~
Building Permit .=#
Site Address
Pill:
Zoning:
fa~~J-i2~ )H; Q+
Subdivision:
/1-d-~3
Legal: 1 B
E.risting Srruc:ure: ~o
CONFORlvIS TO ZOj:'{}l'rG
ORDmAJ.~CE
NO
YES
NO
Is r:h1s an ex:par:.sioc. of the e;,-.:~...ng r"ooq;r.r:: or
building heigh!'?
Rere:- :0 Plar::."'1i.-:g
~
Is me proper:-jloc:ud ~rhl'" me flood plain?
Re:'". co Plar7l;T1g
Does tb.e al!e:arion include any additional k::!c~e:!s?
Refe:- :0 Pla:m:ing
Does me propose:: alte:-ar::on indude any ollcside
em:rances othe:- than patio doors?
Refe:: ~a Pla~~~g
/'
Is the proposed l.lSe of d:.e E:6shei space or
alt~rio1:. for anychi.11g oeb.e:- ilian a GOGlal sir:gle
f~~it.v ~o"""'Q (u-c.~~cQ O-"U~ ~-O"""'l .a /~")~I C'1"",~ ,~",- )..,
..--........... ;,.. 4_.... --..., ;:-.... '-:J ~ ......., ~~ -"''''', ---'J'
R~r""e:- :0 ?13Ir~..'~g
~
THIS CEECG..1ST :'IITiST BE COMJUTED A.l'fD INCLUDED Ii.'! Tb'L BL1LDfi'iG ?L~.MIT mE TO
:Y!AIJ'lT.UN A RECORD Of THE REVIEW.
PRIOR LAKE
INSPECTION RECORD
!-1:f'-3 Fa'; r~JO y I-lfsf1:t
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILD1N
PERMIT NO. D -
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
!!!!! I
~Ckfill) I i
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
l. I v't
--
~ - ~
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