HomeMy WebLinkAboutBuilding Permit 05-1183
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! .D1 Rec'd
(I 30 (4JS--
I PERMIT NO. 6 :)_11 <03
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2 Pink
3_ Yellow
File
City
Applicant
t Lo 05S N DJ2.. -\-hLL:Do6.. e.d
r' V\A t:J 5537 ~
LEGAL ~SCRlPTION (office use only)
//) '?
LO"r - BLOCK ADDITION
ZONING (office use)
PID 2- 5. 4- ~ 0--' I . 0
(Phone) q t) iJ- - 4~18~
~ 55 ~7r
BUILDER
(Name) \-\DY'0.Q... OI..,CfV'Q./'"
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o Misc.
Ii. (! ,
o New Construction
ODeck
ORe-Roofing
OUtility 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 up51 the p p, to JJ?"Jorm. needed inspections.
X I ~l. I/-J'l- C1j-
Signatu Contractor's License No. Date
rmit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTALDUE ~ jJ.../.O!3
;1-:3 if,= I ~~ceiPt NO;'S ~-
v
o Porch
~wer Level Finish
OAddition
o Alteration
o Fireplace
PROJECT COST IV ALUE (excluding land) $ 1...5"".
00,00
2.2.S"
Park Support Fee
SAC
#
#
-
Water Meter
Size 5/8"; 1";
'.00
Pressure Reducer
0-
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
0,00
I Paid
Date
This Application Becomes Your Building Permit When Approved
~~
Building Official
12/I/oS-
Date
$
$
$
$
$
$
$
$
$
?
25
------- .
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 ail 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 Eomes
..
,.
BY: ~ ~~
Date: I~f! tJ S-
Building Permit #
Site Address / ~(J 5 S
Pill:
1-.10 rL T ffW~ ~ D 1C.Il...
Zoning:
Legal: L
B
Subdivision:
E;dsting StTucture:@rNO
I CONFOR1VlS TO ZO~ThG
. ORDIN.A.L~CE
~
NO
YES
NO
Is this an expansion of the existing footprint or ReIer to Planning
building height? NO
Is the property located within the flood plain? I Refe:' to Planning I JJO
Does the alteration include any additional kitchens? I Refe:' to Planning I fO
Does the proposed alte:arion include any outside Refer to Planning
emranc:s other than patio doors? ,JO
Is the proposed use of the finished spac: or Refer to Planning
alteration for anything other than a normal single Ala
famiiy home (offic:, groU1' ho~e, day care, e!c.)?
THIS Cm:CJa.lST :vn:ST BE COMPLETED Al'fD INCUJDED IN TEI BlllDING PER'r{lT mE TO
~L..lJNTA1N A RECORD OF THE REVIEW.
"
T .\'T'";,:\,roT cl. -r,:;', ~ T I,-cr~ nnr
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -.J l.o 0 S S tJO il,:r H wO () 0 g. t) ,
NATURE OF WORK (.."W~ LL::v'c),.. f'f'~r'rf1
USE OF BUILDING S~r. D .
PERMIT NO. ()5./1'&3 DATE ISSUED j2-/\ !fJtf'
CONTRACTOR :J'ft-J\'..~-S f'Au.rc.Ptt V PHONE~Z -L(L{(;..'4 'fir...
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
PLACE NO C -NCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIl=t TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
L_ I
FINA,LS
.'2 I,. ."
- Iv U"
v(~1{,v
~
UILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
I 5 ()7
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