HomeMy WebLinkAboutBuilding 07-0013
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Jan 04 07 08:43a
Mark Mackmiller
952-294-0262
p. 1
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTll..ITY CONNECTION PERMIT
Date Rec'd
I . 4- . 07
~:??: ~~i<a.. I PERMIT NO. 07. 00 1:3 I
ADDRESS Cde;;ewR-Ier- ZONING (office use)
/5''1/3 C, 'rc Ie /VG ~150 I
flA .- ..
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID z.s-. 0501. 00+.0
~= /<4f~1
(Address) I S- '?- / :s
.,. /.:>//4 S Co ~',I,c ~
Ed9.eWar-t>r efr-clc'
(phone) q...}:2.. - L/Y- '7 -1 o~ 7
Pr tOr L4 tf e M/l./ :;-~ S 7 ::z.
IV L::--
~~~~~Name) /?1A'(..,1m../;:.,r Or.s 1~/7 -I /JUt Ie! (Phone) 9F2''1v7?6 dO
(Contact Name) /"J?arK /YZ-..d~,//~r- (Phone) 7C5 -"3:)0 -4<."7 (
(Address) "YbqV {/(-//~9("wovdj Or rcl~'1 >>q,n'r:l M/V S'SJy7
r
TYPE OF WORK 0 New Construction DDeck OPorch ORe-Roo.l'ing DRe-Siding OLower Level Finish 0 Fircpla~
DAddition ~teration OUtility Connection Qg.Misc. { ( ~ ~..clop w /1~
. CODE: lc1f.R.C. DI.:B.C. P~OJECTCOST/VALUE S 1!ifr7tte.Od~
Type o~nstrucrion: I n m IV V A :B (excluding land) q ~O 0 ./.'" fa (
Occupancy Group: A B E F HIM R S U /" :;( <)..:., .oL je't: i lAd. 'r: 7:./'
Division: 1 2 3 4 5 ~ "'"... b of' e.ec " ,.'"
I hl'feby eertify thaI I have furnished information on this application which is 10 tht bnt of my knowledge tnJe and correct. I also ~ify tlur I am the owner "r authonzro agent for the
Olbove.mcnucmrd propertY and thai all eONQ'Ilmon will conform to IU existing stare and local laws and will procced in accord.1nce wirh submiued plans, 1 am aware ltul the building
:fficiaJ~jlror~~"~e~tmeci~OftkW1. ~gn:;;: g:;nie;-~lopnforrn7: T:;' '7
~gnarun: Contractor's LiCC1l5e No. Date
Permit Valuation
Permit Fee
Plan Check Fee ---
State Surcharge * 0
Penalty S
Plumbing Permit Fee S ,[)O
Mechanical Permit Fee S
Sewt'r &: Watrt Permit Fee $
Gas Fireplace Permit Fee S
Park Support Fee
SAC
#
#
s
s
s
s
S
$
s
S
s S.z.s
WaterMcter Si:zeS/S";I";
Pressure Reducer
Sewer/Water Connection Fee #I
Water Tower Fee #
Builder's Deposil
Other
TOTAL DUE
I ~"]:o.h d Y 1/
This Application Becomes Your Buildml Pemrlt When Approved
~ ~ 1/0/67
Buildinl! Official
I Paid
Date
Tills" 10 entity thaI ,he nQuesr in Ihe .bov1: application and Icromp:l3lyitll docummt5 is itlaccOllWU:e wilh me Ci~ Zorlinll Ord.inancc 3tId may proceed.. rt:qu~led, This doeumt"lll
when silnrd by me Cj~ Planner constirutcs a lCmpDrUY Ccnificate of Zoninl eompliAnce 3tId aUows ronslruC1ion to romm.ntt. Before occupancy. a Cl'ttiflCllll" of Occupancy must b(
issued,
PIIIIIIln, Dim:tor
Dare Special Conditions. if any
24 hour ROtite for an insprl"tions (9!i2) 447-98~, fIX (952) 447-424!1
16200 Eagle Qeck Avenue Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
, / / ()7
/.
~. ~~ ~:;y I PERMIT NO. A '7 () 0131
]. Yellow Applicant , J ,
ZONING (office use)
1 ~ ~\ ~
c~ rc..\~
(UG
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
[ OWNER
(Name)
(Address)
(Phone)
(Address)
APPLICANT L~ '$
(Name) P \ VIf<A to ; '" d---
IL\lz 1~ L
(Address)
S CDtt-
-
-l-{\..Q,
(Phone) tu 3- 'J.O'b ~41 '7 (_
,
(\ t"Cl)~r- 5- '5 3 oJ-I
(City) (Zip Code)
(Phone) (0'5\-'11 5- 5 t-t '6 j
\~~~
(U l-.../
(Contact Person)
DATE
u)~
APPLICANT SIGNATURE
Quantity Type of Fixture Quantity Type of Fixture
I Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39,50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Residential, New One & Two::f.amtly-'--i~.so,__..
Residential. Additions ~lterations $39.50 -
/'
DftlO 610c
.50~ giJ/l/O
-"
""'"
Estimated Cost $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Residential Building Permit Checklist
~ ~ . r L~ Interior Alteration to Single Family Homes
~ lJ,...,
BY:
~
,
~
Date:
1/:;/07
,
Building Permit #
Site Address /52. I -3
PID:
E/J 615' tU A-nre..
Zoning:
,
CII<cLE
Legal: L
B
Subdivision:
Existing Structure NO
I CONFORMS TO WNING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? tJO
Is the property located within the flood plain? Refer to Planning NO
Does the alteration include any additional kitchens? Refer to Planning 100
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? NO
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single fJa
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
'.$Z (tIlt.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDIN
PERMIT NO.
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY F THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN
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.
,- ),-{.ffl
'F
---
ryl/(1fJ
/vl~
SIGNED
FOR ALL INSPECTIONS (952) 447-9850