HomeMy WebLinkAbout07-0036
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L z 4- . 07
(Please type or print and sign at bottom)
ADDRESS 17372 Deerfield Dr SE
Prior Lake, Mn 55372-3395
Date Rec' d
I White File
2 Pink Cily
3 Yellow Applicant
PERMIT NO. 01. 003G,
ZONING (office use)
R.2-
! LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone) 952-226-5592
OWNER
(Name) _Renae Halvorson
PID .z-S. 4-00. ()
()
(Address) 17372 Deerfield Dr SE
BUILDER
(Company Name)_John Berg Construction Ine
(Contact Name) _David Aust
(Address) 10129 Blair Ave Inver Grove Heights MN 55077
(Phone) 651-285-0739
(Phone) 952-881- 77 24
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding XLower Level Finish 0 Fireplace
DAddition OAlteration OUtility Connection
CODE~I.R..C. Ol.B.C. DMisc:
Type of onstruction: I II III IV V A B
Occup cy Group: A B E F H I M R S U PROJECT COST IV ALUE $35000.00
Division: I 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on thi.~ 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 confurm 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, T hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x
Signature
Permit Valuation 3.o00.0C
Permit Fee $ '7+.7 S"
Plan Check Fee $ ~
State Surcharge $ 1.50
Penalty $
Plumbing Permit Fee $ 40 .00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
':.? ^>PI""'7 B"~"'ding p,- ~;PProV<d
~ff~ ~/2-~O?
Lie # BC- 20602953
Contractor's License No.
/-)/- ;?OOZ
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1 "; $
Pressure Reducer $
Sewer/Water Connection Fee # $
u__ ..........-.-.......
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE [I #Z i- t.,l } i.2A'.t.'7 $ ilC,.2.S
Paid
Date
1/(" ZS
2./.:J. Of
I~~
S z8(,o
Thi., 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
[)<lte
Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
1. Pink File
2. Green City
3. Yellow Applicant
Date Rec'd
! -.50,01
fit., 5" ~v 0 l. () 03 (p
PERMIT NO. 07_ 005&
at bottom)
ZONING (office
use)
ADDRESS
Ii
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK ~ ADDITION D ~ 6j)... po f ~
PID Z 0) · 4ot>.0 41-0
OWNE~
(Name) :n nUe
b1J U')I:SO\,\
. \
(Phone) q5"a - ::),:Jlc-Sf7/:)
(Address)
Set;
C15J.qd(l-ro}~ -7
/L
(City) (Zip Code)
(Phone) 0158 .4 t},Cj-(y 7{P.J
DATE 1/30/D7
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
(Contact Person)
APPLICANT SIGNATURE
TYPE OF SYSTEM
REA TING OR POWER PLANT
o Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
ired Side Yard
Setbacks
Industrial, Commercial & Multi-Family
\
FEE SCHEDU E
1 % of job cost Residential, Gas Firep
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ I q CD . .-
HEATING PERMIT FEE
STATE SURCHARGE
.... TOTAL PERMIT FEE
Building Permit #
$ ~q,'50
$
$ L\~.oO
.50
This
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY: ~ ~ Date: I /c:9- ~ 7
Legal: L
B
PID: Zoning:
~d ~ St=:,
Subdivision:
Building Permit #
Site Address 173? 2
Existing structure:@r NO
~
NO
I CONFORMS TO ZONING
ORDINANCE
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? Refer to Planning rJa
Does the alteration include any additional kitchens? Refer to Planning Nt)
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ~O
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single rJO
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
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
2,2\.Dj
1. Blue File I PE IT ,~ I
~ ~~:~'W ~~~licant RM NO. 01. DO...;&;
ZONING (office
use)
'1 ~-rd-
ld hi V
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
\d J>viv
':pr \
APPLIC~ ~ ~
(Name) .'. \ \9 ' r\ .
(Add,e,,) ~ ~~i %:~~. ~~
(Address)
(Phone) 9S~ 1~3~
'B/oom"~ 21)
(City) (Zip Code)
(Contact Person)
'B\\\
~\ s c5'f\.
(Phone)
\
\
2-
APPLICANT SIGNATURE
Quantit
e of Fixture
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
(Office Use Only)
Estimated Cost $ S .LD1. s. ~ Building Perm~ #9 . 5u AttiC WITH
PLUMBING PERMIT FEE $ ";;)
STATE SURCHARGE $ .50 BUILDING PERMIT
TOTAL PERMIT FEE $ L-lD .00
This Application Becomes Your Building Permit When Approved
Date 2, z. I . 0 1
By
Buildine 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
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /7372, .oW2Flll-iJ De.
NATURE OF WORK FC'};;. uv~
USE OF BUILDING J ,q//C-
PERMIT NO. 07:. 003 DATE ISSUED /. Z-f. ~7
CONTRACTOR \Jl)NAI 4EJU.f t4#.I77L. PHONE 1/5Z. BlJI. 712,~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~ I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
--
-- -
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
---:--- -
~...
BUIL.:DING
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