HomeMy WebLinkAboutBuilding 07-0085
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/~(}/5 6'LV66'//G-O
Date Rec' d
2; 23.07
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 07. 0085/
7/~ /C-
/VE
ZONING (office use)
/2/
LEGAL DESCRIPTION (office use only)
LOT 0/ BLOCK / ADDITION
Z /':!j?'
~l/jr?L& HILL-S
PID z:.:.;,. 343. uo7 ()
OWNER
(Name)
BKA//lN
.
(Phone)
~S2-23 ~-3~75
/1(1 c/l/,
.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility ConnectIon
ORe-Siding
Lower Level FinIsh
?cr
( ---
~
CODE: ~.R.C. OLB.C. o Mise.
Type of onstmction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hncby certity that 1 have hlrmshed lOformation Oil this application which is to the hest of my knowledge true and correct I also certify that I am the owner or authOrIzed agent for the
,lbove-mentw 'd property an(l thaI all constructwn w1l1 contilrm to all eXIstIng state and Illcal laws and WIll proceed in accurdance with submItted plans I am aware that the blllldIng
()ft\cial ran}t- oke this p.' It for Just cause Furthermore, I hereby agree that the City offICial ur a deSignee may enter upon the prnpel1y to perform needed lnSpcctHms
J _.- 2/23/oL_
, Dat~
x
Permit Valuation 2, 000.00
Permit Fee $ ~ 2 ZS-
Plan Check Fee $ -
I State Surcharge $ I. () 0
t Penalty $
Plumbing Permit Fee $ +0.00
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
~~
Bulldlllg Orticlal
02/&- '3 (0 7
Date
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 i $
Other $
TOTAL DUE $ 1()3. ZS
t No_
TIllS IS to certify that the request In the abovc applIcation and accompanymg documents IS m accnrdance WIth the City Zonmg Ordinance and may pmceed ,lS requested TIllS document
when Signed by the CIty Planner Clll1stltutes a temporary Certiticate of ZonIng complIance and allows Cllnstructwn to commence Before occupancy, a CertJticate of Occupancy must be
J.\slIL'd
Planning Director
Special Conditions. if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
. I Building Permit Checklist
nterior Alteration to Single Family Homes
BY: ~ ~~
Date: d) 1;;- 3/0 7
Building Permit #
Site Address I 'f lJ I 5'
PID:
Zoning:
-z~~ ~ Al.C)
Subdivision: ~
~z,J
Legal: L q
B I
Existing Structur@or NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? ,.10
Is the property located within the flood plain? Refer to Planning tJc>
Does the alteration include any additional kitchens? Refer to Planning ~lJ
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? fJO
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single fJ~
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
04/02/2007 15:25
'3514401 740
,':;L T A CLEAF'I'jA TEF'
PACE 01
Date Rl:'t \\
CITY OF PRIOR LAKE PLUMBING PER1\1IT
I [)'\lC rll. I PT:"RM IT NO
~,r;old c...,. 1:'-, _1 .
:'I VC"11l)..... t'rtr-!;Cilll ~
r:Plc~;c type or print and ~i~ ~t bonom)
ADDRESS ]
-L10/5131ldebRd/i:'M.('j luE
I LEGAL DESCRIPTION (offi"",, ooly)
LOT BLOCK ADDITION prD
-~~~R&-(t/L.f/) MaY~ ,.. _ (Phon(;) ~c:..233.3~70-
~ 0~)17-! T;z;i-d_~.(>>--J_~3-7d- I
APPLIC.AJj1 / / tf{;' -J-. (Pj /A /.;/'/ --- --- c:7'S2 ///j -:;;> - -I
(Name) /-1.d/t2:~ . _ ~Jt?-fJ--~t.~- (Phone) /' - I~{)- <..-.S~#,__ j,
(Address) -L22 )12ldJ1rjtJfAd~1 !&;j~(.LY / Ar~.L Sb.2; J ~~:__ '\
(Address) (Gry) (Zip Code) I
(Contact Person) ...--- ~ Ii r (phone) .~r\T.. - dd- 3. ..------.1
~.{, . - DATE ~/ ~"d/)~_..._ I
(Addrcss)
APPLICANT PLEASE COMPLETE BELOW
Type ofFh:ture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
Lavatory (Bathroom Sink) ~
Laundry Tra.y (1 0f ') eOhljJdl 1I {lcnt smk
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Typt, of Fixture
~
Quantity
----
E_
. Rough-ins
Water Heater !
- -.---,--"'-----~
W otCT Softner :
___,._. .Stand Pipe (Washing Machine) --I
Sewage Ejector
Backflow Assembly ----.-----~r
BackflO\.v Assem Hy Test
Lawn Sprinkler
Oth~r
,
'--'---~,
> .~...........- ,;-."'."
'......l'",.i:..:;.:,'.,:
Rc::3idcntial. New One & T\in-Family $99.50
RcsidcntiRl. Additions &. Ntcra,tion:: $39.50
Estimated Cost $
Building Pemlit # __
PLUMBING PERJ\l1T FEE $
STATESURCr~RGE $
TOTAL PERMIT FEE $
-- I'~ WITI-I
BUl'. .ING PERMIT
(Office U~e Only)
Tbl, App If""on Bocom" Yo", B""dlng P"m It Wh,n APP-'OV'd j..~.' aid
\ D ;r117 LUUI
- Blllldlnr. OfficiAl Dntc .
24 hour notice for all inspections (952) 447'!fflSO,"fux (952) 447-4245
16200 Ell~1e Creek Ave., S.E., Prior Urke,MN55J7,f-1714
-,
!
,
~:"'Pt No.
PRIOR LAKE
INSPECTION RECORD
D:PARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /4-0/5 [fLU68/1GU 772/7/L
NATURE OF WORK LO we_ 'l.- Gt5)/~
USE OF BUILDING 12eJ / /~
- -7
PERMIT NO. 07- 0 0 fJ 5"_ DATE ISSUED 2- 2-3, () 7
CONTRACTOR 1/ 0 E/\/ PHONE
NOTE: THIS IS NOT A PERMIT FOR.f\NY or THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCt'AENT
INsr' ~TOR DATE
~. I -.=--J
~UN)IL ABO~. ~=~EN SIGNED
ROUGH - IN"
------==--- i.
,-
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
T
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
---., -.-
,
BUILD!NG
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinef 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 INSPEr~rONS (952) 447-9850