HomeMy WebLinkAboutBuilding 07-0167
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3.2B-07
File
City
Applicant
I PERMIT NO. 07.0/&7 I
I White
Pink
Yellow
at bottom)
~/~/rJ fdL
ffi'lfo
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Ro^4lcl ~ ski Ir LJf3t-T~(S
/7 L YG-r/.<<lcI ~
(Phone) Q,)2 Vf? & I tr
(;;1z.:-Y~7-'! let 1
(Address)
BUILDER
(Company Name
(Contact Name)
(Address)
Pt,
(Phone)
(Phone)
MWSS"17'
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditIon OAlteration OUtility Connection
CODE:~ C. OLB.C.
Type of ~lction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
?!Sf;',iisC
ORe-Siding OLower Level FinIsh 0 Fireplace
~uYv\. A f1"J II- ~~;~_
PROJECT COST IV ALUE $
(excluding land)
z... . C;'U <...i
/
I hereby certity that l have hlrmshcd mformation on this application which IS tu the best of my knowledge true and correct. I also certify that I am the owner or authOrIzed agent for the
abovc-mentHlned property and that all mnstructHln wIll conform to all eXIstIng statc and local laws and wdl proceed In accordance with submItted plans I am aware that the buddmg
olliClal can revoke tillS 'mil Itlr Just cause Furthermore.] hereby agree that the City official or a deSIgnee may enter upon the propelty to pert(Jrm nee.~d mspectlons
X_ ,~, ~ a7p'39:d/ ~-Z~o7
' - Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $ .-
State Surcharge $ -57)
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace PermIt Fee $
Park Support Fee
SAC
#
#
Water Meter Size5/S"; I",
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
I~~
I lluild1t1g UtJiclal
3/U/() 7
Date
Paid
Date
$
$
$
$
$
$
$
$
$35.2-5
S J2.-" "L
Tim IS to certIty that thc request In the above applicatllln and aecompanYlllg documents IS III accordance with the City Zoning Ordinance and may proceed as requested. Tim document
whcn signed by the CIty Planner mnstlt1ltes a temporary Certificate of Zonlllg compliance and allows coustructllln to commence Before occupancy, a Certificate of Occupancy must be
i.o.;SllL'd
Planning Director
Date
24 hour notice for all inspections (952) ....7-9850, fax (952) ....7-..245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
~
~
Date:
3(2g(07
Building Permit #
Site Address / 7 ~ 0/' ~
PID: Zoning:
~~I
Legal: L
B
Subdivision:
Existing Structure: @'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? jJo
Is the property located within the flood plain? Refer to Planning 'va
Does the alteration include any additional kitchens? Refer to Planning }J(J
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? JUo
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single ;J(j
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
SITE ADDRESS /72-4& DC{;I&F!t3-e--p 011-
TYPE OF WORK L- - ~ -
USE OF BUILDING /l~-S /ll/z-
PERMIT NO. (J7. ()/&I DATE ISSUED .3 ~ 2-B. 07
BUILDER /Ho r; PS 0 tV PHONE # ;, I Z . f? i'o 7. 37tj7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
---- I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~MING I 1f'7 I Vl-1-if 'I
I FINAL I J/'v1/7 I 4~(7/tr) I
,
INSPECTOR
DATE
FOR ALL INSPECTIONS (952) 447-9850