HomeMy WebLinkAboutBuilding 05-0835
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
,..,
.r zA." Of
1 White
Pink
Yellow
File
City
Applicant
PERMIT NO. () 5. 01'"3.1-
ZONING (office use)
I ~L.f17
lue. biRd
~A
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNE~
(Name) 'C.IUilO
I
E ~t\'\(.ill CJ-4
(Phone)
eft..\..
q 5 J. -;)-5(}.-Q3 is
lDt~-dl&.f-'io.l' t
(Address)
1&..(~'1
BUILDER
(Company Name)
(Contact Name)
(Address)
S8t'Yl~
A\ A Bout'
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding ~ower Level Finish J(FirePlacc
OAddition OAlteration OUtility ConnectIOn
CODE: ~.R.C. DI.B.c. o Misc
Type of C nstmction: 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)
J5 DDO
.
I hereby cenily that I have hlrnlshed mformatlon on this applicatIOn which IS to the best of my knowledge true and correct. I also certify that I am the owner or autho!lzed agent telr the
above-mentIOned property and that all construction will conform to all eXlstll1g state and local laws and will proceed in accordance with submItted plans I am aware that the buildmg
official can revoke thIs ermlt for Just cause Furthermore, I hereb agree that the City official or a deSIgnee may enter upon the propet1y to perform needed Inspecttons
Sewer & Water Permit Fee
8 -J(P-OS"
x
Contractor's License No.
Date
&r,:Jr
0,00
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other e1--ecr-, y/ $ /. ()O
TOTAL DUE $ /~7 Z~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
,s-a
Gas Fireplace Permit Fee CL,,.rr.
lfO ,0('
This Application Becomes Your Building Permit When Approved
~~~
BlIildlllt! Olliclal
o/z ~ f,.>
Date
Paid
Date
f ~: /.~
I Rece~No. q99 (3
By I7r .
ThiS 1S to certify that the request in the above applicatIOn and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested Th1s document
when signed by the City Planner ClJl1StltutcS a temporary Certificate of Zonmg compliance and allows constructIon to commence. Before occupancy, a Cerlltlcate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all 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 Homes
~
BY: ~ ~ Date: 5J!Z(P/OS
Building Permit #
Site Address / ~ L/I 7
PIn:
t5IU-1!/~
Zoning:
T~
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? tJD
Is the property located within the flood plain? Refer to Planning ND
Does the alteration include any additional kitchens? Refer to Planning tJ6
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? cJ(J
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single tJO
family home (office, grOUD 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
P R I 0 R LA KE DEPARTMENT OF
, . ' . BUILDING AND INSPECTION
INSPECTION RECORD
.
SITE ADDRESS ~/7 Ut: 15/1l()
NATURE OF WORK
USE OF BUILDING . .
PERMIT NO. OS-,uffJ)' DATE ISS.UED a~ r'
CONTRACTOR I!IcHMiJ iJ~ ~NPHONE'I~-rCflt"/'l11
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
CONCRETE TIL ABOVE HAS BEEN SIGNED
ROUGH - INS
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.- -
.. -
. .
---
BUILDING ~h ~ \\^\ \0\
ELECTRICAL " , , ,
PLUMBING
HEATING ~~
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTIC-E
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