HomeMy WebLinkAboutBuilding 06-1022
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
Date Rec' d
1 White
Pink
Yellow
I PERMIT NO. 0 t:, - /tJ /-.;t-
File
City
Applicant
ZONING (office use)
4~O~
w~:j~ R\:1.
rntLrtAj
{
--
$
$
$
$
$
$
I $
$
PID "
[?
OWNER
(N ame)
10m
an.el
(Address)
(Phone) q~c1 d3'5 7?Q5"
fnN 55'372
i BUILDER
I (Company Name)
II (Contact Name)
(Address)
(Phone)
(Phone)
ORe-Siding
~
~Low~-vel Finish 0 Fireplace. .'
&!Jtl S 'R 06 fYl fI )/15 h
TYPE OF WORK 0 New Construction OOeck OPorch ORe-Roofing
OAdditlOn OAlteration OUtility Connection
CODE: !.R.C. DI.B.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 hereby certify that I have turmshed Inti,rmatlOn on this applicatIOn whIch IS to thc best of my knowledge tIlle and COlTect. I also certify that I am the owner or authOrIzed agent I"r the
above-mentIOned property and that all constructIOn WIll conform to all eXIsting state and local laws and will proceed In accordance with submItted plans I am aware that the building
official can revoke tlus permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propeIty to perh1fm needed lI1specttol1s
x
--rn Q/U~
czO
Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
/.oV
This Application Becomes Your Building Permit When Approved
I~~
13uildlllt! OfIicial
/ t/:!/fJ ~
/1. q, O~
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 f1~ 3~-;[5
~r- t~
I ~;ce~o -5 ?S-5)
Paid
Date
TIllS IS to certIfy that the request m the above applicatIon and accompanymg documents is In accordance with the City Zoning Ordinance and may proceed as requested ThIS ducument
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows constructIon to commence. Be\iire occupancy, a CertIticate of Occupancy must be
Issued
Planning Director
Special Conditions, if ariy
Date
24 honr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:~~
Date: 1/- 9~'o6
Building Permit # PID: Zoning:
Site Address / ~ 0 {)S iu~ ~~ R 4CJY.-
Legal: L B SubdIVIsIOn: O{;fo -/(J z.. "2--
Existing structur@ NO
I~I
I CONFORl'VIS TO ZONING
ORDINANCE
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? Ala
Is the property located within the flood plain? Refer to Planning tJ~
Does the alteration include any additional kitchens? Refer to Planning ~O
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 nonnal single ;JO
family home (office, group home, day care, etc.)?
Tms CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PER.)UT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
----
L\TE11PLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
,,() //
DEPARTMENT OF
BUILDING AND INSPECTION
---- ] I
1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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