HomeMy WebLinkAboutBuilding 02-1300
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MA, f\J
F/GG
~i~i~e ~:~y I PERMIT NO. 02' /,;>/\ 0
Yellow Applicant . _ '-J V
II 1._/;;: ~ ~~
! '()I:.'>A/-:: /A
...--'\<---
, ~;
LEGAL DESCRIPTION (office use only)
~
LOT (-7 BLOCK~;
, "'/1.
-j.., I,'
I ",.>
ADDITION [O\,..,.J., 1\,' "/.(\ , I,)
Date Rec' d
r;,~- -02-
ZONING (office use)
/2.4-
~
I,,)
PID "15--~O~ Olf.7--0
2--
OWNER .
(Name) [..\1[;'/'./5;/;-;r/..c./,,1'\.)
" !
!---< "y, . ..., '....
, (. ' r '1 i./' '--'
(Phone) 0,'5';'- YI':/ (:.. - ,'/ I/~)(-)
1""1/', -
, . \ ;' /'''
, , .", /- . ...;
/'1-1/';'
" ,
BUILDER ) I
(Name)
(Contact Name)
(Address)
.;- (-. "1
,") ~) (./'-
I,,'
,
r"r-/ ;,,/
'---;. ,-;,
'......... .c,~~~ ~, .,.-- '~./,I
/ /
y
(Phone)
,,.., ~-
(Phone) /' (y';; .' :;;3 3
-xerbY
ORe-Roofing
TYPE OF WORK
ODeck
OPorch
OLower Level Finish
o Fireplace
OAddition
o Alteration
o Misc,
PROJECT COST IV ALUE (excluding land) $
I hereby certifY that I have furnished information on this 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 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 this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
X ?S- --"/~f~~-
". ./ /: ,!;gnature
//:: '\;
Contractor's License No,
ORe-Siding
c:.
- -",/. .!"-
Date
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 518' , I";
State Surcharge $ Pressure Reducer
Penalty $ City SAC and WAC
Plumbing Permit Fee $ loo ~ cO Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE
#
#
#
#
$
$
$
$
$
$
$
$
$
~'3-0Z
Date
This 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 CertifSilte of.Z~min~ompliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be
Issued, ~ u. / U~
~
Date Special Conditions" if any
our notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
/
v
L[U0 ·
JfVJ
White - Building
Canary - Engineering
Pink - Planning
Tht ('('nln nr fht takr ("ounl.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
vV ENS M/~ t\;{ tJ
0-5- 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J ~Z 55 Fuu N{7-\ (J'\l H IlL.cS C (
Accepted X
Accepted With Corrections
Denied
~~ Dale: '1-1"1-0(,
See everse ide for Additional Information!
@
Reviewed By:
Comments:
LO"'C L-- O~~1j fj..J A. U ,
l-.Ol 5 0 ~\J~I.V A. <-)
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
11~
se{
IV
)(fL~
White - Building
Canary - Engineering
Pink - Planning
lhE' C't'nlt'r or 'he l.akr COunll")-'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\^JEN5MANtJ
q -~- 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
14-25,5 FOU/JTJ\ (rJ HIL/l~ C~l
Accepted
Accepted With Corrections ~
Denied tl~
Reviewed By:
Comments:
Date: q- 13-C5Z-
~~~}j alkW ~~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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FILE ~,Jo. 502 04/11 '03 06: 52 I D : PL"{fl0UTH PLUf18 I ~,jG
FA/:7635331121
PAGE 7/ 11
CITY OF PRlOR LAKE PLlJMBING PERJ\lIT
Date Rec'd
al \:>ot1C1ml
; ~~~ ~;~,') I PERMIT NO. n - / 3001
J VdIO\.," '\Pcl,,"lnl , eX _
2.0ND..JG (oFicu u,<o1
- OUV\~~
~lt
LEGAL DESCRlPTI0N (omu \lse only)
LOT
BLOCK
ADDITlON
PID
OWNER / "\ I .. (Ptr\
(Namt) ~ ~ ') VV\ () I^ V\ . H:VYIAJ! ~ (Phone) ..f:1 ()( 0 - t.1 L L.{)
lAd dress) \ q,q~ P (1\ To.,. 0, i \J{ I 7, -CS~, I tv{ IV ::5,~ I d- ~
A...PPLICANT 0 ,~...l.. .- ./'J I "\ (
(Name) t"t IJ Vll\.n L .1 \, \ , V I L-t ,'\,\/) I 1''-.5 '). (~hOne) :J lc 2J ~)'~~'-(.j 7:J5 (
(Addr~ss) (04. (} q \1'./1 ,"\ fld + ~ 0. h l~. ~. hro( 'kJj"\ -PAV'\( GC::;L.I;J_~
(Addn:st.) (Clt)'} (Zl}' Cocle)
IlcDm'" P=on) _S; ll_ _oeM '^-~ YVIIA 'f lliL (Phor,e) ill 0 3)5. :i)- L{ 3 S 7
I APPLlCAH1 SIGNATU~ &~~'r1A~ DATE ==:L::J ( - ci3
A])PLlCANT PLEASE COMPLETE BELOW
Q u:m li t)' Typt, of Fixture Qmln tity TYP,,",ofFixtun I
..... f1'-. Bath Tub with or without shower Rough-ins
DishWi\sh~i' I Water Heater
Floor Drain i Watt l' Softnr::r
to\ LZlvatory (Bath:"oom Sink) -\. Stand Pipe (WJ..Shing. ivlncl1lne)
\ LaLlndr~v Tnl)i ( ] or 2 c:.ol11parlment sink Sewage E:iecror
1 Shower Stall BackJlow AssembJ~:
I \ Sinks Bnck:f1o\Ai Assembly Test
- " , , ,
""""'j ...HI U\.
......_"'., _j" .1.....-'
Wiltel' Closel IT(,dcn
I Other
FEE SCHEDULE
InclL1Sln;ll, Cuml11~rcl~1 ~ 1\,1ulll-I.111111v I~'" ilfj,ll\ (;<ISI \\'1111" S:3950 minimum
R,sICJ:nlJ<d. N.;w On~ &. TWll.F"I1I;ly $Cj9,50
Rt~ldcnl1~J. Adcilliun:i &. AII~r:l.Lliln:; 5.3950
ESlin1:lttd Cost $ '1355. CD Building Prmnil '#
"
./0
,':'0
P-
SUII ^~/D ,...
~cJIJVG r~'ft.t
P~~41"..
PLUiviBfNG PERMlT FEE $
STA TE SURCHARGE
TOr.~L PERMIT FElT
/Ulfi;l' U~C (Iul\'1 ~ ~ ~
I Th.s ^ ppl""'..,, a"""" \ "'" Bo d' ;"z Pem" WI"" API'''''.'" ,~~ p", 1 00 : !'
I uU. [l;llc 8.,.,
..-. I
rlllildl"~ (Jfli','''1 1'.111
1(.l:C~IPI bJo
I
F--!
By
:" Illl\lJ" l....lIcC rOI ~lllIlSP~(\WIl:, 1~3~1':; ,- :>,.Il. ~;::_) ~4'7-~~4~
Ih~f\!l '~.:J:':;l' (Ol't't.'l':'\\i',_ .....(... !"'Wl. I 'Il,,' "".,,,' ~~'~"'''\..I''',!
'03 10:58 ID:PLYMOUTH PLUMBING
FAi<:7635331121
PAGE 43_' 47
CiREEII . I'1\.t
TELLOW . APPLICANT
GOLD - elT"
CITY OF PRIOR LAKE S"w. No, d- ~ /3crD
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City_
APPLICANT: .()~l ~IA PllAv'V\ ;~ PHONE:iJ(P'i,)S:?~-L!,~~7
(DDRESS :J L\__ _ I' o:,,,,t.:aiv\ _ \\.., Q'I- DATE: ;).- 11.4- 0 ')
~ S IGNATU~lJ){::j"~i~I)^M.AQtQf ~\ BLDG. PERMIT #
SITE ADDRES~: PID#
FILL IN THE BLANKS
1. Estimated length of water service
I
AD
feet.
2. Size of water service
\ II
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC V.
Cast Iron
5. Estimated length of sewer line ~O
feet.
6. Clean out (if required) I located at
structure.
feet
from
====~=~~==~~======-===================================~=~=====-===
This application becomes your permit when approved.
BY
DATE:
=====~=========~:==~~~~==========================;;=;=~~~~=~~=~===
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permlt.
Surcharge
TOTAL
* fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
*
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. '51 ~)A'.""
/ ,'~fiiff "' ''''.' ,
--.i -')i/~:k/'?l~\/f:
m
AMOUNT PAID
REC'O BY
Cf
DATE PAID
RECEIPT #
By
16200 Eagle Creek Av, ,
sota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponunity Employer
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
#70/~
~: ~e:n ~:~ I PERMIT NO. -, - / -::? OZ) I
3 , Yellow Applicant u-< , } .
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT A .. '/. ~
(Name) /7//~~./ ",Gt!!'~~L'~(Phone) "'/-
(Address) l ?~~?) //~.A::l6~~ ~_ /=--~~
(Address) (Ci~
(Contact Person) AA-/L)~ ~c..~ (Phone) 5/-
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACEMAKEANDMODEL~'1~1\fI -:3I~(JzLlt57o FUEL NA.. C'..rA.f
FLUE SIZE L-f <1 RETURN OPENINGS INPUT 6~ c;nO OUTPUT 5-:-i' dJ()
TYPE OF SYSTEM HEATING OR POWER PLANT
r::lW~ Air Plants o Steam
j5Gravlty 0 Hot Water
~echanical 0 Radiation
rtfAir Conditioning 0 Special Devices
~ent. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64"50
$39.50
Estimated Cost $
Building Permit #
$39"50
$39"50
PAID IAI
BUILD r"lTH
ING PERMIT
· d"~
.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
'--1 ,"'
Receipt No.
Building Official
Date
24 hour notice for all inspections (952) 447 9850, fax (952) 447-4245
By .. ----
L Mal'~ t- Le
DEPARTMENT OF
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS Jld~SC) Fn()V\-!-aCVl t:blls Of~
NATURE OF WORK ~ Qr.;;)
USE OF BUILDING Ff+-
PERMIT NO. ~~ DATE ISSUED q-I,~-oz...
CONTRACTOR LJ ~~) PHONE q62-233~~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING Q4It S(( slip rt17 I..~(~~ ~ 2/~'1jOs
J FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC ~ ~
FRAMING W ~l8V\.
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE .
GAS LINE AIR TEST 51 b'163
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
GRADING (Prior to Sodding)
BUILDING C--
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850