HomeMy WebLinkAboutBuiding Permit 11.117 J
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ii + CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
t o TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z 2--1—/ 1/
E.- t '; AND UTILITY CONNECTION PERMIT
M /n'NESO 'cP I. white File PERMIT NO. `j, 1/
2. Pink City
3 Yellow Applicant ///
(Please type or print and sign at bottom)
ADDRESS �34L w `ISZICi , 1 ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER K (Name) Y o QQ ∎ (Phone) ( t ..( R!) . (.p( M
(Address)
BUILDER
Company � W� (Phone) q`� ' .0 -`�..5
(Company Name) � • • � • � k. � � • = )
�. ii t_L e... \ 1 ! q
(Contact Name) • " r • �l �' f __ _ _ -_ (P a
(Address) 1 ,(p�. . 1 W • ,, : 1 l N . 55
TYPE OF WORK ❑ New Construction ['Deck ❑Porch ['Re-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F 11 I M R S U (excluding land)
Division: 1 2 3 4 5
•
I hereby certify that I have hirnished information on this application which is to the best of my knowledge tnie 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 Am. - ■._ ! �. - i . ! a oL+ 55 O a lai-iti I
. , Signature 1 Contractor's License No. are
Permit Valuation 3 0 C) 0 . O 0 Park Support Fee # $
Permit Fee $ 7 1- . 75- SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ ! / 37) Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ J - i" 5- Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ J am. -¢ 57) TOTAL DUE $ /e5. 2,5
This Application Becomes Your Building Permit When Approved Paid / 9 . Z S Rec pt No. 692/0 0
Date Z. 29- 11 B
Building Official 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 Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
- c ", --- p itlp CITY OF PRIOR LAKE Date Rec'd
° :e HEATING /AIR CONDITIONING /FIREPLACE PERMIT
j � x 3.7. 11
r ,,,
' I NrvEso �� 1. Pink File
2. Ye
City 1 • O ' r7
3. Yellow PERMIT NO . w Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3344 1 \o,,ss
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) &o in 'z.‘ 1 j',� (Phone) "! 5 . 2 – DSO — 19I05
J
(Address) 33 44 W, 1c� ‘0,,„ �" 5c 9 6 tA Lau O' N 55 3 / ).-
I
APPLICANT /' , _ t 1 �,,
(Name) l (p�� \ t' 4� ` i" \ D Yl (Phone) ( 15)- Cl d a7CQ
(Address) l 00 :001 c Oo IOW i Jordan i I W �/ 553 ;J–) --
I (Address) ( / , ) (Zip Code)
(Contact Person) _ 1 .r. iC -!Lets (Phone) °> s `�{ %�' 9c;17 APPLICANT SIGNATURE i �. DATE 3
■ < e IC ANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑ Stearn Units and Fireplaces Cannot Encroach
❑G avity ❑ Hot Water
into Required Side Yard Setbacks.
Mechanical ❑ Radiation
■Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
EVent. System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL \ lay On b ..--S N67
FEE SCH
Industrial, Commercial & Multi Family 1% of job cost Re sident i al, Gas Fireplace ; $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
The Minnesot Statutes § 326B.148
HEATING PERMIT FEE $ tfq. `So "SURCI IJRGE" as been changed for one
STATE SURCHARGE $ ' + Co it effective
L i J �
TOTAL PERMIT FEE $ 5 `f , SO inim curt urge f a I fee" permit
(Office Use Only) is be nni .J f} e010
This Application Becomes Your Building Permit When Approved Paid !J Receip VI ZANE
Date r '101111111.11111
Building Official Date _ f
1
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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PRIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3 W / H OBE PAS
NATURE OF WORK - W E)C- W
USE OF BUILDING W R/2
PERMIT NO. / 1. 0 //7 DATE ISSUED 2 - z�'
L
CONTRACTOR o 6-6 SN,hv4- t PHONE 2-50 . 7 5 6s
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
ORM 1
lumnimmiimmow 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING (d 31
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
BUILDING J 5 5' ��
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.
FOR ALL INSPECTIONS (952) 447 -9850