HomeMy WebLinkAboutBuilding Permit 03-0430
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
L/-14/3
PERMIT NO. 03- '13(1)
-:3 <1 3;J.- (// ~ .,UJcres+ ~/ n::)~
/'
ZONING (office use)
€/ Sf)
LEGAL DESCRIPTION (office use only)
LOTI/BLOCK ~ ADDITION'1t~~Esf- /sIPID ;;25-3 (.0-0/0 "0
, - - ,
OWNER
(Name)
./ - I _
'0 J CL ',-+1 tJl!v-
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
~wer Level Finish
o Misc.
(Phone) q5 L"- Ljt-!O --6 q L/ L/
(Phone)
(Phone)
o Deck
ORe-Roofing
o Alteration
o Porch
o Fireplace
DAddition
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
o Utility Connection
I hereby certify that I have furnished information on this application which is to tbe 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
:1f; 1;.perty,' P rform needed inspections Lj/f q/{) ,3
Contractor's License No. Date
Permit Valuation 4/ (Jot) ()7)
.-
I Permit Fee $ ~7 ~r
Plan Check Fee $
State Surcharge $ J- (/1)
---
Penalty $
Plumbing Permit Fee $ L/~ ,00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $&~}Sl-IAlq
........,
n:;1;PjliC:!J/ Becomes Your Building Permit When Approved
JM 'l~ Lf"/L/-():3
Building Official Date
J,oO
/8fJ .~
., ')r!d
Receipt No. tlL{t / ()
,By fJA: ./
0-
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
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
:1J;A 7?Eonstirures a _po,~ C_te o~:~;:re ~d illows P:; to = B=;~' ~=;p~~ mnSl~
V ~ning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter
Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
e- / e.G,
TOTAL DUE UP/- trr5c; tI-/tj~
I
Other
I Paid
I Date
/'30ldS
Lj-t?;;, - _'3
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or print and sign at bottom)
ADDRESS
I. Blue File PERMIT NO
2. Gold City · 0 3- I J~ l>
3. Yellow Applicant _ '-7 .a
3t:J3:l- thWGY'e-S+ (j/r
ZONING (office use)
~t5D
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
I~ ~/fL
~ey-
I
PI~" 3 bO--OIt.~)-6
(Phone) --Vq't'-S9o/'l/
LOT
BLOCK
ADDITION
(Address)
APPLICANT
(N ame)
(Phone)
(Address)
(Address)
(City)
( Zip Code)
(Contact Person)
~~~
(Phone)
APPLICANT SIGNATURE
DATE
L/ 11'-1 1()3
Quantity
APPLICANT PLEASJ[ COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compa.llllent sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough- ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
,/
Residential, New One & Two-Family $99.50 ,. \
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT ]~EE
$
$
$
Paid ~
.50
\
\P
.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Receipt No.
Date
By
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Residential Building Permit Checklist
.// ~asement Finish or Interior Alteration to Single Family Homes
BY: I jU. PJ;- Date: L.t~/L/~dS
Building Pe.l mit # PID: Zoning:
Site Address 303)... Vt-etv?re..s,r
Legal: L 7 B 2-,
Existing structure:~r NO
Subdivision:
1I(fr"fJ1wd/Jd ~t.j' ~s'/ /sr
CONFORMS TO ZONING
ORDINANCE
e NO
,
Is this an expansion of the existing footprint or
building height?
YES
Refer to Planning
NO
~
Is the property located.within the flood plain?
Refer to Planning
~.
Does the alteration include any additional kitchens?
Refer to Planning
~
~
~
Does the proposed alteration include any outside
entrances other than patio doors?
Refer to Planning
Is the proposed use of the fmished space or
alteration for anything other than a normal single
family home (office, group home, day care, etc.)?
Refer to Planning
THIS CHECKLIST MUST BE COMPLETED AND INCll.UDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TElVIPLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS $ 0 3 ~ I ) ieJ.i) crest- cP.,lrc Ie--
NATURE OF WORK '-' t..--
USE OF BUILDING S F IJ
PERMIT NO. ~B-~ C/ 3CJI [)ATE ISSUED LI-/~--3
CONTRACTOR ,k'tl!4 tte4~ PHONE
NOTE: THIS IS NOT A PERMIT' FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING ~.9 ~- ~.
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE ~
GAS LINE AIR TEST ,11,1." t't'- /V~.s f"rdMi AJ&i 7<lJJI- 3-/"1-0,'3
-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
FINALS
(i)~
(-:1- .~
I
J
'\i
HAS BEEN SIGNED
OCCUPY UNTIL ABOVE
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
TIME
(~{~
SCHE:DULED
3-9-()~
ADDRESS
203? V,'elUr ~~5~
OWNER
PHONE NO.
CON1rR.
PERMIT NO. ~ - q)t)
o FOOTING
o FOUNDATION
o FRAMING
q. INSULATION
':Q-fINAL
o SITE INSPECTION
o PLUMBIN(i RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBINC:; FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
t: ~ '^-
COMMENTS:
Lo~ L~" Cl
/~
~ORK SATISFACTORY. PROCEED
o COR~~~T'ON AND PROCEED
o COR':.C7!RK. CALL FOR REINSPECTION BEFORE COVERING
Inspectc r: h Owner/Contr:
CAWSO FOR THE NEXT INSPE:CTlON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl