HomeMy WebLinkAboutBuilding Permit 04-0177
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
Date Rec'd
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File
City
Applicant
I PERMIT NO. 04-. () n7 I
(Please ~P.CE or orint and sim at bottom)
ADDRESS
~~ I/owi:. Y;o:.E 12c IJU
LEGAL DESCRIPTION (office use only)
ZONING (office use)
Jf!.,lfp
LOT
ADDITION
PID2S..3 "0. 0 Ill. 0
BLOCK
OWNE~-r--
(Name) '----tPAvu
(Phone)
'1fL. t.{qtv ~ ((
I hCleby certify tha lrmshed mformatiJn on this apphcatJon WhFC IS to the best of my knowledge true and correct I also certIfy that I am the owner Dl authorized agent for the
above men propel that all constpfctlon will conform to all c stmg state and local laws and will proceed In accordance with submitted plans I am aware that the buildmg
:fiC n revoke thiS permit fOf JZ.: ::.- , ..~y "" h" the O>ty ~ffiO>'1 Ol' d""nee m,y entel opon the ptoperty to p,,'olm needed '''pee''"n,
gnature _______. Contractor's LICense No Date
~
Permit val''''"71on
Permit Fee
Plan Check F
State Surc;.mrge
Penalty -
$
$
$
$
$
$
$
$
$
iJ
I:rfO
~M("~1'V':::'
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding RrLo;e~e~1 Finish
DAddition DAlteration DUtility Connection 0 Misc. - ~ #WJI1r-I'~
CODE: Din.R.C, DI.B.C.
Type of &;;struction:
Occupancy Group: A B
Division:
III IV
H I
ztV
@A~
M<<1SU
4 5
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
I
-
$
$
$
$
:I, ()OO. 00
74.75
Park Support Fee
#
SAC
#
Water Meter
Size 5/8"; 1 ";
-
I. SO
Pressure Reducer
Sewer/Water Connection Fee
#
Plumbing Permit FJi ,~. $
Mechanical Permit Fi: I $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
4-0. () 0
Water Tower Fee S
Builder's DepOSIt
Other e toE, t!:rJI.I
TOTAL DUE
This Application Becomes Your Building Permit When Approved
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//7. z,..5
"". I. (;/4--
Paid
Date
o Fireplace
/.00
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4--L. ~f!J
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 Df Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Special Conditions, if any
1
.
'L
.
Residential Building Permit Chedilist
Basement Fmish or Interior Alteration to Single Family Homes
BY:
~.~
Building Permit #
Site Addre:!s
PID:
~
Legal: L
36 z..:S
B
E:r:isting Structure~ NO
. CONFORJ.YIS TO ZONING
ORDIN"AJ.~ CE
I
Is this an e:tpmSion or the c:-'..sting footprint or
bm1ding height'?
I Is the pI'Oprn'f 10C:ltcd within the flood plain?
I Docs the altc:"..rion include my additional kitcb.C"..s?
Docs the proposed alteration include my outside.
entrances other than patio doatS?
Is the proposed !.ISe or the fiDisned spacc or
alteration for anything other :hm a Ilor.nal i.ngle
fa.miiy home (occc. gro~ h=:. 6y C:l!"C. etc,)ry
Date: '5/2- ~ /0 </
Zoning:
e;~ RJ.,
Subdivision:
YES
Yl:S
Refe:- to p'~m~
ReIer to PlamriIlg
Ref::' to PlamriIlg
Refer to PlamriIlg
Re:er to Pl=i:Ilg
NO
NO
~o
t0~
N~
lJo
NO
Tms c=CKLIST ){"(;5T BE COMPLETED .~'!D G'lCLUDED G'I Tm: BtlLD[CiG P~R.yIIT mE TO
)L.lJNTA.l!'l A RZCORD OFTm: REVIT\1i.
.
.
.
.
-
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BU,lLDING AND INSPECTION
SITE ADDRESS ..3025 f/1rWK- elnuc;- /ZL)
NATURE OF WORK L.-(JWI-:.,7(., LE'Vt;.-z...-
USE OF BUILDING /26" of /1'/ R-
PERMIT NO. 04-,0177 DATF ISSUED .3.2.5.04-
CONTRACTOR SP/UN'q.s f~ PHONE~O. ZkLL
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
,.... I j
I I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
fI) /
I
I
I
"'\P
S--5
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I 1
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
~ (/) I If -/'7
L.J (... I
V'
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
DATE TIME
CITY OF PRIOR LAKE )-l<;q/
INSPECTION NOTICE SCHEDULED
ADDRESS \0[.'< \-\~Ic erM...__
;.
OWNER CONTR.
PHONE NO. PERMIT NO, (( -/7/
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~NSULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
\, Q. """,.1..t:k... '6c. ti..h-,,""-
,.
o WORK SATISFACTORY. PROCEED
)(CORRECT ACTION AND PROCEED
/0 boRRE1?15CRK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: OWner/Contr:
CALL -9 50 FOR HE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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