HomeMy WebLinkAboutBldg Permit 04-0861
2-J-3-0Lj
I PERMIT NO. (J 1/- X'1t; I I
O~ PR/O,,".
"- t"
,.. .,
- Ii'(
U />j
+'NNESO'\""
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
(Please type or print and siltll at bottom)
ADDRESS U, 782.. 1-1 j \ Ic:res,\ S, S~
LEGAL DE$CRIPTION (office use only)
LOT/~ B~OCK (/) ADDITION P /i~ "SmtJ:lr.
-,
Date Rec' d
Zrr'SOffi""")
PID~5~Oj/J - /I;:)-I?
OWNER
(Name)
\(Et-lT G6r\'-'~""-.
(Phone)
q.;)"2. .<jl,J6 -'-IIZo
(Address)
-"SAM"" -
BUILDER
(Company N~mp'
(Contact Narpe)
(Addtess)
.- <;ELF-
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing
DAddition OAlteration DUtility Connection 0 Misc.
ORe-Siding !i2(Lower Level Finish 0 Fireplace
~~l:Ittr
PROJECT COST IV ALUE S qOl>O-
(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 aUlhonzcd agent for the
above-mentIOned wropeny and thaI all constmction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
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~
---,
CODE: ~.I.C. DI.B.c.
Type of ons1/ruction: I II III IV V A B
Occupancy Gtoup: A B E F H I M R S U
Division: I 2 3 4 5
Signature
Contractor's License No.
Permit Valuatjon
Permit Fee $
Plan Check Fee $
State Surchar~e $
Penalty $
Plumbing Peninit Fee rJWlJe'r $
Mechanical Permit Fee $
Sewer & Wat~r Permit Fee $
Gas Fireplace!Pennit Fee}.Jb $
ilJOOtJ .oa
#
#
Park Support Fee
SAC
.gL{ ~ 7~
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
,~o
L/'tJ, " lJ
Other e I ec....
TOTALDUE t'flt/hd [(-;:)4-(1
-'7 (? . 'Z-~
ilZt(/o-i
9:. '2.:' .0J..f
Date
$
$
$
$
$
$
$
$
$
1,00
'7h .;)5
~cat~n ~nt ~o"i:dmg pe;i:;;~ved
Buildin_g Ollicial r Date
Paid
Date
I Receipt No. If,.",,/{'
By J$:r.
ThiS IS to ct'rtify 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
nate
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
Residential Building Permit Checklist
Basemell! Finish or Interior Alteration to Single Family Homes
# -
13Y:~
N-r'
Date: g -a 3 -oC;
Building Permi, ;I
Site Address
Pill:
G/?fc1
_ Zoning:
~A(ui1 .s+-
~ega]: L
B
Subdivision:
lE.Iisting Strucrure~r NO
i
K:ONFORvIS TO ZONlliG
PRDINAl"'CE
'i-:E S
NO
I'
I
Is this a.., expansion of me e7j=g footprwt or
building height?
!
YES
NO
Refer to Plar.ul..L.J.g
I poes the alteration incluce any additional kitchens?
Does w."le orouosed alte:arion mclude ar..y outside'
entrmc~s ache:- than patio doors?
Refer to Planni" g
ND
,..JCl
r-JO
Is me property located within the flood plain?
Refer to Plar.ning
Refer to Plar.ning
tJa
ts t.~e proposed !.!Se of the B..nished spac~ or
~ltenrion for a.""1~rch.ing otb.e:- than a iloTInal single
ram.il~l come (oac~, groU"9 hame. C2.y c:;,re, ~~c.)?
Refer ~o P~a.uing
No
']rms CHECUIST MUST BE COMPLETED .,,-'11) INCLUDED IN THE BUlLDING PERMIT flU TO
/;tAlIH.UN A RECORD OF THE REVIEW.
,---:''(,/(""::r ..!. -:" ..'. - -~"''':C''':: -:(~c
PRIOR LAKE
DEPARTMENT OF
BUILDING AND INSPECTION
I~SPECTION.RECORD
SITEIADDRESS -':t 782.. HI ~ $"'. S'.~.
NAT~RE OF WORK ~. L . -'A-nt&Y.-..
USE bF BUILDING ~ F: Q, -
PER~. IT NO. DATE ISSUED ~.,
CON RACTOR ~r ~M~ PHoNEttl.WO..Clla.
NOT : THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.-...
t1/T/
I J-. - JU-(/L/
-
//1/(/ ~
t/i( .
/ l so-dL/
I~>O{/ll
I
ELE CTRICAL
PLUMBING
HEt(TING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
, ,4 .
1/11/' y
j/U/y
M
rf/lu/;r
f1/7~S
6/.23/ OJ
R'/~.24S
BEEN SIGNED
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 ~ /
INSPECTION NOTICE SCHEDULED cJ1..2V1l5-
ADDRESS _(;,7 rf2 $/;(. r-e<S -/ 0/
OWNER CONTR.
PHONE NO.
PERMIT NO.
o~- tYt:/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~MBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/;J j,
/J.ffl6/y
/';/
;/">/
rk4-
~/
rho/
~JL
~
/ _/
\. /72"'Jt" A- / ~
~~ SATISFACTORY, PROCEED
/d-. CORRECT ACTION AND PROCEED
o CORRECT WORKU~E~ECTION BEFORE COVERING
Inspector: /~........... Owner/Contr:
>//
----
-- ')
~
~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <I SAFETY/
INSNO"