HomeMy WebLinkAboutBldg Permit 04-0281
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec
L/~ It,~~
While
Pink
Yellow
File
City
Applicant
I PERMIT NO. OLj-if8/1
(Please tvoe or. lrint and silPl at bottom)
ADDRESS
-J 2-.66 tJ r1n00c.- /{ Ph
.f)../~ ~JIe /d1/
ZOlpJ25"'U"1
LEGAL DE iCRIPTION (office use only)
LOTi1 B"OCK I ADDITION IM.ldtJ
,~rd
PID r5?5 - 33/} - 0/'7- 0
OWNER .
(Name)~.-/ A- drJ f qAPr
i
RJr--.kAu S
(Phone) ~S2- 22'15-2 c&2
(Address)
~c~~~~]\ame) /J1,>..f~ &/??.vL/).nf (Phone) q<7.:-27o-2c/Z.
(Contact Nalne) ~_L~~I -r A~......~; (Phone) ~?~Z-"7D-?.Ll4:::
(Address) //~,n E _~~ ~- !~~J"uj/;~ dI/ '::;~f (' 7 -
TYPE OF u~ORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding ~ower Level Finish 0 Fireplace
,.., DAddition DAlteration DUtility Connection 0 Misc.
I
CODE:..d:.J.C. OLB.C.
Type of ~Sl mction:
Occupancy G 'oup: A B
Division:
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify th ,( 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 l)]" authOrized agent for the
above-mentIOned lropelty and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:fiCi'l ::;;;;.:'::::;:::" :;;;~:t:' '~ee th"th, C>~ offici,l 01' d'2';;:;;;;; ;;27 pcr'olm needed ';:;b 6hq'
i Signature:7 .7 Contractor's License No. Date
Permit valuatton ~"!aoo.lJO I Park Support Fee # $ I
Permit Fee : $ .~'~I SAC # $ I
Plan Check Fee $ Water Meter Size 5/8"; 1 "i\., $ I
State Surchaq e $ 1,-:;-0 I Pressure Reducer $ I
Penalty $ I Sewer/Water Connection Fee # $ I
~'_
Plumbing peXit Fe iJJF-1{ .Y, $ 1../0.00 I Water Tower Fee --........-.-.-. # $ I
Mechanical P rmit Fee $ I Builder's Deposit $ I
Sewer & Watl 'f Permit Fee $ I Other $ A'
Gas Fireplace Permit Fee $ I TOTAL DUE $ tlv' ~ I
This Appiicatif" Becomes Your Building Permit When Approved Paid il (~/J--S , I ReceiPt No q(pl./'}d--(
m:Ofli~ --i4r~r Date 4- I l'" - t-t I Bv 0-: I
0
ThiS IS co certify t~at the request in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
whrn signrd by t~e City Planner constitutes a trmporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Crrtlficatr 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
16200 Eagle Creek Avenue Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type ( r Drint and si2ll at bottom)
ADDRES: :
I. Blue File I PERMIT NO II
2 Gold Chy .(J'II- ,(7/
3 Yellow Applicant '-1 ,...-:;-('5 j
ZONING (officeu,,)
3X c,
(,JOlrJ O'-\c.~l Qr
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICA >IT
(Name'
(Address)
5 A-h... or fl vvJ.... L l ('
J
(" <::<-1 'i J(j I '1'-<; ~ /,J
(Address)
~/''''''l
'~
~-
(Phone) C./)%C..>.17.~' '7\~ Y4""8<=~"'"
<;'fu~ CS)/tf""
~ .
(City) (Zip Code)
(Phone) (./)- 3t::e If'?JI
DATE t:l-C ,/Vt'-')-d(J 'f
(Contact P, :rson)
APPLICA >IT SIGNATURE
~
v
Quantit r
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Type of Fixture
PIA -t'Su.., O. - - ./le- MI+-, [AJt)k;.l'\j'uO o,u
,- '" 'ns\7"l~. 'f FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
/2D/OS ~-n $1-<--LflL.
Residential, New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Oily)
B Iilding Official
Date
I Paid
I Date
By
This App lication Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
t6200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Residential Building Permit Checklist
Basemen! Finish or Interior Alter:uion to Single Family Eames
i
fY:~ ~
IB il'. P , ..
u alng ermn;;:
Site Address
Dare:
Pill:
Legal: L
B
IExiSting strucrun(2~O
CONFORl'rlS TO ZONING
ORDINA.!.~-CE
Ii
~s thi~ a1'1 expansion or the e:ds-uLg rootpnnt or
IbUllding heIght?
I ~s the property located within tl:e ilood plain?
I Foes the alteration include any addinonal kitchens?
poes the pro-posed alteration include any oc.tside
fntr"'.illC~S athe: man patio doors?
~s the proposed use of the L'lisi1ed 'Pac" or
lalte::ltlor: for a:.i.ything oeb.er :.~an 1 normal single
'family home (oEice, grou~ nome, day c:::.re. e!::.)?
t;- !~-{JY
Zoning: .
S d.-G ~ mood VUcJ(,
D\.--
Subdivision:
x-"ES
NO
YES
NO
Refer to Pla.T)!ling
Refer to Pla:.-ming
Nt)
tJD
WD
Refer to Pla:ming
Refe: to Planr.ing
00
Refer to Planning
tJo
THIS CHECXLIST MUST BE COiY!}'LETED .-\.i'll) Ii'!CLl;"DED Ii'! THE BmLDli'!G PER'YllT FILE TO
YWi'lT.-'Ji'! .-\.RECORD OF THE REVTEW,
,--::7.,i-:T .:. -::', j, - -~~;:,'-," -:(~l~
PRIOR LAKE
I
I
INSPECTION RECORD
c~~~ ood :;:>",cJ<.. J),,"
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATlJRE OF WORK
USE OF BUILDING . _
PER\i1IT NO. rl DATE ISSUED /./- 1'-0 r../
CONTRACTOR ~ PHONE~.. eiUJ/~
NOTIE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
i. THE PERMIT IS BY SEPARATE DOCUMENT
i INSPECTOR
OATE
I
ior to Backfill) I I
CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FR MING
INS ULATION
EU :CTRICAL
PLlI'MBING
HE~TING (if required)
wC-
f!$ I
I>
Ff
~
~
~~1.8
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BU~LDING
EL CTRICAL
PL MBING
HEJ ~TING
DO NOT
I?PI
I
t
v
J 1
7 /z':-.,-/d~
" .
-
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.
I
___.____._...1--__,. .----.....
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS :5 ).() n
SCHEDULED
PHONE NO.
OWNER CONTR.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
f"?f
-~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
6
r=- \ r-:l <t::>
4-78{
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
-
(' tti
~ ~
'--
rORK SATISFACTORY. PROCEED
o CORRECT ACTIO AND PROCEED
o CORREcr. '. ALL FOR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
CALL - ad" FO~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
",s,m,