HomeMy WebLinkAboutBldg Permit 04-0281 (2)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvue or' lrint and silUl at bottom)
ADDRESS
-J 2- t56 t..;r1nduc.-/{ Ph
LEGAL DE iCRIPTION (office use only)
LOT/1 BWCK I ADDITION IM.ldtJ
OWNER . / J _ I
(Name) '1 /JdA A- c.nrJ f qAPr
---; --
(Address)
White
Pink
Yellow
File
(';ly
Applicant
I PERMIT NO. OLj-if8/j
#/a,.. ~JIe /d1I
,~rd
Date Rec
L/~ I t, ~t/
ZOpJ;;ceU"1
PID r5?5 - 33/) - 0/'7- 0
fJr--.kAu_s
(Phone) q's2- 22-'15 -2 44"'5
~C~~~~N'meL~$-f~~~ !fr/??.vL.!/.n&/ (Phone) q<2270-2o/Z.
(Contact Na,oe) 4I).,._L~~1 T, /'~-.~/ (Phone) ~?-Z-"7D-..?~
(Address) //~,n E -)L:5~ ~ !~~fJJ/;~ ~ '::;~f (' 1 -
TYPE OF" ORK D New Construction DDeck DPorch ORe-Roofing ORe-Siding ~ower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc. )"t...
CODE:..d:..1 ~.C. OLB.C. PROJECT COSTlV ALUE $
Type of ~s1 rnction: I II III IV V A B (excluding land)
OccupancyGionp: A B E F HIM R S U
Division: 1 2 3 4 5
I hereby certity th; t 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 authOrized agcnt for the
above-mentIOned] roperty and that all construction will conform to all existing state and local laws and will proceed in accordance with submincd plans_ I am aware that Ihe building
otflcial can revokelthis pen:it for Just cause. Furtherm~ agree that the city official or a designee may enter upon the property to perform needed ms~ec:w/~_ /
X -#:;I-:?_ /~" .....'h;;.....~ 2c>'JU7h"67 h"//6/ow
-- - - - Signature. // Contractor's License No. Date.
Permit Valuati)n
Permit Fee
Plan Check Fe,
State Surcharg ~
Penalty
Plumbing Pen lit Fe~':fI~"-
Mechanical p~ rmit Fee
Sewer & Wate - Permit Fee
Gas Fireplace Permit Fee
~'!~oo.~o I
: .~'%I
$ 1,<0 I
$ I
$ J{tJ.OO I
$ I
$ I
$ I
Park Support Fee
#
#
$
$
$
$
$
$
$
$
$
I
I
I
I
I
I
I
.....-Y
II~';;-S I
t-/to '-{'7:;--1'
I
SAC
Water Meter Size 5/8"; 1 >f~,
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee _________'If
Builder's Deposit
Other
TOTAL DUE
Paid
Date
.,' -L<"'
fl/n/a"';> ,
2/- I ~ - '1
This Applicati m Becomes Your Building Pennit When Approved
~1~I1iC~ -ik!'y
ThiS is to certify tl 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
when signed by th ' City Planner constitutes a temporary Cel1ificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate Df Occupancy must be
issued
Planning Director
ReceiPt No.
Bv lA
0-
Date Special Conditions, if any
24 hour notice for all inspections (9::;2) 447M9850. fax (952) 447M4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Residential Building Permit Checklist
Basemen! Finish or Interior Alter:ltion to Single Family Eomes
18Y:~
~
Building Permi, ;;
Site Address
~ Date: q-/~-{JY
Pill: Zoning:
Sd-G" 0)60:/ /JUc./(
Subdivision: 0 '.--
Legal: L
B
Existing strucmr~O
CON'"FORlvIS TO ZONING
ORDlliA.!.~CE
Y-:ES
NO
YES
NO
~s this a.,-" ex~ansian of the e;ci~uLg footprint or
Juilding height?
Refer ~o Pla..T]J1ing
I Does the alteration include any additional kitchens?
Joes the pro1'osed alte:ation include any oJ:tside
'IllrJ....lces othe:- than patio doors?
Refer to Planning
Nt!
tJ()
WD
[s the propeny located witllin the flood plain?
Refer to Planning
Refer to Planning
Jo
~'s the proposed use of the Br..ished spac: or
Itenrion for anything ow.~e: t.ha.~ 3. nOT:TIal S1ugie
famiI~1 home (of:f:.c~, grou-p home, day C3.:e, e:c.)?
Refer to Planning
00
rHIS CHECKUST :YlUST BE COMPLETED A..'{1) li'ICLUDED IN THE BUlLDING PERMIT FILE TO
,WNTAIN .-'0 RECORD OF Tm: REVTEW,
,-:7jPT .:::. -:=', ~ - -~"'-..:','-,- ~(~(~
...,--
P
I
lOR LAKE
SPECTION RECORD
0bCl ~kcl<. 1)~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -8~'-
NATIJRE OF WORK
USE OF BUILDING
PER \lilT NO.
CONTRACTOR '-I- PHONE~. OUJ/~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE ISSUED ~- I' -0 r../
INSPECTOR
DATE
I
lor to Backfill) I I
CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FR MING wC- f!5 I
INS UlATION
ELECTRICAL I
PLllMBING I
HE~TING (If required) 17
Ff ~
f>
P~I&
BUI~DING
ELeCTRICAL
PLl MBING
HE~ ,TING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
I~I
v I
D
J 1]
7 /z~-/d~
J .
.
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ;)JLf /J
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
~)a~ ~y,\;
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
0!/-- b ,- \(-)~O
q-78(
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
;JL C)LP
,-' ~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTIO AND PROCEED
o CORRECf.C.' ALL FOR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
CALL - ad FowfHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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