HomeMy WebLinkAboutBuilding Permit 03-0375
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4- /-()0
~. ~i~i~e ~::y I PERMIT NO. O~--037'''-1
] . Yellow Applicant . ..::>
ZONING (office use)
k.\w
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z,}- 3
- Ot , - D
WNER:., ....-;).
Name) \)r", f>.." ,,(V\\c.1v-\~ t'\C>,,<U.VV\v.Uw
~hOne) ~ S 1, -u..J.p' \Q (~ 0
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
\,/
(iTYPE OF WORK
o New Construction
DDeck
o Porch
ORe-Roofing
ORe-Siding
'f/JLower Level Finish
o Fireplace
DAddition
o Alteration
DUtility Connection
o Misc.
PROJECT COST IV ALUE (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
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 plan. 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
enter upo property to erfor eeded in tions.
Contractor's License No.
Date
X
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ /. SV
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
Building Official
Date
TOTAL DUE
This Application Becomes Your Building Permit When Approved
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 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
Residential Building Permit Checklist
Baseme:l.t Finish or Interior Altenrion to Single F:uuily Homes
BY:
D3.t:::
4- ~/~ If J"
.-
Building Perm.it eft ().?- () ']7S
SiTe Address
Pill:
Zonin~:
.:J O.c:ft"
{/I{;;~&,~:f7
legal: 1 B
E.risring so-ucmQ NO
Subdivision:
CONFOR-yIS TO ZONillG y~S NO
o RD ~- _~'1- CE
YES
NO
Is dlls an e:qanslon of cb.e e;usilllg faoqmm or
buildiJ."1.g heigb.t?
Refer ~o Pl2J.Jr-L.j,g
)(
Daes t..'1e alteration inc~ude my addirional ~CLc::.ens?
Refe: La Plam:ing
Is ch.e prap~f iocaced7.llL,1ln ,.he daad p lalIl?
Refer to ?lan.J.-ll.:.""'lg
Does t..1.e proposed al:ention ir:clude an:! ou:side
eTIcr:LTlces othe: than patio doers?
Refer co Pl3.rL.~ing
y
/
Is tb.e proFased tlse of t..'1e E.mshei ~ace or
altenrion for all/'thing OL.1e:" chana :lOrr::al single
~~':"r'1"l'\ t..-..~ ( r ~ IJ"'1'" 1 '... ,~,..;..,\" ,-.,"!""'?' ,=0..,.... \'/
l"'-J..1L,f ,..u,.._e O.J,...C~. ~_:JU::J ,_C171~, "--.' '.-,-, .-~.).
R~fe:- ~o ?lar.nl.J."lg
'--
THIS CillCKl.IST :'tmST BE: COMPLETED ..l...:.'ID I:.'{CLUDED IN T:rn: 8LlLDING PS.RLyIlT FIlE TO
cYLJJi'!T.-\.IN .-\ RICORD OF THE REV1PiV.
----~ ---. ~ -' -........ --..y- ---~ -.. --- -
-".: -' ..:.. - .-.~ ~ -_-:"~-'-.- ~ .-
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT --7")/ e tv! H
(/3- 3~"C;-
~. ~~~w ~~~icant I PERMIT NO. () 3 - Lf S ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDd5"- ~o-- O//-tD
OWNER
(Name)
B r/~/J K{'.uJerJl&cher
(Phone) ;;? ;?lb- &:,/ c., ()
(Address)
APPLICANT
(Name)
(Phone)
(Address)
(Address)
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
OGravity
o Mechanical
Air Conditioning
o nt. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
D MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3 q ~ ,)0
,50
40 ,0 ()
Paid Vi) vO
Date 4 c. ~.-:l.
-/~-~
ac./
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS :304-0 VIGWc.te6ST Gle. Ivv-'"
NATURE OF WORK ~O &4/ EJe G- 6 V 6 V
USE OF BUILDING /Z6S l'i'ge-
PERMIT NO. OS-()375 ATE ISSUED 4-/-0..3
CONTRACTOR ~DvJff(7~ PHONE 22&-&/{' ()
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~~ ...~ I
I ~ t1. ~~{.I!!Ulr I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
1'11._. _ __t:
, L(--.?lP
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
---
,. . .....
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT 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