HomeMy WebLinkAboutBuilding Permit 94-0059
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I 1
I BUILDING PERMIT,
EMPORARY CERTIFICATE OF ZONING COMPLIANCE ~.~. ~ - 1)
AND UTILITY CONNECTION PERMIT PenRlt No. L1 - ~ j
CITY OF PRIOR LAKE
1. While - City
2. Pink - Applicant
3 . Yellow - Assessor
DIRECTION
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom
2. SITE ADDRESS
l2C,
3. LEGAL DESCRIPTION
t{
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
~ ,
LOT
BLOCJC
PID
3~ \ \jOO\- 0
12. NO. OF STORIES
~ 2~ S~
13. TYPE OF CONSTRUCTION
ADOmON ~Di.'\A\~,
~,",l'\ r
2/:,D
14. FLOOR AREA APPORTIONMENT
USE
8. BUILDER
(Address)
(Tel. No.)
..--
7. TYPE OF WORK FlreplaceO SeptlcD HeatlngD PlumbingD ReroofingO PorchD
New Construction 0 Alteratlo~s 0 Addltlon)( Finish AttiC? Residing 0 Finish Basement 0
Chimney 0 Misc. \, ~.\, "'.. 0.... t:::.. :;;..-
8. PROPERTY AREA OR ACRES
S .Ft. No
I .....eby certlty that I ha.e turnlshed Intormatlon on this application which Is to the best 01 my knowledge true and correct. I also certl'y that I am the owner or authorized agent
for the above mentioned property and that all construction will conform to all..lstlng state and lacallaws and will proceed In accordance with submitted plans. I am aware that
the building olllclal can re.okethls permit tor just cause. Furthermore. I hereby agrse that the city olllcla' or a design.. may enter upon the property to perlorm needed inspec.
tlX\~~ C.""'- ~ ~ JIS)qy
Signature Date
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION
TEST 0
PLANS & SPECS -jf SETS
SURVEY 0 COPIES Z-
SETBACKS: Required
Actual
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING b~~ '~..: ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT V ALUA TION I '1~ c.. CJi.J. _ ~ l"\
TYPE OF CONSTRUCTION; I II III IV V
Occupancy Group A BEl H R M
OI.lslon 1 2 3 4 Cj
Permit Fee .. .. . .. .. . .. .. .. . .. .. .. .... s / 8' I (:) ~
Plan Checking Fee. .. .. . .. . .. .. .. .. ... s I 2- 2- . l!::::
State Surcharge .. .. .. .. .. . .. .. . .. .... S ~, ? r::.
Penalty .. .. . .. . .. . . . . . . . .. . . . .. . . . . .. S
Septic System . .. . . .. . . .. . . . . . . . . .. . .. S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Subtotal. .. .. .. .. .. .. . .. .. .. ... s ::::- C- ~ - C-::::
PLOT PLAN
Amount Brought Forward. . . . . . . . . . . .. s .:s. 7. ~-'--
Park Oed. . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sac.................................. S
Plumbing. . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sewer Tap. . . .. . . .. . ........ . . ... . ... S
Sewer Hook.up . . . . . . . . . . . . . . . . . . . . . .. S
Water Hook.up . . . . . . . . . . . . . . . . . . . . . .. S
Meter Horn. . . . . . . . . . . . . . . . . . . . . . . . . .. S
Water Meter. . . . . . . . . . . . . . . . . . . . . . . . .. S
Check if OSewer & Water Connection Fee. . ... .. S
Deferred OWater Tower Fee.. ... . .. . . ......... .. S
Water Tap. . . . . . . . . . . . . . . . . . . . . . . . . . .. S
City Fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Paid T~~~e .~~ ~'~~~i'~; . ~~'.' ~S 3n5(..
Date<1..(- r - q L/ By K rn !;
lleallon and acc panylng doculTlflntslsln accordance with the City Zoning Ordlnance;Tn;; may proceed as requested. This docu,
!lleale ot Zoning compliance and ellows construction to commence. Betore occupancy. a Cerltlllcale ot Occupancy
City:
en
Speclel Conditions it any
24 Hour notice lor all Inspections 447~230 9:00 e.m. . 10:00 a.m.
~
Phone:
1. Btue File
2. Gold City
3. Yellow Applicant
# Clef -I d-. ~
<--{~7' )J272i
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: K~fR-I"- [' /17:4Lfl\..!4f /)
Address: I~ Z- (/'-/ . L0a_:e:L~(f t: T.A1....A.j'
Signature: 'f(?lJ. t,,-- "tl7r.lif't.'A e:
Legal Description: Lot Lj Block
Site Address: :S c~
Building Penn it # '7 t.-/ - .s 7 PID It~ - /1 Y - c 0/ - 0
NOTE: This penn it will not be processed without complete information.
FIXTURE UNITS
Sub:
-:7
!0 (i ,{ ,) I ^-'.~ n1.1 /v' (> e
Unit
Quantity Type of Fixture Amount Total
I Bath Tub with o(~;~~t)hower $ 6.00 to ,0 0
Dishwasher $ 6.00
, Floor Drain $ 6.00 tu.olJ
Lavatory (bathroom sink) $ 6.00
Laundry Tray (1 or 2 compartment sink) $ 6.00
t Shower Stall $ 6.00 In /) 0
':L Sinks: $ 6.00 /:J...o ()
Bar Sink $ 6.00 .J
I Water Closet (toilet) $ 6.00 t;, () 0
Rough-ins $ 6.00
Water Heater $ 6.00
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6.00
Sewage Ejector $ 6.00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10.00
Lawn Sprinkler $25.00
Other $ 6.00
Minimum Fee $25.00
SURCHARGE .50
GRAND TOTAL $ 3 tv ' .s--O
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
o RECEIPT NO. 6--~~ -41/DATE
ATIEST
11 for all inspections 4 hours in advance.
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~d I j..Ar_'yNJ'.52d
APPLICATION RECEIVED _~J~ ( :;:---4.4
The City of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
I ~2~~. '~r--~'~e.... ~~
Reviewed by:
Comments: r.
d.
Accepted with Corrections
Date ~ -I-~~
~~
7-
Accepted
s.~ r~~
~~~~-
1"-\ _"..;c "'-
~
"The issuance or granting of a permit or approval of plans,
specifications and computations shall not be construed to be a
permit for, or an approval of, any violation of any of the
provisions of this code or of any other ordinance of the
jurisdiction. Permits presuming to give authority to violate or
cancel the provisions of this code or other ordinances of the
jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 1'f"z~L>lr' t
NATURE OF WORK
USE OF BUILDING
PERMIT NO. t/t./-J-? DATE ISSUED l/It/ft/
CONTRACTO R 't {PI., -' t. 11;r' ut .
NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
GRADING (Prior to Sodding)
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-4230