HomeMy WebLinkAboutBuilding 07-0058 - Alteration
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~11.-'\ ~~
c.,.,.-
Date Rec' d
1-3/.07
I White
Pink
Yellow
File
City
Applicant
PERMIT NO. 07 oos 8
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID2S-, Sis-. 0(-(,. ()
OWNER
(Name)
(Phone)
(Address)
BUILDER t.J ...,- .
(Company Name) 12-\,.J e'tJ~ / ..YNv
(Contact Name) M \ ~ \.V ll,..l...f ~ ~
(Address) g~ j;3p f\w,(~"1'.::.V', A
(Phone) b 5"l ~~.b 2..{ +
(Phone)
+t~ JC..(AJ ~I~
TYPE OF WORK 0 New consr;.c on ODeck o Porch ORe-Roofing
OAdditlOn Alteration o Utility ConnectIOn
CODE: ~I.R.C. DI.B.c. 0 Mise.
Type of C~~stnlction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level FinIsh
o Firepli\ce
PROJECT COST IV ALUE $
(excluding land)
formation on this application which IS to the best of my knowledge true an<.1 COlTcct. I also certify that I am the owner or authonzed agent for the
,lbnvc-mcntnJncd I) city J. tha <l construction wIll conform to all eXIsting state and local laws and will procccd In accordance with submitted plans I am aware that the ouildlllg
official ca [evnk t s per It f{ J.s Juse Furthermore, I hereby agrec that the City official or a designee may enter upon the propelty to pert{)rm needed mspectl ns
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
$
'.2S"
Penalty $
, Plumbing Permit Fee $
~echanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
l~.'n
I, -
Buildlllg llftlClal
~
1/31/07
f D,{te
u;I"3>~k~3>
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 7fo.oQ
",
ThIS IS to certIfy that thc request In the above application and accompanYll1g documents is Il1 accordance with the City Zoning Ordinance and may proceed as requcsted. ThiS document
when signed by the CIty Planner constItutes a temporary CertIficate of Zonll1g compliance and allows constructltln to eommence Betelre occupancy, a Certlfieate ilf Occupancy must be
issued
Planning Director
Speeial Conditions, if any
Date
24 hour notice for all inspectious (952) .t.t7-9R50. fax (952) .t.t7-.t2.t5
4646 Dakota Street Prior Lake, MN 55372
Residential Buildin Permit Checklist
Basement Finish 0 nterior Alteration 0 Single Family Homes
BY: ~ ~ Date: 1 0'1 J; 7
Building Permit # PID: Zoning:
Site Address 57d1 9~ t!Y- '
Legal: L B Subdivision:
Existing Structur~r NO
I c/Y~
I CONFORMS TO ZONING
ORDINANCE
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? Na
Is the property located within the flood plain? Refer to Planning
rua
Does the alteration include any additional kitchens? Refer to Planning tJO
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ;JCJ
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single (\fL)
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 372.9 :JEF'FS~~ vI.
TYPE OF WORK [; 11 0 NS
USE OF BUILDING S" Jr IL
PERMIT NO. D7 _ 0658 DATE SSUED ..3 (. 0
BUILDER ~O\/Ae6 PHONE# &;5/. 307. ~2./4-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
J FRAMING fP ~~~ 7 LVc- I I
~ 4
I FINAL I It> I <J /2 ~/d~
I
FOR ALL INSPECTIONS (952) 447-9850
INSPECTOR
DATE
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