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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L S<..e. ~Lf{~\... Pt..e.
Date Rec' d
!IX (-7-- 02-
1_ White File
2. Pink City
3. Yellow Applicant
t-/J1&re jJ/v/ PU/
LEGAL DESCRIPTION (office use only) j IL
I f~L ~A./T
LOT BLOCK ADDITION
OWNER
(Name)
C'~iG--k
lZL{(), ,
(Address)
tl) 1/;' et-t/
PID z, -3~' 1-Ob3- 1../
BUILDER
(Name)
(Contact Name)
(Address)
{tLrh e
11/l1;f C(~t1/let(
~ttl'17 e.-
(Phone)
(Phone)
9Ah1~
~/2-3C9 -~~~
-
TYPE OF WORK
New Construction
o Lower Level Finish
(~eck o Porch ORe-Roofing ORe-Siding
/Fireplace DAddition DAlteration OUtility Connection
PROJECTCOST/VALUE (exc1udingland) $ iZ5 ~&t:J
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 plans. 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 upon the prope rform needed inspections.
~~
o Misc.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ ~ 2 ~S-D
Penalty $
Plumbing Permit Fee $ 100. 00
Mechanical Permit Fee $ ,(!)O
Sewer & Water Permit Fee $ -
Gas Fireplace Permit Fee $ 40 . r!XJ
Becomes Your Building Permit When Approved
I -/1:)- 0 2-
Date
2~tJ7~?> ?
Contractor's License No.
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid
Date
;!;{- !l-
#
#
#
#
$
$
$
$
$
$
$
$
$
65 .00
-
"OCJ
100 .aQ
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
::::""'" by <h, C. ,P_~ ="""" , "m""", ",",fia" of Zoo"" romp"",tt md ,,~, ro~o ro'kZ::opm~~ C:;'''''' 0""'_" mo" '"
. ll.2-.3 ({) L t ~ L.t...-~~.!J. LX't-tnts;
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
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White - Building
Canary - Engineering
Pink - Planning
Thf' ("rnln of the' tikI' Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t6fJ-rE-X
1- 7 - 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
_IJ~&B fj/~OOK.,n~/U6 BL-VD.
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
IV,4 l3
~Cf.- tlJc.,"~ h'le..
Date: I-I'I-o~
Comments:
"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."
Tht" Ct"nlt"r of tht" tab Counlr)"
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(!.;6kJ16X
/., 7 - 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-1Jtli~ I5000~n6rw B~VD.
Accepted 7<
Accepted With Corrections
Denied ~ !
Reviewed BY:~~~
Comments:
~~ M~~f:-k
Date: / - frs--2Pr::J2...
"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."
uace Kee <1
CITY OF PRIOR LAKE PLUj\;IBING PERJ."IIT
(Please type or print and slim at bottom)
I ADDRESS rJ
I /t/:2J t v5/tJtfil11(J/f
~. ~~~ ~:~ II PERMIT NO. {)z ~ 0 ()~/ '/ I
J. Yellow Applicant . ~
~/t;d
I ZONING (office llse)
I
I LEGAL DESCRlPTION (office use onlv)
I
i LOT BLOCK ADDLTI00
PID
i OVvl'iE~ if;
i (~clme) t?A P L,t
I (Address)
(Phone)
APPLIC-\.:\T
(Name)
(Address) ?O
9~-(/t?2~ 01/;2/
It~ 53:J6:J/
(Zip Code)
(Contac: Person)
(Phone)
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture
;J/ I Bath Tub with or without shower l' I Rough-ins
I I Dishwasher / Water Heater
I Floor Drain I Water Softner
J Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
/ Shower Stall Backflow Assembly
I Sinks Backtlow Assembly Test
Bar Sink Lawn Sprinkler
:3 Water Closet (Toilet) Other
l:<,EJi: SCH..EDLLE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family 599.50
Residential, Additions & Alterations $39.50
PLUMBING PERMIT FEE $
STATESURCR~RGE $
TOTAL PER.c'IIT FEE $
{)z- 0012-
~PAID W\TH.... .
_~~~~r.,,;,,!...
Estimated Cost :5
Building Permit #
(Office t:se Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
DarEB 2 I 2002
By
24 hour notice for all inspections (952) ~7-9850, fax (952) 447-4245
FIRESIDE CORNER #3127 P.012
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT IvjAA 22. 21m
~:s:.. ~~i_' I PERMJTNOO~_O{j'7~
I=:;S~;:;U~ ~N~
ZONING (QfIlc:c: use)
I
T....EGAL DESCRIPTION (Qffic~ lJ.Se only)
LOT
BLOCK
AoomON
PI
&~~
(phone)
I OWNER
(N11.m.e)
(Address)
APPLICANT
(Nwme) ALLIED FIRESIDE DBA FIRESIDE CORNE~
(Phon.e) 6.51-633-2561
APPLICANT SIGNATURE
ROSEV.ILJ;.E 'MN
(City)
651-633-2561
(phone)
-.SSl]~
(Zip Codt;)
(Addr~s) 2700 N. FAIRVIEW AVENQE
(Adr.mm)
BRENDA hlJ STON
(Contact Person)
DATE
..L-
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTJON 0 REPLACEMENT 0 At TERA TrONS
FURNACE MAKE AND MODEL FUEl...
FLUE SIZE REllJRN OPENINGS INPTJT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plmts 0 St.cllm
DGmvit.y 0 Hot Water
o Mc:chll1ligrJ 0 Radlatlon
DAir Cpnditioning 0 SpeciaJ Pevlc:es
DVent. Sysr.c::m 0 Otlu:r Devl.ces
PLEASE NOTE;
Air Conditioner Units
Cannot Encroach int.o
Required Side Yard
Setbacl(s
FrREPJ..ACE MAKE AND MODEL
tJ(;p
SL
JndU5lTiaJ. CQmmcrcilLl 8r. Multi-Family
FEE SCHEDUJ....E
1 % of job con Rc:sfdcnt.lel. Gu Fireplace
$39.50 minimum
$99.50 Residential. Additions &. Alterations
S64.S0 RcsldetltillJ, AC Only
$39..50
Resjdentilll. H~,ting &. NC (New CQnstr:uc:tion)
Residendal, Heating Only (New ConslnJclion)
$39..50
$39..50
Estimated CoSt $
Building Penn it #
REA TING PERMIT FEE $
STATE SURCHARGE $
TOT AI.. PERMIT FEE S
.50
r
f fA:!')
~UU..olNG Pi:..,
Receipt No.
(Ornce Use Only)
TIlls Application Becomes Your Building Pernlit When Approved Paid
Building Offldlll
D.~
Date3 _ ;;Z ;)-:- d- Sy
."
14 hour notice fltr nil in8pection~ (9$2) 447-9850, fAX (9S:Z) "7-4%4$
MAR-26-02 10:40 AM HEATING @ COOLING TWO 7634283682
CITY OF PRIOR LAKE
P.04
iii 001
CITY OF PRIOR LAKE
DATING/AIR CONDITIONlNGJFIREPLACE PERMIT
Date Ree'd
uboaDm
t =- Sicul I PERMIT NO.O Z ~{JO 7 2-]
.w I ZONING_"'I
ADI>mON
pm
;-IDrVI~.5
(phone)
:#t:qt"~l ? (:.01:)/,0'^-7 7"l.VO
/ Sf S"'SC"::) C c>>'-''' +.., R.d f?1
(Address)
(phone) 7h 3 -'~'). Y": ~ 3" 7'7 '.
/1'71) ,,1-< G rQ..-It S r 3 6. 7
(C~) (Zip Code)
(phone) <- 1)...._ 3'- 3 - s-5"~ 7
DATE 3-.;2-
4PPLICANT PLEASE COMPLETE BELOW
'.'.,. ; .... W CON UCnON REPLACEMENT 0 ALTERAnONS
.' ',A~~~DMODEL E5"'1~f\t 3'i'303~o 70 FUEL (;,5
. SIZE V, REtuRN OPENINGS to INPUT 'dn I 0 00 OUTPUT dsy 00 c)
'tYPE OP SYSTBM HEATING OR POWER PLANT
. ~Iftft Air Plants 0 Steam
. ~ 0 Hot Water
.. MechIUlIcal . Radiation
.. . . lr CoaditionblS B Special Devices
lilt. SyltCm 0 Oth... Devices
PLEASE NOTE: '
Air CoaditlOlu:r Units
Calmot IDcroach lato
Required Side YII'd
Se!bIcks
Oimmacttl. Muld.Pmnlly
, llcatfp. ~AIC (New ConStnJction)
Jir_. Orab (New COQtrUcUon)
Bstlmated Cost S
Jl'EESCREDULIt
1 % of jOb ~st Residential, Gu PireplGC
$39.50 minimum ' .n.'.
S99.S0 Residential, Additions &. Altctations
$64.S0 Residential, AC Only
139.50
S39.S0
S39.SO
BuildinB Permit t#
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
s
s
s
!"I PAlO W\~t;, . I
DUH. D~NG Pr:::..'"....
.50 . 1-
Buildl. OIIId.I
Da"
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U hour notlc. for .n In.,.etlo., (~52) '"'.9150, 'as (951) 447"'2~
10/07/2002 12:00 5
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PAGE 09
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CITY or PlUo. UJCI
SEWS. AND W A. TER nllMJT
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02. -()670 001 {
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:.. 4PPLJCAHr
; (N...) Ie ~ia. R Contractina. Inc.
.32..5 Lake Avenue
i (A",-) _ New Prague. MN 56071
! 9~;~.758.6Z47
(Caaua~ &l.~j ~,' (PIloN)
- ,.ppl.lo;")"rllO~fl'nlQ - - ~ -1 Y~A:': ';i -2 ~;
APPLICANT PL1ASE COMPUTE BELOW
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PAID WTIH
BUILDING PERMIT
~
t~
l
L ':::>ee +\.-Q. 1"\G\\,^- 1\' [~
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~2..(Q8 ~rook~eJ'€.. (5Cvoe.
NATURE OF WORK ^-.J42JJ
USE OF BUILDING SFA-
PERMIT NO. 02--0072 DATE ISSUED /"'\S-2oc>.;L
CONTRACTOR (\ ",,^-~x ~-es: PHONE ~/2 -:;;;~, - )~~3'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I
I FOUNDATION (Prior to Backfill) I I
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 I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections hc,ve be~n 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 (952) 447-9850