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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
11 ~t.J
l-lrr OO-k 4nL
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK
ADDITION
Dev kl e1
Date Rec' d
/- / 7-' 02-
I. White File
2 Pink City
3. Yellow Applicant
~~itr
I PERMIT NO. ()Z,)O /07 I
ING (office use)
PID2S-370-03Q-O
OWNER
(Name)
(Phone)
(Address)
y- ~ ~ Q')-\
~~. s-t-~ .LOb
6'5f)LlY
TYPE OF WORK
fs4JNew Construction
o Misc.
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
(Phone)
(Phone)
q52-~tJ5-1BofJ
"52 --'1..ZJp-133t.1
ODeck
OPorch
ORe-Roofing
ORe-Siding
OUtility Connection
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 th t 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 property to p 0 eeded inspections.
x
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I~~ O~.OD
-It- ~ct=--
611 -(Pc..
8( . 06
es ~it When Approved
I-~'-t -02-
Date
o Fireplace
OAddition
o Alteration
//;7/02-
,
Date
$
$
$
$
$
$
$
$
$8 /94-.0
\00
Paid
Date
(~:~. ~;~
)
I Rece~ <fjW!'
BYI
dOtJ05lP57
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter Siz 5/8'; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
rhis 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
hen 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
I~ ~~A ~_ f\ ~.
~1_1 ;t'k.~~ --1/2-'1/<92- ~~l C-(~~~
Pia ning Director Date 'Sp cial Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
TOTAL DUE
FIRESIDE CORNER
#4793 P.OOl/oOl
Date Rec'd
CITY OF PRIOR J",AKE
HEATING/AIR CONDITlONINGIFJREPLACE PERMIT
hj~i\
c::: 6 "U,"fj')
'- ""'....
-.lPleMr;~ D~rrillr.IIl'l'hign~.atb J1lI)
I ADDRESS
, I ,).;J't fClr:J!.
~::i:.. ~!~ I PERMIT NO. -) _ (1'V7 I
,. Y""tllW .A4:9'iQtm t:..X V ) .
;:AL
I ZONlNG,__> I
LEGAL DESCRlPTION (offi~ use only)
LOT
BLOCK
ADDITION
PID
I OWNER _
(N 30le) f"]) 12
. (Add"",) _ 'b
~
(Phone)
APPLICANT
(Na.m.c) AT..r..IED FIRESIDE DBA FIRESIDE CORNER
(Phone) 651-633-2561
(AdDress) 2 700 N - FAIRVIEW AVF-NUE
(Address)
I3RENDA HUSTON
(Con.tact Pe~soll.)
ROSEV'rLLE ~
(City)
651-633-2561
(Phone)
<;'5] 1 ~
(Zip Code)
APPLICANT SIGNA TIJRE
DATE
tJi.-
APPLICANT PLEASE COMPLETE BELOW
EW CONSTItUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SJZE RETiJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM IfBA TING OR POWER PlANT
DSt.cam.
o Hot Water
o Radill.tion
o Speciel Dev;t;es
o Other Dl:vlcc::s
~WBml Air PllUlts
Gravity
Mec::lllmiGI!I
AIr CondltlDning
Vent.. Sys!em
FIREPLACE MAKE AND MODEL
PLEASE NOTE:
Air Condfrioner Uni~
Cannot Encroacb into
ll,equired Side Yard
l)l!!tbacks
fo~f.s:> S-f.-
IndustrIal. CommerciB.r &. M1JIt.i.F~mily
FEE SCHEDULE
I%ofjob cost Re!lideotial. GllS FjreplD~e
$39.50 minimum
$99.50 Residcllt.ia.l, Additions &. Alr.enltions
$64..50 Rcs;dl:ntiuJ, AC Only
$39.50
Residentllll, Iieilting &. Ale (New ConstroctiDn)
Resfdcnrjul, Heati.ng Only (New ConstT1lct.ion)
$39.5(l
$39.SQ
Estimated Cost $
Building Pcnnit #
.so
^, l':..
4..,. -; r, I ~..' r",
.....i,A.'.".... ,'",
.;.,.1#,/\.' ~_ .
"\.::t'p
....,
HEA TlNG PERMIT FEE
STA TL SURCHARGE
TOTAl.. PERMIT FEE
$
$
$
(omcc Vsr Only)
"11'
This Application Beeomcs Your 3uUd'ng Perm,t When Approved
Paid
ReCf:ipt ~
fhJjrd/,,~ om~hll
Oate
DIl~
24 hDlIr nodce for all Inspection. (952) 447-9850. fOE (9!!2) "'7-414!l
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
~. $~~"w JJ~icant I PERMIT NO. OZ-O /07 I
ZONING (office use)
lit
B lU""v DtU:.-
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
OWNER
(Name)
D \( -\\-b~1-o n
1.D8LD 0 l4h br\ d e....lf-
(Phone)
(Address)
LA.ktvi tie.
t\\,)J 55~"l./
(Contact Person)
(Phone) _L051 !1S2..- 2..115 >
e=I1OaM fVJJ 55l z.z.
~ (City) (Zip Code)
(Phone) lJf51 &..J?Z- 2-11'5
DATE 2.l.r3J 0 '2...
APPLICANT PLEASE COMPLETE BELOW
APPLICANT SIGNATURE
I8INEW CONSTRUCTION o REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL J3r~OJ\:f '12: {. FUEL lJaJ-. ~a.s
FLUE SIZE 'L' 12.. 1>'" e...... RETURN OPENINGS INPUT 1M, {JOD OUTPUT D,ooO
TYPE OF SYSTEM REA TING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
8 Mechanical o Radiation Cannot Encroach into
gAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND 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 & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ 1 DO o. 00
Building Penn it #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
. ., {", ..
.50 f fP-'<~n f :.
, 9U't~J)\~"':,;)
~
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
Building Official
Date
DatfEB , A i..L
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Feb. 6. 2002 1:10PM
GENZ RVAN PLUMBING AND HEATING
No.2991
P () I)
. L ,1
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I ~D1~~:tboao~ ~ io ~ .Q -'
I PERMIT NO.OZ-O/o7 ,
I I ZONING,offi<<_, I
1. Blu~ FrI.
;l. wi"; City
3. Y.llol>' Appli.....t
LEGAL lJESCRIPTION (otfic:.e use only)
LOT
ADDmON
eJp
pro
OWNER
(Name) DR Horton Custom Homes
(phone) 651-454-4663
(Ad&~s) 3459 Washington Dr Ste 204 Eagan; MN 55122
APPUCANT -
(Name)C~);J7 lIY"'T> Pl""'''1ng 1;.. '{;I"'~,iIl8 (phone:) fO"ol:i ] 471 1144
(Address) ~4745 - 55068
So Robert Trail Rosero.ount MN
(Address) (City) (Zip Code)
(Conta.ct Pe:rson) Mary Olson ~ (phone:) 651-423-1144
APPLICANT SIGNATIJRE \ \ :~). 11 , \.... 2IloT~2-
DATE
APPLkANT pT -d ~ ~E CO:MPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
''2-. Bath Tub with or without shower 3 . Rough-ins
\ Dishwasher /., Water Heater
1 Floor Drain .?II Water Softner
~' Lavatory (Bathroom Sink) , Stand Pipe (Washing Machine)
I Laundry Tray (1 or2 compartment sink Sewage Ejector
I Shower Stall BackfJow Assembly
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
.~ Water Closet (Toilet) Other
FEE SCHEDULE
Industnal, CommercIal & Multi.family ] % of job cost With a $3950 minimum R~sldcntlal, New One: & Two~Family $9950
Residc:ntial, Additions & Alterations $3950
Estimated Cost $
Building :Permit # () '2 - 0 /07
PLUMBING PEJU.1IT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
~.
r'f:':':
.50.' . . ,~", -
f" ,.
(Office Use Onl}')
This Applkstion Becomes Your Building Permit When Approved Paid
Building Official
,Date
Date
24 hour lJotlce for all inspections (952) 447-9850. fa}; (95;2) 447-4Z45
FeD. 6. 2002 1:10PM
GENZ RVAN PLUMBING AND HEATING
No.2991
p.
,)
Date Rec:'d
CITY.OF PRIOR LAKE
SEWER AND WATER PERMIT
1 ~~~~~m.Ogn"bo~
\-'1 2S-\ ~
, .
I G"'.... l'il~ I PERMIT NO . I
2. Yoll~.. cit;-.. '02-0/07
J. Gold Apph....t
ZONlNG (o./D.<;r:U'r:)
CelL (~~
LEGAL DESCRIPTION (officeusc: only) '.
LOT -3 BLOCK ADDITION
Pill
OWNER
(Name) D~ Rgrtgn CliSt:9111. RgmQs
(Add:n::ss) 3459 Washington Dr Ste 204
(A~ss)
(phone)
651-4511 4663
55122
(Zip Codr)
Eagan. MN
(City)
APPLICANT
~~~ Genz-Ryan Plumb~ng & HeaLing
(Phone) 651-423-1144
(Address) 14745 So Robert Trail
(A~ss)
(Contact Person) 'Mar
Rosemount. MN 55068
(City) (Zip Cede)
(phOne)
DATE
ASECOMWLETEBELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet
Clean out (if required) located at feet from structure.
feet.
o Cast Iron
Residential sewer and water line connection
Sewer connection only
FEESCBEDULE
$35.50 Industrial, Com'l & M1Jlti-famiIy 1% of job cost WIth a $39..50 minimum
$17.50 Wat~r connection only $17.50
Estimated Cost $
Building Permit #
oz-%7
SEWER AND WATER PERMIT FEE
STAlE SURCHARGE
TOTAL PERMIT FEE
$
$'
$
.IQ"'~ c' ,.
'p.!.., .,'~~-)
C-------
1
r
(Office Uac Only)
This Application Becomes Y OUT Building Pennit When Approve~
L..
.BlIildlng Official
Date
p~
Da"F'=.8 -., lWL.
24 hour notice for ill iOlip",ct,iOll.$ (952) 441-9850, fax (952) 4474245
White - Building
Canary - Engineering
Pink - Planning
The ("rn1t>r of the t.kt> Countr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. Q. H-OR.:TO rJ
{-II-OZ-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17 ZZ 4- BU e.R- OA lC- L-AI'J 6
Accepted
Accepted With Corrections
Denied
Reviewed By: a 124
Comments:
L a~ rA~~ J /;1 ~ cnJ::~
Date: /-25-Q~
"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."
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White - Building
Canary - Engineering
Pink - Planning
Tht" ('t>n'f'r or Ihe t.kr COunlf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I
D. Q, f-i C/<'T(~ !\J
! I-I c-/
1- /- /L-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17 Z 2 4- F~ Lj t.::...l'~ C!-\ IL L-I-\ f'J 6
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/PJ8
Date: /-2'-1-oL
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Grading PI~m, 2) Erosion Control Measures
3) Erosion Control Plan
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be con.._ ued to be a permit for, or an approval of, any violation of
any of the provisions of this ~e 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."
~3/ 23/98 _llO~!): 27. FAX 6124474245
CITY OF PRIOR LAKE
~002
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building Pennit Application)
F or All Properties Located in the Shore land District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address
IJ>)4 N,U/V' rrY~.~
Lot Area 2:2., LO~ Sq. Feet x 30% = .............. 6 66 J
.***************.***....**************...*..*...****..*******.~*****..**
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
x
=
=
ATTACHED GARAGE
=
TOTAL PRINCIPLE STRUCTURE......................
"2.,1 ) f
DETACHED BLDGS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS....................... 0
DRIVEW A YIP A VED AREAS
(Driveway-paved or not)
(SidewalkIParking Areas)
'bw~
S'w
x
x
x
=
169
51
=
=
TOTAL PAVED AREAS......................................... ~ "2.D
P A TIOSIPORCHES/DECKS
x
,x
=
(Open Decks 'I. min. opening between
boards. with a pervious surface below,
arc not considered to be impervious)
=
x
=
TOT AL DECKS........................................................ 2&8
x
X
=
OTHER
=
TOTAL OTHER......................................................... n
TOTAL IMPERVIOUS SURFACE I Jt]63
UNDERlOVER In /V) I 3,"2 <3 g
Prepared By ,~ r Iff'~ Date 1<) 'JI+N 2f)f)2
Company J? f2l4-N DT ~N(,.\ti fJJ21 NC- t >V/2-V 8fi ilL-Phone # '1)2 4:5)" J 96t
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /7d..;)4 nvrr OaLe ~L
NATURE OF WORK (]Pu..>
USE OF BUILDING SED
PERMIT NO. 02- 0/07 DATE ISSUED 1- :J...~-{):;2..
CONTRACTOR .DR. fl-r)~ PHONE 9S;).-~~(p- /:;;sC(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
TKE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
I FOOTING ~ I3t 5/'l/6?/ ~ .
FOUNDATION (Prior to Backfill) ~#, , ,J' D~ ;>-8". dd-
PLACE NO CONCRETE UNTIL ABO E HAS BEEN SI NED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST .. ~ ~. ~ I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
;Vb
q-dtl-o;).-
(17 {J iO I 'uJ...
GRADING (Prior to Sodding)
BUILDING I ~.ll' ID '3 I OZ/
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 ha\ie been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
(j2-,
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850