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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/-/0-02-
1. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. oz-o/z4-1
0)lc'O ~L; l-=,'lAAc.e-
ZONING (office use)
f<ISD
LEGAL DESCRIPTION (office use only)
LOT I ~ BLOCK l ADDITION L;J;. (..1\
oA{l~
PID 2.5-.%+- O/(P-o
I OWNER
(Name)
(Address)
/1/6 V C#6.5T HtJr18S
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
------
1f10~~.5I /-Il'J~e:s
Mte/.!5
--:P,O. 130X 45 C;; ?: ~ .
TYPE OF WORK
(Phone) -
(Phone~~ ~ I ~ 319. I - t.f"8~
New Construction
ODeck
OPorch
ORe-Roofing
o Fireplace
OAddition
o Alteration
o Misc,
OLower Level Finish
,J
PROJECT COST IV ALUE (excluding land) $
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
.
2(:XJ~ 0:;44
Contractor's License No,
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
ORe-Siding
OUtility Connection
j.iO'02-
#
#
Date
'5
z~o' c5!F
100 .00
[ 500 . QJ'
TOTAL DUE
fj3'u;'~ f
- fA) 7.--
Water Meter Si 5/ ;1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
I Paid
Date
n B comes Your Building Pennit When Approved
I - 2. '2"'0 (
Date
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
iSSUWd J~ n ft
, . ,:-~-?_ ";L-f; It.?z- ~ ~-LL~\ C(".~,,~
Pla~ Director Date J:- 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
The Cenler of 1he tlkt COUnlf)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
llil/LC-e651 HOMES
1-10-02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
&352- WILD QAK-6 -rer<..RA~
Accepted
Accepted With Corrections ~
Denied ~
Reviewed Bt/~ ~A
Comments:
I.~ ~i (J(UacU ~~
Date: [-22 -0 (
:2. f?e Ch. '"'~ c.\--,-cIVI v<<-<>.eJ- 'd- ~ .
"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."
lI'p!le^ aq lOU \Ie4s UO!p!pspnf a4l!0 saoueUlPJo
Ja4l0 .10 apoo S!4l !O SUO!s!^o.ld a4l laoueo .10 alelo!^ Ol ,\lP04lne a^!6 ol 6u!wnsaJd
Sl!WJad 'UO!PlPspnf a4l !O aoueu!p.lo .Ia4lo '\ue !O .10 apoo S!4l !O SUO!s!^o.ld a4l !O '\ue
!O uO!lelo!^ '\ue '!O le^oJdde ue .10 'JO! l!WJad B aq ol panJlSUOO aq lOU IIB4s SUO!lBlndwoo
pUB SUOllBO!!!Oads 'sueld !O le^o.ldde .10 l!W.lad e !O 6u!lUe.l6 .10 aouenss! a4.L.
-LoIL/-C
:alBO
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paluao
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paldaooV'
suo!paJJ08 4l!M paldaooV'
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l!WJad 6u!pl!nq a4l paMa!^aJ a^B4 sluaWlJedao 6U!UUBld pUB '6upaau!6u3 '6u!Pl!ns a41
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.lSI1)1~3H~ .lN3W.l1::I'(fd30 NOI.l"~l1dd" .llWI::I3d ~NI01In8
,uluno.1"".'1 I'll JO J.lIU",,) ,)'1.1
6UIUUBld - >luld
6UIJ88UI6U3 - AJBUBO
6uIPI!na - 8~ILlM
,/,", ,",
\ \
M A I NFl L-6
White - Building
Canary - Engineering
Pink - Planning
Thr (.~ntt'r of the tak, ("aunlry
, ~\
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
HIL,L~fc6sT HO(vI~S
1- 10-02-
The Building, Engineering, and Planning Departments have reviewed the building pennit
application for construction activity which is proposed at:
&, 3 52- \IV I 1...- D 0 A IC-S -re: (2je.-A <!.--6
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
h1J:i3
Date:
I-/~ -0 J.
Comments:,See,Reverse Side for Additional Information! . '
easures
"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 01
any of the provisions of this code or of any other ordinance of the jurisdiction. Pennits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
,
02/18/2002 15:41
9528947972
LAKESIDE PLBG
rH'-'lc.
Thr c....". of ,tn: La"" Co",","
CITY OF PRIOR LAKE
c:I..UMSING PERMIT # oz~OI24-
APplicant: :ff4~ff5~ !~~Ei7~7d<()U.
Mdress: =- .. . r" ~ /7'1 JJ .5",3 7J
signature: .
Lagal Cascrlp.on: Lol _ .Block SUb_' -~
SIte Addre68:-"'~~' ~ )JIJ../ C;?~Ll VA':~.J-
Building POrn"" _ . () 7 ;c O/U PIO # - - ~
!'lOTE: ThiS permit w\ll nol ba processed wlt~out completelnlormaUon,
I, BI~o
'l., Geld
3. "cUe'"
fll<
CiIY
~P'i'IiC!Jl1
f/ d}/VLltJf LL/Wl 1M FIXTURE UNITS
Quantity rype of Fixture QuantitY Type of Fixture
.2. 8ath Tub wIth or wIthout shower ~ RoUgh-InS
I Dishwasher J Water Heater
/ Floor DraIn Water softner
-3 Lavatory (bathroom sink) / Stand Pipe (washIng machine)
Laundry Tray (1 or 2 compartment sInk) -. Sewage Eleotor
I Shower stall . ' Bac\clloW Assembly (RPZ, Double Check, PV\
\ .~~ - '. ~ ~ o'
J SInks Backflow ASsembly Tast
Bar SinK Lawn sprinKler
)- Water Closet (toilet) other D. -." ft.15 ,1- '-
FEE SCHEDULE
$99.50
$39.50
$
$ &jf Y
$
$ .50
Industrial, Commercial & Multi-FamilY
(1% 01 job cost, $39.50 minimum)
ResIdential. NeW One & Two Fa.mlly
ResidentIal. Addltlol1s & Alterations
state surcharge
GRAND TOr AL
q:: - ~ ..1\'1'" .,
$ /J,. D fl~\Q ".. ~~~,,^\ \ ,
~/
I 6200 Eagle Creek A v, S ,E" prior Lake, Minnesota 55372 I Ph, (6 \ 2) 447-4230 I FAX (6 \ 2) 447 -4245
An Equal Opportunity Employer
This pc(fl\it is granted upon the e~pre55 condition that said
contractor. shall comply in -.II respects with tne ordinances
of the Sttte]llJmbing Code and, the amc~dmClnts th~reof.
~ O. J~ 2fiJ'E
AiTBS"
Call for all i eetions 24 hours in advance.
-
SIGNATURE:
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE: Sew~r' and Water
contractors must
be registered
with the city.
9S~-
PHONE: flfL{- ~/~r;
DATE: c:2. -;;. 0- 0 2...
_ NO. "Od-1d.-Lj
'f'--
APPLICANT:
ADDRESS:
BLDG. PERMIT #
+..P1.. PlOt C)~ - 3G l/ ~lb - D....~
1.
Estimated length of water service
I ,/
Size of water service inch(es).
f~~t\,{.
", 'j;""~~ ^'"
t-~r!i~t~~/L ,~!, .',
J,::,~:-
Location of any couplings from struc:~!~l'-'n'tr"'=:'" -
Type of sewer pipe. ABS____ pvc )(:. Cast rron ~?
Estimated length of sewer line ~j?~
FILL IN THE BLANKS
.~
.;a.
2.
3 .
4.
5.
feet.
6. Clean out (if required), located at
structure.
feet
from
========================================================-=========
This application becomes your permit when approved.
BY
------------------------------------------------------------------
------------------------------------------------------------------
DATE:
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
$
$
$
35.00
.50
35.50
sewer and water line connection permit.
surcharge
TOTAL
FEES:
...
sewer and water permits issued for new construction' must be
recorded on the building permit card at the time of~ issuance
to insure that no duplicate sewer and water permits are
issued. r'
DA'l'E PArD S _ (, - :J- AMOUNT PAID ,/;;!},(;:,\S-
RECEIPT #
REC' D BY ~?
16200 Eagle Creek Av. S.B.. Prior Lake. Mionesola 553721 Ph. (612) 447-4230 1 FAX (612) 447-4245
An EQual Oooortunitv Emolovcr
'.
;952 894 U;;;1";::'::;'
3 - 2 5 - 0 2; 2: 3 3 PM;
CITY OF PRIOR LAKE
HEA TINGI AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
t ~:~;.. ~l~;unl l PERMIT NO. 6Z-0IZ-4- 1
ZONING (office use)
, ,3s~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Address)
~~~R ~.,Wu,(~e-~\-*LPt,,~
APPLlCA~ . , . .'
n<ame) _~~~A \\.L ~u~
(Address) J r ~ ....~D~ \.~b. (Q
(Address)
(Phone) q S'J..~<i;c14 --0 GOS-
9l\ "i€- ~ . ~ . J."'\G (.-C;.. . ..'SS~'""'\ %
(City) ... .... .... ..... .... ... ..... ...Y (Zip Code)
(Contact Person)
(Phone)
DATE..
APPLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION. . 0 REPLACEMENT 0 ALTERATIONS
F!)RNACE MAKE AND MODEL \ M~. ~ 'J..uC5'!-,- ~I'IlEJ.. ~~,(--e. %)
FLUE SIZE RETURN OPENINGS \D INPUT .-Y3l't'"'CJ. . qUTPUT ..... ..
TYPE OF SYSTEM HEATING OR POWERPLA.NT
o Steam.
o Hot .Water
o Radiation
o Special Devices
o Other Devices
..PLEA~E.NOTE:
Air Conditioner Units
Ca.nnot Encroa.ch . into
Required Side Yard
Setbacks
OWarm AirPlants
OGravity
o Mechanical
OAir Conditioning
oVent. System
t';-
it
Rf'
~
~:.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family 1 % of job cost Residential, Gas Fireplace
~.inimum ..
Residential, Heating & AIC (New Construction) 99.50' ~ Residential. Additions & Alterations
Residential, Heating Only (New Construction) 64.50 Residential. AC Only
$39.50
$39.50
$39.50
Estimated Cost $ Cfnoo. ()C")
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ gq. '$"Q r" PA\O W\"~,fJ,1>1
$ .sO gU\\.D\NG pE
$ (00. C)O \.-
(Office llsc Only)
This Application Becomes Your Building Permit When Approved
Datel\llf\l\ L 0 iJ.'
Date
Buildine Official
14 hour notice for all inspections (951) 447-9850. fu (951) 447-4145
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
.
1. Pi""
1, ar-
). Yellow
~l~icanl l PERMIT NO. Od~! d-LfJ
zoNING (office use)
LEGAL DESCRIPTION (office use only)
PID
~
LOT
BLOCK
ADDITION
(phone) ~do .~'if'7~~ \
~ '-
OWNER
(Name)::J::LJJ) r(lIJLJJ.
(Address) P. D.
APPLICANT - i
(NamelO...~,.. h~ __~ __ ]\.,^~ . ()"'""-- -I- ~,:.. f'nn.,,,, (Phone) ?fIJ-:JIr-7:SQQ
(AddrcsS)9;;)IO ~_' _~---.-N. ~flo,J..., rn1\l .5S~
;. ddress) (City) I (Zill Code)
(Contact Person) ~c=-,"::> \+. (Phooe) 7c..3-3b- -7S/~
I
I
APPLICANT SIGNATURE DATB't( -/O-~
~
APJiLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION 0 REPLACEMENT 0 AL TEIf TIONS
FURNACE MAKE A D MODEL F,UEL
I
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
.. OWarm Air Plants
OGnlvity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Spccial Deviccs
o Othcr Dcviccs
PLEASE NOTE:
Air Conditioner Units
canrtot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FN
Residential, Heating &. AlC (Ncw ConstrUction)
Residential. Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential. Gas Fireplacc
539.50 minimum
599.50 Residential. Additions &. Alterations
564.50 Rcsidential, AC Only
539.50
539.50
539.50
Industrial. Commercial &. Multi-Family
Estimated Cost S
Building Pcrmit #
.50
,-..-
~~,,.., '~"
,~ ,.,~.' ' ......"
HEATING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
$
S
S
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date I~~l\
By
Date
Building Orne""
14 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
ZOO~
X31GIHd 3SVHVS JI~VWO~nv
ZOLOSItZI9 XVd 6t:tI ZO/OI/tO
II
C~TY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
,
I. Pink
1~ On:cn
], y.lluw
~lz.;<&dl r PERMIT NO()~_ ) ~ 'I 1
.
ZONING (office use)
w~ DcJ2.0 T--<2fU\..O.OL
LEGAL DESCRIPTION (office use only)
PID
LOT
BLOCK
ADDITION
OWNER .
(Name):Jd.l. 0 il..s^OL)~L)
(Address) 'P.
(Phone) q~ - ~ - 7 (o(p3
5537
.. OWann Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water .
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditionet Units
Can1\ot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
564.50 Residential, AC Only
$39.50
Industrial. Commercial & Multi-Family
$39.50
539.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
J.p.". . - .'~ '
iJ \, ~-..: _,:j ,<.
.50 H.LIN\ Gl ~'J
'L...-.-
(Ornet list Only)
This Application Becomes Your Building Permit When Approved
Paid
Recei t No.
Date
By
'1[/
L
Date
Building Official
14 hour notice for all inspec:tions (951) 447-9850, fu (951) 447-4145
X31aIM~ 3~VMV~ JI~VWO~rrv ZOLOS1~Z19 XV~ 01:~1 ZO/9Z/tO
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CERTIFICATE OF SURVEY
For: Hillcrest Homes FEB - 6 lUUl
PROPERTY DESCRIPTION: Lots 15 and 16, Block 1, WILD OAKS,
Scott County, Minnesota.
We hereby certify that this is a true and correct survey of the above
described property and that it was performed by me or under my
direct supervision and that I am a duly Licensed Surveyor under the
\ laws of the State of Minnesota. That this survey does not purport to
show all improvements, easements or encroachments, to the property
except as shown thereon.
Signed this 5TH day of JANUARY ,2002 James R. Hill. Inc.,
Not
1. Building dimensions shown ore for
horizontal & vertical placement of structure
only. See architectural plans for building
& foundation dimensions.
2. No specific soils investigation has been
completed on this lot by James R. Hill, Inc,
The suitability of soils to support the specific
house proposed is not the responsibility of
James R. Hill, Inc. or the surveyor.
3. No specific title search for existence or non-
existence of recorded or un-recorded easements
has been conducted by the surveyor as 0 port
of this survey. Only easements per the recorded
plot ore shown.
4. Proposed grades shown were token from
the grading &/or development plan prepared by
JAMES R. HILL. INC.
By:
11529
&.
o
.
x927.6
(930.0)
TC
Denotes set spike
Denotes set iron monument
Denotes found iron monument
Denotes existing elevation
Denotes proposed elevation
Denotes proposed drainage
Denotes top of curb
Bench Mark: 931,59 - TNH- epg 20. SE END
STREET B
Proposed Garage Floor=
Proposed Garage Top of Block=
Proposed House Top of Block=
Proposed Lowest Floor=
930.0
930.4
930.4
921.7
Bearings are on assumed datum
Scale: 1"=20'
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James R. Hill, Inc.
PLANNERS / ENGINEERS / SURVEYORS
2500 w. CTY. Ro. 42, SlI1E 120. B\RMLE. MN 55331
PHM: (952)890-6044 FAX: (952)890-6244
CERTIFICATE OF SURVEY
Hillcrest Homes
L
For:
I
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-VI
-1 -1
I '- t-
1'\\~'(.
140'2
4\,00
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(""I
---
---
---
DRAINAGE & UTILITY
EASEMENT OVER ALL
OF LOT 22
BENCH MARK (\
TOP OF SPIKE (\ v'
ELEV.=929.52 v'
BENCH MARK
66.00 S8702S'00"E \(-, l) TOP OF SPIKE
'200 ELEV=92725
(928.0) '\.
'\.
AFFROV~O '\.
;'\.
'Vv'. ;--/0
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~~\-96'
'fl-9'S
Js.'\.
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James R. Hill, Inc.
'1~
L.. '-./
N
00
4\. ..~
411'\\
N8702S'OO"W
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Page 2 of 2
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ELEV.=929,OO
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PRIOR LAKE
INSPECTION RECORD
L tv\ ~~iI\. t-(' l.e.-
DEPARTMENT OF
BUILDING AND INSPECTION
-
SITE ADDRESS tosS--S W;\,J ~~ ~ \.,~ Q-
NATURE OF WORK rv~)
USE OF BUILDING fffi.
PERMIT NO. () -()/Z4- DATE ISSUED J--2.2.-0~
CONTRACTOR J:lLl\0.\'R.b-f ~rlVV\.CL PHONE qs:z - 87'i?J -7(,~3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
[ FOOTING !
FOUNDATION (Prior to Backfill) hR-f J.- \ <; 0'- - n . if'ifalo2>-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING t",~'
INSULATION
ELECTRICAL
PLUMBING v v'
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST F. ~ ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
11,M..~ ~(. 6r. 7/;>'L~J-,. ~ 5k)~'& I
FINALS
L
{ptf)'tYl/
GRADING (Prior to Soddin )
BUILDING Ie b ' ~ ) IJV
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections h;:ov'd besn approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
. .7/~ D3
71 ~tJ to)
b
~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850