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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Z-)3-0Z
t. White File \ PERMIT NO
2. Pink City . 0"7 - 0/ ()Q
3. Yellow Applicant . V ~
tl'f. - .
. / (/......
\,.
A I (ei ,
ZONING (office use)
R2-
LEGAL DESCRIPTION (office use only)
Lo~6BLOCKI
ADDITION
/h f5C1CJ(C~' Vi ({J
PID 2.5 -364- - OZ~-O
OWNER
(N ame)
(Address)
(Phone)
:;,"'55( S
c; S:J - '-/'-/5-' 7 3 $S'
f . ( , I ,
BUILDER
(Name)
(Contact Name)
(Address)
~
~/ ~I hJ,c
10,.// ~ii':>7C;A1
'I
(Phone)
(Phone)
TYPE OF WORK
New Construction
ORe-Siding
ODeck
OPorch
ORe-Roofing
OUtility Connection
OLower Level Finish
"'f!J Fireplace OAddition o Alteration
PROJECT COST /V ALUE (excluding land) $
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 erty to,.perform needed in ec' s.
~
o Misc.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ l ()" . (!)O
Mechanical Permit Fee $ If)(j .00
Sewer & Water Permit Fee $ 3-S- . ~-n
Gas Fireplace Permit Fee $
Your Building Permit When Approved
~-Ji-2.~
Date
(Sc..;;;?C'CO 7& 737
Contractor's License No.
C~)d Ic~
, Da&'
Park Support Fee
SAC
#
#
$
$
$
$
Water Meter
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE C!l1,{,'
\ ~a~~ 7tt~~~~
3-1- 0&
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 ity Planner constitutes a temporary Certificate of Zoning compliance and allows consuuction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
'2-!2:Cc/CL ~e~ A..WA.( ~~\ ~,~,DI\{~"
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
- c."7C-C.
anning Director
Date Rec'd
CITY OF PRlOR LAKE PLUMBING PER'VlIT
~ ~~I:j r~:~., \PER'\nT l'iO. O' Z-.-' 0 1 (1 a \
] Yeilow ApphC'"1 L [J -I- J
ZONING (office use)
ADDRESS
I
Llr/C/(/:5
(~_r//;;9(1lf
tv()~
i L
=:
\LEGAL DESCRlPTION (office use only)
\ LOT
pm
BLaCK
ADDITIaN
a w:.iER /J - {.IJ I /
(:-i<1me) C";gJt f If IL.
(Phone)
(Address)
~;:;~:~.'u"TI)& /1(1 ~ f)~J#
(Address) ~(JO {)JI1G r j{;JP
(Address)
_ (phone) 9,<,(;' t/ tJ ,,2 ;; 1.1 1
~ ~ ~/a 'A
~r; rfl, j -.;'$oZJ
(City) (Zip Code)
APPLICANT SIG:--rA TURE
UA~
iL! tJ) 1Jl'~
DATE
-=
J/;u4 /5:0JU ~
(Cont:lC: p~:son)
(Phone)
APPLICANT PLEASE COMPLETE BELOW
Quantitv
1
/
\ Type of Fixture
\ Rough-ins
! Water Heater
\ Water Sot'tner
\ Stand Pipe (Washing Machine)
. Sewage Ejector
I P:1Ckl-l('W~.ssemn'v
I Quantity
\ .:;
\ I
/
J
/
I
I Sinks 1 \" Backt10w Assembly Test
Bar Sink \ \ Lawn Sprinkler
~ Water Closet (Toilet) \ \ Other
1 Type of Fixture
\ Bath Tub with or without sho\,,jer
\ Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
\ Laundry Tr::lY (\ or 2 compartment smk
I c::~('w!".. C:t:1J1
FEE SCHED tILE
Industrial. Commercial & Multi-family I % of job cost with a 539.50 minimum
"
R~sidential. New One & Two-Family S99.50
R~sidential. Additions & Alterations 539.50
PLUMBING PERlvllT FEE $
STATE SURCHARGE $
TOTAL PER.'\llT FEE $
.5j2
1 .~ p(
ffCJ-'/' . fI~
/!P).;~
Building Permit i*
Estimated Cost S
\lice Use Only)
his Application Becomes Your Building Permit When Approved
Oat~ ~ 2 0 ~ 01 ~
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
FIRESIDE CORNER #j~qb ~.UU~IUU~
CITY OF PRIOR LAKE DQte Rec'd
HEA rINGI AIR CONDITIONINGIFIREPLACE PERMIT
I. pl~k
1, (irootI
,. .,.11-
APR I '~(J[Y)
~~I_ \PERMIT NO.O~ - / M J
\
ZONING (Qftl~ 'lie)
[l'1_!yo< "'~"d .......-l
[ ADDRESS r .
~ L\~ S~ dl~\.Q:Efh \.~~
LEGAL DESCRIPTION (office l.I~e only)
LOT:;).. ~LOCK / ADDmON
d-
OWNE~
eN ame)
PID ~5- ~ - 0).10
~~_~~-dS46
~Q.~
~rn.A.b
(phone)
(Address)
APPUCANT
~ame) AT~LIED FIRESIDE DBA FIRESIDE CORNE~
(phone) 651-633-2561
(ContAct Person)
ROSF.VTT.T.E IVlN
(CIM
'\:;(phone) 651-633-2561
DATE
E;i;1'":l
(Zip Code)
(Address) 2700 N.
APPLICANT
W CONSTRUCTION
FURNACE MAKE. AND MODEJ...
FLU E SIZE RETlJRN OPENINGS
TYPE OF SYSTEM
DWIlITIl Air Plants
OGtaV;tY
o Mcc;hllnlcal
OAir Conditioning
OVcnt. System
E COMPLETE BELOW
o REPLACEMENT 0 AL TERA TlONS
FUEL \U::o D
INPUT OUTPUT
HEATING OR POWER PLANT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroa~h into
~quired Side yard
Setbacks
~ ~ ~r-utZ-
FlREPLACE MAKE AND MODEL.
o SlelllJl
o Hilt Water
[J Radiatir;m
CJ SpeciaJ Devices
o Other Device$
~~ 2~
Residential. Healing &. Ale (Nc:w CMlstnlction)
Rf:sid.ential, Heating Only (New Construct.lon)
FEE SCHEDULE
1 % of job cost Residential. Oas Fireplace
$39.S0 minimum
599.S0 Residential, Addj,tions &. AlterB1!onS
$64.50 ~identjal, AC Only
$39.51)
539.50
539.50
Industrial. Commercial & Multi-Family
Estimated Cost S \ \ ~ . ~ Building Permit #
(
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PEll1YlIT FEE
$
$
S
.:S~
fOltke Uiie Only)
Thill Application Becomes YDur BuildIng Permit When Approved
Pm
g;:~)
IBU!LO;l\!G I
Receipt 'No.
Date
-/-OJ-
By "
DIU
tJuUlling Officl.l
24 h01fr notice for nllln.pccttonl ('51) 447-9150, fnll (9!Z} 447-4145
. '. .:.,~' '"'. CITY .OF PRIOR LAKE
.. .. . .
HEATING/AIR CONDITIONINGfFlREPLACE PERMIT
I, rlnt fl1.
1. ~ 0".
J. Tellow Applic.llll
f~~~-"'~-:
ADDRESS . .
. Ilf'ln eQ /-to(! ?qk
~JG.l
{\/, ~.
.
LEGAL DESCRIPTION (office ,ue only)
LOT
BLOCK
ADDITION
OWNER
(Name) c:!.eJI f< )It'
(Address)
II 0 1)'\(11 C;;
(phone)
PID
\
(Phone)
7(, 3 - 4')... 7'~ 5(.\71
APPLICANT
(Name) Hp",..J.,,^,
(Address) / <i'S-S'"O
-r~
U it
:). ~Q~ /.''''- J
~ovl1 f'(
(Address)
/"nlfP!4
(Cicy)
("~'c;A ~S"'1'f- f
(Zip ~ode)
L 3 - $'Y(.7
(Contact Person)
--
I,! ,."...,
(phone)
DATE
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION
FURNACE MAKE AND MODEL 13 "'f CI 1\-1-
FLUE SIZE PVC RETURN OPENINGS
TYPE OF SYSTEM
, rgWatm Air Plants
LiOravity
o Mechanical ,
~ir Conditioning
~ent. System
o REPLACEMENT 0 AL TERA nONS
3 s'o '+ ~n 70 FUEL
'Z' INPUT '20. nOO
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial &. Multi-Pamily
FEE SCHEDULE
1 % of job cost Residential. aIlS Fireplace
$39.50 minimum
$99.50 Residential. Additions &. Alterations
$64.50 Residential. AC Only
Residential. Heating &. AlC (New Construction)
Residential, Heating Only (New Consuuction)
Estimated Cost $
Building Permit #
'. . i
PLE.f.SE ~TE:,"
Air qonditi,ncr Units.
C~ En~oacb in~'
Reqqlred S~e Yard'
Setb.c1cs ;
$39.'0
S39.SO
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
~
.50 C:f II r;.~,I') ·
, ~'~' r;.~'.'"" :'''~.........
_"-".~ ,1~."
......., l ~ .
~-'-
(Omee Ule Only)
This Application Becomes Your Duildinl Permit When Approved Pal
Date
suildlaIOmel.' .
Dice
14 hour notice for IlIlnspeetions (952) 447-9850. fn (952) 447....245
te"d
ZS9:%:SZ"":%:9L
OMi ~NI'008 ~ ~Nli~3H
i '..'
. ,....
By >
,.
I
W~ 9g:Le ze-6e-~d~
----
White - Building
Canary - Engineering
Pink - Planning
lh. C.nttr 01 Ih. I..k. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
CENTS! 80rlSS
7--J3-02..,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
14453 ('I1SlIJ;r,nT6.\\Jl\j
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
NYfB
Date:
2 "'/~-o Z-
Comments: See Reverse Side for Additional Information!
I. ; ,~ \.' ,
antral Measures
"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."
White - Building
Canary - Engineering
Pink - Planning
Tht" ('enler or the Like ('ouoln'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
G6NT8X tjOMe6
~-13 -O~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I 4-453 CJt511h 6ft(6 vJ '1
Accepted Accepted With Corrections .><:
Denied ~
Reviewed By: t ~
Date: 2.-1 '1- o~
Comments:
~ ail tdkcLruP ~~
"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,"
White - Building
Canary - Engineering
Pink - Planning
The ('enter of the Like ('ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
',' -~,- X
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:, .._ .,' ;-.i I (....
i .',.- i\_,': !- -' -"'"
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
j /~. f~ i-~, ~..),
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I;
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Accepted
,~
Accepted With Corrections
Date: 2/:z,~UJ2-
"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
Q.C\~t\ e~~~_ (J~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J:i::\ 5"3
NATURE OF WORK -/J4tJA'
USE OF BUILDING Sf:D
PERMIT NO. ~ g DATE ISSUED ;;l.. - I '1 - 0'2
CONTRACTOR. Qp ~ PHONEqQ-lI<!<<). ')35')
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE H
ROUGH - INS
SEWER I WATER I SEPTIC V'
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 BE N
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 (952) 447-9850