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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE FEB 2 8 alE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT /Y'BLOCK
ADDITION
OWNER
(Name)
Nt)
~. ~i~i~e ~:~y I PERMIT NO. 02-- 02/ I,.,
3 . Yellow Applicant fl./
ZONING (office use)
(:1"/
PID ~:J - J JO (, - (j "l/ - ()
(Phone)
(Address)
BUILDER.
(Name) &J[~ Iv' J l:n <::i/V /V
(Contact Name) 6'0.. r y
/
(Address)
2~~
1--1 (J r,., ,':; J
J- 0 A IV ...F () /V
f)1'. (,' .1
Sit
TYPE OF WORK
tI ew Construction
o Fireplace
PROJECT COST IV ALUE (excluding land) $
o Addition
o Alteration
o Utility Connection
DDeck
o Misc.
OLower Level Finish
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 e property to per,4rm nee ed inspections.
. '. r--
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ 0
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
x
e mes Your Building Permit When Approved
?-8 -0""2-
Date
(Phone) (,.5-/- }'u (.. Yj'O /)
(Phone) G /.,2 - J ,; f - /' C, I ~
f .J.. () I)
~ .I.~ /T)
- '/.).;).
OPorch
ORe-Roofing
ORe-Siding
/7'5- .:Y"
Contractor's License No.
;;. -;lfl ..0 :J.....
Date
Park Support Fee
SAC
# $ ---.
# $ 00 . CJ 0
$ tLJ ,(50
$ 5' ()O
# $ :tOO -00
# $ DC) .OC)
$
$
$(P 3 flQ. 5/
tmt~o,'f/S20
Water Meter Size /8'; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date :s - ~C:>-OL..
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
~":":"""h, <h, P1~'cr~'m,",~, "m,=ry c,rt,~ "~~'i~;: ~"U~ ,~,",ruoo AiExr~W'b'
D", * , S""i" Cooditi,",. if MY
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
10/24/01 WED 11:22 FAX 6124474245
CITY OF PRIOR LAKE
I4J 001
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I BIu< Fil.
l. Gold Cil1
l. Yol""" "who",,(
MAR - 0 200'l
I PERMIT NO. 0 Z-, () z- /0l
s ~~<>~ 'N'N
ZONING (omec we)
LEGAL DESCRIPTION (offi~ use only)
LOT ) ~ BLOCK ADDITION
PID
OWNER
(Name)
(phone) bS)-LfDb -tfL/oo
Y\ \M t'\ \ ~J '2Z-
(Phone) ~/- 'fs2- / Si. .
~ MV\, 5S1XL
(City) (Zip CodeJ---
(phone) ~S-/~s;2-15bS
DATE '3 ~ l);L
(Address)
(Address)
(Contact Person)
APPLICANT SIGNATURE
Quantity Type of Fixture Quantity Type of Fixture
~ Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain Water Softner
~ Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink Sewage Ejector
, Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
, Bar Sink Lawn Sprinkler
~ Water Closet (Toilet) Other
PLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commerchil &; Multi-family I % of job cost with a $39.50 minimum R.esidential. New One &; Two-Family $99.50
Residential. Additions &. Alterations $39,50
02~ 02/0
r;-~g~t<\Ii .
Estimated Cost $
Building Penn it #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTALPERNDTFEE $
(Omce Ute Only)
Thi! Application Becomes Your Buildine Permit When Approved
Building Orndal
Date
Date..3_ / Z.-- 0 Z-
::4 hO\l,' l4otit~ for.1I inspedion. (9S1) ....,.9liSV. flilll. ,951) "'.,....245
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CIT~ Or PR!oR LAKE
SEWER AND WAT~R P~RMIT
No.'OZ-OZ-lt;/.,:,," '<
5!G'NA'!'URE:
, '
NO'I'E: Sewe~ and ' Water', :
contraa1:.or;s m~:5~f"
b~ regist:.er,\e~,';:',
\ol J. th the. , c: i. -t-y...,' ,
, "r' "
PHONE: t:zSI-1f~~~J ~br
DATZ: 3/11/~' ',' '
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'AP P LI CAN'! :
ADDRESS:
SI..DG. P::R"!IT #
. 1"
I;'.,' \'
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, '
2.
~stimatec length of water service
I
F!LL IN THE ELANKS
30
1.
feet-.
'1' ,
','J-
J .
, '" 4,.
'5.
T~~e of se~er pipe.
ASS
inc~(es). l\ It^
from st=ucture~feet.
PVC~ Ca~t Iron____
30
fe~;I'_^_
at ~fe.t
fro~, '
Size of water service
Location of any cou~lin~s
" '
..
, ,
. I "
Esti~eted length of seYer line
.. ,
IlL
C:!.ean out
S-:~..Jc't:.ure .
(if
reC!Uirec.) ,
locatec.
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~~~~~~_~~_====;~~=~~~~~~===~==~==~~~~=~~_~_~~;~~~~~~~=C~=~~~~~'
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This a?~lication
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,".
FE:::S:
S
$
S
35.00
.50
35,50
Se14ler and water line connection penn~'t'~
Surcharge
TOTAL
rf.
" '
, ,
" ,
..
ree fo= either seVer or water
S .50 surchar98.
i.ncividually
is
520.00
';P'~U~
:-.
"
'I, ,.."
... I' , ,
* Se~er and yater pe~its issued for nev construction must, bQ
recordee on the bui~din9 permi~ ca~d at the ti~e of i~su~ri~e
to insure that no c!upli.cate se''''e:=- and water perlU it:: s ate',
issuec. . 130; '~
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'," : ':' ' ,~"51':f:I =3.~!= C;'o::~~ .~.'J. S.E., ?~cr" L~..k~. ~(b:le~Cf~ ~::=-: '?':. 1'51 ':' li.7...1.:!::;O IE<\..,"( {812-' ~i~:;:45
9 d 9LSl9Bl99S 'ON/9G:BO 'lS/LG:BO GO ,6l 'SO (3D1)
WOlB
#5335 P.OOl/OOl
FIRESIDE CORNER
CITY OF PRIOR LAKE
IlEA TING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec:'d
f~ S~"' [!ERM1TNO.tJZ_02/~
ZONING ("ffi~ ":!f!)
LEGAL DESCRn'TION (office use onl,)
LOT
BLOCr<
prD
OWNER.
(Name)
(Address
(Phone)
APPLICANT
ONam~ AT~LIED r.lRESl~E DBA F.I.RESIDE CORNER
(Phone) 1551-633-2561
(Address) 2700 N. F1URV:1.EW AVENf.1E
(Address)
BRENDA BUSTO
(Conract Person)
irOSBv tT. 'C,E MN
(City)
(Pbon~ 651-633-2561
'; 5.1.1..3
(Zip Cod~)
APPLICANT SIGNATURE
DATE
~'(J
fndrJStrial. Commercial & Mulr.f-F41mily
APPLICANT PJ...EASE COMPLETE BELOW
. W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TI0NS
FTJRNACE MAKE AND MODEL FUEL
FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PT..ANT
OWann AIr Plams 0 Sleam
DGrav;r.y 0 Hot Wat.cr
o Mecl1aniC/lI , tJ Radiation
DAir Condirioning 0 SpecillJ Deyices
OVent. SYST.etn 0 .other Dcyices
FfREPtACE MAKE AND MODEL~jJ c.)'6, S7-~_' Jt2r1-M..- ~ qw
1 ~- .
FEE SCHEDULE
J % of job COST. Residentilll, OIlS FireplllCe
$39.~O minimum
$99.50
$64,50
PLEASE NOTE:
Air Conditioner Uni~
Cal1rlQt Encroach iJ:Jt.o
R.equlred Side Yard
Selbacks
Residential, Heating & Ale (New Con-Stn,JctIDn)
Residential. HeBting Only (New Construction)
$39,SO
Estimated COST. $
Residendal, Aclditirms & Altt!rations $39.50
Rcsldl'll'lli8J, AC Only $39.50
Building Permit # 0 Z - () 2/ (P
r PAID WI~_~. ,'__
BUILDING Pt:;h....l i
~-
$
S
$
(OlJjc~ Ilse Ollly)
This ApplicSltJon Be~l)mes Your Bllllding Permit Wlu!D Approved
HEA TING PERMIT FEE
STATE SVRCliARGE
TOTAl.. PERMIT FEE
.50
BQI/4InJ: omell"
DIlte
~
Dat6-8-oZ-
Z4 hOllr notlc~ 'or nil In'pecl:lonll (951) 447-9850, rllZ (952) 44"7....,Z45
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'o
~. ~e:n ~!~y I PERMIT NO. J _ J / /
3 . Yellow Applicant . e><. ~ (c:::)
ZONING (office use)
15286 JEFFERS PASS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW A VENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
8/27/02
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL REA TN GLO 6000TR-OAK (FIREPLACE #3)
APPLICANT PLEASE COMPLETE BELOW
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 & A/C (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39,50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
....1.i~/; ,
~~',
~'I:(:,
. -. li- .
'...
(Office Use Only)
This Application Becomes Your Building Permit When Approved
....""(Ii./
Paid
Receipt No.
Buildine: Official
Date
Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
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The- Ce-nle-r or Ihe- I,.kt ('au n II")'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
W SNSVlA~ tJ
2, z,g - () 1-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
15Z60 JSrFS1ff PASS
Accepted
Accepted With Corrections <
Denied ~
Reviewed sL tl37A< A
Comments:
~~ f01~l,~-G~
Date: '3- B -o~
"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 ('tntt' ollht Lib Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
V\) F/ 1"1 5 r I f\ ~ IJ
2~28~{)L-
The Building, Engineering" and Planning DePer1ment~ h~v~ reviewed the building permit
application for construction activity which is proposed at: . . . .
152- rQfo JEFF[lc-( J)ASS
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
h)4{3
Date:
3- ~-P'Z-
Comments:
"
Set 1Yl~""
f",'f~
"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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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
-
SITE ADDRESS 15d..B~ j",ITus ~s..">
NATURE OF WORK "Jew
USE OF BUILDING S ~ A
PERMIT NO. ()2--0Z/0 DATEISSUED 3-8-0'2.
CONTRACTOR ~J€lA':::;,vV\G--,^-,-, PHONE 1a/2 ~ '? b9. ?fn/ 2-
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 L..L. 5, c1 ~ ~ !}lIe
INSULATION ?:~~ o~
ELECTRICAL
PLUMBING L-. L-.
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ~ 5 '(J-u
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING o....U./L.()l-
ELECTRICAL
PLUMBING
HEATING
DO NOT
I ~
/rJ'Ie;
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical sefvice .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