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ADDRESS
q-6 2~ I
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 3 3/ - ~
at bottom)
ele~ So\V\+ S+-
White
Pink
3 Yellow
I PERMIT N~ 05". 0 ?-1-71
File
City
Applicant
ZONING {office use}
L~QAL DESCRIPTION J.9ffice use only)
I u r III I'd-- '1
LOT BLOCK 3 ADDITION
~
PIDcI ~~ (}();} - tJd? 0
OWNER
(Name) \<'0 1\1
(Address)
BUILDER
(Company Name)
(Contact Name) ~
(Address)
Wol.(vo..W\.
)ec,\'j0~+ .;+
Cl52
(Phone)
Lff7 ~J3C'6~"
I
E
III
H
2
IV
I
3
V
M
4
(Phone)
(Phone) 95d - ,:)tJ/... (b'10d.
IfNiy
TYPE OF WORK
o New Construction ODeck OPorch ORe-Roofing
OAddition ~Alteration OUtility ConnectIon rn Misc.
r ~TazJ 0 f1.. (2E"~ D €7-
CODE: 'MLR.C. DLB.c.
Type of <!;nstruction:
Occupancy Group: A B
Division:
II
F
I
A
R
5
B
S U
ORe-Siding ,91Lower Level ~inish 0 Fireplace
{t.:.\"d.';"~iCV\ lie- fv..v
PROJECT COST /V ALUE $ .2. t..'CCJ ~
(excluding land)
I hereby certily that 1 have lurnished mfmmation on this application which IS to the best of my knowledge true and correct. 1 also certify that I am the owner Dr authonzed 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 build 109
official can revok ' thiS permit for Just cause Furthermore. I hereby agree that the City official or a designee may enter upon the property to perform needed msp 'cllons.
X z' 0UJ ( &)0' ~3U/ u5
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
~o.oo
This Application Becomes Your Building Permit When Approved
~I ~ .:;e;JJ1 I .{...i
l3ul dlllg OttlCIa
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 trntf?)) 1- S.()J $3& 0 . 98
Ace
ThIS IS to certify that the request in the above applicatIOn and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
~ ""~_"~ C""",,,, "f~~f;e '"' .0,,, m"","~:;:~=e :::;' :"::"f:~;~: ,
Planning Director 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
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PE~IT , ,-J-I"
II Ie' UN ( i? '
05 -,;) L/ /-?
~. ~~n ~:~y I PERMIT NO. /j2...- _c Q~
3. Yellow Appilcant u.--.J ....::>~
ZONING (office use)
4v~
LEGAL DESCRIPTION (office use only)
LOT BLOCK \( ADDITION
PID ~J.. - C)'*
OWNER
(Name)
Ro^- W 0 It:' 1<4.'\.'
(Phone)
(Address)
APPLICANT-,- ) / A J-
(Name) ~'LI:! _ /.J (0 -L v1 c-
(Address) /.51/3 A 'f1 In ~ L r
(Address)
-
(Contact Person) ~ I M
APPLICANT SIGNATURE
(
(Phone) c; 6' L - F'i''1- 7 f' 7 z..
;1"-r""~ vl4 /'J/II 5-530 6
(City) (Zip Code)
(Phone) 95"2 - Y If!.." -7 q "7 '2..
DATE 6-.2.. L - oS
DNEW CONSTRUCTION ;gr REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL Lc...y 4.lr~ FUEL A/~I-
FLUE SIZE 1. (( flJL RETURN OPENINGS 6' INPUT 6 t;t500 OUTPUT ~ Ik!)O
TYPE OF SYSTEM REA TING OR POWER PLANT
Swarm Air Plants o Steam PLEASE NOTE:
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
APPLICANT PLEASE COMPLETE BELOW
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39,50 minimum
$99,50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
$39,50
$39,50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
~Cf-S- u
[, '0 .50
I r
(Office llse Only)
Date
Paid lJo~
Date0 - &;2-
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
~ ./OC)S-
~. ~~~ ~:~ I PERMIT NO. 05. oz,A-- -}
3 Yellow Applicant ~ ~
Ptb/rf /f?../I
-162-1
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name)
~~~~ IJ~;:~
.j, , Address)
l)Q I'A} ~
(Phone) ~S- ~
S-tv~- ,
(City) "?-
L~/)
LLC
tJ'
(Address)
(Contact Person)
APPLICANT SIGNATURE
APPLICANT P
v tj 7 gc:;;:1 r-
~.. <;;:)7/.)-'
(Zip Code)
2 -C- C/? 3
7(-
Quantity Type of Fixture Quanfity Type of Fixture
1- Bath Tub with or without shower ~ Rough-ins
I Dishwasher (, Water Heater
i Floor Drain / Water Softner
3 Lavatory (Bathroom Sink) 'j Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
.l Water Closet (Toilet) Other
v
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Building Permit # 0 5-: (.) Z--I-7 e {
1J,rIO ~.
r etfJ
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ ~
_/
~50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
P~~
Date
(()_()f"
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
By
~--
Tht' ('t'nlrr flf tht' I.akf' Count'")'
CWhit~ - euiidiii:g::::>
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~?I;r
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4t;;~1 ~ ~
Accepted
Accepted With Corrections
/
Denied
~9~~
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~~~'
Reviewed By:
Comments: ~
Date:
1!s/(JS
"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."
Thf ("fnlfr of thf l.akE' Count'1
White - Building
~ry_ - r=n~ng
Ink - Plannln
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
---.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.,:.~"
Accepted
Accepted With Corrections /'
Denied
Date: ~s!or
,
Comments: ~/ ~ i-o ~ .kl~ ~ ~
~ ~, ~ ~ ~ ~ ~L~ ;Z4.
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,
Reviewed By:
~
+~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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS &/" '=
NATURE OF WORK L. L. tJ .
USE OF BUILDING 5'~'
PERMIT NO. 0 ( , () ,B-1. _ DATE ISSUED ~
CONTRACTOR lD'" ~~ P~'1'- "f!('7.SJ8I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT S BY SEP ATE DOCUMENT
...s/~/'r,v~ /, S;.~ ~
FOOTING
FOUNDATION (Prior to Backfill) .S-:. ~ CI ()5-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC (SePeYl.A\E p€T2.Jt-..i
FRAMING /'
INSULATION
ELECTRICAL
PLUMBING
EATING if re uired
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I FurtVace 05'-6S~ I IU.-J} I /vllJl~(
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
This card must be posted near an elect,ICaI 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.
FOR ALL INSPECTIONS (952) 447-9850