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(Phone) Cf'S'L-'II!1-77/f ADDITION OWNER (Name) 'D42M/1:v~)Je.. Cot.).)t.t~)..v :t,,-L. (Address) /0,40 V';~iu(.. Sv.rk. PhIL Date Rec' d ,3-29- 07_ I. White File I PERMIT NO I 2. Pink City . 0 Z- () 32.0 3. Yellow Applicant . ZONING (office use) R- /.5 D PID 25 -371- 0..3 tJ - 0 to(*' BUILDER (Name) CSAtv..c.. (Contact Name) ~'lL /~ I (Address) (Phone) (Phone) ~A__ ~2..rnll L'in-) ODeck o Porch ORe-Roofing ORe-Siding TYPE OF WORK ~ Construction OLower Level Finish o Fireplace PROJECT COST IV ALUE (excluding land) $ 2..c:.C; 00,>,0 c. o Misc. OAddition OAlteration 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 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 property t erform needed inspections. x Permit Fee $ Plan Check Fee $ State Surcharge $ Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee $ Gas Fireplace Permit Fee $ t./- t/- c2- Date qtz.y Contractor's License No. '5'" 2.1-0 7- Date Park Support Fee SAC Water Meter Sie5/ ;1"; Pressure Reducer Sewer/Water Connection Fee # $ # $ $ $ # $ # $ $ $ ..-()'l-- $ . .30. 25 I ~;ceiPt f!a-Ll/71Y' Water Tower Fee Builder's Deposit Other TOTAL DUE I Paid C( ~ 3~. ~S Date L - I ~ - 0 a- 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 =" byfu c,~_cr,~omN'-'MYC-;;I;=;:'md_~"1;0J:r z~~~ Date Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 White - Building Canary - Engineering Pink - Planning Thr ("rnlrr of Ihr I.ak< Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D S f.,/2.f3e {j o~ -3 -~.7-q , u z- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity Which is proposed at: 32/2 L-fl/c/;,!3..Ll/'FP Accepted x Accepted With Corrections Denied Reviewed By: AlfiE. Date: '( - ~ -0.;2. Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading Plan, 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 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 Thf' Cf'nlf'r or Ihe t.kt Counl,.,., BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT DSSf2. Be-oot:6 3 - z-q --0 2- APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 32/2 L-AJGb E/-UPP Accepted Accepted With Corrections '<" Denied (2Q~ Reviewed By: Date: ~ cf- (JfX. -- Comments: ~ailQ atfQ~ ~~_~- "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." II"P!IB^ eq JOU IIBLls UOlP!pspnf eLlJ lO SeOUBU!pJO J84Jo JO 8pOO S!4J 10 SUO!s!^oJd 84J 18::>UB::> JO 8lBI0!^ OJ AlPo4JnB 8^!6 OJ 6U!WnS8Jd sJ!wJed "UO!PlPspnf eLlJ lO eOUBU!pJO JeLlJo AUB lO JO epoo slLlJ lO SUO!s!^oJd eLlJ lO AUB lO UO!lBIO!^ '\UB 'lO IB^OJddB UB JO 'JOll!WJ8d B 8q Ol p8nJlSuOo 8q lOU IIBljs SUO!lBlndwoo pUB SUO!JBOllpeds 'SUBld lO IB^OJ~dB JO J!wJed B lO 5U!JUBJ5 JO eOUBnSS! eLl.i., D~ --zOJ~/h :eJBO ~,?--~ :A8 peMe!^etl pe!ueo ~/ SUO!peJJOO ljJ!M peJdeooV' peJdaooV' :JB pesodoJd S! ljO!ljM AJ!^!PB UO!pnJlSuoo JOl UO!JBO!lddB J!wJ8d 5u!PI!nq 8L1J P8M8!^8J 8^BLI sJuewJ.lBdeo 5U!UUBld pUB '5UP88U!5U3 '5u!PI!n8 8L11. 03A1303l:l NOI1.V'OllddV' 1.NV'OllddV' ,:jO 3V\1V'N .lSI1:>1:l3H:l .lN3W.lI::IYd30 NOI.l":ll1ddY .llWI::I3d ~NI01In8 6UlUUBld - )jU!d 6UIJaaU!6u3 - ~JBUB::> 6Ulpl!"a - al14M ,uJuno.) "'I.'] .-flU JO J.JIU.J.) ,)q~ .,J n~.2~ 02 WED In:~9 FAX 012.~7.2J3 (In OF PRII)R L-\I:E l4J 00. CITY OF PRIOR LAKE SEWER AND WATER PER1\1[IT Date Rec~d 4- - 2-4 - () 2~ ~. ~:ii.:. ~\; rPERMIT NO'07_ 03'Zi"~1 ) Oald ,\ppll.... ~____... '::"_ '. I LE~ DESC",pnoN (.",,, .... ..,,) - LOT"3 0 BLOCK I ADDITION /VtJ8771IV{iOD (J/11::.S DIl'! n;:s 2 tv};) --.--........-.--...'"'-..--....-.--....-.--....----.--.-.----------...-_.~ "--'''--,-- ,.....~--- 1 [~~n;~~j ~tJ ,..~ PIO ~~. - .~.?I ::-_cJ~Q~.~J :::~~~-c;~~--/~;=-~~~~~:: '1~L :~; .7::j ---.--- (Ad.dT!~L__._.__._..__. -.J~~ (Zir~, ~~ 'd4) APPLICANT .-----.-.---.---,..-.-.-..-.....--.".-.-~^'-. --..---._m______ .. . [N."'<)J~---->'--~~_________.__~ {Plu:>"., "t~2. 4<rfJ' SZ~':::__ (Address) 184~ U!.J!/~ D1~.,.~.._-...._____...._____~_*21L+ U.-v' ~ ->-~_::;? (Addreu) (City) (Zi,.:: Ide) (Con'act P<"on) -~':L---;L _ I" ~ s,____ (Phone). "t> Z "f <f 8 s 2"::" APPLICANT SIGNATURE - DATE '1- Z 4 -l)"2- ....... ---.----------.......- APPI,ICANT PLEASE COMPLETE UELOW Size of water service ...!:t....- inches.~- ----.---. Location of any couplings from strueture _;$.-2.":-feet. TyPe of seWer pipe. _ 0 ABC ~ PVC 0 Cast Iron Estimated length of sewer line ~ ~. Clean ~ut (if required) loca~~_~.~~ ~!~~~rom Struclur~. "'------_~_w .. Rcsidcrnial sewer and Water line cOl\nection Sewer conneCtiOn only $35.50 $J7,50 FEE SCHEDULE Industrial, Com'l & Multi-fami y J% of job c:o~t with a $3') :~) minimum Water conn@Ction only $17 .50 Building Permjt N.::.~. .0 Z. - 0 'SZ-(C B \.( pAID {P 6 VI vD . $ $ ==== .'50 $ Estimated Cost $ SEWER AND WATER. PERMIT FeE STATE SURCHARGE TOTAL PERMIT FEE (Orner UJf Only) This APplic:.Ci~A'~om~ Yo,u' Building Permit When Approved .~. - I n~.it. f.J IOI~ 4- :..Y ' ()?-Dat< -~-4- -02- j By - f..M 8\lilclinl: Offi,i.' Dace -=t Z ___.__.._' , . .. _____ )4 "<<:Iur "<<:Ill.:e for.1I inS1JertioRI (95%) 441-98$0. fu (952) 147-4::zes Date Rec'd CITY OF PRIOR LAKE PLUlVIBI~G PER'IIT 1. Bille File :.. Gold CIV J Yetlow -\polLcJ.nt PER-yIlT NO. (~- -::3 o-b J (?!~:lse ("ne or Dnnt md SIgn at bottom) ADDRESS 3.J-/~ Ld-e 8~/1- Ii; Z 0 L'-iI: j- G (l)tE~:: u~e) A/a! LEGAL DESCRiPTION (0rfiC~ us.: \mlv) LOT BLOCK ADO[T:ON PrD , 0 \\:"i E ? ! C\j-J.:7:e:: (F~or~e) j (.-\ Lid :e~s J i -~. ~PUCA~iT! ~ / ~ fJ / JJr; I (0i;H::C:) /1( If I.{ i (.-\dj;ess) 8'60 at) /(/ Y' f)tJcf (.-\ddress) (Phonc:) v;; ria Jc (C~r:r) 952-~~2-C/C/ . 5S.?5<?..-- (Zip Code) ('-,'~r.1" P~"'o~)' I '-v." '-- v.~ " - i APPLICA?,.iT SIG~i.-\TURE t!A. /~ M.J/!/:v, (?;:cr:~) 1{tx1I;;~ rJ7___ DATE APPLICANT PLEASE COMPLETE BELO\\/ QU:l!ltity I Type of Fixture I Bath Tub with or without shower I Dishwasher I Floor Dr:lln I Lavator/ (Bathroom Sink) I Laundry Tray (lor:: comp:J.rtmc:nr Sink I Shower Stall Sinks I Bar Sink .3 I Water Closet (Toilet) Quantity I I I Type of Fixture I Rough-ins I W:Her Heater I \Vater Sofmer I Stand PiDe I\Vashin!! \-fachinel I Sewage Ejector Backt10w Assembly Backt10w Assembly Test I Lawn Sprinkler i Other .FEE SCHED(jLE Industrial. Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential. New One & Two-Family 599.50 Residential. Additions & Alterations 539.50 Estimated Cost :s Building Permit ;f. PLUMBlNG PERMIT FEE $ STATESURCK~RGE $ TOTAL PERlUIT FEE $ Paid .50 .~ 0-B (Office t:se Only) This Application Becomes Your Building Permit When Approved Receipt No. Building Official Date Dat:5_ () ?>-ocr By 2~ hour notice for all inspectlOns ~95Z) ~7-9850. fax (951) ~47~1~5 . CITY OF PRIOR LAKE REA TING/AIR CONDITIONINGIFIREPLACE PERMIT Date Rec'd . I. Pink 2. an.. J. Vellow ~; I PERMIT NO. "'_'~ '\ r Appll_. c:::;><. .~ O-loo e or riDt and si ADDRESS '3d ld cRo..iu. ~ ~ I\JW ZONING (oma use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNE~ (N arne) (Address) 103 V r.rrn~~ (phone) qS~-~~-771 J p~ APPLICANT SIGNATURE DATE APPLICANT PLEASE COMPLETE BELOW W CONSTRUCTION 0 REPLACEMENT 0 ALTERA nONS FURNACE MAKE A D MODEL ~UEL FLUE SIZE RETURN OPENINGS INPUT ! OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT .. OWarm 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 Conditioner Units Cahnot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Industrial. Commercial &: Multi-Family FEE SCHEDULE I % of job COSI Residential. Gas Fireplace $39.50 minimum $99.S0 Residential. Additions & Alterations $64.50 Residential. AC Only $39.50 Residential. Healing &: AlC (New Construction) Residential, Heating Only (New Construction) 539.50 $39,50 Estimated Cost S Building Pennit # HEA TINO PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Recetpt No. Building Offidal Date 5 20!J2 By Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 C::OO~ X310IHd 3~VHV~ JI~VWO~nv C::OLOS1CC::19 XV~ 61:11 C::0/6C::/SO o~~ THU 14: 14 FAX 612447424.5 CITY OF PRIOR LAKE .\ CITY OF PRIOR LAKE Impervious Surface Calculations (To be Submitted with Building Pennit Application) For All Properties Located in the Shore land District. / The Maximum Impervious Surface Coverage Permitted in 30 Percent. ~;: - Property Address :~.:J\~ Lo..\.L.e. R\\..I..ff {\rde Lot Area rJD L\q.s, Sq. Feet x 30% ;::: .............. (0 \ 4<=\ I . *********.*********************~~~*******+****************************** HOUSE LENGTH 4\.\1 1.4S" WIDTH -35.34 SQ. FEET x x = '"" A TT ACHED GARAGE d.~ x .3\.T2.. "" L:>o,'B TOTAL PRINCIPLE STRUCTURE...................... ,.::),I~:\ DETACHED BLDGS (Garage/Shed) x X TOTAL DETACHED BUILDINGS....................... N~\ D"KlVEW A YIp A VED AREAS .?,...Cil x .~R 0'2. I, OL:>4 (Driveway-paved or not) (~Op X (.;>.") p = ,'S C:l::> (SidewalklParking Areas) d. S 3.~ x .~ "" 7I..D ........ ':"'\ TOTAL PAVED AREAS........."....................".......". 1,640 P A TIOSIPORCHES/DECKS x '"" (Open Decks W' mln, openln~ between X = boards, with a pervious surface below, are not considered to be Impervious) X = TOTAL DECKS................ ......... ............................. ,.. \~/A OTHER "" x: X ::::: TOT AJ.; OTHER........."....................".................,..... ~/A TOTAL IMPERVIOUS SURFACE {UNDE~OVER Prepared By ~1 1"/ (3f...m:;; Company tJptD lu.vl) ['Yd' I ,3 ;lq3 [ da ~5l.t.? Date _~. J &:;-o~ Phone # L7C\/ .4DS-loloCC [x (o;}3 '" ~ ::s ~ ~ ,J ~ ~ ~ ~ .~ ~ ~ . '\0 ~ ~ ~-G ~ ~ '-.J ~V) 02/06/9'( THU 14:14 FAX 6124474245 CITY OF PRIOR LAKE I4J l) 03 -..,~:. .. CITY OF PRIOR LAKE Impervious Surface Calculations (To be Submitted with Building Permit Application) For All Properties Located in the Shoreland District (SD). The Maximum Impervious Surface Coverage Permitted in 30 Percent. Property Address :1~1a. L~ f\\uPf C;('r\~ Lot Area dO,4q~ Sq. Feet x 30% = '....OI....... ~l \'1'\ ************************************************************************ LENGTH WIDTH SQ. FEET HOUSE 41.11 x 35\,~4 = 1.455 x ... ATTACHED GARAGE ~d x ~\:12. = ( 0" 2, TOTAL PRINCIPLE STRUCTURE...................... ..JII""~ DETACHED BLDGS (Garage/Shed) x X TOTAL DETACHED BUILDINGS....................... KIA D"'lUVEW A Y!P A VED AREAS X 0) ~.o'2.. = 1.0<.:>4 :2,"1..<11 (Driveway-paved or not) X = (Sldewal.klParklng Areas) ,1S.~~~ X ~3 "" 71.D TOTAL PAVED AREAS......................................... \ I \40 P A TIOS/PORCHES/DECKS x ... (Open Deeks '11" rnln. opening between X = boards, with a pervious surface below, are not considered to be Impcrvio\.ls) X = TOTAL DECKS.....................,.................................... N/A OTHER x X = = TOTAL OTHER......... '" ............ II U ..",....., .... .....,.t... II TOTAL IMPERVIOUS SURFACE ~~VER Prepared By 1~ f((o/..J,tJ:) Company ----bl ed I..U\r\) fY\S' Date ..3-,;r'7-O-z. Phone # 6.51 - 4 os . ~ G:> Ob PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS 3J.L2 Lak~ 7){VPr - NATURE OF WORK -f)~.) USE OF BUILDING 3ff PERMIT NO. 02-03Z(P DATE ISSUED c..f - if -OL- CONTRACTOR ~ ~~ CkwJL PHONE 'is-2-821-=77LL 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 ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BE I FINALS V" N SIGNED I GRADING (Prior to Sodding) BUILDING T/~.a,~ to , tl'Z-- ELECTRICAL PLUMBING HEATING DO NOT OCCUpy UNTIL ABOVE HAS 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. $~?. ~ JcJ ()~ BEEN SIGNED ... Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850