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mlflA! FILE
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT '-I-q -O.::L-
/f 2.. 9 ;J..
LEGAL DESCRIPTION (office use only)
LOTI7 BLOCK i ADDITION
I. White File
2. Pink City
3. Ye\low Applicant
I PERMIT NO. ();). -() 'I c)jl I
ZONING (office use)
l
PID )..~-- 31(, - (.'70 - 0
I OWNER
(Name)
(Address)
BUILDER 1
(Name) 'bJ t' N 5 m ~ /V N )J () J7" 1'.5
(Contact Name) G ~ "7
/"
(Address) , C c ~ j~z.'. P''' r If
(J .7 /It-r - , It;' ..J 4/
TYPE OF WORK
New Construction
ODeck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
OAlteration
OUtility Connection
o Misc.
(Phone)
(Phone) {"J/ - Y t.J? - y~ () ()
(Phone) (,/;;J,- 367'- ?"/~
o Porch
ORe-Roofing
ORe-Siding
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 property to perfor neede inspections. 4 Ie-I'" '7
X IY5r L~_v,-
Contractor's License No. ' Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ 100.00
Mechanical Permit Fee $ (00. C>O
Sewer & Water Permit Fee $ 3 S' . 56
Gas Fireplace Permit Fee $
omes Your Building Permit When Approved
lj-/7-a l
Date
.--
Park Support Fee
SAC
$---
$
$
$
$
$
$
$
$ '13
I ~~ceiPt No ijf3lf 1-
#
#
Water Meter Si e51 ; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
#
TOTAL DUE
I Paid 1<0Z~' t~
Date - J-C - ~ ___
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
:~; signed by the ity Planner constitutes a temporary Certificate of Zoning compliance and allows construction to co~mmence. Beforewoccupancy, a Certificate of Occupancy must be
fj/WLJ2- ..c' /) /'~ ~~- ~ ~
::u Date ~ <'lx- Special Conditions, if any / L~ ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
.--'
,
~'-.e
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c:oth.D . 01''''
CITY OF PRIOR LAKE
SEWER AND WAT~R PERMIT
NO. 0' - L-l.l-/
r:OTE:
Sewe~ and water
contractors must
:be re<;istered
\o7it.h the City.
APPLICANT' \&mz:e\ ~~l
::::::~z, JS~~ l\\.~.
PHONE :d~-}:;-15~
DATE: s: ~ 0;;-
__"5'!:...L:G.
!?~?~"!IT ::!
1.
F!LL IN THE BL~KS
~O
2 .
J _
4.
5 .
:=:5~ ::..:na:t.ed length
of
seW'er line
6.
Cll:!,~n
out
(if
re9Jired) I
loca~ac
f'Ha;~ I,,,
at ~feet
f:=-Oln
s~=~c~ure.
~~~~===~~=~~====~=~~~=====~~=-~~~~~~=~==~~~~~~~==~~==--===~~~~;~-~
Th~s a?plication becomes yo~r pe~~t vhen approve~.
BY
DATE:
~==~=~~~-~~-=~~~~~==~~=~;~~~==~=~==~~-~~~~===~=~~~=~===~=~~=~~=~~=
F:::::S:
s
s
S
35.00
-50
35.50
SeW'er and vater line connection pe~mit.
Surcharge
TOTAL
* lee fo= either seve~ or ~ater indivicually is 520.00 plus
5 .50 $urc~arg'e.
* Se~er ana vater pe=mits issued for neV construction mus~ be
recordec on the cuildins permit ca=~ at the time of issuance
to i~sure that no du?licat~ $e~e= and ~ater pernits are
- ~ .
OAT" '::::-- :5 '& '()d/ AMOUN~ p_~,~[l bj bl6U/
R~C::I?'!' #- REC' 0 E8 g [;/
1 '=-',1' -::.!"=~-: --:--;~..... :':r, 5.~. "O-:i""'r 'L:.x=, '..!~:-~~r:;r~ ~:"?-: '''?1:. r~1~~ ~-i"--=.'2::() I ~~~( r~1:\ =-.1'"".....J.:.1'5'
1/\ d 9GO l g8l9gS 'ON/LS: 90 '1S/8S: 90 GO ,90 'gO (NOW)
WOHd
,", "
CITY OF PRIOR LAKE
tll 00'1
,l-a:/"Z.ttfH WeD lJ.: ZZ FAX 6124474245
" " '\ ' '
D.te,IU~' d
CITY OF PRIOR LAKE PLUMBING PERMIT
3-/2--02-
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if.', ~s i~c,;). ~ ~oSS t-.\\\J
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~ ~~ ~~'C'" I PERMIT NO:.J~ - ~~l J . ,
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. FEE SCHEDULE
:ll'1~\Illrl~l~ Cg/1'l~C;\.1 &. Muhj.fill11lly 10/.01 jvb l:;on with ill $39.:50 minimum
Resldenlial, ~c;..... One &. T..,o-FdITllJj ,*,~
RMidenlial, Addllicml a A][g8(IOftS 139.S0 " "
. ,
, " ,
I'
I
Estimlltcd Cost S
BUll~ng l'~rmit ~
.' , .
':' '
PLUMBING PERMlT FEE
STATE SUllCHAJlGE
TOT AI.. plJlMlT FEE
$
S
$
.50
f' .'.
I'~"'J ~ v "'~,.:1..) V"': ,"'r-, ,
-"vi: ""'f\j . .~ I
. '~"f"':\ 'i
--... j..\,;Jp:::.':.
Receipt ~4.,
~ I ,"
/, . ,'d~., u~ o,,~,
. rh~ A.'ppJi(".liOJl Be~omcs "Y ou r Build'JlI P,nau Wh.n A.ppro.~
, ~
Pal
ate
, 0 2002
"" ~, BIaIJcl)JII Oft'lc;.1
/," ',.' .,: ' ,
D.j~
:;4 b1161; UQtiLlJ for aJlln.pcdioD' (95%i ....7-~ii5ii, rh \9$1) c:..t',-.410l!l
\1\ d 16G\g919gS 'oN/OO:OI '18/00:0\ GO ,Gl 'SO(~n1)
W01B
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~e:n ~:~y I PERMIT NO. J {j i/
3. Yellow Applicant , r~ - I c:;::r-
ZONING (office use)
15292 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
ROSEVILLE
(City)
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/5/02
X NEW CONSTRUCTION o REPLACEMENT o 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:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
..---..
FIREPLACE MAKE AND MODEL HEATN GLO ST-TRC
APPLICANT PLEASE COMPLETE BELOW
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % 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 $
HEATING PERMIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
L:
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
FIRESIDE CORNER
#0139 P.DD1/DDl
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
e;~~;;"U1~R:us. eCL~\
LEGATJ DESCRlPTION (pffice use anly)
t ~~~ =IOIQI I PERMIT NO. d- Lld-J 1
ZONING (Dffice II~)
LOT . BLOCK
ADDITION
PIO
I::: w~~~^
~aJ::>
(Phone)
APPUCANT
(Name) AJ'..I..IED FIRESIDE DBA FIRESIDE CORNER
(phone) 651-633-2561
(Add.ress) 2700 N. FAlRVIEW AVENUE
(A,ddres:s)
BRENDA HUSTON
(COIlt3ct Person)
ROSEVTT,r.E MN'
(aM
651-633-256J.
(phone)
DATE ':\-l~-ad.-
5511 ~
(Zip Cod~)
APPLICANT SIGNATURE
~EW CONSTRUCTrON o REPLACEMENT o AI.. TERA TIONS
FURNACE MAKE AND MODEL FUEL ~~
FLUE SIZE RETIJRN OPENINGS INPUT OtJlP .
~f SYS1:BM HEATING OR POWP..R PLANT
o Air Plants o SteBm PLEASE NOTE;
DOrsvl1:y o Hot Wliter Air Conditioner Units
o M~chsnical o Radfation Cannot Ez:u:rQach into
DAir Conditioning o Sl'~cjBI Devices Required Side Yard
DVenl Systcn 1.k.w- o Other Devices Setbacks
FIREPLACE MAKE AND MODE!. -Lw C. t- ~LD~ - l,Qu~~~
InduslrisJ. Commercia.! & Mult.l-Fllm.ily
FEE SCHEDUJ..E
1% ofJolJ cost R.esldentlal. GlIs Fireplace
$39.,50 minimum
$99.50 Residentlill, AddjtlQfls & Alr.erations
$64'.50 Residential, AC Only
$39.50
ResidenT.i.llI. Hc~ting & A/C (New Com:t.ructlon)
Residential, HcarJng Only (New COnlrtruction)
$39.50
$39.50
Estima.ted Cost S
Buflding Pennit #
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAl... PERMIT FEE $
.50
24'0. !,\;;-,
J}jUI~ ""," hi i i d
~:o..&JtiNG Pf.;':.:c.r;
_ lIi,l;.iiOl.
Receipt NQ,
comu r),~ Only)
This AppUclltlon. Jkcomell 'rollr Building Permit When Approved Paid.
Dl'ildl.ng OfficiAl
Date
By
Patl:
241lDur notice for aIlIDllpecth1ft! (9!%) 447-9IiSl), fh: (~) 447-4245
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White - Building
Canary - Engineering
Pink - Planning
The Cf'nll"r of thf' I.akt Counlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (j) eNS/'JJdJ// /IJ #0 m eS
APPLICATION RECEIVED L..j - r -() )--/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5 d <;,;)- '- f~./-Pf' e-y-S P tls5 IV tAl
Accepted
Accepted With Corrections ~
Denied -A-/J/2 A/ I
Reviewed BY~kY~ Date: Lf ~
Comments: -,,---;:{'J
fZuuQ cJ~ ~tf?L~ ~~
(7 -~ -
"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' (","In or tht t.,,~ ('ountl')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OFAPPi:JCANT We-///::;/J7dll//IJ #cJ me:;;
APPLICATION RECEIVED '-/- r -() )..--/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l::)dy;;J-,-J~-prcrs PasS /VW
Accepted
x
.....
Accepted With Corrections
Denied
Reviewed By:
/Vi9 /3
Date: o'l-/t -0 z.
Comments: Driveway Mm,t H~ve roncrete Apron
See Reverse Side for Additional Information!
//let /" F, 'Ie
easures
liThe 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' Cf'nlrr of the t.kt Counlr)'
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:
/.f
~/ .,.{..--
r r
oj
,
/
./ /
.V 1,....
Accepted
~.
Accepted With Corrections
Denied j J
Reviewed By: q~~~.c::: ""'<... , Date:
Com nts:
t/llazh2-
"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."
L Ma.\'\I\ ~.\~
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS l5a. ~ ~ ....krrers R~
NATURE OF WORK JJRLt}
USE OF BUILDING S~
PERMIT NO. .j.:~ iZ:-1 DATE ISSUED L( - 17-0<
CONTRACTOR ___~____ ~ PHONE~~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING INSPE~R~~-.J ~ p\~~
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..--
INSULATION
ELECTRICAL
PLUMBING "\
HEATING (if required) if...
FIREPLACE '^-
GAS LINE AIR TEST JO-2.z,-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING ~D ko 8-(-07
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOV
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.
)
to -/
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850