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!J1({I!IJ ?IL E
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT L.j ..... Iii-a d--.
LEGAL DESCRIPTION (office use only)
LOT . BLOCK I ADDITION
I OWNER
(Name)
(Address)
t:;JJ'
1. White File
2 Pink City
1 Yellow Applicant
;!~.
;'"
,J
PERMIT NO. dl- ,0 ell- 11
/.;J
(7f7
ZONING (office use)
~(
PID 2S: 3ot. c.')()Y-o
(Phone)
BUILDEIY ) ,
(Name) wtNJ /774kN l..Jo mfJf
Cd ~ I' ~ 3tJ IJ IV /'0/\/
/
(Address) 'i a- 5' /tf 2 p.. {) r, (,I ,p
(Contact Name)
TYPE OF WORK
.I,
New Construction
DDeck
DMisc,
OLower Level Finish
D Fireplace
PROJECT COST IV ALUE (excluding land) $
DAddition
DAlteration
(Phone)
(Phone)
t,J/ - 'YO t~ .y'Y'l.' Q
&/,Z,- Jt9 -7~/.2...
,
3-/;2
I'
.:z. (" ()
o Porch
ORe-Roofing
000
ORe-Siding
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 e property to perfor neede inspections,
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
~
$
$
$
$
$
$
$
$
.00
[t>O .00
3s N~-o
llo .. 01/
our Building Permit When Approved
Lf:<?-02
.
Date
/Y5Y
Contractor's License No,
Park Support Fee
SAC
Water Meter Siz 5/ ; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
#
#
Y-;t,,, 01...
Date
$
$
$
$
$
$ ,70::).. ()l)
$ , 5 O.6D
$
$
'l ~ ~ cr. (; 1
-,oJ d '-(1'-.
1~~1
I Paid
Date
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 sig ed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be
=00 'f!~,1!2- ~ ~~t~~fM~
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 11:12 FAX 6124474245
CITY OF PRIOR LAKB
Ial DO 1
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
;:;"'id ~:~ I PERMIT ]'40//_ t,J':A,G
) '1'.1- .pPI'nI'l . d Iv "-1
I I ZONlNG_~ I
I ~,;s~~;;u~~o.s~ ~ \.)
LEGAL DESCRlY!lON (olfice UIIl anJy)
LOT 4 BLOCK \ ADDITION ~
~
Pm
OWNER.
(NamB)
(Contact Person)
(Phone) bS)-4D' -WDO
~O n ~", $)'2'2-
(Phone) ,A~-f52-1 s;.
~ IVW\" SS-I;)~
(Ciry) (Zip Cod.c:J.-
(Phone) t.5'/~s;2.-156S
DATB 7 ~ o;t.
(A.ddress)
PLICANT PLEASE COMPLETE BELOW
ype af fixt1lre QlI.uthy l'ype D tan
or WIthout shower
est
FEE SCHEDULE
InduSlrial. CDTJ'Imetclill .. MlJlIi-filJ1\it)' 1% of job ~o,t ....Ith 3 5J9.~O millimum RcSiden\ial. Nw:w One" Two-Film ii, $99.50
llcIidet1lial. Additions" .&lleftllOft5 S39.S0
EstimstEd C"st S
Buil~ing Pennit#
l'"
PLUMBING PERMIT FEE
ST A IE SUltCHARGE
TOTAL PEKMlT FEE
s
S
5
.50
,." p.~ 'D
fiJI',!1 '-'." 1.<",,,-
t, U',O',~ '>'" o/!
,'I\le f>- ,;
.........
(oroCl! Un Only)
ThiJ Applical;Dn Becomes ~ollr BuiJdinl PUllllit Whe.. Appro...,}
'i'.
PaId
Ree&upr No.
."IICl1nc om~lll
Dill'
ate JUL 3
:4 h~l.l~ :aa'l'ia. !for ..., in...r:tla.. 19'!i:z~ ...1.~~. t'a. i9Sl\ ~-,"":l"3
S d H8l g8l ggS 'ON/6g: gO '1S/00: LD GO ,GO 'LD (~nl)
W01H
~
G.II'I!I!M .l"lt.2
Tr.U.O"" . "'''''UC..MT
(00,-0 - or"
C!~y OF PRIOR LAKE
SEWER AND WATER P!Rl'!IT
NO.0-. - Lf'd-C]-
NOTE:
Se~e~ and Water
contractors rnus~
be rec;istered
wi"t.h the city.
PHONE ,tJSt!t9-J~
DATE: -, ~'--
,
s -: ~'7"l ,:,T:?:: ~
?~?~-!!'I' #
APPLICANT:
ADDR~SS:
1.
2.
F!LL IN TE~ BL~~~S
30
J .
4.
5 .
~5~i~~~ed lengtn
of
se(..;er line
fae~ ~ 1Vl..
at ~feet
f:::om
6.
C!.een out
S~='"Jc:"'C.ure.
(if
requirec.) ,
locatec'
~==~~==~~========~==============~~~~=~~==:~~~=~~=;=~o=~====~~===~=
Th~s c?plicetion becomes ~o~r permit ~he~ a99rovec.
BY
CA.'!::::
~~~~-~~=~~~~===~====~=~~-~.~~~~=~~-~=~~======~==~=~~==~=~=~===~==
F-;--;;o'C'.
.....-- .
s
s
S
35.00
.50
35.50
Seuer and ~a~er line connection permit.
Surc:harge
TOTAL
*
res fo~ either sewer or yater i~civicually is
S .50 $urcnar:;e.
$20.00 plus
* S~~er anc vate= pe~its issued for nev constru~tion ~ust be
~eco~cec on the buildin~ pe~it ca~d a~ the ti~e of issuance
~o i~su~e that no cuolicate se~e= ar.d vete~ ~p~~ts are
is"'''e~_. -. ~'I',
- -"Ow JUL 3 20U; ..11J'h'~D:'
D~.'!:'== ?~.=D
A-l"!O UN'!' P _~!: D
cr
R:::C:::!?"!' ;
R~C ' D 3.~
, ... - ,-
Co __ - :.
- -
, ,-
~-';-..- ":"
,1,....
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· ,- p ~,.... .4..:
V d VL81 981 998 'ON/59: 90 '18/00: LO GO ,GO 'LO (3n1)
W01B
FIRESIDE CORNER #1922 P.003/006
CITY OF PRIOR LAKE Date Reetd
REA TING/AIR CONDITIONINGIFIREPLACE PERMIT
?QS.~
~;::.. Sk-t l PERMIT NO. d -'-/ ~9 I
I ZONING ,- -l j
LRGAL DESClUPTION (om~!! u. cmIy)
,
r..OT
BLOCK
ADDmON
PID
~.u-,~~"
I OWNER
. (Name)
(Address)
lb::
(phone)
APPUCANT
(Name) AJ.J..IEJ) FIRESIDE DBA FIRESIDE CO~ER
(Address) 2700 N. FAIRVJ:~ ~VENTJE
(Addresl)
(phone) 651-633-256.l
BRENDA HT1
(Contact Person)
ROSEVTL~ Mn ~~'11
(City) (Zip Code)
651-633-2561
APPLICANT SIGNATURE
DATE -6 a-
APPLICANT PLEASE MPLETE BELOW
NEW CONSTRUCTION 0 REPLACEMENT 0 ALT.EllA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE STZE RETIJRN OPEN'JNGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER. PLANT
o Warm Air PIMu 0 Steam
OGJ'Rvlty 0 Hot W/J~
o M~iCB1 0 Radlalio"
DAir Cond.ldoning 0 Special Devices
DVent. System 0 Other Oevlcl,'.ll
<.. ~() -Pi (/t-
PLEASE NOTE:
Afr Conditioner Units
Cannot Enl;J'calOh into
Requi.red Side Yard
Setbacla
FIREPLACE MAKE AND MODEr..
rndustrie.J. Commercial &. Multi-Fem.ily
FEE SCHEDULE
1% of Job COllt Rt:$Idcn~ial, Ou Fireplace
$39.50 minJmum
$99.50 Resldentinl, Additions & Alterations
$64.50 Residential. AC Only
$39,'0
Residential. HcstJng &. AlC (New Con!lD'Uc:tlon)
Residential, Hr=atlng Only (N~ ConS'trUction)
$39.50
53950
Bstlmmd COBt S .
Building Permit #
HEA TINO PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
s
.so
"........-.
4
...........-:~ ,,~~.~
......._..\;.v".
~~'.\r ,
R.ece~~9"
\~:t
y
.--'\
(om~,! rJ~ OIIly)
This Application Becames V Dur Bulldln, P~mjt WlJen Approved
ai.d.
""""1111 om':/Il/
DIJIl
Dare SEP
24 hour notice fo,. ."In.pection. (951) "'7-'8~&, fax ('52) 447-4245
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White - Building
Canary - Engineering
Pink - Planning
Tht' Cenlt'r or Ihe l..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:
.J' _.
I
,-,
,
--
Accepted l/
Accepted With Corrections
Denied
9~~~
-1
Date:
t/ /2 ~ ~o;z
,
Reviewed By:
"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 ("rnler of the Lakr ('ounlr)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT If) ~~ ~<J.,./
APPLICATION RECEIVED '-1- / /., --Od--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
15~79-9~ fJ~77u)
Accepted Accepted With Corrections X
Denied -AnD L
Reviewed By: (p{-V[I)".~ Date: {-'2 ? -O~
Co~ents:
lK~ ~(I tl1fztcW ~uvts.
"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."
The Cen.er or Ihe l..kt Coun1r)'
():2 .- O'ld 7
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /(J' {?fl.j-,}').ti/}( "'/'1_) .);,) ;11..-t~;,;).../
v ,
.I
APPLICATION RECEIVED 11- / t, -(J;;)-_
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/......)
'/:; "7('-'-,/ .' ~/... (j, .</'Y1/
!::J 0 1" ,i j2 \ ')i::/~' I C,/v"-'- / ( ,A,j
/> C../
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
!VI1B
Date:
'-1- ~LI-t):;
Comments: See Reverse Side for Additional Information!
1Yk/~ F:ll-
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
, 3) ErosionHC6i1tr61 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."
PRIOR LAKE
INSPECTION RECORD
j"Jf~ ~5~
\ t'J\ oJ V\. t-~'1 ~
DEPARTMENT OF
BU,ILDING AND INSPECTION
SITE ADDRESS \ 5~ 19
NATURE OF WORK --.N~~
USE OF BUILDING S,4-
PERMIT NO. 62- - 042-1 DATE ISSUED - ';;2 -07-
CONTRACTOR ~Wlo..,^V\ ~.s. PHONE &/2- - ~ {2-
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 ABOV
ROUGH - INS
D TE
l <-' or;..
~ ,,3
HAS BEEN SIGNED
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
AREPLACE ~
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING 0--- /1
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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