HomeMy WebLinkAboutBuilding 02-0434
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
D~telec' d
4/Q/OZ-
I. White File I PERMIT NO 13
2 Pink City . d 2- 'OA-?
3. Yellow Applicant :r? _
LEGAL DESCRIPTION (office use only)
LOTvZkoCK
(; k A-ppzn
.:J:-.-c-L Ow 5
ADDITION
OWNER
(Name)
j(~.~ ~ .-.' rr ~ ~.~ & &/;l .5
R oBJ5..fLr.::r. fttJD S' AjON-r;
L) .... _. I (Phone) 9 ~;;. - 3 "2 2.. - ( c.f-O ~
'- E-v.€,,~
Lr V I'r'- LS tlI)g\I'
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
tuJ~ ~ L.r~tt f)v.:t...Lj) E-t-5
Jb t+tl ktJOB vA-vc- 8-
ZONING (office use)
sD
.;2s-z~s
/'Ii :2.
'-'
LU-{Phone)
(Phone)
9S2 -'-I7Y--S~62-
~-
tbl 'L- - '-t, 0 - 'f SC-fC
TYPE OF WORK
ODeck
ORe-Roofing
ORe-Siding
Ji(New Construction
DLower Level Finish
o Porch
o Fireplace
DAddition
o Alteration
o Utility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
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 to perform needed inspections. z- 0 2..4 22.. q4-
X L.. Contractor's Licens~ No. ~a2 ,/0 L.
$
$
$
$
$
$
$
$
4""7/1...-0 Z- $ 'J '118. z3
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Siz 5/8,1";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
#
TOTAL DUE
I Paid /j-fs-c)(j' 2"}
. Date _- (~- d--.
~ciPtNO 1J~
ecomes Your Building Permit When Approyed
!:LJ8 - O?
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 signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
su~ kl
t{/~'fJdL- ~(L. ~~&nditio~i}an~~~
Director
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
FILE No.893 OS/24 '02 AM 08:38 ID:D & D MECHANICAL
FAX:952 890 4650
PAGE 1
Please type or print and SIS!:lllt bottom) <.
ADDi6S760 1AJd(-,~~:" x~
Datl1' Ret'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. 01"" fll.
~. (k>I~ City
J. Y.1I0\ll Applicant
I PERMIT NO. d.- L{3:ITJ
I lZONlNO('m~_, I
LEGAL DESCRIPTION (ollice uloe only)
PID
..~
LOT '.tl BLOS.~_ ~ ADDlpON /..I....LdJ~~ {., tL .
-~~:~ J{/1~~~~._~.-. ", LLt!.. . (Phone) 95:1- ~7"1-5.t1:~~ I
(Address) ItJ5t:J ~i./.U ~'"-" gXt..Li.~I~ ~.. 55331 ..
. ., ,
APPLICANT
(Name)
(Address)
(ContaCt Person)
(Address)
,()~~
DaD Medlankal
9025 W Hwy 101
Suite B
Sav8ae, MN 55378
(Phone) ..1,s.:1. 3,/D-- 8:1 'ff t
(City)
(Zip Cod!:)
(Phone)
DATE S/d1 / ~~
APPLICANT SIGNATURE
I)LEASE COMPLETE BELOW
~pe of Flxh_re - Quantity Type o. iixture
Jr without shower Rough-ins
I Water Heater
- Water Softner
I'oom Sink) I Stand Pipe (Washing Machine)
'lor 2 compmtment sink Sewage Ejector -,
. Backflow Assembly
.0 Backflow Assembly Test
Lawn Sprinkler
'oiJet) ~ Other C"'. - _. /T~L
. ,
T:
Hath Tub with (
Dishwasher
Fioor Draill"
Lavatory (Bat"
Laundry Tray (
Shower Stall .
Sinks
Bar Sink
Water Closet ('~
FEE SCHEDULE
Industrial, Commercial & Multi-rllll'ily I'Yn o/"job ~OSI with II 0$39.50 minimum
lomer. liMe Only)
Rcsidentilll, New One & Two-Family $99.5(-
Resldelllllll. Addilions & Altel'llliuns $39.SC
Estimabcd Cost $ .1~ . 00
BuilcJing Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT J4~EE
$ qq.!5o
$ .50
$ /tJ D. DO.
(pJ:.-f3r/. ~/dr.)
, St.JJ.t..o .:~ ~r:- r
....... u~~ '.,
Receipt NO':.:.~
By C(}/ ~
Pai
This Application Becolncs Your Building Permit When Approved
IhJlI<JIlIll om"..,
Oatg.-. n
~ /" rf.Lf-
URic
24 hour notlte ((II' Qllln.pedlon. (952) 447-9850, rail (952) 447-4245
3: 06PM METRO A~ITY OF PRlOI{ LAKE
REA TING/AIR CONDITIONING/FIREPLACE PERMIT
NO. 140
P.l
Da(c Rec'd
~. ~~~ ~i~ fPEIW1T NO'1,. _ d ') rJ
l. V.II",. ^~~I;.,'nl L..: ,'}.. -l ~ -\
\~ \~a ~~ \\o~ ~
ZONING (offit<:use)
L&GAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITlON
PID
OWNER
(Njlmc)
l,~~'vJ \ C;..~\.L.., (':, ~\ ; \ ~v-"~
\ \..\ S 0 \( ~~'" \-\~\\ (.x
(Phone)
~ \ J..- i\ (\ Q~ ~ S L~
(A dress)
MN
APPLICANT '^ \ ~
(~ame) ,\<\~~f'"\.) ~'\"-' _'- t" <.,
(A~drcss) \ ~ "\ ~ lJ
N
(Phone) ~ S :)..~\\l- ~ \~_
(l "(\- \.L. \u.. \'\\\) .s 5., ~~-I ~
(Ciry) (Zip Code)
(Phone) 9 ~~. "\Y -,. ~ I ~
~- ~ ~, ~
DATE
. ~NEW CONSTRUCTION . 0 REPLACEMENT o ALTERATIOll
FU~NACE MAKE AND MODEL '-~....~ '-- ~~ Pr&a FUEL C1. t
FL~E SIZE ~\l L RETURN OPENINGS ~ INPUT ~a, ~~~ OUTPUT I S J (j:j~
TYPE OF SYSTEM HEATING OR POWER PLANT
, . ~arm Air Plants o Sleam (JLEASE NOTE:
o ravily o Hot Walcr ^ir Conditiollcr Units
o MechBllical o Radialion Cannot Encroach inlo
'8Air COlldilioning o Special Oevlt;cs RClluired Side Yard
~Vcnl. System o Other Devices Selhacks
I
FTrtEPLACE MAKE AND MODEL
~
Al'PLICANT PLEASE COMPLETE BELOW
Intlllstrial, Commcrcial &-. MlIlli-f'aml1y
RCl\ldential, Healing &. Ale (Ne.... COllslruction)
Rqjdcnlial, Heating Only (Ne~ Construl;lloll)
FEE SCHEDULE
1% orjob cost Residcntial. Gas l~ireJlIBce
$39.50 minilnulll
199.50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$J9,SO
.';.l9.50
SJ9.5Q
Esllrnaled Cust $
Building Pennil II
(Ol,ice Un Only)
This Application Becomes Your Building Permit When ^pproved
HEA TINO PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(" c_. ,
Paid
Receipt No.
~
>-;
.
Dulldlo(: omdllt
Date
Dille
24 hour notice rot all ill51,eetlons (952.) 447-9850, ru (!lS2) 447-4245
JUN-12-02 07:18 AM
P.01
1:'~,":1l/~:1.1.j2 Hi: Hl
':1E:249S"~1l
KI'[JBL.:JXH EUILDc.PS C
P/,:II:i!:. fJ.
CITY OF PRIOR LAKE
SEWER AND WATER PER.~)T
Date Rec'd
.Jr\~~~11W1.llt alII! Ii. It IlclrQrII)
I AOOUSS
) b 7 ~) 10 u.) I.. L..L. DUJ L, "rN f:..
l_.___._._ _... m_"_"'_.
1 '"".. "1. I PERM.'l' NO . ~ ~
I ,..".... CIt, . . 'd. - '-I .J
.tiJ:.III ",,"'.,.1... __ _
~... '-.0:---,
I ZON'INti 1M"" "'" .
L-
.)
! l.EGAL. TJl:.SCklPTJON (!:Il!1... lI)e tinlyl
~: OT;;I~:"'oCJ< '-I APDITJON
w..:r:..u... t)w L A-N E-
,. --
~~~~-~~~~R 0 ~ fNJ 0 ... ~..9~ Lri v e ~ S crJ(PhonCl ~.~) 3 ~ :l -J 't'e; 6 :
: r.~Lll.lrl:~~; l ~ 7 ~.3 ~(p,E;w~...__ftt--r1+ ~L.E. VJN,..~~ Y I-ftJ. S ~ /...2f
I....~____..____,'_____._.. (A<l4n~ (CI~~ .'_ (Zip Caul _--'
~>... ..:1~l?> - 04._?. ~
pm
I-APi;i.iCA~lT ... ..-..---, .--- 1
,(Nllme) .__~~ (\MJs'nt\l~~~pi;nt) ~~;l." 7~8 ~.ltL_ :
I ";/ I
'(^d.1rml ______,. ~ '3.)( ,~? tJ~P;fk6ul!!.. ~. s6~____ I
I (Ad.:In!'f) lei!)') (ZIJ'I rod"/ i
,'C"".."P',on; ./L(~~. ._c.~on.) ~s~) ?Ql-:~t:9 _:
I ,~,P.!"Llg)iTSIGNATUR~~ _......--c..___._:~_" I, { J(J.".;2 ~
~ ,,/ .
APPLICANT I'LF..4.SE COMPLETE BELOW
Size of waler service ~ inches.
Location of any coupling~ from IttuctUl"e ~ feet,
Type of sewel' pipe, 0 ABC Ii! PVC 0 Cast Iran
: .l::.stimated lenath of sewer line ~o teel.
L-....,...~..~.._____~~ut (if required) localed at ~ feet from structwe.
---..--
I
I
I
-_.-.-J
FEE SCHEDllLI
R~.ickllllaJ M:llrcr IlftO witter lin, c:oMac:ti"n SH.JO In4\1ltrial. Com'llI: Multi.tamil)" :-/i gr~Db COil \IIirh I n!il,~(J 1'I\;f1I1'1'1i.IlTl
lle:we' ccrlnection only $17'0 W&'tI!r cann.tdoft anI)' 517~O
~stjmlltcd Cnst 5
Build in, F>crmit " _...
SEWBR AND ~'A TEIt PERMIT fEE
STATE SURCHAROE
TOTAL PI:RMIT FEE
s
$
S
50
r>: t", ,
fEUr':' .
i.. ;;~D,;
", I
IOlYllt Ltc Or.lt}
!l1I'1 ApPIi:ti;1\ IUl)Q1C1 Ylllar 8~lIdlnK ...;nllt Wbn APPl'o".d
I
, <f j'
I Plj~ - R.o~ejp~-'--'---' --'j
.. .... ! ~ 11;I, I ~ 2ogl"' ~=~
~4 hour nott,. fur .1I11t.p.~lII1D' 19t114.,.!II'E ('ill) "'7~~
1- ...
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At~,N"-O
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II"P!IB^ aq lOU lIB4S UO!p!pspnf a4l!O sa:>uBU!PJO
Ja4l0 JO apo:> S!4l !O SUO!s!^oJd a4l la:>uB:> JO alBlo!^ Ol Al!Jo4lnB a^!6 ol 6u!wnsaJd
Sl!WJed 'UO!PlPspnf e4l !O a:>uBulPJO Ja4l0 AUB !O JO apo:> S!4l !O SUO!s!^oJd a4l !O AUB
!O UOllBIO!^ f\UB '!O IB^OJddB UB JO 'JOl llWJed B eq Ol penJlSUO:> eq lOU IIB4s SUO!lBlndwo:>
~~~OJdde JO I!WJad e 10 6u!IUeJ6 '0 aouenss! a 4_1.,
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l!WJed 6ulPI!nq e4l peMe!^eJ e^B4 Sluewl-lBdeo 6U!UUBld pUB '6upeeu!6u3 '6u!PI!ns e4.L
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.)
White - Building
Canary - Engineering
Pink - Planning
The Ct>nler of the take Countl")'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT KNob I a "'- ch B )J Y'S
APPLICATION RECEIVED L/- (0- {}d-...
-/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
( b 7 Id) Ii; /1/tJ IU 1.-)/
Accepted
Accepted With Corrections X
Denied
Reviewed By: ()J....Q ~ Date: {- /8 .OL
Comments:
~9.. af& a~~ ~ ~
"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."
r'J
1_,,;,
C)Z-oL/3Y
White - Building
Canary - Engineering
Pink - Planning
The C"rn1ef of Ihe take Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /::/V(J /:; /,<t I; ( /
;\
1/ l_/y 5
, ~ Icy
APPLICATION RECEIVED
L/- I D- t)~A.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J I /'~/i(Zz/) // ///!<jj() l~'/i/'
.~,p ,-"
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
AIFJ{j
Date: Lf-,)6-OL
"-...:'
See Reverse Side for Additionallnformationl
Comments:
~;.'"
~ee 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."
.' .. . .' _w..... .'-
CITY OF PRIOR LAKE
Impervious Surface Calculations" .., ..
.. .c-r:o. be ~ubmi~ w.ith B~ilding Permit Appliction)'. .. . .
F or All PropeIties Located in the Shoreiand District (SD).
The Maximum Imp'e'n,i~us Surf~ce CoverageP~rrIDtted. hi 30 Percent~
Property Address 1~7bO 'w~l/ow LaA/le.. L-o[CS, (5/,,(1- 4
Lot A.rea /5 B42- Sq. Feet x. 30% -' ........~.~... 4 753 ~9' Ft.
. ,
*****.****************************************.*****~.******************
LENGTH
WIDTH . SQ. FEET
x =
HOUSE
I
." .
x
x
AITACHED GAR.A.GE
=
TOTAL PRINCIPLE STRUCTURE.....-.....-.--...
2018 ~.T;
DETACHED BLDGS
(GaragelShed)
X:-
X
TOTAL DETACHED BUILDINGS.........._..._......
. .
"{
x.
x
=
DFlVEW A Y IPA VED AREAS
(Driveway-paved or not) ,
(Sidewalk l'arking Are3S)'
=
=
...
TOTAL P A YED AREAS.........................................
'2.3 43 .s. F.
1
x.
x
=
P ATIOS/PORCHES/DECKS
(Opel Dct:Xs ',4" min. .opening' between
boarrls, willi a pervious surface below,
are not considered 'to be. i~pcr:'i~us~.
=
x
-'
. . ..
TOTAL D EC'KS......_.....~_._..._......_................_..
. '. ..
OTHER
x
=
x
=
TOTAL OTHER......-.--..-.......-..-......--..........
. .
TOTAL Il\tIPERVIOUS SURFACE
~OVER .
Prepared By - ~ l..f)fIMk-
Company I/lA)L Z;~M~ 6-
.4f:l1 .\
. ~ ~3Z I.
. 1- ~'3o -oz"--(t1 D-- .
Date .6 z'Z. {)'2-- .
Phone #= 43 L - :$ 000
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
,J SITE ADDRESS l~ 7 ~ 0 \.t 1tU~ { AJ..... Cl_
~ NATURE OF WORK ..,leLD
~ USE OF BUILDING SFD
~ PERMIT NO. 0 Z- --() 4-54-- DATE ISSUED q- fa ~'L--
( .~ CONTRACTOR :}~~ \<V\o~\,Quch 'Eu\~c; PHONE (,l2 -l.{Yo..C(rSt!tJ
J NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
f . THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
J\'. I FOOTING I ~< \ 5/{0(0 2.-
~ i I FOUNDATION (Prior to Backfill) I 75; I 5/ n/ 0 -..-
~~ PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
~
~
] GAS LINE AIR TEST
rJ\ \
~ GRADING (Prior to Sodding)
~ - BUILDING r, ~~.{). tH ff) ~f ~7/
ELECTRICAL
~ PLUMBING
6 HEATING
DO NOT OCCUpy UNTIL ABOVE
NOTICE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
If
"73/(;1:--
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 ba placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850