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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ri Ae St?
LEGAL DESCRIPTION (office use only)
4-1'-Od--
1_ White File
2 Pink City
3. Yellow Applicant
1 PERMIT NO.Ol ,.04-371
ZONING (office use)
;L-
OWNER
(Name)
~
PID075~ -3
(Phone)
(Address)
TYPE OF WORK
")Zf New Construction
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
ODeck
o Misc.
(Phone) qi;2-4 p,t;.... TBD 0
(Phone) QS2- Z-Z-(p- </-73l.
o Porch
ORe-Roofing
o Alteration
OUtility Connection
ORe-Siding
OAddition
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-me ned 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
ente on the property to ed inspections.
x
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
es Your Building Permit When Approved
(Z.7-oL
Date
O(()Ol~s7
Contractor's License No.
'I)~/I) 2-
Date
Park Support Fee
SAC
#
Water Meter
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE '4-.
[Paid ~-6J7'/NReceiPtN~~7b?<
[1>ate _ _~L - 0 J By ge
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
:,~, ",., "' <h, C" P ,'cr m~"'''cr' <Om",,,, C~fi~~;;~ ,,' 'u~'-::s=m~ ~~
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
Apr .29. 2002 1 :04PM
GENZ RVAN PLUMBING AND HEATING
No.2143 p. 22127
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
. i
. ,
1. Bh,liC MI-
2. Gold City
l y dlQ'" APpUClinl
1~;r1~7;:/z;J/ltY~ Cede JE
I PERMIT N002~ IJ3'1 I
I
ZONING (o:tncouse)
LEGAL DESCRIl'TION (otfice use only)
LOT
BLOCK
ADDITION
PID
OWNER
~mn~ DR Horton Custom Homes
'.
(phone)
962 - q 'it 5 ~ 7'6tJ{J
5C64 LJ
(Address)
2ob(cO lLeVlB e.l DSe~ CT
APPLIC.ANT
(Name) G"''''''''-RY:Ul Pl"l1il;";T>g F. l-l''''''f''i];lg
(phone) n ~ 1 1. iq 1 1 1.1.
(Address) 14745 So Robert Trail
(Address)
Rosemount
(City)
MN
55068
(Zip Code)
(Contact Person) 'Mary Olson
(phone)
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quanuty Type of Fixture
J Bath Tub with .or ~ith.out shower Rough-ins
, Dishwasher , , Water Heater ..
, Floor Drain - A..\ \ Water Softner
1 Lavatory (Bathroam Sink) I Stand Pipe (Washing Machine)
Laundry Tray (1 .of 2 compartment sink Sewage Ejector
Shower St3)l Backflow Assembly --
J Sinks Backilow Assembly Test
Bar Sink Lawn Sprinkler
L Water Closet (Toilet) Other
ASE COlVlPLETE BELOW
FEE SCHEDULE
Industnal, Commercial & MultJAamily 1 % of job cost with a $39.50 minimum
Residential, New One & Two-FIIIIlIly $99.50
Residential, Additions & Alterations $3950
Estimated Cost $
Building Permit #
PLUMBING PERlvllT FEE $
STATE SURCHARGE .$
. TOTAL PERMIT FEE $
..50
; .
r
(Omce USe Only)
This Appli(:atio:n Becomes Your Building permit When Apprond Paid
Date
()
By . 0
V
.BllHdillg Official
Date
. Z4 hOLlr notice for ~dl inspE:ctions (952) 441-9850, fax (952) 447-4245
Apr .29, 2002 1 :04PM
GENZ RVAN PLUMBING AND HEATING
No,2143 P,2:1 7
Date Rec'd
CITY ,OF PRIOR LAKE
SEWER AND WATER PERMIT
I
- \
i ~~=.. ~1~._ I PERMIT NO. .'.:1 ~ [.j.. (:2 e)1
. 3. GoLl Apph"""t . ,J
~fg~"'-w~ 0 ede., SE-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~
PID
OWNER
~ame) DR Hor~on Cu~~nw ~QW~~
(phone) _ Cf52 -q '6.5- f 800
(Address)
?o&oQ ~i3~\!X:::e. Or Sit' ~ I m
(Address)
L1:L~~IUe...
(City)
5~l.J
(Zip Cod.,)
APPLICANT
(N~~ Genz-Ry~n Plumbing & Heating
(phone) 651-423-1144
"UCANT SIGNATURE
Rosemo~nt. MN 55068
(City) (Zip Calk)
(phone)
DATE
(Address) 14745 Sb Robert Trail
(Address)
(Contact Person) Mar
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean: out (if required) located at feet from structure.
Res~dcntial sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35..50 Industrial, Com'l & Multi-family
$17.50 Water connection only
1 % of job cost with a $39.50 minimum
$17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE
STATE SURCHA..RGE
TOTAL PERMIT FEE
$
$
$
.50
1
I
. .
Tbis Application Becomes Your Building Permit When Approved
Paid
~--
(Office USl: Ollly)
Date
Buildhlg Offlcial
Dllte
---
24 hour notice fQr all Inspections (952) &47~9S50, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1\' I 5 '/,
~. ~r::n ~;~ I PERMIT NO. 7..._1 /3r1.
3. Yellow Applicant , ~ Y.. ~
ZONING (office use)
1135
W;' 1cJJ.rn. t ss_CiJ:
LEGAL DESCRIPTION (office use only)
:1 ADDITION
PID
(Address)
(Phone) C(5a - q ~5 -70<7,2.
50 L.{
(Address) 3~5{)
~NEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL ~4n+ 3~A--VmwnO FUEL l\.JQ.tlAl'1A \
FLUE SIZE tf-llcla..s~ B RETURN OPENINGS ~ INPUT ,0. boo OUTPUT SUh tJO 0
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants D Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
D Mechanical D Radiation Cannot Encroach into
~ Conditioning D Special Devices Required Side Yard
ent. System DOther Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Pennit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
..~!J'~'D.
(Office llse Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
I 5
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1_ Pink
2_ Green
3. Yellow
~J~icant I PERMIT NOOZ- 0 f 3 ;1
ZONING (office use)
17354 WILDERNESS TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
DR HORTON
(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
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION D REPLACEMENT D 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:
o 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 HEA TN GLO SL-750TR-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Office Use Only)
Building Official
Date
3 200L'.
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
Thf' Cenltr or the Like Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
l) R cMnL~
</- IG --6~
APPLICATION RECEIVED
Accepted
Accepted With Corrections
Denied -r-=7 (] 4
Reviewed By: ~~O /,GjM)'b-
Comments:
Date:
r/- :2 7 -at-
"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."
Tht Ctnltr of 1ht tab eOunll")'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,D~' c/ju;-~
4- /G -6~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7~~SV Ifl~~ ~
Accepted X Accepted With Corrections
Denied
Reviewed By: "/J44 i3
Comments: SC<:' m~/'1 F;'Ir
Date: '-/- .2'1-0 2... ,.
"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."
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----
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS_I ?~~5" Wild.erlAes~ (l,N-.
NATURE OF WORK -.1\€'UJ
USE OF BUILDING SF~
PERMIT NO. OZ-0439 DATE ISSUED '-I-']?-O~
CONTRACTOR \.). ~ \~'""~ PHONE C,S;1.- ~& -<fIn
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING ~ far r;/J-1(, v f/J:r 15 h/o(1-
I .
FOUNDATION (Prior to Backfill) ~ ~~f., $e;-!o 2-
PLACE NO CONCRETE UNTIL A OVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING tf, 6r ( ,Si~ l'f1-
HEATING (if required)/~ .TJ.A. I e-z-
FIREPLACE (. 41,..-
GAS LINE AIR TEST 7 "d ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I ~1-uC'(Q LJk tr 7/~/r;-z-- 4kcU I 0!?7~:> fi~
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
12-- 1fA,,-(fL
I J.....-- ~
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
. 8-2'? -0-;;>
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