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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1-22"02.
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER ~
(Name) 'l-i / .pj
(Address)
~i~~e ~:~y I PJiliMIT NO. . (72- -0592-/
Yellow Applicant . ~ .
ZONING (office use)
~z
(Phone) 95d -OJ33-c::?S'/5
~~;~)ER C~~ /-IC~I7~S
(COmactName),t5~ ~;y70d
~.
(Address) 6CthJf'
TYPE OF WORK
New Construction
OLower Level Finish
(Phone)
(Phone) C;~ ';;35 -d5c/j
ODeck
OPorch
ORe-Roofing
ORe-Siding
o Misc.
o Fireplace OAddition OAlteration o Utility Connection
PROJECTCOST/VALUE (exdudingland) $ ~ 3C;: 7a:::;, c7C
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 op.~rty to perform e' d inspe .ons.
.;?
C/
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
6-;;;'-~
Date
-7.t~o7q757
Contractor's License No.
t?q?~ k~
Da{'{
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Siz 5/ ; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I ~:~ g &' ;J Jj:: 6=;J.
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 th City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued ' ~. /b-:. ^ 0
~--~ ,7)12l!.~ ~~ ~U-r.l~~~(-~~.1/VJ~1<
Planning Director Date ' Special Conditions, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please
ADDRESS
~. ~~:n ~il~ I PERMIT NO. ') 1: ~~.
3. Yellow Applicant (7"",L U (!
ZONING (office use)
14468 CASTLEGATE WAYNW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
CENTEX HOMES
(Phone)
(Address)
APPLICANT
(Name)_ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) _651-633-2561
ROSEVILLE
(City)
(Address)
2700 NORTHFAIRVIEW 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
OWarm 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-550TR-C
APPLICANT PLEASE COMPLETE BELOW
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
(Office Use Only)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
If?"
~\. ,. '.;A:'l'.'
/jUr~ II"'\,~'
\..':---__ .;~;id:Jl\':G
This Application Becomes Your Building Permit When Approved
Paid
. ,
Receipt No.
Building Official
Date
By
./
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
u
. ," CITY OF PRIOR LAKE
REA TING/Affi CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
{Please type or print and sign at bottom)
I ADDRESS
/tt1 ~ ~ C~ ~;-/~ 'c...f~
w0..7
~~ ~l~Kant I PERMITNO.~_ 5~1
] I ZONJNGr_~) j
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) (l,e /'l f< y
/-10 ",., ~ ~
_ (Phone)
<Address)
APPLICANT
(Name) .#~o:Jo+, '^'j
(Address) I 5' S-S"O
~ ~O~ /'~7
C L.)v,rl fy
(Address)
~~
V' if
(Phone)
7(, 3 - 4)... cr- "3(" 77
/>'7~pl., (~ro~
(City)
S"S'FlC.9'
(Zip Code)
(Contact Person)
-
I ~ ~t''1'
(Phone) Ca/ L - 51. 3 - 5'"5(,."7
DA TE,~ -I 9. 0 Z-
APPLICANT PLEASE COMPLETE JdELOW
APPLICANT SIGNA TIJRE
~EW CONSTRUCTION o REPLACEMENT o AL TERA nONS
FURNACE MAKE AND MODEL I3rt.r a ,,+ 3 $'"0 '-+ Yo 070 FUEL Ga.5
FLUE SIZE PVC RETURN OPENINGS i!f INPUT gO. DOO OUTPUT 7 '-I. OliO
lYPE OF SYSTEM HEATINGORPO~RPLANT
[UWann Air Plants o Steam PLEASE NOTE:
. OGravlty o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
taAir Conditioning o Special Devices Required Side Yard
~ent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
./
Industrial. Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas fireplace
S39.50 minimum
$99.50 Residential. Additions &: Alterations
$64.50 Residential, AC Only
$39.50
Residential. Heating &: Ale (New Construction)
Residential. Heating Only (New Construction)
S39.50
$39.50
Estimated Cost S
Building Permit #
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
S
$
S
.50
,... ,"'. .
It),,, ", ').,
';~'", ~ L::'~ :' ~': ~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildlnc Official
Date
..
Paid Receipt No.
Date I Q By
..
.....-
24 hour notice for all inspections (952) 441-9850, fax (952) 447-4145
to.d
2:89~82:17~9.L
OMi ~NII008 ~ ~Nli~3H W~ ~t:60 2:0-6t-Nnr
. .' . .~
Thf C'fnlfr or Ihf I.akf Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.
NAME OF APPLICANT
c~#~~
l}- ::J ?---oY
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/l/Lfi'o? c:!u~c:JL W~
Accepted
)(
Accepted With Corrections
Denied
Reviewed By: -'ffJ-B
Date: 6"-2&02-
Comments: See Reverse Side for Additionallnformationl
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
Th(" ("("nfer of Iht" Lah Countr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (!~-< fl<n?1d~
APPLICATION RECEIVED i-/ - (~;)'-6~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/Lf'fto S' <?~ tJccr
Accepted
Accepted With Corrections
Denied A- /f? tJ
Reviewed BY~f!V~~
cO?1en~
~ a Q1 a.JJacLJ
Date: 6-,2 - :2~'2--
~Q~
"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
Co~d,.. ~o.~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS I L\4lo~
NATURE OF WORK _tJ'e.vJ
USE OF BUILDING :::WO
PERMIT NO. ~-z-05fJ2- DATE ISSUED 5"-:2.-6"2-
CONTRACTOR C~\-eX PHONE CfSJ.. - ~33-':<S'''((5
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
DATE
/
,
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I ,
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL r--
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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 snail be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850