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ZONING (office use) R~ (Phone) 99-';;33 ~e;25<;3 BUILDER (Name) 01-/7> X /3i// Aoh1l'S s..K ijJTo-/fI (Contact Name) (Address) (Phone) CjS::J cJ33 -d5r j (Phone) ~ I'h r' TYPE OF WORK New Construction OLower Level Finish o Misc. ODeck OPorch ORe-Roofing OAlteration o Fireplace OAddition PROJECT COST /V ALUE (excluding land) $ ~c;:J C; ORe-Siding OUtility Connection 'oc 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. m aware that the buildi go ial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon th operty to rform needed' pe ons~ x Permit Valuation Permit Fee Plan Check Fee State Surcharge Penalty Plumbing Permit Fee Mechanical Permit Fee / D.c:JO tOtJ. 00 35. ~y; tf ~ ".00 Sewer & Water Permit Fee Gas Fireplace Permit Fee t/- :<'7-(j?~ Date :;tt otCt'J 7 a; 7.5 7 Contractor's License No. Park Support Fee SAC # # Olf)~~~ " D.de $--c $ $ $ $ $ $ $ $ 1~1ft 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 lanner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued I Water Meter Size / ; 1"; Pressure Reducer Sewer/Water Connection Fee Water Tower Fee Builder's Deposit Other # # TOTAL DUE ,~~~ '1 ~:~;~~~ /~ I'LL /D-2- ~ .-. /tfJ;:z~,~ ;Z(}~/. .D~-t~~/\ . Date ~ , .special Conditions. if any .J 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 ~~::.::c------<, The ('..nler or Ih.. t.k.. Counlr)' White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ~~'xrJ~ 4-1 b-Oa APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 1'1487 fkuit~i6 U~ Accepted Accepted With Corrections ~ Denied Reviewed By: QJ L L. ~ / Comments: ~# Cf4 (ifkc&ecP /uutJ cnJs Date: t/-:l?-OZ "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 ('en fer of 1he Lab Counl"., White - Building Canary - Engineering Pink - Planning 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 -: /./ Accepted V-' Accepted With Corrections Denied ~ Reviewed BY:~ .-7 ~~~ Comm nts: Date: '-I/l?-stb2- (" " ~~~T=~ ~vhJ {~~~ I "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 Thf' (""nlfr of 'ht' I..ltt ("ounlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ~"' '11-A-:)c ji)~ APPLICATION RECEIVED" 4- I b-Oa The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /1!4Q7 WM7ft(f'i6. U ~ Accepted X Accepted With Corrections Denied " Reviewed By: --AI /f 15 Date: .,s-:"2 0-(92... Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading plan, ~) l::roSJon l.;ontrol 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." , CITY OF PRlOR LAKE PLU~IBING PERvIIT D:lte Rec'd (?~e:lse tvlJe or orint md Slim .n bottom) ADDRESS 1. Blue Fde :. wid C,:, J. Yellow .\.pollc:J.n[ ! PER'rIIT NOd - ~3 l /t/{j$1 I!o~galf- Zn"1"','C - '-.J. , ,- I . (,;rf:c, ~:e) i I Mf LEG:-\L DESCRlPTION (otfic: use only) c..()'T BLOCK ADO(TION pm I 'C';V:'iERee f1 i '''.,.............., : \. ',....~, )( . -e V- i 'I (~ J.-'..o(',." \ ~ ,I......~.. ~.~....;, (P~one) !'(;.;~:~.'-1Ai/;(;fI !JI)9 , (AJJ:es:;) crc;,O ()U/Ltif r fI(J~ (.-\ddress) (Pr.one) 9-1/;2 - r/ ()// --;2/02 / '- };)/I#/1 AI. ~ 5'5/35 b (Cry) (Zip Cede) (L-"r:"" .. :J~."'n) I -...J .i.......\",... .I.. '-A ....u~ I APPLICA~T SIG:'iA T1..:RE (?hcr:e) DATE / J' I/z- .., i QU:lntity I Type of Fixture I Quantity I Type of Fixture I .;J/ I Bath Tub with or without shower I y I Rough-ins I I I Dishwasher I I I W:lter Heater APPLICANT PLEASE COMPLETE BELOW ( Floor Dr:llll Lavatorl (Bathroom Sink) Laundry' Tr:lv (lor:: <.:ompartment SInK I \Vater Suhner I Stand PiD~ I\Vashing: Machine) I Sewage Ejector I . - I I Shower Stall I , Backtlow Assembly I I Sinks I I Backtlow Assembly Test I Bar Sink I I Lawn Sprinkler 3' I Water Closet (Toilet) I I Other FEE SCHEDliLE Industria!. Commercial & Multi-family 1 % of job cost with a $39.50 minimum R.:sidentia!, New One & Two-Family $99.50 Residential, Additions & Alterations .'539.50 Estimated Cost :s Building Penn it ;;. (Office t:se Only) This Application Becomes Your Building Permit When Approved PLUMBING PERMIT FEE $ STATESURCK~RGE $ TOTAL PERJ.'\UT FEE $ ,.. P.~'D .50 /CU" D"": lA".,.. '... '\1 1/11',"1-' #J ':~ h__ '1 --. ,-,.... ...." ';{".'l.r~.,... ".. ~'III Paid Receipt No. Building Official Date Date JUN :4 hour notice for all inspections (95:) 447-9850, fax (95:) 447~:45 -: '. CITY OF PRIOR LAKE HEATING/AIR CONDITIONINGIFIREPLACE PERMIT Date Rec:'d ~. ~ ~l~;Qn' I PERMIT NO. ~ - 5 g 3l;.~ ',.~:,,;-:.~/ I ZONING (oftla. lIIC). J' '''ilj,:. l.>~, ;\: :.:";0.,:.:. '"11 . ;_/',F.;' /0/'-1 z, !/Va. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) e.e /I f{ y (Address) );0 ~.'" ~ (Phone) APPLICANT (Name) #c?o.+. ''^''j (Address) J f' S-S-C :}- c: 0<') /, '^ 7 Covr1fy (Address) (Phone) 7~ 3 - 4~?"- 5b 77 r~ /ld' if (Contact Person) - J,! "'''''1 /1"i"lp/~ (.:. (oed (City) (Phone) ~ / L - DATE 5Y3(,9' (Zip Code) APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW EW CONSTRUCTION FURNACE MAKE AND MODEL f3 (" 'of ~ ", +- FLUE SIZE PVC RETURN OPENINGS TYPE OF SYSTEM (DWarm Air Plants OGravity o Mechanical . ~ir Conditioning ~ent. System o REPLACEMENT 0 AL TERA TIONS 35'"0 ,-+Ya:?O FUEL &a5 iff INPUT 60. otOO OUTPUT 7'1.060 REA TING OR POWER PLANT o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Industrial. Commercial ,. Multi-Family FEE SCHEDULE 1 % of job cost Residential. Gr.. Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only $39.50 $39.50 $39.50 Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) Estimated Cost S Building Permit # .......--,,~'O 'Nm--' r":.. ,. ,.1.,.. f (" . HEATING PERMIT FEE $ STATE SURCHARGE $ .50 TOTAL PERMIT FEE S (Office Vie Only) This Application Becomes Your Building Permit When Approved By . ~- .- Receipt No. " DlltF M I 5 200/ Bulldlnc Official Date 14 hour notice for all inspections (952) 447-98'50,r.x (952) 447-4245 10'd Z:8928z:t>29L OM~ ~NII008 ~ ~NI~~3H W~ 81:60 Z:0-~I-,nr , 'i~~'" ~;.t ::,,(.:1~j:' , ~~<'. : ;,:<it i" \~~, ::.J~. <~~~f ~." ~,::._~:'. ~,j~'t :; '/ 'f:~~:': . '.-', 'i~ : ," - ~).', 'i'<~. ': '. .;..t;. ii: ,;. .,',;;.t.- j .<, :;~: ;.',[1 : .'>>: VI' ;-..;:::.J'S ;""1"1":; . '\. -, ;( ...~: .;.~ ." ~\1i:" ~~;; :;;" " '::; '1~; >;~ ;~,:t,. ~'( '-, .-,;; \,; :.. ~ :~,i '~:,.;~ '>;~. .~ '::- ,-:;t~~'. . ',}>;. . -',;, , . ,-,-, . i~1 .. .~.'~ :'. :::,;~. :':':'L,~.' . ..:{~' t~'J~: ,~;~; .li#tl: .."'.......~. "~.~~:X:~~:.:: ~::~: .l>.~:~i!;.'.;, ">.." '.>> .. 07/14/2003 12:06 9524612166 DASEN CONTRACTI~3 FEE-13-2003 09:06 CITY OF PRIOR LAKE PAGE 03 5524474245 P.01/01 Date Rcc'd CITY OF PRIOR LAKE SEWER AND WATER PERlVfIT I, CI.... Flit I PERMIT _I 1. Yetkrw C'J,V . l, c.>l4 ^\'llll- ZONING (~rti,o, UJ<] I ~ LEGAL DESCRIPTION (olnce we only) LOT BLOCK ADDmON Pro (Address) "l (Addre<-..s (Contact Person) APPLICANT SIGNATURE APPLICANT PLEASE COl\1PLETE BELOW Size of water service inche~l. Location of any couplings from strUcture _ feet. Type of sewer pipe. 0 ABC 0 PYC 0 CllSt Iron Estimated length of sewer line _ feet Clean out (if required) located i1t feet from structure. Resldeutial sewer llld wllter line connection Sewer cOMection only FEE SCHEDULE $35.50 IndumiaI, Com'! &: Multi-family 1% of Job C~t with a .$39.50 minimum S 17.50 Water connection on!>, S 17.50 Estimated Cost $ Building Permit #. SEWER AND W A "fER PERlvllT FEE STATE SURCHARGE TOTAL PERMIT FEE S $ S .50 (omu (JJ( Only) Tbl, Appllution BecomC5 Your Bui1dl%lg l'ermit Wbell Approved elll]clln~ omc!al Datt I Pd 0:' ~ :c<!P< No 14 hour notltt Cor nl\Inspection3 (952) 447-911S0, fu (952) +47~14:; TOTAL P.01 PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS 14!J.1Z Cas f{ Cj J:. u.2J-< NATURE OF WORK iJ.ew USE OF BUILDING ~ED PERMIT NO. ~-oSJ3? DATE ISSUED </-'21-07 CONTRACTOR ( PHONE Cf5.:2 '~~3- 25"" V3 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 ABOVE ROUGH - INS 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 I FINALS GRADING (Prior to Sodding) /~ ," BUILDING <:"t" . c.. D U 3D. ELECTRICAL PLUMBING '0'2-- HEATING DO NOT OCCUpy UNTIL ABOVE HAS 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 sh-'3it be placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850