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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-22-02-
~. ~i~i~e ~:;y I PERMIT NO. 02 - 0' .J - L' I
J. Yellow Applicant . ~ _
{;/
~27/
ZONING (office use)
PUSD
LEGAL DESCRIPTION (office use only) L/~
LOT.? BLOCK I ADDITION M,,)5<7r\(j PID25-3"1- 003-0
/
OWNER
(Name) (Phone)
(Address)
BUILDER ,r-
(Name) r, th...>
(Contact Name) ~at' '
(Address) ~ /5t l~ h/,:Jnf/j
t/?-??r2~71
(Phone) 0 {2-t-2-t - ~~(l
~~ ~ ~/Z~
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TYPE OF WORK
ODeck
o Porch
ORe-Roofing
New Construction
OLower Level Finish
o Fireplace
OAddition
OAIteration
o Misc.
PROJECT COST /V ALUE (excluding land) $
ORe-Siding
OUtiIity 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 the to erform needed inspe ti ns.
$
$
$
$
$
$
$
$
It; - ~ --01-- $ 4-.
I ~;jf' 'lk/'7g
~~7Z-
Contractor's License No.
Park Support Fee
SAC
#
Pressure Reducer
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
$
$
$
$
$
$
$
$
TOTAL DUE
#
Water Meter
Siz
Sewer/Water Connection Fee
#
Water Tower Fee
Builder's Deposit
Other
#
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
I Paid 9tf74, & 1
Date
5".. ;;28 -02-
Date
5'"- 22' -0 Z.
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
iss~ .. A c;-- A n
~~~~- c.: /'-I/&;'L- ~~ fi:it\f~I!~X L""J.f{1~~'1~~_
Planning Director 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
White - Building
Canary - Engineering
Pink - Planning
Thf' C"rntrr or Ihr I..kr <-'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
. /'1(!, tf/! ~t-I fJ IV; S
.5- 2-?- 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
-~ application for construction activity which is proposed at:
/527/ N.q(/T/~ tIRC!!...&"
Accepted X
Accepted With Corrections
Denied
Reviewed By:
IJIJ9f!,
Date: &-o4-oc
Comments: See Reverse Side for Additional Informationl
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
-
The ("t>nf('r (If lhe I.akt' Count!")'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
//(J,W;U/11115
'-<; - 2-?- -- 0 2-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/527/
N 4(/// (!A-
Accepted
Accepted With Corrections
~/ eaE
~
Denied ~As
Reviewed By:
comQ;~ ~ f1ff~ pc<uL-
Date: 6 ~ :18 --6 L
"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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07/02/2002 09:43
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ALLIED EXCAVATING
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PAGE 01
0.. R.-c'.
CITY 0' PRlOIt LAKE
SEWER AND WATER PERMIT
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I APPLI{.ANT PLEASE COMPLETE BELOW
'. of *ater..-vice ~ iachcl,
, tlO" oraay 00\11I1'.11 hID tftc~ ~ ,....
,l'PO ohow.. pipe. 0 ~ ./SI we 0 e..."".
slimmed tenlth oflewct line u...
101ft out (if-.uired) lcccncd at feet from Rruct\IJe.
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line COIVIec:U:on 13~5,jO
! 117.S0
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rEE SCHEDULE
Indu.IrIa1, COIll'I * Multi.....lly I'" Gf Job CGII _lib . 135','0 rnlnhnum
W..CunIlCUan _I) "",50
8undin. PmIljt f.-.:.;..." . . .
SiWEk AND W A1E.R PDMlT PEE
ITA TE 9lJl.CHAIlOE
TOT A..L PIIIMlT FII
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11 : 00AM
MATTHEW DANIELS, INC.
423 3017 P.01
LJate Kec'd
CITY OF PRIOR LAKE PLUMBING PERl'VIIT
<1'''''' 'Yl!' ":nnt.." d~~'~~m'
[ ADDRESS, :
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~. ~~~ ~I~ I PERl"IIT NO..:- - / /j ]
J. Ve!!l\o_ ApptiQ.f"IC , _... l...,::;> t.c;::> _
~
I ZONING (oftke ~.c:)
I LEGAL DESCRIPTION (office use only)
LOT .e:. BLOCK I ADDITION
~rD
4Jn (}tlj~'a~
1~':~~t=4 ~:'~~;; (Phone) :~~fl.~ J
i (Ad<ltess) N8!10 _~;)) .___ '. ~ .--1, - Yon, 1/ ' '::Ii n .sS'.:?-.J _
AP~LICANT . ~
(Name) ~ 0'7.) iJ<l1.JJhd. '-...4Jt. (l . (Phone) ~. 4;J.!). J7..!.?(')
(Address) /..-:?'l.:ovJ (J...II Jdr ~ .111('10 J, 1.h; If/h J ~ J ri ~.I J 1 f' 'I....tJ;) .sso6~
(Address) (City) (Zip Code)
, (Contact Person) (Phone)" 66"1. ~ . ..3'1.30
I APPLICANT SIGNATURE DA TE
APPLICANT PLEASE COMPLETE BELO\V
Quan tity Type of Fixture i Quantity Type of Fixture
-:i Bath Tub with or without shower ! 4 Rough-ins
1 Dishwasher i J Water Heater
I
.2. Floor Drai,n ! I Ai.. Water Softner
S- Lavatory (Bathroom Sink) ! J Stand Pipe (Washing Machine)
.:J. Laundry Tray (1 or 2 compartment sink I I Sewage Ejector
I . Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
,Bar Sink I Ih Lawn Sprinkler
..3 Water Closet (Toilet) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with Ii S39.50 minimum
Residential. Ne..... One & Two-FlllT1iIy $99,50
Residential, Additions & Alterations $39.50
(om~~ Use Only)
Estimated Cost S Building Permit # ,91', ' r}v
PLUMBING PERMIT FEE $ fYJ. Sl) R J Ii
STATE SURCHARGE $ .50' . Ii- .
I TOTAL PERMIT FEE $ /I)/).()() ~ ..fP~ ' Cl I.
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
__ ~".iUildinl Omcial
,,~~
....
Dale
Oat/d '5'
14 hour notice for .n inspectlDIIS (9S1) 447-9850, fax (951) 4474145
,
TOTAL P.01
07/00/U1 MU~ ~.lJtl fAl. tiH4414~..~.
,
Lilt Ur ~hlUh LAAL
CITY OF PRIOR LAKE .
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date ~
1/
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ADDRESS '
7/ 0 ;eq ;~/....q ~)/d/ /
~ E:w E~ I PERMIT NO. d- - ( ~ IL' A
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I ZONING ,-"", I
LEGAL DESCR: ~ON (oftice use only)
LOT BLOC: :
ADDITION
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(Contact Person)
A~ U'1~
(Phone) 2'>':;)- 7Y6 --s;JoO
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DATE
PLI T PLEASE COMPLETE BELOW
I I EWCONSTltUCT1~N o REPLACEMENT OALTERATlONS
I FURNACE MAllE AND MODEL 13..-,'-/ XJ ~ -SS~ AVo(;.O /0(;) FUEL AI J<l r-
I FLUE SIZE ~I.v p.1/- 6 RETURN OPENINGS /:2. INPUT /000<:-0 OUTPUT 9~ CJPO
. TYPE OF SYST!)..f REA TING OR POWER PLANT
o Steam
~ Hot WaUl
Radiation
Special Devices
Other Devices
, 'mann Air Plants
Gravity
MDdlanical
Air Conditionini
I ent. Sy,tem
I FIREPLACE M;' KE AND MODEL
I
i
I
Industrial, Comml ciaJ & Multi-Family
PLEASE NOTE:
Air Conditioner Units
Cannot EDcroach into '
Required Side Yard
setbacks
, ,
I
Residential, HC&t:i i & Ale (New ConstNCtion)
KlIsidential. Hta11 g Only (New CQnstn!ctlon)
FEESCBEDULE
1 % of job cost Resl~entlal. Gas fireplace
$39.50 minimum
$99.50
$64.S0
Residential. Adc1idon. &. A1teratiolU
Residential. AC Only
$39,50
$39.50
$39.50
E!timated Cost $
Buildinl Permit #
HEAlT:NOPERNUTFEB
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.~
(omc' Ute Only)
.'
This AppUCll1 ion Becomes your Building Permit When A.pproval
Bulldi = O('flclal
Dale
~ad
Date
AUG 2 8 Iili J/
I_:~NO
z.f hour Dotil:' for 1111 il.p,ction. (952) 447-9S~O, fn (9~%) 447...:-45