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10
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
6- :J.-()fo
File
City
Applicant
I PERMIT NO. fXp. 057/
White
Pink
Yellow
(Please type or print and sign at bottom)
ADDRESS
1~33~ 6EQEJS
c..,..
JtJ
LEGAL DESCRIPTION (office use only)
S- I '!ER..,.1s I.Jooe.S
LOT BLOCK ADDITION
ZONING (office use)
IC I~ j)
OWNER
(Name)
(Phone)
J~ISOJ
C. UARt[!. ~ d)€8LA
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address) J~I
tOil
...\06'
''is /fiiU\"""'E"e.5. -r~c::..
RuR.r..Jt\A.
(Phone)
(Phone)
q,""~ - ~"'~- 3~3rr-
~ S" J - 7-~ to - S(".;l s-cf
TYPE OF WORK ~ New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish ~ FirePlace(j)
OAddition OAlteration OUtility ConnectIOn r'
CODE: jilJI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S
u
PROJECT COST IV ALUE
(excluding land)
$ -:1.7~ t::JDo
-H J.47- ,OS-O
f-
I hereby certIly that I have furnished mt()rmatlOn 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-mentlOned ro 'ly and that all const. on will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
otlicial can revok IS erm cau Fu. hermore, I hereby agree that the c!ty official or a designee may enter upon the property to perform needed mspectlOns
x ~O~5"3"6~
Contractor's License No.
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE
#
#
#
#
~ /3n/ t".
Date
$
$
$
$
$
$
$
$
~
ThIS IS to certify that the request m the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
I when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must bc
iSS~~ foH~6 ~ o-d Ch-J.-,&
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
t'1NhitA - RI'i1~ln~
Canary - Engmeermg
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
10 /1 f) rO$
.
fr;- ~ -0&
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~ich is proposed at:
(~33lf {j~ ~
X
Accepted
Accepted With Corrections
Denied I
Reviewed By: VZ1 ~
Date: ul"~
I
Comments:
I. QO\Ji~
w (~J...
t~\\;\~..tI"l' ~1Il ~..er\"'t
Loo..el 4L~ ~I"__~()
w~ c)lMr
;~~,~
(
LO {,. 'to t1PH
"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
c:::1'ink - Pla~
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:
Accepted
Accepted With Corrections
;/
Denied
Reviewed By: i /
!"
/
/
/ ~......,
/
/
Date:
/'
Comooents:
i \..'
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:- \ .
; \,
,.
I
,
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~__ .L? n... . ~ .~
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?~/ ~ d-1- ~ ~"!~~
/1~'L~ ~~ ~
~ ~L~()#-~ ,
~
Air Cunditioner ,. ....ld Other MecllR.Riea1
Units Cannot Encroach into Required
SIde Yard Setbacb
"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."
.,.. .... -"-_.... I I~~,...._____
White - Building
~anary - Engineerli'fg)
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
-To /1 [) r ()5
!p ~ (,~. {)(c
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ~'7)1 /; /7Y
I, /)~) J.. .f'" 'I... -1 ,l..)!" ( /
i L"'~/ .../ . "___,.',"_.-_' ,..-s- .,.,'.1 ,__.............
Accepted
Denied
)(
.
Accepted With Corrections
Reviewed By:
IYW!>
Date:
;-1/-06
Comments: See Reverse Side for Additional Information!
See Attachments:.!) Grading Plan~ 2) Erosion Control MeQ:~l1res
"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."
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by: ~ ~ Date: "//41/0(.0
PID: Zoning:
~ (!:j-. iJ. t.J .
Building Permit #
Address: I ~ :33 i./
Legal: L ,5 , B /
Subdivision: ~
~
Existing Structure? YE~
Existing Nonconforming Structure? YES@)
I CONFORMS TO ZONING
ORDINANCE
~
NO
Standard
25'
10'1
25' if abutting a street
/
I
· Sidewall exceeding 50' requires additional side 2"
setback for eve l' over 50' in len th
· Rear Yard
· Patio Door: provide for minimum 10' deck or sign
statement indicatin no deck will be built in the future
· From 100 year flood elevation of wetland/NURP
ond
· From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
!Ja,u€
AI.I'I
75' or setback average of
adjacent structures, but no
less than 50'
;VA
Floor Area Ratio: NA I FAt
.30 Maximum
Yard Encroachments: NA I FAILS OMPLI
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line Easements.
AlC and other equipment cannot encroach on interior
side ards.
Standard
Pro osed
Tree Preservation: (NAV FAILS I COMPLIES Standard Proposed
. Total caliper inches
. Permit 25% Removal
. Caliper Inches Removed
. Caliper Inches Preserved
. Replacement %:1
L:\TEMPLA TE\BLDGLIST.DOC
Da te Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
'Ple<lse <It bottom)
ADDRESS
/b':?:?:r /3~cAlS CT=-
; ~i:~7~,~ ~ii~. I PERMIT NO~. t::'111
J Gold Applll:an,', ~ ~ :J
ZONING (ofiicp
Ll6~)
LEGAL DESCRIPTION (office use only)
Lor
BLOCK
ADDlI'ION
1'10
I OWNER
(Name)
/O/..J-
(Phone)
(Address)
(Address)
(City) (Zip Code)
APPLICANT
(Name) DSM EXCAVATING CO,
(Phone) 651-480-1355
(Address) 2916 ENTERPRISE AVE. , HASTINGS, MN, 55033
(Address) (City)
(bp Code)
(Contact Person)
JEFF CHILDERS
(Phone)
612-919-2729
APFLICANT SIGN ATURE
~
DATE
7-/Z-b
APPLICANT PLEASE COMPLETE BELOW
Size of water service -L... inches,
Location of any couplings from structure - feet.
Type of sewer pipe. D ABC )81 rvc D Cast Iron
Estimated length of sewer line ~ feeL
Clean out (if required) located at -. feet from structure,
I
J
Residential sewer and vvater line connection $35.50
Sewer connection only SI7.50
FEE SCHEDULE
Industrial, Com' I & Multi-family I % of job cost with a $39.50 minimum
Water connection only $17,50
Estimated Cost $
Building Permit # ______
PAID ~
.SfJUILDING ~iH
ERMli
SEWER AND WATER PERMIT FEE
SI A IE SURCHARGE
('OTAL PERMIT FEE
$
$
$
(Oftke Use Only)
..
This Applicatiun ~umes Yuur Building Permit 'Wllcn Appruvcd
Paid
Rel:eipt Nu,
Huildinl! Ofndal
Date
(1/1 b By
i:/ v"-
Date
24 hour notice fural! inspections (952) 447-9850, tax (952) 447-4245
J
_'~""'.,-".,_..~..,~~--_... "-~--'-~~-""~""~"""'---""'."------_,,_~~",,__'__"'.'~';""""".AA___",_ .....,...._
SEP-06-2006 12:22
CITY OF PRIOR LAKE
9524474245
P.02
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I, pj.k
1, Cro..
:!,'teU"...
P:~<M1 I PERMIT NO. , 'S I} (
ZONING (ot~!
use)
~u
LEGAL DESCRlmON (oHice Ilse only)
tOT BLOCK
ADDITION
pm
(Address)
(Phone) (P5) - 79~ - idS9
QWNI3R -r ,.J) ()
(Name) ----1..U~
APPLICA.N1'
(Name~;r ,,~ lX-rA. d-
(AddreSSJ?
'fro /o9.J4.. rk.}{I~ JJ #/cX)fJ
(J\dd:css) ;
(Contact Perso;\) y r\3 ~n eJ'l"\O rl
F" P (Phone) 1103. Sr"lI-dS'dS
CAannr'l~~(.JI:lyrn) f} 5S3/~
CI (Zip Code)
, (Phone) fl~~ - S"<.o-/~ H.Q
APPLICANT SIGNA TURn
FURNACE MAKE
fLUE SIZE
DA 1'E
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
MODEL FUEL
RETURN OPENINGS INPUT OUTPUT
TIn: OF SYSTEM HEATING OR POWER PLA.N'r
OWann Air Plan't~
OOravity
o Mechanical
OAir Condicioning
OVent. System
o Steam
o Hot Wa.tl:r
o Radiation
o Speci41 Devices
o Other Devices
PLEASE NOTE~
Air Conditioner UnitS
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEESCHED'ULE
1 % of job cost Residential, Gas Fireplace
$39,50 minimum
S9!UQ Residen'tiaL Additiol\S &. Alterations
$64,50 ~idential. AC Only
.1:39.50
Indllstrilll, Commercial &. MuHi-Fnmily
Resid~llti:ill, Heating &. Ale (New Cons'lroCtion)
Residen~illl, Heating Only (New Construction)
S39,SO
.1:39,50
Estimated Cost $ Building Permit #
HEA TING PERMrT PEE $
STATE SURCHARGE S
TOTAL PERMIT FEE $
(Office Use Only) (7"-, I,e>
This Appliclltion Becomt.9 Your Building Permit Wben Approvcd \'1 ~~ = Paid'
! i I
I '\
Buildint Ofl'i,;"' DAte L \
14 hOllr notice for all inspections (951) @?!~!"Ia~,_(9SB.!!'7 424~:::~~j
PAID WfTH
,so BUILDING PERMIT
-------::~:. ..
Receipt No,
By
,,",.,IT ':rl.\V\JV"" "'T TWr\TJIV
66ZL 9LS ~9L IV~ 99:11 90/90/60
TOTAL P.02
Sep,22, 2006 1:03PM
PI ymoutr Plumhl ng & Heat I ng
~h 0 4 6 2 P, 1
CIIY OF PRIOR LAKE
HEATING/AIR CONDITiONINGIFIREPLACE PERMIT
Date Rcc'd
(l'lea&e type err print 3J\d ~ at bottom)
I ADDRESS
, <.;. ~ ~\..\ &V-e-n ")
~v.x+
~ ~~ Ji.., I PERMIT NO. ft. 57 J
ZONING (office
o.<e)
LEGAL DESCRIPTION (office U5e only)
LOT BLOCK
ADDmON
PID
OWNER
(Name) 'To \ \ '<'>v-o+-~~
(pho.ne)
\40Cl Lor por,,-\.(... ~~ ~ vc. ~~ \ L ~
(Address)
r"nN 'S'S \1...\
1..\
APPLICANT
(Name) PI ~C'>).6....+-\-,. P\~..m b.Lr-,,~ of: ~ t.L """''''d
(phone) llo ~ - Lj~ \.s;> - to tOO
(Address)
11.l")\;)
4~r.;.. ~+- NE
(Address)
~~. rntL.h~
(Oty)
5"; ~Ilp
(Zip COdl')
(Contact Person) ~~
APPUCAJIT SIGNA TIJRE
(Phone)
"~~-491,,- ""I~-D
DATE
PI. PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 ALTERA nONS
FURNACEMAKEANDMODEL Le.Y\Y"D~ {;,4~v..r - ~L, ~ - 010 FUEL t\.\~,
FLUE SIZE RETIJRN OPENINGS INPUT OU1J>UT
TYPE OF SYSTEM REA TING OR POWER PLANT
Dwonn Air Plants 0 Steam
o Gravity 0 Hot Water
o Mechanical 0 Radiation
OAir Conditioning 0 Special Dc:vicc~
OVen!. Sy~icm 0 Other Devices
~ /2- '- Lr>to
't!-~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. CClmnlcrCW &. Multi-Family
FEE SCHEDULE
1 % of job con Residential, Gas Fireplace
$39,50 minimum
$99.50 Regidential, Additions & AlteratioQs
$64,50 Residential, AC Only
S39,50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New COll5lrUction)
$39,50
$39,50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT I<1!:E
Building Pennit #
$
$
$
.50
~Q '4\J\~~~\\
~~ ~G ~€.
e\)\\.P~
\Receipt No.
8 Z006
(O/Jice Use ODly)
This Application Becomes Your Building Permit When Approved Paid
BoUd!D2 omd;ll
Date
Dllte
24 hour Dotice for aU illSpectiODS (952) 447-9~f).lax.(9S2} 447-4245-
Property Address /633'1 4.?e&>:-; CT AJUJ "-6+ 0 tJlo,; / f]erc~ i.JrpJs
. - . , (:;0/1"'+ 59'/ .
Lot Area .2 7 3/0 sq. ft. )( 300iO .:.. .............. e, / 'i .3
......................"*........*"..*.............*.*."...........*****.....,,....................""."......"".......
CITY OFPRlORLAKE
Impervious Surface Calculations
(To be Submitted with Building PezmitApplication) By
For All Properties Located in the Shoreland District ;:;
The Maximum. Impervious Surface Coverage Pennitted is 30 Percent.
~~U~~}2~G;-W ..... .
HOUSE
LENGTH:
WIDTH
SQ. FEET
;;: 2, (7?
x
x
ATTAC1lB]) GARAGE
=
x = 'f?63
TOTAL PRINCIPAL ST.R.UCTU.RE........................ 3 (J'f Z.
"
DBTACHBD BUILDINGS
.(~.
x
x
- -
D1UV:8WAYIPA VED AREAS
(Drivc:way-pa~ or mn) .
. . (~arldng~)
TOTAL DETACHED BUILDINGS........................ i1j~'l(, ~h0u/1. ()1 :s"r (.' c-
PAnOSlPO.RCHEslDECKs
(Open Decb ~.. miD..~ bctweea
boards. with a~.aur&oo below,
are DOt ~ to be impernOUS)
TOT ~ P A \lED AREAs...........--................_.........
x = 7tJ 2-
X =
X : '13
7Lf.s
X ::: I 22-
x -
x =
'OTImR
TOTAL DECK.S.............................._........................ I '2 Z
, x '
, X
=;
TOTAL lMPERy!OUS SURFACE
l.lNDERlO~ ~ /
~dBy' ..'_'~~
Company ~er/~O~,67
TOTAL O'l1IEa.............................:........................
L 3; 9CJ y' J
1- /f 28~ ]
Date {:~2/d{,' '
Phone # J~2-137--5/~'6
PRIOR LAKE
INSPECTION RECORD
334 ere ENS ~T
NATURE OF WORK r: L. L.
USE OF BUILDING
PERMIT NO. at..- . 05[. DATE ISSUED IS". "4.
CONTRACTOR rat, f!RtJS PHO .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
~)
1
FOOTING ~ "()V
FOUNDATION (Prior to Backfill) J/U...,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION()
ELECTRICAL '/'f. ,,'
PLUMBING 4 t. -X~ v\J
HEATING (if required) ~. 6.6
FIREPLACE '.2--2'-- f)b
GAS LINE AIR TEST .flit ~ ;)-2- (!J~
COVER NO WORK UNTIL AB}>VE HAS BEEN SIGNED
lWH5 t Ho"SEe.J~1tI' r7"w ~ #t1 ~~] ]
FINALS
GRADING (Prior to Sodding)
.
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/~~*U
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.
//Vf;
I
OCCUpy UNTIL ABOVE HAS
NOTICE
l --)tj- [f,
L.,-/t?"rAo
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
.
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