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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
<fYS"
/fc
~/
LEGAL DESCRIPTION (office use only)
LOT II BLOCK 1. ADDITION
f~f/ Nw
VVk.Cl-t h'\~
Date Rec' d
t--/~-O(J-
White File
Pink City
YeHow Applicant
I PERMIT NO.02-018r I
ZOf!{1 (office use)
/JOYT'I'-1'
2~
L.,.... vR
PID s- 3f6 . (j;J.7 - CJ
OWNER
(N ame)
(Address)
(Phone)
BUILDER
(Name) tJ t' /V.J/n ~.N,IV
(Contact Name) G tI r y
/
(Address)
TYPE OF WORK
o Misc.
OLower Level Finish
ew Construction
(Phone) t.5/- "Yv t. "IYo l.'
(Phone) t, I;;" - .3 if j - 71-1;)-
.2.-
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
OAlteration
OUtility Connection
PROJECTCOST/VALUE (excluding land) $ 15"0.00
s Your Building Permit When Approved
Cu-Vb -0'&
Date
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 he property to per rm need inspections.
j'Y5 J'
Contractor's License No.
t, ~ /,;2 . ~ .~
Date
x
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter
#
#
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
I Paid 1'3~/q
Date _....() V
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
iSSU~ t +~ ~-<--,r--r___ t /2<0 I Cql--_ ~ { (krc~t.~~ (' (' ,~\,(k ~
7'- ~g Director Date ~~ial condition~ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
The ('enle( nr Ihe L.kl' Countr)'
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:
\.".-.
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~~~
Comments:
Date:
b/J-o/D2-
,
,
"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
lhr ('rnlrr 01 Ihr I.okr ('ounlrl
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ;j ~L[S- ?i21dfJ
APPLICATION RECEIVED 0- !;) - ~
/JCkJA-- ~/ uJ
( ,
The Building, Engineering, and Planning Departments bave reviewed the building permit
~~ ._~ applicationfor construction activi~y which is pro~ord at: . ~.
jj)--P/!l4/)f';'~4/JU ~
~;
Accepted
Accepted With Corrections
Denied
Reviewed By: -A#) B
Date:
~--:<g-() ~
Comments: See Reverse Side for Additional Information!
Driveway Must Have Concrete Apron
me, /" F,./ (...
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."
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C!~y OF PRIOR LrlKE
S ZW'ER ~.1JD \JATER P~:u-!IT
NO. d/I~q
~TOTE :
Sewe~ and Water
contractors must
be registered
uith the city.
s :: ~~T ~_;:-T:?:: ~
PHONE :tJs,!jt:9- J 565
DA'!'~: 1. ~lO;:l
APPLICM'!':
ADDR~SS:
3":.~G_
:;,.~:: ? ~'! :!: ':' #
1.
2 .
F~LL IN TEE B~~K5
'30
3.
4 .
5.
f eel ~ JVl..
at ~feet
f:r-am
6.
Cle.an
cut
(if
rec;:uirec) ,
loca':.li!c
st.=~...!C:l:u:::"e -
~====~~~=---~~~===~==~=~==~~~~~=~~-~~~~~====-~~~==~-;=~--=-===~~==
T~~s ~~plicaticn becomes your pe~it ~hen aP9rovec.
13"::'
DAT=::
=~~~===~==~=~~~~~~~~~~~~~~~~~~~=~===~~~~:=~==~=~~~=~==~~~~==~=~~=~
FE=:S:
s
s
s
35.00
.50
35.50
SeVer and ~ater line connection p~~~it.
surcharge
TOT .~!.
* :ee fo~ either sewer or ~ater i~cividua~ly ~s $20.00 plus
~ .50 gu~c~arge_
* Se~e= anc ~ate= pe~its issued for new construction ~~st be
=e~o=ded on the buildin~ pe=mi~ ~a~= at the timQ of issuance
~::l i:1~u~e ~hat no dU~OlO~c:a~e se.....e~ and ~2tE(.11 ,,,pe~its are
lssue_. AUG - 6 z L, ~ ~'~'~'~:GPti~J,
D;'::-::: ?~.:O }'.!10UN'!' P.~.!D ___' ~
~Z~~!~~ ~ rtZC'O a, ~/
~.""-I--=....
~ .. ~ -:
?~~.., '.-,=
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f : I ....., .~oIl- ._~.-. ~ r I ";:' ~ .~( / :;", 1 -: ~
!-~- ..1...... .~~
9/G d L68l 981998 'oNl9v: 8! 18/l9: 8 I GO ,GO 'LO (~nl)
WOH.!!
lO/Z4/01 WED 11:2Z FAX 6124<<14245
CITY OF P~IOR LAKE
III DO 1
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I~~~~~~~ ~..st ~~
~~~
~ :;; ~~; I PERMIT NO. -") -f oq ]
) Vo'. """,,,.., . "" <1 ~ _
I lZDmNG~~ I
LEGAL :O~SCR1PT10N (ctfia: UIIl! anly)
Len r \ BLOCK ~ ADDITION
PJD
OWNER.
(Name)
<Phone) bS)-'iO'-'/ijOQ
~f\, ~J::Zz.
(Phone) gj-1s:2- / ~
'Mn & S5l :l ')
(City) CZip C~
(Phone) GS" --49. -/5&,S
DATE ~~ C?-.
(Acfdress)
(Address)
(Cc:mraa Person)
Type 0 tare
Ing Machme)
l!lIt
FEESCUDULE
Indu,rrillI. Commerc:llil '" Multi-fan-Illy 1 % of jab te,t .....Ith a S39.'O minimum ResidcrnillJ. Nc.... One Ii. T....o-FMr1ily n9.'O
Relidenlial, Aclditions.. AJruaucns S39.SD
Estimlltcd Cpst S
Builciina Pennit ~
PLUMBING PERMlT FEE
ST A IE SURCHAJ.GE
TOTAL PERMIT FEE
$
$
$
.50
A eU!. ~4'" ~.. '
. '....
/1
.,
Ili:eClipr No.
i ~
fomcc U'e Only)
ThiJ AppJic:.ti,m BeC01n&!J YOllr B~i1dinc Fermil When Apprond
PaId
.;r
aulldl", Olliei..
ate
AUG - 6 2002
Dan
:0 11~,"r 'gvti,,, for all i11llplCliOll" ~i ~7.~gs;,; tlolll. .95i) ca-,-4143
9/t d L68t 981998 'ON/9r: 8 I 'IS/t 9: 8 I GO ,GO 'LO (~nl)
wmp
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. [~~w ~!~jcant I PERMIT NO. J- - I 2'1
ZONING (office use)
3845 REGAL PASS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
9/16/02
xD 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
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEA TN GLO 6000TR-OAK X 2
APPLICANT PLEASE COMPLETE BELOW
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 & 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
p~,~,~
J ,~~::'" ~.~ .-"-.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
SEP I 9
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 38LIS- ~llO ~
NATU RE OF WORK N e.u.:>
USE OF BUILDING SFA-
PERMIT NO. 02-07@t; DATE ISSUED (g-{B-OZ-
CONTRACTOR \.J.e,^5\N\a.v\~ ~ ~ PHONE 1I12. - 3(,'7-1c"1'J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
l t'\a\V\ t, ~
INSPECTOR DATE
I FOOTING Jjl./ 17-) )-~,
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
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 ~CA) tb, l~'O
ELECTRICAL
PLUMBING - / y
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
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 shall be placed near main entrance.
FOR ALL INSPECTJONS (952) 447-9850