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ADDRESS
3120 t?o~-rfZAIL
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
b - dU- LT;A
I PERMIT NO. 02- () 807
I. White File
2 Pink City
3. Yellow Applicant
LOT4-3 BLOCK I
LEGAL DESCRIPTION (office use only)
ADDITION 1lt~ 'rJi Lf)
Tit
ZONING (office use)
K
OWNER
(Name)
PID
(Address)
(Phone)
BUILDER
(Name) 1{ 1\ T 'Z..LAfF
(Contact Name) ~~
(Address)
/Jo"-U:;" '7, l N'C--,
,
(Phone)
(Phone)
CfS'L-1Bs-~1Eff
1'Sz.-1es- 4/7S
TYPE OF WORK
~ New Construction
OLower Level Finish
o Misc.
~Deck
Jii Fireplace
o Porch
ORe-Roofing
OAddition
OAlteration
Ooc
ORe-Siding
OUtility 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
mle 00 th, pm to p'no nttd<d m",,,,,"o... / /1 /01 ?
X 10/0/0707 Ct2L1 Ii ~
Contractor's License No. . Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
PROJECT COST/VALUE (excluding land) $
$
$
$
$
$
$
$
$
Water Meter Size 5/8' . I"'
Pressure Reducer
Sewer/Water Connection Fee #
Park Support Fee #
SAC #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE ... 3 "'02-
es Your Building Permit When Approved
I Paid ~ Z-Z&- 7/
Date 7-Q-o Z--
I ~;~ n.:r?e
,..;) )-o?
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 Ci Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
issued "k- ()
7 /2-/0'2- ~(! ~.L'"LQ ~'.x.. C-c.'VJJ.~MA
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
...---..
White - Building
Canary - Engineering
Pink - Planning
Thf' ('rnlr, or Ihr I.akf' Country
BUILDING PERMIT,APPLlCATION DEPARTMENT CHECKLIST
NAME OF APPLlCAN;7!trh bf-f
(,-- ,;}-QOC3-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity w?i9h is proposed at:
~ 1;2D ~~<<L-!-' Tt-
Accepted
Denied
Reviewed By: /J14B
x
Accepted With Corrections
Date: ~-:;~-O2....
Comments: See Reverse Side for Additional Informationl' .'
Driveway Mll~t 'f-T::l-'T/:~ ronrrp.tp. Apron
"Dr",'",,!, ~<9~1;ol.1 .s~tJ~/,j~, o/;'cc/uJ d~",., Of.rf /(!)'i-
I'
no f, (J;a -f.o +14/5 Iropul-y
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Fro~ion 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 cod,e orofc,l,ny 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(' ('("nler of the t.kt <-'oun.,.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPllCAN~ /up..;:
G,- ;;JJ-Oa--
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity W~h_ is proposed at:._
~ 1;20 ~IJCk+- / t-
Accepted
Accepted With Corrections K..
Denied
C/47~-
Date: ~.... ::<?-OL
Reviewed By:
~ents:
~Q a)( a1tackd. ~
"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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Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
1- /f}- ()2-
I. Green File I PERMIT NO
2. Yellow City. . ~ _ 0 1'1.() '7
3. Gold Applicant V L- r;;
ZONING (office use)
:SI16 (3c€C4<r T~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) f2-1) T z-cof,c
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT "-
(Name) f)(L15J U f-:-tt E "(c--
(Address) J~ OJ J()fLt.,j <.--JAy
(Address)
(Contact Person) ~<-\ .- ( LI
APPLICANT SIGNATURE
(Phone) (9S.).) ~~J -~ '1ob
L-1l/tGc/:J;1 L/: rS-tJl/LJ
(City) (Zip Code)
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
Size of water service J inches.
Location of any couplings from structure -=- feet.
Type of sewer pipe. 0 ABC [8pvc 0 Cast Iron
Estimated length of sewer line .!i];L feet.
Clean out (if required) located at - feet from structure.
Estimated Cost $
$35.50
$17.50
.,.0
C]DO ...
FEE SCHEDULE
Industrial, Com'l & Multi-family
Water connection only
1 % of job cost with a $39.50 minimum
$17.50
Residential sewer and water line connection
Sewer connection only
Building Permit #
o 2-r O!JP 7
~-
fA"O
B 1 (t-.
evO
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ ~
/
(Office Use Only)
7/1 r /uV
Date
- 0 z,,--
s Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
08-14-02 08:52 AM FROM FGTN PLG HTG
TO 6124474245
POI
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
_ (flcase type or print ud .i~ at belttQm)
ADDRESS
31 ~ ~ &'b C.d" \" r \
'81.... Fil. I PERMIT NO.
Z (".,!d Cil,
J, yol..... "pp1iCHI
'd - &> 0';1
ZONING (o~ u.~)
LEGAL DESCRIPTION (omer use only)
LOT
BLOCK
ADDITION
PIO
OWNER
(Name)
~(J.'t3 )q f f
30 Ho\
tfom eS
c \-.::..e.
e.
(PhOne~~~ -~::: 95~
.l~ k.€- v: U e _ _ __
(Address)
APPLICANT
(Name) t-o..r rY'\ " ~ +0""
(Address) fO C'
(Ad s)
(Contact Person) 5Ja.~.
APPLlCANTSIGNATURE ~~ L ~o~
(Phone) hSt - 4 lD 3 ~ 7 '8 ~ t.t
(Zip Code)
(Phone)
DATE
g- II-( -O'""L
Quantity Type of Fixture Quantity Type of Fixture
:A Bath Tub with or without shower 3 Roulh-ins
- Dishwasher Water Heater
i I
1 Floor Drain Water Softner
n_ Lavlltory (Bathroom Sink) I Stand Pipe (Washing Machine)
Lt
\ Laundry Tray (t or 2 compartment sink Sewage Ejector
, Shower Stall Backflow Assembly
I Sinks Bac:kfJow Assembly Test
Bar Sink Lawn Sprinkler
.J Water Closet (Toilet) Other
-.,.
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commer~illl & Mulli.family W. of job !:OSI wid! a $39.50 minimum
Residential, New One & Tlllo-Family S99.S0
Rcsidc:ntial, Additions &: Altr:nllion, S39.S0
(om<~ l"~ Only)
Estimllled COSI S j I J, Building Permit II
"'ef,. ~ .
P PERMtT F~it"1 $
STATESURC $
TOTAL PERMIT FEE
"
~"",
-",:r~,--,
4,.~R~p ..
.
Dundin. omcl.1
D.rr
Date A'I~ I 5 I!)[l:!
By
This Appll~.tion Becomes Your Buildinc Permit When Approved Paid
1.. hDur nDrll!1! r..r alllnspl!cllon. (951) "'-9850, r.. (952) "74U!l
CITY OF PRIOR LAKE.
HEATING/AIR CO:N~ITIONING/FIREPLACE PERMIT
I:
@oolli
Date Rec'd Ii
-~ - ~ -._.-".'_. -_ .._. .__-_-. ~ __ ~._--~=- -.. ....".1U.!'l. LAKE
.a F~~;.:ED
~: ~I,::, ~~~ I PERMIT NO~~.. C/'.P'1l
J, 't .II~ Ap~ll"'"t . (-;{ 0- v ( _
(p]e'~c e or :nr!!.Il:l ii@ :l;t b<:~m)
ADDRESS
ZONING (Qffir. "*e)
3/&0
~bcQ.r
7/8J)
A.J. /A.j ,
I LEG_~ DESCRIPTION (omCI! U~l: ~nl:r)
L_ LOT BLOCK A.DDITION
PID
I OWNER 4/ () (J
I (Name) ~Ajt,,?r-t:"
L0.ddxess) / ~L
APPllCANT -:---;::: -
(Name) ~ J~~D ~
~I-??~
(l'iwnc)
Qg5':" 7S'7s"
-tL~L.__~
(AddTCSS) dldJ.Q.._E.a.fr;~ A.t')e~
(.....~e!~)
(Pho::'le) 7"~ - ~ :;:)~
riL~ 51~1)
(Contac( Person)
~LICA..1\iT S!GNATuRE ~~
Zzir~J
(phone)
I
D.!'.TE.
h-a7-()~
APPLICANT PLEASE COMPLETE BELOW
I ~W CONSTRUCTION . 0 REF'L.....CEMENT 0 At TERA nONS
I ~~J.~_N'A CE MAKE AND MODEL YOJJ 1C . 7U y. / co c 9~l?' FUEL J..J/}. l-
I FLUE SIZE () Ir ~UC _ RETIJRN OPENINGS . 9 rN'PUT /~r-cQ OUTPUT _~ ~
/ TYf'E OF SYSTEM HEATING OR POWER PLANT
DWann Air Plllllts 0 Stearn PLEASR NOTE:
I QCjpviry 0 Hot Water .~ir Con.ditione. Units
~cchanjc:~ .' 0 Rndil1tlcb C2:(l!)o! Encroach into
~~ir C"l'lditicr-.ing 0 Sp:;iaj Devices ReCjui:r"d stele Ya.d
;J!!!fY C:1.t, System 0 'Other Dcvic:::s Sc::~ba<::1::s
! ;:;IR.EPLACEMAKEA1-Il)~ODEL Ileal ^.J GA5 ~L 7s/:)
"'---"
I
I
....J
FER SC:rr.E::OUL~
TnoI..lSlri::.l. COl"i1H1::rcilil & MIJlti-PamHy 1'10 of job CO~[ R.l:sidt:ntial, Gu FiTeplJ,ce
S39.50 minimum
R..sid~l'lti.=.i.. H~ac~hl:: &. ."jC (Ntlw COtlsu'1.lc!ionJ . S99,:'iO Redd"""i:is:, Ad::ihio;;s 6: AI~..r~.ti":J~
~.~~i-:l~ilti::d. 'r:=~::;ng Onfy ~}!r':"",,' C('!'~~Tr'I.'c1i~JJ:) ~64.5'J ~eS't-j:.~i~!i!.:: AC O!l]Y
S39.50
5:3;1,50
::;'9 5(1
Estim5td Cost S
Building ?e!'1'!'Jit #.
REA TING PERMIT FEB
STATE SURCHARGE
TOTAL PER-lIrUT F'EE
$
$
$
.50
rome:, (1.~ Drily)
Tl1i! Al(p!ic:atlon Becomes Your Building Permit Wnc:n Approved j Pli.id.
Dare
13uilding Oll1~iJd
O~tc
1.4 l\oUr notkc for :!III insp..eiibn3 (952) 447-9SS0, fu (952) ~7-424S
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HIV <I3110H.LNO;)
9LZ909tTS9 XVd CO:LO nH~ ZOOZ/tT/TT
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3J:;}O 5obcCI. 4-. --r;o.l (
NATURE OF WORK -fjPLJ
USE OF BUILDING 5FO
PERMIT NO. 6~-O~07 DATE ISSUED (;,-22-<:>""L
CONTRACTOR~o.+ --loa P ~~ PHONE Cf'~,)-18S-.Y/7S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill) "Q-~ 6 'V
PLACE NO CONCRETE UNTIL A OVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
".
r .
~~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Soddin )
BUILDING ~[O -/1 () 'j/j
ELECTRICAL
PLUMBING
HEATING
DO NOT
. /&.c??
t -I
11- /::.~.-o~
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, car.d ahall be placed near main entrance.
......~'Y'
FOR ALL INSPECTIONS (952) 447-9850