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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMITj-ll- J-
N/A
~. ~i~~e ~::y I PERMIT NO. O? .-;005/ I
3. Yellow Applicant . V 7 .
ZONING (office use)
tJtb-X~d1to ct
LEGAL DESCRIPTION (office use only)
LOT lCl BLOCK ~ ADDITION t-Oln-- \ A..... \-l \ \ S
2~
PID
OWNER
(Name)
l"\? Y""" ~
(Address)
\~ c)5
~~.es
D\ t.ZA DNV'<-
~~.le
(Phone) ~S~ 40~ 4400
200 E~~ t-l\N. 55122
BUILDER
(N ame)
(Contact Name)
(Address)
s~
~
~ ~~tv<.
tJ\ AZtJ-'\. ~ L-
(Phone)
(Phone)
(j,5~ 46t - 44 s3
TYPE OF WORK
OPorch
ORe-Roofing
ORe-Siding
New Construction
ODeck
o Misc.
OLower Level Finish
o Fireplace OAddition O~ation
PROJECT COST/V AWE (excluding land) $ "1f' 6'2 000
OUtility Connection
x
mis ed information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
ve- entioned prope and that all construction will conform to all existing state and local laws and will proceed in accordance with
e at the official can revoke this permit for just cause. Furthermore, I hereby agree that the city offici I or a/eSign. ee may
fo m spections. 1t 1 ~ <6 '7 17 /0 L
Contractor's License No. Date
I hereby certify that I have
authorized agent for the a
submitted pia
enter upon t
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
es Your Building Permit When Approved
I-?.~. ()2-
Date
Park Support Fee # $
SAC # $
Water Meter Siz '; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
~cr $
TOTAL DUE $ So 7/2.. z..
l~~:' ~'t~d;;! I ~';iPtNo~jJf'
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 si ed by the ity Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issue . J
7 1,:.sJ:) ( 1..') 2-
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
Thr ('('nlrr of 1ht' Lakt COUnlf)'
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
V J.v/)L<VYYl~ 1!trnU2--a..---
7-1/-Od.-.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
LtJ+fl/13L ~I :J-m.l~ tJ..t.1.& ~;.d
Accepted L
/ LId. Ljq
--- ~
-::;-m..L'/JLbd-C./)'L/
,j~' /' /J . //} 1 -
~(fl
Accepted With Corrections
Denied --r:1t-
Reviewed By\J'y
com?nts: ~ S;l
oet~, ~U~~ \.L
Date:
l~l(.; en
"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."
St'-t v{\J\5l:J f"~LL
The Ctnfrr of 1t1t I.lke ('ountr)'
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
l.{J j)/JL'(\/Y}1o~ 1Vb~
7-/I-Od-.-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
. application for construction activity which is proposed at:
b+ f1t iJL 3, 1-0UAt~ tJ~ ~ ;d
/ cfJ//9
'f-Ulv,i--r;;u11' ~
o-r
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Comments:
everse Side for Additional Information!
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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-,----~--.-...........,.."--_.-----~_._--_..__. -_._.~-------_._----- '.-- --_._-----~...__._. ._-_.......- - _. ._----
FILE No.885 10/04 '02 06:26
ID:PLYMOUTH PLUMBING
FAX:7635331121
PAGE 10/ 11
4J'R/~
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CITY OF PRIOR LAKE t ~~L '~~;Uoapl
PLUMBING PERMIT PPNo. ~- qtJj/
~~~:.:~.~~~~~w:e:;~~~~;
Legal Description: Lot Block Sub
Site Address:~ F~ ,~,.-n..i 11\ \ti ~ \:J -
Building Permit # PID #
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
r"r Lrnltt nf lhr lJlh COLII}I"
Quantity Type of Fixture Quantity Type of Fixture
\ Bath Tub with or without shower Rough-ins
I Dishwasher \ Water Heater
\ Floor Drain l Water Softner
11--- Lavatory (bathroom sink) l Stand Pipe (washing machine)
l Laundry Tray (1 or 2 compar1ment sink) Sewage Ejector
Shower Stall Backflow Assembly (APZ, Double Check, PVB)
\ Sinks Sackflow Assembly Test
Bar Sink Lawn Sprinkler
I rl- Water Closet (to ilet) l Other ~It L(rrl'lr fL,
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential. New One & TWD Family
Residential. Additions & Alterations
Slate Surcharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAL $
f'-.,.,
This permit is ,\:ranled upon the express condition that said
contrllctor, shall comply in all rl!spects with the ordinllnces
of the Stale Plumbing Code and the amendments thereof.
RECEIPT NO. DATE
A TrEST
Call for all inspeCtions 24 hours in advance. (J/--...
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612)~7-4245
An Equal Opportunity Employer
I -, 4. 2002
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PERMIT
~'7?~
Date Rec'd
~: ~~n ~!;y. I PERMIT NO. . r') -- q C( I
3. Yellow Applicant d J,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
(Phone) C(5b1 ~ q ~5 -7017,2,
~~e~RD.~. Horfon Cudem
APPLICANT All' t r-
(Name) , C\t1 . ~ .
(Address) 3(PSO !i...enne bec- lX-.
(Address)
f Z;
S+e. #/
(Phone) Ip51- .<./5~ - cf?775
;;a8al1 55/.22
(City) (Zip Code)
(Phone) ~5/-45~. ~77~
(Contact Person)
DATE
0NEW CONSTRUCTION DREPLACEMENT D AL TeRA TIONS
FURNACE MAKE AND MODEL ~a.n+ 38'3KA-vbVil)'o FUEL J\JoJlAr'1A I
FLUE SIZE 1f"cla.S'D B RETURN OPENINGS '-l- INPUT 10. beO OUTPUT 61.o..t>00
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
o Gravity o Hot Water Air Conditioner Units
o Mechanical . o Radiation Cannot Encroach into
~ Conditioning o Special Devices Required Side Yard
ent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL
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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
{/ ,50
r--
g;;;"' ~ '"
J?,1 '~i.~.~~":~'
" ~ .-.
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
FILE No, :303 02/14 '03 10: 54 I D : PLYflOUTH PLUf18 I NG
FA)<: 7635331121
PAGE 10/ 47
QREe. . fiLE:
TELLOW . ...""LIC....T
GOI.O . on'
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
$,W. No.;), - q5 (
Sewer and Water
contractors must
be registered
with the city.
APPLICAN~~r,( ,-'rIA PlcJ.i/VIl0 ~
(ADDRESS: . .. r o,'V\T:ai '^ ~ .. \ \.., (2'\.
SIGNA TU::C \Jlt~ ~f\l/'Yl\J.J.JQ Q D \
SITE ADDRES :
PHONE :t}/JJj)S?J:!J' L\ 057
DATE: J.. - \ W - 0 'J
BLDG. PERMIT #
PID#
FILL IN THE BLANKS
1. Estimated length of water service
I
A()
feet.
2. Size of water service
\ "
inch (es) .
J. Location of any couplings from structure
feet.
4. Type of sewer pipe. ASS PVC V Cast Iron
5. Estimated length of sewer line J.-( 0
feet.
6. Clean out (if required), located at
structure.
feet
from
======;:===============~================~==~=~~:~====~============
This application becomes your permit when approved.
BY
DATE;
------------------------------------------------------------------
------------------------------------------------------------------
fEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card Qt the time of issuance
to insure t 0 duplicate sewer and water ~~~~i are
issued. 0 [t @ [t..BUILDING PE.
DATE PAID 0 117 [} fij AMOUNT PAID
RECEIPT # By 8 1 8 20 3 I!J/ REC' D BY q
~~
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponuniry Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
l Se-4. ~ Ma,'\A. h-~
SITE ADDRESS jt(c>-i/'l 9mL~iJ<ft2~
NATURE OF WORK l\)ew L \ 4'" ~ {;:XM~~Wl(<3
USE OF BUILDING SFt)
PERMIT NO. ~ DATE ISSUED I ~'l~-cr:<
CONTRACTOR liP ~~ PHONE CP5l--'-IoG,-cjCf??
./
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
INSPECTOR
DATE
I ~ !7-7 t0~
I FOUNDATION (Prior to Backfill) I ~ I ~} Lt /e~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
c~U
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
GAS LINE AIR TEST
vw
((-)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding) Q,v2, U t ~ tc(j
BUILDING \ -fW\{? UY1 h I ~ 'I-t~ t'lt( /2--/ t-CJ1_
ELECTRICAL
PLUMBING ~ I~ - Jt- cfL
HEATING ~ Il-11-(/J-
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 INSPECTIONS (952) 447-9850