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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-30-02-
White File
Pink City
Y cllow Applicant
PERMIT NO. 02 -I {; q 7_
LEGAL DESCRIPTION (office use only)
LOT (.5 BLOCK 3 ADDITION
J--Ofo'1- 0
OWNER
(N ame)
1\ ~.;\\ j'j(l1-1 Ve U D me':)..j femcd: Ii OJ,J nc
. tLy'L \
ZONING (office use)
'Rf
(Phone)
( (p J2) 7()1 .t.PSLJ ()
(Address)
~~~)ER DISZl.n<2f1 Vi' =e.3
(Contact Name) - _- ~~ WO 1 . .~/1
(Address)
?I<
(Phone) 7(?F- ~ -ff/~/
.
(Phone) 41IL - /61/- 6Jf'o
TYPE OF WORK
New Construction
OLower Level Finish
o Misc.
ODeck
OPorch
ORe. Roofing
o Fireplace
DAddition
DAlteration
PROJECT COST IV ALUE (excluding land) $
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 wit\!
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 p.::;rty to pe~eeded in~~ections.
X ~() 'd,')./4 7 7 ._1"/ 2t1J'bL
.~ Contractor's License No. I Date
./
/
Permit Valuation
Signature
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
o
Park Support Fee
SAC
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
#
#
Water Meter
Size 5/8' ; I'
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
:.3
ove application and accompanying dQcuments is in accordance with the City Zoning Ordinance and may proceed as requested. This document
tes a ~mporary Certificate f Zonin compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
TOTAL DUE
~aid Z (j~Z- f!
Date . ?" t7 ,. ~
~~
White - Building
Canary - Engineering
Pink - Planning
The Cfnlt'r or .he tlke Countl"}'
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
piST/NCT"\\JE- (~
C; /3 I I c .~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
? I ~ \ Sot5 CAT
Accepted
Denied
Accepted With Corrections '><
Reviewed By:
rz-D~
Date:
g !Z-S ~~
Comments:
'24 '
L.')<.2-f.=,i
fVl.A)C D IL\ v~Lk':\l
CAN T I I..- E\,E::1iL o~
uJ ID r!-1
REA (L OF l~o,j ,>6-.
"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."
c.---- ..
The' Cf'nle'r of fhr Lib ('ounlry
111
White - Building
Canary - Engineering
Pink - Planning
~~~~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
~
NAME OF APPLICANT
APPLICATION RECEIVED
jQi-1'-Z~<^ft~ ib-nr ~
5--31-0;)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activitywhich is proposed at: ... .
c2931 .,&ohca:e--
Accepted
x
...............
Accepted With Corrections
Denied
Reviewed By: ~
Date:
g-2./-o~
Comments: See Reverse Side for Addition;::lllnform;::ltionl
~ee 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 Crnlrr of 1ht' Lakt COUnlF)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
iQui;-~ ihnuzJ
5-~ I-();) ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
6293/ ,&oh~
Accepted
Accepted With Corrections
'A
Denied
Qf~~
Date:
0-tD-O~
Reviewed By:
Comments:
jeA& a.l\ a:tt-Q.c~e.J. VlOvv'\J out
"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
Thr ('('nfer of the Lab CaUnlf)'
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:
Date:
Comments:
liThe 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."
0g!20!2002 12:53 4g88702
UWl19/D2 THu 15; 18 P.\! 11124474245
KOTHRADE
CIT~ OF PRIOR LAKE
PAGE 02
~OOl
. '. '''I.~.\':~.
Date Rec'd .
CITY OJ PRIOR LAKE
SEWER AND WATER PERMIT
l~~i"'e~w TY-a.-i/IJW
~: 5- ~1i~11 P~TNO. 3~ IOqJ1
I I ZO~G(~-) I
LEGAL DESCJUPTION (c6le IIIC: OI\Iy)
Lot BLOCK
ADDITION
flD
OWNER
(Name)
fl/~ . '7DI- :;;l./fi~
~3:;r;
CCIda)
(Addren)
. APPLICANT PLEASE COMPLETE BELOW
Size ofwaterler-"i~e inches.
Location of any c:auplinp !10m strUCt\D'e feet.
Type of sewer pipe- 0 ABC [JPVC 0 Cast Iron
Estitnated length of sewer lme _ feet.
CICllll out.{if.reqUii'cd) located at _ feet frQm IlJ11Cture.
FEE SCHEDULE
Jt_ldanti,llI:Wet and w8k!:rli.ne COIUJcctjOft 535.S0 tndustrial, Com'lli: Multi.funily J" of job cOli WM . SJ~I'O ndllunum
Sew,,. connection only. $ J 1,'0 Wiler connection 0" ly S 17.50
Enilnatod eo$lS.
8uiJdln& Pettnit #- ~.-,-'
SE~R.AND W ATEI. PBKMIT FEE
StATB Sm.cKAlUiB
TerrAL PUMlT R&
s
S
$
~so
D.t~
(O&:. 0,. Onl7)
Tbi, Application ~mes YDllr BlrildtaE Per.1t W.... Apprcnl.
,,1M!.. Olli~..'
,. It,ur ..~~.I.r .u in..'.ci.... (952) 64'-1850. '.1: (HZ) M1-'US
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONINGlFlREPLACE PERMIT
Dat~ Rec'd
L Pi.k
z. Gi_
}. YcI!.w
I~;D~;~~.'&-:~O~ 7J1a;fl
,'~ I
i:m.. PERMIT NO. ;)-!t) t/;)., I
I
LEGAL DESCRIPTION (olfice IIse only)
LOT
BLOCK
ADDITION
PID
1::::))~V1Q:fi~ lIDYr}~s.
APPLIC"rt:l:.r .fin. ^ Ih" ._' ,..1
(Namc=) ~ VillLt,!..lLlA"l[ cn 0 ~C. (Phone) 'J/D.3~'I'3 </- 'J~c.r7
(Address) LLaClll ~AJA.n ~. nG. '1JflHr) rIv ka.. J mn. 55:?:OC{
(Mdress) / (City) (Zip Code)
(Contact Pc=rson) (Phone) '1~ 3- '/34- ?J-zc.f?
APPLICANTSIGNAiURE DATE 9-30 -OJ-.
(Phone)
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION 0 REPLACEMEN. 0 ALTERATIONS
FURNACE MAKE AND MODEL ,. FUEL jJccf _
FLUE SIZE RETURN OPENfNGS rNPUT Cl OUTPUT ~) ?~D
TYPE OF SYSTEM HEATING OR. POWER PLANT
OWarm Air Plants
I ~o VilY
cchanical
Air Condhioning
DVent. System
o Sleam
o Hot Water
o R.diadon
o Special J>t:vjces
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannor Encro.c;h in~o
Required Side Yard
Setbac;ks
FIREPLACE MAKE AND MODEL
/,l
FEE SCHEDULE
I % of job c;;ost RC3idenlial. Oas Firl;pl.,c
S39.30 minimum
$99.S0 Re3identi.l. Additions &: Alterations
564.S0 Residential. AC Qnly
$39.30
Industrial. Commercial 8t. Multi-Family
R~idcntial. Heating &; AlC (New Construction)
Residential. Heating Only (New Constnlclion)
539.S0
S39..50
Estimated Cos~ S
'fI.~
Building Permit N
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PER.,,~IT FEE
s 99 I::J)
s .so
s: -If;fJ.-
(Office Use Only)
This Application Becomes ., our Building Permit When Approved
Paid
Receipt No.
Buildinl Official
Date
Dale
14 hour notice for ;III i..,peo;tion, (953) 447-9850, fn (952) 447--41.5
Z0 39'i1d
N'i1H:J3W ?:1I'i1
669-tPEPZ t9
SE:Z0 Z00Z/0E/60
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
/ ().-;3/~O 2-
I. Blue File I PERMIT NO I
2 Gold City . /j :? __ / () 07 '?
J. Yellow Applicant VV-. ~
(Please
ADDRESS
ZONING (office use)
Z?3/
fftJlJ't!/I/7/2/?/ L_
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT~ \=> \'>W'-~ \ ~ -t:~ (Phone) ,\a~ - d--~YS - ~i~\
(Name) - ~~ a-
(Address) \\:,"S~ \\:)~~ k ~ ~\~ ~ ~~ ~~~\o~
(Address) (City) (Zip Code)
(Contact Person) t ' t--..:...... ~ ! -- (Phone) C-t:\ \o\~- ~\- l"t:l'-t-\
\ % If) ~ 3/ ".o~
APPLICANT SIGNATURE o l ~ DATE
A PPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations
Estimated Cost $
Building Permit #
ffll ~lIfJ? .
C"~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application)~~mtfs Your Building Permit When AP. proved
(}h-l};J- l D - J{ - 02-
Building Official Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~~ ~l~icant I PERMIT NO;2_ If) CfC)
ZONING (office use)
2931 BOBCAT TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
DISTINCTIVE HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/1/02
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA TlONS
FURNACE MAKE AND MODEL FUEL
FLUE SiZE RETURN OPENINGS INPUT OUTPUT
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
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO SL-550TR-C
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % 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
"'-fPA~fj WITH
~1~nt~~G PE~~."
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
NOV - 5 2002 By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS "292> ( ~~ CA~ ~, '-
NATURE OF WORK -=:;r"1<':'~ ~~''-'1 t>~~,v6
USE OF BUILDING c:; ~ t> , I
PERMIT NO. ()2- --/092- DATE ISSUED S/Z.S/o't
CONTRACTOR t>'~"'NC.,.,~ ~S PHONE (b',,-.'o'''<:OS4~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~s~ DATE
I FOOTING 6t'-. .1)~ ~ 1ft ' I 9/;3/oZ-
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) t2- () <--
FIREPLACE ~ L '2 (~
GAS LINE AIR TEST .,p~~ '3(o~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I L-A ,t-t~ I ~ruc (.0 I I
FINALS
/.. ,I. P ->
-----------
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850