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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK J...... ADDITION
OWNER
(N ame)
(Address)
BUILDER
(Name) "0 (~ N-L //;!q;N N
(Contact Name) &Oa /' y
,
(Address) /17 f 7t:i' .?.o.,
TYPE OF WORK
White File I PERMIT NO
Pink City . 0 Z ~ ( I .3~
Yellow Applicant - J
L-J
ZONING (office use)
ICI
JJ 6 /7J t?../
.
,...... i/ f
o Misc.
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
c.
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 e property to perti nee inspe 'ons.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
:; (.;, So
/
PID 2..S-Jcf-h --OJI- 0
(Phone)
(Phone) &(..51- -y 0 ~ ..y.y 0 U
(Phone) "/,2,. -....] 6, 9 -7~ / :L
/..2
ORe-Siding
ODeck
o Porch
ORe-Roofing
o Fireplace
OAddition
o Alteration
OUtility Connection
IY~~
Contractor's License No.
0- -.;(.). - (J :l-
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
't -:;;- . -
\ 2- t:..c:
~OO.
.--
t 7_Q:; . -
Water Meter Size 5/8"; I";
Pressure Reducer
2S0.-~
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
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 sign d by the City lanner constitutes a temporary Certificate of Zoning compliance and allows constructIOn to commence Before occupancy, a Certificate of Occupancy must be
ISSU , '~d/-, q/tD!()Z 5po ~LJ~/t G~J,AJ.tL
irector Date' J 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
The C"t'nlt'r or Ihe 1.8ke Counlr}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~j;/J(AJ/YJ'JC?/}//}() IJ~
APPLICATION RECEIVED R -~ d- - ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5:;).f9 9tftjti4 p~
Accepted
,/
Accepted With Corrections
Reviewed By:
(20 It
Date; 1,lf
Denied
Comments:
"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
Tht' Ct"nlf'r of the L.kt Counlr)'
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:
II
';". .~_.~~.._..~.-'
Accepted
~
Accepted With Corrections
,
,
,/
Denied
q~;;;, ~~~
Date:
c] /Ifl / 87-
/
Reviewed By:
Comments:
.,~
"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
Th. ('.nl., nl Ih. "ok< COUnlF)'
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
ZI ~/J{(}A1lrJ1/}//}(.J IJ~
R-dd--~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
. application for construction activity which is proposed at:
/5;).. f9 9tftUA tP tU4..-/
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Comments:
tm~
5<. e fJ1c,t'n F,' I(
Date:
q - 9-() J..
tiThe 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.tI
lOlZ4/01 WEO 11;22 FAX 612447424~
CITY OF PRIOR LARE
\g) 001
Date lbc'd
CITY OF PRlOR LAKE PLUMBING PERMIT
I lIw ",.
J, "'14 Cllt
) '.Iboo .pp1I~"1
(J'1l:1Ue type ~rint I.Ild Jig!! at lxltlOm)
l ADDJW;S J ~<;?'1 ~ ~oa.~ ~W
fl'ERM1T NO. ;< - I (J 5
I lZDNINC;'-'~]
LEGAL DESCRIYnON (c8'ia: use .,nJy)
LOT ~ BLOCX ~ ADDITION ~~ ~C!:. t-
PID
APPLICANT SIGNATURE
(Phont:) GS)-'fD' .-WOO
~ ~", SS""} 22-
(Phone) 69 --952-ISi.
Mn, 5Sl;)J
;:l t$/~-;5Z~
"7 p3/0?-
O"WNER
(Name)
(Addres5)
(Address)
(Contact Pe~on)
DATE
Type of l:Ilun
FEE SCHEDULE
Ind\l!l[rillL CDmmerchd &: Muhi-famlly 10/. af job ca!l1 with II 539.50 minimum
'Re.Sidenli.l, ~~;,,/ OI'JC /& T~o-FolITIil1 S99.S0
RC!!Iidel')tjlll. Addirions &. Allet'allons 539.50
E.stjms~d Con S
Building pennit #
PLUMBING PERMIT FEE S
STATE SURCHARGE $
TOTAL PDOIlT FEE S
.50
/>"
l::,I I!.., $. ,...."
A .".... ~ ,..",
(Olliu Uu: Oilb')
TlIi!t Applic2Irjon Bet'omeJ Your BuildinE Permi. WII... APPTowed
Paid
~~l
R.ecelpt lIIo.
Build1nc Omel.1
J)II~
D"te c$
By
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2 Green
3. Yellow
~l~icanl I PERMIT NO. 02 --1135 I
I
ZONING (office use)
(Pleas' ;, '" ~' "'" ,ion" bottOm)
I ADDRESS
15 ~.. ..JF~
~5
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER . I J
(Name) {A.R/,/~J~/A-I
(Address)
(Phone) ~51-t:1c>~ 44tXJ
~~;~~AN;~~/-I~/ ~;/4G
q3J 0# ~#p
(Address)
Lh"A/
APPLICANT SIGNATURE ~/I
(Address)
(Phone) Ic/51- mcr .L7:'??g
~/-/ ...di ~Z2
City} (Zip Code)
/14/k
(Phone)
DATE
(Contact Person)
q/7!
;'
APPLICANT PLEASE COMPLETE BELOW
)aMEW CONSTRUCTION 0 REPLACEMENT
FURNACE MAKE AND MODEL.AS'd.At'...?/, ~ 6~ ~ :s., S"
I II~
FLUE SIZE rJ "')i- jc.... RETURN OPENINGS . ~ - ~ INPUT
o AL TERA nONS
FUEL Ndt-
,SDCD OUTPUT ~poO
TYPE OF SYSTEM
JaWarrn Air Plants
DGravity
.,0'Mechanical
~ir Conditioning
0'ent. System
I FIREPLACE MAKE AND MODEL
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
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 Pennit #
../
02, "'113'?
REA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
PAID WITH
BUILDING PERMIT
I ,
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Date
Date~ lo...
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~"w ~l~icant I PERMIT NO. d - / J 3 s-I
ZONING (office use)
15289 JEFFERS PASS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700NORTHFAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/8/02
APPLICANT PLEASE COMPLETE BELOW
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
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
o tvlechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
Dv l'llt. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO 6000TR-OAK
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 & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Pennit #
$
$
$
.50
..:\
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Bnildinl! Official
Date
By
Date
u
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1. Pink
2. Green
J. Yellow
~
~J~icant I PERMIT NO. d-'(f5J I
I
ZONING (office use)
I ~~~;;d~:;;~
fJass
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) (Akr!S/YIa/' /r./
~~
,
(Phone) ~~/~~ -~~
(Address)
APPLICANT "' /.
(Name) ~.tl?""o I /'/e.//9C
(Address) 4!--?,1 ~ d' -5J -61::;/
(Address)
0-//,/
(Phone) ~SI-gqc; -C/g:?-P
4~/~1 ~k~".1 $S/2-z..
~ (Zip Code)
(Contact Person)
(Phone)
DATE
/1
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION o REPLACEMENT o AL TERA nONS
FUR.J"J'ACE MAKE AND MODEL .LPH~t:>X' 6~~cQ31S- FUEL A/a I-
FLUE SIZE c-~3'\Pvc RETURN OPENINGS b INPUT ~a.o OUTPUT ~LCD
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
~Mechanical o Radiation Cannot Encroach into
Z\ir Conditioning o Special Devices Required Side Yard
OVent. 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
$64.50
$39.50
Residential. Heating & NC (New Construction)
Residential. Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office lIse Only)
.~;,
This Application Becomes Your Building Permit When Approved
Paid
'-,
Receipt No. '-.
. "v f>
Date
2 0 200 By
Building Official
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 lSZBl J~ffLfhJ f7~S<?
NATURE OF WORKs~
USE OF BUILDING <);;-/--\ I f
PERMIT NO. (}2-j /3~ DATE ISSUED i 10(07
CONTRACTOR [J-J~SfV\N-f-J ~ PHONE (p'z-s~1-7(",'"Z-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING~~
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING tJ
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
9>>- e
-/(-0
If /3"
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABO E HAS
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.
2-('7-66
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850