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8
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
S~?-f- y
See Main Fde;~,,,.", I PERMIT NO. ~-f/771
at bottom)
ADDRESS
I /7/
wiclr
t.J
LEGAL DESCRIPTION (office use only)
LOT
BLOCK ~ ADDITION
tJ('/V5/71
OWNER
(Name)
Date Rec' d
ZONING (office use)
l~
PID J..f"- YIf"-o57-()
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
/-l{JI'nPJ
~(NJm9/VN
6'4 I" Y
,
.>. J?~ z~
/.r
['~
(Phone) /'...l"I- YtJ t. - yy~ ~
tl.:z - .J& 7- ?t/;2...
55/.:1 2-
t:(:,N
(Phone)
a/V
ew Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish
OAddition OAlteration OUtility Connection 0 Mise.
I hereby certify that I have fhrnished mformation on this applicatIOn which is to the best of my knowledge true and correcl. I also certifY that I am the owner or authoTlzed agent for the
above-mentIOned property and that all construction wiIl conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revo e this permIt for Just caus Furth ore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspections.
/YS~
CODE: DI.R.C. ~.B.C.
Type of Construction: I
Occupancy Group: A B E
Division:
II III IV ~ A <it>
F HI M<1t)SU
I 2 6' 4 5
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
loa.() e
DD.DO
..35. :5""0
'10. 00
Sewer & Water Permit Fee
$
$
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
~~
Buildll1!! Ollicial
'/~t:t jOt{
Date
o Fireplace
(l ,)
PROJECT COST /V ALUE $ / I (). () 0 ~
(excluding land) /
s-- ;;..r -0 y
Contractor's License No. Date
Park Support Fee # $
SAC # $
Water Meter .1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
t No. +1ff..r-
ThIS is to certifY that the request in the above application and accompanymg documents is 10 accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg comphance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
iSS1~ '?-./b{:J1U &,4,/0'( Se ·
Planning Director . ~ Date , if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
(
~~
See Main File
White - Building
Canary - Engineering
CPink - Plannm~
Thf Cfnlt'r nr the I..kf Count').
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:
I Ii /' / .., .',
, .I I vI ...-- ./. i J /
/ I ! /' ./..
'/ t ;'{-
Accepted
/
Accepted With Corrections
.
Denied
Reviewed By:
~
A1{}~
Date:
t,/Z9/o{
,
f 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."
Thf' ('f'ntf'r of .ht" L.kr Coun.I')'
See Main File
CWhite - Bui~
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
a/~~ #~
s- ~~- CJ l(
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ L-/ 1'1 ,- UJflZ~ P {IJLic-
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
~
,.
~
Date: ~,/2-,9 /o~
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."
See Main File
The Ct>ntt'r nl 1hl" Lllkt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
i~:~>~;(;>1{ -,j<>X;' ?;~'-'(.;;/ L.// '[,.:"1 ).i ((:.,:
.", .-..... L
".." ,.. ... ; .,~.., ..' f '} I.,
,~~'"> \:":> , ,1') ,\.....'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propos~d at: / .;. (
~I i' /"1 ' .,,-') .."1 /:' .,". /. ,--,,!}...-~t~L.
1/:.-.11 '-'J.' 1-- (11/' /(/(J. j l /2): Ii '"
. f.; /J.~. ... ...- ..' C..
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
fY)1i3
See /114/11'I F, Ie
.
Date:.. ~ -7 -0'1
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."
JUN.29.20048:54AM
GENZ RYAN SERVICE :
NO. 644
P. 7
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
ADDRESS "
l~ 4 (' .vvi{~s Pa
I. Ott~n Fifo [PERMIT NO )
1. YollOw Ci1f. . 04- 0 7711
J. Ool~ ^pploClO' . 1I
ZONING (office IlJJC)
y) V1J.
LEGAL DESCRIPTION (office use only)
ADDITION VVtvL~ mA Vl h
LOT
L(*"
PID
OWNER
(Name) Wensmann Homes
(Phone)
651-905-3709
(Address) 1895 Plaza Dr Ste 200
(Address)
Ea~8n. MN
(Cll)')
55122
(Zip Code)
APPUCANT
(Name) Genz-Rvan Plumbing & Heating
(phone) 651-423-1144
Rosemou.nJ;;. ''N
(City)
5~068
(Zip Code)
"~ICANT SIGNATURE
(phone) 65~423-11~
DATE ,.aq
APPLICANT PLEASE COMPLETE BELOW
Size of water service _ inches.
Location of any couplings from Structure _ feet.
Type of sewer pipe. 0 ABC 0 PVC D Cast Iron
Estimated length of sewe1,' line _ feet.
. 'Clean out (if required) l.ocated at~ feet from structure.
Residential sewer and water. line connection
Sewer connection only
FEE SCHEDULE
$3S.S0 Industrial, Com'} & Multi-family 1 % of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost .$
Building Permit #
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
,50
l
Dulldin~ OCllclld
- \ \i D~f.JG 1 1 '
, Date I' .'.'.'. '
i II L_'-
li\
24 hour notice tor llll inspectJons (952) 44t~~So,fax (952) 447-4245___
WITH
G
(oroce Use Only)
This Ap~licatlon Become" Your BuJldinl:! Permit When Approved ! ii" ,
! 'j:
8:55AM
GENZ RYAN SERVICE:
NO. 644
P. 17
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1. Blut PII.
1. Oold CilY
3. YIllGw App11C1J1l
lPERMlT NO.04. 017~ r
ZONJNG (o~e U!C)
N~
LEGAL DESCRIPTION (office U!C only)
LOT ~ BLOCK '2... ADDITION VVU1< ~ V\ L/ 111
PID
OWNER
(Name) Wensms.nn ~omee
~hone) 651-905-3709
(Address) 1895 Plaza Dr
Eagan, MN 55122
APPLICANT
~~e) Genz-Ryan Plumbing & Heating
(Address) 14745 So Robert Trl
(Ad9xess)
(Contact Person) -.0ltJ ~ 11
(Phone) 651-423-1144
.......,
Roaemount, MN
(City)
55068
(Zip Code)
(Phone)
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
rJ-. Bath Tub with or without shower Rough-ins
r Dishwasher I Water Heater
I Floor Drain . Tl;f Water Softner
t.../ Lavatory (Bathroom Sink) I Stand Pipo (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
( Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
\~ Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & MuJti.flunily 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost .$
Building Pennit #
(Office Un Cllly)
ThJ!I Application Becomes Your Building Permit WIlen Approved
PLUMBING PERMIT FEE
STA TE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.5
AID WITH
B DING
BuildIng Ofiidsl
Dille
24 hour notice for all inspections (952) 447
8:57AM GENZ RYAN SERVICE: NO. 644
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
P. 27
Date Ree'd
"P~
w.
~ ~:w fi~~Mr t PERMIT NO. 01. 077 fj!
ZONING (office use)
LEGAL DESCRIPTION (office Use only) 'II I _I...
LOT BLOCK"2 ADDITION V'^Ol(~nh
+fh
PID
OWNER
(Name) JN~nl'lm::l.nTl J.lnmpQ
(Phon~ 651-90~-3709
Eagan, MN 55122
(Address) 1895 Plaza Dr Ste 200
APPLICANT
(Name) Gem!:-Ryan Pl,lJ:1l1Unr. & Heating
(Address) ~745 So Robert Trl
n 1/\ IIJ l ,^ddre~$)
(Contact Person) _.~ VK.(I
APPLICANT SIGNATURE
(Phone) 6'11-,"?1-1144
Rosemount, MN
(City)
55068
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATlNG OR POWER PLANT
OWnrm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Stellm
o HOI Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cal1Ilot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial &. Multi-Pamily .
FEE SCHEDULE .
1% of job cost Residentia~ Gas Pireplllee
$39.50 minimum
$99.50 Residential, Additions &. Alterations
$64.50 Residential, AC Only
$39.$0
$39,50
$39JO
ResidentJal, Heating & Ale (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
Building Pennit #
(f'-- '" Use Only)
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50 FlijDWilri
Blll;.D~~3 FERWf
"
I; '.
. .,~ll Application Becomes Your Building Permit When Approved I [j
ip
. .1
UI
Dire
n Receipt No.
II
Bulldllle Otlielsl
DAt~G 1 1 2004
! By ,
24/Jour notice for all In'pectioll5 (952) 4
L
50, fu (952) 447-4245
CITY OF PRIOR LAKE
HEA TlNGI AIR CONDITIONINGIFIREPLACE PERMlT
Date Rec'd
I. rink
2- Gr=
]. Yellow
E5,i..., I PERMIT NO.o+ .tIT1PJ
ZONING (oJlice
,,~)
w~~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) (6)./fi1~
(phone) ~S-I.... (fOCrr <../{{()()
(Address) /8'95' A
APPLICANT
(Namefl I ,~"" h r_, ~~ Cx-t-A. d-- F, P
(Addres~
'fro /09~ DA tf'~ V H/cnCJ
(Address) ,
(Contact Person) j( ~\~_~n~,-.I
(Phone) '-'\,03. Srt l-dS"dS
APPUCANT SIGNATURE
~jJ~ )mrJ 553J(p
(City) (Zip Code)
(phone) fl~3 - S'7<.o- Id I '"
J /-/~-{Y-/
DATE
APPLICANT PLEASE COMPLETE BELOW
. W CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTIUT
TIPE OF SYSTEM HEATING OR POWER PLANT
OW.UID Air Plants
o Gravity
o Mechanical
OAir Conditioning
DVc:nt. System
o Stcpm
o liot Water
o Rlldilllion
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
lUO d3Ca
FEE SCHEDULE
1 % of job cost R.esidential, Gas Fireplace
$39.50 minimum
S99.50 R.esidential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, HeaLing & Ale (New COl1struction)
Residential, Hearing Only (Nc:w Construction)
S39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Orne. tlSt Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
Date
I P~d
Date
I :~i~N'
24 huur notice for al\ inspection$ (952) 447-9850, fllX (952) 447-4245
600!i)
MOOG a~VMV~ JILVWOLfiV
666L 9LS e9L XVd 86:61 to/91/Tl
PRIOR LAKE
INSPECTION RECORD
~q "S P~-I- A
DEPARTMENT ~ee Main p:l Q
BUILDING AND INSPECTION A.~
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. DATE ISSUED
CONTRACTOR PH~.~9-"l"'.;t
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I I J
I FOUNDATION (Prior to Backfill) i r J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SI
I 1
FINALS
r
1
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL /'\
PLUMBING tJC fl'1:? J ~ </ - o-S-
HEATING ,
~.~_.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