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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
CJ r~~~ d-
1_ White File I PERMIT NO
2. Pink City . 0' 7 _ -/IIL 7-
J. Yellow Applicant . ... t.r
LEGAL DESCRIPTION (office use only)
LO~ BLOCK
ADDITION
OWNER
(Name)
r:'-f)-1-kY~ fireS'
~ 00
PID
ZONING (office use)
red....
'; 3gL/-000'-o
f}rlK
(Phone) 9S;)-9'?6,-7~'~5
A t'#J1~;7b1 ,.11, ~:.S; 7113
(Address)
BUILDER
(Name) {~~ &;v;4"
(Contact Name).' t'h/)5' l:1/p5 hrtt7
~I'~ a~
(Address)
(Phone)
(Phone)
9S;) ~9:?-t r-7 g~J
f~ ), - :J 2.. {'- ~''-/~
(,.(/ nt=r'
TYPE OF WORK
ORe-Siding
~ New Construction
ODeck
o Porch
ORe-Roofing
o Misc.
o Lower Level Finish
PROJECT COST IV ALUE (excluding land) $
I :2. ~, v-O 0
o Fireplace
OAddition
OUtility Connection
o Alteration
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~
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 ~erty to perfOr~CtiOns. 0
X -~.--- .... tj0076717 2g;tJ~
-- Signature Contractor's Licfnse No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
#
#
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
4(;.0
TOTAL DUE
omes Your Building Permit When Approved
Paid
Date
?-S-02-
Date
$
$
$
$
$
$
$
$
.00
7e>o .0(/
7,3. / q
.Jel I:;
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 City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
1
Planning Director
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
The ('t'nlfor of Ihe Like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I / ~~.~ "/'
, }
L
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: ~~~4~
Comments:
Date:
q/lL /02-
"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' ("rnl('r of 'he Lake Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
d~M-
/'-183 g>-
&MJk I/1-fM-f t fuel
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
9- ~ d'-O~_
Accepted Y-- Accepted With Corrections
Denied ~1f2 A
Reviewed BV~(I ~ c- Date:
7-362-
Comments:
~ tie.- M~ ~ .Q:I J?
"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 Crn,l.r of Ihr I.ak,'('ounlry
t
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(/~7bL
ILl 53 ?
f110tJk ~ i51 ud
The Building, Engineering, and Planning Departments have reviewed the building permit
. application for construction activity which is proposed at:
9- 9-;;--0 A-
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
Comments:
/ilJ4fJ
S( e !114,n h'lc
Date: Cj-S--O{
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."
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CITY OF PRlOR LAKE PLC-:'f:sr:;C PER.\IIT
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APPLIC.-\~T PLE.-\SE CO~IPLETE BELO\V
Type of Fixture i QU:Jnriry I
BJt:: Tub ',\itth or without sho\ve:- l.::i I
DlshwJshc:::-
I f [oor Dr::J.ln
I LJ';:ltcr: (8ath:-aom Sink)
Type of Fixture
RJu:;h-tnS
\V:lte:- t-:C::Jte:-
\'vJt~:- Su fu1~:-
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S c::J.nd P: r.~ ( '..V;15;1 In:; :Vf :lC!lI n::: )
I S~..v:J.g~ EJc:::::ur
I Backr10w Assembly
I Backt10w Assembly T c::st
I Lawn Sprinkler
I Othe:-
L:lUnl.1ry Ir:J.Y ( l or: -:CrTip:lr:r.:c:!t :>In:-.:
I Showe:- SCJ.ll
Sinks
Bar Sink
Water Closet tToilc::t)
fEE SCHEDl.;LE
[ndu$,~:ll. Comme~c::l1 & Mujti-t~miiy I % of job cost with J :539.50 minimum
R~side:1ti:lJ. New One & Two-Funily 599.50
R~$id:::1tiJJ, Additions & Alte:-:ltions S39.50
E:;;:im;J,t~:! C0St :S
8~iit!in~ Pe:'iliic=f.
?-,
PLtJ1v03CNG PER-vaT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEE $
-.
(Office t:se Only)
This "\pplic:ltion Becomes Your Buildin~ Permit When Approved
-
PJ.id
I Receipt No.
I By
-
Buildin~ Ollicial
DasfP I 3 2Ui.~.'
Dare
:.. 11'lur noti.:e for all inspectlons ~9::) ....7-9:iSiJ. f:u (9:5:) ....7~:..;i
09/25/2002 13:55 5
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(;1'1, OF 'RJQR LAXI
PAGE 01
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K &: R Contracting, Incorporated
I (Ad4NtI) - 3245 Lake Avenue
I New Prague, MN 56071 (ClIr) as:-'-7
~ (COnw.1 hnar &c.l.o/ /? __ ('PJ.orac) - { , ",..
· APPUc.\"'" SIIDl1-TTJU-~,fi~'-i-<Jr.h ~TI
4PPLICAA~ PLEASE COMPUTE BILOW
SiD ar..-1GW.c .J..:ii.. inch..
LocaQol1 of my ccn.&P =- from.~ M flee.
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aeaD ogt (if nquit8d) located at ~ &at &am S'lNCU't.
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bli.l'lt~.! Infer IDd w.ar h'IIOM'~oe "',50 IlutultrlI1, COl'l\'l ~ )Iu1tl-bil)' 1~ o'jo~ COlt IIIhh. '3',50......
s.wer e.,nlle.tlon O1Ily 11"UO W__ CGf.a-*'aD .J, S11,jO
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SEwn ,."D WA TD. 'BIUfI1'T fI.E
STATE SuaeHAIlGE
TOtId. naMIT nz
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CITY OF JaRIOR LAKE
REA TING/AIJt CONnITIONINGIFIREPLACE PERMIT..
'.'~. '. .
(P_~M;tud'~"_:
I AD~~S; ~ t3~ ~~cl
. nate Rec:'d
LEGAL DESCRIPTION (offU:e \lse only)
B/~ r:;i'
~~.. :~kant I PERMIT NO~ - / /1..-/ .Yl
l . ZONING _...)
LOT
BLOCK
ADDITION
prD
OWNER '
(Name) (!~~ f-~ Y..
(Address)
ff <I J.t..Il S
.,....,.... .
(Phone)
, :':'.~~'~< "~~~"~: ,f":', \'.~,~.
APPUCANT
(Name) , A',..." ~.' -1
(Address) ~) ?,~"$"G)
~ ~CJa(l^, ~
~.:/ '"
t:'CJ\o,jI ^;+~
(Addres~
(Contact Person) ~, '( C ~ I!;
APPLICANT SIGNATURE
(phone) 7'3.. ~;l.9 - -:J' 77
/>t_P/4 c..-.....c S:S-3' 9
(City) (Zip Code)
(Phone) G.." 2 - '3'c". ~ -.t:;'~(a7
DATE /I~G.-~~.':
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION
FURNACE MAKE AND MODEL 8~.,,,,.,.;
FLUE SIZE 4 I' RETURN OPENINGS
TYPE OF SYSTEM
. ~mn Air PlltI1ts
, OGravity
CJ ~Cx:hanicol .
[Q<<ir Conditioning
OVlmt, System
FIREPLACE MAKE AND MODEL
o REPLACEMENT 0 AL TERA TIONS
'3 Z.3a ~"c 7'0 FUEL .C;..5
~ INPUT 70,ocJ9 OUTPUT S-S; 000
HEATINGORPO~RPLANT
o Steam
o Hot Water .
o bdiatioh
o Special Devlcc:s
o Other Devices
PLEASE NOTE:
Air Conditioner Units
ClI1U1ot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE .
1 % of job Clost Residential, Oas Flrcplace
$39.50 minimum
$99.50
$64.50
Industrial. Commercial & Multi-Family
Residential, Heating &: AlC (New Construction)
Residential, Heating Only (New Construc;tion)
Estimated Cost $
$39.50
$39.~O
$39.~O
Residenthal, Additions &. Alterations
. Residential, AC Only
Building Pennft #
HEATING PERMIT FEE _ $
STATE SURCHARGE S
TOTAL PERMIT FEE S
(omet V.e Only)
This Application Becomes Your Building Penn It When Approved
.50
Date
Date
i
;/- b~;r
o.
. BuUdlnl Ornela'
24 hour notice for allln.pectloft' (9SZ) 447-98!O, fax (952) 447-4245
vd W~6C:80 c00c 90 'AoN
c89[8cv[9L: 'ON X~~
OMl-8NIlOO~-8NI1~~H: WO~~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~nw JJ~icant I PERMIT NO. ;)~I/ q ,)- I
ZONING (office use)
14338 BROOKMERE BLVD NW
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) CENTEX HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/14/02
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 D Steam PLEASE NOTE:
DGravity D Hot Water Air Conditioner Units
D Mechanical D Radiation Cannot Encroach into
DAir Conditioning D Special Devices Required Side Yard
DVent. System D Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO SL-550TR-C
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 $
REA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
l~f?-. WIn., --,
'; .'~~:-"'1r:"1
c]~
(Office Use Only)
Buildinl! Official
Date
This Application Becomes Your Building Permit When Approved Paid
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS Jj-:rsP, ~)~ 'ElucJ..
NATURE OF WORK AJ.,,_/
USE OF BUILDING SF 14
PERMIT NO. 0 Z-j 14- Z-- DATE ISSUED 7- J -cr-z
CONTRACTOR ~~ PHONE qUa 25$-2!;c{2-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ t4- ~~ +-2ie
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING I
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)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
If -13. ol..
( , --fJ2"
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'( - (3- (/l.
11- 13 .. I)..
/IVP
GRADING (Prior to Sodding)
BUILDING I _ ~l
ELECTRICAL
PLUMBING 'f C&Wec::\~
HEATING
DO NOT OCCUpy UNTIL ABOVE 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850