HomeMy WebLinkAboutBuilding 02-1148
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I PERMIT NO. O~'l/40 I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'- White File
2 Pink City
3. Yellow Applicant
f) Aid ,'!
BY~
Fo y. rlu~
AJt~
LA 1\ I=:
t;;'S37
LEGAL DESCRIPTION (office use only)
LOT a BLOCK I ADDITION THe:- \1\.1 IL})S
Date Rec' d
ZONING (office use)
PUC;!J
PID
OWNER r _
(Name) ~ OA/u
t-\ 0(>1 P S
LLC
(Phone) G, j;2 5-91- If oG.3,
(Address)
~~~;~)ER GaR Orl"v H 0 fY\ r-=<; (L L
'-' .', .(20 O.^: 0 :-"'0 '
(Contact Name) ~, ......., "'::'\\-1 Q(Z./v
(Address) ~~$S- CA/Y)gP,IDGk:. MOAO
(Phone)
(Phone)
q~:J - <..t ()~ - c'1"3, c1
f.o I ~- 591- - Y l) <0''5
TYPE OF WORK
New Construction
ODeck
OPorch
ORe-Roofing
OLower Level Finish
o Fireplace
OAddition
OAlteration
o Misc.
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
'oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
. ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
tl inspections.
J 03/.).. ~&~
Contractor's License No.
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" I'"
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
4-Lt..1 c2 D/6.l...
L/ Dat~
$
$
$
$
$
$
$
$
$9 j{}O.V
-
O. h 8 4-S"
requ s in th&above application and acc panying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
tes a temporary Certific te Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be
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
The- CE'nlE'r of 'he take COUnll"}'
White - Building
Canary - Engineering
Pink - Planning
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:
Comments:
f2 0 /-J
r))L
Date:
"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 Ct'nlt'r nf .ht" t.kt Counlr}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ OrdalJ j/o m ei'
APPLICATION RECEIVED S>-d-D~O ;A.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
t- <7)
a g l/_r;'- lOX A ~( f.-J
Accepted
Accepted With Corrections V"
Denied
Reviewed By: (Lj) kt
Comments: ~ Pc...ANS
Seo- ~,vD o...Ji5
ri ~1z-
Date:
"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."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~::n ~~~. I PERMIT NO. /'J~-IIc...1 P--
3. Yellow Applicant VC7\ 9
ZONING (office use)
:J SL/4-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
G~~.~
(Phone)
APPLICANT~ /?' /J
(Name) J.' ...--e-c- . r /
(Address) 5/ -5 A /7/ <? <).r
(Address)
5~-R-f
'.~
(Contact Person)
(Phone) b ~ / - 0/ t:>
/~~~~
(Phone)
.-; '- /;:2 d '3
5' sC' ';2 L/
(Zip Code)
APPLICANT SIGNATURE
DATE
/7
- ,;
/<9
- (J;;L
APPLICANT PLEASE COMPLETE BELOW
IaJNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL G~ FUEL /JJ-
FLUE SIZE "3 '("o/C RETURN OPENINGS /,;; INPUT /;Jc:>v..~ OUTPUT / A{(x:,e
, , /
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants o Steam PLEASE NOTE:
Gravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
IXtAir Conditioning o Special Devices ~ Required Side Yard
~Vent. System o Other Devices . ...e.-t Setbacks
FIREPLACE MAKE AND MODEL
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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Building Official
Date
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~. ~~~~ ~:~y I PERMIT NO. O~-J /l-;l~
3 Yellow Applicant QJ
(Please
ADDRESS
J -, If ~-
ZONING (office use)
cry:: ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I ~~~R C~ J1c~~
(Address)
(Phone)
APPLICAN~ >
(Name) t:.:? /f.{;~ f{m 'l Iv' (. e
?p/7
(Phone) C; 5" / .- ~/ t? -J- / .;;2 ,A. 3
7(' /V
(Address)
J tJ (""
(Address)
/5';// S'a-u'.~~t
~~
(Zip Code)
(Contact Person)
(Phone)
APPLICANT SIGNATURE
DATE
/ :J- - r;;; - (J
.-,
v<-
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
,~ Bath Tub with or without shower -~.~ Rough-ins
I Dishwasher / Water Heater
I Floor Drain I Water Softner
~ Lavatory (Bathroom Sink) / Stand Pipe (Washing Machine)
/' Laundry Tray (lor 2 compartment sink Sewage Ejector
;;2 Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
J 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 $39.50
Building Permit #
Estimated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Receipt No.
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
DEC-19-82
1.'.1 I' lj..
84:34 P~1
I l1:. I) " .j 1 r :1..1,
SAUBER PLUMBING 651
I)j~~~!~~i:> l'l'r\' (IF PR11)R L.\l\E
463 2775
P.82/82
'"' I III
/'-r~;-'",
/ f "/0 '\
I 0 /""~-" of' \
/:,//!~\ \~~\
Hc~ };-)
" ~ ~ /
" '~~!.~~/
CITY OF PRIOR LAKE
SEWER AND ,\VATfi:R PERMIT
DAte Rt'c'd
i ;;:.~ ~~!;,.., ~~~T NOt?.2 -fl"if ,..:
u.-----1 '
1_
_2:2~'.o ~.~:..l.Cc..J(J) ~~__._
I ADDRl:SS _ _ ,)
1_.._. _.-2)1.75 .- .~f? (' ~.;/ /?0J._
;-r p.GArJ)i:~';CRrPTION(~ffiC<l u.. enl)')
~.JC! ___.!?LOC~_ApDnJ.ON
--.--.-....
Pro
..J
ow~_./~'-- "-:::-\-r-'
I Ii\} <l;J~~ _ .00 r ~. '5 t. d. di) 0-
I
. &'/;_ ')9 '7--YC:1/;,:Y-:
IPhor.e) -.- .....__. I
I
'.. . .-----..-
I
; (Aa<1.r.::;. i _.. ''''__
IAUl"""1
(City)
(Zip C::odt)
. i
. _...J
.--.- .-
! A?pr ;C;..NT..... \] /'
I (Nli.meL .~~~.{~_ 6 S, "'(lf1"~_~Jv
I / /), ) - ? 0 "':7
~Add.Jcss) ....L t-,'_~ -" v ~___.
: (MJr\':II)
(Con"" p'''on) __J:., r y. "- 7'
..:.'<l'PLlC.4.NT ?G!'ATUg~2y_~c?_
,--..../ 0
--.. ---.--.\
(Phone) t Y j- j/t, ;- /(1 Y _.. "u i
0-1N__,
, (CTy) - (7'lf' C'Mf), " ~ ~ _ I
(Phone) c' 0/ c: /2. ',i-L \ ". Jr; -! y. It.;! 7- ',-'J 'J'~
. DArD ~ / -< - / t~ cJ.2. _ I
I-
I
I
I
APPLICANT PLEASE COMPL~TL nELO\\)
Size Ijf wal~i sCTvice -.L _ inche~ ..
Location of any COuFlin~, from structure -- feet.
Type of ~t:wcr pipe. 0 ABC [KTPVC il C~t Iron
btin:l;"ted Ieng:h of Scw\:r line ~ fee:.
Clean oUt (ifr~qulre?) IOca/~d at _~ f~et from structure.
I
--~
~~c~i~(;nT:~1 ~('Wc e.nd v.al",r IJnE: ~onnecllon
Se".cr con(l~':TJon only
FEE SCHUl) ULE
~35.50 Industrial, Corn '1 &. Multi.family
!; 17.~ 0 ',v iter :O:Jne:llon on I}'
1% otJl)b ~gt with a $39.50 minimum
S17.50
E.:a:mared C(J:)t $ J liO, tJ.~
-----
Building Permit ft. ~.-: .
SE\\'ER A?\iD WA TER PE.RM1T FEE
<;TA.TF SITRCHARGc;
TOTAL PERmT FEr:
$ -----....-.... -
S .5:)
$
((Jll;(( \. "t lJnJ))
~~pph~~~n llccoll\cs Your Buildin;'Permlt 'n'lJ~n !\.prmveil
I ,
I I
-'-B'~'I~;"l; acrid.1 D~tl I
24 !lour nOIJ~ fflr ~ll inapG"ion6 (n2) 4-17-9850, fu (952) 441-42'~
i P.id L1
r-.:.:--'
i Dale I d.. "do - "L
'---- _e:::.._
Recelpt No.
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