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8
I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
Date Rec' d
t '/ 1--0;Y
~i~~e ~::y I PERMIT NO. 0"" __II'-a. I
Yellow Applicant v - ~ If----J
ADDITION
O(//~
-a:;tf -0
OWNER
(N ame)
~P/J ~ X
J
hil} ?'S
/
. ( It<7tr
(Address)
ZONING (office use)
f2.?-
$Ct#Jf'
13'/1
. (
BUILDER
(Name)
(Contact Name)
(Address)
5~~^1
(Phone)
(Phone) 99 -d~3 '-d?5~3
TYPE OF WORK
New Construction
OLower Level Finish
Deck
OPorch
ORe-Roofing
o Fireplace
OAddition
o Alteration
ORe-Siding
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
o Misc.
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 ware that the building officia can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the pro to p~form needed insp .
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
()
IOfd!L
3S~
Lto tg
t- /7-07
Date
,#'o?m7~737
Contractor's License No.
o~.~~
Dae
Park Support Fee
SAC
#
#
I )..00 w
).. ro CO
~S-(/O
I )..00 CC)
70bCIrJ
I S 00 UO
$
$
$
$
$
$
$
$ 7. ~ &8 . 0
Date Special Conditions. if any
our notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter Size 5/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
I Paid +t8~ 'or
Date 'g; 1C7.-
r
I Receipt No. .ef,4C:S2s
By fL() . .
the above application an acco panying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
stitu~s a temporary C ilk e of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
White - Building
Canary - Engineering
Pink - Planning
The ("{'nler of the Lakf Count!")
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST jP () )- -
(1e-1Uf~
APPLICATION RECEIVED 8- ~ 7 -() d
NAME OF APPLICANT
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ;:)~
.;135'1 ..s;~+ (f-'~
Accepted
Accepted With Corrections
Denied ~ tV-=
Reviewed By:L
Comments:
(J~ ~ ul(llC~ W ~
Date:
7- I 7--t:lZ-
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."
"- ----
-..............
(
White - Building
Canary - Engineering
Pink - Planning
The Ctnfrr of the tlkt Counlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
;
,
\~ i ,~~.,:-'l;< _' '
~'" /J."':~_
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.___.J-...
,.. I
I
'",,}r
Accepted
./
Accepted With Corrections
Denied
/2JJ /4
L. ""-..:/ "'_ D
J~ rl.Aiv5
rLL
r I
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."
or, ..."..
". '., ~\;'''~ ,,;t.', I": \,."
. I ; ~ -:-\'1,.
--
White - Building
Canary - Engineering
Pink - Planning
lh. C.nt.. .llh. Lab Country
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST )t 0 d- -
CeJUf-e~
APPLICATION RECEIVED 8- ~ 7-0 d
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity,which is proposed at: n
~3 5 [I -.S~.Ae<Y+ v-Jr:;;t;t
Accepted
ex
Accepted With Corrections
Denied
Reviewed By:
~
Date: 7-1:2:oL
Comments: See Reverse Side for Arlrlitinl1~1 Infnrm~tinn'
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
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."
Ullf~OfU'
12:31 9524512155
U1L1 lJ:Utl l"!\A tlJ,ZQ41Hl.)a
DASEN CONTRACTING
CITY UI-' t'I<IOR LAKE
PAGE Ell
~OOl
1E1/E12/2002
Date Re~' d
CITY OF PRIOR LAKE PLUMBING PERMIT
I. !tlllt 'F1l.
1. o..LtI CIIlI
}. Y_ "IIP11.'"
r PERMIT N06J / Iw~. . J
~!
ZONING tcl'llCl: UIC)
....... "'" -"'~;::..-
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,
LEGAL DESCI:UPTION (oft!ce WI': only)
LO-r'/g BLOCI{ . ADDITION
PIP
OW'NB'Jt: '0 ~ 0
(Name) . I.;.,;.-~V'
(A6d.ress)
1J () fYl/.5 .
CPhot'le)
(Contact Pmon)
.~
___ Vl .
DA T:E
Quantity
APPLICANT PLEASE COMPLETE BELOW
T of F tun Quantity Ty e ofFiuure
or without shower
achine)
FEE SCHEDULE
Indu~ri!ll. Commcrc:ia.1 &. Multi.tamlly 11>(. of job cost with Il. $39.50 mlnilTlum RClidential. New One lit. T\l/o-tamil1 599.50
P.Bllic:lefl~ial. Ad.ditions &. Allcratlons $39.50
Estimated Cost $
B-uilding Permit #
PLUMBING PERMl'T FE!. $
STATE StJRCHARGE . $
TOTAL PERNaT FEE $
.50
p.le
"..
(omcc Use Only)
This AppllcatiDn Becomes Your.Bulldlng pt:rmit Wrlen Approved I
ta..lIding Oftlellll
24 hDur I\gtice for alllnRpmo:tloD5 ~Sl) 447-9850, flU. (!1S1) 447-4'2.45
16Z00 "agle Creek AYe., S.E., Prl&r ]..ake, MJIl' 55372-\714
~,
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- -
CITY Of PRlOR LAKE PLC-:V!Br~G PER.\I1T
D:.a~ R~t:'d
\-~I/':/
"\. ...::-;. /
~
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PER-yIlT ~O, ;;;"-/1 ~~ !
.. ,-;.,101 c::',
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A.PPLIC.-\~T PLE.-\SE CO~{PLETE BELO'.,','-
QU:lntiry Type of Fixture I QU:lnriry I Type of Fixture
Ba:h Tub wIth or without sl1c\'ve:- I I Rvu~h-Ins
I Dish\v:lsher W:!te:- He:lte:-
/ I f [oor Dnw \Vacer Sotme:-
-3 I L.1'i:!torl (Bathroom Sin!--:) ! SC.1nd P:r.~ I"'V:lShln~ \-L1C!llr:::l
I L:J.unJry Ir:!:, ( i or: .;cmp:.lccme:lt 5jn:~ Se'.V:!g~ Ejector
I I Showe:- Scali Backt10w Assembly
( Sinks Backr10w Assembly Test
Bar Sink I Lawn Sprinkler
S W:lcer Closet ( Toilet) I Other
i
l
I
fEE. SCHEDliLE.
[ndus~ri~l. Comme~c:al & Multi-family l % of job cost with a 539.50 minimum
R.:sidentbl. New One & Two-F:lIi1ily 599.50
R.:sid::ntial. Additions & Alte:-J.t:ons 539.50
E:;tim;lte~ Cost :s
8uikiing Pe~it #-
PLUMBCNG PERivlIT FEE :s
STATE SURCHA,RGE :5
TOTAL PERMIT FEE :s
.50
,..------
p~ DfRI ~.'i\V!TR.~
(Office t.:se Only)
This Applic:lCion Bc:comes Your Building Permit When Approved
Paid
Receipt No.
Buildin~ Official
Date
By
Dare
( ,
:..4l'lIJur nutic~ fur:lil insp~ctJons \95:) ~7-'J::l5iJ. f:u (Y:5:) ..447....:...5
i ,~"._>_::':- ,-,CITY'OF JJRIOR LAKE
REA TING/AIR CONDITIONINGIFlREPLACE PERMIT
'.. . ,; . , '. I . .
Date Rec'd
t 5:.. E~I_' I PERMIT NO. a - I J!of
ZONING (offi.ce Use)
~3~
Sfd
c~< s ~
+1-
N.vJ.
LEGAL DESCRIPTION (office: \l$e only)
LOT
BLOCK
ADDmON
PIO
OWNER.
(Name) (;e ~ f~ y
)I ~ ""'" <"
(phone)
(Address)
APPLICANT
(Name) H~~+, ir-J
(Acidress) I r'S-S-C
~ (?Q~ /I'~ j
(~ 0 ~,., r "t
(Adc1rll$s)
...,..- ~
U if
(Phone)
~I/ 3 - I, "'I
_~ ...,......7- 5(,77
(Conta.ct Person)
-
I ~ '''''1
.rn~,pb ('~ I~h,o(' S"".1-3 C, 'T
( City) (Zip Co de)
(Phone) ~ / L - "5 (. 3 . S-5~ 7
DATE )1-/3" G>2-
APPLICANT SIGNATURE
APPLICANT PLEASE CO~LETE BELOW
EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAK.E AND MODEL 13 ~.., Q ", -+ '3.s0 4 ~~ 70 FUEL Gd.~
FLUE SIZE PV.c RE111RN OPENINGS ~. INPUT ogQ( n(JO OUTPu:r 74,oiSt'",;]
TYPE OF SYSTEM HEAnNG OR POWER PLANT
(UWa:m Air Plants 0 StelUIl
DOrQ.vity 0 Hot Wilter
o Mc:~hanieal . D.Radlatlon
gAlr Conditioning 0 Special Devi~~s
~cnt. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Rcsidc::ntlal. Heating & AlC (New ConstrUction)
Residential, Heating Only (New ConstrUction)
FEE SCHEDULE
1 % of job cost Residc::ntial, Ol\.S Fireplac::e
$39.50 minimum
$99.50
$64.S0
$39.50
Industrial, Commercial & Multi-Family
Residentlal, Additions &. Altera.tions
. Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building l>ennlt #
HEA UNG PERMIT FEE .. S
5T A TB SURCHARGE S
TOTAL PERMIT FEE S
,so
Date
(Office U,e Only)
This Application Becomes Your Building Permit When Apprond Paid
Date
. Building Omel.'
24 hour nDtlce rDr an Inspections (95:1) 447-9850, ral (95:1) 447~24~
ld W~0~:80 c00c ~l 'nON
c89~8cv~9L: 'ON X~~
OMl-8NIIOO~-8NI1~3H: WO~~
CITY ('lr, PHTOR LAKE
REA TING/ AIR CO 1',' r \ 1 ';' r 0 N I NG/FIREPLACE PERMIT
Date Rec'{\
~. :~n ~::y I PERMIT NO. ':J -----II b v
3. Yellow Applicant <7 0
ZONING (office use)
ADDRESS
2354 STONE CREST P A TI I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
CENTEX HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRES!'
(Phone)
651-633-2561
\. T 1 ~ ~ 1
(Address)
2700 NORTH FAlRVIE\"
(AdLlress)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
DATE
11/20/02
BRENDA HU c: '
--, ,
APPLTCA ,\,'
xD NEW CONSTI{UlTI
FUPNACE MAKE AND MODEL
, \ " : r'OMPLETE BELOW
'LACEMENT 0 ALTERATIONS
FUEL
FLUE SIZE
RETURN 01';:
TYPE OF SYSTE1\ f
INPUT
~'1NG OR POWER PLANT
OUTPUT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
I FIREPLACE MAKE AND MODEL _-,-1 Jr,\T'
<1L~aln
'" Water
:ldiation
. "lc'cial Devices
,~r U.:vices
PLEASE NOTE:
Air Conditioner Units I
Cannot Encroach into
Required Side Yard
Setbacks
, ,.('
Indll>;trial, Commercial & Multi-Family
I"
)OLE
Ik,idential, Gas Fireplace
$39,50
Rc" ;cntial, Heating & NC (New Construction)
R.:si .:c'ntial, Heating Only (New Construct i, ,,,)
j,i
Ii ,'>;idential, Additions & Alterations
'\.Loldential, AC Only
$39.50
$39.50
.50
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Estimated Cost S
IIEATING'
ST/\TE SI
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')! lilding Permit #
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(on'f{' 11se Only)
r,,;, Application Becomes Yon' "";"~
l Duildin!!: Official
l
Date
Paid
Receipt No.
2-11, r" ,cr ,
:..7-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
(j)dtv
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~35't.J g~ Q.r~
NATURE OF WORK fLRt. J
USE OF BUILDING ,SF 0
PERMIT NO. 02- - //(pfj DATE ISSUED 1'-/7-0 Z-
CONTRACTOR C~ PHONE Cfc;?-,.;23")"'2sf:?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING 0/3C V'2-
FOUNDATION (Prior to Backfill) (;0 ~ () ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING vs Co\, 'Itt~
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
tc 1 tt/~
/( ~ }.;O~ d2
II-))..
GRADING (Prior to Sodding)
BUILDING ~ 0
ELECTRICAL
PLUMBING
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.
11'7
I 1M 103
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850