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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT t') - /IJ - ;;L-
~t:
.5jC/J1 ~Cf,.qs?
GIlA
LEGAL DESCRIPTION (office use only)
LOT 5oBLOCK
Pc;(~
ADDITION
OWNER
(Name)
(Address)
~. ~i~i~e ~:~y I PERMIT NO. 0'1/1 7,,'2
) Yellow Applicant . V [,A,).,;/
PI
ZONING (office use)
d-'"
l?52J
S-3t5<1-od6 - 0
(Phone) 99-d53~5'q3
Wd~3~'3
BUILDER
(Name)
(Contact Name)
(Address)
5/C/o7VN
/
;$0 #1'p
/f;//
(Phone)
(Phone) 95'd - c::l33 - o?:5~ .3
TYPE OF WORK
New Construction
o Lower Level Finish
o Misc.
DDeck
o Porch
ORe-Roofing
o Fireplace
DAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
OUtility Connection
Co.cc
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. am aware that the buildin official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon th eIt;' to perform need . pectio
x
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
toe> . c? (>
100 . 06
.60
0.06
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
ecomes Your Building Permit When Approved
?-17-0<-
Date
~~0c17&737
Contractor's License No.
Park Support Fee
SAC
#
#
09kCJ~~
, 'Date
$
$
$
$
$
$
$
$
$'1.
-
Water Meter
Size
'; 1";
I Paid
Date
.1A'~
7 ~? ~. ~)
/0-. -(-,;r--
I P=ci? N? /.f il '(; 10 J-.
By ~..,
Cf-/?-OL
the r quest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
ity anner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
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
, C;' .-"'~ .....,
......--"... 'r ..' ~:~-. /: . '<.. - "
'-~".~"-./"'j''l'i''1~'--''''''''.'''r'''""~.~...,~,,,'''''''''.-'.'# _.'." A ~,,' .__. ,. "~:.,.;:.
White - Building
Canary - Engineering
Pink - Planning
Thr Crnln nf Ihr "'kr Counlry
:;
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~fct i/~
fi-IO-~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity Whic~roposed at: .
a 31.0 fo l-muaAL4!- p~
Accepted )(
Denied
Accepted With Corrections
Reviewed By:
~
Date:
9-;(0-02-
Comments:
" -
See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
. 3) Erosion Control Plan
"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' C"f'nlrr flf the I.akt ('ounll1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~cfct
1-10.-- ~
~~
.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is Qroposed at:
a3b0 ~fffr~tUMf- p~
Accepted
Accepted With Corrections X
Denied
(/2If!J
Date:
1'- /'?-c1C.-
Reviewed By:
Comments:
~ dlJ aJ~ U...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."
Tht' Ct'nlt'r of 'ht' L.k~ Country
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:
/
"<', / (:":J
Accepted ~.
Accepted With Corrections
Denied
~.
Date:
1f-/7-d"'t-
Reviewed By:
Comments:
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."
10/17/2002 07:25 9524512155
UI!l/LO/UL 1t1~1 i~ rli.A Oi'ljlj(lj'\I<I
I.d .1.1. U r
DASEN CONTRACTING
r/\LU/\ L.^J\L
PAGE
01
~V"".L
Date Rec'd
1~5iL;'~u~~f
CITY OF PRIOR LAKE PLUMBING PERMIT
~Uif~J- LJ~ ~ ?
~ ~w ;11...' r PERMIT NO.O ~ 1(}6.3 -I
I
ZONING lom~ ""'0)
LEGAL DESCRIP"nON coma ~ C1a1y)
LO
ADDmON
~Ul.e..~ .
PlO
i g.:~~+ tb.n~=
(Addrci.:l )
(phone)
I
(Atktte.ss)
(ContaCt Person) _
APPLICANT SIGNATURE
Quantiry Type oU"aNn Qoantity ~ype of }I'ixture
., Ba.th Tub with or without shower Rough-ins
Dishwasher Water Huter
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Wasning Machine)
Laundry Tray (lOT 2 compartment glnk Se:wage Ejector
Snower Stall Back.f1ow Assc::mbly
Si.,xs Backflow Assembly T cst
Bar S il\k Lawn Sprinkler
Water Closet (ToIlet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commcrellll 8z. Multi-fal\'\lIy \% of jOb COgl with tl S39.50 minimum R,esldet\t1al. ~ew One l1. Two-r:unily $99,50
R.esldential. Additions & Alterations 539.50
Estimated Cost S
Building pennit #
PLUMBING PERMIT FEE S
S1 A TE SURCHARGE . $
TOTAL PERMIT FEE $
r.
.50
,.,...
~J}~) ~J:;
(QJT\~~ U!e Onl}')
This Application Becomes Your,Building Permit When Approved
Bid
Receipt No.
Buildlnl ol'!i.,;..
tht~
DarcOCT ? S nn?
By
14 hour nClti~ for all1nttJec:tlons (952) 447.9850, fax (951) 447-4145
16200 tagle Creek I\>n., S.l., Prior Like, MN 55371-\714
....-..-:-~':---~.. .
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CITY OFPRlOR LAKE PLF:\iIBE"-G PER\IIT
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APPUC')I..~'T PLEASE COMPLETE BELO..,.
Type llf Fi;ttul'e
Ba[h TI,l!J ",,'jell or wil!hJUr .5h(:Wl~i
Dishwasher
I Flo(,r Dram
.-,...-....... I L;l,v;"J,[C'r/ (Bar.hroGm S~)'
-------..."',,.-H..rCllJni.iry TrJ,y ( I or .:. ..:qmf?:J.r~~nt sin:.;
i . -.-- I 'Shower Sr~ll .
I Sinks
-......._--
Ba.r Sink
Warer Closet nl.)il~[)_
[--,.
FEE SCHED(jLi
IrldllS.ri:l.1. C(lrniT:<:.C:::::ll & Multi-tJmil~ I ~.':) afjob ';OSI with;l SJ9.50 minimum
E~;:im;1[ct! ClJ:;, :s.
I Type or Fi;(ture i
I Rough-ins J
I Water H~Jter __ ;
I \VJ,rei Sl)fm~.. I
I StJ.nd Pir.~ I \V:lsh[n~ \-f:lchir:c I I
.-........--....-.. --.....--:
I S~w:lge Eje:;:or j
I Backtlow Assembly I
I Backtlo"V Assembly Test -l
I Lawn Sprinkler I
I Other _=:J
Rcsidc:ntial. New One &. T.....Q.F:unil~ S99H~a
R.;::;id=mi:d, AJditil:lns &. Altci.ltians S:;9..50
Buii...:ing P~m'lit.:t- 02-- (Z. 0:3
(01lic~ (;~c Only)
PLUMBCNG PER.l\'UT FEE S
STATE SURCHARGE S
TOTAL PERJ.'UlT FEE $
1"hi~ ,~pplic:1Ci()n Bllcorncs Your Building PI:rmit Wben Approved Paid
DatNOV
a"ildin~ Offici",
OUI!
WITH
ING
J
~., nlll,lr n\ld~l: Ill( >lil inspc~rjQl'l.i 195':) ~-;"-~)l:I50. flU {95:) ~~7-l:..~
S0/c0'd
JNIOJ9NI8wnld^3ll~~
90:80 c00c-SI-~ON
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~nw JJ~icant I PERMIT NO. "d- I:J-O '3 I
ZONING (office use)
2366 STONE CREST PATH
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
CENTEX HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/24/02
xD NEW CONSTRUCTION o REPLACEMENT o ALTERATIONS
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 Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEA TN GLO SL-550TR-C
APPLICANT PLEASE COMPLETE BELOW
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Office lJse Only)
Buildinl! Official
Date
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONlNGfFlREPLACE PERMIT..
Date Re~'d
,;)ge, (,
~ ~:. ~!~ I PERMIT NO. ).. /'....1"\ ~
3. Y.UD" AppllWlI . ~ ~V
ZONING (Qft'lce USe)
LEGAL DESCRIPTION (office UlIc: only)
LOT
BLOCK
ADDITION
PID
OWNBR
(Name)
H~~s
(Address)
APPLICANT
(Name) . #t"'_ -1-.' ,......,
(Address) ~ J (",J-$'G>
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(Addre~
(Contact Person) :~, '( C ~ i';
APPLICANT SIGNATURE
(Phone)
"'r'''',::'i~''/!.\. (.', ):'::.
7l'~o
'Kt
(Phone) 7(;,3- "1;1.9 - .;?~ 77
h1.P/4 c:....-.... ~'5 ~'r:r
(City) (Zip Code)
(Phone) "I:! - ~l..=': -~~(n7
DATE /1- ;;'c., ., ~'.., .
APPLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION
FURNACE MAKE AND MObEL 8~y ",n';
FLUE SIZE 4 II RETURN OPENINGS
TYPE OF SYSTEM
[3'Warm Air Plants
. OGravity
o Mec:hanlcal .
[g.(lr Conditioning
OVent. System
FlREPLACE MAKE AND MODEL
:::--
o REPLACEMENT 0 ALTERA nONS
~ :I ~ 0 '" G.. e '1'0 FUEL <a '*' S
~ INPUT "'0, oQQ OUTPUT S-S: 0<.)0
HEATING OR POWER. PLANT
o Steam
o Hot Water
o Radiation
o SpQC;11I1 Oevle~s
o Other Devite$
PLEASE NOTE:
Air Condition"" Units
Cannot Encroach into
Required Side Yard
Setbacks
Residential. Heating 8L Ale (New Construction)
Residential, Heating Only (New Constt'l.lctiDn)
FEE SCHEDULE
I % of job cost RllSidentilll. GIL'I Fireplace
$3',50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, Commercial .It Multi-Fwnily
$39.50
$39.50
$39.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE. $
STA TE SURCHARGE $
TOTAL PERMIT FEE $
comee Uae Only)
. Receipt 0,
This AppUclltion Becomes Your Bl.lildJng Pet'lI'Ilt When Approved
Bulldlnl orncla'
...~_..
....
Dale
Z4 hour notice for.1I In'peetfon. <'52) 447.98SO, I.~ <'!!il) 447-4245
ld W~6C:01 c00c 9c .AoN
c89~8cv~9L: 'ON X~~
OMl-8NIlOOJ-8NI1~3H: WO~~
PRIOR LAKE
INSPECTION RECORD
~~ ~fA.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS '23f.plr; S~
NATURE OF WORK /J-e'-V
USE OF BUILDING SFD
PERMIT NO. 02..-/2-03 DATEISSUED 1-rl-CR-
CONTRACTOR 0~ PHONE lfS'2- 217-2~'f:J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
! FOOTING ~!p1 ~J (;! -").-
. FOUNDATION (Prior to Backfill) ft 'I '0 -' 7 _ 0"-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
v
SEWER I WATER I SEPTIC
FRAMING J ~1,/~)zS'1.1;'7
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
10/17-
11-/ tj tic'';
11- 142
t-l
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL CS1.<-
PLUMBING ttV ~
HEATING
DO NOT OCCUpy
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS '-. 1I"'VO C_
I
c9 ' l ., D~
" .(& _0)
21 [0 ~~"l
L...L6{O~
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