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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
ADDRESS
'-/3 ~8
'f2..bF )::;~-€~ ~ t/J.€V/l-12-1)
LEGAL DESCRIPTION (office use only)
LOT51BLOCK (ADDITION fttt:/rP()WVIE~
OWNER
(Name)
(Phone)
/VTTJL.
(Address)/~~~ ~/ft'ffW~ /}/lfR
Me:?
r;J.()
rt:/I
BUILDER
(Name)
(Contact Name)
(Address)
fA-At
/#/LI'/
/T~
95'J -93(, -78'?;7
/Z1Y ~S-3'1';$
~L~~#-~
(Phone)
(Phone)
.>:;r~
?5-~-:233-.2SY-<
.n..
C-1'!2 -3'7-'(7OJ.9
TYPE OF WORK
New Construction
OPorch
ORe-Roofing
OLower Level Finish
o Fireplace
DAddition
OAlteration DUtiIity Connection
/~ s: o-trO
o Misc.
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
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
or the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
w t buil 'ng official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
t ee inspections.
x
,;2 0-0"7 ,,'?"(
Contractor's License No.
Water Meter Size 5/8"; I";
Pressure Reducer
Permit Valuation
Permit Fee $
Plan Check Fee (,. ~( $
State Surcharge $ Q.. S"6
Penalty $
Plumbing Permit Fee $ ttTC) . t)> 0
Mechanical Permit Fee $ ,,~ ~~
Sewer & Water Permit Fee $ ..,.
$ 4o.W
Park Support Fee
SAC
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid ~~~-/ 6'!d
Date 6- C../ - ;' r-j....
. tion e mes Your Building Pennit When Approved
r-17-~
Date
#
#
#
#
Date
$
$
$ ,
$
$
$
$c:-
$
$
2()o~t:%J
-
I ~;ceiPtNO~~ 1-~
I,
This is to cert fy 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. ~ i~p l(j/Lj /oz- ~ ~ '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
k-~~
Thf' Ct'nlt'r or the t.kr ('ounll"
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
~ :/df-J
~ ~ 1;Iv
Date:
laN4 Z-
I
Reviewed By:
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."
~~
White - Building
Canary - Engineering
Pink - Planning
The Ct"nlrr or the l..kt ('ounl'1"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (l~'#~
APPLICATION RECEIVED (/-( 0'- d-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
143,)~ i5rCKJ~~ b/I/~
Accepted yt-. Accepted With Corrections
Denied f)
Reviewed By: ~/b
Comments:
Date:
t?-ll'(}C
~o ~ ~f2--k
"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' C"f'ntf'r or Ihf I..kf Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT '. (~~ #(~
APPLICATION RECEIVED 9-1 0- d-
The Building, Engjneering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/435g nrovt7??M/--/ i3/t/cl/
Accepted X
. Accepted With Corrections
Denied
, PI. .A!_
Reviewed By: . ~v+ Date: I
Comments: See Reverse Side for Additional Information!
S~ yY\~ (~uf
See Attachments:
"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."
~'"
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CITY OF PRJOR L-\KE PLC:.IBr~G PER.\IIT
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APPLIC-\:'iT PLE.-\SE CO:VIPLETE BELO"'':
QU:.lntiry Type of Fixture I QU:.lnriry I Type of Fixture
Bath Tub with or without 5how~:- I 3 I Rou~h-!Os
I Dlsh\IiJsh~r ""Jter He:.He:-
I I floor Or:.J.Jn Vvate:- Sut'me:-
J I LJ'i:J.torl (Bathroom Sink) I StJnd P;r.~ ('vV:lShin!,; \-f;lchlnel
I Laundry Tr:.J.~ ( I or: -:cmp:.lI-:menr SIr.:,: I S~'.V:.J.g~ EJec:ur
( I Showe:- Stall I Backt10w Assembly
I Sinks I Backt10w Assembly Test
Bar Sink I Lawn Sprinkler
Water Closet ( Toiler) I Othe:-
fEE SCHEDl;LE
Indus,rial. Commercial & Multi-f;J.mily 1 % of job cost with a :539.50 minimum
R~sidenti:11. New One & Two-F:uniIy 599.50
R.::;ide:1tiaJ. Additions & Altent:ons 539.50
E:.itimatd Cost S
8uiiding Pe:7:lit :#
PLtJ1vrBfNG PER..vUT FEE :5
STATE SURCHARGE :5
TOTAL PE&.'''1IT FEE :5
,...
.50
I"'.
~ ~\!
;.,.,.
. ,
(Office L'se Only)
This Applic:1tion Bc=comes Your Building Permit When Approved
Paid
Receipt No.
Buildin~ Official
Date
Dact)CT - 4 2002
:~ l1'lur notice ior ail insp~ctlons t?:5:) ~7-!}:i:5U. flU: (9:5:) ~47~:~5
10/07/2002 12:00 5
-... ,'... .",...WIt, ~
PAGE 11
Ii 001
Da" Rcc'4
CITY or PRIOR LAD
SEWER AND WATER PUlM1T
LOT
BLOCK
Al)~mO'N
02 -1248 41J, p~.
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I ("""-,. ~W 11 )h~~. fir SfptJ.
. APPUCANT
I (N&me)
K & R Contracting, Inc.
3245 Lake Avenue
I (~l - New Prague, MN 56071
I 952.758.6247
r (CClDtad hncln) ~
i ""PUCANT5ION~ttJU ~J;t/fM.~
(Pboae)
ca"
(P~)
D~TI
~ CDOIJ
APPLICANT PLEASE COMPLETE BELOW
SiD of..- M:tYicc LA ia&:baI. .
Locarion of my coup1iDp from s1r\JCtIft 1i:fL r-.
1yp1: r:JIlfter p&pc. 0 ABC ;lSj YVC 0 C..1IQn
2--....... 1__ of IIWW lrM 0 .
OdD out (ifnquind) locat.ld at: r.t from ~,.....
I'D SCB&DULJ:
J.aW-ci.l;..-wet _1..._IiDIICInD~ S!!..50 r"'It\'W, COlII'I. )lCwll.fUIUy l~ ofj" *t "hili '39,50 u.'"
Snfct ~.CIIian anly &17.'0 W... c:GllZc" 0111:; 111,SO
I~.._ Cost S Bllildilll Pft'lftit .,
PAID WTIH
(~u..~l BUilDING PERMIT
T1ai.. AP9Ilc:a.... i..g.. y,... ..11d.1.' ,....... W1I.. Apll""ec1 \ G..-
1 - JDY
- ......... or'w .. -.
M _.IlI,.... tar.n......... ('12) M'...... fa. ["2~ "'7"'1"
SEWD. AND '11.4 T!1 P!lMlT FIE
ITA n Su.cHAaOE
TOT /tL'UM1T not
e
l
CITY OF ,RlOR LAKE
HEATING/AIR CONDITIONlNG/F'IREPLACE PERMIT,.
Iiate Rec'd
I =..\':;'s;.'>rln<......" -..)
/ 't3sr ~l~at ~~
~l.. 0
}. :~w ~~kM\ I PERMIT NO. 0 Z - (Ur
I ZONING (...~ ,..,
LEGAL DESCRIPTION (oflic:e \UC only)
LOT
BLOCK
ADDITION
prD
OWNER
(Name)
(Addres:;)
<::!.t" f-~ ~
H<:J~s
(Phone)
. '.I 1,..: . ~ './J,', i. : ':,
APPUCANT
(Name) . A'~CllI -1-. ' -, +- t? CJ Q (I ^1 ~tO
(Address) ;.) P-","'S"d ~ b,....,.~ ~QI' Wi.
C.i ~ddreslj
(Contact Person) ..~.. 't c::: h ~
APPLICANT SIGNATURE
(Phone) '?G3-4tJ.)>...~" 71
hI.lIIl.. G.,~ 5:'1)-3' 9
(CItY) (Zip Code)
(Phone) ~I '- - "3(. 3 - ,~~" 7
. ., ...\....' ,.'
DATE ~ .0 z.'
APPLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION
FURNACE MAKE AND MODEL 8~"',,";'
FLUE SIZE l.J 'I RETURN OPENINGS
TYPE OF SYSTEM
~arm Air Plants
, OOravlty .
o Mechlltlical .
~r Conditioning
OVent. System
o REPLACEMENT 0 AL TERA TIONS
'< R.3 (7 ., G" e 70 FUEL .G:, 01\ S
~ INPUT "70, u<JO OUTPUT ~s: 000
HEATING OR POWER PLANT
o Steam
o Hot Watcr
8 Radiation
Special Devicd
o Othcr Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Roquired Side YlIofd
Setba<:ks
FIREPLACE MAKE AND MODEL
Estimated CO::lt $
FEE SCHEDULE
1 % of job cost Residential, OIlS Fireplace
$39.50 minimum
$9~.50 Residential. Additions & Alterations
$64.~O Residential, AC Only
Building Permit # fJ Z ,. / Z41
$39.50
$39.50
$39.50
Industrial, Commercial &. Multi-Family
Residential, Heating & Ale (Ncw Construction)
Residcntial, HCll.ting Only (New Constt\lction)
REA TlNG PERMIT FEE. S
STATE SURCHARGE $
TOTAL PERNDT FEE $
. Building Ol1lclal
Dale
(om~" V.e Ollly)
This Application Becornei Yo-.ar Building Permit When Approved
2<& hour notice for .lIlnlpeetiDnl (952) <&4'.9850, fill (9~) 44'-42.5
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