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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
(~J{PO
1. White File
2. Pink City
3. Yellow Applicant
PERMIT NO,
13~'''~ ~ 8IJdt-E//1t12-U
?-
PID 'J-1/- 3 ~4' 059-0
e;
tPr /f/7rlL /fiM- c5
/2..71'1 W~~R7C'/Z- /}pvc
OWNER
(Name)
(Address)
(Phone) 95:). -9~c.-' f! 33
.,nf:" ld2d /ltr~1f- /Y'A/ ~J7~Y
BUILDER tC'" A IJ~
(Name) ./ "7,v,....
(contactNam~ C/i/lf / Pt-/t7~
(Address) ?Pr~
5~
(Phone) ~p-;;r37'-~ .5Y'..2
c,t.l- -3(g~ - Y;l..2?
(Phone)
TYPE OF WORK
w Construction
o Misc.
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
/2S;~
eck
DPorch
ORe-Roofing
ORe-Siding
DUtility 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
authorized agent for e above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans a aw that th buildin officia can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon p perfo ne ed' pe s.
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
mes Your Building Permit When Approved
Oft, ("1 ~dl-
Date
$
$
$
$
$
$
$ ..
$
$ 5Z . /
??1l~jLI Receipt No. .r:J:I ,+--
I ~ I !../ .. By 77_:_
DAddition
OAlteration
Date
.~
.:2~7 '-7':17
Contractor's License No.
Park Support Fee
#
~c:;t:)
.00
SAC
#
Water Meter
Size 5/8"; 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
""" ~ ":(~ ItJ/16~ ~-L ~ ~
Planning Director I 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
Pressure Reducer
City SAC and WAC
#
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
~~
White - Building
Canary - Engineering
Pink - Planning
Thr ('rnlr, or Ihr tokr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~.
APPLICATION RECEIVED 9-lo-'~
.._~ '.. , ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
fL/,??O \j}zgo'-~ 8/1/ d
Accepted
)<
Accepted With Corrections. .
Denied
Reviewed By:
Date:
~
Comments:
for Additionallnformation\
6f-( W\~ f1-u:::.
See Attachments: 1) Grading Plan, .2) Erosion Control Measures
. 3) Ero~ion' Con~rol 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."
White - Building
Canary - Engineering
Pink - Planning
The ("enlt'r of the L.kt Counlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~.E{'4
APPLICATION RECEIVED 9 -10- ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/Lf?~{) \~~ IJ/ud
Accepted Cx-___
Accepted With Corrections
Denied ~
Reviewed By: 8- .
Comments:
Date:
1-(7-(J? -
~~~
1/LA..t'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,"
~~ 4-~
White - Building
Canary - Engineering
Pink - Planning
The Center or the L.kr Countr}'
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 With Corrections
/
Accepted
Denied
~~ 1-~P
~ -JI1~ ~
Date:
I~/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."
~. i'.\.r.',
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/:/ If \ \:~
D:;,t~ R~t:'d
CITY OF PRlOR LAKE PLC)'IBI~G PER.\IlT
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C.:.. TE
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APPLIC-\:\T PLEASE CO~{PLETE BELO""'"
Type of Fixture I QU:lntity I Type of Fixture
Bath Tub Vvtrh or without 5ho\Ii~:- I I Rou:;h-ms
Dlshw:J.sh~:- / i W:J.te:- E~:J.te:-
floor Dr:lln \V:J.t~:- Sufu1~:-
L:J.'i:J.wrl (8athroom Sink) I 1 StJ.nd P:r.~ (\V:J.shin~ ~f:J.c!1In::)
LJ.unJry Tr:lY ( I or :: ~omp:J.r:m~:1t SIn:,: Sc::w:J.g~ Ejc::c:or
Showe:- StJ,lI Backr10w Assembly
Sinks Backt10w Assembly Test
Bar Sink I Lawn Sprinkle:-
'v'heel" Closet (Toilt:t) I Othe:-
QU:ln ti ry
:v
I
/
-.1
I
FEE SCHEDGLE
lndu$tr:al. Commerc:al & Multi-family l % of job CO$t with a 539.50 minimum
R~sidential. New One & Two-FJrnily S99.50
R~$ide:1tial. Additions & Alterations 539.50
E;;tim;J,td Cost :s
8uiiJing Pe::nit ;;.
PLUMBfNG PER...vUT FEE :5
STATESURCR~RGE :5
TOTAL PE&)HT FEE :5
~(
.50 ~~
'--'- .~
'.............,1) ,
(Office L'se Only)
This Applic:ltion Bo=comes Your Building Permit When Approved Paid
Date
OCT-
Buildin~ Official
Date
:..l1.)ur nutice fur ail inspections \')5:) .....7-')350. f:l:t t95:) ~7-C..;5
10/07/2002 12:00
5
-... ....... ."4>1.1I' ~
PAGE 11
iii 001
D.te Rce'.
CITY or PRIOR LAXI
SEWER AND WATER naMlT
~~I ,. ";1&1:111" \
. {If,3t;;{r /p.:< ~ hJvi
02 -1248 / z4LI,
t ;. S'v" f"'ID!' "O~'Z5ll
8/;& /;2 _ . j i ZONING__I
LOT ILOC~
A%)l'mON
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fi;/~Ittd?{, fttA(,.!j?!3 .
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UlGAL D.JSCJUPTIi::>>l'f (... - ..~
PJD
ig.= (}~~~: .
1(-, /d/fa) 11!i:H~ ~ SI Po
. APPUCANr
I (,N-.me)
K & R Contracting, Inc.
3245 Lake Avenue
I (Ad.d.nIt) - New Pngue, MN 56071
I C 952,758.6247
! ( oaW!.PftO'I) &.e1f .
I APPUCANT SlOl:!~ttlU ~~ tt./Jl fnd~
(PbOae)
..
(0If)
cP....)
CATI.
a:If "'*J
APPLICANT PLEASE COMPLETE BELOW
Slza of ___ JCtW:c .
LOCIIIioJl Df my ccupliDp from s1r\1CNr8 ~ tea
Tn- at.wet pipe. 0 ABC ;g) P'VC 0 C.. Iron
2........-4 1'- of tlNm'TIM () .
Oec out (ifnquind) 1ocatold at ""!rem ~r."".
4>.-
ru. SCBEDULJ:
.....ci;a~ ...11I' _1..._1iu llGU~ l!~,.50 I........., c_'lA )l(w\l.faJnUy 1,. oIj" *t whll . '39.5D __111II
ScwCt ;.(Mecaian DIlly .17.50 Vt'...I:GI'Jl...... OIly 111,'0
11t..- Cost S 11lildiDI '.mit ·
PAID WITH
(.... u.. OItIl BUll.DING PERMIT
Tllil A"Uea". i.o.. y,... ..1Id.'.' ._It W1I.. ",,rev- 1 ~.._
1 - 1ay
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sswu ,u.lt) '\If ~:t!1 P!aMlT FIE
STA l1t Su-.cHAaOE
TOT IeL rUM1T R&
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l
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
t ~~:w ~l~icant I PERMIT NO, d-/d-5D I
ZONING (office use)
14360 BROOKMERE BLVD
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 FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/13/02
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO SL550TR-C
APPLICANT PLEASE COMPLETE BELOW
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
,50
$39.50
~ $39.50
('."~~
".I~~
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".... .. ~
,
~'-..
Estimated Cost $
REA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No,
Date NO\! I .A 'j: II 'I By
Buildin!! Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF ;PRIOR LAKE
HEATING/AIR CONDmONlNGlFlREPLACE PERMIT."
Dat" Ret'd
(3 I.., .0
i: =~ ~~~'- I PERMIT NO.O Z, - f z 60
1.1 ZONlNq,.__) I
I ~::s~2rint.... ...at_:m
83~ r61r e>t. ~
LEGAL DESCRIPTION (offtce use only)
LOT
BLOCK
ADDITION
PID
HQ~s
(Phone)
.: ,"",.-
I
I OWNER. .
(Name) . <::!.M ~...
(Address)
. ': :".: ~:':' . /;i',: ~.:;.:'
APPLICANT
(Name) . H~c:lI -1-,' _.,
(Address) ~ J ?J-S"c:)
+- ('leaf'",
~(j ~ "'~t ~-'
(Acldres
Pr"~
gl
(Phone)
7'3" /i~~ - -:J' 71
~~-~" fJ
(Zip Code)
'3c.3-5;'S~7
'. ....., "
..D~'
(Contact Person) .~.. '(
APPLICANT SIGNATURE
COa~
f'J't .pI... Go I'Ot.oo4
(City)
(Phone) '" 2.. -
DATE
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTION
FURNACE MAKE AND MODEL 8",'1 "'If.,L
fLUE SIZE 'J 1/ RETURN OPENINGS
TYPE OF SYSTEM
" ~ann Air Plants
DGravity
o McchaniCllI ,
[g.(\'r Condltioning
DV cnt. System
FIREPLACE MAKE AND MODEL
o REPLACEMENT 0 AL reRA TIONS
~ 11 ~ 0 ~ e:.. e 7'Q FUEL .G., .... S
~ INPUT 70. (ldO OUTPUT .5"S: 0100
HEATING OR POWER PLANT
o Stl'lllJTl
o Hot Water
o Rtu:liarlon
o Special Devices
o Other Devic;es
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into.
Required Sidc Yard
Sotbacks
Industrial, Commercial & Multi-Pamily
FEE SCH2DULE
1% of job IOOst Residential, Gas Fireplace:
$39.S0 minimum
$99.S0
$64.50
Residential. Additions &. AtteNtions
Residential, AC Only
Building PCl'l11it # 6' Z. '" I zEi 0
$39.50
$39.50
$39.50
R.eside:ntial. Heating & A/C (New ConstlUction)
Residential, Heating Only (New Construc:tiJ;Jn)
Estimated Cost S
Building Ornelal
Date
MEA TING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Orne!: US" Only)
This Applh::ation Becomes Your BulldlDC Permit When Approved
Z4 hour Dotlce for .11 I".peetlon. (9SZ) 447-!l850, fill (9!~) 447.4245
[d W~c[:01 c00c v0 '83Q
cB9[Bcv[9L: 'ON X~~
OMl-9NIIOOJ-9Nll~3H: WO~~
PRIOR LAKE DEPARTMENTOF~~~<t?~
BUILDING AND INSPECTIOff
INSPECTION RECORD
SITE ADDRESS ~3(p() ~ ~ ~
NATURE OF WORK tJ'fl.A-
USE OF BUILDING cz,PD
PERMIT NO. 6~ DATE ISSUED "J-n-6(
CONTRACTOR ) PHONE &152" 235" 25lf2--
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING ~ /,0 IIJ..!o2-
FOUNDATION (Prior to Backfill) ~~ ~t9 ~ t '7 ~ [) 3
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
J j,--f (.. 02.
12.-1t~(J2
tL- "'~
)., - (fr ff2-
J..-I"o~
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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.
I
i~Lr.;~
FOR ALL INSPECTIONS (952) 447-9850