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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
LOT 6 BLOCK
ADDITION
(Address)
f6CJ'k
White File
Pink City
Yellow Applicant
Lv])
lL-
PID
Date Rec' d
(Phone) 9's,)-936 - 7 n"3
/1/
BUILDER
(Name) S ~ rh -e
(Contact Name) ::r--Ol'"" 5MY}; r)-9
(Address) ~ n j/'I z...
(Phone)
(Phone)
;;;: If~
<?~?- 9'0"( ~ 6;) YO
TYPE OF WORK
ORe-Siding
o Misc.
DLower Level Finish
New Construction
~eck
o Fireplace
OPorch
ORe-Roofing
DAddition
DAlteration
OUtility Connection
o c:> ()
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 aware building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo property to d inspections.
ture
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
oo.e>O
00.00
Yo .00
mes Your Building Permit When Approved
7-/7-dZ
Date
d00707~7
Contractor's License No.
Park Support Fee
SAC
#
#
g- ;}6---o ~
Date
$
$
$
$
$
$
$
$
,
, 20a .06
Water Meter Size 5/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
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
issued.
~ '::(~'"
Planning Director
/~/1/oz..- ~ ~ ~
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
Thr (.rnlrr or Ihr t.kr ('ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
tt/Jf;tEif ~~
q-Io-~.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'/3g:j ~k ~ 13 /0 d
Accepted
)(
A~cepted With CorrE;3ctions
Denied
,
Reviewed By:
M413
.,Se e.. /J1.o,/~ F/ Ie
Date:
Q-;)3-0L
Comments:
nriVp.w~y Mw~t H~vp. roncrp.te Apron
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. II
White - Building
Canary . Engineering
Pink - Planning
Thf ('tnler of the I.akf Count.,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
b/JlJV! ~
q-I O-~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'/3g5 ~k~ /3/vd
Accepted 'X:.
Accepted With Corrections
Denied
-GJJ
~~~#
Date:
f-(7-c:JC
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."
0tt~ ~ ~
White - Building
Canary - Engineering
Pink - Planning
The ("t'nler of the Lab Counlrl
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:
,( '-:./
1'.1 ~,.. '
t ' ....? '-;,~
Accepted With Corrections
/
Accepted
Denied
Reviewed By:
Comments:
~
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y.-dJ f-
~l
Date:
10/'-1 ~ 1-
,
"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."
10/07/2002 12:00 5
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I \0" :.. 32't5 Lake Awnue c.r-
i (A~) - N~ Praiue, MN S6071
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CITY OF PRIOR lAKE PlL~),I3r~'G PER\fIT
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:-\.PPUCA:',"T PLEASE COl\[PLETE BElO\Y
Ty!,~ of fi:trur~ I Ql1:Jndry I Type of Fi:W1il~
, 8a~h Tub '.A.'trh or wirhour ..itH)we:::- I I Ruu~h.in$
OishwJsher I Water r-:e:He:-
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J Sho'-ve:- SC:l,lI , 8.1ckt1ow Assembly
I Sinks I Backt10w Assembl~ Test
Bar Sink I Lawn Sprinkh:r
Water Closet lTtJde::n I Omc:
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R.::sidc!\tI:1L 1'1","... One: & T.,.,o-F<Ilnil:, S99.$0
R::sidc:l.li:J.l. ""J<.tiricns & .-l.J:=r;lcicnsS:i9$<)
8uiir..:ir;g P:::-:nic # 6 Z. - 1253
(om<:e t:.:lc: Onl~)
PLOMBlNG PER..\tUT FEE :5
STATE SURCH..'\RGE S
TOTAL PER..'\IlT FEE S
WITH
DING
This Applic::ItlQII 8<:cornl!s Your Bl.lilding Permit When Approved
Po.id
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Builc/in( Officilll
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1)3/23/02 :lION 1:5:~-1 F.\.\ IH2447H43
CITY OF PRIOR LAKE
~UOl
CITY OF PRIOR LAKE
REA TINGI AIR CONDITIONINGIFIREPLACE PERMIT
Date RceJd
?7~~ A.' </L)
t~ ~~II PE~NO.~_ (~53]
I ZONING I""" ,", I
LEGAL DESCJtUlTION (office use onJy)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) _~ I-~ '/.
Ad~es91
;-/ a .......~.5
(Phone:)
APPLICANT
(Name) ./Lc:" f,. d
(AddICS3)__~~2 S-'f"'o
~ C ool:^1
c ~ ='J-;~)lrJ
/1.-1/ 0
(Phone) 763 - ~J. 7 - "5& 71'
~/
7"'., ,,,,1.. G ,.,;; .-:t
(City)
(phone) G 1.2.- '5 ~.3
DATE )-,
~-S-36~ ._
(Zip COdc~.
- S-5-':" J
'0 :;--
APPLICANT SIGNATURE
(Contact Person)
\
APPLICA.~T PLEASE COMPLETE BELOW
~W CONSTRUCTION CJ REPLACEMENT 0 AL TEAA TIONS
FURNACE Iv1AKE AND MODEL ~ f' '10" 1- ..3"?' 3 0 3G-..u::> 7CJ FUEL G <( S
fi . ,
FLUE SIZE q RETURN OPENINGS C:::> INPUT ? 0 j 9 CX,.;J OUTPUT 5"':~,? 0
TYPE OF SYSTEM HEA1D1G OR POWER PLANT
, ~arm Air Plants 0 Sceam
Gravity 0 Hot Wltor
MllChlUl[cal . 8 IUdlllUon
rg~lr Conditioning Spc~llL1 Dcvh;C8 _
g\'L'nt. SYStem 0 Other Dcvlcc:s
I f1.....,.. ,'Ion:,
AIr Conditioner Units
ClIll10t Enc:ro&Qh into
Roquircd Sid/) YIrd
Setbacks
I
FIREPLACE MAKE AND MODEL
Indu,trllll, Commcrclll.\ & Multl.FlUn1l1
RClIldcntilll. HOiltln3 &. Ale (New Constnlctlon)
ResidentllLl. Heatlt161 001)' (NIIW COfUtrUction)
FEE SCHEDULE
I % of job cost Rcaldcntlw. 011.1 Flrcplaci:
$J9.~ minimum" .,
S99.jO Residential. Additions & Altcratlon~
S64.'O Resi4entllll. A.C Only
S3P.'O
S39.~O
S39.~O
Elltlmated COllt S
BuildinS Pcnr..it #
.1
HEATtNOPERNnTFEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
F-
.50
DulldhllJ omclal
D'IO
4$
(Office U~1l Only) !: '1 1J:, l:J ~ U
Thili Applir.:atloD Becomes Your Building Permit Wben Approved! U
24 Jlour notlc. for allln.pecdo.. (!J!2) 447-5'850, a
[d ~'JIjC'O : 01 [OOC' .:.. 1: . u.e.r
C'89[8C'\7[9.:..: 'Ot~ ><Ij.:l
Or(ll-~t~ I lOOJ-~t~ I IIj3H: ~'JOd.:l
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;ekel1 ~:~y I PERMIT NO. "1./ J '/5 3_'J
3, Yellow Applicant ~ I t7".
ZONING (office use)
14385 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 F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/16/03
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 HEAT N 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 $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
\.:-l....
- ~-,
.50
'--'-
'--.
Buildinl!: Official
Date
- ~....
(Office Use Only)
This Application Becomes Your Building Permit When Approved
[':"),
24 hour notice for all inspections (952) 447'-.
PRIOR LAKE
INSPECTION RECORD
~-teuL~~to
DEPARTMENT OF
BUILDING AND INSPECTION
SITEADDRESS J'I38S- ~~~ f;>fUq
NATURE OF WORK ^"~
USE OF BUILDING Sf=V\
PERMIT NO. 02 --/2--5..3 DATE ISSUED 1--/ ?-t:J"L
CONTRACTOR (1~ 7 PHONE 9)?-t.fo~. t,27'o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING W l(ft'rtc:,~lI\o;l
INSULATION
ELECTRICAL
PLUMBING vJ I [rI,ru rr
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING W
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.
FOR ALL INSPECTIONS (952) 447-9850