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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/53.5C
Lu OOD D.x.l:: ----r7--A I
LEGAL DESCRIPTION (office use only)
LOT /4 BLOCK
ADDITION T+tE. lAJ I Lt)s
OWNER
(Name)
Mc.])e.u fTt- H-oMC-J :L;:'c..
Date Rec' d
1. White File
2 Pink City
J. Yellow Applicant
NIAJ
$O~+\~
(Phone)
(Address) J36YD PLAG.STAF
-0
/
BUILDER \ I
(Name)=--ML ~~,tt- ~M~v
(Contact Name) ~A.. ~("'-' A.
(Address) :S AW\F:- t
:IZL
1\1\ \"c. "~
(Phone) 952-99/-5730
(Phone) 6/2- (!;f$.s - ~ ,,3::1
ODeck
ORe-Siding
TYPE OF WORK
~New Construction
o Lower Level Finish
o Fireplace
PROJECT COST/VALUE (exc1udingland) $ 260) OClO
'"
o Mise.
OPorch
ORe-Roofing
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 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 that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform neede 'nspections.
X MG .tt Vt-z~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(00 .
3S..50
({O.OO
?-/'!.o1-
Date
DAddition
o Alteration
7-CJ Y-o,--
Date
$
$
$
$
$
$
$
$
$
200sSY/Y
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; ".
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Other
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 documF
,ned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy ml'
,
~~
Planning Director
Iqh;:~ ~ ~~
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
'')l..::-:-;.rr.-,~'..:._;:-:, -
..'.(
White - Building
Canary - Engineering
Pink - Planning
Tht Ctnlt, or lht I..kt Country
BUILDING PERMIT APPL1CATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
Me-DEVITT HoME-S
g - 0 - OL
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5351 0/00D DU~ 772ft/L NN.
Accepted ---A. -
Denied
Accepted With Corrections
Reviewed By:
M:B
Date:
IO-~-oz..
I _
Comments: See Reverse Side for Addition::lllnform::ltionl
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." -
rhe ("enlt'f of fhr Lakr COUnlf):
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/VI c DEV I I I I-toM ~S
CJ-.~-OL
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5,351
tAl 0 ()D
T)l/ {!z .772ft / L_
NN
Accepted
Accepted With Corrections y
Date:
9-/'3-02
"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
Th... Ct'nlt"r or the I..kr Counll1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,. i, I -T"---/'- i 1(' ,'- . r- /'
J ! .'/t. /1 I , 11..1/\.../--.--"
APPLICATION RECEIVED
( ,
.....-.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/
I
l~ (' ~.
I
1 /~
'Ieo'
-" I --____
ii/IlL I
l I 1...
J I \ ,
1\,/ ~ \j
..,. . --., --
c' ,," /'
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
r
~ ~~ Date: /tJ/5~ z.-
, ,
~ ~~ ~J~
Comments: A. C
#~,
"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."
Nov 17 02 07:49p Mike Schiltz 651-681-8306
U/I/15/02 THt: 14:41 }-',\.\ lilZU1Uol5 t:ln' Ut I"I<IUI< LAI\l:
p _ 1
~UU!
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
(Please type or DriDllllcl ,a .t ~1Ill
I ADDRESS
/535C]
0vou~
Que\,-(
Tf' co
I PERMIT NO.Oz.-J U5 7 I
I I ZONING (o/I\ft us., I
I,.... "le
J 0.14 Co,
J_ Ycl"_ ^.,..t---
LeGAL DESCRJPnON (DfI5cr wr OJ'IIy)
LOT
BLOCK
ADDITION
PID
OWNER.
(Name)
Me
.Q.. J ; +t-
\~ u ,...., ~ j~
(Phon~)
~~J-S7JO
(Addn::ss)
APPUCANT
(Nunc)
(phone) (, S 1- ~ (P &'" 1- ~ ~ .s c..
(Address)
HessisA PluWhing Services. Inc.
P.o. Box 22172
(Address) Eagan, IVIN 05122-6172
(Contact Person) ~ ~~
/~
APPLICANT SIGNATURE . VI d
(City) (Zip Code)
DATE
/ /- / -; -0- c..
Quantity lYoe or Fisture Quaatity Type of Fixture
--' Rou'gn-ins I
~ B8th Tub wit'" or without !lhower 5
I Dishwasher ( Water Heater
I Floor Drain I Water Softncr
5 Lavatory (Bathroom Sink) I Stand Pipe (Washmg Machine)
I Laundry Tray (1 or 2 comparuncnt smk Sewage Ejector
i I Shower Stall Backflow Assembly
Sinks ---...-..- Backflow Assembly Test
I
Bar Sink Lawn Sprinkler
:J Warn Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commerdal k Multi-flllllily t% of job "o~" wi'" . 139.50 minimum
IUsidcnliaJ. New One &. Two-family 199,50
Raidenli.l, Addilions II: Alte~lion' 139,50
EstirnMed Cost S
Duildin! Pcnnit" 01- -' ( '2.S 7
PLUMBING PERMIT fEE $
STATE SURCHARGE S
TOTAL PERMIT FEE S
,so
(Ollirr V.e Only)
This Applh:.Ciun Be~me!l YODr Buildin~ Permit When Approved Paid
Bllilding 0fIis:ia1
D.l~
24 Bur .otiu ror III iIIIpKCio.. ('51) ,"1-"50, r.. (951) ~
16100 IaJIe Creek AVIr.. SoL. Prior Laic., MN 55371-171
:ALLIED EXCAUATING
0',."02 TUE "ilt' FAI 6.2"7"'1
~
l
I
I
I
I :: =- S- [PERMIT NO. ()d. "la57 J
~g;~~~d~~~ -Yr~\ \, \kic'1 L~iC;J
I
jl L~OA.L OEsCJUP1N (llC!lCll "" OOly)
LOT SLOCK ! ADtlmOS
--. -.....-.-.r-_
APPLICANT & fTt ~!' .
IN....) ~ c;...H.~V(;:\-~
(Addlesa) ,LtC.~ LU \~ ta~ ee t
. \~)
'tV'- ~
i
I
.R~i(!.ntia.l $eWCl ~c1 ~ 1:1\. COM."liOl!l
Sc:wC' ..or.nection only I
i
'lltlmated Cost $
!
I
FROM
OWNER
O'"ame)
(Ad..iress)
i (Ccmtaa Penon)
l APPLICANT'SlGN
r-
L
FAX NO. :952-895-9394
Oct. 22 2002 i2:49PM
Pi
~OOl.
CITY OF PRIOj L~KE
Date Ree'cI
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
rtmlG~-)1
~I
I
PlD
I
CPnanc) gj
AOtJle. vvlley .558:"1: .
~ (~IpC~
(Phon.,) qS~.. e'14 - 83 4 c) I
S'-V~~ 5537PJ I
(OJ) (ZIP OW) I
(Phozae) qS~ -9,'1\.[ -21340
DATe J ),_ O~
I
I APPLICANT PLEASE COMPLETE BELOW
ti Il!1.
~i. of walei' service --L-. inehes. ~
ijac;ation of uy eOUFIiags from struCtuR . feet.
'It)'JIC of sewe: pi~. 0 AS vc 0 Cut Iron
,timlted lenSth of 8eW=r line feet. L..J 0 (
lean out (if required) located at feet nom struct1.D'e.
$3:5.S0
$17.$0
FEE SCHEDVl,.-E
Indulrrial. Com'l * Multi-famIly I ~ of JOD COIiI: wtch . 139..50 miabrr.nn
W.. COllnllC:\i&lft only $1;.10
8\1Udinl Pennit jI.. ..-...
SiWEk ANI) W A TaR PEItMlT FEE
STAT2SVllCRARGE
TOT.I.L PERMIT FEE
5
S
S
:so
(Olficc "'" o.fy)
r Thi. .."....... -raY... ....i.. .....1. w~ ...'.....1' - I:;~ 1<":.-
--.---- j' - [Dan, =1 ~ tf-
__ 8uIl4'", Olli,;. b'l~ . I I ... , . ] ;1 .
J4 hour 1I0rill. rot .1l1",plCtio... ('5%) '~'1-915e. fa (t51) "'7~S I
"
-1
I
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~"w JJ~icant I PERMIT NO.~ - I.:i 5' q I
ZONING (office use)
15359 WOODDUCK TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
MCDEVITI HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
11/8/02
APPLICANT PLEASE COMPLETE BELOW
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
OWanll 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
OVen!. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEATN GLO SL-750TR-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
.I {7;Jj /."c.
., ~([j (i
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildine: Official
Date
\ 2. 2002 By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 15351 ~ Que\;.. '''.
NATURE OF WORK N<~
USE OF BUILDING g~O
PERMIT NO. 02"'-/2->7 DATE ISSUED --.::J-ls.o'L
CONTRACTOR ~c ~,'~ \-\~~ PHONE C I?. - &$5-&;;)"33
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING IN~ DATE
_ I .Jt!) --- IS- .. &-}
FOUNDATION (Prior to Backfill) ~ i' 0 -2.,/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~6
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST If 21
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I ~.\.\JCco rf:::dfA ') I H /2-2/ I
FINALS
/0 "
1[--2
GRADING (Prior to Sodding)
BUILDING(\; ~_\'07 ...\\.~:>
ELECTRICAL
PLUMBING
HEATING
DO NOT
- -r
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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