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CITY OF PRIOR LAKE BUILDING PERMI ,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1 White File
2 Pink City
3. Yellow Applicant
PERMIT NO. 0
1'.
loulev-orf
/
.8V g
LEGAL DESCRIPTION (office use only)
ADDITION
--eqt7'c>u..--1/ 'Pu/ PID
OWNER
(Name) L ~n~><flt:Jh-1 e r
(Address)
(Phone) 9s;)-7?o~ 7e?3
W ~S3 G
BUILDER C
(Name) J C? .Yl-1-E'.....
(Contact Name) -:r-cr S jvd n /c j--t7/.
(Address) s: Q h'1-e..
(Phone)
(Phone)
S ?? VV1 -e
rS)-~CJs'-6;;; Vo
TYPE OF WORK
ORe-Siding
~ew Construction
DLower Level Finish
D Fireplace
PROJECTCOST/VALUE (excluding land) $ /;}.S 000
DUtility Connection
DMisc.
Deck
OPorch
ORe-Roofing
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 i1ding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the operty to perform . sections.
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
$
$
$
$
$
$
$
$
-
"1)
This Application Becomes Your Building Permit When Approved
~~~
Building Official
9/1? Jy-z-
,. Date
DAddition
DAlteration
g~;26-0;)
Date
#
#
$
$
$
$
$
$
$
$
~
/) 00767'57
Contractor's License No.
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
-
'Zoo. 0-0
-
#
#
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 consnuction to commence. Before occupancy, a Certificate of Occupancy must be
issue~ ~I-J I(}h~~ ~ ~ ~
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
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~~~
Tht ("tnltr or Ih" t.kt ('ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t~ il~
1- lo-~
The Building, Engineering, and Planning Departrnents have reviewed the building permit
application for construction activity which is proposed at:
/f/3f/q ~rna~ /:J/vc.:t
Accepted ... l\
Accepted With Corrections. .
Denied
ReVieWed~Y: ~_ Date: llilOL
Comments: S~for Additional Information!
/
5a YY\ KJi:J (~~
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."
10/07/2002 12:00 5
-...-. --, --_.. ~ ------ .......-
"11 1 ur. PIU 011 L4Xi
PAGE 12
11001
D... Ibc'C
CITY or PRIOR LAX!
SEWER AND WATER PERMIT
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UlGA.t. PISau:rnON (.- _ ..:
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~API'UCANT
i (Name)
_ K &. R Contracting, Inc.
3245 Lake Avenue
(AG4rnII - New Prague, MN 56071
952.758.6247
(Cabtac.fPmon)
l APPUCANT SIO~~.rou
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Type of.,.,. pipe. (j ABC ia PVC D C.. Iron
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FLUMBrNG PERi.\,UT FEE
STATE SURCHARGE
TOT..lt.L PE,R.1Hrr FEE
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Rec::ipc No.
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17(:Vc0 . d
JNIOJ8Nlewnld^3ll~~
9[:171 c00c-6c-1JO
68? Dec. 31 2002 12: 18PM P3
FA>< ~n : 7634283 ~
CITY OF PRIOR LAKE Dt\ta R~~'d
HEATING/AIR CONDITIONlNGfFIREPLACE PERMIT
at bottom)
~: ~~~ ~I~ ! PERMIT NO..._ / -:J / ~ c1
!, V.llow ^,~I\CMI . <-j. _ (Z f.P
ZONING (office Ule)
I
t3IVD
LEGAL DESCRIPTION (office u~e only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
c ('" t--<.. 'r(
H<'~.s.
(Phone)
::' -~ I '
APPLICANT
(Name) ~~Q1 -!-, ' "',
(Address) .) ?'J-$'"c.)
i- (7 fOC (l"-9 -r"L/O
, ~
~CJ'-.4 ~~~ eq/ got
(AddreslJ
(Phone) 7'3- q~9 - ~fo 77
(Contact Person) 0/r 't
APPLICANT SIGNATURE
/'nt>>p!.q oC.rou-4. ~"j,-3" <f
(City) (Zip Code)
(Phone) -1a1 2 - 3<. ~ - C;-~Vt 7
DATE --I;) - 3/ . 0 )-
APPLICANT PLEASE COMPLETE BELOW
EW CONSTRUCTION
FURNACE MAKE AND MODEL /3,.,-y ~ I'J ..f
FLUE SIZE 4 'I RETURN OPENINGS
TYPE OF SYSTEM
[S'Warm Air Plants
DGrnvity
o Mechaniclll
[Q;.(jr Cond ition ing
OVent. System
o REPLACEMENT 0 AL TERA TIONS
~ :i--3 0 ~ G, <!) 7'0 FUEL ~ 0.. S
~ INPUT /0, G<JO OUTPUT 5"5". 00<:)
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Roquired Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrlnl. Commcrcial & 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 & Ale (New Comtruction)
Residcntial. Hcating Only (New Construction)
$39,50
$39,'sO
Estimated Cost S
Building Permit #
(omCt Us~ Ollly)
This Application Become'l Your Building Permit When Approved
REA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
.50
r-
&MOr!:UO ~1iI'~
~ ~ING F:.:'
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Paid
Receipt No.
Buildlllg OmCIAI
Date
j-d, - 3
By .
DAtt
24 hour notIce for RIIlnsprctio", (952) 447-9850, fnx (952) 447~245
"'
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;e~n ~:;y I PERMIT NO. -:J ~ IJ 1.9]
3. Yellow Applicant c2:!. I ()c- (CJ .
ZONING (office use)
14384 BROOKMERE BLVD NEW
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 NORTHFAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/6/03
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants D Steam PLEASE NOTE:
DGravity D Hot Water Air Conditioner Units
D Mechanical D Radiation Cannot Encroach into
DAir Conditioning D Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEATN 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 & 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
(Office Use Only)
Buildinl! Official
Date
eceipt No.
This Application Becomes Your Building Permit When Approved
- 9 2003
y
24 hour notice for all inspections (952) 447-9
PRIOR LAKE
INSPECTION RECORD
SEe- MJ..c.(t-J FtLE
DEPARTMENT 0
BUILDING AND INSPE ION
SITE ADDRESS L=f38L( ~~o~E" ~lu&..
NATURE OF WORK t-J6lO c.o~rr~I&,J
USE OF BUILDING 5 ~ .4- I .
PERMIT NO. 02 -IZ-~ DATE ISSUED -9.\ '71 O"Z-
CONTRACTOR ~T8)( __M.-ES PHONE <=tS''2,.-'J31o-7R1:1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING v'iA~~1
I FOUNDATION (Prior to Backfill) ~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING w ~~~
INSULATION
ELECTRICAL
PLUMBING .l0 ~\ r9/\ ~
HEATING (if required) tAl
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
If\
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
7
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