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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/7
LEGAL DESCRIPTION (office use only)
LO
ADDITION
OWNER / I
(Name) {" rn-1-../ rtorn-€'\'
J.l.-,L __
(Address) tv/', .
..pre
qcJc;w
Date Rec' d
1. White File
2. Pink City
J. Yellow Applicant
--J-
51-V
?--
,
l--e U/'
PID J-5 ",3gQ-IJ5 7-0
(Phone)
9~;}~ ~]6~7eJ~
/J1 /Y S
BUILDER
(Name)
Sa~-e
:ro-C' .5-fvJ f1 ; r )-C(
5 Cf~--€-
(Contact Name)
(Address)
(Phone)
(Phone)
S 4'h-1~
9S;} - ~o~.- 6;) I/O
ORe-Siding
TYPE OF WORK
~New Construction
o Lower Level Finish
~eck
o Fireplace
o Misc.
o Porch
ORe-Roofing
OAddition
OAlteration
OUtility Connection
000
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
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-m ntioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aw that the ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon property to perform n ections.
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
9-'7-C/L
Date
;}.c;c7767'37
Contractor's License No.
g.-~tf~o~
Date
Park Support Fee
SAC
#
#
rex>
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
:~:~"1;;;~""- C"fiW';~h~:cr md,uom '~..~=~;:~' ~,rupm~ =,,~
Planning Director ' Date speci~lOns, Ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~?~
Thr (".-"fer of the Lib Counlr)"
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
Reviewed By:
~ ~~~ Date:
~ ~ 1-~
/Llh;; z,-
I
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."
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White - Building
Canary ~ Engineering
Pink - Planning
The' Ctnlf'r or .Ihr tlb ('ounlry
. . .
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (f~ ~
APPLICATION RECEIVED 9 - /0 -:;(
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction act,? which is proposed at:
!l/I/I)- ~1J~'fUAV t'U-
)(
Accepted
Accepted With Corrections
Denied
ReviewedBy:.. ,AtJttL~
Comments: 5~e. IYJ'M~" F'/~-.
pate:
9-~o-oc
"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 ("f'nlt'f of lht' LlIkt' Countf)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (/J~ ~
APPLICATION RECEIVED () - /O._~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction actA which is proposed at:
/ l/L//)-- VlbWtnu/..u ~
. .
Accepted
y
Accepted With Corrections
Denied
~
Date: ~?~
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."
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STATE$URCK~GE S
TOTAL PER."rrr FEE S
ICI1':,,< L'~~ On,y)
This .~ppli('.:HllJl1 3c:cume~ Your BLli.ldin~ Per-;nit When Approv.ed
P::l.td.
R<:c:it=c t'io.
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DatI!:
.1 .3 2002
By
3111l<lil1~ Oll'ir.l:ll
O~te
:~ huur nu<;IL:c (llr ;Jll in~p"<:cllJn.:i \9:::) .,u-:-_1)::t::iJ. (:u ('.1:5:) +-l,;,,~:..j
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I. Pink
2. Green
J. Yellow
~:~y I PERMIT NO. 02- ('Z 7rcJ I
Applicant -I-
ZONING (office use)
14412 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
1/23/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
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 D Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEA TN GLO SL-550TR-C
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
.50
$39.50
FO 6q~
~JO
Residential. Heating & AlC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
Date
Receipt No.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine: Official
By
24 hour notice for all inspections (952) 447
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~~w Jl~icant I PERMIT NO.;<. - /;)- 71 I
ZONING (office use)
ADDRESS
14412 BROOKMERE BLVD
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
CENTEX HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW A VENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/29/03
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 HEA TN GLO SL-550TR-C
APPLICANT PLEASE COMPLETE BELOW
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
Building Permit #
$
$
$
.50
(Office Use Only)
Buildine Official
Date
eceipt No.
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9 50, fax (952) 447-4245
By
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
$/u//
i: ~~~:., ~l~i_.1 PERMIT NO. ;;2-1;3-1q I
ZONING (otne~ use)
I ~~~""~d'i~";;~~~ ~
LEGAL DESCRIPTION (office 11)1: only)
LOT
BLOCK
ADDITION
PID
[ OWNER
(Name)
(Address)
c ( /1 f.-<,. "!.
He) n-J( S
(Phone)
APPLICANT
(Name) /9~Cf -1-.' "'7
(Address) ) ?'.J-S--o
i- (?oc(l^9
,
~c/ g/
?7 +-,0
(Phone) 7~3- q~9 - -;;07"1
(!O~ I\.~t
(A cldre s
rn ... p I ~ C. I'au.-ot
(City)
'5'" ~- -; '" 9
(Zip Code)
~'1
APPLICANT SIGNATURE
(Contact Person)
cOol::.-
-4."
~
APPLICANT PLEASE COMPLETE BELOW
'EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL 8r'f-I'9'l-f "? 5130 :t (.,~ 70 FUEL (Q 0.. S
FLUE SIZE '7 II RE1lJRNOPENINGS (., INPUT 70. ()<J~ OUTPUT 5"'5".OoCQ
TYPE OF SYSTEM HEATING OR POWER PLANT
[3Wann Air Plants 0 Steam
, OGrl!.vity 0 Hot Water
o McchilJ1ical 0 Radiation
[QpSjr Conditioning 0 Special Deviccs
OVent. System OOthcr Devices
(Phone)
lot::' - ?~ ~- ~C;-Cn 7
DATE
,;L- /3 -03
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE l\1AKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplacc
$39.50 minimum
$99.50 Residcntial, Addition~ & Alterations
$64.50 Residential, AC Only
$39.50
Rcsidentitll. Heating & NC (New Construction)
R;sidcntilll, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
.50
Building Omchd
Date
( "--.
.",_.~ \....;.
(Office lf3C Only)
This Application Becomes Your Building Permit When Approve
Receipt o.
24 hour notice for all Inspection, (9
24
[d W~00:60 [002 [t 'qa~
289[82t'[9,-: 'Ot'j ><~~
-
mil -:J~j liOOJ-:Jt'j I 1~3H: l,JOd.:!
PRIOR LAKE
INSPECTION RECORD
f((~
L ~~~~
DEPARTMENT OF -
BUILDING AND INSPECTION
SITEADDRESS ~2. ~~~
NATURE OF WORK -1J ,~
USE OF BUILDING - A
PERMIT NO. 2 --- DATE ISSUED 1-/? ~ 02...
CONTRACTOR PHONE 9~2 - t.fo '3 - fa '2 'Ii)
NOTE: THIS IS NOT A PE MIT 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 Lv ~~...s
INSULATION
ELECTRICAL
PLUMBING ...-z
HEATING (if required) '2
FIREPLACE
GAS LINE AIR TEST\.;
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING lI\'\ ~ \ ~ -I
ELECTRICAL
PLUMBING V~
HEATING
DO NOT OCCUpy
l.1-lMr/c[}
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