HomeMy WebLinkAboutBuilding 02-1295, Porch 02-1486
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CITY OF PRIOR LAKE
~t}larttllllUt of ~ui1hiug Jlusprrtiou
1 Final Permitted IJ Conditional e.O. Expires -
Thi,' Cdtiftca" iy,,"cd po"oant to thc "qoi",,",n" of Sedion 307 of the UnifMm Boilding Code ,'dtifyin,
that at thc time of i"oaore thiy ""odo" waY in compliance with the ,",ioo,' ominance< of thc City of p,io'
Lake regulating building construction or use. For the following:
u~ CI,,''''''''"" sIXGU. fA~lLY BId, p"m" No,__02::l~5--
O"oP,ocy Typ' ~_ Type Co",,,,,ct'OO _---'"'----- fire '""' ___"lA---- Zoo'og Di""ct --"-"-----
L",I ",,~,'plioo l,q. B", fctUNTA1~ PI' ,LS SECOND ADUlTIO"
Owner of Building
C"""",",'. N"'" & Ad"''' ,,'f,N S'1ANN H()~E S, '895 ? 1 .AZA DR.. S 1 I cr. 20(', IN;A' 5' 1"
Site Address 14131 FOU';'T1I.IN K:',':'s COl1R.T N.f,.
DON RYE
ROBER.T D. R1.1TCHINS
Building Official
Date: ' V . 17,. ( .--'
City Planner
Date:
----------
ADDRESS I" I
OCCUPANT
HEAT LOSS DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By _ Gas Line By
TYPE OF HEAT GA _FA *HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
II GAS DESIGN CONVERSION
MAKE //P-/Gy /,/116/1 MAKE OF BURNER
Model , ,_ _ Model
Serial Max. BTU Rating
INPUT MAKE OF FURNACE
Model
HOUSE HEATING TEST RECORD
r".),o(."'-~.k( ,4, 1& i:(
JOB #
MJB"7
APT._FLOOR_CITY
OWNER
SUBURB
THERMOSTAT
Valve
Limit.
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L. W. Cut Off
CONTROLS
Heat Plug
<"? I (
Vent Size ~
KIND OF LINER
SIZE
RegulaTor
Number
NONE
Draft Hood
Filters Size IW~'2..",
Chimney Location Inside
D. /"/-......
Chimney Construction r V...
Outside
f/$<~
I
Smoke Bomb
Draft
Door Pressure
Wiring
Test Tag
Lighting Inst.
Pressure
Input CFH
Stack Temp.
Form 235
1" ' ~.;
Percent cO2
Percent O2
Percent CO
u,c)
I/~
I./I//YJ
Date Tested 2 - 13 - ,-I :>
Company Testing Frederickson Heating & A/C, 3650 Kennebec Dr., Eagan, MN 55122
Name of Tester ~'1D..J~~~b
...-.,........;,.......,....
. .........-
...
.". >'-
-,,' ". '". .
. -.' ~
,/
./
,/
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
t zit )..Ct:J3
SCHEDULED
ADDRESS
/4-/1/- 6/
FOUtJTYflN Hlt~5 u:
OWNER
CONTR.
(JZ-/Z-tjO - 95
0.-
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
tLO S[
FIGE
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~fL1 __
Inspector: ~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
11'1S1'lOTl
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
'-/21
<_,(;; I'v/ /\ I ~...)
" ,
I-i-I II~:
LEGAL DESCRIPTION (office use only)
LOT ) BLOCK '}-~ ADDITION
r, ,.-_ ../
P -<: )?.) 1'../ I f I
OWNER -
(Name) r,\)l:;.fj~;j/h/;;,'j^)
j ,'. - (
Hb;/I..-,:'5
" ,. -
(Address) /
'i'" /'--
'. "
# ZO()
Date Rec' d
9-4'-tJ~
I PERMITNO.O~ '-/~f~sr
1. White File
2 Pink City
] Yellow Applicant
I"'~--
I" /"
1-/-1 iI;
/i
Z/./;)
PID-?t0J-=-3'70 .- OC';:- 0
ZONING (office use)
(<L
I;;:
(Phone)
J
C:)-I'-~/()C; ._~/f()O
!.~il. A) /.'-'(/ :2.< JI
'!/i,YV .,l' t/17
BUILDER /-1' /--:, '/ r,
/ /
(Name) (Phone) A ;y J1611
7 -""A 1-
(Contact Name) (<- . '7....7 / ' c: (' I~>-/l- / 0 .c--) _ .--, 7'< .._
~J"-. .~. (Phone) /',.J ('7- (7,) "
/ ;I
--
(Address) \
\
TYPE OF WORK ew Construction DDeck DPorch ORe-Roofing ORe-Siding
OLower Level Finish o Fireplace DAddition o Alteration OUtility Connection
o Misc. 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-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
ffi~CO"'~ nee"" ;.,,,""0..,
X - /", I"
(:'__.l/; 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 $
Your Building Permit When Approved
q"'~<t-()7-
Date
// -;/ ~ -'(f7
Contractor's License No.
.., ;;:~
\.-<" ,- ~;.
/ "j ,,"""--'-
Date
Park Support Fee
SAC
#
#
1~7J'
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
#
#
( l-el? . / /
<1'2.1 "71
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
iSSU~ -f~~
Planning Director
Builder's Deposit
Other
TOTAL DUE
I ~~~ fj~!{:~ ~
u
~,
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
Id/?/bl-
{ . Date
~
,",'."
Th. ('.nl., ollh. I..k. COOnl1"}
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
V~t/~~
t( - C}-O;l..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ILl! fl 701L/Jdt;t.(/1(' IilLo (} 1-
Accepted X
Accepted With Corrections
Denied
Reviewed By:
~~~ ... Date: qfw(o'L
s~e Reverse Side for Additional Information!
Sf( W\J(G.J r'::r.l-f,
Comments:
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
.... -- 3) Erosion Control 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."
Th(' C('n1('r of .h(' Lakf Coun1r)
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
((k1~C/~ ~
1- q-o~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
It/I fl 7-01~~ ~ G -r-
Accepted
y
Accepted With Corrections
Denied
.(?i;
Date:
q-(:5~ CJ? ~
Reviewed By:
Comments:
~J-Rz ~ R1J
"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."
~~;L~
Thf ('t'nlff of 'he Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
. i/, ../ . h -'" /".'
r ../
!.
~.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I -7 ,/
/ I " ~ ~'"
t
Accepted With Corrections
~
Accepted
Denied
Reviewed By:
~
~
r
-:::j~~
r
~~
Date: /{J /7./o?/
,
.f
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."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
~~J;77
~: ~c:n ~:~. I PERMIT NO. 'J~ J') b./I
3. Yellow Applicant , G2t _ ~ ../ ~ _
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
.??~
cd-
a
~?~V
~ I
-~.~.
/0/J 65/d
APPLICANT ./'? , / ./U'./ . -'
(Name) /7///~.,L- //&c:~/c:~ (Phone) &5/-L/5/-277'7----
(Address) ~~Z'.J /~fi-Lhe.- a~ ,sa/k / e;;9'~./??A
(Address) (City) J (ZiPCode)66~
(Contact PeOlon), N /' /' ~ ?i<<'?~~ne) ":;'57- L/~ - d 77-'7
APPLICANT SIGNATURE I tt. r~ DATE
TYPE OF SYSTEM
OWarm Air Plants
DGravity
D~echanical .
~i!" Conditioning
~t. System
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
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
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.~>
''\
Estimated Cost $
Building Pennit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
c:tf .50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
~Q'2.002
By
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
1_ Pink
2_ Green
3. Yellow
(~qS-
I PERMITNO.;<-J~>- I
File
City
Applicant
ZONING (office use)
14181 FOUNTAIN HILLS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WENSMANN 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
1/10/03
APPLICANT PLEASE COMPLETE BELOW
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 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 HEATN GLO SL750TR
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 $
HEATING PERMIT FEE
ST ATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
/f?::/i I
" ""'-"C'
....:.(~
.50
Building Official
Date
IIJ[E
(Office Use Only)
This Application Becomes Your Building Permit When Approved
ceipt No.
24 hour notice for all inspections (952) 447-98
FILE No.938 12/18 '02 10:57
ID:PLYMOUTH PLUMBING
2lX : 7635331121
PAGE 7/ 7
~:~<~
'.....~ItNE.~O~.,..."
-----
Date Rec'd
CITY OF PR10R LAKE PLUMBING PERM.IT
I Blue File
: GnlU Cill'
:' Ycllu~u '\lJIII;'~..nl
(d-q~
~_~RMIT NO-:.~':~.\
(p)~a~~ l\'Pl' or print and s~; . ill l,ulWnl \ .
! ADDRESS
l-LL\ J ~ l
]
r"'zoNfNC; (1)I'k,,"~,,\-1
L.,___.... J
~ CLUV\;~"'J-&{\ ~\ \ ~
r LEGAL'DESCRIPTlON (MflC( 1m oldy)
. LOT BLOCK ADDITION
1....._...---..-........-,.......
PID
___~...,_..._..u.____-
-~----~.._...-..._.'''_..
OWNER f ~
(Name) ~ 1~~.i'\1\ 'd.v"\v\.. DV'^-.!2.. ~ ____.__.. .___ (Phone)
(Address)
~..\_-----_....-..-.
APPLICANT [)l -\-.n " \.
(Name)__...x.:. ~?II\r'\.(")(_i . ki.~ .._d~'\"\, ,'), '^'j
\1 (Addre~s) ...llq c.. q _ \tJ.L t.\.tuJ: 'c 0\ A t..o,...{: . k:
(Alidre.ss)
\ (Cllnlacr Person) ~1 \., _~_ C-V'\ V
lu!-PP~:I_~:~T SJGNJo~!'ll~'~ ~'*-Q[I.~~.-
iJ
(r7 ~) c-). ""2..7-._ l.-1 "?. c:: --
(Phone::) -.!. L~. " _~':X) - , :J ,=:) (
__1:>r (><' "- ~f1':k G!'5 L.latiS-.' --
(Cit (Zi.p Code)
\ \ f r (Phone) ('i u ~)5~ ?:> .- t...~. ,~) ~ I . -..
I\. I'd - ~.- -.'.1
. DATE __ . .1- L~...:==-=~..
,.---.....-- Type of Fixtul-e Quantity TYJ~t; II
u , -". .-._~-""-' .~
ath Tub Willi,)!" without shower Rough-ins
;"llwilsh~i'-..- . .-..' ....-.-.....,,-- .1.-.. ..'_.~_..- Walt'lr Heater
._.__'.M__ ........' . Walersoflner
1001' Dra in -..+"-...- ~---
avatory (Buthn;O~l Sink) Stand Pip~ (WlJ."hin2
uUildry Tray ~J...~.!:"'~ compartl1'1enl sink Sewage Ejector"
- ~,--
lower Stall Backflow Assernbly
inks -_.'. Backflow Assel11bly
._~_.... - _...-, .. . ....-..
AI>PLICANT PLEASE COMPLETE BELOW
r Fixtur-e
1"-'Q-U::l1ltj~' i--
~~~::=::'~bi-
i---t'--.- I r-
f~ ---- h
r--r-'" -. ! c
i.--' ----L---Jil
.-.__....._L~
g I'vlachinej---.---
.._ ..__._.___..___....~-~~Ii
Test ----.
.........,__..___. ... _..n.' ...
.--- -.---.-.-.-1
.J
I I t...JI&.U 1-"1'1\,
C'-'-:::S.-"-" i ~!ater Clo~el.(T'(\lf~l-)..
-\
--I ..-.... ~t-" ....,,_.
'"-' . Other
FEE SCHEDVLE
Ind\l~11"Ial. (:nml11<:.ITi:ll & Mllili-(;mlil~' III." llf.1llb C:llSl wilh;1 $39.50 minitllllm
R~siuelllilll. N~w (1111': &. '!'wl1.Family $99 so
r{CSl,k.nli~l. ^ddiliLJn~ cS:. AHC:I'Ulilll1S ~3').511
Estimated Cost ,I; (JLIJ 7f).{J{)
Building Pemlil #
IJLUMBING l'ERMlT FEE:: 5;
ST..;'TE SURCl-LA.RGE $
TOTALI'ERMTT F'f:R $
-....
..5 ()
II llTI<:1: I i.c Onl)')
This Application [knlml:~ YIIllr Buildiug Permit Whr.::n Apprnv!:!! I P;I'j,j"-" .-..---..-..,... ! Rcccirli-.J{1--'---.-' ...
..__.._.__.... ...__.._..._.......___...... ..______.~ I Dm:: DEe 2f)2Wl"+8:~---zp-" .-..-.
Iluildill::. llfjj,'j,d lhll,. i
....-'-' u'-.. .__._-...u._-~~~I.~':~hlr all il\~pt:clillll~ (95~1 ~47.l)1j5/l. r:l~-~~5:n 4:~~"C:--"-" .....-..
I (,:!.Oll Fa~k (.n','I, .w".. ."Y.. P,'j", I al". 'VIr.' :;Q7:!.li14
FILE ~.Jo.303 02/14 '0:3 10:55 ID:PL\/f'lDUTH PLUf'lBH.JG
FAX:76:353:31121
PAGE 17/ 47
WUOf. . FN..f
YfLLOW - Al'l'llCANT
GOLD - ell"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
Qs
S.w. No, ;}. --- 1;)-1
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: .v11't"( 1-tIA PluVY! ~;~ PHONE:0~~)S'J2J-.L\ '?S7
(ADDRESS:-1L-\I___ fOl)V\t-a\v\._'\~ ~~, DATE: d--~L4-0~
_ SIGNATU::CQj)e-::f'~ ff~l\ BLDG. PERMIT #
SITE ADORES : PID#
FILL IN THE BLANKS
I
A()
feet.
1. Estimated length of water service
2. Size of water service
\ "
inch (e5) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC y..'
5. Estimated length of sewer line ~[)
Cast Iron
feet.
6. Clean out (if required) I located at
structure.
feet
from
=======~~==========~~====~;;=======~==~====~=~========:=:=========
This application beccmes your permit when approved.
BY
DATE:
============~=;=======================;=~===~===========~==~=~~===
fEES:
$
$
$
35.00
.50
35.:'0
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually lS $20.00 plus
$ .50 surcharge.
*
Sewer and water permits issued for new construction must be
recordeql Ofi:'-tbe,puilding permit card at the time of issuance
to insu e ;~hat:no. -~..<,;a.o.;.~.. .~..' cate sewer and water permits are
lssued. t" , ,'.! :'! i PA'r,
I~.M N'.,' ,~. t~/.!:., -
I FE'" / ii '9~)(!1D!Nr>.
_t'l :'<,"', I. ,i AMOUNT PAID '.'
C(
D.A/fE PAID
RECEIPT #
,
/jl
REC/D BY
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
~e -\.ha.. fvh\~ ~'le
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~Fou,^~,^ liJls C-\-
NATURE OF WORK ---.J.Jeu..)
USE OF BUILDING S~ A
PERMIT NO. 02 ---/zC;5 DATE ISSUED ~-OL
CONTRACTOR W.eu.SW\o..VWL PHONE Cf52.~ ~~-ml.oi
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I vV\, { J l-e hi to 3
I FOUNDATION (Prior to Backfill) I Wv~ I Lz..,f /;1-- t63
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING l...v .. f
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ~o'\ rr:..v fl",,~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~'\ 1 C C, b 7~ FINALS
( . GRADING (Prior to Sodding)
~lf.. BUILDING
ELECTRICAL
PLUMBING
HEATING W
DO NOT OCCUpy
~ I-u. tD3
J/y b 7-(1:;3
~~
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
M~F~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Rate Rec'd
o f2.C.H-es y
to D\/b
-h Is
(:-7
/( .)( )iV i'f'--'I. I !I...)
LEGAL DESCRIPTION (office use only)
LOT X BLOCK 'z:~
<;:-n.J....> -rJ:..., A...J
, >.
ADDITION
OVfNER ;
'M I"~ _,J '/"" .. I
(Name) I (.. ."-"::,/'lrl,(:;\.[',),-..
/J./'Yt1 t.~5
(Address) I Y'1"-)
[) A-.& A
h
BUILDER
(Name)
(Contact Name)
(Address)
~:.~ ~
._./...:Jrt/J-,1 c:;
White File
Pink City
Yellow Applicant
/:"L [( :5
2 .A..J .b
PID !J <,-; 7. J -,)~ /),']J", (:)
,,- _, ;.)/<..' .. I
(Phone) G~ <) !-- (I() (;-if i/C 16
.
2- (-'-~)
D;.4 (~ :'t U
(Phone)
(Phone)
TYPE OF WORK
o New Construction
o Lower Level Finish
Porch
ORe-Roofing
DAlteration
ORe-Siding
OUtility Connection
ODeck
PROJECT COST IV ALUE (excluding land) $
o Fireplace
DAddition
o Misc.
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
enterupontheprop?'toperfo~r /((\---)' It) :; (-[' I.~
X 0...;- sigI)i'~~e /~,?/~ Contractor's License No. ~ - J Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
.....
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Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ / {, Z .. 4b
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
II !t~/oL-
, 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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White - Building
Canary - Engineering
Pink - Planning
The ernler of .hl!' t.ke Country
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
tUj/~1ct/~/}L-J ~
16-- ~J-O,Y
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1'-;// ~I 7'~~u~ 1h/ilo ()-;
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Accepted
Accepted With Corrections
Denied
Reviewed By:
~
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Date:
/1/(2/02/
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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Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
, .
BY: pen-,J;~ 17;/0 r
Date: /I/t z.-J""Z/
Building Permit #
Site Address / if / PI
Legal: L r B
Pill: ZS--"!'d -00'-0 Zoning: 1C.,'f
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? ~ #..~~ts Z,..I)
~ Subdivision: V"7'J7A-Nr/t/~ / (J
Existing Structure: YES or NO 13e;cN-.:) Co f-,)'ST,eM.cTE'D
I CONFORt"VIS TO ZONING
ORDINAi'{CE
YES
NO
YES NO
Is this an expansion of the existing footprwt or Refer to Planning Wa-
building height?
Is the property located within the flood plain? I Refer to Planning tllJ
Does the alteration include any additional kitchens? I Refer to Planning tJO
Does the proposed alteration include any outside Refer to Planning
entrances other than patio doors? ~O
Is the proposed use of the finished space or Rder to Planning
alteration for anything other than a normal single f.lo
family home (office, group horne, day care, etc.)?
THIS CmCKl.lST ~lUST BE COMPLETED .-\.'ffi INCLUDED IN THE Bl:ILDING PER:.vIIT mE TO
.\'LVNTA1N A RECORD OF THE REVIEW.
-
L\TE:vfPLA TE\A.L TeRc':Z.poc
PRIOR LAKE
INSPECTION RECORD
VV\.AI k) Fi L~
DEPARTMENT OF C> fl
BUILDING AND INSPECTION UtES
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SITE ADDRESS I~ / Yf ius 0-..
NATURE OF WORK NfJAJ fOt2-Uf
USE OF BUILDING S.I:; A.
PERMIT NO. ~ /~(p DATE ISSUED III 'Z-(tJ~
CONTRACTOR bJ6 M. N Ho"-"-r:s- PHONEbS/-%" -<{<tOO
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
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PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
HEATING
DO NOT 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