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CITY OF PRIOR LAKE BUILDING PEmIt! If / A/
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1 -It -
""<CdS
<.I"'; ,v "fA I,..J
LEGAL DESCRIPTION (office use only)
']
LOT '.- BLOCK "7-- ADDITION
IJ v I".! J ..(: ~ J-)
OWNER
(Name) lA.,' (f/, , S !/I-J .A:..\ A) (')
/" I /
-(DYl; d S
(Address) /
:;J //1 .? ",i
',/,",I ~__ ,
FflF
Date Rec'ct
cj 9-.;L
~i~i~e ~:~y I PERMIT NO.O' Z ,/'Z/lr I
Yellow Applicant _ _ LW .
/~r
..... ./ /
I~ji /Is'
ZONIN~ ~fficeuse)
1<- '1
/./ '1)
--, /1,/~
'..1'./
.?t ..
./""\"/.- /~v" ///;;-:/'1./'\
(Phone) '/" /. /( /" ? ,0 (/,-./
I
. 1 .I ./ J j ;. ) C(.. .".. /',
IV /e . \ ", _/ / c:J d.
/--..<, --.
I~-/ ../ 1 &7
(.
BUILDER
(Name)
(Contact Name)
(Address)
"/
c
,;<',,; '..J 1.>'2
l./
~. r;..l~> ~\ nfJ
.j ~-
(Phone).
(Phone) {It:;;)-;:;. :? 5' >"'/5 /,~"
TYPE OF WORK
o New Construction
ORe-Siding
DLower Level Finish
o Misc.
DDeck
DPorch
ORe-Roofing
o Fireplace
DAddition
DAlteration
PROJECT COST IV ALUE (excluding land) $
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~p.~Jform nee~
X <.9 ~?z ,/ ./">1/'f??"
s(gnature' ,~ Contractor's License No. 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 $
~
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size / ; 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.
~ -1~f--
Planning Director
/Ij?ftt-- ~ ~~ ~,
Date Special Condt IOns, If any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
f(\~W~
Thr Crnlr' 01 Ihr l..kr Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~U~ f)o-yJ1.-c-.:;?
4- Cj-()C)-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
II/liS -pZ01J0//v #~ rJ2-t-
X
Accepted With Corrections
Accepted
Denied
Date:
CJ (ZD/OG
, .
Reviewed By:
Comments:
everse Siae for Additional Information!
See Attachments: 1) Grading Plan, 2) Erosion Control Mea"sures
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 p~rmit 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."
~1~
-
['hI;' (-('nlt'r (If the Lakt ('oUnlr1'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
lU-btl,.Y:WlO/14/?t- ;)~_.
C?_ C/__()C)-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/LI/f~ ~i~ #~ tl2j
Accepted Accepted With Corrections X
Denied ~
Reviewed BY~__ .
Comments:
tf
Date:
f- /1-02-
~
qJQ ~ ~a-:h
"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,"
~M
The ("('nln of 'he Lake Countr)'
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:
~
~~
r
-:f-~,0
ad~
Date: /d/?/6-z-
,
~-&JS
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 CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;e:n ~:~y I PERMIT NO.. '7 _ {~J C) lJ
). Yellow Applicant , ~ ( I ~~ =:1
ZONING (office use)
14185 FOUNTAIN HILLS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(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
2/12/03
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 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 HEAT N GLO SL 750TR
APPLICANT PLEASE COMPLETE BELOW
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
Buildine Official
Date
J:"'"< J
(Office llse Only)
'1'
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-424
FILE r..Jo, 303 02/14 . 03 10: 56 I D : PL\'r10UTH PLlJr1B I NG
FAX:76353:31121
PAGE 24/ 47
eIlE&!. - FILE
YELLOW. APPLICA.r
aOLD. COY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
;::;l. - rlc;' /'
S.w. No,' /0' (??
Sewer and Water
contractors must
be registered
with the city.
APPLICANT:~O"-tVl P\C<VV\ VJ ~ PHONE :hlll'l)5'h- L\ ;:,57
(ADDRESS: jl..-.\ij: f Ol)'~-t:ai '^ ~ . \ \., 0:'\- DATE: ~ d-~ \ L\- (I 'j
~SIGNATu~tj)&)Jv\\JLf~Yr)\U~JQp'~1 BLDG. PERMIT #
S ITE ADDRES~: PID#
FILL IN THE BLANKS
1. Estimated length of water service
i
At)
feet.
2. Size of water service
\ ..
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. )l.BS PVC Y. Cast Iron_
5. Estimated length of sewer line ~(C) feet.
6. Clean out (if required), located at
structure.
feet
from
;;========~=================~~=====~~====;=;====;====~==;===~=====
This application becomes your permit when approved.
BY
DATE:
===~==========~=~=====;===========:==~=~~=~===========;===========
fEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
*
for new construction must be
at the time of issuance
and wa ter 1C:ll?i~~~/i"r,a,re
'-.:-og'l",DtNG PEr.' ,/...,...
. ~ a r
AMOUNT PAID
Dl-.r.CE PAID
RECEIPT
REC'O BY
Yf
16200 Eagle Creek Av. S.E., Prior Like, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opponunity Employer
FROM :ALLIED EXCAVATING
UJ/lS/O:.! 'rfE I)Ujt.1 FAX S:2U74ZU
.' \
[
I
" \
FAX NO. :952-895-.
"'... -I ."iI a .-,
Oct. 29 2002 12:43PM Pi
Data ~c:rcl
CITY OF PlUOR LAKE
SEWER AND WATER PERMIT
\
..Jl$~ttmatlll4~lIot~) ---
i ADDRESS I .
U 11 I BS Eopf'~"V"\ \\ \ \ \ ~
riWAL Oisci:iPTi3N (el!lict -.>
i q B. I C \. \\'\\
LLor Bl:~~ . ADPmO~ ..I.Q~YYTc.. \~ t'\ \ \ \ ~
i -,..~
OWNE~' \:\
(Name) ~~~~~... Q""'e..>
1 (Ad4J\'SS) J~q~ W\a2Q.. tk\v~_"*~DD
I (A__J ~
I
r A.PPI.lCM''I\''\\:~ C' . . q~ ~A,I. O~,., ^
I Cl'I.,...) '" ,...--Sell- co. vc:. \- '~ (l'>>o..) - . 0 .. o<..>"t '-'
(~)~\ lW \;;)to~s ~\-v ~\J~e- m~ QS:3>lB
I i (~) ,ca", (ZiP CaU)
I (Coo...' ,.."on) ~ ~~ (P_l _&~
I A1'PUCAm 51G>I~ _. . .~ ~ ."4 Q.~ PAn; _ LQ. ~ri'1:.Q ;J.
i
I
: APPLICANT PLEASE COMPLETE BELOW
._-~ water service -L- iJlChea,
~t1.on or any cO\qllin8' from .ttuc~ ~ "'d.
. !YPC of se~t pipe. 0 ABC 'l(l PVC 0 Cast I;on
slim.led len&th of sewer line" feet,
:Ioan oul (if"'llliled) located N.1'ecI from muolla.
;: ~ ~ [PERMlT "~. .{f- ! J- q ~
;-\ Lo--l
C~( ~O'( L.~ 'qt_~ ~
I
.J
PlO
(fhlXlC) UP} - '-IO~ - 4 &.JOLl
EQ~~~'t0'S5\~~ II,
t)' (Zlp~)
--,
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,
R.\dan~i,t seWe)' and ~ Ene CONl'~lion S3~.SO
SewlIlftOnneet!Cln onl)' r. 517.50
I
I
fsttmated ~ S
I
i SIWEk ANI) W AiV. PDMIT FEE
!. STATE stJ).CHAROB
I ~OTALPI~TfEE
I
I
'o.;:~ ':,;.:,... + y- -... ..,:;;itWi... .........1 'ii<l I ......~>', 0, l'
____. d D.. r-r 'f' \ r '/~/l ./
J,,"~I'" Otriei. . i b.1e __ "'~.:....~ - ,.lJ. I.:.../"
1 34 hour "1lI~' ror 11I1,,~p_IG", ('5J) .a4.'''UG. ..~ OJSZ} 6t~4Z6
FEE SCHEDULE
Indllsltial. Com'l &. Mulci.r.m!ll' I'" CJf Job tOtlt wldJ a $39.,50 miDi1lMD
Wa. conn.nk1n emly S17.'0
Builclinl P.ltt\it ~'.'--' .
s
s
$
:5ji
FILE No.937 01/30 '03 14:08
I D : PL\'11DUTH PLUr'18 I ~.jG
FA>! : 7635331121
PAGE 6/ 8
---
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CITY OF PRIOH LAKE PLUlVIBING PERMIT
Dale R~(:'d
(n~".~ 1\"~:11l1 .11\0 SIQll "! l'Oil<'rli I_
e ADDRfSS
I_~ +ouvtb f4((s
I f!h.... Fdi:
: G'lld CIl;"
l \' (11,)\~- Al1l'llqln'
I PERMIT NO, d--I;ql
----~. ~
J
rZONING i(lrlic,~.~
L____ _J
-
: LEe AL DESCRJPT10N IIJ'Jj" US(. on/vi
LLg..! BLOCK ADDlll0N
rnWr~l:::R .. -------,.
I ;Nam'~J _ I 1()"AA~~1A~V\ ~vt.<..Q,j
I ~ \
I
i (Ad~rm)
pm
'-'-1
(Phone)
(Phone) 0- (C ~} fJ.e")'")y-~ ~~)'~~-I
~Jrr)[)k \Jt/1, f-+~~ k F)5L.lrl_7~ I
(CJty. (ZlP Code)
(C:>n(J't PCl'<.or.) ~ L 6~~VV\u-e l\ ec ,__ (Phon~) t;J.t.~-2V.~,~-:?J--4 3~'7 ..._._
lyrucMJT SI9!'Al_U~~~_ DATE \ - ?!>:D~~
APPLICANT PLEASE COMPLETE BELOW
APPTJCANT f)'
iN,m" _ ~^-('~:h:l 1:" I U.''\:l,l~l~
I Addrr.:s~l J.2:l C q \"/I,rln..L1 r ~.. A \ H k
,
( Ac1dr~~~)
!01~mtitJ ., T~'r>t' of Pi
I--.~----- -----, -..----.
: Bath lub WI111 ur wlth(Jll
I
f---
!
)-....
I
~..~-
I
!-
"
. Dishwil;;h~r
xtu re Quantity' I ~~pc-of Fi,tu r~--
t SlhlV.C:I' -:i;' ROLIgl1-in:,
.-.. - Hli!at~i- -.
-.l Walel
.' .. \ Wat::I'So{tner _.
-. - Stand Pir~ (Wa.:.;l1lnS tvIJchinc.\
' ) I
,1 panni tnl s'=t= Sev.'agt Ejector
Back flow As:;~mblj. ".'-
Backllow Assci'nbly .,.
: est
- .~-_.
--"'--'1
,-.=~~I
'~-=-..-I
..-- ,--I
,____..1
----I
-.
..-'.....-j
.._----......
flcl,)r Drain
I Ln'vatory (.BJ.thr(\UITI Sin)
LlLIndry lrflj" ( I o~2 COI'
Shower Stall
Sinks
L__ \
i v.... -."""
t---~.. '-\\7"j-tcr CI_(.':~I h:(\I~;..l \
i _~_.....-.iQ.~I';~I: "'" ......v...
FEE SCHEDULE
Intllllll"i,\1. COnJl11<:rcl.lI.i.~ ~'lllltl-I..Inll ,I I"." C>j'ii,h ~i\;1 with" $JLJ 5]11111111:111:r[l
k<:~ldc:nllill. N<:v,' One 0; lw,'.hmilj J;'.j'.l)1I
1'~~IJ:':IHlill AdllIlIU'1, &. !\Ilt:rall()n~ );3':l 511
bllm;jl~d C(.\~l .$ I 'O--/o.m
Buiidln(l P:1'1TlI! II
;:l __.",_
PLl!MBtNC PEPJv!n fEE
ST.;T[ SURCl.L.;,RCE
TOTAL PERMIT FEF
Ib[(
.:'1)
@JMg~90 WiTH
~~IP~iFu"~GJ'
IUlli,," I ,~, 1\,,1\1
I Thl$ Applicarion BCCiJfll(;~ YOUr" Rulidlllg ('Crlllll WiJrll 6,ppn1vt:cI
I
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., 'tlPI Nr;-'
..-'::.~
Illl"d",~ or!'".""
-_. -- '.---...#.-.. .-._'
---d4v
1_..- ......__.... '.
._ _____6. ........"..
.------ . 8
~-l IIOUl' flll1l<:I.: /,,1' JII in\I'C"llill" I'J:;;, -+-17-'1 . ,
1',~111i l:il~l, ("'-"1\" '. r I', ,,,; I .J! I' :\11\. -';;';":-1714
PRIOR LAKE
INSPECTION RECORD
M ~ .'11\ h-l-e-
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -l1J ~ wvrku'l/) l1ill5 Q,t."
NATURE OF WORK -1J..t2.lD
USE OF BUILDING Sc: It-
PERMIT NO. 0 2 ~ /2- 9C:? DATE ISSUED q - tC.l-CJ2
CONTRACTOR ~'MaMV\ PHONE qL;'1 -;;'S5-tE€3{~V
- /
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
!~PECTOR
I FOUNDATION (Prior to Backfill) I M {:J I Lib /83
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
I FOOTING
f 6 ....),.-! ---O'L
SEWER I WATER I SEPTIC
FRAMING ~
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS 0 ~I t \ 03
t~3
'~ 2.,~ ~
GRADING (Prior to Sodding)
BUILDING W ~ L6M--.S
ELECTRICAL
PLUMBING
HEATING
DO NOT
;)IJlv e;3
313( ![;3
4s- ;f / lf8
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850