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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
':: ~ f,_/ It.../' -r'~ I !\.J
,
/-::t':
Date Rec' d
9,5-02-
White File
Pink City
Yellow Applicant
PERMIT NOtJt -/303
/.,. ...,..-
ZONING (office use)
1<.4-
LEGAL DESCRIPTION (office use only)
LOT /./ BLOCK?
ADDITION I>;)> ,\/~...:, " AJ
/.~
-
L.'"
PlDd~)7(?" (?t'({) c.J
OWNER /,' ,
(Name) ~1\. (~".J) 'v! p:, ,J^l
(Address) '7::;; <;- P;'A
BUILDER / ,,-
(Name) I f\ C'J
- '....5/' k? i :~ .1\./ /' )
(Contact Name)
(Address)
/l ~ __, --7..._ ;.:-
TYPE OF WORK
/~-;.))~, ,5':f
r)
7_..
/ I _; /..->(
i ""(f._'J..c '{/ \
~/:<..,,-,~,
;'
/
/'t~"--
.0,..........
o Misc,
OLower Level Finish
New Construction
/~ ~ -i~
<.:;; ~'
)1/': /- (//~?j(')
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'1 ~. /\
/ /.X-'
L-._ ~,_.
'/fA)
<'--T~-' ~J;;Z
/' '. /. . ,,,;/c,r /"'r. T' )
(Ph ) '" c:- /' - 'r /) / 'j" ,r /{-,
one '-,I- __' / ,:__/ \;:--J '~I....
(Phone) ~'<;;:~';23f.~L .~ :JlG.
ODeck
OPorch
ORe-Roofing
ORe-Siding
OUtility Connection
,'v"'-
o Fireplace
o Alteration
OAddition
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
enter upon the r7erty~e~d~peCtiOns . .. / ,.' S- .2 ;~ _ ~1 - 2-
X { 0")..,. /1 ~~~ 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 $
s Your Building Permit When Approved
~-('] -02-
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ &> {1 8 q. & c:.
~O.I.OQ-
Date Special Conditions. if any
our notice for all inspections (952) 447-9850, fax (95i) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter Size / ; I";
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.
Tht ('tntn of tht t..kt Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\IvENS MANN
q-s- 02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
142 &; f FUU/'JTA IN 1-11 Gl,~ ~ T.
Accepted'. )( Accepted With Corrections
::::::edIBY: +4 Date: Jf(~jOL
Comments:
5~( y(\k(.~ ~~
See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan, 2) Erosion Control MeaslJrP.s
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."
--.-..
~~~
White - Building
Canary - Engineering
Pink - Planning
The Cf'ntt'f of the LII~f Countr}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, !
,,\. '-
t\, i \ -, i
'II/\;\.:I
/', r'
, I -
l ./
\ t---
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
./
t ! ; 'i . _r'
,e '/\ I i I 1'__\/"
: 1
I ",
I
i / I
1--:-
Accepted J
Accepted With Corrections
Denied
Reviewed By: ~
Date:
C1 qo~
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."
-
The Cenltr of the Llkt ('ounll1'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
Vv(NS MANN
q-!;;- 02-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J4-L~1 FOUt\JTAIN i-II~L/S c!;T,
Accepted
x
Accepted With Corrections
Denied
-(]J
~~
Date:
q-(3-CJ2-
Reviewed By:
Comments:
~
pt,
"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."
. 0:3 10: 59 I D : PLYf'10UTH PLlJ18 I ~.jG
FAX:76:353:31121
PAGE 46/ 47
ORer. . FILE
TELLOw . AP'lICAIlT
,"OLD' CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
;) / .3 O~
S.W. No, ( ..-- ,_
.
Sewer and Water
contractors must
be registered
with the city.
APPLICAN~Ol ,+111 PllAliYI ~
c:DDRESS: .._.1g l F QLW\t -ai '^ . \ \::, t::'-\.
S IGNATU~] (j)&~~1'\I.UQQ~1 \
ITE ADORES :
PHONE :/'7{J).'))S'-;:j-'u' b57
'- ....
DATE: d-- \W-O~
BLDG. PERMIT #
PID#
FILL IN THE BLANKS
1, Estimated length of water service
f
AD
feet.
2. Size of water service
\ "
inch(es).
3. Location of any couplings from structure
feet.
4. Type of seWer pipe. ABS
pvc y: Cast Iron
5. Estimated length of sewer line t-IO
feet.
6. Clean out (if required) I located at
structure.
feet
from
==~====~~=;====~=~=============~=========;========~~=~~=;=====;===
This application becomes your permit when approved.
8'1
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.
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no dupl icate sewer and Ii/a ter , peRi ts are
is s ue J!lJ!~Z' Wlit!
DATE PAID AMOUNT PAID .. ~G pc. ,
()-
*
REC'O BY
Ii I
II!
I
1
I
----I
16200 Eagle Creek Av. S.E., Prior Lake, Mmnesota 55372 / Ph. (612) 447-4230 / FAX (6 I 2) 447-4245
An Equal Opportunity Employer
RECEIPT #
By___
.)
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
#70/b?
EJ~icant I PERMIT N~;2 ~ I '00 -' I
1. Pink
2. Green
3. Yellow
ZONING (office use)
h.J~~ ~/ ---<- /-.///$
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT A . /. ./~
(Name) /7'//~A.,A.r /'~~..,-r~ (Phone) ;,/-
(Address) l ~~7) /4"'-?A::,I 6~ ~ ~_ /=--- ~~
(Address) (CityV' n
(Contact Person) .A~/':)~ ~c..~ (Phone) "/-
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
qzLNEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL ~/('l M::JQ-ZL/O'70 ~~ FUEL f\f~ as
t..jl{ .
FLUE SIZE RE1lJRN OPENINGS INPUT 66. CY)r) OUTPUT 5'"'<, ~)
I .'
TYPE OF SYSTEM HEATING OR POWER PLANT
[!]'warm Air Plants o 'Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
1M'''',"'''] o Radiation Cannot Encroach into
Air Conditioning o Special Devices Required Side Yard
Vent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL .
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 & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ Building Penn it #
Date
PAID ~
. _ /SUILO/NG 7iH
Q<!/ PERMI;
.50
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Receipt No.
Building Official
By
24 hour notice for all inspections (952) 44 -9850, fax (952) 447-4245
By ____.__ 'nn ",""nnnn'_
FILE ~,jo, 502 04/11 . 03 06: 53
I D : PL"fll0UTH PLUm I ~,jG
FA~<: 7635331121
PAGE 10/ 11
Date Rec'd
CIT\.' OF PRlOR LAKE PLU1\1BING PERMIT
~ ~~~ ~::)' l PERMIT NO. ~ - (30 "j
J \~lIu~. Apph'lllll . ~
~\ bocm1'li I
ZONING I offICe elsel
,- OU VI~-o{
~~t
LOT
BLOCK
ADD1TJON
PID
~
I
I
LEGAL DESCFJPTJON (,)/T1Cl u~c only)
~~:~R v.-J --0V\ ) VV\ ~ I/t V\ 1-hVv\.Q S (phune) L\ 0 (O - ~ L.( ~)
lAd""'" \ <q,~,::> P ('711"" Or l ~ I 1< ~ fVIA t~ Io-J ;5 ,<ll Ci-- ~
~ \- ') \
A.PPLICA.NT /) '\
(Namel \/ Lj I,,\(, c'\-\ ~Y I u l 1'" \1\ I ^ ~ (Phon,) b I.!-' }) ~)"';".. '-1705 I'
/' I I ~ 1\ r' .-"LI ') <.'
I (Adjress) ( 0 () ( N t......r ' "- '1\ .p;: '" ( (J 10', {'\
(Addn:ssl (Cn)''). (ZIp Code)
I'CO,"C p"mn) :Ii I ( ,6c.J/\ ~1i~ YYll,{ ~ illt !Phone) t!! 0 ys :f)-- LeOS 7
t APPLICANT SIGNATU? ft..1~MJ.l~ DATE ~ -- I ( -- CT3
APPLICANT PLEASE COMPLETE BELO\\!
Quan ti(y Typt, of Fixtul"e QU~Lntii)' Typf:: of Fixture
\ Bath Tub With 01 wlthmil sh0\.Vei' Rough-Ins
I Dishwasher I Water Heater
'rl... Floor Drain \ Wattr S011111:r
:;;[ Lnvatory (Bathi"OOm Sink) l Stand Pipe (Wa..shlllg l\llZlChll~e) I
Laundry Tr<l:v ( ] or 2 C,Olllp<lrlmenl sm/, Sewage. Ejector
Shower Sta II BaclcnO\,v Assembl:>'
\ Sinks Backtlow Assembly Test I
- . ,
Water Close, I-(Iikl\
...,,,~, .,.), I jJ\
FEE SCHEDULE
Inc!\IWI;\1. CCn1mcr,,~1 & Iviu\II.f';llllily 1% llfjl.ll~ ~(iSI willI ~ $395011l1J:II1IUm
R-c~ldc:nl1.d, N.w One & TWLl"F~mll> $qC) 50
RcsldcnliJI. ,...dlillIUI\;: &. AJlcralh\:l:: ~:395tl
E.~llril:lU:d COS! $ S \ ~O. 6J
Building Pemlll #
rlllillJ,,\~ o f/i ""i1
J);ltc
.50
6~~4/() IA_
~G ry/~
~~~~
PLUMBING PERMIT FEE $
STATES'JRCHARGE
TOTAL PERMIT FEE
lurflcI' u.. OnlYI
This A['lpli~~ti(ln B(;cllm(;~ \Ollr Building Permil WileI'! Apprnved
, R~Ci;:lpl No.
!
B:'
~-'
~~ IIIIUI llilllCl lor' ~111I\,~pCl:tIIl'" (9;;~1447.9t);;1i, r;I', (Y:>_\ ~
11,~illi 1'.".>1,' (/'(','1, ';'''j:.. :-,,1'., 1'1'\'"' I."I,~ \1'" ;~,"'.I~'J
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
~ ~ lQ~i?Lk
":-
SITE ADDRESS I t.f?~ { fn(~o;.... tiC ((5 n t(
NATURE OF WORK --J Jev-
USE OF BUILDING s~A
PERMIT NO. ()2---/3Q3 DATE ISSUED Cf-/?tJ2
CONTRACTOR W.e<-?~ -I-t---<Z7 PHONE1S:'2-23?-~~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BEL W
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 ,~ C.
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS€::-l () ,,8:
I
f!) % 1 --L '/21 ,
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