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SEE: ~(N
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~I
LEGAL DESCRIPTION (office use only)
LOTb BLOCK ;L ADDITION
ClSJ"
1f~4./
FiLE
Ii) 'Ir- () 2-
I, White File
2 Pink City
3. Yellow Applicant
I PERMIT NO. Ol- f43q
ZONING (office use)
jJJ
.
CreJr
,e/
PID;J..:) -31" - u..:l}/- 0
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name) h./'" NJ .h.7 ~# N
(Contact Name) G 'l r y
(Address) II? S I'It. 'l..t.\
TYPE OF WORK
/.J 0 "' t"../'
IJ'"
New Construction
DDeck
o Misc.
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
o Addition
(Phone) "5/- 1v (" 9YfJj)
(Phone) ~ /.;J... - 3 ~ , - 7t, /2-
I ;J.. 2.
OPorch
ORe-Roofing
OAlteration
ORe-Siding
OUtility 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 th property to perfo neede inspections.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
{JO. 00
/0 () t 01)
..35. 5' ~
(J. t'tJ
This Application Becomes Your Building Permit When Approved
~~;J
Building Official
/0 ~ ::J-Io %..--
,
Date
/Y5- l'
Contractor's License No.
/0 -/0 -(jA
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
-
00
-
Water Meter Si 5/ ';1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE $ __5; '74 q
I~~~ S7l:c&!~)lJl~;eiPtC;::i{r
/d/;.P'~L- ~ ~ ~
. 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
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
iss~ i~
Planning Director
White - Building
Canary - Engineering
Pink - Planning
ThE' Cf'nlfr or Ihe t.kt ('ounIr1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ([)iJ.--11MY!{i/Jv11;J 6~
APPLICATION RECEIVED /0 - / '-1-0 ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for c. onstruc~n ~ty WhiC~ is ~posed at:
3%7S- N>/jl~ r~
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
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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f'.U 61244742;j~'
CITY OF PRIOR LAKE
~OPl
Date R"'d
C1Ti OF l'RlO1"<:l.Al<E PLUMBING P:ERMIT
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:. ~~ ~~'nl'l ! PERM1T NO. ~ _/l/"3~
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R~idenlhll. AdditJons &. AllUlallOI1S SJ9.~O
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Estirnate.d CO$! S
auilding PErml! .
, . .PLUMBI"NG .pf.RMl;r fEE $
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. ~ , ~.,p./!~.rto'~,&"om~ Your &ildjatr.~mii .Wh~~ APP.TOYK!
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C,!TY OF Ps'IOR LAKE
Sar'::R .U1D WATER ?::::<1-!rr'
No_J~(437
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NOTE: Seuer and Wa~er
contractors must
be reg istered
1.lith the City.
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~~?e of sewe~ pipe- AaS PVC~ Ccst Iran
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C~e~n out (if rec::uir'ec.), l=::eo:: --._~-~ feet
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Se~er and w~~e~ llr.e connection pe~mit.
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S .50 s'...r::"c:.ar;e.
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-::~c~::'dec. on. the. buildinr; pe:=-mit ca:'-c. c::' :':-J.e t!..;ne of
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;~(Jl:l
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACEPERMIT
(Please lJpe or ,riD< and:;)
I ADDRESS
Jg'75- /
Date Rec'd
t ~ ~~~icant I PERMIT NO. CJ-- /1139 I
I ZONING t,,,,, =) I
h?~s
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER A4 ~
(Name) (A'- 'Y-/<oJ4~H !/Y2J:?5
#
(phone) 0"/-400-#00
(Address)
APPLICANT . / /-
(Name) /{P#lb/ ,//yfiC
(Address) 4/1/ ~~/ 3/1>b/'/
(Ad~
cf=?.?J/~ /
(Phone) ~~/~t/-qgt?,f
.592Z
(City) (Zip Code)
(Contact Person)
APPLICANT SIGNATURE
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
EW CONSTRUCTION
FURNACE MAKE AND MODEL b/-#/~;<
FLUE SIZE J; / fie. RE~ OPENINGS
TYPE OF SYSTEM
OWarm Air Plants
OGravity
B'Mechanical
.Q1\ir Conditioning
QVent. System
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
Residential. Heating & NC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
o REPLACEMENT'
~/ --
....} f.c> N.:n ~
b INPUT
o AL TERA TIONS
FUEL ~/-
7'SfY;(J OUTPUT I4/":'cX~.J
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
$39.50
Residenti~l. Additions & Alterations
Residential, AC Only
$39.50
$39.50
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
$
$
$
/,-
.50
Building Official
Date
ceipt No.
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-98
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~::n ~~;y I PERMIT NO. y:. -/ LIB C; I
3. Yellow Applicant L .
ZONING (office use)
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 F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
71ll/03
APPLICANT PLEASE COMPLETE BELOW
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 D Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO 6000TR-OAK
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
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
PAID ~
BUILO/NG 7TH
, . PERMIi
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildine: Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 357 c:::; ~e..~L- ~ s s ,). W,
NATURE OF WORK NEAJ CeJAj'ST~cr/(J:J
USE OF BUILDING :S . ~ A... .
PERMIT NO. OZ~/~~ DATE ISSUED /O!z..I/o Z-
CONTRACTOR WbAJSMA-^.) ~ tftJ/V\.cs PHONE ~/Z.-3~<j - 7'/2-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
SeE: ~N N FT l-8,
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING V\'\a,1\1 I
I FOUNDATION (Prior to Backfill) Vv.Q[ /\ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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
vy.. 0.' V'
-~
1-~/~(J)
~-
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/2
{;-tlfr-d>
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