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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
OWNER
(N ame)
LOT30 BLOCK (
ADDITION
Date Rec' d
IO~ z,5-02-
I. White File \ PERMIT NO
2 Pink City . 0 Z- - / ,I I; 0/
3. Yellow Applicant . 'r '(;.
ZONING (office use)
~2-
(Phone) 95::) -0235 -d S-~3
dblo
(Address)
BUILDER 5;,
(Name) ,,- /1::.~
(Contact Name)-='- ' /
(Address)
, <)~'r7?71'1
(Phone)
(Phone)
95"'eJ -c7'...53 -~Sq..s
t;5d -ol35 -~S'-l3
TYPE OF WORK
New Construction
ODeck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $ /
o Misc.
OPorch
ORe-Roofing
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 the rty to perform neede in ections.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
d~(t1j)
(40. () D
3'5, $'0
Gas Fireplace Permit Fee
,tffJ
This Application Becomes Your Building Permit When Approved
~~~
Building Official
/ I /11 /1) 2---
, ,
Date
o Addition
o Alteration
7Tc?l(J07~ 7.5 7
Contractor's License No.
/o?5-ka-2
. 6ate
$
$
$
$
$
$
$
$
1/ f/) lOV $ 10. /
\ ~;cciFJ ().15 'I
-
J
Park Support Fee
SAC
#
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
;~ ;tdp /(hllZ/.du ~
Planning Director I 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
Water Meter
...
,
#
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
\ Paid
Date
"z" 10 ff:=
t- I~"'C
White - Building
Canary - Engineering
Pink - Planning
The ('tntrf of Ihe L.kt ('ounll")'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
CJENTSX fioKSS
I (J - Z.5 --- 0'2-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J 441.0 { ('AS JlA:;; 6j A fu V'i~
Accepted With Corrections '/
Accepted
Denied
~~ t'~~ Date: ///,,10"&
~ (
. ~ a.Lf a:;e(~~-~.
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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A.tIUno.) .I".") .1111 JU J.lIU.I.) .lll.l
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White - Building
Canary - Engineering
Pink - Planning
Th. C.n,., 01 ,h. \.ok. Coun,ry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
l)EJJTSX
I 0 - Z-S -
H()~I t; s
02-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
)44&1 C/-\jrLEgf\!S 1(11~
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
11118
Date: 11- If -6//
Comments: See Reverse Side for Additional Information!
P,ilo-(l4l1l( 1Yle,)( Vv,'df&..: ~'-I'
See Attachments. 1) Gradine Plan, 2) Ero~ion Control Measures
"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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..l...PPUCl..."\T PLEASE Cr)'\..[PLETE BELO','\'
'-70;;1[:,; T:/;;~ ill' lfi.,nln: (2'L..:nrrr:~ I
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PLljlY(B~'G PER.\,.UT FEE :s
STArr SURCHARGE :s
TOTAL p.ERyrrr FEE :s
fLi/,
50 .
{Office t:sc: 0,,1:-)
ec::p( No.
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Thi:i Applic::Ic:on Becomr:s Your Buildin~ Permit When Approved
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TO: 91 D30c-D3-t~ljf
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;e:n ~~~y I PERMIT NO. ~-I /JJ_ G1
3. Yellow Applicant . c::><. -/ to
ZONING (office use)
ADDRESS
14461 CASTLE GATE WAY
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)
2700NORTHFAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/14/03
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
o Warm 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 HEAT N GLO SL550TR
APPLICANT PLEASE COMPLETE BELOW
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
Building Permit #
$
$
$
;'V
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
(Office llse Only)
This Application Becomes Your Building Permit When Approved
Buildine: Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-42
.~ CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rcc'd
~. ~:" ~i~ [ PE~lIT NO.I) -. 1'1 /~- Q7
l. Y.llo'" APpliwll . L::X' 7 <::..J
h
ZONING (offieeUlc) i
U/Z1
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) Ce,/1 f-{ y
JI CJ /h.v <'.
(Phone)
(Address)
APPLICANT
(Name) #~"'+, 'V".~
/
(Address) l 7,5-:)"0
~ (l.Ct'l I. '" 9
,
-rr~
(Phone)
7(, 3 - 4). '?'- -:?C- 77
(2 (".) :...//'" r"(
(Addrm)
(?-~/ Sr
/>7..pl.; (:l/e.""
(City)
5"~-;:J (, c,.
(Zip Code)
I (Contact Person) ~"""7'
~PPLICANT SIGNATURE
~~f:-
Z7 ~-rt
(Phone)
G,I 2.. - ? I.. ::; . >5 C. 7
DATE
/~ 3/~()3
APPLICANT PLEASE COMPLETE BELOW
/
[gNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FUR..'lACE MAKE AND MODEL 13 rl.j a /1 +- 3 ~o '-+ ?:-J ?O FUEL GaS
FLUE SIZE PVC RETURN OPENINGS ;g' INPUT 60, ("l'Jt'";) OUTPUT 7'1 000
TYPE OF SYSTEM HEATING OR POWER PLANT
[U<Varm Air PliUlts 0 Ste;:m
DGraYl\)' 0 Hot Water
D Mechanical . 0 Radiation
~ir Conditioning 0 Special Dcvic~s
~ent. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I
I
FIREPLACE MAKE AND MODEL
Industrial. Commercia] & Multi-Family
FEE SCHEDULE
] % of job cost Residential, Ga.s Fireplace
~39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential. AC Only
$39.50
Residcntial, H~ating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost S
Building Permit #
(Omee u~c Ollly)
This Application Becomes Your Building Permit When Approved Paid
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Building Omclal
Date
c~, ,'"
. ~:~~';II.:
"'....
Dare
24 hour notice for IllJ lnspectlon~ (9~2) 447-9850, fax (952)
~d W~LS:80 [00~ T[ 'uEf
~89[8~~[9L: 'ON X~~
04/15/2003 14:37 9524512155
FEE-13-2003 09:06
DASEtJ CONTRACTIt,JG
PA(:;E 81
CITY OF PRIOR LAKE
9524474245
P.131/131
CITY OF PRIOR LAKE
SEWER AND WATERPEMnT
Date Rec'd
LEGAL DESCRIPTION (otnce use only)
Lor. ADOmON fJ\
~ Sw ~u....l PERMIT NO'Oc:2/.Ilb? 1
[ ZONING "....-'l
PIn
(Addte,,)
=~J
(Adcfxess)
(Contact Person)
DATE
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Locatioll of any couP~om structure _ f~t
Type of sewer pipe. 0 AB C 0 PVC 0 Cast Iron
Estimated length of sewer line _ feet.
Clean out (ifrequired) located at _ feet from structure.
FEE SCHEDULE
~Id.euti.llawer lLOd Wll1er line: connectlon $3S.50 Indu.roial. Com'Z &: Multi.(amlly 1 % of Job CQft with. $39.50 minimum
Sewer conn~ion only $17.50 Water connection on~ S 17.50
Estimated Cost S
Building Permit fJ
SEVIER AND WATER PERMlT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
S
$
.SQ
'PAlO WITH
BUILDING PERMIT
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