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Sa- n1A;;J
CITY OF PRIOR LAKE BUILDING PE
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/0 ',M -{)l~
White File
Pink City
Yellow Applicant
PERMIT NO. 02 -/4 74-
1(-0: 1
LEGAL DESCRIPTION (office use only)
LOT ;7 BLOCK..:2. ADDITION uJ::.roiY'a..;"t\ ;;trJ j~
OWNER
(Name) We\l\SwV\..oiU'\
(Address) t. '1S
P to_.::La
l-b('C :;,
r,..c .
(Phone)
PID
ZONING (office use)
Rd-
5s1~
BUILDER
c: -
(Name) 2lC:::U:::Jj C\.. S
(Contact Name) v.d
(Address)
j)f.l~
':::1 . -t-t" ..).c"tJ
f; ~--~ ,
IV\ t<J
c:..\r.v1l4
R SQ~
(Phone)
(Phone) aI q~) 4Lb -'-IS8 7
TYPE OF WORK
o Re.Siding
)i'N ew Construction
OLower Level Finish
o Misc.
ODeck
OPorch
o Re.Roofing
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 property to perform needed inspections.
x
We~\3
-b f"-e-::'
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
o Fireplace
DAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Water Meter Si
; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
,00
This Application Becomes Your Building Permit When Approved
~ ~~/-J
Building Official
/~c Z--
#
#
#
#
1 oJ.;u. /0.:(
.
Date
$
$
$
$
$
$
$
$
~4,v
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
~ ~
>k~
S . led' 'f
pecla on (Hons. I any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
JI/I~z,
( ate
White - Building
Canary - Engineering
Pink - Planning
The ('fnlrr of rhf \,okf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
o .. i
NAME OF APPLICANT W-e/?//J/YlAW1~0 iJo-nLf2-a/
APPLICATION RECEIVED 10- ;;) d -;0 a-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3b{!CJ.- r:/)yTOd I t-
Accepted
^
Accepted With Corrections
Denied
Reviewed By:
j}?4o
S~(. II1c,/VI F,/c
Date:
(&.... 3/-e:rz_
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."
Thf ('fnlfr or Ihe I..kr ('ounIl1'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT U)-<:1//)",'ru~
APPLICATION RECEIVED 10-- ~ ~ --03-
&1~
r
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3bL/~ r:/JKTa;,i Tt-
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~ yt~p
~ ~~
Date: //~~z---
~/
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."
~k 7Y/~ 7~
Thf ("tnlf'r or thE' I..kt COunlF')'
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
l./
Accepted With Corrections
/
Denied
Reviewed By:
~ ,<1,~~
.~p /J:1~
Date: I tit .ia....z---
/ '
~
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."
Od.23. 2002 10:58AM
GENZ RVAN PLUMBING AND HEATING
No,1929 P,5/5
Date Rec,' d
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I ~irsS3&7;E
I 01'""" File PERMIT NO
z. y.lk... cltf. .-J_ Lj--? .
~. G.,ld 'If>pU_, C7' / '
LEGAL DESCR1PTI~ (office we only)
LOT J'/BLOCK ~ADDITION
-fix JoJ~ i-V/
/)JmsruuL., drd PID
ZONING (offia: use)
OWNER
0N~~ Wensmann Homes
(phon~) 651-905-3709
(Address) 1895 Plaza Dr Ste 200
(Address)
Eagan, MN 55122
(City) (Zip Code)
APPLICANT
(Name) Genz-Rvan Plumbi~~ & Heat:in~
(phone) 651~423-1144
(Address) 14745 So Robert Trl
(Adih-ess)
(Contact Person) ~ ..
"'N
55068
(Zip Code)
651-423-1144
/ O--c;3--()(}
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. D ABC 0 pve 0 Cast hon
Estimated length of sewer line feet.
: Clean out (if required) Ipcated at. feet from structure.
ReSldentiaJ .sewer and water line connection
Sewer connection only
FEE SCHEDULE
$3550 Industrial, Com'l &: Multi-famIly 1% of job co$t with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.50
Date
Receipt No.
(Office Un Only) ,
This Application Becomes YOl,lr BuildiDg :Penait When Approved
Building Omcilll
24 hour notice for all Inspections (~) 441-9850, fax (9S1) 4474~45
11 : ~ 8 AM
GENZ RVAN PLUMBING AND HEATING
No.56~O P. jJ ~~
Date Rec'd
CITY OF PRIOR LAKE PL"IDvffiING PERMIT
1 Blue File
2., ('Jt);d, C;t.\"
~ Y oJl.,'" ApplioUll
I PERl\tnT NO. ~ - l'-f 74'
ZONJNG ,,"" ~,) l
(Please e or :mr and s.!en at bottonl
ADDRE:? ~ t{(;?
r---"
ft) /(
Ja; ~t
.......
Iy/
LEGAL DESCRlP110N (office u~e ollly)
LOT BLOCK::< ADDITION W mSlY7-12JUL ~/l d
PID
OWNER
~ame) Wensmann Homes
(phone) 651-905-3709
(Address) 1895 Plaza Dr
Eagan, ~lN
55122
APPLICAN1'
(Name)~?~-R2!..~, Plumbing & ~eating
(phone) 651-423-1144
(Address) 14745 So Robert Irl
(Address)
~
(Contact Person) _ /
( ""
.APPLlCANT SIGNATU1<..E ,/
Roseroount, t-rn
(City)
55068
(Zip Code)
.(phone) 651-423-1144
S;ATE A6/(l"5
APPLICANT PLEASE C01V1J>LETE BELOW
Quantity -TYPe of Fb:tilre Quantity Type of Fi'\:ture _.-
Bath Tub v,,"ith or without shower --- Rough-ins
-)
Dishwasher - ....... J ...---
J Water Heater
J Floor Drain J2jJ:-1 Water Softner
.,---..........------. ,,-
:..; Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
..."'...- J Laundry Tray (f or"2c"OmpaTiment sink ,..., Sewage Ejector
^'
Shower Stall Backflow Assembly
- ,-,",-_...-~--...._-
J Sinks Backflow Assembly Test
r-~" Bar Sjnk---~'~'--~--'-'-~ Lawn SprinkleE__~._
{ Water Closet (Toilet) Other
-
FEE SCHEDULE
InduslmJ. Commercial & MU)tl-f3ml)Y ) '},;, of Job cost With a $39 50 minimum ReSldenoa), New One & Two-Family $99 50
Residential, AddItions & AJteratio;lS $39 50
EstImated Cost $
BU11dmg Permit -#
PLUMBlNG PERMIT FEE
STA IE SURCHARGE
TOTAL PERj"llT FEE
$
$
$
y
PAID Wi'I-.,
BUILO/NG."" Ii
PERMIT
-1
771/t
._^~
.50
(Officc Usc Only)
This Appliclltion Becomes Your Building Permit When Approved
.i"....
'..~i~ildi~ Official
Receipt No
Datc
Mar. 7. 2003
(~~
il:28AM GEN=RVANPLUMBINGANDHEM., No.5620
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACEPERl\flT
p. i 4 22
Date Rec'd
1 Pink
.. Gn:...
3 Yol'-
Jl~l_' rwRMIT NO. ~ - /4 ~
] [ ZONmG to"', ~,' I
I
I
PlD
(Ple.'l.Se e or nnr 3D~_~t bottom)
ADDRESS :::?
. 0&4;}. fOx
/~y
7Y/
LEGAJoJ DESCRIPTION (office use:: only)
LOT I BLOCK 6< ADDITION (jJ .fj:J5)'11J1 yU( dt1 d
O'WNER
(~an1e) Wpnqm~nn Hnmp~
(Pbont:) 651-905- 3 709
(Address) 1895 Plaza Dr Ste 200
Eagan. MN
55122
APPI.ICANT
(Name:) Genz-Rvan. fJ.llrnhinE: F, Hei'lt'fng
(Phone) n'i1 4'-; 1144
(Address) 14745 So Robert Trl Rosemount) UN 55068
~_ (Add.rc::ss) (City) (Zip Code)
(Contact Person) ~ I ~/~. H (p~o~e) ---6.5J.d? 3- 1 1 U u
I APPLJCANT~IGNATURE _@v'/1V.il--lYUJ:1P~'DATE 3)/5)03
. APPLICANT PLEASE COMPLETE BELOW
~w CONSTRUCTION. 0 REPLA(''EMENr 0 ALTERATIONS ---
FURNACE MAKE AND MODEL fhlf)O K 6LfO -i/fh3tR/1- ,/_0 FUEL Cfloi ~6c;o
FLUE SIZE RETURN OPENINGS 5" INPUT /}[) d3D OUTPUT [;0/ I (.
TYPE OF SYSTEM
~arm Air Pl.anl~
OGravity
QMechanJc;a[
~~lr ConditionIng
OVcnt S)':>tc::m
REA TING OR POWER PLANT
OStcam
o Hot Wetr:r
o RadIatIOn
o Special Dev1ces
o Other Devices
PLEASE NOTE:
Air Coumtloner UOItS
Cannot Encroach lITto
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, CommercIal & Multi-Famlly
FEE SCHE:DULE
J % of Job cost Rcsidc:ntla~ Gas FIreplace
$39 50 mInimum
$99 50 ReSld~t1al. AddItions & Alterations
$64,50 Residential, AC Only
$39.50
Residential. HCll.tmg & Ale (New ConstructIon)
R~jdential, Heatmg Only (New Conm11ction)
$3950
$39 50
Estimated Cost .$
Building Pennlt #__.
.50
PAID
BUILD/~ Wl1h
G P/2t:fMr.'
HEA TlNG PERMIT FEE
STA IE SURCHARGE
TOTAL PERl'1IT FEE
$
$
$
(8';,:\;~ Use pnly)
,'r',:,~.:..i':,-'::~'~
~.'.~':,i~ Application Becomes Your Building Permit When Approved
Paid
Receipt No
Building Official
Date
By
Date
24 hour noncl.' for all inspections (952) 447-9850, fsx (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
36b MA.r,J HLE
DEPARTMENT 0
BUILDING AND INSPECTION
~~TEU~~D;FE~~RK 3fo~~ ~~N~~~'
USE OF BUILDING ~ A .
PERMIT NO. d22 Liz DATE ISSUED JJ/, I 0 L-
CONTRACTOR ~,J . - .M&> PHdNE'75z- ~~6- <1SS7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING 7:rt ~
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST po_.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
tf-Jb s-/
Lf-2
~-
s-J
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING LA) C---
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