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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTmCATE OF ZONING COMPLIANCE .
AND UTILITY CONNECI'lON PERMIT
~-<<_........-
ADDRESS
I ~I \ 11 <2,\(,0\01 fue.q
Date Rec'd
I. _ File
2. Piook City
lY_~
5. Z I. () 7
12/;'? /1 IV r) N
I PERMIT NO. 07.04-/8
I
TU\L
s.~
ZONING (oIIice lilt)
/c/sv
LOT BLOCK
LEGAL DESCIUPTION (office use only)
ADDmON
PIDZS-. C}30. ()4-J.O
I OWNER ·
0<-) ~~ ~
(Address) t /1
=
=.~~ ~~
(phone) .!J '5 ~ - L.\.Y. 5 - g{" zl
~UAf.S
~~~o,.J
(
~~-~a;
(Pho) - 3 - z..,. ~
TYPE OF WORK 0 New Construction ODedc OPorch ORe-Roofing OJle.SidiDs OLower Level Finish 0 Fin!place
6l.(ddition id1Yteration OUtiIity Connection 0 Mille.
eP
. CODE: ~I.R.C. OI.B.C. PROJECT COST/VALUE S J~$', ODD. -:=
Type of~oa: I D m IV V A B (acWiq land)
OmapaacyGroup: A B E F HIM R S U
DiYisioa: 1 Z 3 4 5
I badly c:enilY lbat I baft liIrDisbed information 011 this ilppliciltioa whid! iI to the bat 01 my ImowIecIee lI'IIe UId com:a. I ilIso catilY 1bat I ilIII tIIr 0WDa" ... &lIlIIoriud IFIll ... tIIr
~mmllOlll!d propmy UId thilt ilI1 c:oasttuction will oonfbrm to ilI1 exiItina _ IIIId local Iilws IIIId 1riII JlIOCftd in lICaJRIant:e willi submiar:d plus. I ilIII _ tbat the buiIdina
o . eilll mIOke thiI . . ust DIe. PUJthcrmore, I bmby qree tbat the city oIIIciaI or il dcsipee IIIilJ enter IIpDIl the JlIopaty to perIbrm IIftded 1IIIpCCtions.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer &; Water Permit Fee
Gu Fireplace Permit Fee
~,I)b
'I1ds A(lllliadion Itecomes Your Baldini Permit WIleD Appnmi
~~ sj~7
11{0 '7
CoaIndor's LiceDIe No.
5'-l-o'l
Dale
Park Support Fee #l- S
SAC #I- $
Water Meter Size 5/8"; I"; S
Pressure Reducer S
Sewer/Water Connection Fee #l- S
Water Tower Fee #l- S
Builder's Deposit S
Other S
TOTAL DUE {!flU(3P .531 (.'7 $2/1 &8. 28
~
I Paid 1;~r~
Date 1 ~/O
I Rea:~No. S3 r 7"L
By ~
nus IS to cerriIY that the request in the above application and ~ docummts if in ill:COIdance willi tile CiIy Zoninc 0rdiJwIcr IIIId IIIilY proceed ill reqIII:III:d. TlIis document
whm sipIcd by the City Plannt!r constiNtcs il tmlpOI'ilIJ CcrtiIkate of Zoninc compIiilnc:c IIIId allows constructioa to COIIlll'1CIICC. Ilef\n OCClIpilIlCJ, il CcrtiIiaI1: of<kcupancy must be
issued
J-dJ-t7 ;::;"
DIlle Spet:iaI CwdIdta. if
Z4l1oar..tift fer.n iupectiou (~2) "7-91..'18. fll (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN .5.5372
White - Building
Canary - Enaineering
@nk - Plan~
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
x
Accepted With Corrections
Denied
Reviewed By:
?f/~
Date:
-6---'<3 - 07
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."
.--------.--.-,--.--.,--.--.--.,.--
--Wl:lit8-.~ Buildi~
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I'k~~~.~~
~-- 2l u 1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ac 'vity which is proposed at:
~~'
1 ..r; ...., f'
UA.;; (......-
Accepted With Corrections /'
-.J
Accepted
Denied
~
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S'-o-:A.- ~~ .P CO. ~ i.., ~~
-& ~ ~/'~, ~ ~ .k.-.~
~L<~ a..-<....> -::J~' Nut.l___ ~,~
@ ~.'r~ ~~,
Reviewed By:
c'k4J-I..;
Date:
S-/z.~~7
.
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."
White - Building
C canary - Englneer~
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
J-/ ~ 1;{ /
l2-ak. .', .~ ~_~' &;) L-v..1.-----
~-. Z I (, 1
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction ac 'vity which is proposed at:
~,.
, . ..;? . /.,./ ,
4 b.t( ;-[i" --- l(/(Y L- .Cu...-
i)
L--
Accepted
!IX
Accepted With Corrections
Denied
Reviewed By:
~
Date:
s~ 23 -07
I
Comments: See Reverse Side for Additi'onal Information!
See Attachments: 1) Grading Plan, 2) Erosion Control Meas~tes
"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
Impervious Surface Calculations
(To be Submitted with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted is 30 Percent..
Property Address J tIll- -:r SH^D~ (?EA<:.n l11A1L <; C
Lot Area 2 S I \ (..11.-1 sq. ft. x 30% = .............. 7-, ~LJ ~ 0:; F-
************************************************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
x
=
=
ATTACHED GARAGE
=
TOTAL PRINCIPAL STRUCTURE...................... 3/4~1,..1 Sf
DETACHED BUILDINGS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.....:.................
c;Y sF
DRIVEW A YIP A VED AREAS
(Driveway-paved or not)
(Sidewa1klParking Are"as)
x
x
X
=
=
TOTAL P A YED AREAS.........................................
\1 '13"L S~
P A TIOSIPORCHES/DECKS
(Open Decks y.," min. .opening between
boards, with a pervious surface below,
are not considered to be impervious)
X
X
=
=
x
TOTAL DECKS.......... ........................ .......... ...... ......
Lt 9 S s F
OTHER
X
X
=
=
TOTAL OTHER. ....................... ........ .................. ....
TOTAL IMPERVIOUS SURFACE
~OVER
Prepared By :; HALJAJ gt.eCJ1
20mnanv C::;'c9,ut::gf2t;v~ E:AM't\J~I.AJG,
I ~965sF I
I L 57<6 SF I
Date SI [<6/~T '
Ph",",,,, ++ CJ~2-Lfo2-~Lo2..
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
e" l.' '" O'J
I ~,;;:rs~~m;~"bo~~Ar fuc ~ ~
LEGAL DESCRIPTION (office use only)
1. Blue File
2. Gold City
3 Yellow Applicant
I PERMIT NO. 07, () '1/8
ZONING (office use)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name) (Phone)
(Address)
(City)
VI
(Zip Code)
(Address)
(Contact Perso
(Phone)
~5) "
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
, Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
, ~1
prr,,~j j)fr
Estimated Cost $
Building Permit #
(Office IJse Only)
Building Official
Date
This Application Becomes Your Building Permit When Approved Paid
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
7. 3.0!
~. ~i~~:w l~~icant I PERMIT NO'07 04-1 DI
ADDRESS / ~/ 77
ZONING (office use)
S1-/71D~/ /JEJ9Crl 7JG,H/ L-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name)_k:'A 1(~l'f\.J('~
-P, {) \ (S c j( 7 7
(Addressf
~r t-
lct..t
(Phone) q~2--qQ,~-I' ~ 3
<J../I ~ I 'l... - q, q - <.../ ?" 7
L M:I< e"" It <'.... c;--.c-o ~ <./
(City) (Zip Code)
(Address)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
DNEW 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
PLEASE NOTE: Air Conditioner
DWarm Air Plants D Steam Units and Fireplaces Cannot Encroach
DGravity D Hot Water into Required Side Yard Setbacks,
D Mechanical D Radiation
DAir Conditioning D Special Devices Fireplaces with Box Additions or
DVent. System D Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
PAID WITH
84{t.O/NG PERMIT
(Office Use Only)
Buildin!! Official
Date
~
Date 7 2-. 0
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~/ll .J'H,f/)Y 11~~11 Tat., S',E;
NATURE OF WORK AI~ A 177t~7J ~~ A'-[!J:7Z.,+ 71'Mr
USE OF BUILDING J7F: D-
PERMIT NO. ~~8 DATE ISSUED .52'2 ~.,
CONTRACTOR $A . ~~ PHONE~ z-~~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
A . THE pERMIT IS BY SEPARATE DOCUMENT
~'T/IJ' ~f'1.,J ~ Afu 1>>~Mr'NSP~~ DAT>
! FOOTING --_ VVY' I Cdf/f7
I FOUNDATION (Prior to Backfill) I .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DEPARTMENT OF
BUILDING AND INSPECTION
J
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
ItArNr f 1I~"je ~ I I
FINALS
GRAD!NG (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
Li- '/ ~
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