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QIrrfifirafr nf @rrupanrl!
CITY OF PRIOR LAKE
~rpztrbttruf nf ~uil~iuB JIusprrfinu
)ZJ Final Permitted
D Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section lID of the 0 Residential / 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classification _5/ /, 0 L E ;:-,.../1' / I L Y Bldg. Permit No. ((I' , ( / ?: Z.
,
Legal Description
..:_ I _~.,
Type Construction
C-; :-- I /:
VI.
Zoning District
/- / L- <"jt::
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Occupancy Type
I --,,7
/...........-....'
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Owner of Building
Site Address
2 i 2...2- !. ~L /'IOI'"T ,l.) liE.
Contractor's Name & Address ./ 1..::,(:('::::. +CC ('C/.....? /1<., v!(,6, 14/a Ef)(-'jrIA
Ie: ( /.f. /..T O. II L' Fe H / N.::: !. 'ZY~y Planner:'Tf1/v E I~/I IV .: I ~
.
Building Official
Date: L~-/ (~: () 6 Date:
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
~Id-;l ~~'\- Jrve- NW
LEGAL DESCRIPTION (office use only)
LOT \'3 BLOCK '5 ADDITION S~"'"
Date Rec' d
5'.2.0(17
] White
Pink
3 Yellow
nt..6 wi ~lr. fiB z-
I PERMIT NO. 0& . 0334-1
File
City
Applicant
ZONING (office use)
i< 150
PID
-c1~o- O/?-e
OWNER -;'\ \L
(Name) =-(D
~tb~
~c.-
(Address)
(Phone)
BUILDER
(Company Name)
k.
(Phone)
(Phone)
M-AJ
9.9, 4c..cS' - ~ 4 78'
6~1- 7Cf6 -4(CI~
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe.Siding
OAddition o Alteration OUtility Connection
ower Level Finish 0 Fireplace
CODE: ~.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
III
H
2
IV V
I M
3 4
A
R
5
I
E
II
F
1
o Misc.
B
S
101' 0 ~O
U
PROJECT COST IV ALUE
(excluding land)
$
ed mformation 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
at all construction Will conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
o Just cause Furthermore. I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectIons
x
Permit Valuation 4, tl t/t?_ t' (I
Permit Fee $ ~
87. 2-':::'
Plan Check Fee $ --
State Surcharge $ Z-. (10
Penalty $
Plumbing Permit Fee $ 4- 0.00
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permtt Fee $ ~ -
This Application Becomes Your Building Permit When Approved
~~
Buildll1~ omcial
sh/a"
Date
dO~ 16b;J..
Contractor's License No,
6" '1?( '"f:>,b
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE .. - ,.~ s: 3. Oe:, $ /z9 zS
~J
/1 /
ThIS IS to ct'rtify that the request 10 the above applicatIOn and accompanymg documents is m accordance With the City Zoning Ordinance and may proceed as requested, TIllS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence, Before occupancy. a Certltlcate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
;)./~
Date Rec' d
I White
Pink
Yellow
PI L-b 6lR. 0' ~ Z-
PERMIT NO. 0& .O~OeJ I
File
City
Applicant
ZONING (office use)
,e ISD
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
PID z5. ~4--0. 6/7.11
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
'E~UrHEL.5.
6l uZ,7.J6"-
,J- Ai/E
-rOi \
_L~F
~,Jl-
(Phone)
(Phone)
~ ~/- 79'- 8"'~s-1
TYPE OF WORK 0 New Construction
OAddition o Alter
eck OPorch ORe-Roofing ORe.Siding OLower Level Finish 0 Fireplace
OUtility Connectlon
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
III
H
2
IV
I
3
V
M
4
o Misc,
A
R
5
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
x
I hereby certify that 1 have hlrnished mformation 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,mentlOned prop"ly t at all constructlDn co form to all eXlstmg state and local laws and WIll proceed in accordance with submitted plans, I am aware that the bmldmg
official can revoke thIS e It fa Just th 'more. I reby agree that the City official or a deSIgnee may enter upon the propeny to perform needed mspectlons
Permit Valuation 3 00 CJ. V 0
Permit Fee $ fr.~(
Plan Check Fee $ ~7.3rc
State Surcharge $ I. rV
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
omes Your Building Permit When Approved
7- 7r() ~
Date
Contractor's License No.
~ - .sO ',- Co
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /41. J I
.
ittNO
..57~h
Paid
Date
Itr/I
7. t ()f,
Thls IS to certify that the requl'st in the abovl' applicatlon and accompanY1Og documents is 10 accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zomng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
rt~ttJ cld ~Vf)1-
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
MAY-01-2006 MON 04:20 PM RAY WELTER HEATING & A. C
.~ " . ... . .
FAX NO. 6128252303
p, 02
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONINGlFlREPLACE PERMIT
at bottOm
ADDRESS ./1'
dJ~~ (be.ZhlbAJrI1Vt!.,AAIJ
Date Rec'd
I. Pink
2, ~.
). Veil.'"
~~y I PERMIT NO. O(p 0 {~ ~
-\p,hol!\l ' {7
ZONING (ol'ficeuse)
LEGAL DESCRlPTION (office! use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address)
APPLICANT
(N ame)
(Address)
(Contact Person)
~ S 1- Jb~ ... ()S~ L
/Jo
(Phone)
DATE 6... ~-IJ/.p
APPLICANT PLEASE COMPLETE BELOW
o REPLACEMENT 0 AL TEM TIONth
.___ FUEL f & ~
INPUT j ~OJ /JlJZ) OUTPUT I/) 'l; IJIJ7)
HEATING OR POWER PLANT
EW CONST CTTON
FURNACE MAKE AND MODEL
UE SIZE ~ RETURN OPENINGS ..
~ M~e:.. T~ OF SYS'rEM
I ~\\~ ((Dt)tV\ d'warm Air Plants
I 'Il:~ \k~V~ O~ity.
IV echamcal
1lJnrJ'c\ e,e. Air Conditioning
?.. ~~~O))'()\ OVent System
FIREPLACE MAKE AND MODEL
o Steam
o 1.lot Water
~a iation
0' ial Devices
herl)evices tll'k..r'JI ~1'1L.J ~t~~~
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
1% of job cost Re~jdential, Gas Fireplace
S39.511 minimum
S99.50 Re~identi&l. Additions & Alterations
$64,50 Residential, AC Only
Dille
24 hour notice fur all inspections (952) 447-9850, fax (~S2) 447-4245
16200 Eagle Creek Avenut!, Prior Lake, MN 55372
Industrial. Commercial &. Multi-Family
Residential. Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Offiee US( Only)
This Application Becomes Vour Building Permit When Approved
Building OlTitilll
$39.50
$39.50
$39.50
Building Pennit #
$
$_-_.
$
.5G~:~
Paid Receipt No.
~Rfe 0 9 2006 By
Plymout~ PI umb I ng & Heat I ng
No. :1986 P. 1 1
ApI.28. 2006 6:28AM
(Plca.'iC type or print and silm at bottom)
I ADDRESS
'd \ d C> ~-e.. \""""'0 l"\\"
Date Rec' d
CITY OF PRIOR LAKE PLUMBING PERMIT
J Blu" Fil"
l, Gold City
], Yollow Al'l'lice"u
I PERMITNO.O~. 0lB4
I
ZONlNG (office use)
~~. "-l 'N
LEGAL DESCRIPTION (office use only)
ADDITION
PID
LOT BLOCK
OWNER
(Name) ~\\ \3'('"'"bYr-D~ l""Inc....
(Address)
(phone)
'f'ro.
APPLICANT
(Name) ?\"\'t"" ov+t.. ~\~\o\^CA. + ""-o.1-i.c"9(-=- (phone) I(,~ - t..t ctta - ~ t~a
J ~.\\
(Address) -X041o 4'?,ca-.. So\.. ~ e S-t-:. ~'\~tJ..Q...\ 1 ).AN '5'Ssl"
(Address) (Ciry) (Zip Code)
(ContacrPerson) So,,~ Eu \ \ (Phone) -ll~s - y'qta - ~ VS6
APPLICANT SIGNATURE
l./
ate.
DATE
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pi e (Washincr Machine)
Sewa e E' cctor
Backflow Assembl
I Backflow Assembl Test
La\VI1 Sprinkler
\ Other Sv....
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum Rcsidential. New One & Two-Family $99,50
Residential, Additions & Alterations $39.50
Estimated Cost $ \ '3 ) 0 bO . ~ 6
Building Pennit # ()~ - D \ '0 d
~D~~
.5W~~.~~\(\~
\ ()C"("ro. \~
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
~Jt\
.
~I)~
I
(Office Use Ollly)
This Application Becomes Your Building Permit When Approved
Receipt No.
~ujldillll Offici" I
: Paid
:
j DalMAY U 9 2006
By
D3te
24 hour notice for all iospectloos (9S2) 447-~.&SO, flU (952) 441-i24S
]6200 Eagle Creek Ave., S.E., Prior La&u;..ll1L~5S3-7l-17U.
----;----_._---..~.~_._._---~------ .--.-
..
-
Residential Building Permit Che~klist
Basement Fmish or Interior Alteration to Single Family Hom~
BY:~
r
~
Date: Sj.r/o (0
L~: L / 3
B 3
PID: Zoning:
~~.;U.~.
Subdivision: ~~ ~r
Building Permit #
Site Address ~ I ~;;;J..
E.risting StructuIe@r NO
~
~.O
I CONFORl,l\'IS TO ZOl'fIl'fG
ORDlli.AJ.~CE
I YES NO
I Is this an ~on of the e:M....sting footprint or R-:fe:- to Plamring
bm1ding heigh!'? tJO
Is the prOP~f located wirlrin the flood plain? I R=:::::- to Planning I I
~O
Does the alte:':lrion mciude my additional ki!c~os? I R::::::- to Pla.1:::n:ing I I
N'O
Does the orot:cse:i alte:-ation mdude mv outside' R~f::" w PI~~i1mg
. . .
e::trmc:s othc::" than patio doors? NO
Is the pr~ose:i '.lSe of the finisiled spac:: or R~:e:- to Pla'M"' ,., 1 g
alte:-arion for anything orlle:- ~j,:11" a nor.nal single ND
family heme (ace::. grail;' hcee. d.:ly e~:. e':c.)?
Tms c~Cc..1S7 :yn:S7 BE COMPL.E7ID .~'ffi fi'(CLUDED TN T:IT BllLD[:';'G PS:x..'t(J7 FIlE TO
;, L.lJN7 All" A R..:: CORD 0 F TliE R.;:Vrrw.
..
..
..
~hite - Buildinp
allmy - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
TOLL L3eos.
3.8.00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ZIZZ- 86~JVlONT I1V6. /lIW
Accepted
Accepted With Corrections /"
Denied
,..
/i< c '/-!A r: ~
Reviewed By: ~ ~ Date:
Comments: ~ CLf!--t ~.
~L~~'I ~ ~
:fc33/o ~
.
~ ci
~~.
"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 - ~naineering
~lnk - 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:
,-. ""---~~.
/ I . ,/
Accepted
Accepted With Corrections /
Denied
~
~ CJ-L(
..
~ Date: 3/..;) 3/0 f;;
, ,
"
~.
Reviewed By:
Comments:
; ":i: (~: ;~-~: f;; '~~:: ,;: ("~l'
f:':",,'('::-1~i?:Jlj...'~-<O ~,-~; ;,'..
liThe 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."
"ll.
/~
White . Building
l"Cinarv . Enalneerlng:, "
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
TOLL 8/205.
3.8,00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
2/22- OEt.,.;vJONT /i1/6 /vW
Accepted
Denied
)(
Accepted With Corrections
Reviewed By:
IYIJ6
3'" Z.I.~"
Date:
Comments: See Rev~rse Side for AdditionallnfQrmation!
0-"." "'-_'i.~~~.~.
See A$Chi11~~: 1) ('Trading Plan, 2) RTos;o~~o~trQl M~aSl]reS
liThe 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."
I vI ~d--'
u. ~
" '5 II:, ,.hL,t III/V
",.-", ,
,. II IM"I
lULL DI\UI ntK;)"', ~
,", ",".",,~ .
No. j~',l \' :~'. r.~.<~.,~..
~. :
.' . ~~..o: \..
"0 ,
'. . :,-,' \
~ .
.' ~.
CITY OF PRIOR LAKE . .
Imperviou.s Surface Calculations
(To be Submitted with Bu.ilding Pcm1itApplicaticn)
. For All Properties Located in th~ Shoreland District (SD), "
The Maximum. Impervious Surface Coverage Permitted is 30 Percent
. '."
. ...,
Property Address
/.07- 13 I .. BlocK 3
Lot Area /6, 0 '19 sq. ft. l( 30% :... ....__....... 1, Sf 1(. 70 .
*************************************************************.**********
LENGT.H
WIDTB:
x
x
=
SQ.F~
j90rB
HOUSE
ATTAC1iEI) GARAGE
=
.' .
x = 8Y I
TOTAL PRINCIPAL STlUIC'I'URE........._......~. . 2, 7~q
DETACHED BUILDINGS
.c~.
x
x
DRIV:BWAYIPAVBD AREAs
(Drlvftay~ Gr:QOt) .
. '(~A:Ca)
. ,
TOTAL DIITACHEJJ Bt1ILDiNcs-__ tlbne. 6 ~ 0";' ,,~ SON~':l
x
:x:
x
:::' gOB
=-
=
PAUOSIPORCBEslDECKS
COpen Decb Wi.miil..~ bctw~
bciIrds. with a PtrYiDas.sarJace bdow.
II:" DOt CODSidcrcd to be impervioUS)
, 0
TOTAL PAVED AREAS....._._~..._,._.. 60 e
x
x
=/~o
:=
x
=
'OTHER
TOTAL DECKS....._.._._......_..........._....., /'0
. X .
, X
=
==
TOTAL O'l'HER:...._................'........:.........................
TOTAL Il\1PE~VIOUS SURFACE
UNDERtOVER . ..~
~BY_4:4r~"',{(. ./~~ Date
Company Nc:tWZi/~ . Phone #
1:3\/11' J
I~-/I O<i7. 70J
3!?~t
7.~~9.3l-5jSo
~
'"
~
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
1. Green
2 Ye!low
3, Gold
~ii;: I PERMIT NO.a-/?dt-
Applicant
(Please type or print and sign at bottom)
I ADDRESS 13
d- J d- ~ '1 j/Yn dn -r
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK ADDITION
PID
OWNER
(Name)
r;, II rtJ5
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT
(Name) PS A1 1'i/t:"ALlfr7l1Uf-. ~-
(Address) ,29/~ ..eP76</~JS~ AvL ) Jl"sr,.~f
(Address)
(Phone) ~..s-I- <tJ'() -I ~.s- J-
/14~ f..s-o.7 7
(City)
(Zip Code)
(Contact Person) ~FF
(Phone) biZ -9'9 -~7.:29
DATE C/-~-~
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Size of water service ---L- inches.
Location of any couplings from structure _ feet.
Type of sewer pipe. D ABC zPVC D Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family
$17.50 Water connection only
1 % of job cost with a $39.50 minimum
$17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
!~
Date
Receipt No.
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I"lAY-HJ-2006 11: 58
CITY OF PRIOR LAKE
9524474245
P.02
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
~.~':" ~:~. I. PERMIT NO./- J~~'-
1 v.ll_ Appl,...l ,. ~ ..~
ZONING (olfU:e
llge)
f'le"se
ADDRESS
;)td-~ ~ ~ V0W
LEGAL DESCRIPTION (office use only)
LOT BLOCK
AD'DmON
PlO
(Phone) (,SJ-3CtJS -D5SI
w~
(Address)
APl'LICANT
(NamerL<~A"'l.h:c..,~ {):yA. d-
(AddressL....
_~ro I09,j.,.1, C2.t~~ V, #jfflO
(Addm~)
(Contact Person) r.(..\~ ~ne.(\"'O,-I
r=P
(phone) 'l~~. Sfll- dS'dS
C"..hn/Yn./J J.;~Yl . rn/1 553J l.A
----r- (City) (Zip Code)
(Phone) rJ~~~ - S~<.o-/~ IlL,
APPLICANT SIGNATIJRE
DATE
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION D REPLACEMENT 0 AL TE'RA nONS
FURNACE MAKE ANn MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM REA TING OR POWER l'LANT
OWann Air Flants 0 Steam
o Gnv(ly 0 Hol Willer
o Mechllllical 0 R~di2tioD.
OA(r Conditioning 0 Special Devices
OVent. System 0 Other Devices
PLEA.SE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
~r0
FEE SCHEDULE
I % of job cost Re.sidential, Ga.9 Fireplace
139.50 MInimum
$99.50 RC$idential, A.ddi1ions &. Alterations
S64.50 R~Jjdcntial. AC Only
S3950
Indugtrial. Commercial &: Multi-Family
Residential, Heating &. Ale (New Construction)
RCGidenti'il. Hco.ting Only (New Construction)
S39.50
S39.50
Estimated Cost S
HEATING PERMIT FEE
ST A TE SURCHARGE
TOTAL PERMIT FEE
Building Permit "
$
$
s
PAID WITH
BmlDING PERMIT
(Office Us~ O"ly)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Date
By
Dde
Bl.lildi"e Oflic~1
14 hour notiu: lor .11 in~pec:t1ons (952) 447.9850, fu (952) 447-42.45
_____ __v........._ _......._......"..,
~~~I ^'~ ~n' ~~J T~..TT on/nT/en
TOTAL P.02
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~;;~'a4;:;:
I ).4.__ · "^ ,
Date Rec' d
---5 B. O~:;
I, White File
2, Pink City
1 Yellow AppliClm
I PERMIT NO.O(P .0 18tL I
I
BUUJ)ER ~~ ~
(Company Name) ,e.. . _ '" IJ..< rS
(Contact Name) -g ~ e...k.r~~
(Address)
Ave.
/VvJ,
ZONING (office use)
R/50
LOT
LEGAL DESCRIPTION (office use only)
ADDITION 5 b'~'Yhc::..r ~,d e...
-0
OWNER
(Name)
(Address)
\[)\ "
PID
(Phone)
~ 6~-1
(Phone)
(Phone) 65/-741..-41'1"
TYPE OF WORK ~ew Construction ODeck OPorch ORe. Roofing ORe-Siding OLower Level Fimsh 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: a.R.C. DI.B.c. W~ O~0
PROJECT COST /V ALUE S /
Type of Construction: I n ill IV V A B (excluding land)
Ocrupancy Group: A B E F H I M R S U
Division: 1 2 3 4 S
I hereby certify Ihall have furnished information on Ihis applicalion which is 10 lhe besl of my Icnowledge true and correct. I also certify that I am the owner llr authonzed agent for Ihe
above-menl eel property and rhat aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
;cial ca ~hiS p. it for just cause. Furthermor , I hereby agree Ihatthe city offic?;~e;e~;;6:?: the property to perform n3: t;;O~~ 6
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
This Application Becomes Your Building Permit When Approved
~~~
Buildin!! Otlicinl
3{'2../ to ~
Dae
I Paid
Date
Park Support Fee
SAC
#
#
Water Meter Size 51
Pressure Reducer
Sewer/Water Connection Fee
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 requl'Sted. This ducument
when signed by the City Planner const~tutcs a temporary Certificate of Zoning compliance and aUows construction to commence. Before occu ancy, a Cl'rtlficate of Occupancy must be
~u~ ~ 3/2'2.(0(, M.. rd( f
Planning Director Date S
24 hour notice for all inspections (9!12) 447-98!\O. fax (9!12) 447-424!1
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 2. ,'Z.-. ~ L. Wlo ~ r ~. N, /AJ.
NATURE OF WORK ~tu ce I Wit ....r L.t. F/#JJIII ,~(It
USE OF BUILDING .s: I': />,
PERMIT NO. CJt;;.0/82- DATE ISSUED ~2.11 ,t,
CONTRACTOR ~LC. ~~TtfEI.S, ItJc. pHQNEl.SI-"'.-I/If.t,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING ~ I -rJ/ /:~
I FOUNDATION (Prior to Backfill) I t/VtP' I 11- 7-/ J1 )
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING (0- 5"q-d" 3-//-(,'"
HEATING (if required) ~/(1.lJ.p
FIREPLACE ~.. n.. '
GAS LINE AIR TEST )v 7 ""
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~4" r h~II$G /AJ~A.I' I I
,
FINALS
GRADING (Prior to Sodding)
BUILD~NG vV1 I w\~\ tD'\'w
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE
NOTICE
J I '(.8. dtJ
/('lY
<;. ~-..(1
BEEN SIGNED
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