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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
& ,~1. 01
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 1....- (p U
ZONING (office use)
/ ~o"/ LJ
I
,(J2-'TALa;;t%!J Jj
/b
AJ /-u
Q.i~
LEGAL DESCRIPTION (office use only)
LOT~ BLOCK 3 ADDITION
6~S
i~
PIDZ\ 3lcO. 6 fb. 0
OWNER
(Name)
',e,
~~'nvLt'VCJOJ)
(Phone) t./ q" "
~.9~
(Address)
~l)
).J4J
,. BUILDER
(Company Name)
I (Contact Name)
(Address) (
;)~ j].~/S.
&~ d~pe./t-t
t1 / C?/;.i< ,1!?4
(Phone)
(Phone)
9S-,:; . 8S~~' /~cPt'
~"-:? 7/9 35'37:::>
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectIOn
CODE: ~.R.C. DI.B.c. o Misc.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ /~ C>oa
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
I hereby certifY that I have hlrnished mformation on this application which IS to the best of my knowledge trut.' and correct. I also certify that I am the owner Of authOrIzed agent for the
.lbnve-menuoned property and that all construcuon WIll conform to all extsung state and local laws and WIll proceed In accordance with submItted plans I am aware that the buIldIng
Ilflicial can re lke tillS permIt for Just caus ,. Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propel1y to pert(Jrm needed InSpectlllOs. /.
X ~ --...-.-,,- n#o _,to //1 &1 ;19 Li! eJt!) 7
Contractor's License No. Date
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
Permit Valuation
Water Tower Fee
#
$
$
$
$
$
$
$
$
$
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
.5'~ 00
Pressure Reducer
Sewer/Water Connection Fee
#
4-0.00
Builder's Deposit
Other
Sewer & Water Permit Fee
I~~
Buildlllg OftJcial
7/9/0 7
, r)ate
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Thts 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 TIllS document
when signed by the Ctty Planner CllOstItutes a temporary CertIficate of ZonIng compliance and allows constructIon to commence Before occupancy, a CertIficate Ilf Occupancy must be
isslled
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
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
Denied
Accepted With Corrections /'
Reviewed By:
~
,.
~
Date: 7/1/d 7
Comments: ALLf ~ ~ ~ ~
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~ ~ ((i) ~~~..J O(}~ ~ ~
I '
~ ~ ~ ,~~ ~ ~IJ~ fJ4-I~.A.d/
rf~J ~. ~ ~ ~,
"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 - BuildinQ:)
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
?AL&~- z9~ ---
r'o . 9. f) 7
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/r"o 7() ~Ol;ma/(2fTd~ .-;f}mct /VN
Accepted With Corrections /
Accepted
Denied
Reviewed By: ~
Comments: '4JL p~ ~oW'-, (7~ ~
~ ~ 2; ~ <1-<.ff- d>- ~' {H<.
c:- { ../ L.. ' ".
oJ r. .,. ........--.r- -t-L <1<<"4 r- ~I""~
~ fL".L/~ ~~ ~n.,.~ ~ a.Lf'
1Z.v~.J ~ ~ ~.c-- ~ ~ to
~
Date:
7/9 In
.
IJ~,
I
"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."
------' -
~~ ~:~ing __
, - ineerl~)
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,.-
? d/~ _ O-?fl~ J--"
C fJct () 7
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I/d)70 ~17tZh<X'UU?f/ --;P~ /VIr/'
Accepted X" Accepted With Corrections
Denied
Reviewed By:
~
Date:
7-11- 01
Comments: See Reverse Side for Additional lnformation!
See Attachments: 1) Grading Plan, 2) Erosion'G~trol Measure~
"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
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
-z Z/'>. (,J 1
; ~i~:n ~~~y I PERMIT NO.O 7. C(y I) I
3. Yellow Applicant .
ZONING (office use)
ADDRESS
/070 NOIl7JIy)&J/J
QD.
At 0,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
\ OWNER
(Name)
(Address)
(Phone)
APPLICANT '-r' y r C
(Name) """~~) ~€Jl.VVCbS
(Address)~LL ~ ~0 DflJJ6
(Address)
~k~
(Phone)
(pf) - 1K)'" lf CUr
(City)
(Zip Code)
(Contact Person)
(Phone)
DATE
7-Jr,.o7
APPLICANT SIGNATURE
DNEW CONSTRUCTION o REPLACEMENT o ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWann Air Plants o Steam Units and Fireplaces Cannot Encroach
DGravity o Hot Water into Required Side Yard Setbacks.
o Mechanical o Radiation
DAir Conditioning o Special Devices Fireplaces with Box Additions or
DVent. System o Other Devices Cantilevers to the Outside of Buildings
POOV I trK- - Require a Building Permit.
,FIRFPT.Ar€e"MAKE AND MODEL
T PLEASE COMPLETE BELOW
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39,50 minimum
$99,50
$64.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$39,50
$39,50
Estimated Cost $
Building Permit #
() 151
ffi~~,L /
HEATING PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$ ./
$ ~.50
$~
../
(Office Use Only)
Date
This Application Becomes Your Building Permit When Approved Paid
BuUdin!! Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
P R I 0 R L'AKE DEPARTMENT OF
. " BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 1kdJ" 0 #O~TH bJotJo RtMo AltJJ.
TYPE OF WORK 11J-(;JllDeI~1J /30' ecy /ITL,.
USE OF BUILDING ,.
PERMIT NO. D 1 ,0(0 l \ DATE ISSUED
BUILDER ~LLer /{,.,Lr PHONE # Z- ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
IN~R 4 DRTE
I FOOTINGIPi~r I ~ /P~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING t/\ ~ V '1.J
.5'~ € GI\~S" 7lJ ~~ ~~
FINAL
~JIt<; ,,(.. ~ hiJ"cS""
FOR ALL INSPECTIONS (952) 447-9850
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