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I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
J /- ko;r
I. White File I PERMIT NO
2. P;nk C;ly . /l'7 /L. 5/1' 1
J. Yellow AppHcant . ~ _ c.-
LEGAL DESCRIPTION (office use only)
LOT;2~LOCK 3 ADDITION -rhe. WI Ids ~
g;::~~ tklA51~
(Address) . O~ (?OX 240
ZONING (office use)
I
8~- 07 -()
BUILDER
(Name)
(Contact Name)
(Address)
(Phone((oI2) 3?8 - 2-' gg
(Phone)C~ 12.) 32$ -ZJ 8<l
rntJ .
TYPE OF WORK
ODeck
OPorch
ORe-Roofing
New Construction
ORe-Siding
OLower Level Finish
o Fireplace OAddition o Alteration
PROJECTCOST/VALUE (exc1udingland) $ E..z3
OUtility Connection
:53.~
o Misc,
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 the property to pe neede spections,
=#: )7/5
/ /-/-OL
Date
$
$
$
$
$
$
$
$
II--' Z- $'&.
l~~~ 'l7r-~~~1 ~~ceiPtfji!;''I 13 I
Contractor's License No.
I Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $ -
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter
Size 5/8"
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~t~p
1~/lvL:~
Building Official
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
:::2CPlW~;-"~ c..~~;~:" Wd'":&:Q" "m~Q~ ,rn,ro"",, ID,"b.
Planning Director Date Specl ondlt1ons, (fany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White - Building
Canary - Engineering
Pink - Planning
Thf ("fnlrr of Ihf l.a"-" {"ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
ff1. . H ~II .
~~~1-- Yj (r10/U/I";~
, //- /-();).. ,
/7
(1:/]-'2(1'; .
j
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3 0 L/ 3 #u/;/ rl To
Accepted
X'
Accepted With Corrections
Denied
Reviewed By:
IYFIB
Date:
J /- I'I-o~
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan, 2) Rro~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."
Tht' Ct'ntt'r or Iht' L.k~ ('ounIl1'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ VI 4 &HfJ'
APPLICATION RECEIVED /1- I-() ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
23 0 t/ 3 ~{)!J(:d
Accepted With Corrections
Ttf
/
Accepted
Denied
Reviewed By: ~ 1~t.J Date: 11!11!()'Z--'
Comments: 1~ ad ~ ~-~
"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 - Engineering
Pink - Planning
Thf' ("("nltr of Ihf' L.kr <-"ounlry
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
/
Accepted With Corrections
Denied
Reviewed By: ~ :/~ Date: IJ/11/oZ/
. I
Comments: _ A, e. ~ ~ ~ t:n- A.. , :fl." ~_
~.
"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."
FROM :RLLIED EXCRURTING
FRX NO. : 952-895-939~._
Dec. 03 2002 01:05PM Pi
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
J. 0.- l'll. I P...LlIUI'..... N _
:. =-- ~ --'''.u~ 4 O.~ -JSJa. I
ADDRESS
~ ~3 ~bcA.""*~k~~\()Y ~G /ZONINO-.",,]
I LEGAL DESCRIPTION (olliQt We only) .
I LOT BLOCK ADDITION
~
OWNER.
I (Ncne)
i (Address)
:=
+le,{
pro
f APPLICANT
(N lUUc)
I (Addr...) I Y
I
jl (ContaCt Person)
APPLICANT SIGNA
(Address
lei)
(Zip Code)
~
. (Phc..)q~~" -83'10
~\.l~ae __ _ S Q(\ ,8
(CI~ (Zip Code)
(Phone) ~ A--Yi
DATE I C~
l
!
I
i
I
APPLICANT PLEASE COMPLETE BELOW
Siu of WBter service' inches.
Location of any ~ouplings from St.Nct~e~ '& feet.
Type of sewer pipe. 0 ABC t8PVC' 0 Cast Iron
Estimated length of st:wer line feet.
Clean out (if requi.red) located at teet from struCture.
FEE SCHEDULE
ReSldentiai SeWer and Water line COl\nectioD $35.50 fndWltrial, Com'l &: Multi-family 1% of job cast with a $39.50 n1icimwn
Sewer conneCtion only $17.50 Warer connection only $17.50
Estimated Cost $
Building Permit 1#
SEWeR. AND W A TEa PERMIT .FEE
ST A ts SURCHARGE
TOTAL PERMI.T n:~
s
S
S
.50
,r-g;AHO
l~DflJJ)J~!(:
-'C._.
(Otftet Cae ani)')
This AppUeatfob &cOlbes Your 81J1i1dine PerlDjt When Approved
PSlCi
.Receipt No.
BlIilcliq omc:ial
Date
By
O.te
24 hDur notice for aU l"'pectIOIl. ('52) 447"91~, f8ll: (9$2) 441..aZ4S
;l
CITY OF PRIOR LAKE .
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec' d
/
~. ::n ~!tey I PERMIT NO.1_/.5" f"""' ~
3. Yellow Appilcant . c./'..::::J
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone) 'f5J- rJ/- 4/.lp<
I~cl ,),,( ( 1../1 ttZ.I. 5$/:/ <t
(Phone) ~/t5l fAr';b8'&7
(Address)
I '
APPLICANT
(Name)
(Address)
(Contact Person)
r (City) (Zip Code)
(Phone) J/2 Y2J'~ bf'6?1
DATE 1- g",,~ ~
APPLICANT PLEAS COMPLETE BELOW
o REPLACEMENT
IPJ
DALTERATIO)kf
FUEL ~J
/A>,AJi) OUTPUT 9'~no
INPUT
~ OF SYSTEM
, . ~W ~ Air Plants
ravlty
EJ~chanical
0Air Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o !).adiation ~
~~':'~:~' !h:1f4z:;
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Addilions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Official
Date
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HEA TING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
FRon IAIEL TER ~l BLA'/LOCI<
PHONE rn
612 8828573
Jan 20 2003 04: 31Pt'1 Pi
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CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: iA..) e- / t~v- ~ 131 a.- y [0 e /-c
Address: ~t:> 9 c:- /-I f..<:J_
, f
Signature: l..t.)
Legal Description: Lot Sub '-<J; I d$ 5-,4 +l.
Site Address: ~o 4 3 8ohc..~ + "__'U_"___"
Building Permit # '" 02.- / Sf ~ PID # .:< S- 3 g ~ C> 7, - D
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
i I
I Quantity Type of Fixture Quantity Type of Fixture
I I Bath Tub with or without shower Rough-ins
i / Dishwasher / Water Heater
!
I c:< Floor Drain Ix< Sequ",+ / Water Softner
, 1--."'J ~ ",q 5> e..
i
I 3 Lavatory (bathroom sink) I Stand Pipe (washing machine)
I I laundry Tray (1 or 2 compartment sink) Sewage Ejector
I
I c:< Shower Stall Backflow Assembly (RPZ, Double Check. PVB)
I.
r / Backflow Assembly Test
I Sinks
i
! Bar Sink Lawn Sprinkler
!
, .3 Water Closet (toilet) c;( Other. Cf4 .$ .fDr J/ref,/~ <! e
+- d. #"'1 ~ ,-.
FEE SCHEDULE
Industrial. Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Fami:y
Residenlial, Additions & Alterations
$99.50
$39.50
$
$
$
$ .-- .._.~~
State Surcharge
GRAND TOTAL $
,
, ",
~-
Tll" pcrltlll r~ granled "I','n the ~xprc\.\ ,~()ridil <em that "lid
COfllr,h:lor. ,hall Cil1T1ply In ail rc~pcc1, ".lth - )~efC': n \!I ~,
q{ Ih" $1:\1'- P1Ull1hll'~ ('ode and the amcnome 18 c\fD u; U ...
RECEIPT NO ~. DATE 1 ~!,\.,.,.
_.. - . -dAN. '2 ., ,
y __:..;~~.-..c". ..-.---....'. .-:~._--'"...
16200 EClglc Creek Av. S.F... Prior l.ake, MN 55372 / Ph {(;12) 47.9gS0 / FAX (612) 447.4245
.6..n I:r~rl".J OPl'UI1IJl'lll',' Elllpl0:cr
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~~nw Ji~icant I PERMIT NO. !~ - /15/ if
ZONING (office use)
3043 BOBCAT TRAIL
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
BUTLER HOUSING CO.
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
(Phone) _651-633-2561
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/29/03
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA TI0NS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
OAir Conditioning o Special Devices Required Side Yard
OVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEA TN GLO 6000TR-OAK
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
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
-...
Building Permit #
$
$
$
~-
.50
"'"-'r, ~
Buildine Official
Date
Receipt No.
(Office lJse Only)
This Application Becomes Your Building Permit When Approv
24 hour notice for all inspections (
47-42 5
02/0G/9'( THU 14:14 FAX 6124474245
CITY OF PRIOR LAKE
l4J003
.
....,
......,,;~ ..
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with BuUding Permit Application)
For All Properties Located in the Shoreland District (SD),
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address ~~D,:\~ ~D'hc.cd: 170', \
.\
Lot Area I ~, D40 Sq. Feet x 30% = .,~......,.... .3\lo\~
***.***..**********.**~********~****.*****~*****************************
HOUSE
LENGTH
3(Q
WIDTH
x LoS.
=
SQ. FEET
\ ;rqe
ATTACHED GARAGE
x ...
3~ x 2>3.lq( =: \\04~
TOTAL PRINCIPLE STRUCTURE...................... ~ ,840
DETACHED BLDGS
(Oar<lge/Shed)
x
x
TOTAL DETACHED BUILDINGS....................... ~ /A
. D':tUVEW A YfPA VED AREAS
(Driveway-paved or not)
(SldewalklParking Areas)
31
x
x
x
55
=
=
==
TOTAL PAVED AREAS"........"................................ ~ 1 ~
P A TIOSIPORCHES/DECKS i~ x >4 ... eA
(Open Decks W' mIn. opening between X =
boards, with 8 pCrYious surface below,
are not consIdered to be fmpcrviol.ls)
x ==
TOTAL DECKS......................................................,.. B4
OTHER
x
x
=
=
TOTAL OTHER.......,.",..........,........"........,..............
TOTAL IMPERVIOUS SURFACE
~VER
3,5'\4
ILQ
Prepared By
~~ Wte&t=I~
Date
IO-~C'07-
Company
I-IQ&lun.& [t\.~ '
Phone # l.o5/~ 405-(P(cOD
DEPARTMENT OF
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 3043 Dcs,(J\.\ Tl<.AiL-
NATURE OF WORK New CO~~{t2.U..c:{""'( 0 r:::J
USE OF BUILDING S,Fp,
PERMIT NO. DATE ISSUED ~ ~ (o-z.....-
CONTRACTOR ~ . PHONE bJ2- 3e.8 - '2r88
NOTE: THIS IS NOT A PERMIT F ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
DATE
I ) '";J".,,-
FOUNDATION (Prior to Backfill) J 2 c:::> b
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING IL, jIl(' )-1 ti'
INSULATION ? /,.) L ~ S./
ELECTRICAL
PLUMBING t,.~. /'(
HEATING (if required) (.,,~. ~ j,.-('{{
FIREPLACE
GAS LINE AIR TEST ~ ~ ~ .."
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I LAme .{31ttar"Cal?Zt.<:'6'l1 sr-",J}- ~. S -IY I
( . FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
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 INSPE"TIONS (952) 447-9850