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(j) nmatllln on thIs applicatIOn which IS to the best of my knowledge true and COlTect I also certIfy that I am the owner or authorIzed age tin the I constructIon wIll confllrm to all eXIstIng state and local laws and will proceed in accordance with submItted plans I am aware that 1St c~urthcrmore, I hereby agree that the city Off~ u; 3lgl6lnt~uzn the propeny to perf(Jrm nee 'd Insr;[:srr' 0 <( Signature Contractor's License No. Date u 111 IV V A HIM R 2 3 4 5 Occupancy Group: Division: A B E F I abnvc-mcntlOned (lftlcial can revoke x Permit Valuation Permit Fee $ Plan Check Fee $ State Surcharge $ 1.00 Penalty $ Plumbing Permit Fee $ Mechal1lcal Permit Fee $ Sewer & Water Permit Fee I $ Gas Fireplace PermIt Fee $ This Application Becomes Y OUT Building Permit When Approved ~~ Buildll1g Uftlcial '1(/0//07 Date B S U PROJECT COST IV ALUE $ (excluding land) / ()OO j - Park Support Fee # $ SAC # $ Water Meter Size 5/8"; I"; $ Pressure Reducer $ Sewer/Water ConnectlOn Fee # $ , Water Tower Fee # $ Builder's Deposit $ Other $ TOTAL DUE $ 1/3. 2S ~~t~ ;;,~i~{ ~~CCi~. 55~7? ThiS IS to certify that the request in the abllVl' appliCJtlOn and accompanYIng documents is 111 accordance with the City loning Ordinance and may proceed as requested ThIS document when Signed by the CIty PI,lI1ner constitutes a temporary Certificate of ZOnIng compliance and allows construCtIon to commence Befme occupancy, a Ccrtlficate of Occupancy must be issucd Planning Director Special Conditions, if any Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 4646 Dakota Street Prior Lake, MN 55372 Residential Building Permit Checklist Basement Finish or Interior Alteration to Single Family Homes /? ---~: BY: ~_ ,............... , ~ Date: 1p~~ Building Permit # Site Address / S' 'I C( 2- Legal: L__ B PID: Zoning: ~ ~~ Subdivision: Existing Structur@er NO I CONFORMS TO WNlNG ORDINANCE I CYE~ I NO I YES NO Is this an expansion of the existing footprint or Refer to Planning building height? AJc Is the property located within the flood plain? Refer to Planning ,.Ja Does the alteration include any additional kitchens? Refer to Planning t-JO Does the proposed alteration include any outside Refer to Planning entrances other than patio doors? iJo Is the proposed use of the finished space or Refer to Planning alteration for anything other than a normal single Alo family home (office, group home, day care, etc.)? THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO MAINTAIN A RECORD OF THE REVIEW. L:\TEMPLA TE\ALTCHCK.DOC CITY OF PRIOR LAKE PLUMBING PERMIT ~ 5/~~f? ~ WtbS-Ol73 I. Blu. Fil. I PERMI NO. ./ 2. Gold City 3. Yellow Applicanl I Date Rec'd ZONING (office use) LEGAL DESCRIPTION (office use only) LOT ~ BLOCK I ADDITION '- '" I~ IJ~ ~ PID I I OWNER (Name) (Address) (Phone) APPLICANT IA 117 If) . (Name) rVtA' /, ~ (Address) ~ LLi!/(phone) t.6l-45<- /~ ~ (phone) (Zip Code) :;;z DATE Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softner I 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 , Water Closet (Toilet) Other ANT PLEASE COMPLETE BELOW FEE SCHEDULE Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum ..., ()C.:::> Estimated Cost $ ,j,c9.[)::) - / Residential, New One & Two-Family ~ ~"SC> Residential, Additions & Alterations ~ -4 q ,5D Building Penn it # fR. .fr ~f fPj , ~ (Office Use Only) This Application Becomes Your Building Permit When Approved PLUMBING PERMIT FEE $ 81' ATE SURCHARGE $ TOTAL PERMIT FEE $ Paid Receipt No, BuDding Official Date By Date 24 bour 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 HI:ATING/AIR CONDITIONINGIFIREPLACE PERMIT Date Rec'd ~: ~ ~!~. I PERMIT NO, Q . ,'13 I 3. Yellow Applicant . U . I ZONING,_=> I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER _ (Name) ~ ~ ~e!'-L\,\. ~) (Address) (Phone) APPLICANT (Name) (Address) HEAnNO & COOUNO TWO lNo. 1GOOU County Rd. 81 Maple Grove, UN 65389-823. (~~~=~ (Phone) (City) (Zip Code) (Contact Person) (Phone) DATE APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BE ONEW CONSTRUCTION 0 REPLACEMENT FURNACE MAKE AND MODEL FLUE SIZE RETURN OPENINGS INPUT OW ALTERATIONS FUEL OUTPUT TYPE OF SYSTEM OWarm Air Plants OGravity o Mechanical OAir Conditioning OVent. System HEATING OR POWER PLANT o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL .. Industrial, Commercial & Multi..Family FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only $39.50 Residential, Heating & NC (New ConstructiOllj Residential, Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ $eo. c>c::. Building Permit # (Office Use Only) This Application Becomes Your Building Permit When Approved HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 Building Official Date Date eipt No. 55 7 ~() 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 DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS 15+42.. I3LA~ bEAK CA~~l6 NATURE OF WORK LOW5f2-- ~EVE1_ USE OF BUILDING ~ Aft PERMIT NO.. 0 B, 0 Jt3 I DATE ISSUED 4,.(1-, 06 CONTRACTOR T.13lC.Ds. PHONE 1~3.1Jz...e13/ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ~ : I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS INSPECTOR DATE FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS BUILDING . ELECTRICAL PLUMBING HEATING . DO NOT OCCUpy UNTIL ABOVE AS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough-in inspections and maintainE!d until all inspections have been approved. On buildings and additions where no serviice cabinet is available, card shall be placed near main entrance. FOR All INSPECTIONS (952) 447-9850 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 8 JtA.G)C / S 1-/ ~I ~ Date Rec' d +, /+--, o;r I White Pink Yellow I PERMIT NO, 08,6/73 File City Applicant ZONING (office use) &/rr G'r-Lk LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) BUILDER (Company Name) (Contact Name) (Address) :r- - itf't'J fh-4-j fJ19#1t' CJ.t ",C)C -:;0 hY1 f>e>V'\ P Dr /j 2-3 ...,... 7 /'3 7 /2 ~')7? A"wy.J(7)I.Jt. J"'lN{Done) -0 .) (f..> (Phone) G /1I 553/ TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing DAddition DAlteration DUtility Connecl1on ower Level Finish 0 FIreplace ~ 1W1$ nmatlon on this applicatIon which IS to the best of my knowledge true and correct. I also certIfy that I am the owner or authorIzed age for the I construction will conform to all existmg state and local laws and will proceed In accordance with submitted plans_ I am aware that l' buildmg 1st cal~Furthermore, I hereby agree that the city Off~ 0; ~lgz: 6lnt~u2n the propeI1~ to pertiJIm nee 'd lI1sr;[:~'r2f' 0 <( Signature Contractor's License No. Date CODE: OLR.C. OLB.C. Type of Constmction: Occupancy Group: A II Division: I E II F I III H 2 IV I 3 V M 4 x Permit Valuation Permit Fee $ Plan Check Fee $ State Surcharge $ 1.00 Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee I $ Gas Fireplace Permit Fee $ I This Application Becomes Your Building Permit When Approved I ~ ~ '1/10//07 ! Illllldlllg Official Date o MISe. A R 5 / ()OO j / B S U PROJECT COST IV ALUE (excluding land) $ 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 $ ( 13. 2S ~~:e f)1~i~{ I ~;"'1i; 55~7? This IS to certify that the requl'st 10 the above applicatIon and accompanYll1g document.s is 1Il accordance with the City Zoning Ordinance and may proceed as requested. ThlS dllcumcnt when Signed by the CIty Planner Ctlnstltutes a templlrary Certlticate llf ZOl1ll1g cllmplrancc and allows Clll1structml1 III commence Before llccupancy, a Certificate of Occupancy must be lssucd Planning Direclor Special Condilions. if any Date 24 hOllr notice for all inspections (952) 447-985ll, fax (952) 447-4245 4646 Dakota Street Prior Lake, MN 55372