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o� -- dp CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
i TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
t=' AND UTILITY CONNECTION PERMIT
2l 2? 1
,•
r S F
AWE5D
I. White File PERMIT NO .
2. Pink City /2- - OC*
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5gzz L5o s /_
/ . P/ti•uP1-d./
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25. 9. 6 6 Z . 0
(NaWNER As 1-4 tiSOXId (Phone) c f 52 " '4 25 2
(Address) GB 28 1 S ST 1 0 [ Y
BUII.,DER ' , A
(Company Name) M f - O A)4 L) u- L LO S t t 4C (Phone) 4 5 2-
- 7 r 2 788
(Contact Name) (Phone)
(Address) 7 c`3 Z i iii l S $T• St..-V .P4x- mAl. 5 6 37 43
TYPE OF WORK brew Construction ['Deck ['Porch DRe-Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace
DAddition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B 1 2
Occupancy Group: A B E F III MR S U PROJECT COST /VALUE $ l, ow •
Division: 1 2 3 4 5 (excluding land)
I hereby ce i - that I e fu • e. w ' o4,r. . don • . • is application which is • e best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-m, ton d p p • tha �,r, T. stru•. • . will conform to all - •i,...,- . e and local laws and will proceed in accordance with submitted plans. I am aware that the building
official. i re •ke •
fo T • , use.. i, ermore, I hereby • =� ' the city official or a designee may enter upon the property to perform needed inspections.
1-1- / 40) 2, 5 / t 1
Si: ature Contractor's License No. Date
Permit Valuation m Z C%� 4Z . Park Support Fee # $
Permit Fee ' $ 9 •Z s SAC # $ .
Plan Check Fee $ - `1't L 3 Water Meter Size 5/8 "; 1"; $
State Surcharge $ 1 ‘ . T Pressure Reducer $
Penalty . $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 4 c;i Water Tower Fee # $
Mechanical Permit Fee $ S 4 . '3-0 Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE ( C. 77 // / 4- // , $ t (` '7 .Z ,13
This,. lie. tion ! ` t mes, , ', ur Building Permit When Ap oved Paid /47Z. /3 Rec i t No. G 77(
/ Date /, / 7. /2. By
Y 11
Building Official Date
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
when signed by the City Planne constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
71-- y— /(
Planning ector Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
r PRip
e
u
x
White - Building
Canary - Engineering
` Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT / 17 HV W ft fo W E7€S
APPLICATION RECEIVED /0 . 2;7_,I J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
50 2 e 0 7 4 & ( . .
Accepted L4 Accepted With Corrections
Denied
Reviewed By: t ( Date:
Comments: 1P e- L-- - 1-- • ' 7)
"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."
O� PRIp1
ti x
U rn
White - Building
�, �� Canary - Engineering
NNESO Pink - 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:
Accepted X Accepted With Corrections
Denied
Reviewed By: - / Date: /(— �1 — /0
Ibe
/ / / , / / / /� r 1
Comments: G� ra rs an a -c�ie� kra Ey GT ZT�"n� �-I-LY(
Glue /6 Coned C / .
"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."
01/24/2012 05:53 5528947372 LAKESIDE PLU9FIN3 PAGE 31/DAD
P .Rto Date Recd
i...- .,,, CITY OF PRIOR LAKE PLUMBING PERMIT , .....
'tom . -.. , „�
IQ* ERIVII
T - ri1I).
a. 'Mk AcDI 'u _
Please type_ or pr and Rigs at batrom)
^ WDRESS 'ZONING (nmcenea)
— — LI a'ey I5'0 z.S _.. .
�. LEGAL DESCMPTION Office use only}
LOT BLOCK ADDITION PID
t lsZame) Ct U- - (Illoae) . -
i Address) - a „..10a.4) -_ _ ...... _ .. _
t PLICAI,iT (} � : N � �2c
Name) 11 ;ye Chit 1 , (Thom) __95.d.,: 5± ? _ _,
iAddress) _. GpO ___Zif 10...0-_ v.-/- s v ... ,s ie
(Address) (City) (Zip Code)
( 2.ontact Person) ay (Phone) ... _..__ ... __. _�
,PPLT.CANT STGNATUirE 4t. _ 4� . DATE ! - a / -+k _
APPLICANT PLEASE COMPLETE BELOW
Quantity Typo of Fixture Quantity Type of Fixture
l
Bag) Tub with. or without shower Rough -ins - -
1 Dishwasher 'l Water Heater _
_ ( Floor Drain T.w___ -_..._ .. Water Softener
. Lavatory (Bathroontl Sink) t _ Stand. Pipe (Washing M4.ohine)
_ —___1. .... Laundry Tray (1 or 2 compartmer._t sink - Sewag jector
Shower Stall Paclrflow Assembly _._.._
_ ..1... - Sinks .... Backflow Assembly Tel i .
Bar S ittk — _ Lawn Sprinkler -
_ t j Water C _ Closet (Toiled_ Other
FEE SCHEDULE
Industrial, Commercial & Multi- fatuity 1% of job cost with a S49.50 minimum Residential, New Ono & Two-Family $149.50
Residential, Additions & A1trr tipn.: $49.50
so Miumcsotn. Statutes ¢ 32.513.1 r1$ Est Building Fermi:
"SU &C'1•!A.RC;13” has been c1miiged for one PAID VY1 11'
year effective PLUM.B)NG : ERTV.IIT FEE $ (�,�± p
. lily i, 2011}, until .lune 30, 2011. STATE SURCHARGE $ .5Q J LDING PERMIT
ime m ninth in enrd,nrgt for n''tixcd Pee" pnenit TOTAL PERMIT FEE
is Li. itegi nrtine July 1, 2010 - - -
This Application Becomes Your $utlding Permit When Approved Paid Receipt 11o.
Date By
flo olfidal DaM
24 hour notice for 1111 inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, 31Tion.egota 55372
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS I f Z tc"
NATURE OF WORK
US BUILDING . - - z a 712-
" ERMIT NO. � /¢ DATE ISSUED i‘ ict t�
PHONE 4-A • z-1.5&%
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
( THE PERMIT IS BY SEPARATE OC _
� S
poor r 7 . S It�3 � �^ % ^�C1p' —.S c__ A INSP�ECTbR �` � DATE
1
1- FOUNDAT1ON1Prior 10 Backti --� K11 S r 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING r � ,%
INSULATION /�� 1 iZk-
ELECTRICAL
PLUMBING Vie, - „ ,0 l #iti /U 7>i,
HEATING (if required)
FIREPi A
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
Igo` WV
FINALS
BUILDING
ELECTRICAL
PLUMBING p 14 (24
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 INSPECTIONS (952) 447 -9850