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F Tal CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
° � 4. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
t,. ,, v AND UTILITY CONNECTION PERMIT _,
411 A'NESO°' 2 Pink Ede PERMIT l 5.5
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3575" - 7 - 0./tie - f- l 1z vc P0-`..)P
LEGAL DESCRIPTION (office use only)
LOT /7- BLOCK / ADDITION llt Gift te_Y Si h, $ .2 1) PID 2.5. 4U. C 12 .0
OWNER
(Name) (Phone)
(Address)
BUILDER D R HORTON, INC 952- 985 7272
(Company Nance) (Phone)
Brooke Hareid bmhareid @drhorton.com Phone 952- 985 -7806
(Contact Name) ( )
(Address) 20860 Kenbridge Court, Lakeville, MN 55044
TYPE OF WORK New Construction DDeck (Porch DRe- Roofing DRe- Siding ALaiver Level Finish At Fireplace
DAddition DAiteration DUtility Connection
CODE: ®1.R.C. DI.B.C. D Misc. _
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ ) g 4 7 C. are
Occupancy Group: A I3 E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also realty that I am the owner ur authorized agent for the
above - mentioned property and that all constriction 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 pern at for Just cause Furthermore, I hereby agree that the cry official of a designee may enter upon the property to perform needed Inspections
BC605657 2/ / / 3
a
attire Contractor's License No, Date
Permit Valuation • DDO Park Support Fee # $
Od
Permit Fee $ $t1. zS SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1"; $
State Surcharge $ 2. 0 p Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ J t. 4 .5D Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 5 ¢... 6i TOTAL DUE $ qa 1
6 . /. s This Application Becomes Your Building Penult When Approved Paid ,!l/ ff. L 1 ceipt NO.
'
- 7,, Date - 7,, 2, a y�
d % �
tinklin 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_ Thts document
when signed by the City Flannel constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
•
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• :
•
S .
Rio CITY OF PRIOR LAKE Date Rec'd
� HEATING /AIR CONDITIONINGIFIREPLACE PERMIT
P 2
t, rin Fil I
'�riveso� z. Zen a ;.Y PERMIT NO. /J _ /53
3. Yellow Applicant
(Please type or print and sign at bottom) —
ADDRESS ZONING (office use)
27 C ,GA,,. ,v c 5 w •
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER 6 n
(Name) : 4 uv j- (Phone) � ` Z- 4"- 7
(Address) 2 C c e (IC 41.).1rr41 rc 41 i DO
APPLICANT HEARTH & HOME TECHNOLOGIES
(Name) dba FIRESIDE HEARTH & HQMEine)
Lic 662656
(Address) 2700 FAIRVIEW AVENUE N
(Address) ROSEVILLE, MN 55113 (City) (Zip Code)
651.633.2561
(Contact Person) (Phone) •
1 /} � r- DATE / 1
3
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
lEW CONSTRUCTION ❑ REPLACEM4NT ❑ ALTE RATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
DAir Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
['Vent. System ❑ Other Devices � Require a Building Permit.
FIREPLACE MAKE AND MODEL /T' 1' " 5Z R 7 2�2 3 /3r
FEE SCHEDULE
Industrial, Commercial & Multi - Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alflike WITH $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Onl y V `IL E PERM 49.50
Estimated Cost $ / – C'. coo Building Permit # 1 l�
The Minnesota Statutes § 326E3.148
"Sl RC11ARGE" has been changed for one
HEATING PERMIT FEE $ year effective
STATE SURCHARGE $ .50 Jul) 1, 21110, until June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "Pled fee" permit
— is S5, beginning July 1.2010
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
- Building Official Date ;
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3975 1 , d . tx.
NATURE OF WORK
4 t,.,0
USE OF BUILD G ' Ara; /
PERMIT NO. IL F.A. DATE ISSUED 4' /L
CONTRACTOR • 31j PHONE
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREE AT ALL TIMES
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING ljc/
FIREPLACE
0111W
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
HOUSEWRAP LATH
FINALS
GRADING ( PRIOR TO SODDING)
BUILDING p
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 INSPECTIONS (952) 447 -9850