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*Ty, CITY OF PRIOR LAKE `_' ''
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,; . i1j !rparfnuttf of Puittrin 1nsprrft.n ;..:;;
(t' ❑ Final Permitted ❑ Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential l ❑ International
Building Code certifying that at the time of issuance this structure was in compliance with the various
tg. ordinances of the City of Prior Lake regulating building construction or use. For the following: :i40
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Contractor's Name & Address / / '
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'4.ty Building Official
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o, p i? CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
( '(/ . �
\ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE - / 1/., 1 i i �' AND UTILITY CONNECTION PERMIT
er J
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.rNESO
t. white Nile
2. Pink City PERMIT NO. /Z _ 4-13
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
t s y G bpi oe- ( 4J
LEGAL DESCRIPTION (office use only) .
LOT ( BLOCK ( ADDITION (it I we) gy G 5 -2(1 PID
OWNER / 6 S
(Name) Q 9,M. 15 �rO SVL /✓€ Z (Phone) G S ( 9 —'-' J /
(Address) (it t 9 La- X(uVsi- • e T t o K '' Y 6 (' K `/—
BUELDER /� `/ c1 N /�
(Company Name) C I�ct( to S Me rrc H 0 /14. c- S s N C (Phone) (OS ( L i Co Z ( FO
(Contact Name) co e it, r ( i + fi (Phone) qJZ 2 - ° / 2-
(Address) 3(0 3 o S P /mot [as ffcv•-/ i /`. 5
TYPE OF WORK
Ac
New Construction ❑Deck ❑Porch DRe-Roofing DRe-Siding DLower Level Finish ❑ Fireplace
ddition ['Alteration ❑Utility Connection
CODE: [1C]I.R.C. ❑I.B.C. ❑ Mme:
Type of Construction: I II III IV V A 13
Occupancy Group: A B E F III M R S U PROJECT COST /VALUE $ 2$ 0, x 0 0
Division: 1 2 3 4 5 (excluding land)
1 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 acuurdance 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 upon the property to perform needed inspections.
X /14C ------ b� CP3 /3Z9 s -t(— (2-
_ I Signa N e Contractor's License No. Date
c
Permit Valuation Z c( Park Support Fee # $
_ __ O OO
Permit Fee $ 7. • SAC # $ Z 3 (o c '
Plan Check Fee $ ( 4 41.18 Water Meter Size !`: "; 1 "; $ 46o —
State Surcharge $ I t g 4 Pressure Reducer $ (2p
Penalty $ Sewer /Water Connection Fee # $ l S
Plumbing Permit Fee $ ( 5-4.c, Water Tower Fee # $ ( r
t s � • � —
Mechanical Permit Fee $ B uilder's Deposit $ l S'
Sewer & Water Permit Fee $ r 7 (0 • 5° Other $
Gas Fireplace Permit Fee ' $ 54 .4.,-. TOTAL DUE rA► V -0 0 51iii $ 1 i r 21 1 , G6
This 4, plicati • 1 comes Your Building Permit Ap ved Paid A 2 Ll G 1/ ceipt No. (, s
// Date t, _ /, eU Y t
Bui lci2l Date
This is to c , that th- ig•i uest • . the above application and accompanying menu is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when si by th• C ,, n • constitutes a temporary Certificate of Zoning mplian and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. ,
/ / i r! - Z � tZ — -- — — 1 Director Date Special Conditions, if any
A ■ our notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
O � P RIO R
ti
U .
White - Building
�� �A Canary - Engineering
NNES° Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT &1 --6 t4L/' /Tr /run S // , 1
APPLICATION RECEIVED " 12—
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ 3E' moo, /I/6" .
Accepted .
1 Accepted With Corrections
Denied T
Y
Reviewed By: I : Date: 5 Z4' /-
Comments: (- cow-tL % (.&^) P #,4A-' ?4(N Cc
/-- i 7r .
'Z , LJP 2., . I /is Y' &2#I V 1 A24- (iv /i" %
7 &rn /a., - ,
3. G . Lr / gs.- L /moo 7r 1641' � Ste,
4 r 4./57c /¢ e- CA) r 1 1.4,6tt A-,�
/-(r-r" -- , tertsj<sr
"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."
U
White - Building
Canary - Engineering
rNNFSO� 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 Accepted With Corrections
Denied
Reviewed By: Date: 57 4 a--
Comments:
"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."
x ° ldl j:ac p�w[+na: AAnxa.«r a:.c.n+v
O � PRIO
;-", ,' i '7 ' /Z•
White - Building
'a �� Canary - Engineering
LANES° 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 5- Accepted With Corrections
Denied
Reviewed By: 2,7r/4 c____
Date: /ZJ`�
Comments: See Attachments_ 1) Grading Plan, 2) Erosion Control Standards
See Reverse Side for Additional Information!
"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."
r ,.. • — s w.. -wow- V werrwrsyr. rY m• ' f°p!' � n •rw T ' - :F •� ^�O'P �.11�^ . .
•
o t 1' R10 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT — 7 . r1 v
4 47 1
'. Blue File
2. Gold Cit y / PERMIT NO. / a 4 7i3
City
3. Yellow Applicant
ease t ype o t and sign at bottom)
ADDRESS ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PIT)
OWNER
(Name) (Phone)
(Address)
I
( P1 ' r c et << � r-� . ,. _ v • (Phone) c a- - %-1 - 1 1
' Address 400 P.:, Tr • \ (--%' . r ..k L MA/ .S" 31
(A: dress) (City) (Zip Code)
(Contact Person) D 0 o (Phone)
ii PLICANT SIGNATURE / / DATE — a
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough -ins
Dishwasher Water Heater
Floor Drain Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi - family 1 % of job cost with a $49.50 minimum Residential, New One & Two -Famil $149.50
Residential, Additions • • erations $4'. 1
The Minnesota Statutes § 326B.148 t $ Building Permit # /(
"SURCHARGE" has been extended AID D
until June 30, 2013, PLUMBING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ .50 S Li
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
r R/ CITY OF PRIOR LAKE Date Rec'd
Ot / mot ..
=� HEATING /AIR CONDITIONING /FIREPLACE PERMIT
INNESO 1. Gree n City 2 PERMIT NO . /2 — � /. /I
. Gree City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS -, D i ZONING (office use)
/ 5 (/ & f) - i I V ) 7 ' - i -
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
((NaWNER /r `� ('' ; ) i ' �i' 2' - i --) (Phone) /' 5 3 / 70'0
(Address) ", / L '- l , 1, 1( ' { } j // 7 5 _ L
APPLICANT;' / // �/� _ �1 /9--)---. (`
(Name) C.__-'/ C /1 1 -rte% .11 1 t 'i / (Phone) i J � � � / � /
r
(Address) 'C- . a C'� f / S 35
(Ad ress) (City) (Zip Code)
(Contact Person) _ (L t C kL. ;( (Phone) (-- q/ ` i
APPLICANT SIGNATURE . ." DATE' 1 �� cJ z'/
APPLICANT PLEASE COMPLETE BELOW
/ ISNEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL ) J < 7 Sc ,� 3 / - `e-. i FUEL /'„ l . c 2. t `. 7
FLUE SIZE l - RETURN OPENINGS INPUT OUTPUT 'J SC c.
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravit ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation
['Air Conditioning El Special Devices Fireplaces with Box Additions or
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
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 & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
ost $ ` I ' Building Permit # 6 - / LO
The Minnesota Statutes § 326B.148
"SURCHARGE" has been extended HEATING PERMIT FEE $
until June 30, 2013, STATE SURCHARGE $ .50
The minimum surcharge for a TOTAL PERMIT FEE $
"fixed fee" permit is $5.00
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
P RI R LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS - , ►40C. - , C5
NATURE OF WORK = fv, 1N3G . DezK. Fcxct - + (ice;. L- 1._. 4
USE OF BUILDING ry - A. . -)
PERMIT NO. i DA E ISSUED s t i
CONTRACTOR "t}A4 1-1-65 tl it rlt yr ' ( PHONE 9'2-1 Z -6 T &(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERK T IS BY SEPARAJE DOCUI NT -
i emu- St C 3 C" jA c . c -1.,1 CtO� E 1
I FOOTING ctA-FTV S(24)(r \Awl U13 1 414edi'e— I
I FOUNDATION (Prior to Backfill) I PS -2 I
402,t-' 5`1 L--1 LACE NQ CONC TE TIL AAOVE HAS BEEN SIGNED
S R {
O G H I �
SEWER /WATER / SEPTIC WC- Pis 7 6 2 4 , 2 - -
FRAMING ( ). V.6 01a
INSULATION (i 7A'
ELECTRICAL
PLUMBING ,.)
HEATING (if required) P 72 FIREPLACE 8 ) z/iz
GAS INE AIR TEST � � ( I7 to �2
OD6'`) kt P IN l6 - _. JD -
COVER O WORK UNTIL ABOVE HAS BEEN SIG D.
1 ( '4 (k-o \ LA--1 1 -it I r(26(vz I
FINALS
GRADING (Prior to Sodding) 0O e4 /Zf."--,
BUILDING P .6 f t3 f 5/
ELECTRICAL
PLUMBING kit %//'2
HEATING Gr 4115112'
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
CITY OF PRIOR LAKE.
Impervious Surface Calculations
(To be Submitted with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address: 1546 Belmont Avenue (Lot 1, Block 1, BELMONT ESTATES, Scott Co., MN)
Lot Area 20,000 Sq. Feet x 30% = 6,000 Sq. Feet
************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
LENGTH WIDTH SQ. FEET
HOUSE irregular x = 2.168
x =
ATTACHED GARAGE irregular x = 938
TOTAL PRINCIPLE STRUCTURE 3,106
DETACHED BLDGS x
(Proposed Shed) X
TOTAL DETACHED BUILDINGS 0
DRIVEWAY/PAVED AREAS x =
(Driveway -paved or not) irregular x = 912
(Paved Right -Of -Way) X
(Sidewalk) X =
TOTAL PAVED AREAS 912
PATIOS/PORCHES/DECKS Front Porch = 290
(Open Decks 1 /4 min. opening between
boards, with a pervious surface below, Rear Porch = 168
are not considered to be impervious)
Deck to have min. openings = 0
TOTAL DECKS 458
Other =
TOTAL OTHER 0
TOTAL IMPERVIOUS SURFACE 4,476
UNDER/OVER 1,524
Prepared By Harold C. Peterson, L.S. MN License No. 12294 Date 4/23/12
Company James R. Hill, Inc. Phone # (952)- 890 -6044
•