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( ` CITY OF PRIO LAKE •
,
tI Prparfturxt± of Puiltritt c ainsprrfion
❑ Final Permitted ❑ Conditional C.O. Expires t'
,• - This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International + ;i)
Building Code certifying that at the time of issuance this structure was in compliance with the various
O .
ordinances of the City Prior Lake re gulating K ' nances oe y of ror ae regu building construction or use. For the following: :__
O A.. I / Z.... . r i )
Use Classification LS//v a'eZ / /"1/ Bldg. Permit No. '
Occupancy Type /�- • Type Construct vet/ Zoning District S� \
, Legal Description L— / f 1. 1, e � $ Q�”' /vQ��Q� L2 ����
Owner of Building Z7 74 , 'Vfr f z,/,0&-
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Contractor's Name &Address �� , S -- 7 ,) ,-/6 -
/ �+ r`�f ` ? �L- /� S ` •
��. � �-7 U/ C:f ' /��� / City Planner
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11 y
wilding Official _ ..: )
0 r I Date: I J 1 – ( Date: --1.2),
POST IN CONSPICUOUS
PLACE
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of P Rlp k CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
/IL
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT c5 22 Z _ �Z
1 A� �NNESO�P 2 Pin
'ke File P NO.
3 Yellow Applicant i
(Please type or print and sign at bottom) .
ADDRESS ` // ./ , ZONING (office use)
t n / 7 30 !'f a v n- •' /,(/ VIA/ •
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK / ADDITION t3' 014 ,, , ,d PID 0 0Q (p
OE
( gym ) R r f tud✓.. /'
Name t a s- I ' G "y1 ily Al 9 M e 5 (Phone) C l sDZ 4 -d
(Address) .
BUILDER L
(Company Name) ,.e 6 To , , u ' i • rh t
.� + (Phone) f_c / G�7- 'aO
(Contact Name) S/ � 8th 6 "; / i�'
q e ,4,�- ....-� -,� �D J) $ 5 0 h (Phone) t w / /
(Address) / 761/5' NG►. AL ° 4 `f' 4 1.4t de /3.- I,4h a r,%s , H/1 41 S`S`p 'r
TYPE OF WORK .I+�New Construction :Meek ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑Fireplace
❑Addition DAlteration ❑Utility Connection
CODE: '�I.R.C. ❑I.B.C, ❑ Misc.
Type of Construction: I II IlI I \' V A B PROJECT COST /VALUE $ 13 t!
Occupancy Group: A B E F III MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby eenify that I have furnished i . ormation on this application which is to the best of my knowledge nue and correct. 1 also certify that I am the owner rr authonzed agent for the
above - mentioned property and that constntction will conform to all existing state and focal laws and will proceed in accordance with submitted plans 1 am aware that the building
official can revo: cause Funheumore. 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections
a� x3 ( •) ' !/ G s - /z
Signature Contractors License No. Date
Permit Valuation i col' F cat O - Park Support Fee ti $
t�/ t
Permit Fee $
$ 167.E SAC -CG�.
Plan Check Fee $ C1_5 . Water Meter Size "; 1 ";
fl7 .
State Surcharge 5 Pressure Reducer $ i
Penalty 5 Sewer /Water Connection Fee ii $
( - 5 -, 3°-
Plumbin Permit Fee $ ( 5 _ 5 J Water Tower Fee 4 $ (
Mechanical Permit Fee $ ( 4- _ c. Builder's Deposit 5 f
Sewer & Water Permit Fee $ Other 5
—
5 �J
Gas Fireplace Permit Fee $ c i - 50 TOTAL DUE
This A s ' • Iica/ on I ont es Your Building Peniut whe Appro ed Paid f
/ �P r I�� 67 ' c! D R ec ' t No. �, 7C1��
�Z Date l /(_, /Z-- 8 :�
Buildin 011icinl I ate
This is to cer *7 hat tb • rem"' 5 the above applic Lion and accompanying documents i n 7 danee with the City Zoning Ordinance and may proceed as requested. This document
when signe the C PI of Zoning complian anws constriction to commence. Before occupancy. a Cetuficate of Occupancy must he
issued / , 4 Z
Plannin lire ate Special Conditions, if any
24 hour notice for sill inspections (952) 447 -9850, fax (952) 447.4245
4646 Dakota Street Prior Lake, MN 55372
t
_
7 -
es
i . PRI0
m
White - Building
Canary - Engineering
" �INNESO ` P Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT / ∎DS/Z J PH/ /L-/ !"'o r7 g5
APPLICATION RECEIVED . 7_2_ /2_
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L0 h ✓C, / i 6 le-0 A/W .
Accepted '/ Accepted With Corrections
Denied k ,
y Reviewed B Date:
Comments: - / ft '1-o-U P-ty -
AP 7,---,-- ( Gyp-1.55
"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."
i c IPR/0 *
,4 6::: " L e
ti a x
U m
White - Building
y� z Canary - Engineering
/NES° 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 r ,
Reviewed By: Date: r Z.-
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."
(c � �x
U trf
White - Building
Canary Engineering
NNESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ri , ,1 ' 01/ ! files
APPLICATION RECEIVED J • 2- - l 2_
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.-
4 1 - 767 fi=t 1 IG. i d 60 leo Ai 01
Accepted Accepted With Corrections
Denied &/5//
Reviewed By: TA Date:
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."
ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS
• Surface storm water drainage flowing to the perimeter of this lot to
and from adjoining properties must be conveyed to the roadway
and /or to the rear of the lot in drainage swales within the drainage
easement.
• All bare soil areas must be protected from eroding into neighboring
properties through the properly installed and maintained silt fence or
bales.
• The silt fence required by the erosion control plan must be installed
prior to any earthwork being started.
• The builder is responsible for maintaining the erosion control
measures until the turf is established.
• The rock construction entrance must be installed at the time of
backfilling of the foundation.
G; \Admin \dept info \ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS,doc
Residential Building Permit Checklist
New Construction for Single or Two - family Dwellings in -1 or -2 Districts
Reviewed by: Date:
Building Permit # PID: Zoning: Qp
Address: Z `t'1(0 \` - (2_, t �— I (Th
Legal: L , B Subdivision:
Existing Structure? YES 1 N . Existing Nonconforming Structure? YES /14®
CONFORMS TO ZONING YtS NO
ORDINANCE
I Yard Setbacks: NA 1 FAILS/ COM6tS Standard Proposed
• Front Yard (can be 20' if avg. w /in 150') 25' 25. 0
• Side Yards S
25' if abutting a street l .
- -
• Sidewall exceeding 60' requires additional side 2" 10' setback +
setback for every 1' over 60' in length. Not required 2 "/1' over 60'
if building wall is 10' -0" or greater of being parallel to
a side lot line.
• Rear Yard 25' 6 1
• Patio Door: provide for minimum 10' deck or sign 10' side/ _
statement indicating no deck will be built in the future 25' rear
• From 100 year flood elevation of wetland /NURP 30'
pond.
• Refer in- ground pools to the Planning Department
• From OHW (Prior or Spring Lake) 75' or setback average of
adjacent structures, but no --
less than 50'
I Floor Area Ratio: NA 1 FAILS / COMPJS 1 .30 Maximum 1 ' "".q 16
Yard Encroachments: NA 1 FAILS /COOLIES Standard Proposed
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line (Easements).
A/C and other equipment cannot encroach on interior
side yards. tab `{ -
Tree Preservation: tv / FAILS / COMPLIES 1 Standard Proposed
• Total caliper inches
• Permit 35% Removal
• Caliper Inches Rer?oved
• Calipalnches P,r6served
• Replacementf 1 /2:1
L: \TEMPLATE\BLDGLIST.DOC
Driveway: NA/ FAILS / C w ' LIES Standard Proposed
• Maximum width at prIVO line 24' - Z
• Required setback
5' from side lot line or
_ 30' from r -o -w on corner lots 'I -
• Maximum slope 10% S-_Cr=,
• All parking areas to be paved including R -V or
spaces adjacent to the garage -
• Location to match subdivision grading plan r .k,,
1 Building Height: N A I F A I L S I C I J E S 1 35' Maximum I -2- 3 •
Shoreland District: NA/ FAILS 1 CI PLIES , Standard Proposed
Minimum lot area (square feet) 7,500 Rip, 7,999 Non -rip
Minimum lot width 50' Rip, 57.3' Non -rip
Shoreland alterations
Impervious surface 30% Maximum ¢-,) Z C-, -C
Bluff in Shoreland FAILS / COMPLIES Standard Proposed
• Setback from t of bluff By planning dept.
• Bluff impact zone 20' From Top of Bluff
• Engineering certification submitted /approved By City Engineer
• Grading in bluff or bluff impact zone No importing /exporting
Floodplai / FAILS / COMPLIES Standard Proposed I
• 100 y r flood elevation 908.9' Prior Lake
914.4' Spring Lake
• Lowest floor elevation 909.9' Prior Lake /
915.4' Spring Lake
• Proposed lowest floor elevation Must be 1' above flood
elevation for new and existing
structures. If existing
structure was constructed
9/19/90- 11/22/97 then
additional foot is not required.
• Elevations 15 feet from structure Must be flood elevation or
higher
• Road access must be no more than 2 feet below 907.9' for Prior Lake
Regulatory Flood Protection Elevation 913.4' for Spring Lake
Accessory Structure:/ FAILS / COMPLIES Standard Proposed
• Size 1000 sq,ft. or 30% rear yard
• Not located in front yard (Materials)
• Side yard and rear yard setbacks 10'
• Maximum height 15'
• Materials compatible with principle structure
L: \TEMPLATE\BLDGLIST.DOC
•
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 Z 9 7.6 Hal. )1 1? e (2oa 0I
Z.
Lot Area `7 S Sq. Feet x 60Ao�= z 7 7
* * * * * * * * * * * ** *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
LENGTH WIDTH SQ. FEET
HOUSE x _
x =
ATTACHED GARAGE x =
TOTAL PRINCIPLE STRUCTURE / 3 5 -
DETACHED BLDGS x
(Garage /Shed) x
TOTAL DETACHED BUILDINGS
DRIVEWAY/PAVED AREAS x
(Driveway -paved or not) x =
(Sidewalk/Parking Areas) x -
TOTAL PAVED AREAS G LJ
PATIOS/PORCHES /DECKS x =
(Open Decks''A" min. opening between X =
boards, with a pervious surface below,
are not considered to be impervious) _
X _
TOTAL DECKS
OTHER x
x =
TOTAL OTHER
TOTAL IMPERVIOUS SURFACE z. O 7 1
UNDE :IOVER / Z / U I
Prepared By e� r Li Date
Company /?o', �rt57,.;,ee -': 67,, 1.c.r. Phone if 95Z /3z- doc)
P RIp� CITY OF PRIOR LAKE Date Reed
° HEATING /AIR CONDITIONING/FIREPLACE PERMIT
drjNNESac¢ I. I mk F +le PERMIT NO
2. (hem Ci
J. Yellow Appliust
{ (Please type or print and sign at bottom)
ADDRESS r ^ ZONING (o�R use)
; aql Ci .- 1 — frAit / L' K' ° Oil Pef A
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone) •
(Address)
APPLICANT
(Name) GENZ -RYAN (Phone) 952- 767 -1847
(Address) 2200 HIGHWAY 13 W, BURNSVILLE, MN 5533
(Address) (City) (Zip Code)
(Contact Person) LISA HERNAN2 E ZZ JJ� (Phone) 952-767-1847 •
APPLICANT SIGNATURE
• A' ' 14 .i / I �F' 4 • D ATE � i / 2�
APPLICANT PLEASE COMP E BELOW 1
k
I 1`3L`lEW CON UC•I'I N ❑ REPLACEME /� 0 ALTERATION / •
FURNACE MAKE AND MODEL `. e 31 Cp FUEL I AA '
FLUE SIZE RETURN OPENINGS INPUT U 6 1 00 Q OUTPUT 5 , 70D
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑ ravity ❑ Hot Water into Required Side Yard Setbacks.
MI echanical ❑ Radiation
., it Conditioning ❑ Special Devices Fireplaces with Box Additions or
V 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 �o $49.50
l
Estimated Cost $ q
;° Building Permit pvI���
i ` i d es * 326f3.148
HEATING PERMIT FEE $ BU L13 n ' ` ern changed I one
year effective
STATE SURCHARGE $ .50 Jnly 1. 211111, until June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for n "rived fee" permit
(Office Use Only) is Sti, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Bulldlne On'x ®I — _ Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 - 4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
6
pRI Date Rec'd
CITY OF PRIOR LAKE ( l ,
Q SEWER AND WATER PERMIT
�/k NESO� P
1.
2. G Golreen File PERMIT NO. 4 (�rcj
3. Gold d Applicant
Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
a 7 & /4 of r-ici,, pc,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) FWG/ C,441,1 i (1 (Phone)
(Address)
(Address) (City) (Zip Code)
APPLICANT / j'' �I„ //) ..6 G/
(Name) (7 / ` "1 ?v 5 c-- 2 G. (Phone) (o
(Address)
(Address) (City) (Zip Code)
(Contact Person) (Phone) l
APPLICANT SIGNATURE r- — i DATE // /C id
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. ❑ ABC ❑ PVC ❑ Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $51.50 Industrial, Com'l & Multi- family 1% of job cost with a $51.50 minimum
Sewer connection only $25.50 Water connection only $25.50 -_-. _____ "- .
Estimated Cost $ Building Permit #
FA1 9
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $ 13 d l L 4--
(Office Use Only)
This Application Becomes our Building Permit When Approved Paid
Date By
Building Offici Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
.. p Rip Date Rec'd
°� "='- ` �' CITY OF PRIOR LAKE PLU MB1NG PERMIT
A = ,
4,4,000 L Blue File
z. Oold City PERMIT NO.
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
197& 14 tl , 17 - " )21)/C)- D
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) F — / L G V il S TO t U ,. - Fig i 1 't t l U (Phone) L/52 ` 80( ,
(Address) 1 7 6 .) 0 1 FE tom—. PA i7t *135 L / Ev /t..t+. I MN 55r 4-
APPLY , ,✓ ii--�� -.{ I - 3 lei - 42
( Name) CAN I I . �tG 1�- t F- '' i s- (Phone) 0
(Address) I/1 L— O )2i116 #at"' LAo'"41V i it4 IQ 5 1 z
�
(Address) (City) // j } (Zip Code)
'}
(Contact Person) �' ` °� (Phone) t 6 ^ 3 j - - - / 2.
Q 9) — APPLICANT SIGNATURE c' Q l DATE . q/15./2242-
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
i Bath Tub with or without shower Rough -ins
I Dishwasher I Water Heater
Floor Drain Water Softener
A- Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
1 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 - Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes * 32613.148 - Est $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50
The minimum surcharge for a "tiled fee" permit ,
is 5., beginning July 1, Mt) TOTAL PJultMIT FEE $
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildtn2 Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
1 I'R_tp
o � � Builders Depos it
u 4
5..
. City of Prior Lake
A $1,500,00 Builders Deposit is included in the Building Permit fee, The Builders Deposit Is Issued as security to insure compliance for a
Final Occupancy Permit, (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree
planting, driveways, siding and . painting shall be completed 180 days after the date the buliding permit is issued. If the work is not complete
within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the
$1,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation.
A $500.00 Tree Deposit may also be required and will be refunded If specified trees are preserved for a period of one year.
p
DATE: • / f"--/ 2--
SITE ADDRESS: 2 976 , /4 wit- g.f4e.. XV PERMIT # / ' (a5
REFUND TO BE MAILED TO: /76 vtA it o p 44( g / /35
.s4Le '// ins i'ro yy
AUTHORIZATION TO RELEASE iii
PLEASE REMEMBER
-4/.5Oc . (A)
�ynda S Allen, Building Services Amount
1. KEEP STREETS CLEAN DURING CONSTRUCTION 1 7-3 (3 Acct. 801.20204
Date
2. KEEP EROSION CONTROL IN PLACE
3. TEMPORARY OCCUPANCY PERMIT MU," OT EXPIRE OR $500.00 WILL BE FORFEITED
SIGNATURE: l�
' Np
9058
4t m0* 0 •47, r .::i ` ,- ?; * ,' - .t x tfAm CASTLE ROCK BANK
1 i CASTLE ROCK, MN FARMINOT MN � mod" , Fraud
5507A macuo
Fieldstone Family Homes, Inc. D� (93777641-3771514-9 (651)46-4014
7 Juniper Path, Suite 135 19
Lakeville, MN 55044
Phone: 952- 469 -880 Fax 952- 469 -880 0
* * * * * * * * * * * * * * ** *Nine thousand eight hundred ninety dollars and 88 cents
ay • CHECK NO AMOUNT
DATE
di
September 10, 2012 9058 $******9,89
8
PAY
TO THE
ORDER City Prior Lake
OF 4646 Dakota Street S . Le ____ - -- THOHIZED SIGNATURE
Prior Lake, MN 55372
'i'0090 1:09 L9 L3 L48t: 231.12070L0
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 4 k G Q
NATURE OF WORK * -lo t>tr---cc ( RAI . - -
USE OF BUILDING �-
PERMIT NO. Iz- `Cb5 DATE ISSUED b�4
CONTRACTOR r -vsr 6 (4-- PHONE i'2 - 461-66304)
NOTE: THIS IS NOT A PERMIT FOR A OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DNT
I N1' t , �,� '
�� ,� INSPECTOR DATE
I FOOTING I /3 4j,
I FOUNDATION (Prior to Backfill) I g% /f7, 1
P ACE NO CONCR TE U IL ABOVE HA BEEN SIGNED
f)--="041'' l � c lam.' VA- 0��1 0 u `-� �� v 44 -1\i i&
H -I
SEWER / WATER / SEPTIC
f eo /ze,/i7
INSULATION �� l
ELECTRICAL
PLUMBING Vg's t) P6 /aP (Z X6 /��/Z
HEATING (if required) 4
FIREPLACE
GAS IMIE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I (.4 & 6 u /Z /r z beer -v I / .READ' L u6,p r i /41. k W -1 FINALS
GRADING (Prior to Sodding) � r2 � i z /3 /r--
BUILDING '-f" 502_ �Q ta �j8 7/.21 ! )
ELECTRICAL
J
PLUMBING
HEATING /2/3 , 2
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