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- CITY OF PRIOR LAKE ='" 7..„ :
!rpr±mru± o PuitMtu ns r rfon
- ,L1.. Final Permitted ❑ Conditional C.O. Expires ••)'
This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International
•
Building Code certifying that at the time of issuance this structure was in compliance with the various
4 1-7A ordinances of the City of Prior Lake regulating building construction or use. For the follow , ,'
Use Classification S /i16 F PI / L ry Bldg. Permit No. /Z - 2- LS�
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Occupancy Type Type Construction y Zoning District
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#11-i g Description / a Z / JFF 2/ S /2 /VU 4 1
Legal Descri lion - -�! ,(� q ,
= Owner of Buildin 37l3 Pa / N / ('i P� / f ` 1 '
g Site Address
( i
` Contractor's Name & Address - � / / &i iND 1
.r" /e L I /TJ/ 1'1'//5 City Planner
Building Official r ` , r
f KC A Date: -f 44' F 7 4 Date:
POST IN CONSPICUOUS PLACE
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of PRI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
Z. AND UTILITY CONNECTION PERMIT
�r
4 I. White File
2. Pink City PERMIT NO. .
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (of use)
fl l �j POi 1+ �tS5 m. ,,t), ; i....i,
LEGAL DESCRIPTION (office use only)
LOT BLOCK - ADDITION i��/ ( ?c — 4th ri & I + r1D 25 419 O O 6, 0
OWNER
(Name) (Phone)
(Address)
BUILDER i n ��
(Company Name) �\ 1 t ' s '�. — ° 15D- - (Phone) G _ ( b �c�
(Contact Name � (3 e)r ,/ : ( Phone) A ' L 00E
(Address) "J Aniit vVQ i ve Eel 1, i i� Y' ' 1 M 5 3 L - Lf
TYPE OF WORK Iew Construction ❑Deck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑addition ❑Alteration ❑Utility Connection
CODE:J.R.C. ❑LB.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 1 0
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that I have burnished 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 accordance with submitted plans. I am aware that the building
official can revoke this permit for )u cause Fu thermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature 9 Contractor's License No. Date
Permit Valuation 000 ,,--- Park Support Fee # $
Permit Fee $ V Z
■
. ; S AC # $ 7-30 , c
Plan Check Fee $ Wt
Water Meter Size 5/8 "(�)/; $
f l Sz —�'1� 9101
State Surcharge $ k 1 0_ Pressure Reducer $ (G® ..
Go,
Penalty $ Sewer /Water Connection Fee # $ (y c) J4
Plumbing Permit Fee $ (S4. j Water Tower Fee # $ ( o o -
Mechanical Permit Fee $ 1 - 5 - 4. -T-) Builder's Deposit $ ( ;
Sewer & Water Permit Fee $ Other $
(V r"f J
Gas Fireplace Permit Fee $ 5 4• 5-, TOTAL DUE Cf/Al 34% / - $ /0/ 5j/,1
This Ap / / • ti f n Be o.. . • s Y Building Permit When Approv d Paid /a. . S 7 j . R ipt No. (a3J - 7,)--7
I .
Date / ( L B /r
' - i J - / "2.-- i
Building Oftici.' Date (
This is to ce that th Titles the above application and accompanying doc ments s in accordance with the City Zoning Ordinance and may proceed as requested. This document
0 when sign •i . th • ann• nstitutes a temporary Certificate of Zoning mpli cc and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
lissued j ; f
'. i 4J�� /
' 7wt • 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
Residential Building Permit Checklist p Ne str , ion for Single or Two - family Dwellings in R -1 r R- Districts
Reviewed by: / Date: r
Building Permit # Zoning:
Address: 31(.3 F
D ��
Legal: L , B Subdivision:
Existing Structure? YES Existing Nonconforming Structure? YES 1 NO
CONFORMS TO ZONING I , NO
ORDINANCE '
Yard Setbacks: NA / FAILS/ CO S Standard Proposed
I
• Front Yard (can be 20' if avg. /in 150') 25' Z5 `'�
• Side Yards .7,
25' if abutting a stree i 4
• 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 `e 5* 4
• 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
Tess than 50'
I Floor Area Ratio: NA 1 FAILS / CO Li S I .30 Maximum Pte' IC7 , ` I I
Yard Encroachments: 4 F AILS /COMPLIES Standard � Proposed
Eaves and Gutters no , - than 2 feet in width and no
closer than 5 feet to a lo line (Easements).
NC and other equipment cannot encroach on interior
side yards.
„
I Tree Preservation A FAILS 1 COMPLIES Standard I Proposed I
• Total caliper the e s
• Permit 35% Removal
• Caliper Inches Rerr?oved
• Caliper Inches P,r4served
• R6lacement/ %:1
L: \TEMPLATE\BLDGLIST.DOC
Driveway: NA / FAILS / C • " P ES
Standard Proposed I
• Maximum width at pro. - • - line 24' -�
• Required setback • 5' from side lot line or
30' from r -o -w on corner lots f ‘
• Maximum slope 10 % 2---
• All parking areas to be paved including R -V or
spaces adjacent to the garage
• Location to match subdivision grading plan ,
I Building Height: NA / FAILS / C01#1 1 35' Maximum 1 2_
Shoreland District: NA / FAILS / C011-.7.13 , 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 p< "2 2-
Bluff in Shoreland: / FAILS / COMPLIES Standard I Proposed
• Setback from to of bluff By planning dept.
• Bluff impact zo e 20' From Top of Bluff
• Engineering certification submitted /approved By City Engineer
• Grading in bluff or bluff impact zone _ No importing /exporting
Floodplain: / FAILS / COMPLIES Standard Proposed
• 100 yea ood elevation 908.9' Prior Lake
914.4' Spring Lake
• Lowest fl or 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: A FAILS / COMPLIES Standard 1 Proposed I
• Size 1000 sq.ft. or 30% rear yard
• Not located in front and (Materials) _
• Side yard and rear yard setbacks _ 10'
• Maximum height 15'
• Materials compatible with principle structure
L: \TEMPLATE\BLDGLIST.DOC
PRIp
O �
U ri
White - Building
Canary - Engineering
M`NHESO� Pink - Planning
BUILDING PERMIT APPLICATIQN DEPARTMENT CHECKLIST
NAME OF APPLICANT r AID D 1 "1F:3
APPLICATION RECEIVED f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted Accepted With Corrections
Denied /
1/ /`
Reviewed By: 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 mu 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 s established.
• The rock construction entrance must be installed at the time of
•
ibackfilling of the foundation.
6: \Admin \dept info \ADDITIONAL COMMENTS FOR BUILCIN6 PERMIT APPLICATIONS,doc
0 RIp�
u
White - Building
y �P 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:
- 7' f A 1 1
Accepted Accepted With Corrections
Denied
‘
Reviewed By: Date:
Comments: `— .- — u
7 1--z. 41
"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."
.,60+ 'A N °' ', r — „•tot me, n=,.. ' ww, , '^..F®r...r,...."...!.
r C) PRIple
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White - Building
P Canary - Engineering
1INNesoz Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT / -�L-i9
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
). , ,--c” f r I
Accepted Accepted With Corrections
Denied `
/
* , ......,rt
: Date:
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."
,
o CITY OF PRIOR LASE
°'" rRr yt�� HEATING /AIR CONDITIONING/FIREPLACE PERMIT
z (Wren Recd City PERMIT NO. l
Unease a or rant and sign at hnttom) �' )(crow molars
t31? .. F g
ADDRESS ZONING (otscc use)
1 i 31iS Po ifje_ , Pr A/ V
LEGAL, DESCRIPTION (office use only)
LOT BLOCK ADDITION P1D
OWNER
(Name)
(Phone)
(Address)
APPLICANT
(Name)_ GENZ - RYAN
_ (Phone) 952- 767 -1847
(Address) 2200 HIGHWAY 13 W, BURNSVILLE, MN 55337
(Address) (City)
(Zip Code)
(Contact Person) LISA HERNANDEZ
(Phone) _ 952 - 767 -- 1
APPLICANT SIGNATURE t i/ U f DATE G I ' 2--
_
1 4
APPLICANT PLEASE C ' LETE BELOW
'NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS —
FURNACE MAKE AND MODEL G 4 t;,, ,_ S�Z. OD S2 ! T FUEL At It i 0 i
FLUE SIZE RETURN OPENINGS INPUT - t C(.7� COG) OUTPUT V do Z
TYPE OF SYSTEM
HEATING OR POWER PLANT _
PLEASE NOTE: Air Conditioner
❑Warm Air Planes 0 Steam
Units and Fireplaces Cannot Encroach
LGravity 0 Hot Water
Mechanical ❑ Radiation into Required Side Yard Setbacks.
:4 . it Conditioning ❑ Special Devices Fireplaces with Box Additions or
'Went. System ❑ Other Devices �� S (/t 4 `u Cantilevers to the Outside of Buildings
FIREPLACE MAKE AND MODEL
1 . si'C .1 t / ttt r r'l � �f Require a Building Permit.
FEE SCHEDULE
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace 549.50
549.50 minimum
Residential, Heating & A/C (New Construction) 5149.50 Residential, Additions & Alterations 549.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only 549.50
Estimated Cost $ 1 ! IC) Building Permit fI
The Minnesota Statutes v s' 32611.1411
HEATING PERMIT FEE $ "SURCHARGE" has been changed for one
STATE SURCHARGE $ s� year en
.full I. .'.010, MI fit 11 June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for n "fixed fee" permit
(Office Use Only) Is Sc, beginning July 1.21110
This Application Becomes Your Building Permit When Approved Paid Receipt No.
_ Date B
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
o _\ Date Reed ''a 1 CITY OF PRIOR LAKE PLUMBING PERMIT
(mitt t:co,t-
t. am �td ca> d poll ( PERMIT NO.
z o
(Please type or print and alga at bottom) 3. Yellow Ary l,cai
l ADDRESS T —
31 3 R oi / fWtI f I ZONING t�iree,�e,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION ND
OWNER
(Name)
— (Phone)
(Address)
APPLICANT
(Name)_ GENZ -RYAN (Phone) 952-767-1847
(Address) 2200J4IGHWAY 13 W , BURNSVILLE, MN 55337
(Address) (City)
(Zip Code)
(Contact Person) LISA HERNANDE��Z (Phone) 952-767-1847
•
'
APPLICANT SIGNATURE ! k , /41thJI t _ - DATE . 2- /2--
APPLICANT PLEASE CO LETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower y Rough -ins
g
1 Dishwasher — —
1 Water Heater
I Floor Drain Water Softener
6 Lavat_yr (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 I , Lawn Sprinkler
L Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi - family 1% of job cost with a S49.50 minimum Residential, Now One & Two - Family $149.50
Residential, Additions & Alterations $49.50
The Minnesota Statutes 0 32613.148 15t $ 16 i - 11 - 1 Building Permit #
"St IRCHARG " has been changed for one
year effective PLUMBING PERMIT FEE S _
July t. 2010, until June 30, 2011. STATE SURCHARGE S .50
he minimum surcharge for "toted fee" permit
is .$5., beginning July 1, 2010
TOTAL PERMIT FEE S
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Buntline Official Date
By
Date
-
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
MAY- S -201E 17:57 FROM: STAR PLUMBING AND EX 19528847468 TO: 9524474245 P.1 PG
pRlO Date Rec'd
4 i A CITY OF PRIOR LAKE
1 e SEWER AND WATER PERMIT
4
' z v
'' °`cnm. Na Fn° y PERMIT NO. a z t5
3. Gold Applicant
or t and sign at bottom)
ADDRESS ZONoffi F P474-4-- iv, ,
LEGAL DESCRIPTION (office use only)
LOT BLACK ADDITION PH)
OWNEB.
(Name) _ .4. . Ai S _ ilk • ". e. r (Phone)
(Address)
(Address) (City) (Zip Code)
APPLICANT > . ; 1 •
(Name) I .+..a1.. ' —1 ,., 3i (Phone) ,�,c .: -� W
(Address) 0 r IL cc, Ale. I M II I I Iri Zvi .* lit.- -
(Address) / (City) ; (Zip Code)
(Contact Person) M + . . _ (Phone) 60---,21-300 '
APPLICANT SIGNA • 1. 1 DATE C5 /0
APPLICANT PLEASE COMPLETE BELOW
Size of water service / " inches.
Location of any couplings from structure feet.
Type of sewer pipe. ❑ ABC cgt PVC ❑ Cast Iron
Estimated length of sewer line t'S29 feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer'atid Waterline connection $51.50 Industrial, Com'l & Multi - family l% ofjob cost. with a.$5L50 minimum
Sewer connection only $25.50 Water connection only $25.50
Estimated Cost $ Building Permit #
SEWER AND WATER PERMIT FEE $ 50 �/q'®
STATE SURCHARGE $ WIT H
+
TOTAL PERMIT FEE $ ') . IIV�a �I�
((Met Use Only) Recei t No.
This Application Becomes Your Building Permit When Approved
P
Date By
ultdIna Official the
24 hour notice for all Inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
`- RP to ` Date Recd
.,:-! j.„ CITY OF PRIOR LAKE PLUMBING PERMIT
l rlivpi ��
I. Blue File ( PERMIT NO. 1
z. °old City
1. Yellow Arydicmi
(Please typo or print and sign at bottom) -'— ""—
I ADDRESS - - N[NG once me)
31 P / 1 !Th/ L_
LEGAL DESCRIPTION (office u$r only)
LOT BLOCK ADDITION PID
OWNER
(Name) -. (Phone)
(Address)
APPLICANT
(Nacho)_ GENZ - RYAN
i (Phone) 952 - 767 -1847
I (Address) 22004IGHWAY 13 W , BURNSVILLE, MN 55337
(Address) (City) (Zip Code)
(Contact Person) LISA HERNANDEZ Z (Phone) 952-767-1847
�"��
APPLICANT SIGNATURE a hY/ a i 1 4 DATE 5) 2- (/ 1 l
2-
APPLICANT PLEASE CO ' LETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
2. 4
Bath Tub with or without shower Rough -ins
Dishwasher 1 _ Water Heater
1 Floor Drain ( Water Softener _
I.avat ' (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (1 or 2 compartment sulk Sewage Ejector
I Shower Stall Backflow Assembly
L 1 Sinks Backflow Assembly Test
LA Bar Sink 1 Lawn Sprinkler
L� Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi- family I% of job cost with a S49.50 minimum Residential, New One & Two - Family 5149.50
Residential, Additions & Alterations 549.50
The Minnesota Statutes § 326B.148 1st $ 11� ' Building Permit #
"St IRCI LARGE" has been changed for one
year effective PLUMBING PERMIT FEE $
.tiny 1. 2010, until June 30, 2011. STATE STJRCHARGE $ .50
he minimum surcharge for "fixed fee" permit TOTAL PERMIT FEE S
is 55, beginning .July 1, 2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Bnildlne Orficial Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
i
0 P CITY OF PRIOR LAKE Date Reed
.:, HEATING/AIR CONDITIONING /FIREPLACE PERMIT
� 3 " c s
1-NN65Cl�r 1 rnk r.c
z mK„ c t y PERMIT NO. J
1 . vo... AI, Ikmd
(Please type or print and sign at bottom)
ADDRESS / ZONING (office use)
i 3113 Po1a � n J MA/
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 55337
(Address) (City) (Zip Code)
Contact Person) ) LISA HERNANDEZ (Phone) 952 - 767 -'1847
APPLICANT SIGNATURE 160 P if V t t el DATE • 21 12-
APPLICANT PLEASE C 6 ' LETE BELOW
NEW CONSTRUCTION ❑ REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL OZ.__ S 1 (j
Z (�S2 FU EL IN I1 1 6
FLUE SIZE RETURN OPENINGS INPUT 1% coo OUTPUT qz, oo c?
TYPE OF SYSTEM HEATING OR POWER. PLANT
❑Warm Air Plants E] Steam PLEASE NOTE: Air Conditioner
❑Gravi
Units and Fireplaces Cannot Encroach
Mechanical ❑ Radiation into Required Side Yard Setbacks.
�� . it Conditioning Fireplaces with Box Additions or
S ❑ Special Devices
Vent. System ❑ Other Devices S (114 1'11 Cantilevers to the Outside of Buildings
lYrn Require a Building Permit.
FIREPLACE MAKE AND MODEL i'�, l t�f. '
FEE SCHEDULE
Industrial, Commercial & Multi - Family I% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) 5149.50 Residential, Additions & Alterations S49.50
Residential, Heating Only (Ncw Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $1 I ( Building Permit #
The Minnesota Statutes § 32613.14K
HEATING PERMIT FEE $ "St;RC:I- 1ARGE" has been changed for one
year effectRc
STATE SURCHARGE $ .50 July 1.1.010. until June 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "r,ed fir" permit
(Offlee Use Only) Is t�, beginning 1.2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
~ Date By
HuI1dlne Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 - 4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
i
MN CITY OF PRIOR LAKE Date Rec'd
, f ' � ,,, HEATING /AIR CONDITIONING /FIREPLACE PERMIT ej/
let it41.1..
ANNEso Applicant t. rink Fite PERMIT NO . ,T
3. Yellow r ot. Cit /� r �i
I Yellow
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
37 1 3 P k Pa/ 24 4,,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) /),,,.4.. , f"
(Phone)
(Address) .
APPLICAN
(Name) /2/ ' (Phone)
,
(Address) 2700 / vi-r.e c v-eiv , 5Tt ( 3
(Address) (City) (Zip Code)
(Contact Person) (Phone) �7
APPLICANT SIGNATURE DATE L — 2-` 1— /
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants PLEASE NOTE: Air Conditioner
❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water
❑ Mechanical ❑Radiation into Required Side Yard Setbacks.
DAir Conditioning ❑ Special Devices Fireplaces with Box Additions or
❑Vent. System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODELAa 4/01/ 3 c'3 3,r
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 & Alteratio : $49.5 1
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ /e00. GQ Building Permit # 1 D (� ,
"1' e sofa Statutes a ... I48
c
HEATING PERMIT FEE $ "SURCI IA .. :; effective
angel for one
Peal' f li:Ct1vL
STATE SURCHARGE $ .50 duly 1, 2010. until ,tune 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge fora "fixed fee" permit
(Office Use Only) is S5, beginning ,Judy 1.2010
This Application Bee ■ :, Approved our Building Permit When proved Paid Receipt No.
/� , z � ,
'l� � Date By
Building Ofticia Date
/ 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
C1 PR-
Builders Deposit
U ty
sooA 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 building 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. By signing this 1, the undersigned contractor, acknowledge that I am aware of the erosion control
requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors
handout. -
DATE: .r� SITE ADDRESS: O1 � � i Y+ } W. PERMIT # ; - Z
REFUND TO BE MAILED TO: aRi lC
VL e �
AUTHORIZATION TO RELEASE
PLEASE REMEMBER r i 5 - 6 0
,ynda S. wen, Building Services Amount
1. KEEP STREETS CLEAN DURING CONSTRUCTION ' -5 '7 Acct.801.20204
2. KEEP EROSION CONTROL IN PLACE Date
3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED
SIGNATURE: Dth os ip • .
M1
1357
JPMORGAN CHASE BANK, N.A. 5/4/2012
THE RYLAND GROUP, INC. COLUMBUS, OHIO
56- 1544 -4
RYLAND HOMES TWIN CITIES CD
7599 ANAGRAM DRIVE 2
EDEN PRAIRIE, MN 55344 '10,571.2 °
DAY TO THE City Of Prior Lake DOLLARS
ORDER OF ******
Ten Thousand Five Hundred Seventy-One and 281100
CHECKS NOT VALID OVER $50,000
4646 Dakota St SE
Prior Lake, MN 55372
AUTHORIZE kV ATURE
MEMO
Bldg Permit for 3713 Pointe Pass NW, eac
936 L9455 11
n 1:041, L L544 1 :
00000 135W°
.r -u IS \BUILDERS DEPOSIT FORM.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 39 146,, 5 5 � VL
Lot Area yy yy yyyy ,yy yyy.y yyyy yy y yyyyyyyyyy yyyy x 30% = y AM. 4, yy
T T T T T T T* ** T T* T T T T T T* T T T T T* T T T* T T* T T T T* T T* T T T T T T T T T T T T T T T T T T T T T T* T T T T ** T T
LENGTH WIDTH SQ. FEET
HOUSE x =
x =
ATTACHED GARAGE x =
TOTAL PRINCIPLE STRUCTURE Mc 5J
DETACHED BLDGS x
(Garage /Shed) x
TOTAL DETACHED BUILDINGS
DRIVEWAY/PAVED AREAS x =
(Driveway -paved or not) x G/rve
(Sidewalk/Parking Areas) x = j F
TOTAL PAVED AREAS 7z g 5 f
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 (dec
OTHER x =
X =
TOTAL OTHER
TOTAL IMPERVIOUS SURFACE Z7o6.5F
UNDER/OVER lV_d . 5e P
Prepared By 6tPr (I: l� w , Date y`
Company / jv /1 toe/ 4-`'1 4 toer7/ / 4 Phone # (65/) g/ "MA/
P R I O R LAKE
BUILPADING TMEN AND IN SPECTION
INSPECTION
RECORD
SITE ADDRESS - "It r s- &I,-
NATURE OF WORK ' , Oct (--i ce= , c (? ^-1,�
USE OF BUILDING ? A-- h
PERMIT NO. (7 - 2--g 5 ; DATE ISSU D 3 r 2 -
CONTRACTOR O , PHONE Q'S z • z�c(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSP CTI NS BELOW
THE PERMIT IS BY 5EgRATE EN r
r N -e:'S L G4? rt__ r iNSPEC oA DATE
I FOOTING
1 I
I FOUNDATION (Prior to Backfill) I ri? h/- / I
PLACE NO . ONCR TE WITIL A E AS BEEN SIGNED
j RO INS
SEWER /WATER /SEPTIC ( ? /l1 5/'z ,
FRAMING ' ,/ej/,
INSULATION /;' Co / / ,1, ( /,y
ELECTRICAL
PLUMBING \ '`' Cl l` (4 5 ,/;- / /1) �:
HEATING (if required) / F6 6// l� FIREPLACE /W //-2 f GAS L AIR TEST . �J % 7 o Jr-
(2.A.)44.) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
GRADING (Prior to Sodding) Fl\lt '1H IZ
BUILDING
ELECTRICAL
PLUMBING 7//3 _
HEATING / 7 ` 2 f //z
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