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■
o f PRip CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
�' I
�' "Iv es °�� ' White File PERMIT N. ° 12 (211 . O
2 Pink AppItcant
(Please (L Z 2.�-
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS (office use)
W CW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNE ViJV V " iyF 0 n . -4 ( 61 2. 212 - ii 1 /t-
(Name) Phone)
(Address) I (i'i bM iLt 1 Poe-SA)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck OPorch ORe- Roofing ORe- Siding OLower Level Finish 0 Fireplace
Addition DAlteration DUtility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V AB
PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best ofmy knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above- mentioned roperty and that all construction will conform to all existing state and local laws and will proceed ino accordance with submitted plans. I am aware that the building
offie can rev u p tt ) t ca c Furthermore, I hereby agree that the city official or a design ma y enter upon the property to perform necdel inspections.
Signature Contractor's License No. Date
Permit Valuation 4e to DO. ' Park Support Fee # $
f eoo- rte= 3OO
Permit Fee $ 44,i .50 SAC # $
Plan Check Fee $ c". 18 g Water Meter Size 5/8 "; I "; �� h�Y`�t $
State Surcharge $ 15,--
Pressure Red $
Penalty $ Sewer /Water Connection Fee # $ 21 S — �- —�
Plumbing Permit Fee I _ $ — Water Tower Fee # $ f
Mechanical Permit Fee $ 54.50 Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE A M : t) I ( . 1 ( , I Z .... $ 4 044 C3
This • ; plicatio' Beco -s Your Building Permit en A proved Paid ( 1_ieIC. Receipt No. 7(p S '1
/ / A Date /( /�ii --/ By // r
a. __ 1� �, ( Z--
- Building Official Dat
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 Planner consti tes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
1/ — 0,s - /
Planning rector 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
PRro
Ua r
White - Building
yl "' Canary - Engineering
NES° P 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 _A__
Denied
Reviewed By: Date: / //. ,esz /2
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."
). PRIp
tin _.t
U m
White - Building
Canary - Engineering
�`NVES °cA Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
L. I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: qq
Accepted Accepted With Corrections
Denied
i
Reviewed By: / Date:
\1 .
Comments: 1 r""-' , 11 • , _ P — ' :.{ t A . -7 ..r ', s '-I) , &I1 P 5c.)01
: V i e) �:. r o o mp" T % IN $ c -A-t"' o - 51.7-' E: t` /4/ 7
MI- V t n� L~ N ri-t,9 � 0 V��. 5- J I-} -, 'tbT '5 - -6 11,06,70 ,
1 - ✓ r a►. 1 G]�. (h a.. 5;4( A LTZ , 64 "1 Pet 1l`-S 14 /
w 1 L. /\1 I At) v DR�TN
"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."
-..-._ 0 r , - ....., ...,,gyp.... s Aa 44, !.&:r; :� .vzarM'.. �a,+wn..awas
i VRI0, Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
,,..
...„ ! ,-...„
..t .
illiVivr.so'C't* I BI T F'l I PERMIT NO.12
2 Go d Ci y
3. Yellow Appla.ml a
Please type or print and sign at bottom)
ADDRESS 1 ZONING ((ace use)
i 0 ' +/V-
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER 71).„,,
(Name) L'' ■1 1 -4 1 --c, .,,-. , ( Phone)
(Address) 1 (.., 4 -3.,00 tt...A_, ,--- ( / Sc4,..)
APPLICANT
(Name) ,/k.ecsw'v'v-i .'? 3 4-1-43 (Phone)
(Address) 1 I 7„. Le 0 VI t.A Q t'nt13\A-rv lee-CA , -re to- t- DitA
(Address) (City) (Zip Code)
(Contact Person) SeLt 4".-. , (Phone) 7 C a - --/` L (..)- • S --1
4 ---
i - 0
APPLICANT SIGNATURE - 4-1/1- DATE c/a/7)-
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
1 Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain. Water Softener
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (I or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
C9s Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
t Water Closet (Toilet) Other
r Th,c__ , 0 c t e ,,,L (i Vja- ...- V tr 1 / 1 4.- *
FEE SCHEDULE
Industrial, Commercial & Multi 1% of job cost with a $49.50 minimum Residential, New One & Two-Family $149.50
Residential, Additions & Alterations $49.50
' • - ist
The Minnesota Statutes § 320.148 $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEB $
July 1, 2010, until June 30, 2011. STATE SURCHARGE $ .50
l'he minimum surcharge for "fixed fee" permit TOTAL PERMIT FEE $
is 5,`.5, beginning July 1,2010
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
, _ - -- -----
Oi 0 4Date Rec'd
( C CITY OF PRIOR LAKE PLUMBING PERMIT
4
1. Blue City 2. Geld PERMIT NO .
Airy Z 1 2
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I L 5: bLtr Lt ( &kik (`,=V\f;
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) �� 1 N1 t K' 1 1 (Phone) L i 2 2-12. 1 Li
(Address) 1( 0 ' am k I lC Ay'
i SAN,
APPLICANT ]� n i , ^ f /� -(�
(Name) `V t M 1 1 14 K (Phone) `""l GS2 Z � 2- -- I 14
(Address) 1 V✓t`'V (. f 1 t F fvc , ` V v i
(Address) (City) (Zip Code) .
•
(Contact Person) � 1\ � (Phone) q s2 - 21' 2 - � L4
APPLICANT SIGNATUIk 1 i ° 4 ' L t L t,LL . ,�4, Y \ DATE � � 4 1 20,
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
. i 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 - Family $149.50
xResidential, Additions & Alterations $49.50
,ost $ Building Permit #
The Minnesota Statutes § 326B.148 t
"SURCHARGE" has been extended PLUMBING PERMIT FEE $
until June 30, 2013, STATE SURCHARGE $ .50
The minimum surcharge for a w ,,
c C �
"fixed fee" permit is $5.00 TOTAL PERMIT FEE $ .
This Appli ti p1 Becomes Your Building Permit When Approved Paid Receipt No.
i Date By
luildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
v�71 ..rrt'1�s.: d77t'.L1M! ►.a : IN ..e _ ;,� iNp —.�- ,_ .. _. _ 7M
1 i`1
4
(
01 PRI%
4646 Dakota Street SE
Prior Lake, MN 55372
NES
August 20, 2013
Pan Mickkelson
16560 Dunkirk Ave S
Prior Lake MN 55372
RE: Building Permit Number 12 -1272 F N otice
In review of the building permit files it was discovered there is an open building permit for home
remodel. The City would like your cooperation to schedule a status inspection. Please call by August,
30, 2013 to set up the inspection. If there has been no contact by August 30, 2013 the City will deem the
permit abandoned and invalid per State Building Code R105.3.2. This will be recorded in the permanent
public record. Any additional work will require new permits.
If you have any questions feel free to call between 8:00 and 8:45 AM Monday through Friday at (952)
447 -9853.
Sincerely
a ul Baumga ner
Building Inspector
Phone 952 447.9800 / Fax 952.447.4245 / www.cityofpriorlake.com
P R I R LA K E BUILDING AND INSPECTION
RECORD
INSPECTION
SITE ADDRESS l( see) . I tic Ly �•
NATURE OF WORK ADD tT1 O■■•1
USE OF BUILDING .ete-s a /
PERMIT NO. t7- ( 2 DATE ISSUED
CONTRACTOR 'A'l 14 04iGEt-5e , -) PHONE `15•Z12
NOTE: THIS THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
10 s.Z�V"- 1.9 -cam �an� C-4 U � " t- 61`-' t TOO DATE
►►v - I/�3 (� G INSPECTOR AT
I FOOTING - c tz" y# 1 tz I�-- I t t/ 3 I2_-
I FOUNDATION (Prior to Backfill) t 'lc .ia°,i`lYZt- {4,,om.,r 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING We -
1
INSULATION 1 j 1 ; /L f
ELECTRICAL
PLUMBING tg I aim) t -_..,,
HEATING (if required) f'
FIREPLACE
GAS LINE AIR TEST / `t: y�
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 46),>5 1 1
FINALS
GRADING (Prior to Soddinal
BUILDING _ -
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