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"K� CITY OF PRIOR LAKE � '
„Ass., Prjaarfturtlf of reldquilbinl; c lIttsprtfiatt
✓I;''r Aar* y ? � ' ■
j/, - _ _ F Permitted ❑ Conditional C.O. Expires
I. �._, This Certificate issued pursuant to the requirements of Section 110 of the II Residential 1 El International .,
Building Code certifying that at the time of issuance this structure was in compliance with the various
R ordinances of the City of Prior Lake regulating building construction or use For the following: a '
Use Classification , S / /(/6 C - / !l'I % L Bldg. Permit No. / L I - O F l / ) '
> S . Occupancy Type Type Construction Zoning District / �
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It:
Legal Description ❑ ! V /� / �c o _�/ r (� f e'. S 7 /V � Owner of Building Site Address � /O (O 7 �� L% W�, !.4.1
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Contractor's Name &Address � /*2 / /� /� �,
i`�, -- � 9 1 - hi - /.. s i ' Planner Y ,, l
Building Official 1 , ,
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Date: /ti /�o/ 2 Date: s°ii
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�,�, CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd at ir
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT L k 1 ' 1
. File 1. White File
2. Pink City PERMIT NO. /Z J G //as
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 7j�� ZONING (office use)
1 ( 4 \ c ,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID/5 , `;i 2 , (1 .
OWNER 2.... I i f/'-
(Name) Ik r4)r ) t n)Kt9 / vel d (Phone) _q(5.- q'g " 7 0 Cc
(Address) oZ &O l )Prtri p NCO - C.. /ce Lrk?(VJ 14AI t c >5 4y /
BUILDER D.R. Horton, Inc. ) 952 - 985 -7272
(Company Name) (Phone)
Phone
(Contact Name) Brooke Nereid 952 - 985 -7806
/� Lott--,617/ / (Phone)
(Address) 2 r2t) T.) (1 9 ( ti-t- r9k J/ () -�, 1/lt MAL 6cI14L
TYPE OF WORK N New Construction ['Deck ['Porch ❑Re Roofin ❑Re -Siding g g ❑Lower Level Finish 0 Fireplace
['Addition DAlteration DUtilit Connection
CODE: JI.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ / .6' , 4 9 Le
Division: 1 2 3 4 5 (excluding land)
I 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 accordance with submitted plans. I am aware that the building
official can revoke this permit fi just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X A r : - aff' '# Ce.636 57 7 - /-4 -/
Signature Contractor's License No. Date
Permit Valuation t 18 OW -' Park Support Fee # $
Permit Fee $ t cc 4 5 o SAC # $ -72,&s.;_,-
Plan Check Fee $ i Water Meter Size 5/8 "; $ 5 s. -
State Surcharge $ ( ` 1 .- Pressure Reducer $ ( (,- 2 —
Penalty $ Sewer /Water Connection Fee # $ t t o::). -+
Plumbing Permit Fee $ (s-4L-"ir Water Tower Fee # $ (
Mechanical Permit Fee $ IS S--(=2 Builder's Deposit ) $ (, 5-00- -
Sewer & Water Permit Fee $ O ther $
5 � S�°
Gas Fireplace Permit Fee $
c-+- TOTAL DUE $ 1 0 34-z. 45
This , , ca o , 1 co our Building Permit en A proved Paid / O r 3 Z , '¢S . a t NO. (p to /0
/ ,/ Date . /3 , � - B
Building Offici: Date
This is to c , ' that A ues ` the above application and accompanying d' ments • in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign. e 'y : .ues j •nsti 'y a temporary Certificate of Zonin. complia ce and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. / ,/
r '��_ - `l
Planning 1' - r. Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
O� PRI
t"
White - Building
�, �� 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 Accepted With Corrections
Denied
Reviewed By: 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."
F r Ri o CITY OF PRIOR LAKE Date Rec'd
,� ( HEATING /AIR CONDITIONING/FIREPLACE PERMIT
H
M I ARVESO P I. Pink File PERMIT NO. .� _ � �� L
2. Green City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
170 Ctita Sw •
•
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER - �Li ( 7 6 O
(Name) _ (Phone) 2 ^ x 7 Z •
(Address) •
HEARTH & HOME TECHNOLOGIFc TN( •
APPLICANT dba FIRESIDE HEARTH & HOME
(Name) Lic. BCO512060 (Phone) •
2700 FAIRVIEW AVENUE N
(Address) Rt7SFVTl I F MN 55113
CISt 533.2561 (City) (Zip Code)
(Contact Person) Pix4. Si ('(2 -13413- � 2 -1 - 7S (Phone)
APPLICANT SIGNATURE t7` DATE ? - 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
❑Warm Air Plants PLEASE NOTE: Air Conditioner
❑ S team Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water
aIOlechanical ❑ Radiation into Required Side Yard Setbacks.
❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or
DVent. System ❑ Other Devices Cantilevers to the Outside of Buildings
� -.p Require a Building Permit.
N
FIREPLACE MAKE AND MODEL r 3 ? co e 2 ,e;. 3/> /t
J FEE SCHEDULE
Industrial, Commercial & Multi- Family I% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum PAID Residential, Heating & A/C (New Construction) $149.50 PA
0 Residential, Additions & Alterations A
Residential, Heating Only (New Construction) $64,50 Residential, AC Only
BUILDING PMcT'
Estimated Cost $ `I 9O. CO Building Permit #
The Minnesota Statutes § 326E3.148
HEATING PERMIT FEE $
"SURCHARGE." has been changed lbr one
year effective
STATE SURCHARGE $ .50 July 1, 2010. until June 30. 2011.
TOTAL PERMIT FEE $ 0,0e) The minimum surcharge for a "Pled fee" permit
(Office Use Only) is 5 beginning duly 1.2010
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
ARIA CITY OF PRIOR LAKE Date Rec'd
,i -- e HEATING/AIR CONDITIONING /FIREPLACE PERMIT
H
4 7NNESOc• t. Pin k e i�IIT NO.
2 Yellow Chp Fil PERI
3. Yctloir Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 7 e- 7 ey .0-7.7.e.---
LEGAL DESCRIPTION ( office use only)
LOT BLOCK ADDITION PID
OWNER 1 ����
(Name) (Phone)
(Address)
APPLICANT „i
(Name) /.--- S 4 � eejq ill (Phone)
(Address) / ( .� ,moo >W,_ 533 79
`(Address)) / (City) (Zip Code)
(Contact Person) PZ 2 /.' ---J (Phone)
APPLICANT SIGNATURE !.. -ls, j , /� /— DATE i
APPLICANT PLEASE COMPLETE BELOW
!+ EW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE ' DMODEL Ca- ad-Z-1 g rc. 5- 9e4 ,3-4Og ? S'/ FUEL l
FLUE SIZE 3' fit/ C...- RETURN OPENINGS 7 INPUT , 6e ) OUTPUT 73,
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
fore arm Air Plants El Steam Units and Fireplaces Cannot Encroach
■ ravity ❑ Hot Water
WI Mechanical into Required Side Yard Setbacks.
❑ Radiation Fireplaces with Box Additions or
ir Conditioning ❑ Special Devices p
DVenL 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
Estimated Cost $ Building Permit #
Mc Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ "SURC'IIARGE" has been changed for one
STATE SURCHARGE Year effective unlit Junn
`® t or I, 20 10, e 3)). 21)11.
TOTAL PERMIT FEE $ t utnlun surchlnt!e for a "fixed fee" permit
(Office Use Only) �� ,�r>4 " 15 51, beginning dug } 1.2tlltt
This Application Becomes Your Building Permit When Approved Paid Receipt No.
—
Date By
Building Official Hate
24 (tour notice for all inspections (952) 447 fax (952) 447 - 4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
PRI0 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
drfivNESDo 1. et. Pile PERMIT NO. ' Z
. Gold City
3
3. Yellow Appiicnrti b
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/704 7 yr• 0-7 .��
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Nam) 0 /2_ AC "--z T® (Phone)
(Name)
(Address)
APPLICANT �+ U/Q
(Name) ✓ e- � a-+ -1 -- — (Phone) 7 J —1 y J / L
(Address) J5 Q LZ /" Z` -- , ,/ I z
(Address) (City) (Zip Code)
(Contact Person) r�� / (Phone)
APPLICANT SIGNATURE / _ / _ DATE 201Z—
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
3 Water Closet (Toilet) Other
FEE SCHEDULE T
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 § 326B.148 Est $ Building Permit #
"SURCHARGE" has been changed for one
year effective PLUMBING PERMIT FEB $ PAID WITH
J
.July 1, 2010, until June 30, 2011. STATE SURCHARGE $ . 1/ ING P �p
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE S L�rlll4r 1
is Si, 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
A, 46- f .V.. s
U t to . .. . . .. .
.... ..
•
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.......,
4,.vescii_r'
•
BUILDERS b.I@POSY'1'/' IREE DEPOSIT
CITY OP PRIOR, X. Al E
A 51.500.00 Builders Deposit Is included In the Building Permit fee. The Builders Deposit Is Issued as security to Insure
compliance fora Final Occupancy Permit. (It is not an escrow account.) A $500.00 Tree Deposit may also be required and
will be refunded if specified trees are preserved fora period of one year.
DATE: tom /It - ) a
SITE ADDRESS: I
(Weil C vL) •
PERMIT #_________.___/ . /12-
REFUND TO BE MAILED TO:
•R• 1 4ORToo y IINC 41tvi RRLyd! YOUA/
„ AUTHORIZATION TO-RELEASE
O
t brt • . ` 1 S7 •loo
/t1.6
it( S0v yv
4., 4 0 Lynda S. en, Building Services Amount
f (, D t Acct. 801.20204
e
1.111EILSE l ,rilrrDIVERrIt ''.
TO AVOID pItOBLriIIS
~
1. KEEP STREETS CLEAN DURING CONSTRUCTION
2. KEEP EROSION CONTROL IN PLACE
3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE
FORFEITED
......_
SIGNATURE: C , •e fvc/
H =
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Order Of CITY OF PRIOR LAKE (PERMITS)
4646 DAKOTA STREET SE
PRIOR LAKE MN 55372 _ pip,
o A.
IIJIfS' ',II'll!Cpll it a l -, I I�I�
0004044 350 1 :06LLL27881: 329 903 676611'
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECOR in
SITE ADDRESS 17o6/ 6N1. - "� File
NATURE OF WORK Fiteni ko (mc.. bet-►c 4F01/4i,LL ry o T• 41
USE OF BUILDING sFA
PERMIT NO. IL- okoz DATE ISSUED Z / Z'I It
CONTRACTOR ky• e , 14ap- -roi -J PHONE qs2- `165•
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARIVE DOC lli N cr sus K A, Tht'`t
O$ ( C.„,44.46496. ' INSPECTOR DATE
I FOOTING
I FOUNDATION (Prior to Backfill)
PLACE NO p NCRE UNTI�, ABO�[E _iAS BEEN SIGNED
F.P1/4i)o..1 ���� STS O - INS ,3•I
SEWER / WATER /SEPTIC
FRAMING -,
INSULATION (p a
ELECTRICAL
PLUMBING t, U
HEATING (if required) 1 j e
FIREPLACE
GAS LINE AIR T6T �t/1�.,..., ,, j � I X2
° COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1
FINALS
GRADING (Prior to Sodding)
BUILDING 1,,euip if' ),?y 1
ELECTRICAL � -
PLUMBING Pb 5 //z-
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