HomeMy WebLinkAboutBuilding Permit 12. 0516 ' G t
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CITY O OF PRIOR LAKE
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,] Final Permitted ❑ Conditional C.O. Expires
c 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 i n compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
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Use Classification Bldg Permit N o.
Occupancy Type 3 Type Construction � ' `� ' / ZZo D i s tri ct ` U�
/ C..
Legal Description .� , l / o E FI 6k S PO/ ∎R../ �j D m /1 o AI
i Owner of Building Site Address 6. 4& / O /N I p , s
Contractor's Name &Address / a /i_fl fV L) / r V/ L '/ 6..5
l wf 2 t✓f C_ / t�
B uilding Official L ;
Date: � . %�/ Date:
POS T IN CONSPICUOUS PLACE
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O4 PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
A. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 5 3f 6, c
iv
,.
AND UTILITY CONNECTION PERMIT
OS� I. White File PERMIT NO .
2
Pink City /� � j //�
3
3 Yellow Applicant j *--/ ([�
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
36 LEG 17cir* 1456 • i.
LEGAL DESCRIPTION (office use only)
LOTS BLOCK ADDITION -e 6 Pio / ~ / I D
OWNER
(Name) (Phone)
(Address)
BUILDER ��,,�.. --�/� /
(Company Name) 6_ I
6I aILI,/'� 9
(Phone) aN -. - t om `°" 1 bb ()
(Contact Name) I. Of � j ' A _
J , (Phone) . , 1V1 ci 6 Q`c ✓- i
(Address) n 4� , ft 1-- /Y1 'IV. )s#
TYPE OF WORK Construction ❑Deck :Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
,....*1
ddition ❑Alteration ❑Utility Connection
CODE.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 1 r
(05 6 0 0
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5 1
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 1 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
offici. n re oke th' 'emit for ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ; • L 6c.-03 LILf3 5-31- -i .;—
Signa a Contractor's License No. Date
Permit Valuation 40 / C70G (Do Park Support Fee # $
Permit Fee $ 21013.50 SAC # $,36S-16110
3
Plan Check Fee $ '/ 308 7 $ Water Meter Size 5/8 "n $ 5 90. 00
State Surcharge $ / 3o 4 00 Pressure Reducer $ 0 - 690
Penalty $ Sewer /Water Connection Fee # $ / $00.06
Plumbing Permit Fee $ / 5 ..5-0 Water Tower Fee # $ ` DO Q i eV
Mechanical Permit Fee $ 1 S - CO Builder's Deposit $ / / 500
Sewer & Water Permit Fee $ t
X 57) � Other $
Gas Fireplace Permit Fee $ 5-7, TOTAL DUE $ ZiS � T - A p - ca on f omes Your Building Permit en Approved P r aid /c C O �- Z- R t No. ��
/ 11 _ 31`I 2 Date C - 2. `7 B _ ,
Bui _ Official Date
J
T c • ify ee�above accomu use h e City Zoning Ore d pe as requested. This d ument
when his is sign to th th ty e Planner rquest cons th titutes a tempora application ry Ceand rtificate of panying Zoning doc com m lance is a in a allows c ordance on to commence. dinanc Before oancanay cy roc a Certi ficate of Occupanc off must be
issued.
/ / 2+—
Director ate 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
New Constructs • n for Single or Two - family Dwellings i R -1 or -2 Districts
M —
Reviewed by: �� Date:
LIIIL
Building Permit # \ PID: • Zoning:
Address: + F ' � U
Legal: L , B Subdivision:
Existing Structure? YES / NO . Existing Nonconforming Structure? YES 1 NO
CONFORMS TO ZONING NO
ORDINANCE
Yard Setbacks: NA 1 FAILS/ COMPS Standard Proposed
• Front Yard can be 20' if ay.. wlin 150' 25' z- 5 - ��
• Side Yards 0 / 7.5
25' if abutting a street I # • °`
' ts.o
• Sidewall exceeding 60' requires additional side 2" 10' setback +
setback for every 1' over 60' in length. Not required 2 71' over 60'
if building wall is 10' -0" or greater of being parallel to
a side lot line. ■
• Rear Yard '' ( 0 g teC!' .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 Plannin• De•artment
• From OHW (Prior or Spring Lake) 75' or setback average of .
adjacent structures, but no
less than 50'
Z7 G, 43 t o
1 Floor Area Ratio: NA/ FAILS 1 i e.:IES I .30 Maximum I : L z
I Yard Encroachments: 6 FAILS /COMPLIES 1 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.
Tree Preservation: NA 1 FAILS / COMPLIES 1 Standard Proposed
• Total caliper inches
• Permit 35% Removal
• Caliper Inches Rena'oved
• • Caliprlrlches P,r4served
• Replacement/ 1/2:1
L : \T GLIST.D 0 C
Driveway: NA / FAILS / CO' ' S Standard Proposed I
• Maximum width at prope ' ine 24' 2 1. ►
• Required setback 5' from side lot line or i
30' from r -o -w on corner lots / f
• Maximum slope . 10 % 1 . (p
• All parking areas to be paved including R -V or
spaces adjacent to the garage —
• Location to match subdivision grading plan a-i■Jot
Building Height: NA / FAILS / CO IS 35' Maximum gip a•
Shoreland District: NA/ FAILS / CO ES , Standard Proposed
Minimum lot area (square feet) 11 �� 7,500 Rip, 7,999 Non -rip
Minimum lot width 50' Rip, 57.3' Non -rip
Shoreland alterations
Impervious surface 30% Maximum 0 Z-1 , 3
I 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 .
Floodplain: NA/ FAILS / COMPLIES Standard Proposed (
• 100 year 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: NA / FAILS / COMPLIES 1 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 com.atible with •rinci.le structure
L : \TEMPLATE\BLD GLIST.D O C
1'Yti
� Q � o .� B I I D
Bu ders
Deposit
.�h City of P Lake
A $1,500.00 Builders Deposit is include in the Building Permit fee. The Builders Deposit is issued as secu to
1
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 I, 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. / 1
DATE: c� --SITE ADDRESS 3C7`1'( C Ai • PERMIT # t 2,---51( 0
REFUND TO BE MAILED TO: fl'5 11 P ./vl,\'� cal �
.' /� ' //' / 1 \.
PLEASE REMEMBE
ii C i
`1 t 51)6' M ) ll 1. KEEP STREETS CLEAN DURING CONSTRUCTION ynda. ten, Building Serv Amount
2. KEEP EROSION CONTROL IN PLACE iz- v. r3 Acct. soi.2o2oa
Atair
3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $50 Date
SIGNATURE: l'■ � �
L Y Poppl City Engineer;
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4 ,
u'00 i:044iL5 9 36 1945 54 ii •
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 36 "/‘ Poi 44 ass L ( 74-64 - 6:2, PP.vo fFr// `meiI 'iew
Lot Area yy /0 49 t' y. yy yy yy y �yy ,yy yy .yy yy yy yy 30% i(/4.. yyS��eP A,�
q ��
* * TTT T ** * * *** * * * * ** ********* ** ***** y T * *******) yy TTT ******Tyl * * * ** T * * TTT y * * *
LENGTH WIDTH SQ. FEET
HOUSE x =
x =
ATTACHED GARAGE x =
TOTAL PRINCIPLE STRUCTURE Z $r
•
DETACHED BLDGS x
(Garage/Shed) x
TOTAL DETACHED BUILDINGS
DRIVEWAY/PAVED AREAS x =
• (Driveway -paved or not) x = 4.59 5r
(Sidewalk/Parking Areas) X 5arw4o c/y $F
TOTAL PAVED AREAS 4 r 5F
PATIOS/PORCHES/DECKS x =
(Open Decks'' /" min. opening between X =
boards, with a pervious surface below,
are not considered to be impervious)
X =
TOTAL DECKS P '' " � 37 5F
OTHER x =
X =
TOTAL OTHER
TOTAL IMPERVIOUS SURFACE 3 evel5F
UNDER. /OVER /VA $e 11°
Prepared By ti 1 A Date 6 -z -/Z
Company ,;c• r ,r Lay; n OW/15 P.4 Phone ;# �`g /) 69-,Q��
„.. , . - .. "u:e eagles x2- a� H:YFe2?, °. -PA +. , "-A, PotxrTfr, rNr,M?
0
M
i PRIo
V or
White - Building
4, �P Ca - Engineering
NNESO Pink Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT I--A N- 1 M E'S
APPLICATION RECEIVED 1 1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3( 44-b Po 1 Ki it FA e i\i, .
0\1
Accepted X Accepted With Corrections
Denied
Reviewed By: TA- C Date: th 8 1/ Z
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
F . :ibackf-illing of the foundation. •
•
6: \Admin \dept inf \ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS,doc
.,< ' ..47 '.,..: r*,,r, w, er r°.mr^. ^n. .....: ,..g.r.� ''.t..'im,N,' ^ '+., nsk ':4E n.., :...,v,,...,.v ! 'F.gfilik
~.sw*. 'fir- „ .. ,
Oi PRI°41
Z.”)
ril
White - Building
Canary - Engineering
�'INNESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ' ' t �` i ` i` l
APPLICATION RECEIVED F , • ! . I 2---
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity
I \ it which is proposed at: V _... .. (J �` I -j V 1 ` t✓ 1 \ e . �7'... 4. ': .
i/
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."
O PRIO
White - Building
Canary - Engineering
INNESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Ry, A Nip i m �S
APPLICATION RECEIVED 5 • 3 I. ( Z--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: r
3( 4-0 P o rpcsc
Accepted Accepted With Corrections
Denied
Reviewed By: Date: ( !N/ -2---
Comments: /
I • 40prrx9-P. - Ul)Sid✓� etxtrA IM oc ✓�2 t�l p IC1C� Cd cc l L TI ,S
A-vr ZS eS1cc iS
Keep +kg Sk. �. �e�-�
3` tJwd` 12.60 Skr).‘i f.vo c�
COP, {- ( a/4) � 4/4-C ; a"-
"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."
JUN -27- 2012 65:13 FROM: STAR PLUMBING AND EX 19528847468 TO :9524474245 P.1 0A0
4 0Rtp Date Reed N CrrY of PRIOR LAKE
S AND WATER PERMIT
Azoissffr
'• °r° Ms
I. PERMIT NO.
OW alai,
Miane aatbotam)
ADDRESS iddt - ZONING .,r.. .. 4
LEGAL DESCRIPTION (office use onyx
LOT BLOCK ADDMON PID ,
OWI L
(Name) ()
APPLICANT • / i .
�' +` ( )W — `417.
(Address) 40 i //Li ...d,_;!X ' / _ (OW 0241 000
(Co�tP� Joe ( ) 6/ -3R n - •
APPLICANT SIONA `?� DATE 6 )? �" 1 /�
APPLICANT PLEASE COMPLETE BELOW
Size of water service /''' inches. • .
• Location of any couplings from structure feet. - . .
Type of sewerpipe. ❑ ABC ►_ PVC ❑ Cast Yzon. _: _ •
Estimated length of sewer line t.2 -
Clean out if - .:. , Iocated at feet from structure.
•
FEE SCHEDULE
r::+ N .. oness.iQ• on $51,50 n. •-ri4 (kee l.& 17V • ....e?,
Sesist cosse6tion only+ $25.3 0 Water connection only 525.50
Batimuted Coat S Building Permit #
•
SEWER AND WATER PERMIT FEE S = • •
S �� � � s •s Rt PAID WITH ,
I .
LDING PERMIT • .
mince Use Oitv) .
Tbd Application Becomes Your Butler Perimlt Whea Approved Paid Receipt No.
_ Date By
BONNE omdat Dare
24 hoar eotice for al Inspections (952) 447 -9850, fax (952) 441 -4245
4646 Dakoh Street S.B., Prior Lake, Minnesota 55372
are .S7
i
CITY OF PRIOR LAKE Date Reed
HEATING/AIR CONDITIONING/DREPLACE PERMIT
I ) - • ;,-- I 'i.
U Z '
AVIVES°11.' 1. Fmk File
2 �my Lily
PER1VIIT NO
.12
3. Yellow MARINA 0
lease type or print and sign at bottom) _
DRESS
31 PoiNit fA- /V
r .
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PE)
OWNER
(Name) (Phone)
(Address)
.---
APPLICANT
(N GENZ RYAN (Phone) 952 -767 -1847
(Add 2200 HIGHWAY 13 W, BIJR.NSVILLE , MN 55337
(Address) (City) (Zip Code)
(Contact Person) LISA HERNANDEZ / , (Phone) 952
I APNI I
APPLICANT SIGNATLTRE ....i DATE
IrAttrM ;HEIM L1
APPLICANT PLEASE COM * ETE BELOW
, NEW CONSTRUCTION D REPLACEMENT Ej ALTERATIONS
FURNACE MAKE AND MODEL CBTR) Ce.-- Sci SC9 A 1 00-s9- ( FUEL NAT 6
FLUE SIZE RETURN OPENINGS INPUT PO ( C1)0 OUTPUT got 0 OD
TYPE OF SYSTEM HEATING OR POWER. PLANT
PLEASE NOTE: Air Conditioner
DWarm Air Plants ID Steam Units and Fireplaces Cannot Encroach
OGravity 0 Hot Wider
Mechanical 0 Radiation into Required Side Yard Setbacks.
rIli
Air Conditioning El 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 MODEL
FEE SCHEDULE
Industrial, Commercial & Multi I% ofjob 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 $ 5 5 )0
i Building Permit # ,
.iritr d r ies § 32611.148
HEATING PERMIT FEE $
siv , , ... h a s . een clum or one
k__ NICx\Zf...2 i i s year eflective
STATE SURCHARGE $ . 0 ,Jul 1, 21110, until June 30, 2011.
TOTAL PERMIT FEE se The minimum surcharge for n "fixed fee' permit
(Office Use Only) Is S. beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Italldtaa Official Date
24 hour notice for all Inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E. Prior Lake, Minnesota 55372
X118. SI
'PRt Date Rec'd
° V CITY OF PRIOR LAKE PLUMBING PERMIT
U
1= F ct PERMIT NO.
3. Yea. h •
lease type or print and sign at bottom)
ADDRESS ZONING tam we) vpi4c, pt65_,, Nik/ 302.4i41
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT
(Name)
G (Phone)
Z RYAN 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 1 i� .l1! i DATE le .
APPLICANT PLEASE COMPLETE BELOW
Quantity __ Type of Fixture Quantity Type of Fixture
1-- Bath Tub with or without shower v} Rough - ins
I Dishwasher 1 Water Heater
l _ Floor Drain 1 Water Softener
1 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
it . �_ . _ Laundry Tray (1 or 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
1 ,- 1 Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
., ) Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi - family 1% of job cost with a 54930 minimum Residential, New One & Two-Family 5149.50
Residential, Additions & A1l $49.50
Building Permit #
The Minnesota Statutes $ 32613.1 I° $
"SURCIaARGE" has been changed for one
year effective PLUMBING PERMIT FEE $ P WITI -�
July 1, 2010, until June 30, 2011, STATE SURCHARGE $ S t U PERMIT
The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $
is 1, beginning July 1, 2010
This Application Becomes Your Building Permit When Approved Paid Receipt No
_ Date By
Baildi 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�.x�
CITY OF PRIOR LAKE Date Rec'd
0 u
, �. -
E,,. e HEATING /AIR CONDITIONING /FIREPLACE PERMIT
,-,,,,,r !�I " n�
„ s(r 1. Pink File
z. PTet„ File PERMIT NO.
3 Yellow Applicant '� •
(Please type: arprint and sign at bottom)
ADDRESS ZONING ((Accuse)
3Cq& %;4 PaL /iJt/
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PIE)
OWNER.: �'�-, q L- 1'24 6 00
(Name) ,. 1 f (Phone)
(Address) ?, q q citit , � . i
HEARTH . HOMe TELHNOtOGI INC: . —
APPLICANT dba F1RES'1OE titAFM9 & HOME
(N Lic. 6CO512060 N hone)
W
2700 FAIRVIE AVENUE
(Address) ROSEVILLE, MN 55113
(Address) 651.633.2561 (Cit (Zip Code)
(Contact .Person) lett.j (Phone) •
APPLICANT SIGNATURE Pala J � a1' C'Y __ DATE q - /IT i 2.-
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
PLEASE NOTE: Air Conditioner
❑Warn Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water
❑ Mechanical into Required Side Yard Setbacks.
❑ Radiation Fireplaces with Box Additions or
['Air Conditioning ❑ Special Devices
❑Vent. System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL /4......-0 . , N m Z2G,t:0 9„.
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 $ feet:. et/ Building Permit #
The Minnesota Statutes § 32613.148
HEATING PERMIT FEE $ "SURCI IARUE" has been changed for one
year effective
STATE SURCHARGE $ .50 Jai). I. 2,11)0, until Ione 30, 2011.
TOTAL PERMIT FEE $ The minimum surcharge for a "fixed fee" permit
(Office Use Only) is SF., beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid revittAll
Date r t-
Building Official Date •
•
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.F.., Prior Lake, Minnesota 55372
P R I R DEPARTMENT OF
LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS Flo <I Le Papi h.-4-.f. Q ss
NATURE OF WORK IJew Qsri'uc4.at
USE OF BUILDING % %544 ..:1_ 47.e4-4cLa
PERMIT NO. 12 - 4 DATE ISSUED
CONTRACTOR R 1 }lam PHONE s}cve. L912 2 ? 2 -
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS
BELOW
THE PERMIT t_ IS BY SEPARATE DOCUMENT
eI SOY £L +
Y'o4 I I4, INSPECTOR fl CC..D
_ DATE
I FOOTING 1 1
I FOUNDATION (Prior to Backfill) 1 ,'.D
PLACE 1 0 CO I CRETE UNTIL ABOVE HAS BEEN SIGNED
R aciatA ae L.I O U G H - INS RRgc,oc• -Are-
SEWER / WATER / SEPTIC -���
FRAMING e1/4.47/
INSULATION 11-11 a--
ELECTRICAL
T wf�
PLUMBING �� ?I '
HEATING (if required)' P Gs n
FIREPLACE
1
GAS LINE AIR TEST ed. /64-2.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
4o0se (4r 11)1 'Li-. 1 1
FINALS
GRADING (Prior to Sodding) d z
MAD
B UILDING �� �v I� T �b l �i l 2 Fl h 27
ELECTRICAL
PLUMBING ,4. gV
HEATING IA / 52-
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