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(5i PR:;NP CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / AND UTILITY CONNECTION PERMIT iv .i NESOo. 1. White File NO. �7
2 Pink City PERMIT NO /3 /�
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS _ ZONING (office use)
1 LEGAL DESCRIPTION (office use only) x
LOT � BLOCK ADDITION l s AJ A V/ e� 4 ND p - j �- a75Z — ®W— O
OWNER 0 .
(Name) t \ -e I J- h (Z e." ( (Phone)
(Address)
BUILDER c,,
(Company Name) e V'j }�3 r+� l�u>ti.�� �cy tai S2 Ac�i -1 ►^� (Phone) Lo t �C'? -� ' q Z �%
(Contact Name) PE c e . 2- P % (Phone)
(Address) '7 8 t ' C'(2Qd ,k- PAL c j
TYPE OF WORK 0 New Conson DDeck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace
❑Addition Alteration DUtility Connection
CODE: Q9LR.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V AB
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
1 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 for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ____4 'fC- li, B zol Si :.. ,tr Contractor's License No. D ate
Permit Valuation 4900 Park Support Fee # $
d
Permit Fee $ ( 0 . SAC # $
Plan Check Fee $ - '�� Water Meter Size 5/8 "; I"; $
State Surcharge $ .Z r — Pressure Reducer $
`
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 5 -Z) Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE e ,-29 I/,1 /i $ Z Z6 -
This Ap, fi io n . comes Yt B uilding Permit When Ap ove � • + ` � � 4/ Receipt No. 6)-3 g q‘
II ate I I i By <---. i , ,) Buildu g Oftic l Da ., r
Z This is to cetti that OF request in the above application and accompanying doe ttnents is i acco rdance w City Zoning rdinance and may procee as requeste ument
signed b e C Pla c onstitute s at ip ora ry Certif o f Zoning co np liance nd allows constructi the on w commence Before occupancy, a Ce rtfcate of Occupancy This doc must be
issued
(` r
Planning Direc 1 Dat ( 3 Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
_. _ _
o r Rro�, CITY OF PRIOR LAKE Date Rec'd
ti HEATING /AIR CONDITIONING/FIREPLACE PERMIT
q ./ / Ja 42-47
t �P 1. Pink File PERMIT NO.
NNES> 2. Green City 43- /3 9 /
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
5 - 1._ � l aim A
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER VAQS `- e 1(\itY&c -j,� h
(Name) W 1lXJ (Phone) o�'� oC� a, Co 9
(Address)
APPLICANT, ,\,� r e - ' ,(� e
(Name) — V �NV �1 K, VAN-an IC A, l , VAC , (Phone - S 2— ^
(Address)_ 0 ‘12 . a i fi C" t 0 1 { L ji k) _ ;s"
(Contact Person) ! L / , i (Phone) ,' 99 5 i ?9
APPLICANT SIGNATURE ,L ( 4, /NW DATE /
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
❑ Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑Hot Water into Required Side Yard Setbacks.
❑Mechanical DRadiation Fireplaces with Box Additions or
❑ Air Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings
❑ Vent. System ❑ Other Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL E • r�1
d t , S k - � r � FEE SCHED LE 4
Industrial, o nmercial & 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 9.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Cost $ B ` 1 g 1 5"0
Permit#
HEATING PERMIT FEE $ f
STATE SURCHARGE $ 5.00
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid ° Receipt No. 7
Building Official Date Date / 143 Pititn.
24 hour notice for all inspections (952) 447 -9850
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
►. _ r _
•
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /573 3 /54-e -2.J0 V/ el"/
NATURE OF WORK 7 7 77
USE OF BUILDING /t - i.--
PERMIT NO. / DATE ISSUED - G J
CONTRACTOR C',037 f I 60 2 - , PHONE 6/ z /z • C 1-6 f
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
kfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING PP jZ,lq
INSULATION -
ELECTRICAL
PLUMBING �/s�k --� r —
HEATING
IIOMME
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
LATH 1 1
FINALS
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