HomeMy WebLinkAboutBuilding Permit #13-368 :..��.` , .�...:'i�:�� . e`r. .'t� j` . °i" } . _. .. ,.. v � v . r ., . .. . ... � , i . . � . r .. ,
. N , . . . . ... �
_ ..-... ... .._. .�RVwr ... ,..
. . . . . . . � . . . .. w''�' _, e . . . � . � . . . . .
Cn���������� �� (������x�r
CIT'Y OF PRIOR LAKE
����x���c��� �� �ix�����r� �������YV�
inal Perrnitted ❑ Conditional C.O. Expires
' This Certificate issued pursuant to the requirements of Section IIO of the L� Residential / � Interncttional
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classifica6on � Y �{�F F A �•1 ��, T Bldg. Pernut No. ��i —�16�
Occu anc T e n � Ty�e Constniction Y ' v Zoning District ���
P Y YP
Leg� veS�ription i. L3 B�.-.-�.�-F F F F R C Pf l 1V Tl C�,�---Q-�-� T.-I (1 N
Owner of Building
S1teAddress 14955 JEFFERS PASS NW
Contractor's Name & Address RY� A NP N� -r.,�.�'
R� A� L f� I U� fi U l C fl l I Y J �-! 1 ' v City Planner ..
Building OfFicial
Date:
L �� Date:
POST 1N CONSPICUOUS PLACE
DATE TIME
CITY OF PRIOR LAKfi _`��
INSPECTION NOTICE SCHEDULED
ADDRESS J��� T��2T`� ��
OWNER CONTR.
PHONE NO. PERMtT NO. I 3� "" S�
0 FOOTING O PI.UMBING RI ❑ EX/GRAD/FILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAM(NG ❑ WATER HOOKUP ❑ FtREP[ACE RI
❑ iNSULATION O SEWER HOOKUP 0 FIREPUICE FiNAI
�-FINAL O PLUMBING FINAL O GASLINE AIR 7ST
O SITE INSPECTION O MECH FINAI. �
COMMENTS:
t � 6 �. 1 V��
. ,
z . So�
� S�.>.� d�-- k�� $
�
❑ WORK SATISFACTORY, PROCEED
❑ CORRECT A TION AND PROCEED
� CORREC W K, CALL FOR REINSPECTION BEFORE COVERiNG
lnspector. OwnedContr.
CALL 447-9850 FOR THE NEXT 1NSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
�xsdvon
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ( l�
ADDRESS 1�� �s ��( p ��elS �1'��
OWNER CONTR.
PHONE NO. PERMIT NO. � 3-- �-'��'' ��
� O PLUMBING RI ❑ EXlGRAD/FILUNG
O FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
❑ INSULATION O SEWER HOOKUP C.] FIREPLACE FfNAL
� FINAL O PLUMBING FINAL � GASLINE AIR TST
❑ SITE iNSPECTION 0 MECH FINA� ❑
COMMENTS: �2.� l�ax�
, 2a��
z, ' � ���� .� �
_
❑ WORK SATISFACTORY, PROCEED
�CORRECT ACTION AND PROCEED
❑ CORRE T ORK, CALL FOR REINSPECTION BEFORE COVERiNG
Inspectoc Owner/Contr.
CALL -9 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE IREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY.�
uvsiror�
DA TIME
CITY OF PRIOR LAKE
lNSPECTION NOTlCE SCHEDUIED � ��J �
ADDRESS `� I� � V �J 2��S (
OWNER CONTR. ��
PHONE NO. PERMIT NO. I 3'�
O FOOTING O PLUMBING RI ❑ EXlGRADIFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
O FRAMtNG � WATER HOOKUP � FIREPLACE R[
❑ INSULATION ❑ �SEWER HOOKUP ❑ FIREPLACE FINAt
� FtNAL ,�pLUMBING FINAL O GASLINE AIR TST
❑ SITE INSPECTION 0 MECH FtNA� ❑
COMMENTS:
I,
Z (�
� WORK SATISFACTORY, PROCEED
� CORRE CTION AND PROCEED
❑ CORitE T K, CALL FOR REINSPEGTION BEFORE COVERING
inspector. OwnedContr.
CAL 447-9 Q FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY!
uesnon
pATE TIME
CITY OF PRfOR LAKE
INSPECTION NOTICE SCHEDULED ���
ADDRESS I � ( �� ,�.� �,_��_
OWNER CONTR.
PHONE NO. PERMIT NO. � �—' ��O
❑ FOOTING 0 PIUMBING RI ❑ EX/GRADJFILLING
❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT
❑ FRAMING ❑ WATER HOOKUP � FIREPLACE RI
O INSULATION � SEWER HOOKUP ❑ FIREPLACE FtNAL
O FINAL O PLUMBING FINAL � GASLIN T
❑ SITE tNSPECTION O MECH FINAL ❑ W1 ,
COMMENTS:
� WORK SATISFACTORY, PROCEED
❑ CORRECT A AND PROCEED
❑ CORRECT , CALL FOR REINSPECTION BEFORE COVERING
Inspector. OwnerlContr.
CAI.L 44fi 50 FOR TNE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTSARE FOR YOUR PERSONAL HE4LTH dc SAFETYI
Uvsnon
oF pRt CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � ' � �j _ � 3
.. � AND UTILITY CONNECTION PERMIT
� �
+. i. White File pERMIT NO. / (/�
2. Pink City � /� � / n� /
3 Yellow AppiiwM � \J l.L�� %
Ptcase or 'ut and si at bottom
ADDRESS ZONING (of►'ice use)
I ��J�� �`� s ��
LEGAL DESCRIPTION (oflFice use only)
LOT�( BLOCK � ADDITION����°�� ���,, Io� ,"' P1b 2�', $ O S_�
OWNER
(Name) (Phone)
(Address)
BUII,DER a�,� , n n► _f'„� Z5�
(Company Name) (Phone) "��'" o`��" �� �
(Contact Name) Phone) ��a � ���� �
� � � �
(Address) ��-' l 1�d,�1 �
TYPE OF WO New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Levei Finish ❑ Fireplace
ddition ❑Alterarion ❑Utility Connection
CODE: �I.R.C. []I.B.C. O Misc.
Type of Co�stiuction: I II III N V 1°► B PROJECT COST/VALiTE $�cf�' }�- 0 v
Occupancy Group: A B E F H I M R S U (excluding land) /
Division: 1 2 3 4 5
I hereby certify that I have fumished information un this application which is ta the best of my knowlcdge true and correc[. t atso certify thaz I am the owner or authonzcd agrnt for the
atwve-ment�oned property and that ail construction will conform ro ail exuting state and local laws and will proceed in accordance with submitted plans. I am awarr that the buitdmg
ufficial can revoke this pe it for just use Furthermore, I hereby agree that the dty officia! or a designee may enrer upon the property to perform necdcd mspcctinns.
l X � ��C����� _ �-i�-1�
Signature Contractor's Lieense No. Date
Permit Valuation S o �� f -- Park Support Fee # $ — --
Permit Fee $ � 3 SAC # $ Z¢3J� (/ v
�
Plan Check Fee � �� (� Z Water Meter Size 5/8"; �►"; $ � � i
.
State Surcharge $ e( Z� � Pressure Reducer $ � ,�� r
Penalty $ Sewer/Water Conneetion Fee # $ J r�� �(� (5
Plumbing Permit Fee $ �� a � Water Tower Fee # $ Q v � Q
Mechanical Permit Fee $ c Buitder's Deposit $ �O ` Q
Sewer & Water Permit Fee $ . Other $
Gas Fireplace Permit Fee $ � TOTAL DUE ��� �, 3 $
This Appii tion B Your Build' g Permit Whea ppro ed Paid ei t NO.
Date
q- �3
Buildin � Ot�'icial Date
7'hu is to cert that thr quest i t e abuve applicanan and accumpanyrog documents ' in acc rdance with the City Zoning Ordinance and may proceed ac requisted. Th�s diuument
when signed th Ciry nner � umtes a tempurary Certificate of Zoning comptian and a ows consttuctlun tu commence. Beiure �xcupancy, a CcmuPicare uf Occupancy must be
issucd.
Planning � Dat Speciai Conditions, if any
24 hour noticc for ali inspecKons (95 ) 447-9850, fax (952) 447-4245
4646 Dakota Sh�eet Prior Lake, MN 55372 �
O4 PRip�
� �
ti
U t�
White --Building
P Canary - Enginesring
"'`^'NES°`� Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT � •.S
APPLICATION RECEIVED � . � � • l�
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ��.,,�a "� .�����%/�.S r-'�S..S� /��
Accepted Accepted With Corrections
Denied
Reviewed By: Date: y S-�..3
Comments See Reverae Side for Addi�onal Information!
�a �ti S�id � � Wi l� �.� .l ' Co✓t/ �� r��/t � �
. <�
� � � � � . .. . � . �tRi
. . . . . � . . . Q��,
. . � . . � pk .,.
See Attachments: 1) Grading Plan, 2) Erosion Contr�l Standards
"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 ordinanc� of the jurisdiction. Permits
presuming to give authority to violate or cancel the �i��1-s of this code or other
ordinances of the jurisdiction shall not be valid." ����
, : �,,
O � PRIp�
C
� ��
U t�
White - Building
Canary - Engineering
�rNNES��P Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT � ��
APPLICATION RECEIVED � - ` � � �J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
� �q5'� ���l� ���5 /��1 �
�
Accepted Accepted With Corrections
`
Denied
Reviewed By: �~ � �_-! Date: �
Comments:
r Co�-+��— �°s �..�—� � �',4r�c-�- ,�.J
��
� w M ��
"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 � PRIp�,
�
� ��
V �
White - Building
Canary - Engineering
�tn'NESO�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: �
�" � �:�. �' � , � — ' �,,,r" � , �,.- �- ��, ��
I �� � �� .,....� x E'' . �, , �`ti..�..:� r r°° d �,.,�
Accepted � Accepted With Corrections
Denied ''
-...�..,_,...._
R�viewed 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."
� �
Residential Building Permit Checklist
New Cans4ructton for Single or Two-family pwellings in •1 or 2 Qisfiricfs
Revlewed by: Date: � 2 c� ��
Building Permif #
„ , ; • Zoning: � �
Address: �
Legal: L , B " Subdivtsion:
Ex�sting Structure? YES 1 NO . Extsting Nonconforming Structure? Y�S 1 NO •
CON�ORMS TO ZON(NG YES NO
ORDINANCE
Yard Sefbacks: NA 1 FAiI.S! C IES Standard Proposed
• Front Yard can ba 20' if a g. wlin 150' 25' z5. S'
• Side Yards 0 C� ag �" �• , '� ''� � �
� � � � �� }' 7�'' i fi abu�ng a stree Z.
, � . t 1 Vor ' � ' �
1 L � . �- .
• Sidewail exceeding 60' requires additional side 2" 10' setback +
setback for every 1' over 60' in length. Not required 2"11' over 60'
if building wall is 10'-0" or greater o€ being paral(el to
a side lot line. � � ~
• RearYard � �'
•� Patio Qoor; provide for minimum 10' deck or sign � 5 f
statementindicatin no deck wil! be bui[f in th�future 25' rear
• From 100 year flood elevation of wetlandlNURP 30' -
pond. � � . �
• Refer in- round pools to the Plannin De artment ,
• From OHW (Prfor or Spring lake) 75' or setback average of
adjacent strucfures, but no �
' less than 50'
Floor Area Ratio: NA 1 FAILS ! CO P S .30 Maximum �' `'° .
Yard Encroachments; NA l�AILS IC M LI�S Standard Proposed
Eaves and Gufters no more than 2 feet n width and no ��r�' ��� �� �� �� �� ��`
closer than 5 feet to a lot line Easements . �I��S ��dl�t �1 �� �� '.
A!C and other equipment cannot encroach on fnferior �id�'1� ���b�.�'� �
side ards. �
Tree Preservation: FAILS / COMPLIES Standard Pro osed
• iotal cali er i s
• Permit 35% Removai
• Gali er Inches Re oved
• ' Cali �i ches Pr�served '
• R laceme '/
Lt\TF� TE�BLDGLTST.DOC
�
Driveway, NA / FAILS / COM •
� Standard Pro osed
• Maximum width at ro e line 24� 2 ,
• Required setback • 5' from side lot line or
30' from r-o-w on comer lots '� _�
• Maximum slo e 10°fo
• Afl parking areas fo be paved including R V or
s aces ad acent to fhe ara e •
•[.ocation to match subdlvision radin lan - L,� �
Buildtng Height: NA/FAILSlCO 35' Maximum �C'� �
Shoreland Disfrtcf; NA 1 FAILS / CO P IES , Standard � pro osed
Minimum lot area s uare feet 7,500 Ri , 7,999 Non-ri
Minimum lot wi�th • 50' Ri , 57.3' Non-ri
Shoreland altera�ons
Im ervious surFace .,
�/3646-p��� �� 2,,6 _
Bfuf�F tn Shoreland: 1 FAIL31 COMPLI�S .' -�
' Sfandard Pro osed �
� Setback from t p of b(uff By planning dept,
• B(uff im act zone 20' From To of Btuff
• En ineerin certification submitfed/a oved '�y Ci Engineer
• Gradin in bluff �or bluff im act zone No im ortingle orting
Flood lain: I FAIlS 1 COMPLIES Standard Pro osed
• 100 ye ood elevation 908,9' Prior Lake
+ Lowest floor elevatiorr 914.4' S rin Lake
� � 909.9' Prior Lake / � �
915.4' S rin Lake
• Proposed lowest floor elevation Must be 1' above flood •
elevation for new and existing
• structures. If e�stir�g
� strucfure was consfrucfed
� 9/19/90-11/22197 then �
� additional foot is not r uired. �
• Elevations 15 feet from sfruucture Must be flood elevation or }' '
hi her
• Road access must be no more than 2 feet below 907.9' for Prior Lake
Re ulafo Flood Profection Elevation 913.4' for S ring lake
Accesso Sfructure: / FAfLS / COMPLIES Standazd Pro osed
• Size 1000 sq,ft. or 30% rear yard
• Not located in front ard Maferials
• Side ard and rear ard sefbacks qp�
� • Maximum hei ht 15'
� Maferials com atible with rincl fe sfrucfure
L.�'TBMPLATB�BLDGLIST.DOC
J � .� �Rip Date Rec'd
�,R,�m't. Y . e�
,� _. §�,� CITY OF PRIOR LAKE PLUMBING PERNIIT
� 4 ���
M �:
� y ..
�INK�'Sn�* I. 6k� �sle /3 i(/ �Q
z, oa„ c„v PERMIT NO. -�
3. Yellmv Appliail
, � �{Pleaae type or pr}ni awd ed�n at 6ottom
ADDBESS ZONIN'(� (o�oe uee}
� � � _ �--.
� S ' ffi ____�.._.
LEGALDESCRZPTION(ol�oeu�eonly) D�nIG �LRI�IT
LOT BLOCK ADDITION PID
OWNBR
tName) (Phone)
{Address
'c�'m ,_ 2 P� n �,,�� S�- �1n7-/C�
(Address) �aaG Y �� 1� �1 ��� _� 33�
(Addness) . _—._ �CitY) (ZiP Code)
(ContactPe�son)f j � �✓�{ �C � �JS� G�� (Phone} __ 7 S� � �,(�I 7 � S �
APPLICANT SIGNATURE `�1 �%.� 1 ��L. �'` DATE �r (1 �� 3
APPLICANT PLEASE COMPLETE BELOW
Quanti e of Firture antl __ ofFl�fan
Bath 1hb with or without shower Rou h-ins
Disbwasher Water Heater
�_ Floar brain Water Sottener
Lavato Bathroom Sink _ �tand �i ashia MachinG
Laun Tra I or 2 cam artmellf sink Sewa e B'ector
Shower Stall _ Bacl�low Assembl
Sinks Backflpw Assembl Tesk
Bar Sink Lawa `ukler
Water Closet Toilet Other 1
FEE SCHEDULE
Industrial, Commercial & Muld-family I Ye of job cosl with a S49.i0 minimum Residential, New One 8c'ItivaFamily $ f 49.5Q
�,;,r Residential, Addidoas & Alt�ations 549.50
` "� l.l�--r
Thc M inn�sota Stntutes § 32GI3.14g ��St $ J�'J � Huilding Permit #
"SllRGIiARGE" bas been changed for ooe , f��
year e(Teclive PLUMBING P�RMIT FEE $ �c�
Ju1y Y, 2010, unwJ June 30, ZO[ t. "STATE SURCHARGB $ .50 �� � f �
'The minimum cnrchnr�c for a" Q�ed 1'a° pn�ni� TOTAL PERMIT FEE $ �
is,�?, be�inaiu� July 1, 2D1 D
'Cdis Applicatton Becomes Your Batlding Permit When Approved Paid Receipt No.
B�a o�� a�
# na� A �11VITH
�4 hour nodca for all inapecliaas (95Z) 447-9850, faa (952) 447-4Z45 ' " ����
4b46 Dakota Street S.E., Pr�er La�e, Mlnne�ota 55372
i
`' � pRr CITY OF PRIOR LAKE Dste Rec'd
° �~ ��'�' AEATI�IG/AIlt CONDITIONII�iG/F�REPLAC� PERMIT
�g
F ��.�� �� •Y
� � � ��
; ��ntivssQ'��' i" o� i.� PERMIT NO. /3�0�
� 3. Ydbw Appiiam
} (Please e or at and si su botiom
' , ADDRESS � � , ZONING (oe6oe u�e)
� � �c� c
LBGALDESCRIPTION(o��on�y� PAID WITH
I.OT BLOCK ADDITION �U�IDIIVC�I PERMIT
OWNER � .
(Name) (Phone)
(Address) �
, APPLYCANT y� , ('�' � '� �'� � �\/\/\
{Name) � d 4 (Phone — 1 � ��J
_ . �
� � �� Q� 5�33�?
. . , �� .
{Addtess)
(Add ) (City� (Zip'code)
(Contact Peison) J-I ' 4��1.�� s��'`J `� � (�hane} � Sa � `p� 1 (� � I
APPLICANT SIGNATUR'E � �J` DATE SllS �L J
APPLICANT PLEASE COMPLETE BLLOW �
CONSTRUCTION ❑ REPLACEMfiNT ❑ ALTERATIONS �� � � �
FURNACE MAKFs A D MODEL �-tl�i 1�1 �.1' S� 5 c�-����5 i � FUSL �"f o ip
I'LUE SI7,E RE"fURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATiNG OR POWLA PLANT
❑W � � p' �� �LEASE NOTE: Air Conditioner
❑ Steam UNts and �'ireplwces Connot Eacroach
ravity �t Water into Reqnired SWe Yard Setbacks.
° Mocbamcal ❑ Radiation �,y� �� g Addition: or
ir Condition3ng ❑ Spxiel bevices
vent. Syst�n ❑ Other Deviccs Cantilevcrs to the Ontside of Bnildiaga
Regnire a Bupdfng Permif.
FlREPLACE MAKE AND MODEL
FF.E SCHEDULE
Industrial, Comrnercial & Mulu Family I% nF job cast Residential. Gas Fireplace 549.50
S49.50 minimum
Residential, Heating & A/C (New Consuuction) 5149.50 Residentiel, Additions & Alteration .r 549.50
Residential, Htstiog Only (New Canstruction) 564.56 Resideplial, AC Only .\� �� 549.50
�,� ��A ,�}� `�
L�stimated Cast $ Building Permit # �
Thc Minncu�ta SitHutcs � 32613.14(t
HEA7'ING PERMIT FBB $ "S�%RGI IAR(iF hns hcen chtu►4�cd for tme
ycar uffi�tivc
STATE SURCHARQ�E $ .50 dul� �, .�.cllt► until June 30 2�►� i.
TOTA�, PERMIT T�EE � Thc minimum surchnr�e for a°�xetl fce" permit
(Omee Use Only) is �;, bcRinnin� Jul��� i. 2b10
This App6cation Becomes Your Building Qermit W6en Approved Peid ReceiptNo.
°a� �IIVITH
BuildEae O(Ikb�l Dite
24 hour notice [or dl iaspectioas (952) 447-9650, fa�e (952) 4d7-4245
4646 Dakota Slreet S.E., Prfor Lake, Minncaota 5537Z
���
� � rRip�� Date Rec'd
� �, CITY OF PRIOR LAKE `Z Z3 �3
� � SEWER AND WATER PERMIT
�
�. ��„ File pERMIT NO. �
� 2. Yellow City
3. Gold Applicant �
lease or ' t and si at bottom
ADDRESS ZONING (ot�ce use)
��9�- S
LEGAL DESCRIPTION (ofl['ice use only)
LOT BLOCK ADDITION PID
OWNER ��,,,,
(Name) G� � LS� � (Phone)
(Address)
(Address) (City) (Zip Code)
APPLICANT ) �� .. „���., ���
(Name) � � � (Phone
.
(Address) �� s'� � J4/� �s�J7
(Address) , � (City) (Zip Co e)
` � 1�i2� gf9��'
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE �� �f
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. ❑ ABC ❑ PVC ❑ Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEESCHEDULE
Residential sewer and water line connection $S1.S0 Industrial, Com'1 & Multi-family 1% of job cost with a$51.50 minimum
Sewer connection only $25.50 Water connection only $25.50
�'°*�m°*ed Cost $ Building Permit #
"E'he Minnesota Statutes § 326B.148 \
'"St�RCHARGE" has been extended � �� V
,EWER AND WATER PERMIT FEE $ �
`�'�� minimum surcharge for a, STATE SURCHARGE $
"fixed fee" permit is �5.00 ; TOTAL PERMIT FEE $
--- _.
v� �
(Oftice Use Only)
This Application Becomes Your Building Permit When Approved Paid eceipt No.
ate By
Bulldine Official Date
24 hour notice for all inspectious (952) 447-9850, fax (95 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 72
`DEPARTMENT OF
BUILDING AND INSPECTION
SITE`ADDRESS S� L, � ,
NATURE OF WORK = ,.� �, c C�c.
USE OF BUILDING ,� �- ".> Ec�.. �,,
PERMIT NO. 3� DATE I UED � z
CONTRACTOR XZKt./�(� 1 �-S PHONE ajsz•z�I �600g
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
FOOTING s = �� i 3
FOUNDATION (Prior To Backfill) /�/,�*
RADON RETARDER
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWERNVATER/SEPTIC � /� i
FRAMING (� - � z- -1 �
INSULATION � - tY- �3
ELECTRICAL
PLUMBING ' G S' ��
HEATING � /y��3
FIREPLACE
GAS LINE AIR TEST �� i
RADON�.� Q�P»a�, S s
COVER NO WORK UNTIL THE ABOV HA B EN SIGNED
HOUSEWRAP LATH -
FIN S
GRADING ( PRIOR TO SODDING)
�� BUILDING� l! �
�° ELECTRICAL
� PLUMBING ? �
HEATING ��
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIG D
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
4� p ��+�
h Buiiders Deposit
u �
�� City of Prior Lake
A�2,500.00 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 includi�g but
not limited to grading, sodding, tandscaping, tree planting, driveways, siding and painti�g 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 shail notify the appiicant of the violation and the applicant shall have 10 days to comply or the �2,500.00
builders deposit will be forfeited and the applicant will be billed for clean up or corrective woric to rectify the
situation.
A�500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a pe�iod 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 Erosian Contral Measures for Building Contractors
handout. �
DATE: ��� SITE ADDRESS: ���J� � �Cl�� PERMtT # 13 ����
REFUND TO BE MAILED TO: `� ' � �-�"r 1�
� ,� �
PLEA►SE REM�MBE
C ._._ -�Z, 5U l�, GC�
1. . KEEP STREETS CLEAN DURING CONSTRUCTION � s� �ten, Bui1d� g Services Amount
2. KEEP EROSION CONTROL IN PLACE a��� soi.2o2oa
3; .TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR s5 Da �
SIGNATURE:
a p er, itY ngineer
�
;.
,: , ,
� � � ,�. � t � � � 3 .� : x� e � � � � � �a�`� � t �� x ���� � �y-��, ,.
, � " ,. , � � , '���'� f
�� ` �� } � � , � _ ° �.. ��F a �' � �"���'��.�"�� �`'�� �` } ����� .s� �"t�',�'� °�,+ ` %� ��
r �� � � ,a�=�, �s ' s i , .,�. t��,�"r , � "� '�c �.� t �- ., t ??" � �"� �x
�",.�� 'S.� "°E���" '� < t� {. � g � ���-��� s ��.�. ` �� ,s�£."��tr,.��'°t'��''��''-�-;f., „3,§s`'�. a �i���.` x ?
� '�' ��'" � i � r ' �� ` ��` �'�e� `� �1�" � ��'„*�F��^ �{'�.�""�'���.�� > rt `�(-��#3��3
�° ; � .
w ..
a
. �.` ».�I -,;� r ,� � ��a } e s� .€t:��""� z4"i,° � # ti�i S�'� !r taa � � � � �- ` # F! � x
x,i = � '.`�. .�� a , ? ,.....4 - "�- , :��},v �.. . s� �, � � r �.. ��r.,�3! ^{r f -.`,...� � . � � f �� � ,��i���"� � z
.�'�,, c°�v ,r v .,��e � w� � ;it,i�;.��? , t r, r_ *� �,.,� r� ��. ;„^�` 2 �cr,��.4N�' ,CC . _, � `�, t 1 •;.:� %r � >, i��>
� 4.�� 4' .�..x .�.� �a:' _,�• ^-^�s d' { ..„£� .».{t � � ."=* t i.t.� F �... �.—„t �#ts u, t ..,,,�+ � .,I��� �# a .$�#^::e.. {'�F x � z� S�t � , ` g g.,,"" Sf "�}�'.;- .�-E
x �
_' " � . ��
�-,,, �- r,.,„ .�'�s, �{ * � 4, r � ""��€' •� �« �.,t a€��-��`i � ��� ���'��`� ��: -��z i�'� �,�3,�tx�+ "C="� = f k�r
�` � �� `�a^ ..,t , .. f �1������F � 9'�iA„-�,. ,,, ��s�`y'�tF� , � �i� s��� s�.��r �„�x�i`r-"�3;LT` s w �, �-�.� �",'� '"�.�..tl ,�?i�... 4* ���^Y�?�� �.,.w
5.����5 t + �.u�l� t � , . *»�,. eav-'. . o-, r.� t�`:?^ ."�. � �m':-'� 3" 2 .���'' �`,�"�'d �.....=,���� ��'�[��L��
,��"- t =3 � .�.. ��� �, :r— . �.;�- ,x, q x � s � - x, $ ��,i�.Ee .:'i� x �...> �:?!� �?'.�, �� -,�.�, +�T at�:..° zt„ - �...;,rs,�3���
�� ,� �'`, a : �, �t 3 31 'S��c �:cr e��.����`t r _ g ��t "�� �*f� � h3�'�'T:t #' �tt', s' }� �sayi. �,::.c� �F�-' ,�iL. �1 F' ��3s . �R , .�� '� y-�."��,f .��--'.�`T'�.
��
k Z � „ y �
�� `e�—��"�Ti' a �°`2Z� 3�x`.,..k''i »� c °, ;'�`':. ` � �. �n_. `� 1� y +. �iy .R� 1 r�:,�C} e� L..... f '1 4 . �Si + t »;,� `S. a—.-.,F . 2.< "4+.�
�' .� „a�,;;�.! s `3 A� . 4 �. ,: r ., �' ��� � •g8�#;'', s, „�{�,Ss < ..,+,e f�'� �.,.�.t,s�€7'.E„,��4't��}',t,_ x a .._�� x :.��'� � e<;:; � �t �'" ,„� � r 1t.� 3.� �� �#��
,`�� , : , �Z ¢ �. #�m�' .. ��8 � _�� � ,�� -:: € . :K,.*�r�»"�, t �.�r:�v�� '�i.a < � � �'v. �z.,...s.s�3;.�- � ��'�:t; �Y��Y�, �� �4�� � e '����q :a4 f i.•-.' �. :� I 4:
& ,t mk�' '.��a x'A,��, '�. ;�� �' �(z�- � �°� ,. E�". ��"� s d �; 2t°�s� I Sa-^a��r���:� , .ia �"t -� , �s ^33 w$.
� . ,
� F °�
�°�x.t"� r aw ��-^� �.J;:4��'� � t ;� ; �-` ` .' ' f��"� t� � x "�� �� �.�� �� �, �.�� �; ,,»,�, �. ���, { � �,>% ��Y.-� .� �� � � ,�� . .�t�"�±�;3.°�v�
ts y�„,u t�, � ry��pS f .�... - .3 „ ,� �,....:�a a�3�� - .�s ..�� - .?.�4 r°'�.^ �s ; sti"' w.l .; }, �r {�::.vss r � r,�� � �.r��. �`��` �. t f �" tt�''�' �ta�c..,� � t�� S� s�" t�" € .�y , :
�a s� � 9� ; ��' 4 . F {, "�;*..��' .o..d �,a t.. :�F ;,� .:+� � >��;. }�� ,�, � �'�' �.� z.., � s$ � � x � � � t '��`, � t L.".:._s . � . 3`�c: ��.
,.�a2�-; �s�" � , �„'��;� �«-�, �- �.$.° a ��� ��� �„ �:� � �.� ; E -�3 � t �c.�' �'�� ?�' :�_. #x� _..�,£, i ..� ;� ��`;.. .�F ;1���3 � '�;,�:
.,
y� {� } �'
M�
»a.x ` h 1 C - 3 Y
• - c sse .�, y, t 8 �a't"r' t `�� 3 �F .at a :�t ���, �1.� � �" � `� r. �v �;€1 � � ��T a � � � -;t fx'�R? . a �, b� -°� r:`'' i � ;� t��s ���
,� `�-;�� t�. s � `�u� .�.��,�t`s„� ��� � ,'.,;�-��� , M;�g*--+� . f� � p -��.��� E"e i �c-� ��� r . � . --d � � _ s,� �' ��� � -� r ,, '��3 �e., ���.,�� ,.°� *�
,.f tar�`�s u s�'� , � �.,�,� .s� "�s.�a� �''� _��°°. T"• �., . .,�, ,� t '� a " S ::�� re "} •� �,�,.
-. 'k -.�a�.�r ,*.:"€. . �'�r »�� • :'.:9.. 1-.M '�.r». 3?°°;^a'c# � z ,� � a". � . `^ , ° t� ; . t ^�:,- s Yt' r `v-ti 3 �, �} � .�S , - -M.z,�j�S .2b ` .,»,.�f -�:a� �
., a:£:. s� �.�`�«_» : 5..�� r� a;��Et ...:�,,.s Y '�.�� a �=^Y` < Ftt � � �,. : 's�,� �� .,:,.�-,��.'� -i':CS �;t �,' gE '`,a�.r�^M., a y „� •':�.�"' f � M"'� y .g" ° � , k}��a. ..�:�. ,i';
,-...:i: �S, � �.:::3 �� �; � f .��� (t`^ �y�.I �}� ��g� -�:r,e �`#'"" _....$"s_...,�?� ..�,�3 �r.� Y'( �:��'�sa �� �. W {; , ��,r 1f .i... � _„ �..i� .x. � � a � 4 �
3 �e= - t' e ;:�?t�� �,t�`��"� h.� .� �' Y��*'�'Sex :.�aa'�`..».t �'°.,,.� h��'�,�� �' �, ': s ' ..✓ �.�.tr # .�
��h""s�-�t ' F ..3sr�` �� z tt ,.�-S "". 3 �`°'" c �.:. � .. a � . Z'� �yE "`� i 4# � .�- § t c t3,.^^ �-�' + �
F <:� �'� ��t �.,.�„,„}.i1 '.�',.;-...xs �y',^^'^�,� �.�:.ww. Y3Y?_." y £�:.,.�t � , ,� �" �;�r �r � es � ��f �?"^^. i � '�', tr t k. ; s€ ` ; �' r '�.";' »"`�€� � ;^^�`��7 .
<�
f .C",. �� �� _,.�2f� �,�kP'v.a�� " M�S-���7, �;, �sS '�,.�i'� � w'��-'s. t..s � r �L .`t,"S ;'t ft '� t�:.ri< � tr�., , ��,-�iy i �l� y � , '� ' G..,... _ a P°`» `- � "�S`t
$I'�.4� S� ":>i� .} 'kY: . �.a.k2 ,,,1 9. . , ��a. n7�rs.. ':�,. . wa-� ,
4#.« _+^' S �� "fi � Q ,: 2r # ... � t �f � ,. 5" � 7� F °'k ''� � ti� �.. 4
1F � .. � j z , ":� �}� t� �' f �� �C��ii� .r��j "S } ''�fZ �.u$ �-a� t,�r ' r; �° i+�^ ! �f�� � sr �,...�� � � a�,- - z :.���"'�-�� �`� �as ; r,�;
'� .�� "�Cr � � C 4� ����1:� � � ,.���r����i . � +�'�� `„�.� .�.. �, � � t t �b r ., -�, ^�., ` �C f - � ca d {i . �E �'�t f� � �
��,�.,��'" ;�. �e� ����a, .�'� �.� �aass_"?t�;: �. �'�- .�i���.-a�� °��������+,. -€�°� t� � §�-#��. > ;� z �'` r...���'"`� �..�a�. _��at�.,.�_ ��.r�..� .R. �s,�
���
C:1Usersldl�osleylAppDatalLocallMicrosoftlWindowslTemporary Internet FileslContent.Outlook18K9CDVBUIBUILDERS
DEPOSIT FORM.DOC ,
�
c»
�„ � Z� �r C m z z z xcoz �rz z z
n o o Do o-�o Zoo 0 0 �� r r (�
D o o O O � �� z,��, ,� ��r�, � a�,�, ,��, �r�, ^ x � D O O O
� f - � O - � I _" � rn rn ao c� � m m z � o v -i a � o ■ 'D �� � j �
� � � ° ■ D O t O cn �
c, . � � z �p �' o� Z A o � �� v o 0 0 0 � ° °o � ■ rn Tt -i ( � r o m C� �(n '0 2 r �
� � Q C.. TI -< c� � i� �-< � Z � m r� c � � cn T I T l rTl D �� Z �� p� p O _fi
� �� - -I n N o o� o A� p� a ;� z o 0 0 0 0 o f � r - r - < C � �C fTl C �
O � N -� c r o rn r� m m m m D C 0 r*1 r' Z= m� n N
m �p -C� = fTl x A�� � ���cn zy n z z z z rnz W Z O r O �� C A �D=m� �
Z C �� O � m o 0 0 0 �o co DD
� n � � �r W � � � oD z �o ��� Z o � � r� � z� m c � � < � --�� � T.DD � n
T. ' TI N z r� p m� � m Z � m z rn v� �n �n o cn �— � fTl D W V= D ITI '� �� D (� '"
C!) = N p Z � O..� A -i � v � o vi c� m v �i S o v m n�° m O frTl � r Oo �.�T. II �� D D II N
C� Z - o_ ��x � < rn
�I m-i �� 0 0 m A��^ mW r� o �� m m z�� °� Z D Z 'TI � Oo II � � N CrJ
�'J -1 O D D� n� mC� n�1z O�''� D C O 6') C� � r� N r Z W ��� � � 7
� � O �'N r r� �° A ov o�� v vm z �� � �� O< Z � � ��W��(n � �
�"I �= Y N Z a r�i o� v ��� mz g �� a '�m � m O '�*1 �� C �.
m Z � O f � m�n c� r m m <� o D r- -� (n � "�
fT1 - � L .`.� � a { �°� C�x �Qz� < � o a Z .. .. .. .. m � �� � � �
-i S � � y o . �NN ���2 gz � ^� z g A� c�o C c�o � D � � =° ���
�� � � c� w �$� �'S o N a w i► rn O p �r � � r
��m"�"� �G � � o Z � r � i �m !^np p-�+ z F v v v O Z � � O C � o �
0, � � � ° m No� �A � m � � �' �
A r�'i p r*1 (/) A � N � -�i °� c = r� \ \ \ � �p � � d ' � e �1
w i,, .. � � ' ; m r�* � m � g w D �l�JI � � � q
V1 � � omo �
z��° ° O N � ��z �g �,A °° � ' �O �7 �
A D � � -� o z
� s $ fTl � N � '� � � r � N � � � ;Cl ITt � u `� �
s= �� 0 D � "� o �N � cn r N cn �
°� _ � �' � Dc � � N D � r �
� ° � � '� o � � z +� Z � �
o= X rn � o
m c�i+ Q � �
W Z = ° N � C �`" �'�
.�' ° � � 2
J m D � � �i �� � o� ��� �
x � � � v cn � �o '"<
m 0 n p � �� +� t��.
� � � �" � �'/ yD���'�
-�
�
m v 0 � • ? � o N � o�
c o � z m � Z � v �
� = cn (� , p o�
L � z � � z�1 �'� �•
_ � Z �' \\ \ W r r � �d
- D oo �
� � ��
� m � Z ��\ � m m �
�' � y
� � � � \ ��n, \,�\ • '— Z � 7d
o � � � � � �� m � n
� Z � D � \�' �,, \\, � \ FF FR � � �
r /
r ,,� S a a
� m
o ,
� � p S � � �
m � � � �� � ��\. � z
Z Z � �O� � � �-�
o � m ��Z � 9 m ��Q>» \�\�\ D
7 �
-� .� o �� � = 9 r� 9 � �' �, �` �� � �, ,
N � CO � � �
CO D v � .Zl � '° /\ � � \ � \ ` �/
W I'�T1 � N � 0 � \ \ /" 9 \,' � � /
� � �
�.9J \�� O�" S � o ��� �� /
. �� \ � \ N �, � \ .,
� _ . �. .. _ -.. .
.. ... .. . . . .,�\\ . ./ / M . . \ 6 � �. �\\\ /� �\\,. \ .
� � i � �
� ?sb � p � % � ����
„ � ` ,� � \
Qj vJ � v ) �\\ fw qY� C �� � O m-i � � \\
� , � � � ..�' � m - z � "
o � � 4 •ti `; 4) A \ < n
�b"0 / o 0 2p o v � �•� o= �
,, 0 � �.- '' � � N (9�
� cn // GqR � ` f� � �''//// `� � � .�,'�' 0?) �
� �' '�GE � Jr ' JI � J m /�
o,
,V � � �,.. �ti . % 1 . ? S6 7� / /O
� � 9j ' (9 • i ♦ �
W / ti�' ,. � 1 ' �� i � � ` � ` 1
�9 / 'J por �h / 1 / ti�
�� � 8.�; / � ` g
/
• � / 8 4 ��� S e 0 + � :./ /� N
.C�� .a� > � / Fe � 0 + J' � � x
� � � \.�ti � /� m G)
�- � .� 24 /ti g �'
y4 � i 83 °� �� �� � / /� � ��
O // i � (9p �' 2 � 7� � � �/ ��
��.
� / i �' �`. � /�� ��J o1
/� �i (9 � 5 �) � '�46�, `Y
.,
:
/ � � � � �..�-
/ ° f / a�'� $�o
� � co3
// � // �R /` 'o
/ i - P / ' ' ',' �' �
�
S � /� � N � � o
� m � � � i / � � c
� c � ` i � � \
m � i
�o \ / i d � � V
� (8? N� _ � � �.� N3w ��� o ��� � ���4 =w�r.�Z-�z
D °- �� ��A ��` \ � �d��d'�� ti �N°z z�
c�i� /�( SS . � ���L� L �� `� � moo�Z�c
�n i 8° ,.� �� O DD (��mr
�a i �
Z� / `��� Li Z NZ N O
�. . , F�� g��� �
�� �� i i L�� �=o �
� Dr m c�
���""' �;' � 56 �3 ( rJ �o m N
� �, , � � -,
/ ��O � .+0�� �a �� °� Z N n
� `°�'� ^y ��� � � / ` � ` � m � �i
,,y �y� � � � o z
��.`� p�a' � � � � Q
�.� �' � � � �
� �