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Building Permit 13. 1374
jicAA A sEAr it 7i i A rC A AAAA A A v RAF� ( j rffltr xfr in (err axt -,, K. CITY OF PRIOR LAKE '. !iparfnwnf of ixilbing 1nspirfui Final Permitted ❑ Conditional C.O. Expires This Certificate issued pursuant to the requirements of Section 110 of the ❑Residential l❑International Building Code certifying that at the time of issuance this structure was in compliance with the various x ordinances of the City of Prior Lake regulating building construction or use. For the following: Use Classification SINGLE FAMILY Bldg.Permit No. 13-13714 Occupancy Type R3 Type Construction VN Zoning District PUSD Legal Description Ltt,_-,R3 , HICKORY SHORES FOURTH ADDITION v+^ 3574 HICKORY CIRCLE Owner of Building Site Address Contractor's Name&Address D . R. HO RTON, INC. ROBERT D. HUTC H I N S v-c.,i pity Panner Building Official Date: c" 1 $r( 1' Date: POST IN CONSPICUOUS PLACE V V V V `y _y y' `yY > `°yy y Y yflyY Yy y. y , y, ' * y y i. y / §_ 1p § A- 3 �a � c, \ \ Q \ Kaid id < k k 2 &��R0 m « ° � � � re Z w k ‘Nr li _ . ❑ cO ❑ O § m % 2 �� � §�� w � iv w d nzanZ Id � z ° K 0 © � � � 0 Q 0 § ` ILI I- § 2 2§ 2 ¢ - ; tn 0 | k 0 2 miulax (0 - ix § Q � 20 2 2 z I- 0 a § § ■ a � 88r 2 8 re % 000000 ■ § w0 k �\ Z El / Z / o Y0 z 0g ■ § 9 U. § � ■ © 0 ■ 2 z oZ w � < 3 q @ z © a- Z ■ © © w u.u.0 g 1- 22= � � 2 . W et ts 0 § 02 k w Ul z uu.u2 § 2 ' . S S a ■ o £ t2 < 0 a 0000 O U 0 W Z - H 1 tr P JHCCLLce v d , \ V E = cwi0 y z14,4 T ° 555 ' 1 z Ill ` M w z 6, ) 2c :: o\. 000000 , Ce 14 M i 1 . w z ►- d a 0 j 0 = � xxz � "d ` 1 w 0. Z1.1i 0 N 0 a mxwwgx ld y z a • y W W Z W a.X3mJa2 r UJ W owc y6 000000 ( ` 'C W Z Cl Ce xa LL I- V0 IQ 4 re J T' z 0 W , ^ Z V O �f of oC XV u) zo f. ¢Q ori F' 0 W V S 0) ii- pZ �0O a Z ._.� / y v v 4 w ..� O (7 < ZH N d 1 �1 x W W L J A au.� uNi Z I- z2gJZW g Id cc c �°, v e OW W W Z O � N1F- V V t,a p O LLLL �= u. in ,r^' ❑ a 5z 4 O a 000000 0 J P JZ 12 LL's 0 E CD 0z •411 � MM a = tti o _ ` 0 ❑ ❑0 ❑ ❑ • > -7--- to 0 o W = C '� A 0N tori W O » Q Z c 0 44 t E Qp J O 0 W ip W V Z s 0 000Z1114 ,►_ v m a D I 0 a maWmma a z cz W • V E3WtigjE3W ` 1 ' W W 2 x C a23w 2 W W W W ; 0000K Oa' a0' O W a a a z p J t ge ZJ re 5P r o afp- re co 5 gZ ddi 0W W W O� a 0 2S 0 V oW. 0 0 OOwZ �i0 0 V 0 a 5z a 0 a 000000 0 1❑ ❑ -` S, - 1- CITY OF PRIOR.LAKE BUILDING PEST, Date Reed ,4 t. TEM=:PORARY CERDII KATIE O1 ZONING COMPLIANCE pz •AND UTILITY 1ECTION PERMIT f / <_/; r tpev.atr t PE TNO, /3. L37+. iiih, z tet t'ax a vetta v ..041.... . (MAK type or lsOtt004 ADDRESS ZOtr ware use) 357/ ��/eY 6' P o(7-b LEGAL DESC trerrow tolltiee use only) • LOT // BLOCK 3 A ITION thio 4 Y s-Ho y./4 ,�- V 9 -0 2 3 -o OWNER (Name) (P1G :l) .. (Add ess) TO:T.> U 952-985-7272 (n `zty a dD.R NORTON, INC,. Brooke Hareid bmhareid@drhorton.com 952-985-7806 (Ad 20860 Kenbridge Court, Lakeville, MN 55044 . TYPE OP WQnt I itiartonsitarc0au Elthvg OVt o n -Cf. :ft,stoftg CIPoottlAi4 Nit C {t y). �.Mtr COM E JTJLC, { {.L.C« t.Ate. /� T getsf ctintttrat�a. I I'S' 'V A X c' i $ 50 7i5.75-8 oCCLIilatxt�"' ' #3 . . b' P. P I 11 IS S [J (OZeittsitiltiAlle 1 ivis n: I . ..2., 3 4 5 '14_amity tltat.1 tugfill shdd ttiHis sci is i u-vttttett ii kt.Ihtc Eir+Of`4 ' eluitet Olultt 1400.C+ t4*:&s Ott u".Te c�as p t rar.Ole ,�f dt n i , l 44t sk 4 mHc* Wafte ftlanSeirid:i pen a nre s iitteadplan I. s.,00.41e ttougoftg : :,ifltctal'CAltcV01 lil 'petaNtifM'" use=li.k _ t-: that Qttrt t.t _+ 'enpia t tst kl ioln cetent.s. BC605657 1/a//3 t — 15erntit Inn nt Oben .t7 #> - W y 3 Nortntt ke $ 7 `j�. )[� pian Chet*P . tt� s :2 ,�;:Qoe�� •State SurcI.ar=fie 0 6 , 'P sant R4dti $ O. c2c) Penalty . ..$ - Se rtit tiettitin.�? i' , • 5 /$72. t7 0 Plumbing Permit:Pee $ /5' `• -Ce) VInterTt'ss rli # $ /674 _ DO Mechanical Pertitit Pod $ $Uil er`s bepasit t Sewer&Water Penn*P s %• Sd Oth-ei $ y ' Gas Fireplace Petr,*te:, - V Si/ -Se) T0 � 5 g 'i7�ts 0 e' 'CO as*'our$uilrling Pent'lit A. ." e A o,rov d - Paid ,ijr•ru• 79 R^ �_ Date /1/it8 � Tilts is to certify than titer rest'•alto abtavc apfxtica ton anxi areenipang doming ti is io< • ortiancf,wit6 itte City Zoning Ordinance and'may proceed as request . This docutiapal wb'n signit by r,t' i, ` nn onsbtotes a temporary Certificate Of Wittig,• ace a `aifows.C# ntetion to commence. Before occupancy,a Certificate of'Occopat.y moo be Mucci // Ait '6.- fZ.. A /3 PlaniiIng't+t tatty to _ Spat 00ttditivns,,ifari+y 24 Lour notice for all I speciioni(9$23 441444,:fax'0:M447-4145 4.S 4646 Dakota Street Prior Laker 55372 * Builders Deposit , -.... . : . City of Pilor Lake -mit too- -ostaktowoopost- WI.040.. d 4$4113.mitillr. -40,b1sure comPitanie fbr a 4:444q474°1341*W"°41"*"11P14Walal"4"''.P. - lar4 li,. .41411icilttibtit4K&111111tttd ttiVatt(1146-titaitfihili lattettaa4dag,woe pitiopMfrigtOillei0g; Of(S no'an --.0.virAProntra,-.M.ezitet,--- ,--Ma:.-„ ..ill :waRtioa.pottrittli rs$1/44. ittti,Wikak ts..notoompt01. ploihm.i...drivoicionsi4iiiiktaltrid,palOittig Shaft birstrimplited 4.804:14110,..00.#1.f,44r:,..!;!., ..,...0 . .. silo., . . to nonin y or the IMMO 110100 lia3'cAtti*p87160/1fte MAAR ilOgeitg*0001011t'Of 110:'WO 4b 6114 '. Ontritio28:407ire.:=011.. i wilt4ablitoottinViceart.op.oro . vitz). .. - . - $1401)404041.q.**4.0,01t',WW1*(04.0)fgettitact4hq.afPfkarit- . . . .s.. .. . , tot perroortinotoat, A.4t.000-Tre.e-bilpostiortly atsobe-requiroillind sylitholiziftwidati ftsfygoittot ROW 04 Preservaa DATE:. •. 11.7-74.- /3. . , ••._ • , it- /3. /374- striototssot: _36'79 .. r ,- r (--1 gc./--a- , PERMIT ..: , . ., ..... ..,. _ . ,. . . . .__.,. . ... . . putputotiti BE juin,.T0,,,,. D.R. Horton, Inc. A ttn: JADA &Rea)WA LAT 20860 Kenbridge Court Suite 100 . _ .Lakeville,liANI 55644 71 , 4t2,(560,00 . __ .. ...... . , Lynda S. '4 en,Buildi7Services Amount „Lt./ Acct.801.20204 • Date \ j I'll'()H,„\ Ill( WI I Is ,1,1,,l, . . . . . . • - '1' .,,* " . ... .,-. . . . . „ • - WC*STREETS-OLEAWOUINe, : e ...sIntioirt4): 14. , ,.......----- 2- KEEP EROSION CONTROL IN PLACE . • Larry oppler, City Engineer • :a, >.TRAWORARY OCCUPAtiOrPORMIT. MUST NOT 15.X.M...4-0:11, $000,. .. . ..00H.W114. BEPOW EMO. OtalitiAlrOPttl . .. .. . . ... . . .. _, .... _, , . . . ..,, ' l' i ' INKTHEE ICALIAND BLEACH REACTIVE PAPER WITH INVISIBLE.LUO.,E-s,N.f. SAti PRO THIS CHECK IS PRINTED IN RED AND BLUEON PAC ON CliEjli ,.., \., ,•,„,, ''''.•,,,\\\;„:..\•,,i...- '-•:i.„';,,, •:',''r- .;.--..,'-.,,.„,:!..,-,-.,,,A,.,. • . .. ., ...,;•\,,,,,,, -: ..,..„.‘ „:.•;,,,,....N ..,,A.1 .-,.. , \\.• *, . ' ',4„ •\t..,••••\''..',.;4..\,. ,. ‘ : ,\ ' led'Irz:It .,L, 1-16'te ,k.4 i \kkke \ bruit Inc. souiii Disb Account Atlanta,Dekalb County,GeoTa,,,,, 301 Commerce Street,Suitee0 '',1- , \ \ •" . IA . :\M\,,.*,•., \ .,. 1.Y,-I.-!!!..IR ki,Vd,T.0,401,4,4 Ar,,,• -.:-4,,k1:1. % riort cVorth,TX 76102 7 , ' \' ' \\ .41)a, ,\ Noi4 iftek.;6:097gYsir.,1%a,t s:','1/4,404tt.'77.,, ‘, : `‘.-x' : , s - __ - ,, - : ,. , - .,:- 4.2)-,1:;::-T.,,i-44g4--,,•-•_s,'%t-•,.-.A,4„,.-„,;.,..-,,,- ;e2.,,..A.,•.. kw, Pal' FOURTEEN THOUSAND FIVE HUNDRED THIRTY AND 79/100 ************* ******''***"********* I ') , . i • To die / k, :: ,‘,. :\'' ..\• ..\\h, , ,, ,;e,;s:1,,,,',;,"-"':;:':':":ljr,i,,,:4::':')t:'.'j,:-4T.:14t:r.41`.,::::: 15k';._N.::::,4:,,Nt'S::-,::z.e:7,,..421:,,,,,:.,.• Order Of: CITY OF PRIOR LAKEIPERMITS) \s, , , -\% \ r .::•`,.=,',',J',.,-144-,ktv..i.:-.,+*Y.--$,...k;-y,u,- .n.-,.'• 4646 DAKOTA'STREET SE' PRIOR LAKE MN 55372 4 ,:.: k: , -- s . „ ;. -, ) ) 41 .k, etLcZ--t• ,•.• / , i ' .' lk 4,,,,,,.. . '' -5 ) "0058803911' II:06 I 11 278al: 329 905_, 6766" , I , White Building Canary -Engineering ' rssdo* Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT-2)Z41 -14)/e- APPLICATION RECEIVED /1 /.3 The Building, Engineering,and Planning Departments have reviewed the building permit application for construction activity which is proposed at: .3574 , � � Yle • Accepted Accepted With Corrections Denied Reviewed By: Date: / 2-119 Comments: See Reverse Skis far Mditlanal Ingarrnatinrd See Attachments: 1)Grady Plan. 2)Erten Control Bigndards' "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." 600* 1111° White -Building Canary -Engineering 'hnrv$so'll* Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT,2)Z 4/4_443--ye__ APPLICATION RECEIVED // 2 �� The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 357 Accepted Accepted With Corrections Denied Reviewed By: , Date: /2–ilf Comments: (- (`dt,-1 / r-'14--i c,\J 577/1- 17-4 . /(1F - AC-4/ 7;11 "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." 0. P8t0+1' White -Building Canary -Engineering 40,y$ do' Pink -Planning BUILDING PERMIT APPLICATION-DEPARTMENT CHECKLIST NAME OF APPLICANT 2),e 44-46A APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 35711/ (11 ?G ''., - Accepted ier Accepted With Corrections Denied Reviewed By: Date: /2_ 1 r Comments: 4,4 "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 Construction for Single or Two-family Dwellings in R• or R-2 ' tricts Reviewed by: Date: 7 C ->174— , Building Permit# PID: oning: pL s Address: 5 S-? 41.-t(. __.(c__,...„,-..-• 1 L____,(,a_c_:_,c.c....,Q___ Legal:L , B Subdivision: Existing Structure? YES ' Existing Nonconforming Structure? YES I NO . CONFORMS TO ZONING E NO ORDINANCE • Yard Setbacks: NA/FAILS/CO • L 1 Standard Proposed • Front Yard(can be 20'if avg.w/in 150') 25' `z Ss • Side Yards 10'/ 25'if abutting a street I o,a . • Sidewall exceeding 60'requires additional side 2" 10'setback+ setback for every 1'over 60'in length. Not required 2"/1'over 60' if building wall is 10'-0"or greater of being parallel to a side lot line. �t • Rear Yard 25' •(7.0 • 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/NIJRP 30' - pond. • Refer in-ground pools to the Planning Department • From 0HW(Prior or Spring Lake) 75'or setback average of adjacent structures,but no less than 50' w. Floor Area Ratio: NAI FAILS 1 CO E•S7� I .30 Maximum I ck ' • Yard Encroachments. /FAILS ICOMPLII S Standard Proposed Eaves and Gutters no re than 2 feet In width and no closer than 5 feet to a lot line(Easements). NC and other equipment cannot encroach on interior - side yards. • . Tree Preservation:7 A FAILS/COMPLIES Standard Proposed. I. • Total caliper Inc a • Permit 35%Removal • Caliper Inches Rer loved •' Calipelgches P,rrserved ' • Re placements Y:1 L:\ MP.LKTB\BLD GLIST.D 0 C i The City of Prior Lake T.mperviotts Surface Calcuiat ions (To be subnikted with building permit upplioulion) For All Properties Located in the Shoreiand Distrid (SD) `Me MaximumimperftitS Suri Coverage Pemitted is 30 Percent Property Address 3574 Hickory Circle Lot Area 17,884 sq. ft.X 30% = 5,365.2_ LENGTH WIDTH sQl_TARIE FEET 10USE T-rAci IUD GARAGE TOTAL PRINCIPAL STRUCTURE 2,984 DETACHED BUILDINGS (Garage/Shed) TOTAL DETACHED BTAT DINOS 0 DRIVEWAY/PAVED AREAS 931 (Driveway- paved or not) (S i kiParkine Ar ) x 81 TOTAL PAVL:D AICAS 1 ,012 PATIOS/PORCHES/DECKS xU (OperjEuks Vg."job, ripening betwczii X vpitli a ritrelou uurrac,-bziricv, X are[1.07 ConsLi:k.'icd ID be impervicui) TOTAL DECKS OTHER TOTAL CVFHE.R 0 TOTAL IMPERVIOUS SURFACE 3,996 6P--046At 06 November 2013 Date Rec'd 011 RfO iv j. >., CITY OF PRIOR LAKE PLUMBING I LX 9T iii .441Nnso° l'"4 PERMIT NO a'I t.OW City S.Ycitow Applicata (Please type or print and sign at bottom) ADDRESS ZONING(orate use) 3 51 y OfiLktn 0.-0(' a.� SW LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICANT" P (Name) D kYLf Lb p) °t- 1,111 (Phone) l�-i 1D ''113.2.241 (Address) 1556 1A/ Qii 11rLd1 4 PIt4A1AiA1\ 5 d �� (A dress) (Cit.]) (Zip Code) (Contact Person) /..j_A 4.A (Phone) 12S1 ' APPLICANT SIGNATUREi -■- ciAlti i OGUAA.hatiii,L DATE IL-51- 2 0 1,3 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 Water Closet(Toilet) Other FEE SCHEDULE Industrial,Commercial&Multi-family 1%of job cost with a$4930 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $4930 1 "est $ - Building Permit l# • The Minnesota Statutes§326B.148 • ��� "SURCHARGE"has been changed for one year effective PLUMBING PERMIT FEE $ t t t 1.e r _ $ h11 July 1.2010,until June 30,2011. STATE SURCHARGE $ .51jte, r1'"t The minimum surcharge fora"fired rce"permit TOTAL PERMIT FEE $ is SS.beginning Job,1.2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Dulidina Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 .r Rio* CITY OF PRIOR LAKE Date Recd HEATING/AIR CONDITIONING/FIREPLACE PERMIT 'k'NNcso* I.?:Pink File city [ilMIT NU.r3 A374. • 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONENEG(office use) • LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID • • OWNER. (Name) (Phone) (Address) (Name) — P144-- �) �✓ (Phone) 1(05 •413• 12-VT (Address) e'55'' MQJ(L, O l y f'J/i 55 ti tie/ (Address) 1 (City) (Zip Code) (Contact Person) .5 DU .A.A (Phone) 1/ 1..1 k APPLICANT SIGNATURE gor t.Giti( AAAAA ut t,L DATE 11'3 t').-O APPLICANT PLEASE COMPLETE BELOW ONEW CONSTRUCTION ❑REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT []Warm Air Plants Steam PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach ['Gravity ❑Hot Water ❑Mechanical ❑Radiation into Required Side Yard Setbacks. DAir Conditioning ❑Special Devices Fireplaces with Box Additions or ❑Vent.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 # HEATING PERMIT FEE $ k PAID D ITH STATE SURCHARGE $ .5 U L e G PERMIT TOTAL PERMIT FEE $ (Office Use Only) 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 PRip Dates Rec'd _..8 y CITY OF PRIOR LAKE I5 SEWER AND WATER PERMIT 1. Green File PERMIT NO./3 2. Gold p , � 3. Gold Applicant (Please type or print and sign at bottom) - ADDRESS • °//2,6/) ZONING(office use) 7 � 9 ' LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER P r I 771"" " (Phone) (Name) (Address) (Address) (City) (Zip Code) APPLICANT � ��,� / 4' 2' 19 (Name) A Sr/e, �����o <�Q ✓b 44 i (Phone) (� (Address) 29l� E-34 /2// ASPA/ (�Addd�dress) (City) /01 (Zip Code) AL (Contact Person) //�'Pli . � ��� �N` (Phone) �o 9/9 �a��' APPLICANT SIGNATURE // ./ AIL_W DATE /2"3A-'13 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. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial,Com'l&Multi-family 1%of job cost with a$51.50 minimum Sewer connection only $25.50 Water connection only $25.50 Estimated Cost $ Building Permit# SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ 17-H TOTAL PERMIT FEE $ rUILd�iPERMIT (Office Use Only) 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 1 di p)(Up CITY OF PRIOR LAKE Date Rec'd H ,i: ._ HEATING/AIR CONDITIONING/FIREPLACE PERMIT - j Mvgsott` '.Ore Ch PERMIT Ni /3• I37i 1 Yellow pvsdm ase type or mint and sten■t battom m c le ADD1k.. ZONING(oma one) ‘CarKarl---CITC—Arand • LEGAL DESCRIPTION(office use only) I • LOT 1 BLOCK / ADDITION r • _ P..• -- ry , • (I° NER,r 1'Z ' '�U v.-1--on H OYY�S _ (Phone) -[5Z- ! g✓ 7272. • (Address) 2'CPO Ken bridges C+•..#(W i...iceuti ler ti+V 55,E A(113.1' "`;ANT T reside teavii q Am(Phone) 605/— Cv 33-2 5(v/ . (Address) 2100 F i rVi 4.R) 11-vc kl e l)(1 le- , itA'v J/�5� I 13 (Address) (City) / (Zip Code) • (Contact Person) eak\ er (Phone) tQ61- (473B- 12 APPLICANT SIGNATURE DATE \... y , LA, s APPLICANT PLEASE COMPLETE BELOW • m.• ' , CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS `' FURNACE MAKE A D MODEL PURL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT []Warm Air Plants Steam PLEASE NOTE: Mr Conditioner Units and Fireplaces Cannot Encroach - ❑s :vlty 0 Hot Water into Required Side Yard Setbacks. „A ,apical ❑Radiation I Air Conditioning ❑Special Devices Fireplaces with Box Additions or DVent.System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit FIREPLACE MAKE AND MODEL S t-----76-0 3- — Lcp-\-t FEE SCHEDULE Industrial,Commercial&Multi-Family I%of Job cost Residential,Gas Fireplace •$49.50 $49.50 minimum Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations PAID WITH Residential,Heating Only(New Construction) $64.50 Residential,AC Only • t z e 1111Pil IT Estimated Cost$2 ;1 -CYO Building Permit # The Minnesota Statutes§326B.148 HEATING PERMIT FEE $ "SURCHARGE"hyear as�b ;eehangcd for on: • STATE SURCHARGE $ .50 July 1,2010.until June 30,2011. TOTAL PERMIT FEE $ The minbnam surcharge for a"Osed fee"permit . (Offlee Use Only) Is$,i,beginning July 1,21110 E This Application Becomes Your Building Permit When Approved Paid Receipt No. .. l Date By liaadtas Official Date 24 hour notice for all inspections(952)447-9650,fax(952)447-4245 4646 Dakota StreetS.E.,Prior Lake,Minnesota 55372 • . PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECT ! • RECORD . ., SITE ADDRESS .III 40 0 r � NATURE OF WORK ,i% - ide/ !�It' Z' J ' r LG /1) _ USE OF BUILDIN 4114/� � fp ISSUED ' PERMIT NO. L� $r �Z CONTRACTe : _:i�tirMie i PHON a° i'' 1 INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSP C •R ' ATE FOOTING ivG `z 7/ 3 FOUNDATION (Prior To Backfill) RADON RETARDER /'J? / t1 k PLACE NO CONCRETE UNTIL ABO E AS BEEN SIGNED ROUGH�- INS/ ),,,, SEWER/WATER/SEPTIC i l {,L r FRAMING 2)Z Com/i' INSULATION c - -- ELECTRICAL PLUMBING V,S Of it zjr 1 P4 , Q7f) HEATING FIREPLACEPg /�(� 1 GAS LINE AIR TEST d I9 RADON P(d/AJG Piti Vreekt COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED HOUSEWRAP R 211,61 11 LATH FINALS ,/ • GRADING ( PRIOR TO SODDING) !:511 /11/ BUILDING ! 13h1 ELECTRICAL PLUMBING D' l / HEATING "D ( <._/ ( DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNE 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