HomeMy WebLinkAboutBuilding Permit 12. 0702 a.
K
tr t 'Irafof (fir pantg
CITY OF PRIOR LAKE '
�tpurfnt tf of atI Mng n pirfhi
►� Final_ Permitted ❑ Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the❑Residential t❑International
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:
$7it/C 1'& 15/414/L- /Z .16 2r
KUse Classification y� 1 '/ Bldg.Permit.No. n, / ��
K Occupancy Type 1` f"V
Type Construction r Zoning District SA./
Legal Description L /Z., 8 1� T1 - LO tJ( S 6F kt6/L-T7-1 NVOO 0 N 671 DO I11/41S x
/ ,fir
Owner of Building Site Address 1?D4 0 /M1/1//6— r�l ng a/e-,0 ^
Contractor's Name&Address
K r2,ti8e)z.:.i- /l_ �-fv,C ?/X/SS it Planner C.
y
_.,, jbuilding Official
Date: i 1 f �i a� Date:
POST IN CON US PLACE Y
= rCONSPICUOUS
A
•
or
J
W Z 1 `)
a E W
31 - h V w
*Z � cWiQci
Z w
re
'o 5.4
C1 Ce W =
U. N
p q• aaJ a m c 0 oC
cm az 0 F
J WF oo g U. J O U V 4�
O.
2 Z a' Z .- = = ZZ W g II' ` H 0
W C..) d m = W = m =
L] O 2 f" 0
,, 0 W W K
_OM
wtai = z
■ ❑ 0000❑ V
, O °
a
p
J
=
0
es -"OW
w
074
JQ
O ' h
gg ,
VZ p Z N 4t4L:yy:)
.- � 1L F
-- Z � Z iiP- N y W W
O.
ZZreN F ed sa) V V<
vs %d D 0 S.
z a 0 =a
v ❑O0O�� 0 T
J
us z 1N
N t _W W
II Zg
000 W000 p 12
o
x
0 A poi
0 a. o. m i Z
w O.J Ad z = ' a Ca o 0 W
o ii
t_- n oou. J 0 U 0 44
O W
a
i � z - = =zz � N 0
to w a z
CO 0 d =w1- g5 :50uxtuwax W W Z x D4
cu :E % coCTe i W V w Z
❑ 0000❑ ` ''� o°c o w ''a a a p
CI
I-
P
W Ili
Z N
gy 6 _ 01
p tZ
r. Z ? z N
et Fi
g La
LL w
N4
ow 0M31z � a o c t5 <
of 0 0 c
t�= < O a 000000 0
J
Y! Z w)
17:
r
a a � � _ ui
C
G UVn zo gt
b 20. 55 WZ -� > v
04. r ❑0O000 p r
` .
W O
J Z » <
c •
Z
C 88 " W 5
Z
W
11111
° U wn. 4
a a
0 0 W ibcta' zmrt.
Cl) 0 0. ?WLVI d eZ 2
� ? W L
WWZ O
x
000000 C) 0 a0' O = `t
O a a a
co
o Z Ou
HctO O F-
04-co 1 W W ?J Iga0Vww � '� �) ^ 0 0 0 t5 V 0
H c o $LL�Z y o ,I 0 0 1.
6 ? Q O a 000000 C) 0 ❑ —`
J
Lii 3 2 1
A� G
~ .z Z W W a Z 0
,�\ V V '
,v � gda3 V O Q •f!
7�U' 2W LU u) Z
< W C� tL IL � 4"
W Z
IV 000000 U 0 Lt6j
W =
re W O aa < M = cc 0 NCw
J t GG 88LJ �/ ._ 0 U �L
C C a U r) a j
= Z Z _ SSZ _ y� W z
Z
fUq V a aXce WZa5 , a Z
V f
3Wu P"< _iW W W K LL
aa3w Te `1- _ W W re W
V Z
‘‘ 0000 1� p = 'C
a a U.
, IIIJ0 144
.....7.: �- F- Z NE p
Y V 0 ) •• 4C O S CO
co is 01
re O ZO W I- < I- F- 4
Z ~ OF a Z 1\ ) y 0 V J W
�� UJ IJJ
N . _ � °z :�<Z 2 i.,� A- vJ le re al
pi
O O O V
o §ill o u.uu..u.= LL p 0 ❑ a
C5 i a 0 d 0000 0 C.) `'l`�
0-i-. k/op
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�; / ��- TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2 I
u'% ( AND UTILITY CONNECTION PE 2M1T
r>v,N E,�C7
-----.---2_
t. whirr Pile
2. Piot: city PERMIT NO. 12 - /,
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
ZONING(Mho:use)
� ,,
`67`€C .0 /-01/144::- RdD�/�i U /v W RJ96
- v
LEGALw j DESCRIPTION(office use only) ff - ` Vo
LOT t BLOCK ( ADDITION IIA,4- C..D u 675 C5'{ ane44-1,,,,,,..d PID 17,. Ii, 0 12.0
OWNER __..�Ce r r 4Q e��
(Name)
V ' (Phone)
(Address) _
BUILDER ((,�, y�/� '-s--¢ �J ��-'N (05 ( y(" cl �1 a
(Company Name) e kW tes 1 ' e,TT' `t H `v.Mc%� C- (Phone)
(Contact Name) — JAY td r(r (Phone) q J"2 2.9 Z 0?(;(
(Address) 3(o 3 ::-.4 s i /.4,t rti f t / ,1/-/ 5-5 ', 2( —
TYPE OF WORK NEA-New Construction }Deck e}icrch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ['Utility Connection
CODE: C. DI.B.C. ❑Misc: — — --
Type of Construction: I II III IV V AB - `�
Occupancy Group: ABE F III MRSU PROJECT COST/VALUE $ 2i 50 ( CLO_____
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have burnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above-mentioned properly 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 lust cause. Furthermore,I hereby agree that the city official or a designee may utter upon the property to perform needed inspections.
716 3 G0 3/32t_.// E
- _ -
Signat Contractor's License No. Date
Permit Valuation 10 t Park Support Fee #
Permit Fee $ • e,rJ SAC # $Z 360,Cel
%
Plan Check Fee r$ is .GS Water Meter Size 0"; 1"; — $ �' ,<
��.
Stale Surcharge $ IrSr Pressure Reducer $ i 2 0 s
�
Penalty $ Sewer/Water Connection Fee # $ a
Plumbing Permit Fee $ S-7° Water Tower Fee # $ D00 , -.
Mechanical Permit Fee $ �� Builder's Deposit $ ` S 0tr "
Sewer&Water Permit Fee $ � 5�`ra > Other $
Gas Fireplace Permit Fee $ l `"`'� > TOTAL DUE $ x' ;
� S 1
This 'f li ati tes Your Building Permit en pproved Paid /1f ✓/ r,`reit No.
/ i/ J ‘ Date 8 ,/D,r-I— 5) —
Building Oficial D e
This is to c• Cityat quest in the r jttve application and accompanying ocu nts is in accordance with the City Zoning Ordinance and may proceed as requested. Th s document
when si; d by/f ell ,'tr erosritutes a temporary Certificate of Zo • *con Hance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
4 '
in,Director (Z.--
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 PRION '
A, . ` Builders Deposit
� - '0- li;
x,v
. •
1.
rSaA City of Prior Lake
A$1,500.00 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 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.
DATE: -2r-ft- SITE ADDRESS: _ /671-- 0 66 f fir �` d PERMIT# 7.-- -1 Z--
REFUND TO BE MAILED TO: C Ls!' (c S (14L.17`41 t4 ez °`te-e
3(c 1°. sr
Ftil ;wf 'foN /cN 550-2-
\
PLEASE REMEMBER 7/
.�(J 000,00
Lynda S Allen,
n,Buil ' g Services Amount
1. KEEP STREETS CLEAN DURING CONSTRUCTION e 17..i4- Acct 801.20204
2. KEEP EROSION CONTROL IN PLACE Date
3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR$500.
SIGNATURE: 9/latc"'‘------",(4.,1--------
Larry oppler,`City Engineer
DOCUMENT HAS A COLORED BACKGFOUNND ON WHITE PAPER AND ORGNAL DOCUMENT SECURITY SCREEN
•
THE FACE OFIS ham; � ;> F ,e ` "+�'.. „�
ro � `P , k t qx„� # v. 4 r y frks1 x '
'xt y.l _ -G rw : d At•i.i },. k kL a „y, 5$y
`� A .�'�""s !e r �� ° a '� "�
, a D � t r° �3�
t � • '
KoministratorlLocal SettingslTemporary Internet FileslOLl(2D01BUILDERS DEPOSIT
ruRNIDOC
Residential Building Permit Checklist
New Constru ton for ingte or Two-family Dwellings in R- or R-2 Districts
Reviewed by: Date: g 1 !Z—
Building Permit# D: Zoning:
Address: 1 4£90 (-- ata062— Cr_
Legal: L , B Subdivision:
•
Existing Structure? YES 11si` . Existing Nonconforming Structure? YES I NO
CONFORMS TO ZONING Yip NO
ORDINANCE
Yard Setbacks: NA 1 FAILS/CO 1 Standard Proposed I
• Front Yard(can be 20'if avg. , 150') 25' Z
• Side Yards 10'/ ; " t
25'if abutting a street 7
• 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.
• Rear Yard 25' 4-o• 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 Planning Department
• From OHW(Prior or Spring Lake) 75'or setback average of
adjacent structures,but no ....---
less
/less than 50'
—2-1 (34 441 I(15.6.;1 Flor Area Ratio: NA 1 FAILS IC•a IES .30 Maximum I • t1 .
Yard Encroachments: FAILS!COMPLIES Standard Proposed I
Eaves and Gutters no mo a 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: FAILS 1 COMPLIES Standard Proposed i
• Total caliper in hes 1
• Permit 35%Removal
• Caliper Inches Rerr1oved
•• Calip ?'lr ches P,rrrserved
• Replaceme f 1/2:1
L:\TBMPDi4TE\BLD GLIST.D 0 C
a
fE.UWhite - Building
y, �P Canary -Engineering
NNESO Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT MAW.--...5 Ni; t - 14-t)
APPLICATION RECEIVED "7 2 , i a tac-s03,4 ii lop 7. 0).16.
The Building, Engineering, and Planning Departments have - _ _ - - _ .' a ing permit
application for construction activity which is proposed at:
1 ( a- O \l r- .. I O , .
Accepted ✓ Accepted With Corrections
Denied ,�/� ,
Reviewed By: /�J - � Date: 3/3/2—
Comments:
3 /ZComments:
See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan, 2) Erosion Control 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 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."
Oi PRIo.
tr rx
U tri
White -Building
y, 2P Canary -Engineering
NivEso Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT A- V5 Kra •1 14t)
APPLICATION RECEIVED 7. 2 , 12_ 4-S V avl 000 00 7- lat Z,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
j ( 4- o 14-&-woo6. :: rAO . .
Accepted , Accepted With Corrections
Denied
Reviewed By: Date: 8/S/2
Comments: L® — as1� �' nAtio,rr� C�-
_____ 14-- 4,,L `-ka.._, ___v __.
"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."
,.N,. ,.:°`i.. 'xtia.9.a.. M,._ .,a.aha-rsi.. .w.,rt»'4r'+ ..., •' h�rU M,«,., • 'u,;w: w-rf` F
(0 •1PRIp�
H
tr1
White -Building
�INNEso�P Canary -Engineering
Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
•
Accepted ' Accepted With Corrections
f; Denied
Reviewed By: ~ Date: v f 2--
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."
,tom . ..T
O PRip�
ti
z
White -Building
41INNEs6CtCanary -Engineerling
Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANTk MEA, f
APPLICATION RECEIVED 2 • j Z'-- -503'4 t-rjco 7. (aiZ-
The Building, Engineering, and Planning Departments have - •- - : .' ,ing permit
application for construction activity which is proposed at:
(.0a H1C\Arr.--- C.,1 (C'e- .
Accepted ✓ Accepted With Corrections
Denied
Reviewed By: Date: 3/3//
Comments: 3/Comments:
See Reverse Side for Additional Infoanatiag
See Attachments: 1) Grading Plan, 2) Erosion Control 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 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."
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: 16480 HAWK RIDGE COURT
(Lot 12, Block 1, THE COVES OF NORTHWOOD MEADOWS
Lot Area 19,563 Sq. Feet x 30% = 5,869 Sq. Feet
LENGTH WIDTH SQ. FEET
HOUSE irregular x = 2,194
x =
ATTACHED GARAGE irregular x = 719
TOTAL PRINCIPLE STRUCTURE 2,913
DETACHED BLDGS x =
(Proposed Shed) X =
TOTAL DETACHED BUILDINGS 0
DRIVEWAY/PAVED AREAS x =
(Driveway-paved or not) irregular x = 761
(Paved Right-Of-Way) X =
(Sidewalk) X =
TOTAL PAVED AREAS 761
PATIOS/PORCHES/DECKS Porch(front) = 299
(Open Decks 1/4 min.opening between
boards,with a pervious surface below, Porch (rear) = 168
are not considered to be impervious)
Deck to have min. openings= 0
TOTAL DECKS 467
Other
TOTAL OTHER 0
TOTAL IMPERVIOUS SURFACE 4,141
UNDER/OVER 1,728
Prepared By Harold C. Peterson, L.S. MN License No. 12294 Date 8/8/12
Company James R. Hill, Inc. Phone# (952)-890-6044
r RI?3 Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
�IA'NESD�A
2.
'.=ed ciFilety PERMIT NO.Gol
(Please 3.Yellow Applicant
type or print and sign at bottom)
ADDRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICAN n (�
(Name) Fi c}c f r v�
�. (Phone) X-4y 1 - Sl 6I
(Address) G400 1-� �� ,-�ll" 1 .—, 1 der ;Ne,r L L SS 31 )—
(Address) (City) (Zip Code)
(Contact Person) D C-1 o L, (Phone) 3- 9 as el
APPLICANT SIGNATURE 1 _> £22( DATE `A 1.2-1 ) C.—
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$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
$ Building Permit# at 89,� �l
The Minnesota Statutes§326B.148
"SURCHARGE"has been extended PLUMBING PERMIT FEE $ �'�b/�`v, 771until June 30,2013, STATE SURCHARGE $ .50 p',L`i �'rr
The minimum surcharge for a TOTAL PERMIT FEE $
"fixed fee"permit is$5.00
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
Ø):
DateRead
BEATING/AIR GOND ONINGfFPLACE PETIT .
U
• 4141913e): : . . . .
s. Iper
or ane bo :.raw. NO.
2:71
ADDRESS .r___ 1 lab
rI ZONING concli in*
F
LEGAL DESCRIPTION(office useonly)
Y..QT • BLOCK ADDITION
Mame) A W ' ♦l ti ` OW ' " (Phone) I-tgo3 - 19 9 b
(Addie$L3i 0 - . c i- , `‘r "el, .
� •. � ••
APPLICANT
.
(Name) io its - allk 1 teir (Phone) I • .
(Address) iii 0 (111 C.4. I 1 •.,,� NI S5 3 S ......_
( .) (i
(Contact Person) + ) I C _ • (phone) 1 : ' . .- ---Cl -i Cn
APPLICANT SIGNATURE •
,„,-.141111.4, � �'
eiiE) di PLEASE COMPLETElino* I
:l maw CON • r ON 0 REPLACI IT ' 0 ALTERATIONS . .
FURNACE MAKE 11 MODEL, - . . ( • .
FLUE SIZE'; RETURN OPENINGS •INPUT 5 OUTPUT
TYPE OF SYSTEM BEATING OR POWER PLANT -
OWaim Air Pleats PLEASE N e ': Air Couditioaor •
Gravity Units and Carnot Encroach,
Radiatio , Into : =, - SEte Yard Setbacks.
' Conditioning Special Doric=
placeM ,, Baal Addition as'
Meet.Sym ❑Mgr Devices - Cance .•the Outside of Buis
rr [, w • Require a B . Permit.
FIREPLACE MAKE AND MODEL 1 "• sr. �"l4. •- . _ _...
• — trI-•E
Industrial,Coimneroial&Multi-Family 1%oijob coat
, + $49.50
S49.50 minimum _.,_�
Residential,Retains&A/C(New mon) $149.50 Residential,Additions'dot Alt:atioasI $49.50 '
Residential,Beating Only ew•Conaa echoes) S64.50 •Raeidautiai,AC Only $49.50
Estimated Coat Buil g Pe unit ,# . .
�. 'fie Minnesota Statutes 1132611.148 -
.,� ABATING PERMIT FEB $ . c�t) "SU HARM"Iles been changed for ono
3 STATE SURCHARGE . $ yew efitctive
Tom,per' $ u .c--c) dye 1,2638,meal Jane 38, N si. •
TO
(per ika i . .Thew bum metro hr a ifeed 1tc permit
haim ute;My1,2411
This Applicatibi DiemenYatier Building permit Whin Approved •Paid
B�didim OWetai Ants .
•
34 tour notice for all tnspooilom(952)441,9950,fax(953)447.4245 ,
014/T9 39Vd 1•pIH!:Hiakf3-1 91Ii'1019 9009Z6PZ56 60:ET ZTeZf0j'60
PRI{ ' Date Recd
H CITY OF,PRIOR LAKE
Uo SEWER AND WATER PERMIT
a''wrvssct`
s: x`utr, I PERMIT NO.3. Gold Applicant 1411020.0
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
`i ' 1
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Capt C,..3? c od' Cir' (Phone)41 Sa•4'1 -
(Address)
(Address) (City) (Zip Code)
—
APPLICANT
(Name) T I tcca LLC (Phone) (.p la, l tai 9lc
(Address) 5 Z." 1 . ,- . u S S Pr(-- 6.05 `
(Address) (City) (Zip Code)
(Contact Person) ,1, (CUL c.c (Phone)Lo
r
APPLICANT SIGNATURE + ` DATE )/ /q t20 i Z.
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.:
Location of any couplings from structure: feet.
Type of sewer pipe. 0 ABC 17 PVC ❑ Cast Iron
Estimated length of sewer line $46 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 $ ,50 PAID WITH
TOTAL PERMIT FEE $ PERMIT
A
.a
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Bt.�1Re1�►cei1pt 1r1Na.
Date By1..
Building Official Date
24 hour notice for all inspections(952)447-9854,fax(952)447-4245
4646 Dakota Street S.E,,Prior Lake,Minnesota 55372
(gf4 rRI CITY OF PRIOR LAKE Date Rec'd
�e HEATING/AIR CONDITIONING/FIREPLACE PERMIT
' .
4
�ltj �Q' 1.Pink File
NNEso 2.Green City PERMIT NO.3.Yellow Applicant 12/ I
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1 k,c-t IQ) 0 OctutAcKoloje of
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT
Per -c-t-- cll. :1_'-, c (Phone) 6 i a.----zic7 6 6,c2
(Address) ( 1 d`°1--- C Are q_ 1-4:11k 1-N Sellbe?4 I f ,ZOD,V
(Address) (City) (Zip Code)
(Contact Person) Mei 1b PA ' ° 0 (Phone) G t — 7 (o 6 U1
Py
APPLICANT SIGNATURE it—ail /_�5" r TE
_A/III D (Z
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION El 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 0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks..
❑Mechanical 0 Radiation Fireplaces with Box Additions or
DAir Conditioning 0 Special Devices
['Vent.System 0 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 $49.50
— - ' A
The Minnesota Statutes§326B.148 Cost$ Building Permit # ID
"SURCHARGE"has been extended
until June 30,2013, HEATING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ .50 —_
"fixed fee"permit is$5.00 TOTAL PERMIT FEE $
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
R 'OR
L
DEPARTMENT OF F
BUI,DING AND
INSPECTION
INSPECTION R
SITE ADDRESS l'4150 ( Ati4i [L
NATURE OF WORK Sr-c> (QC . arc . Pica* f N, L L
USE OF BUILDING tr.19 —rvn t t�
PERMIT NO. (7.---101- DAT. iq ISSUEDto tz_
CONTRACTOR Gets (l612-(Z.t i- PHONE 152--z Z-c'ik,I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPE TIO S BELOW
THE P RMIT IS BY SEPARATE DOCU E T Tievi
v lam*- S toe-) S 144VApplig
ZTO
DATE
I FOOTING Peek 5A(k_
I FOUNDATION (Prior to Backfill) J
PLACE N9 CONCRETE UNTIL ABOVE HAS BEEN SIGNED
4)atjftgomOd(2.- kA- ROUGH - INS
SEWER /WATER/SEPTIC
FRAMING
INSULATION
O • 5/27 J-2,
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE �W
AS LINE Al TEST
t,' COVE N ORK UNTIL ABOVE AS BEEN SI "
1 � a kztAt - /?, /1,x42
FINALS
GRADING (Prior o Sodding) �� ti R
BUILDINGS -71,1,,; (7-0 17 1 v
ELE
cTRICAL
PLUMBING g, t ct tic !L
HEATING p.,
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