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67/ ' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
\Ivo.) AND UTILITY CONNECTION PERMIT 1 r ) . i c
fNATESO
1.white ale PERMIT NO. f�_ /
2 Pink City
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
Z7 3 I COU6,42 int r14
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PIDc5 44- 6-01:71
(Name)OWNER 0/14.- Y1 (Phone)
(Address) 273/ CvvoiK Aro /7MICA &irf )44V \
BUILDER ''nnom�.
(Company Name) .-Ji l /'�'/irno e/Tam 4"#Oftl.ti /A,L. (Phone) 6/? v 69/d
(Contact Name) ,/104-01 y • fAtilifIk h i 4 (Phone) ‘/2— 9/6`a/b
(Address) /if) w 1/1v4,4,4-) OH - Y,t/4lro/v.t /!?T/ ,ff 3 7 9
TYPE OF WORK 0 New Construction DDeck ❑Porch DRe-Roofing ORe-Siding er Level Finish 0 Fireplace
DAddition DAlteration ['Utility Connection /Z-P1 f
CODE: DLR.C. I.B.C. 0 Misc.
Type of Construction: I II III IV V A B
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ /O, or o
Division: 1 2 3 4 5 (excluding lana]---
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 I am the owner or authorized.i gent 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 . '.. ca ,ertnore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
% ice' Z3c W•6 2.gAz /z/i'J
S gnature Contractor's License No. --Date_____________)
Permit Va1ua i,. Park Support Fee
,� UCj0 � �) PP # $
I
Permit Fee $ , 4" 7J) SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ / 3-0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Jr 5-0 Water Tower Fee # $
Mechanical Permit Fee . $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ .� c TOTAL DUE 52
This Application Becomes Your Building Permit When Approved Paid ./T-5-, L-S ceipt No. i®IU
/5 Date /_ G /j
/. 5.
Buildi g Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. Thi;:document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions,if any
24 hour antler far all inanertions(9521447-95150.fax(9521447-424.5
oi ?Rro CITY OF PRIOR LAKE Date Rec'd
` �� HEATING/AIR CONDITIONING/FIREPLACE PERMIT
U
A
i trr
�lNHeS�P 1.Pink File PERMIT NO. II
2,Green City 5•
3.Yellow Applicant
I
(Please type or print and sign at bottom)
ADDRESS ZONING(office ase)
12)\ C.NIMA oj P& u
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID j • -
•OWNS
(Name)' J1
\ (P-1
amI
(Phone) (iIL G.1 �l V
(Address)
APPLICANT HEARTH & HOME TECHNOLOGIES
(Name) dim FIRESIDE-HEAR i H &HOME (Phone)
(Address) tic BC662656
2700 FAIRVIEW AVENUE N
(Contact Person) ROSFVILIF, MN 55113 (Phone)
APPLICANT SIGNATURE 633.2561 ,,,. _DATE1/9 it I
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 Elliot Water into Required Side Yard Setbacks.
ii-Mechanical ❑Radiation
Fireplaces with Box Additions or
DAir Conditio 'ng El Special Devices Cantilevers to the Outside of Buildings
❑Vent. System 0 Other Delfices Require a Building Permit.
FIREPLACE MAKE AND MODEL t ai laty/nD(1,3 X33
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&Alt tions $49.50
Residential,Heating Only(New Construction) �,;1 4.50 Residential,AC Only $49,50 -
Cost$ Vi ib Building Permit-11
HEATING PERMIT FEE $
STATE SURCHARGE $ .00 tP
TOTAL PERMIT FEE $3
15 •
This Application Becomes Your Building Permit When Approved Paid V eceipt No.
•
Date By
Building Official Date •
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
YRTp Date Rec'd
citCITY OF PRIOR LAKE PLUMBING PERMIT
v it 1,d- f i
4r socr
I.
Goa City PERMIT NO. /31_0y
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING cOffice use)
A-131 Coi -ar Pct. -y\
LEGAL DESCRIPTION(office use only) 1.�
LOT BLOCK ADDITION PID C' 119 01/
OWNER
(Name) (Phone)
(Address)
APPLIC T ! 402 �
(Name),Sa 1Gt,Y� et.Y S0 f 1`5 �vrxb i A✓+� Y`C (Phone) t-P� ' , 0j gY
(Address) /1O U.)1`1'U(/J C>A6 e bf. -5-to t 1-.6r1S Z.60 6'
(Address) (City) (Zip Code)
(Contact Person) (Phone) 6 a02- 71 ' f I? 7
APPLICANT SIGNATURE _ �rMDATE /J4L 1/S
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
j Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
( Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
1 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
Estimated Cost $ Building Permit# The Minnesota Statutes ;26B._ 8
"SURCHARGE"has been extended
PLUMBING PERMIT FEE $ The 11117141111111 strcharge for a
STATE SURCHARGE $
TOTAL PERMIT FEE $ "fn t d fe,2" permit'ts Y,t;.00
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid Rffc i ski No.
Date n A
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
DEPARTMENT OF
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 2731 0 A
NATURE OF WORK
USE OF PERMIT NO. Df �1 DATE ISSUED /. S. /S _
CONTRACTOR 50tl7W 7k. llanVef/ PHONE &/2.. 9/4 � �',; /4
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS A ALL TIMES
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING /Pi
INSULATION _
ELECTRICAL
PLUMBING U 50 _
HEATING _
FIREPLACE
GAS LINE AIR TEST _
COVER N WORK UNTIL THE ABOVE HAS BEEN SIGNED
1101111111111111 0.11111
FINALS
BIUILDING -
ELECTRICAL -
PLUMBING -
HEATING _
DO NOT OCCUPY UNTIL ABOVE H 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