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(6).H.Rio_ CITY OF PRIOR LAKE BUILDING PERMIT, D to Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 7 ( / /'.4!
„E i. White File L
2. Pink City PERMIT N I. ' . -:o
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/CP o& Q 1-ei.h e, l-c- 'p(o_ge PL
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID Z'5-51- '//
( WNEame) '?f"' k . ( j 11-C T/ (Phone) 1. 12'' n S /9
(Address) ! , Q 6q Ted, " `c'` P ) d c-L,
BUILDER
(Company Name) �S :Gn r..Ce^4,-l�
'r7' 1 fn,[, (Phone)
(Contact Name) Se' 'e } (Phone) L l'z 9 0 �S '
(Address) 2.16 p!'"v- i f(( Plc �-^G
TYPE OF WORK all New Construction ['Deck DPorch ['Re-Roofing GRe-Siding ❑Lower Level Fi ish jZFireplace
ddition ❑Alteration DUtility Connection
CODE:[ I.R.C. ❑I.B.C. ❑Misc.
Type of Co3istruction: I II III IV V A B PROJECT COST/VALUE
3el: 0(27
Occupancy Group: A B E F H I M R S U $ / ,
Division: 1 2 3 4 5 (excluding land) \
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 agent • the
above-mens ed property an that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plaits_ I am aware':hat the b.ilding
official c re oke his perm' or just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 8G6 36) 97t1 9.--/(_ jy ,
Signature Contractor's License No. Date
Permit Valuatio 1O( e, / Park Support Fee # $
Permit Fee $ r SAC # $
Plan Check Fee $ '� Water Meter Size 5/8"; 1"; f.fr...
State Surcharge $ C Pressure ReducerPenalty $ / Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ „vvBuilder's Deposit $
Sewer&Water Permit Fee $ `Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
(f This A r Bec t mei Your Building Permit pproved Paid (. ' Receipt No.-7
Date X1 i y By
ii ding • ' • "fate
This is to certify tha he reg est in the above application and accompanyin docu ents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by th ty ' ner 7 nstitattes a temporary Certificate of Zo ng co pliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
hpir
7
arming Director 7.I Date Special Conditions,if any
24 hour notice for a I inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
18/28/2014 15:84 9524926086 GLOWING HEARTH PAGE 01/paD
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CITY OF PRIOR,LAKE Date Rec'd
ii
HEATING/AIR GOND ONING/FIREPLACE PERMIT /a /`1
t.Pik "Fite t
z.t PEI XT NO. ,•ga
' MvE � - • .' 3.Yellow Apptica -"�,
(Please ty a orztat and sign at bots di) .--
ZONING G(office use}
ADiu'- to kn el Pu S
LEGAL DESCRIPTION(office use only)
LOT 1( BLOCK / ADDITIONMe/31P A /l.W 41 t me-A o & PID R5• qS9-• a11-Z
OWNER ���.
(Name) 1121.1_4, (Phone) 11- 3
51,40
(Address '\.P 'NR.. ..._.. Citeki
(Name)CAN % tom. ' ��� �'"„ (Phone) 4? 4' - el Ylio
�.�aatii+�►
(Address)Sec) \.. f Pt-f•• v,-.. 55 _ _
(Contact Person) ?` (Phone) et . .-1 LPQ__
APPLICANT SIGNATURE. DATE lob b el t'L'
. APPLICANT PLEASE COMPLETE BELOW
ONEVV CONSTRUCTION 0REPLACEMENTLTEKAT11ONS
FURNACE MAKE AND MODEL L
EL
FLUE SIZE RETURN'OPENINGS INPUT OL1'TPUT_
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
0 Warm Air Plants D Steam Units and Fireplaces Cannot Encroach
■Gravity 7Rot Water into Required Side Yard Setbacks.
n' .echanical LU1 Radiation Fireplaces with Box Additions or
I Air Conditioning 0 Special Devices — Cantilevers to the Outside of Buildings
OVent.System DOther Devices Require a Building Permit.
FIREPLACE MAKE AND MODEL r # --
FEE SCUEDULE
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 $4?•5t1
irl t+. l Ae2t a C j i qVi in t ucti") . $64.50 Residential,AC Only
innesot tato es 3 b 14 Cost 8 Building Permit#
been extended Cost
"SURCHARGE"has
pAvin
The minimum surcharge fora SEATING PERrixIT FEF $
" ,. . >TATB SCJRCI•IA.RGE t---01.___.
fired fee pertsait TOTALPERMIT PAID WITH
This Application Becomes Your Building Permit When Approved Paidi
Date ...IA e I ...•
Bu tn3 O dal Date .
24 hour notice for all inspections(952)447-9850
4146%kata Street S.E..Prior Lake,Minnesota 55372•
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /4'0/0 ThAii/ , Plea
NATURE OF WORK Pte)
USE OF BUILDIN 0 rA_
PERMIT NO. o t - I DATE ISSUED
CONTRACTOR .m..0,. 1 i,&A /45 PHONE -
INSTALL EROSION ' ONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTO DATE
FOOTING 1,6 /0i3- (,,�
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING (i)L 1626 9/.// //--°7
INSULATION INSULATION
ELECTRICAL
drinaiiiitim
HEATING
emmen. fp 11 3
,, to,
GAS LINE AIR TEST
COVER NO WO K UNTIL THE ABOVE HAS BEEN SIGNED
HOUSEWRAP fl(> u 1_( ISIS
FINALS
ledealealapam
BUILDING fel g i 1p
/ `'v
ELECTRICAL
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