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A u A U A A U U A A A A A U U A u A A A U u u
Cerfifiraft of Orrttpattrg ,.
CITY OF PRIOR LAKE
Prparfutrufixrxha
j g.Final Permitted ❑ Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the ❑Residential/❑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:
'k� Use Classification S/NC t G ft-i Wf/L-4� / J�/'�l
/ Bldg.Permit No:
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Occupancy Type Type Construction Zoning District PC/0
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K Legal Description L /, e Z/ SHO 16(7, (_'1,4(..1--;,.....:D. /J/ —i V(` !
Owner of Building Site Address /''/-2..J-L- ,...57-0/2.,&— GG,-� / �' y
K ' Contractor's Name&Address k�� ✓Al-S-7L-h"/ 4-7 6.1—C/CJ/ / /1')/116.(75-
K:. i 66/,.,)'/:-./L-4 C ._ //6/76/-1/A-/�i, City Planner
K Building Official /�
Date: �C�P�.) Date:
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t CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE '4— l5-
AND UTILITY CONNECTION PERMIT
rkN E jr5d
I. White File
City
2. Pink CPERMIT NO. /5 5/0
3.Yellow Applicant
(Please type or print and sign at bottom) I
ADDRESS ZONING(office use)
/'y� `�/ 5 e' t'e-3- '� �
LEGAL DESCRIPTION(office use only) /"L
fy
LOT / BLOCK r ADDITION �`P /'z 4'J 7 PID
OWNER We4tsv &n is t t t_5fe rt, r7 e ��,
(Name) Vie fSn~t n
�Gt� F�'FQ��P ICPS. �G (Phone) '7�'/rJ' 3-g gga
41,
(Address) (ASS 11-14.0 Si- W 23)2_ 4ppie Valley, H N •S 12-4
BUILDER /�
(Company Name)hleriStra r t CUS+om e (Phone) g5a-!gs -q$Qa
(Contact Name) `Icrr4 Wer1S fl - n (Phone) (P 1 9'; 8-70 3 7
(Address)(s S5 I Lk,' Sf IA/ *ZDZ. Apple al Li-L(1 V)1/1 S S I a4
TYPE OF WORK 0 New Construction DDeck [Porch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: .R.C. ,,,...c. D Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ p 66,00e
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I ha.. famished info[niation 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 for the
above-mentioned .• and that allwill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revo :.- permit for j urthermore,I hereby agree that the city official or a designee may enter upon the�pr/operty to perform needed inspectio
X -a( I1010v -‘''6f- - r';'et'; 6 C c 1)64 341 .5--// f'.
aKon
Signature Contractor's License No. ate
Permit ValuationPark Support Fee
# $
4)D O pO--
Permit Fee $ A'�%3. t---0SAC # $ A/71675 DO
Plan Check Fee $ 36 e' 1�8, Water Meter Sizi , 1"; $ 56 0. 0 0
State Surcharge $ /3 CJ 0® Pressure Reducer ' $ /5-6. 0 0
Penalty $ c___,_____, Sewer/Water Connection Fee # $
lJ6,• 00
Plumbing Permit Fee $ if 5-4/ s^® Water Tower Fee # ' $ /000.00
Mechanical Permit Fee $ / 5-ti,„S-0 Builder's Deposit $ 1.5.6 .Go
Sewer&Water Permit Fee $ 5^6 Sc) Other
3^ $
Gas Fireplace Permit Fee $ � /J . {� TOTAL DUEtem. .ZO,Is- $ /8 009 'r\l
This Application Becomes Your Building Permit When Approved Paid CZ (10 7- Z-1 R t No. ( f
e.1444.1 / Date c. 2-I• (f B
Building Official
This is to certify..t th - the above application and accompanying documents is' actor ce with the City Zoning Ordinance and may proceed as requested. This document
when signed. �„ Ci lann., c..,..• .temporary Certificate of Zoning complian and ws construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. /
e
. Planning l i v ate . 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
1
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-'I or R-2 Districts
Reviewed by: KO , ► Date: C/ L .___________.
Building Permit# PID: Zoning: ,U h
Address: 1411 if,"
�a t- 4311 '-'0-- —i.--..\�
-
Legal: L , B Subdivision:
Existing Structure? YES/ill Existing Nonconforming Structure? YES I NO
CONFORMS TO ZONING Y Y NO
ORDINANCE
Yard Setbacks: NA/FAILS/COM .1 Standard c Proposed
• Front Yard(can be 20'if avg. ' 50') , N7 ( Ct, , 4
• Side Yards ' '?.i-. •-� t
25'if abg a s ree t 4,0
• 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
• 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 than 50'
1 Floor Area Ratio: NA/FAILS/CO t?),IES I .30 Maximum I 0 I
`Yard Encroachments: FAILS/COMPLIES Standard Proposed
Eaves and Gutters no m e 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 I COMPLIES Standard Proposed I
• Total caliper incily)
_ • Permit 35%Removal
• Caliper Inches Removed
• Caliper Inches Preserved
• Replacement 1/2:1
L:ITEMPLATE\BLDGLIST.DOC
o PR/04.
White -Building
•1asole* P nk Canary - Planini 9'ing
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 4-4
APPLICATION RECEIVED Y/•S/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ 171a / 5//42/2_6--- c e l .
Accepted Accepted With Corrections 777000
Denied
Reviewed By: Date: ( 15
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."
` 0 PR1 �
•
White -Building
�*
Canary -Engineering
' N,vBso
Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT�i 4f9.4 (7A 45
APPLICATION RECEIVED 4,1147/
'
'The Building, Engineering, and Planning Departments have reviewed the buildih permit
application for construction activity which is proposed at:
/ 4i a 9.v e dit & Lys - V&
Accepted P7 Accepted With Corrections
Denied
Reviewed By: `; ���� Date: Ir
- - 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."
y0 Date Recd
o. � _� CITY OF PRIOR LAKE PLUMBING PERMIT I. 3
1�=v�n�
o�P 1.Blue He PERMIT
2.Bald City PERMIT NO. /5 /co
3.Yellow Applkanl /
(Please type or print and sign at bottom)
ADDRESS \ ZONING(office use)
IPCILt SACC . `v
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address) 1AP / q LI
(NPmI)ANT e \ l p C . (Phone) �`'t5/ 4 51 /" G �o
(Address)
?ASS- Ve-Tni� J.�C, --'. C)( ��r� J l
(Address)�� (City) (Zip Code)
(Contact Person) _ �►`�"'`S ' --- - (Phone) C���r�+ I
APPLICANT SIGNATURE / dig_______— DATE I J;3_)i5
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher 1 Water Heater
I Floor Drain Water Softener
�jl Lavatory(Bathroom Sink) 1 Stand Pipe(Washing Machine)
I Laundry Tray(1 or 2 compartment sink Sewage Ejector
A Shower Stall Backflow Assembly
1 Sinks Backflow Assembly Test
I Bar Sink Lawn Sprinkler
3 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 ` ,
�J 1
The Minnesota Statutes§32613.148
–1st $ Building Permit# •
"SURCHARGE"has been changed for one
year effectiveil3uPLUMBING PERMIT FEB $ ( °pif/
July 1•.,2010,until:tune 30,2011. STATE SURCHARGE $ .50 r '
The minimum surcharge for a"fixed fee"permit TOTAL PERMIT FEE $ V
is S5,beginning duly 1,2010 0
This Application Becomes Your Building Permit When Approved Paid Receipt o.
Date By
Building Official Date
24 hour notice for ail inspections(952)447-9850,fax(952)447-4245
- 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
ao\s- --) 3 .-. 4
4 rRio CITY OF PRIOR LAKE Date Rec'd
,� A HEATING/AIR CONDITIONING/FIREPLACE PERMIT
,..), ,
IT
2G.. F.C.t PERMIT NO.15 sir)
T 3 G¢cn Cd,
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(otfxce use)
14 `--\ 9(\o(Qcifle5s\
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER '
(Name) (Phone)
(Address)
APPLICANT(' �(� 1 _ /
(Name) C l /12 (Phone) t� I O Lc-)
(Address)_ D'�' `)\ 1-2- W WiV i\'-Q U tJ S5 3 .'1
(Addresh\u \C
(City) i (Zip
Code)
(Contact Person) (-\ n 1 .A. (Phone) Ci5D.—1 (01 - 18U —)
APPLICANT SIGNATURE `
(.1�NQ DATE 0%r�Ks,..- L 5
APPLICANT PLEASE COMPLETE BELOW
fty
NEW CONSTRUCTION ❑REPLACEMENT ❑ALTERATIONS
FURNACE MAKE ANMODEL ( cuji)9l ..5j'51213(.1,00 S 17 ! Cc FUEL CA As
FLUE SIZE `�`)()00 RETURN OPENINGS 9 INPUT 9 '3.7 V OUTPUT SS ZOO
TYPE OF SYSTEM HEATING OR POWER PLANT
❑Warm Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
❑Gravity 0 Hot Water into Required Side Yard Setbacks.
>17.! Mechanical ❑Radiation
Fireplaces with Box Additions or
I it Conditioning 0 Special Devices p
IV ent.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&AIC(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50Residential,AC Only $49.50
r I.y
-4--`-'Cost$ 0106 Building Permit #
The Minnesota Statutes§326B.148
"SURCHARGE"has been changed for one HEATING PERMIT FEE $ '&14Oi
year effective STATE SURCHARGE $_ .5t• ,,? p,"::.,.;' ;
July 1,2010,until June 30,2011.
TOTAL PERMIT FEE $ t
t
The minimum surcharge for a"fixed fee"permit `Iy �
is S5,beginning July 1,2010
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Buildine Official Dale
24 hour notice for all inspections( 52)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
eDatePRfo„
Rec'd
CITY OF PRIOR LAKE
AN.5-E, SEWER AND WATER PERMIT �', ZO. /S
kryEs°
GYerellen FCilety /h h /PERMIT NO. r
ow i
3. Gold Applicant V ✓ l0
v
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
14294 Shore Crest Drive Pub
LEGAL DESCRIPTION(office use only)
LOT 1 BLOCK 2 ADDITION Jeffers Pond, 7th PID 255010060
OWNER
(Name) Wensmann Real Estate Services (Phone) 952-953-9892
(Address) 6955 146th Street W Apple Valley 55124
(Address) (City) (Zip Code)
APPLICANT
(Name) Bohn Well Drilling Co (Phone) 952-445-4809
(Address) 18190 Dairy Lane,Suite 101 Jordan 55352
(Address) (City) (Zip Code)
(Contact Person) Charlie Bohn // (Phone) 612-919-1542
APPLICANT SIGNATURE 152,Cui2 ah - DATE
APPLICANT PLEASE COMPLETE BELOW
Size of water service 1 inches.
Location of any couplings from structure NA feet.
Type of sewer pipe. ❑ ABC R PVC ❑ Cast Iron
Estimated length of sewer line 50 feet.
Clean out(if required) located at NA 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
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid IAWWI
BUIL
. B " R + 4
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
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS AO fly „um.. ciAszb .Zi°. .
NATURE OF WORK ;, 41& 4) A � ri
USE OF BUILDIN , _ 1-B''1� 95 7, _%'_� A. ' 0 .6 , �"'��
PERMIT NO. /5,.51O DATE IS' ED
CONTRACTORG'-e-I..S/1l /, e`vs�oy-7 z 4 S PHONE 952 /c3 7f
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECj} ATE
FOOTING I.JC— /Al'/ s /
_ Vi -
FOUNDATION (Prior To Backfill) f� �,�/c.
RADON RETARDER , )006
�,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATER/SEPTIC 1'I (al /CC—
FRAMING
CC ---
FRAMING �C �g > �y i
INSULATION 6 Ss-i
ELECTRICAL
PLUMBINGVis Udo fi // 27/ " l 06 27/. /6---
HEATING
FIREPLACE A115
GAS LINE AIR TEST , , /v L g ��
RADON �
COVER NO WORWC.
/NTIL THE ABOVE & ( l/b
HAS BEEN SI N D
HOUSEWRAP 0 71( .-- LATH
FINALS
GRADING ( PRIOR TOODDIN W C. T1' P V e/r
BUILDING r' Ove 4e I/ i C i6-
LECTRICAL
PLUMBING ed. i20 <�
HEATING Me/
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
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