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OF._17t,//04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
,, a TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
= x AND UTILITY CONNECTION PERMIT
u til
414NESOI.r 1. White File
2. Pink city PERMIT NO. r Q
3 Yellow Applicant 1S
.. rp_{3 .
(Please type or print and sign at bottom)
ADD RESS //�� ZONING(office use)
I (P L"0 Ad/ Are .Sa- /`as f-"
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) I<(Chard Il• b ta,b rJe i s-o n (Phone) De), (et 1 a ) /of_ kO o i
(Address) (4%O Do/0 i1 4t- Sau �j 15:44..s.4-
BUILDER
(Company Name) \\Coe- ` CooNs 4- ..c... (Phone) ( to l,�-) c/ 1 — -74112
(Contact Name) 1.J di--` G "
° -`f"-— (Phone)
(Address) E ( 7 4 I Y s-4-is 4-,,,c- N'^' 1 44-#-.,014.-... ...- S c 3 e+3
TYPE OF WORK ❑New Construction [ eck ['porch Re-Roofing Erse-Siding avower Level Finish Er<Teplace
['Addition ['Alteration ['Utility Connection
•
CODE: I.R.C. ❑I.B.C. Misc. 7 roc.. "T'dh
Type of Construction: I II HI IV V A B 4d, rj
Occupancy Group: ABE F HI MR SU
PROJECT COST/VALUE $ l dr-it DO
(excluding land)
Division: 1 2 3 4 5
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 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 this ermit for Just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X 4-c a-o 5--cg/ci k 7-/5 -do// --
Signature Contractor's License No. Date
Permit Valuation to ( (). — Park Support Fee # $
Permit Fee $ (5-K SAC # $
Plan Check Fee $ t0,M''OP Water Meter Size 5/8"; 1"; $ r
•
State Surcharge $ e{3, !� Pressure Reducer $
Penalty $ 1 Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 54_Seo Water Tower Fee # $ --
Mechanical Permit Fee $ S 4 .S0 Builder's Deposit $ .--
Sewer
Sewer&Water Permit Fee $ Other $ ..
Gas Fireplace Permit Fee $ 4;1- TOTAL DUE $ Z' /_
0 . 5e
This lica ion 'i•co •sYou`BuildingPermit n •+.provedi ik Paid . 56 Receipt No.4p �pZ
�i ,� 1) Date L 1 I By
•
•
Build'''. Date
r
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. This document
when signed by the C Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued // // /`ep��ee �alr.ge ?Ire.
7.o?/—
P. fling Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
rO� PRIp,e
ti
U tr I m
i to - Building
JNNEso�P Pink - PI nn nging
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT _ 0 L _A. N c._
APPLICATION RECEIVED 1 ( 4E, fl‘
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Co lk"c,c:7 D LY b L.).-T-Ct.-- L-- S. E. '; ' .
Accepted Accepted With Corrections
Denied
,i
Reviewed By: L , .;t _ Date: 42, 1 ( 1'
Comments:
- Ccw^x�t-.� E12.--- ,S1 0- •) . ^ 4f N T —t'
LiCy`4siO ST-r2-(Z-- —S kr-- kut--774.1.&-5 .
"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."
AUG. 30. 2011 12:26PM METRO AIR 952-447-8126 NO. 622 P. 1
CITY OF 1'1UOIR LAKE Mite)fleet
0 VRI0
n ,:,. )'.:1,I HEATING/AIR CONDITIONING/FIREPLACE PERMIT
i
1-"kik niq FintiV.—ifFINOitreQ��NiY115 � x Ydium A ccd .,,r_
luny qv or mint hifbalga bottom) _._, ---.- — --��— ZONING(untccwe)
A1FT
7DItI35S . .. _ .
L_. obv\'&V- __-k--. r-
..
13I(311L T)11SCitxi''TION(once use only)
LOTBLOCKADDITION _ PIO _ '
(Name)._.,C,� `;T•kc\
(1�'tt,LI %I 'A' ti' 1 k�'Y'D 5 n .-C L- - (Phone � `�Ut 1 "2)5
\(4 k\ L 0 rt.k. )/ kk C r'I .01" \-544-9 5' S" .31
(Address} -
� � -
(Address)
(city) .r (Zip Code)
C1 -\1� ` �_�
..
(Contact l'erso .) trC (‘) ..L . Pum, , _..__ -
AAI7SAVFLICANT SIoNA:rUU
s^(-c1" BELOW
APPLICANT PLEASE COM BLOW .�
°NUW CONSTRUCTION = �c>✓1 LAC1sN413N•r [1 nu:113 AT1ONS
FURNACE MACE?AND MODJiT �1 1V( *P 1p0 PUrL Nc
I?LUJ.i Sall) f X G =rum OPItNING'S --- INP w' 9 WI_. OUTPUT O
T YPL OF SYSTEM HEATING,Olt POWER FLAJV T "'
y 1'l, "Asig NOTE; Air Conditioner
-LllYarm Mr Plants 0 Stout U11iis anti Fireplaces Cannot Encroach
17.1 arm,ity • • El 111)0I'eter into Itcquiraci Side Yard Setbacks,
1Hctc11(In1CFlt El Radiation • ltifoplii i<.s•witll Box Additions or
Air Conditioning El Special Devices._ ,.____ __
C_JVenl.Systeut 0 onwr Doing -_-_ enutllevers to Mu Onlslde otllulltllttg
_._....V-._. I,tec}uil:all Itu11dliigPCI'I1111.
1f IRl"sPLACl3 MAKE AND MOD)31, --
FFI:E SCHEDULE
lutluslrinl,Com ic:relul&MttlltAm.ily 1%oajob cost Itcaidonlial,Ons Itiroptscu - $419,50
$49.50 tnininnun •
Rcsidei i I,llenling&A/C(Now Construction) $149,5D Ite:Moulinl,Atttlilioni&Manila's $49,50
Residential,I1c ting Only(New Conntmctiou) $G4.50 lteeldenllnl,AC Only . $49.50
FicAD ]3st ilunteti Cost S Bn klittg Permit II _,,,_,., • _ _
AUG 3 t 2411
GfLATNa LIKMIT I;13B $.___
p4
RSiCt4N ' STATE SURCIIABO S_ I® W
ini
TOTAL I',EItdITIr1L $ _Y- 11. 1 �Mel. w Ueo only) // -
� ' i
Tit is Altlt}icallon MMus Your Building Peru]it Wlii n Agi oved Paid - RocoiptNo. -�
Italldlnk OJttekd Dalt w
24!tour mike for ilk lattpggltons(952)447.9850,fox(952).447-4245
4646 Dakota Strcc .I,.,I'rior;Alto,Mims ata 55372
.. P Itlp Date Rec'd
a, CITY OF PRIOR LAKE PLUMBING PERMIT qz_/1
kt,,
,.BluGold
File
PERMIT NO.HIV
2.Gold i
3.Ycllov Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
16a1COO Dui ofh ve
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PM
OWNER
(Name) (Phone)
(Address)
APPLICANT i
(Name) eke 13 l u rve 1l9 4- Di a i l a to n oli 1 L l(,(Phone) I(P51) 325 - 8137_
(Address) Col q.1 Hok L
� DY 'V9� La k Vik.1
(Address) (City) (Zip Code)
(Contact Person) . I (Phone) '(.(D I' 115 - 007-q
APPLICANT SIGNATURE r, i 'A..,.� DAI`h I . /
f
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Z Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
1 Floor Drain Water Softener
?) Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
l Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Z 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
The Minnesota Statutes§326B.148 est $ Building Permit#
"SURCHARGE"has been changed for one
year efTective PLUMBING PERMIT FEE $ PAID WITH
July 1,2010,until June 30,2011. STATE SURCHARGE $ .5°BUILDING PER
The minimum surcharge fora"fixed fee"permit TOTAL PERMIT FEE $ MIS`
is 55,beginning.July 1,2010
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
EDEPARTMENT OP
PROR LAKBUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS t L 4 7 z--b.4 ,4 v-6-
NATURE OF WORK - E-o IP �iFt� _ c- SL ,t -: -
USE OF BUILDING
PERMIT NO. kl-(o93 DATE ISSUED a/ ill
CONTRACTOR &06-rr (.3c. PHONE (a (-4- 151 --7c-,7 ZNOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS 1ELAOW,
E PERMIT IS BY SEPARAT DOCUM NT
Ivy
THE �; :�-� y 1� �,� -� DATE
�crrot s
�cr- - l�o �fy Iw C.._ -'�"' L.. NSPEC �-'•-� t�"
FOOTING c, 1�-
(Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING - C. j2• t K ?
INSULATION 'l '15 /J
ELECTRICAL
PLUMBING V) / - -Afa-S-4 Pt‘-gait
HEATING if required) !- 7/
(
FIREPLACE A 1o4r i e EA-s /,'J j: L6c 7tfW Zia /14oWR
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BE N SI NED
41- - ro /'o 1,, f(io to /2 ! '1A/4
FINALS
(Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING ' € l efr7'11
HEATING /I /d(07(«
DO NOT OCCUPY UNTIL ABOVE HA 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