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of PR1f3 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE O 4
AND UTILITY CONNECTION PERMIT l- tel. `S
rn
'dI�rNE$p'�� I. White File
2 pini City PERMIT NO. //� !/7
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/ oSG A°r6.1 0.0sc -S're1
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNERj� 9
(Name) jai h h kre, -�1 t'9_0 (Phone)
(Address) 1 6 0S Art 4.1 oa set. 4'r i
BUILDER rr /
(Company Name) /+Spc,% P.C�-e�cl'r-c IAC (Phone) / r
(Contact Name) 1f11�Ce^ (Phone) 41Z �!q Q e 0
(Address) vie r_ "c. s7
TYPE OF WORK ❑New Construction ['Deck ['Porch [Me-Roofing Elite-Siding pfower Level Finish 9 Fireplace
❑Addition ❑Alteration OUtility Connection 3 s
CODE: ❑I.R.C. ❑I.B.C. 9 Misc.
Type of Construction: I II III IV V A BP
•
PROJECT COST/VALUE $ Zeto®B•o—
Occupancy Group: ABE F HI MR SU
(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 c evoke is permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X -("e^ 13 C C23 W 7 9 -29- 1S
Signature Contractor's License No. Date
Permit Valuation 31 U 0 o _ 00 I, Park Support Fee # $
Permit Fee $ 7 V IrSAC # $
Plan Check Fee $ ��__� Water Meter Size 5/8"; 1"; $
State Surcharge $ / x--11t1 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5t2 , 5-0 Water Tower Fee # $ /
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 50_ 50 TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid /77 2-3-2-3— Relpt No. 300-0
Q
Date !,Z_? :,/ •
Building Official Date 410
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 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 notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
°4 FRt°,A
CITY OF PRIOR LAKE Date Rec'd
1( NTA
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
*NESQ) I
r
Pull%en fide PERMIT NO. till 1
. Crrec�tr
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS , IZONING(orrice use)
a 13'°%7 1WtOt14
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)amRrtc "�-l 1 - (Phone) LiI q o
,,,
(Address)9---)Ci ?toe (be 1,t prittiai (..49‘011
APPLI Ira .`�` �{"� � ,� j�
(Name) . t✓ t ) (Phone) ti l` ! " 6
(Address) V i(ado td ..i �.: v
(Addre s) ( 7.4...-. Z Code)
(Contact Person) �filL, _ .. (Phone) 6 " Lig?VCI IL,
APPLICANT SIGNATURE ( rkit c
,' S
v j DATE
ICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION D REPLACEMENT ]ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM H'F,ATING OR POWER PLANT
DWarm Air PlantsPLEASE NOTE: Air Conditioner
0 Steam Units and Fireplaces Cannot Encroach
0Gravity
'Mechanical 0 Hot Water into Required Side Yard Setbacks.
0 Radiation Fireplaces with Box Additions or
DAir Conditioning ❑Special Devices
['Vent.System ❑Other Devices Cantilevers to the Outside of Buildings
/�" �r��. Require a Building Permit.
FIREPLACE MAKE AND MODEL Y1 (r 6 L O "t t.
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 $49.50
Estimated Cost$ Building Permit
/°# T�
Pilo
HEATING PERMIT FEE $ 14 .0"' Or"
STATE SURCHARGE $ 1.00 , IN; r
TOTAL PERMIT FEE 5 . !Q
(Office Use Only)
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
4646 Dakota Street S.E.,Prior Lake,Minnesota 555372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /565 (, APPA OrA
NATURE OF WORK / .l lili5
USE OF BUILDING 3 �lfs-
PERMIT NO. /S. Hi? DATE ISSUED 9. 21. 15-
CONTRACTOR ,spot/ /t h7ed,61 ' PHONE (,iz , fO. WO
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SISINIMMUNIIma
FRAMING (1//2./
INSULATION
ELECTRICAL
PLUMBING
HEATING
FIREPLACE
GAS LINE AIR TEST
arm 11110111111.1
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
BUILDING 92/}j ),
ELECTRICAL
PLUMBING
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