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aF PRioR CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
Ft.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ( ls. (6,
tt7
AND UTILITY CONNECTION PERMIT
41/HNESo2! i. White File
2. Pink City PERMIT NO. /67.. 2 6
3 Yellow Applicant �C
(Please type or print and sign at bottom)
ADDRESS
ZONING(office use)
r
c � l
N\I\I
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name)
Pen l 1 J ay C.1e-,vice_ _ K.r-_No--
(Phone) l�e9 i 920 O
(Address) 3135 -/1�`„: ----Fra, , IQ
BUILDER • ��- C. /
(Company Name) LJ J1 n ) 'J C 4 j V)� O 11 (Phone) �s� !P ljd 7 7k)
(Contact Name) (Phone)
(Address) 0 7 O- - _ --1--‘rci1 1
TYPE OF WORK ❑New Construction ['Deck ❑Porch [112.e-Roofing ['Re-Siding ,ower Level Finish ❑Fireplace
❑Addition ❑Alteration ['Utility Connection 3 4411.s ,-
CODE:
CODE: ❑I.R.C. ❑I.B.C. ❑Misc. •
Type of Construction: I II III IV V A B
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
(excluding land)
Division: 1 2 3 4 5
I hereby certify that I have hirnished information on this application which is to the best of my knowledge true and correct. I also certify that I am he owner or authorized agent for the
above-men 'ned property and that all constr tion will conform to all existing state and local laws and will proceed in accordance with submitted lans. I am aware that the building
officia afg, oke thu permit for just c'use trther orr0, ree t the city official or a designee may enter upon the property to perform needed inspections.
X ' i...) • / -71, /_is
Signa e C o Date
Permit Valuation 4-, 0 0 0. 06 Park Support Fee # $
/
Permit Fee $ /1/. `✓ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ I.`O O Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5-0• 50 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ ZZ"2
This Ap. it 't,I:, omes Your Building Permit When Approved Paid Z Z3, 4--..5-' Re 1pt NO. 947
(�' (� Date (� �$ IGB
1
1.0 i init 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. 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 PRxo Date Rec'd
`9 i3
i.'`, -1,4
CITY OF PRIOR LAKE PLUMBING PERMIT
1.011e N
Cie
PERMIT O1� 3(Q
2.Oold City Y 1V
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 3 13s s\ ��a N� ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID ` '
OWNER �`� e��``� Voy\> lJ�'� 7C -- ' `UO!•
(Name) �' ` (Phone)
(Address) V.
APPLICANT l� % s1 -- 31 / G- &
(Name) i,,M j � -� (Phone)
(Address)165- \*21-YrN'IN S"bf %'tie-) Se;,r"\- ,53-A/
(Address) (City) (Zip Code)
(Contact Person) \1` "`2, re-N_ . (Phone) 657)- 775--H.S'/
APPLICANT SIGNATURE � dt — DATE �/ ) /lV
APPLICANT PLEASE COMPLETE BELOW I
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub withor without shower Rough-ins
Dishwasher - Water Heater
Floor Drain Water Softener
Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
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 ••
i
i
The Minnesota Statutes§3260.148 est $ Building Permit#
"SURCHARGE"has been changed for one MO
year effective PLUMBING PERMIT FEE $ . •
duly 1,2010,until June 30,2011. STATE SURCHARGE , $ 't �
The minimum surcharge fora"fixed fee"permit TOTAL PERMIT FEE $ ems
is ,beginning duty 1,2010 'it/-
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
Platt Contracting 952-400-4976 p.1 PO
04 IIRI0� CITY OF PRIOR LAKE Date Recd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT Z. f/ 16
rzg i/,i9,���, /(e -6.03b
l*NB9o�
r yi!e PERMIT NO. �j, U//
2.Gran Cay
3.Yellow Applicant
(Please type or print and sign at bottom) TOI�III+TG((Accuse)
ADDRESS )
LEGALALOCK
DgSCRIP'I`IOI3( use only) c-'27,14-4
� ,, ` J //
LOT ADDTTIO '//7 PID 25---2),R2 "L'7 `7`--
O(N ) Valliir) t Ff.'i.rl kooxi (Phone) r – la&`17SO
(Address) "3 (;s"- &,‘,4.4-4f- i1 Jut..
APPLICANT° �,a hone �'1 Z`�3 C 7l$(o
(Name) T 1�� („�h�fb"w�t f_____.,e�Jz(.��j Z �✓" - (Phone)
Zi � P we I Dr. Pyr,a kr /+ke t ►� O X6'-37 L..
(Address) o i>1(Address) (City) (Zip Code)
�-� {t" (Phone) (�!z —OW— 0�fY�G.,
(Contact Person) /i` ri — J y� /j
�,�,I DATE
APPLICANT SIGNATURE _–E'.!��"
APPLICANT PLEASE COMPLETE BEL/41,1
DNEW CONSTRUCTION 0 REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL &GPIT Pei i Isil t^+( (943 I+w +s Fel.0-4. F.P. FUEL
FLUE SIZE
RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM SEATING OR POWER PLANT PLEASE NOTE: Air Conditioner
°Warm Air Plants Cl Steam Units and Fireplaces Cannot Encroach
°Gravity 0 Hot Water into Required Side Yard Setbacks.
Q Mechanical Cl Radiation Fireplaces with Box Addittiions or
°Air Conditioning 0 Special Devices Cantilevers to the Outside of Buildings
[WentS�y.�+ ❑Other Devices Require a Building Permit.
FIREPLACE MAKE Alm MODEL
FEE SCHEDULE $49.50
Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace
$49.50 minimum S49.So
Residential,Heating&AIC(New Construction) $149.50 xrResidential,AC Only $49.50
Residential,Additions&Alterations
Residential,Heating Only(New Construction) $64.50
Estimated Cost$ `7 1'GI) Building Permit #
HEATING PERMIT FEE $ '1' ,,,s-z)
STATE SURCHARGE $ 1.00
TOTAL PERMIT FEE $ `iO.50
(Office Use Only)
d r� Receipt No.
�
This Application Becomes Your Building Permit When Approved ( Paid \ r�;
1.Date rll�� I�( , ; (� By ` �" `^9 f
Satldine Official Date TJ
24 hour notice for all inspections(952)447.9650
4646 Dakota Street S..,Prior Lake,Minnesota 5538
PRIOR
LAKE '
AND DEPARTMENTBUILDING OFINSPECTIONS ENGINEERING
INSPECTION RECORD
SITE ADDRESS 3135 &2w4rr '7 TOM- NA/
NATURE OF WORK Ld Wf L
USE OF BUILDING £s 4//
PERMIT NO. /6. 0034 DATE ISSUED 1. /51.
CONTRACTOR gQWlyr PHONE_ 2, 484_ 7Sb
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECT1.11.11
,Q DATE
r
esota DULL Online Electrical Permit System
For IIomeowner,
111111.1.11111111111/ www.dli.mn gov/COLD/
PLACE NO CONCRETE UNTIL ABOVE hkp�CC;� ;;=`homeowner
ROUGH - INS
FRAMING
Pk/ 3/74-Z
INSULATION
ELECTRICAL
PLUMBING
HEATING
FIREPLACE
ammisma
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
BUILDING "Am" 7/z,--/
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