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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I/~/o~
White
Pink
Yellow
File
City
Applicant
PERMIT NO. Ofo . 00.5 Z.
ZONING (office use)
1215" D
LEGAL DESCRIPTION (office use only)
LOT .3 BLOCK S ADDITION
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PID 25./4-3. O~~.O
OWNER
(N ame)
(Phone) (;,5:/- U 0 - '-10 ))
(Address)
(Address)
(Phoneff'52.-- f tt -S~ 7d'
(Phone1t11, - 'iff - 5"~)i' C"-;q-) Jt
,J '2.0
TYPE OF WORK QJJew Construction ODeck OPorch ORe-Roofing
~ddition OAlteration OUtility Connection
CODE: 'lSll.R.C. DI.B.C. 0 Misc.
Type of cto~stmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
/SO/ (J7}t;
I hereby certify that I have ti.lmished mformation on this application which is to the best of my knowledgc true and conec!. I also certify that I am the owner or authonzed 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 buildmg
official can revoke this permit for Just ause Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspectlOns.
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Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; I"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee t..D "rr $ Water Tower Fee # $
Mechanical Permit Fee 'CcNl. $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE CAue70 I . Iq. Ot;? $
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 Cit Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
/-/7- d.6"
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
....
White . Building
cana~ . Enaineering
~ink , . Planning)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ~ ~?) C .~i::' Vi ,I I~j E / IcE lj u C /v/'/
I
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Accepted
Accepted With Corrections
Denied
Reviewed By:
~~
Date:
/- 6- 06
Comments:
"i"
~
liThe 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."
ltNhite - BUil~
Canary - Eng neering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
IfONCO~ eONSTK-o
/. 3. 0&
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/57CJ{) SKfLlrJ6 AVENUE: ;tiN
Accepted
Accepted With Corrections "'7
Denied 2P A
Reviewed B( Q$/". .
Comments:
Date:
I /'5'fr.
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liThe 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."
w~ . ~U:tll~~
ct,. ry. n Ineerln
Pink - Plann ng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
IfONCOI2 COtJSTlC-.
/. 3. 0&
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
157Qo S/G<fL/rJ6 /'IV6NuG NN
Accepted X'
Denied
Accepted With Corrections
Reviewed By:
~
Date:
1I1- ( 2. be
Comments: See:: Reverse Side for Aqditfonal Inform~tion!
. See ~t~fchments: 1) Grarding Plan, 2) Erosion Control Measures
"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."
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
3 n~()6
I. Blue File
2. Gold City
3 . Yellow Applicant
I PERMITNO.~~. OOSZ-t
ZONING (office use)
/5790 SKAjL/NC /ttIc
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 'cr-.. I'll. (;', ,. Ll
I OWNER
(Name)
(Address)
(Phone)
APPLICANT
(Name) AJl/l3o
(Address) t r; 0 ,
//~ r..re.J('c;a..~ ~((JM~(41C
I' .
Z:---+5T ;2 <gO Sr t,/-P b C,t~K
(Address) (City)
(phone)
1'iJ fie I -; 7VQ
')7db~
(Zip Code)
q/i) )9;1 /Ci/,,'
(Contact Person)
.T(~
(Phone)
APPLICANT SIGNATURE
DATE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Residential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
6t{
fit' 0 or7--
r5111l/
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
37.~V
.50
H. I/l..-
Date
Da~ cYj ()~
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONINGIFIREPLACE-PERMIT
\!-:.s ~Pf\;c.tXI(J- (C/r ~ ~ ~f '
~ 1 f69L/
Date Rec'd
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L~e-V ~1/__.sA-Ip-.... w/P...~,. w... ) i ~
3->8" r(}(,,; _ J. Yellow
"
/579()
sY-
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Address) . /
N,W,
~.
APPLICANT W r,
(Name) _~ -'Lg
(Address) \ l
(Contact Person) R \ c
\\v ~ C
sr\~
(Address)
~\~. 6S-l}~
City) (Zip Code)
(Phone) ~~ J ~ ~r;Lj~ 98'9 K
DATE' 3 ~;)/-O b
I APPLICANT SIGNATURE
APP ANT PLEAS COMPLETE BELO\V
DNEW CONSTRUCTION 0 REPLACEMENT ALTERATIONS . \
FUR.1'1ACE MAKE AND MODEL \7Wu-.. \U v()~()(l9v . FUEL tv k
FLUE SIZE )" ~V<- RETURN OPENINGS ~ INPUT L.O,060 OUTPUT 6S"-,J-O()
TYPE OF SYSTEM REA TING OR POWER PLANT
~arm Air Plants 0 Steam
OGravity 0 Hot Water
o Mechanical 0 Radiation
~ Conditioning 0 Special Devices
OVent System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Estimated Cost $ Building Permit #
fft.\ 0
&~I
Residential. Heating & NC (New Construction)
Residential. Heating Only (New Construction)
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Office Use Only)
.
This Application Becomes Your Building Permit When Approved
I :~eiPI No.
Date
I Pwd
Date
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
.
BUILDIMG AND INSPECTION
SITEADDRESS Jstr9'O S~~i\AO J4ve. ~
NATURE OF WORK 2".J... ~~u J4cM,^
USE OF BUILDING S FO
PERMIT NO. O&~". {J052. DJ\.TE ISSUED liSle<"
CONTRACTOR j~r- ~. . ~ V'\i~PHONE 95J-2''*' 'fS' 7~ 'Z~. (4
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT A L.. 4/2 . '(~o - ?'1~1
INSPECTOR DATE
I FOOTING f!P
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ,.~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I H~~,,"'f' F,~"t~fs){" I
.J ]0 ()b
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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59a~
/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
..M1'lUMBING FINAL
~H FINAL
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Pee t: h ~c=e If
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DATE TIME
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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.K"WORK ISFACTORY, PROCEED
(6'tORRECT ACTIO
o CORRECT WORK, CALL R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
_11
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/