HomeMy WebLinkAboutBuilding Permit 93-0436
~" "l<'b'"
.'.,.,.... ,
'..:,
.;, ',-'
~" '" ." ~..,.. '.v...... ~ 'A'~''''''' """".. " ...... ''';b
","'-.\... ....~-"..~',
4 z 0 if
a: (') ."
w ::> C\I t
~ 0 tu '1"
Z(l)
i= ~ -0 a: "'-
-r ::lz ...I ...I ~ I
u -~ I- el:: ...I
zatu (I) z 3:
w u::: I
! o~ I- a:
i=0~ a:...I ...I z ~
W
w fd~a:~Ci:~w~ ~
!;< &>~~3~iL~~ ~ ofrl
0 ~ ZlL
~:;C(l)lL...IflL::r -(I)
a:z
OW~(I) Wo ~ w-
~~~8~~~~ >.
lL 0(1)
oa:
0 0 00000000 0 w::;) en
z W W a:O (I)
...I Iii
2i ::;) o::r W a)
~ 0 ...I II.. ~ U
W lL Z W C
...I ::r ~ 0 CD as
< ~ 8 a:lL~lL~ ...I z W >
0 0 .0 -g
'::;)::;)::;)...I...=~ i=za:z
a:~8~~~3:~ o-O~ .5:
w~ta: U)
~ ~z::r(l) 3:~z lL_W< ...
(I)~lL ::I
(\1\ iii< a: a: a:ooiii oo3:z(l)~ 0
~::rw~w~~~ WWWoz .s=
s.. ::;)O!;< ~ ::;) wwa: -
...I~~:! WW...l ~~~~~~
t lL (I)(I)(I)lL
00000000 lL II..zo.
III III ..lL...IO .0
~ (.) ~o~o~~
j 0 ~~~~(I)5
II:~ o~~~~@
2z z ~ii~ffi
0 III I
II: 0 z i~~~~~
IlL _ Z en 0 III
II. t- ... i
t- en II: % .s= 0
o fd III ~a:a:a:lLW - ~
i II: III IlL ...
~ Ii z III 0a:a:8o&> 0
II: Q 00 I-z - Q.
~ -' J
III Q III 00 (1)_ a; U)
- z .s:
<J- IlL C 0 t- 0000 000 (.) 00000 u
1A13::1t1S ONtI H11t13H 1t1NOSl:J3d l:Jno). l:JO::l 3l:JtI SlN3n3l:Jtn03l:J 3000
W
:!
i=
~
~
W
!<
o
~
o 0
W W
3: :5 tu
o Q ...I
W W lL
::l ::r :!
<3 ~ 8
IIIIII~
~(.)tr"
~ S~
II:z~
o
a: z .
IlLOO
- Z
II. t- t-
0(.)-
> ~ :E
L- .,. a:
.- VI' III
U~1lL
if',
z
a:
::>
I-
W
a:
...I
...I
~
a:
o
I-
ofrl
ZlL.
if~
w-
>.
0(1)
oa:
w::> en
a:0 (I)
0:I: W III
II.. 0 0
W (,) C
m < as
z W >
o .0"0
i=za:z as
o_o~ c
w~t;a: U)
5;-w< ...
z~lL.o ::I
filO-z(l)1- ~
wlfj~o3:...I v
gooa:E::l~ N
a:0 0<0 c
lLa:II..ZO. 0
..lL...IO .0 :;:;
ii:o~ofil~ 0
OZOWI--
1-< IL(I)::;)
o O~~<OWO
Z <a:a:(I)Q.
ILOOZa:a:
III Z ~ . ~ ~~~::>wz ...
U) ~ ooQo i= ~ t- !<1-1-t;~S g
U) :z:: zz!;(m ~...,ja: z (l)frlfdwoo U 0
III a: IlL i=~J...I...IzOlL III ~a:a:a:lLW - U
a: ~ III 8<~...I<::>:!w :E ~a:a:~o&> ~ III
g ~ irl ILlf~~~~~~ ~ ~880~~ a; c ~
cOt- 00000000 (.) 000000 u ~ .s:
1A13::1t1S aNti H11t13H 1t1NOSl:J3d l:Jno;.. l:J0:J 3l:JtI SlN3W3l:Jln03l:J 3000
Ii
t-
Z
o
(.)
o
Z(l)
-0
::lz
~:5
zotu
o~
i=0~ ...I,
O<Wt-lL<
wa:a:z::;)3:(,)
5;~~3~IL~
Z:;c(l)lLO~lL
WO!::!:!::llLW
I-X<OOW-
C;;WJOIL(I)IL
0000000'R
Z
o
lL~lL...,j ...I
::;)::;)::;)...I...=~
...I~t::~<z-
- 8 81- IL
a:< I- (1)-
o~....w....z~o
zz....(I)...._~z
iii<a:a:a:ooiii
:!:I:WW~i=i=:!
OI-I-;>lLlL::>
3w~Wwww...J
lL.~;>~(I)(I)(I)lL.
oo~oqJOoo
z
W
~
~
o
I-
o
:I:
lL.
o
o
(')
C\I
~
"'-
~
~
.,
~
l
I
I
~
~
.~
~
~
g
i
W
:!
i=
~I
1
~
W
l-
e(
o
o 0
Z ~ ~
C5 ::> W
W 0 ...J
...J W lL.
...J :I: :!
< 0 0
0(1)0
~
.~
I
~ ~K"
Ci=~
..... 0
a: z
o
a: ~ 0
IlL i= Z
"- (.) t-
o III i
~ Ii a:
u ~ ~
c-.
1
,~
S:
fJ
"t
...,
U)
U) a:
III III
a: Z
g ~
C 0
a:
t-
Z
o
(.)
CJ
Z(I)
-0
::lz
~:5
zot;
o~
i=0~ ...J
O~Wl-lL<W
W,"oa:Z::;)3: 0
lL..... -'IL
(I);:I:~~o~
~<ff3lLgi=lL
WO~O:!...JlL ~
t-X< OW-
CiiWJOIL(I) II..
00000000
z
o
lL.~lL...,j ...J
::;)::;)::J...J...=~
...J~t::~<z-
- 8 81- IL
a:< I- (1)-
O~""W:I:Z~CJ
zz....(I) -~z
iii<a:a:a:ooiii
:!:I:WWWi=i=:!
::>frl!<t;~lL.~
...J"";>",,www
lL~;>~(I)(I)(I)
0000000
~
J
i
d
~
o
Z
~ ~ ~ =>
o CJCJi=o ~ W
:z:: ZZ~ID <...Ja:
IlL 8 -I-~::>:J~~~~
III a: (I) <~:J W a:
-' ILIL~~ !LOU:
~ 0000 00
1).13:J'rIS ON'rI H17'r13H 7'r1N
z
a:
::>
I-
W
a:
...J
...J
~
no).. ~O:J 3~'rI SlN3W3~m03~ 3000
o
(')
C\I
'1"
"'-
~
,f
"-
."
i
I
I
~
-
)(
III ...
C C
III 0
oS ~
... ...
.!2 ~
(ij ~
o 0
o
(j
CD
Q.
Ul
C
~
~
{
~
i
COr;.EOUIREMENTS ARE FOR YOUR PERSONAL HEALTH i SAFETYI
f 5" 0 n 00000 n 000 0000 ~ 0 . ." n
(I) ~ ~ z(I)oOO~ 0 ~o~ ~z~~ ~ ~ 0 m =t
J "0 ::I - ~ 00 -mO- ~8 Z 0 :II -<
~ CD 0 ~~~~~~ K ~~~~F~~~ ~ :II K
.., .., m 0
0 - - m ~~~~ m ~ or ~__ :II m =t
0 ':7 OOmmm(l) Z ~r> m zz % = ."
.., 0 III Z
~~O~~> ~ m ~ ~~~~ 0 ."
I- 3. ::J oo~ ~ < 0 0 Z ~ :II
:" CD z~e~~~ ~. Z z m
~ :u z o~ z 5
3' m~~~~~ 0 :II
(I) O(l)~' ~ . r-
OO S;~mo~o .
CD ~~o~o~ ~
!l 0' or~.. m
0' . OZ~~~ 00000000
::J O>OO~H . ~(I)cn(l)~~i:~
I\) >r=l~
.,.. rr_ m rmmm~>mE
rzO:tJmm e~~~ ~O~
':7 ~(I)Z!!!om ~-~mmm::l:m
0 O~~z 0 moo~~~>_
c Z~Z8(1):I:3:~
.., >m_~
U) ~O~m Q>(I) 0
3' ~d~O ~~~ m8>~
I>> z~z~ Z, ~~e~r;-
Q. Q' 0 ~ r~~~2:! 0 ~ 0
< m z 0 >
I>> > m 0 ~ :I: r
::I R m Z ~ m r
n ~ 0 m
~ :I: 0 r Ii'
m ~ e
(I) O~ r Z
~ em 0 oooooo~o m
0 0
~o ~ i:~(I)QO!; ~
(1)0 I
'< I m]jm>o~x~
-m 0 O'll~~iiifj
z~ d
(1)- >!;Oz!;:I: (f) 0
~z
~Q ~ 3:o!!m- ~ >
~
d ~ gm~~~ ~ m
m
i z r~
~ ~ ~ z
~ - m
i Z (I)
t r= ~ ~!;-
r zr
I ~ ~ oC ~
~ (l)Z f
~
I\) e m
..- ~ ~
i 0 ;Z
-,"._-~-'''-'-
.....~ -
---_..~
CITY OF PRIOR LAKE
DEe BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
-AND1JTILlTY CONNECTION PERMIT Q l: I, 7 (
Permit No. - I -..l....l...::::. \.,.c::::>
1. White
2. Pink
3, Yellow
File
City
Applicant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1. DATE
/,tP
'?7J
S"E.
3. LEGAL DESCRIPTION
LOT f:i /(
ADDITION ~
12, NO, OF STORIES
-03/0
14. FLOOR AREA APPORTIONMENT USE
/
Residing LI
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, ESTIMATED VALUE
I
Chimney LI Misc.
8. PROPERTY AREA OR ACRES 9, PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. tI Width tf 0 Depth I..? f Yes No
I hereby ce' that I have fumished information on this application which is to the best of my knowledge true and correct, I also that m the owner or authorized agent for
the abov e on op d t all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildi offi' k for lust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X #- /-.570 Lm1seNo. /Y /';L? 3
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPUCATION
SOIL TESTS LI ENERGY DATA -f--
SETBACKS: Required
Actual
PROPOSED GRADE FOUNDATION
IN RELATiON TO CURB OR CROWN
OF STREET
USE OF BUILDING
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS LI
PLANS & SPECS -rt-
SURVEY ~
PERCOLATION TESTS LI
SETS
COPIES Z-
TYPE OF CONSTRUCTION: I II III IV ~
Occupancy Group A BEl f(B).1
Division 1 2<!)
Permit Fee ..........,........,............... $ ~ r-lt:':1. ..s::: ~
Plan Checking Fee ........,.......,..,..... $ ~ c <c"., ,=-'7
State Surcharge ..,........,.........,....... $ ~ ~. CO
Penalty .............,......................... $
Septic System ,............,........,........ $
City:
/ -4 OJ ~ ~ ~ PLOT PLAN LI
Amount Brought Forward .................. $ I ~ $: <.:. ~ ('f
Park Support Fee ........................... $ 2:.~ ~ \ <:>. c:::.
SAC ......................................... $ 1"'7 (;. ~, '" ~
Collective Street Fee ....................... $ 2-C(::-.,. ,..)~
SewerTap ,.........................,........ $
Ucense Check Fee ......................... $
Pressure Reducer ..............,........... $
Meter Hom ................................... $
WaterMeter ...................,............. $
4s.
~(::)
Other .......,..,..................,........... $
Subtotal..,..,......................... $ 13 :::;: (~ - 1'7
Check if
Deferred
LI Sewer & Water Connection Fee ....,...... $
LI
Water Tower Fee ........................... $
q{:,~
'7~~. ~
...s.~~. "b
Certificate of Occupancy
Issued
WaterTJl!,.iJR.::.:.'~........i..l:... $
Other ..~.................~.L, $ I ~ ~ ~~. ~~
Other .......,....................,............ $
... T~~~~7r~~:~t~:: n
Date I d ';:3(2 -2:j By f( I1t-S
the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
s a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be issued.
..-- I 2 - 2...3,_C'~
Date Special Conditions ~ any
This Aplicati Becomes Your Building Permit When Approved,
By Date (2.. - 2.3> -c::;~
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
GREEN . FILE
YELLOW . APPLICANT
GOLD. CIT'f
CITY OF PRIOR LAKE NO. r; 1/ -J /)
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
SITE ADDRESS:
. ^ \
L\ I:, (
c_
PHONE: '0 C{J ~. J(( 4
DATE: 3/3~/ftf
BLDG. PERMIT # CC3 ~J~"
PID# J.s-J.!I - 113/ -IJ
l,v\
SIGNATURE:
FILL IN THE BLANKS
1. Estimated length of water service
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC
Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY ..)j1/'1-dJ;;Jw/f IV DATE: J/3.;,.;
======= ==========~==~==========================:=================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID ..3/3()/?tJ
RECEIPT # ,~ljJ
AMOUNT PAID ~~.J-V
REC'D BY 1-U
4629 Dakota 51. 5,E" Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLDYER
d
~
,
"'tl
m
:Xl
3:
:::j
-n
m
m
en
~
V\
-..........
f
\JCJ1
~O
:Xl
CD
o
CD
-S
'*I:
en
~
m
en
c
:Xl
()
:I:
>
:Xl
G)
m
~
~ ~
~~~
CD \ CD \
iL~
::I:
m
~
Z
G)
-0
m
:Xl
:s:::
:::j
-n
m
m
~
::0
CD
"0
III
:::;'
>
;:+
CD
.,
e
o'
:J
en
m
1Il
()
o
!!l.
~
L--j
~
\~ m
~~
::0
CD
"0
ii)
o
CD
3
CD
3.
~ ~
l'
.~~ ~
~ CD
co
-0
CD
3
:- ~ ~
t ~
~ g>
:J
!!l.
2
!l
o'
:J
r
III -. a. :J III -
"O:J 0 III g::r
~~m5<~
<00;) CD CD CD
III ., 0 en -, Sf
-a.....lllen~
so~g5.8~
~2883""Q.
;)~3a.""Q.-::.
en -. CD CD CD 0
. :T n't. (fJ ..... ..,
... 0 CD
...."0 ..... III 3
i6~"":JCD
III 3 i6a.g.
"O::+o~~
~ C 3: 0 0-'
O:J~c:
iii~~@!!!..
a. !!!. a. m ~
"0 co ~ ., en
ii)~ """::rm
:Ja.::r1ll3
:rCTS-:UJ
.... '< CD ::r"O
::r g. en CD CD
CDCD![~3
2 OJ CD Q ::+
ll:~g;>;"~
So05:~a.
l1b z~. ;;:: ;;;-
G)...... CD 0
~ 0 ~ -, 5
Q-no:Jo
;>;"-n::ro~
~C'5~gCD
::r - _0 _ ~
(5">2 Qco
::r.r:--3CD
m::r8~::T
.ge~oe
ii3' g. ,lI! : g.
en CD .... < CD
., ~ ::r ""'.
CDO~::ra
~. ~ :T =r Q
~ ~ iii' CD 3
III == 0 Q e
5. g 3 !?: g'
:c!
'tI
m
o
'T1
~
o
:D
~
)>
r-
r-
~
o
:D
~
3!:
c:
~
tD
m
Z
en
'tI
m
o
-I
m
c
'i
~ 0
~ c:
I C')
t :J:
Co) .:..
? z
)>
z
C
'T1
Z
)>
r-
......
I
()
3'
Q
::r
~
o
CD
<
o'
CD
en
o
)>
r-
r-
o
~
:I:
)>
r-
r-
m
~
s- ::OCD en ~ ()
-g ~-6 ~g
t j i ~i
o :!! ~
c: c:
-6" CD
c en
.... N"
~ l' CD
~
~
~
~
'"
3:
o
a.
~
en
j:.;r
CD
CD< ? 3: G) :E -I
.... m .... Q) <
3.()0~.,'tI
, 0::r::+3m
en:J ~'< >0
7ii g: o' :::;. 'T1
mer!!!.. -oen
3 2. ii) -<
<5 ~~
m
3!:
en:Xl:I:en:I:
-g~g.mm
o -. <:: III )>
;;;' e <:: 3 :::!
~ o' e z
:? ;) ~ C')
~. 0
2 :D
en 'tI
o
~
m
:D
'tI
r-
)>
Z
-I
()
~
::I:
l1b
CT
c:
en
5'
CD
en
en
::r
o
C
.,
en
III
m
<Xl
pi
3
~>"O"O
rn-o-<~
-0 III .,
-0'.,0
., 00.0
Q' > 3
, :::! CD ~
~O~5'
.CD z :;
en ()
3:z3:g~
> III en-
<.n -< ~. "0
<.n[Dg~
~meno
!'>3:en"O
>6~
r= ~ :J
m:JC?
o
-I
o
-I
:I:
m
()
~
o
-n
-0
:Xl
o
:Xl
"""
(.)
o
l'
3
m
:I:~o
m ~ ~.
~~::r
, ~ ~
o ~ 3
en m CT
en en ~
() Q So
> III en
'a.c:
() a. "0
C ::+ "0
, 0'-<
}> 11l III
:::! en ;)
~OCDa.
~~~~
~-o8:;
m>"o
I\) -< "0 "0
to 3: ii) ~
o m :J -.
III Z ~ <5
6-15' en
ill > en iii'
en.~ Z c: m
~ 0'"9 a.
F'f
:J :I:
co 0
o c:
CD en
::\. CD
::o::I:
o' CD
a e
CD 5'
o co
.....-1
o CD
g !!l.
-6 ::0
III CD
5 8
'< a.
~ 3
c:
g ~
iji" CT
en CD
c: en
CD c:
a. CT
3
:::;:
m
a.
~
~
>-1
a. ::r
a. CD
;:+'
g' -g.
!!!.. 2
5' 0
en _
"0,<
CD 0
g. c:
o .,
:J ::r
en CD
~. ~,
CT :J
CD co
g-g
CD .,
a. 3
e ;::,:
~ :J
I\) !2.
!11 c
o a.
o CD
CD en
~ g
?" CD
(3
c:
co
::r
,
CD
.,
CT
CD
0'
m
CT
!::.
9=
-I
CD
CD
"0
::r
o
:J
CD
'*l:
}>
a.
a.
m
en
Ul
::I:
CD
e
5'
CO
~
<.n
o
b
o
~
III
:J
a.
o
<
~
:J
III
:J
a.
o
:J
CD
g- m
:J CJ.)
!!!..I\)
~g:
g Q
o g.
Q CD
.....
@ -
~ ~
c5" ~
:J <.n
g.o
CD a
m 0
o 0
:-+'"'2.
c:
en
~
--.J
en
o
~
CD
III
o
::r
III
a.
a.
"
:J
!!!..
:J
en
"0
CD
!l
o'
:J
}>
a.
a.
m
en
Ul
o ' en
~ g. "",.
;) CD
~~>
en' &:
~ - ~
3 OJ en
CD 0'
o
;>;"
~
~
o
b
o
~
~
~
~
o
o
o
.....
~
o
o
o
~
<.n
o
a
o
o
~
.....
o
b
o
o
~ 0' ~
o :J CJ.)
a III I\)
o en
!:l~o
..........
g Q
o g.
o CD
o .....
., .,
.....!!l.
m
!l
- -
..... I\)
o 0
o 0
o 0
o
o Q
.,
.....g.
@ CD
!l .....
~r ~
g.~
CD
m a
So8
0""Q.
III C
:J en
a.~
~. N
c<.n
Q.Q
5' .
co CD
~~
o ::r
a III
o l5:
!=> ::+
0'
:J
!!!..
I\)
~
So
15"
CT
<
III
C
J>
3
5'
~
I\)
!:l
o
o
~
~
o
0' a
:J 0
.... 0
~""Q.
., c:
CD en
_2. ~
o 8
~ ~
a.
5' m
o g.
c:
a.~
:J a.
to .."
\
o
V
-
,
(j
c....
o
OJ
<
>
,
c
>
-I
o
Z
-n
m
m
-
Ul
Ul
Co)
.....
N
(')
=i
-<
o
-n
"tJ
::D
-
o
::D
r-
:I:-
"
m
i 1
"tJ
m
JJ
3:
=t
"'lJ
CD
3
;:,:
Z
o
~
~
()
o
3
3
CD
o
~
en
5'
co
CD
-n
III
3
-<
r
s-
a.
c:
~
~
-I
~
o
-T,
III
3
-<
"'lJ
c:
2:
o'
Q
::r
CD
.,
3:
C
:::+
:;:;
III
3
-<
~~~
-(G)"tl
~$~
~ :::l
b'Q~
:::l':<<D
~
ll:
Q
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~,~ ,~.tf
APPLICATION RECEIVED ,--=- _::- ___
The City of Prior Lake BUILDING Department has reviewed the
building perm~...l~cation for c~nstruction activity located
/ :7 f ~ 9 . dLA-~ ~.. f!;1 ~C'~c .
Accepted
Reviewed by:
Comments: i
-c:-
--..::. '
at
Accepted with Corrections +
.DJn.. ied
L~ Date 12.- ~-~
It... " ~ I::.,. t 1--1/"- ..... "I O\. ~;:'<:",.....J ~ 'l:\: \
s,,,,,,,,\\ ~ (~r~u'te..;..~ ,.....~1 I,~
~.=:'~ E..,...~0I-~ci..,. OZ\~ +=:.
~ I
)---e,.~ ~ ,r.:"" ~,
~
~~: N +~ I~ 6-4)~I'<'t''' ~-.;~ I .
C',_~ I6dx - . "'" f;e~t's,- ~~~6.- ,___+,
_~2:'"~ ~'-',.... ~A...L,::.- Q .:::-, ~.p.^_O'v~ s.~l.-.... A~l E',
L= N "'" S, -\c..d~ \ ~ ~~~
Dr-~ -tr^-...~ \ ~~ - --.;;:;.~<-
~~~.
hf_"::;'"
("::;;~\.rt!>o.
~
AAj:.... .\..::; I...,'./.. \
-=- ~\1f>:\-c:.. '^^H::;;,
"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."
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 9~ ~ un !Jf
APPLICATION RECEIVED I:) c~ - 9~3
The City of Prior Lake ENGINEERING Department has reviewed the
building permit~apPlication for construction activity located
/730'1 j(~-,~ ~2 S~ .
vi
at
Reviewed
Accepted
Accepted
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."
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
:::r:T:::L:::VE9 ~ ~~~~1 ~{
The City of Prior Lake PLANNING Department has reviewed the
building permit application
/73(" '1 ;gd-r'~
for construction activity located at
(!~ ,5 ~
/
Accepted f.
Reviewed by:
Comments:
Denied
M(],
Accepted
Date
/
"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."
~~
- ')J
V'
- I
CITY OF PRIOR LAKE
1, Blue
2. Gold
3, Yellow
File
City
Applicant
Appl_t &~U~~':C;;!:~n; Phone: 0/';;t}
..~~'~ ~~ I ,-./ /
A~dress: / L ". X)~ ~""_,....--
Signature: ~. e..-
Legal Description: Lot B ock SUb:
Site Address: /73 f.~ '/ MdJtvDoO e=-f-
Building Pennit # cr 3.- Y ~L, PID #JS--1-?t/ -0..3/-1)
NOTE: This permit will not be processed without complete infonnation.
FIXTURE UNITS
Unit
Quantity Type of Fixture Amount Total
?- Bath Tub with or without shower $ 6.00 /;A- ()~
I Dishwasher $ 6.00 ~.OO
I Floor Drain $ 6.00 ~. 00
5"" Lavatory (bathroom sink) $ 6.00 3006
/ Laundry Tray (1 or 2 compartment sink) $ 6.00 t.OO
-'Z Shower Stall $ 6.00 /2 DC::.
J $ 6.00 . 00
Sinks: b
Bar Sink $ 6.00
.~ Water Closet (toilet) $ 6.00 zy 00
Rough-ins $ 6.00
I Water Heater $ 6.00 ~,OO
Water Softner $ 6.00
Stand Pipe (washing machine) $ 6.00
Sewage Ejector $ 6.00
Backflow Assembly (RPZ, Double Check, PVB) $25.00
Backflow Assembly Test $10.00
Lawn Sprinkler $25.00
Other $ 6.00
Minimum Fee $25.00 / () too
SURCHARGE .50
GRAND TOTAL $ 10 ( JU
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
o~ th~ S~te Plumbing Code and the amepdm.e9tst\Jereof.
S t ECEIPTNO. Sf i f!.f1.J DATE
ATTEST
Call for all inspe 0 s 24 hours in advance.
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
AN EQUAL OPPORTUNITY EMPLOYER