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(I) ~ ... >< W Z W J: ... 0:: ;;; (0.. ~ ~ 'll i:: ~ ~ c ~ Q., ~ ~ ~ ~ ~ ~ ~ ~ ~ ::5 Cl ~ Ill; ~ 8 I CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d I ~~~~ew ~l~lican, I PERMIT NO. t/ 5' I J-J-f (Please at bottom) ZONING (office use) ADDRESS /'-I5C;0 11/1 II) ~ PI{ IA/Y {JuS'D LEGAL DESCRIPTION (office use only) LOT I () BLOCK -3 ADDITION PID '1- G) -3 ;;2- (Address) 7/~ i ~ /4,;s(:J PI[lJ('{~ /, tcl<:,. (Phone) OWNER (Name) P/~ (,J BUILDER (Company Name) (Contact Name) (Address) (Phone) (Phone) TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OAddition OAlteration OUtility Connection 0 Misc. ower Level Finish 0 Fireplace CODE: ~I.R.C. DI.B.c. PROJECT COST IV ALUE $ Type of onstruction: I II III IV V A B (excluding land) Occupancy Group: A B E F H I M R S U Division: I 2 3 4 5 Contractor's License No. Gas Fireplace Permit Fee ()~oo Park SuppeJffFee # $ SAC # $ Water Meter Size 5/8"; 1"; $ Pressure Reducer $ Sewer/Water Connection Fee # $ Water Tower Fee # $ Builder's Deposit $ Other $ I" O() TOTAL DUE $ /7tl, t,.~ Permit Valuation Permit Fee Plan Check Fee State Surcharge Penalty Plumbing Permit Fee/] 'v. Mechanical Permit Fee r-- 2.60 Sewer & Water Permit Fee This Application Becomes Your Building Pennit When Approved ~?jf lluildlll!! Official dl/ {(plOY r Date ThIS IS to certify that the request m the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constautes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be I issued Planning Director Special Conditions, if any Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd I. Pink File 2 Green City 3_ Yellow Applicant cJ. () C. (; ( V L.- NO. 05- 07 I ~gs~Prin7~;;~ ZONING (office use) (j)r' II) <;. Qack tilt) :J LEGAL DESCRlPTION (office use only) LOT BLOCK ADDITION PID I OWNER (Name) (Address) 7;;~ ~~t;QP~r~ ULC1~ APPLIC~ a 11 th cd g (Name) \ fe ~ 1'(, (2 to~(' ,om e, I/HfDj7 3950 Wlfwy /3 (Address) S (Phone) Gi~-~3~""B9~~ APPLICA DNEW CONSTRUCTION FURNACE MAKE AND MODEL FLUE SIZE RETURN OPENINGS (Phone) Cf ,d,- cPrlt'.- O?sg EtA Yflsv,'J/(!- J 117 tIJ...5S331 (City) I (Zip Code) (Phone) C{s) - 090 --I'J75lf DATE ~ (Address) (Contact Person) , APPLICANT SIGNATURE PLEASE COMPLETE BELOW D REPLACEMENT D AL TERA TIONS FUEL TYPE OF SYSTEM INPUT REA TING OR POWER PLANT OUTPUT DWarm Air Plants DGravity o Mechanical DAir Conditioning DVent. System o Steam o Hot Water o Radiation o Special Devices o Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks 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 Residential. Heating & AIC (New Construction) Residential. Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ Building Permit # HEA TING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ 39,)0 .50 qO,() 0 (Office Use Only) pplication Becomes Y p.ur Building Permit When Approved B.nd;., :ffid., (),J WI LOS 24 hour notice for all inspections (952) 447-9850, fax ( 52) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 By Paid Receipt No. 19f:Ll? Residential Building Permit Checklist Basemen! Finish or Interior }Jteration to Single Family Homes cI5-1J-:J.- Bv. ~ . ~~ Date: :;)-/s-s Zoning: .. 1(/5'~O j/J-dJLt0 /l4if, Subdivision: ~ JJJL ~ Building Permir #: Site Address Pill: Legal: L 10 B :5 E.risting 5trucrure@or NO CONFORLvIS TO ZONlliG Y~S NO ORDINAJ.'fCE YES NO Is chis ~"l ex:panslon of the exi~c.ng foorprill[ or R~fe: ~o Pl2.Iil~"1.g building height? j}tJ Is w.1e proPer:-f located within the t100d plain? I Refer to Pl3.I1J."ling I NO Does t.he alteration inciude any additional ~<:itchens? I Refer m Planning I ~IJ Does the pro-posed alteration include any oetslde Refer [Q Plar.w.JJng entr-illces orne:- than patio doors? Jl() Is ,he proposed. use of the rmishd space or R-::fe, [Q Planrili"lg al~eration for anythi."lg otb.e:- c.han a nOGlal single tJe I f'1~'I~' T . g ( F .;a a-rr"l I. T .0:. d~~ "'''''':r,:::il~r \'/ _~"..lL! nom,- o__.C_, d-uUP nom,-, ~/ \.:___,__G.). Tms CH:ECG..1ST M1:ST BE COMPLETED _.l....'fD 11'lCLTJDED 11'1 Tm.: BtnLDING PER-yIlT FILE TO ~L-\lNTA1N A RECORD Of THE REVrrW. ~";"/i--:T .'.. --:-' ~ ~ ....................;(--,... -'Cl~ PRIOR LAKE INSPECTION RECORD /lJ/~iJS ~ AHf' ~ DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS /1/5So NATURE OF WORK USE OF BUILDING PERMIT NO. ()5 .~ Il7. DATE ISSUED CONTRACTOR C'H~J. PI-IiJlA" PHO E NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE 1imIiImT1i7~_ I . . E NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if re uired) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED {A~ I I~ I 3, (s-Uf FINALS BUILDING ELECTRICAL PLUMBING HEATING DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electric:a~ service cabinet prior to rough-in inspections and maintained until all Inspectlons~ 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