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Ro m"ll3:CIlO ..:.0 m ~ C "ll::!"ll6Q ~ < >~>;U~ )> ~~~~~ ;;J z 0 r- m- ~ ..., !'" -4.... .... ~ r-C )IoZ 3: z(i) m C i i g i ::J III "'0 CD o ~ o ~ J it i t ~ o. il t ....... ~ I\) U) o CQD~EQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY! ~ 00000 8 00000000 ; 0 · zenooo "TIC"TI"TI~z"TI"TI r ~ C Q ~b~~~~ - I ~~g~~~~8 m ~ ~ ~ m"V~~~~ m "VO~II>~~ ~ ~ m ~ g~~~~~ ~ ~r~ ~~~~ 0 ~ ::J 00-1 -I ~ < - . 0 Z m zme~~~ ~. ~ z m ~ :D:DzOO"TI Z 3' m~~~~~ 0 III Oen"TI' -I . "'0 S:-Imo~O m ~~o~o~ !l 0' 0'-0" g' O~~~~~ I\) ~l=3:DO(") .,. ,-O:Dmm =r -I~zm~m o O-o~z 0 ~ >m_~ III :DO-lm ~b;;O ::I Z:Dz~ I>> G)' 0 ~ m z I>> > al ::I 0 m o 0 "TI m m :I:O en O:D ~ em :DO enO < -m ~~ -oZ ~G) -I o :D ~ r= . :D m -I e :D z o -0 :I: ~ o -I > ~ m z ~ C' (\ DDD~Di'sJDD -oenenen~~~-o e,mmmm>mE -o-o~-I-Io" ~:;j:;jmmm:I:""' alOO:D:D:D>!!! Z~-:I:en:I:Zz G)>~8m8oG> --I -I >:D ~~>~=l~I- >' l=e~e . ,-oz-o o z ..b. o ?l 00000000 "'I'Ieno"TIorm~ -m 0,.><-1 ~-ol~~om -II m>- ~ o-o~en<z ,. ~,.:I:=-en O"TI.-OG)-o mZez:D:Dm )lo-o-l [!! >0 I ~C~ mZO -IG)z !;!! Z' oC enz G) (") o Z -t ;II ." Z (") m (I) =t ~.,,< ~ m =t (") 0 Z -t ." ~ ~ J Z 0 ~O ~ -t r o · m ~ CJ-1 --! o en 0 00> ~ :I: . '1l m I 10m m e 9 iT! hi z o 0 ~ ~ o ~ m -I f m 1. While 2, Pink 3. Yellow Fik City Applicant CITY OF PRIOR LAKE BUILDING PERMIT, j'TEMRd&lRY CERTIFICATE OF ZONING COMPLIANCE ANQ; ~TILlTY CONNECTION PERMIT (2 J. ----.J L/ Permit No. - ,l...j - I DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 2, SITEZj~B~ 1M(2:~-2- &~IT- N 3. LEGAL DESCRIPTION LOT .;ST 7- BLOCK ADDITION 771e= H/ft23t!7 ~ 4, OW~~ ,,(Nam~ (Address) 1tff1<~tZ.- .p/f!~P~7/1!!25 /A.I c..., 5, ARCHIT50CT (Name) (Address) _ \ IP YJ!lLol'" .-?~7' ..f)I ~:i!c::'..;7/o.u5 I/v LJ YoM,J 6, BUIL9~R/Uo (Name) (Address) (Tel. No,) /-ff'L 7900 ~7"~/!!M)/! Y iJ/l. tJI..M~>-.,.J 7, TYPE OF WORK New Constructio~ Chimney 0 Misc, 8, PROPERTY AREA OR ACRES Sq, Ft. /CJOD Fireplace 0 Alterations 0 IYl 1,DATE MAt 6/ /7'1 BUILDING INFORMATION 11, SIZE OF STRUCTURE (Height) (Width) (Depth) - ,- '---' 12, NO. OF STORIES / PID '3s.-;;.,(, '3 '-00 ~ ~~ ~&Jff/,'AJ 13, TYPE OF CONSTRUCTION ~~ot/S"8 (Tel. No,) r..>>r 14, FLOOR AREA APPORTIONMENT USE ~03/ 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS SEATS ~, ESTIMATED VALUE =:r / s-o J:::- 17, COMPLETION DATE I? - ':2-~ /!Ios Septic 0 Addition 0 Heating 0 Plumbing 0 Finish Attic 0 Residing 0 Reroofing 0 Porch 0 Finish Basement 0 9, PROPERTY DIMENSIONS Width '32--Depth'" 5- 10. CULVERT SIZE Yes No I hereby certify 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 i ed property and that a nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the n voke t ' ust cause, Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections, :e- 72(/.-<j.~/'-6 '9V Signature License No, Date / SETBACKS: Required Actual Front PROPOSED GRADE FOUNDATION IN RELATION TO CURB OR CROWN OF STREET USE OF BUILDING Occupancy Group A BEl tlii) DMsion 1 ID Permit Fee ................................... $ Pian Checking Fee ......................... $ State Surcharge............................. $ Penalty ....................................... $ Septic System ............................... $ Other ......................................... $ FOR ADMINISTRATIVE USE MATERIAL FILED WITH APPLICATION Back Side Side SOIL TESTS o ENERGY DATA OFF STREET PARKING SPACES REO, SPACES ON PLAN PERMIT VALUATION I ~ , <.:::::Q~ SURVEY PLOT PLAN City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ License Check Fee ......................... $ Pressure Reducer .......................... $ Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ WaterTowerFee ........................... $ Water Tap ................I................. $ Builder's Deposit ..b!...A............. $ Other ......................................... $ c;- ~" ~~ ~ ,.....~ 71~,~ S20 . -4 ~ iSt Q~ ~ -1., ,"~ 1-4/ ,?, ~~ Check if Deferred ~ By r Building Permit When APP~Ved. ~ ~. '. ~ "\' . Date -:.> --:J=-::.. Certificate of Occupancy Issued Date plication and acco.mpa,ny~, documents is in,accordance with the City Zoning Ordinance a may proceed as requ sted. This document when ry Certifi~goning co liance and allows construction ~"nce, ~pre occuJl.C!ncy, a ~cate of Occupancy M be issued, ~ ~~. s..~ "-- i~""" .-..r"f..l.-I ~'1 ~ u~n~ Date Special Conditions ~ any ~ 24 Hour notice for all inspections 447.42309:00 a,m, . 10:00 a.m. 1Lf-/(f GREEN . FILE YELLOW . APPLICANT GOLD - CIT" CITY OF PRIOR LAKE NO. qt-/y/ SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the City. APPLICANT: ~ ~Lh Ik VI . t /2. \ ADDRESS :11-z,~ LA1u..tA fLl..rt.." J ~ Y . SIGNATURE: f:i ~~ SITE ADDRESS ~ t!i$4- ~f)R.. .L5llfi L.J\. FILL IN THE BLANKS PHONE: 'ii9 ..~ ?g DATE: g -2- ,/4- BLDG. PERMIT # I ~ 9 ~ 91- PID# "B -~t3 -00 7-D 1. Estimated length of water service ?o feet. 2. Size of water service \ inch(es} . 3. Location of any couplings from structure ( 0 feet. 4. Type of sewer pipe. ABS~ PVC Cast Iron 5. Estimated length of sewer line \0 feet. 6. Clean out (if required), located at structure. -e- feet from ------------------------------------------------------------------ ------------------------------------------------------------------ This application becomes your permit when approved. BY j1r!-?~v {W. DATE: f/!/?y ======-=========~_!=============================================== 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 RECEIPT # ;;:;7 '2 .--..S?} AMOUNT PAID c:;>J5J ~ ~ REC'D BY /f ~ 4629 Dakota 51. 5.E., Prior Lake, Minnesota 55372 / Ph, (612) 447-4230 / Fax (612) 447-4245 AN EQUAL OPPORTUNITY EMPLDYER GREE. . FILE YELLOW . APPLICA.T GOLD. CIT'I CITY OF PRIOR LAKE NO. /'1', hll SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the City. APPLICANT: Jv' /i; .' lu', i/ _ 1\(' PHONE: '.. /1 " --; r: J / (5 ( r~ ,I ) I LJ ADDRESS: ///1 /,' ,': , . .',' -ell !~J~'I'_~" / : ~{ Ir-.{' ,\ DATE: /" .. I " SIGNATURE: '4,-{ , l{/~ ( ,"if 7.;- SITE ADDRESS.:" ;L?~2cJ -'t{t1..2JJi:'''/ "\ i ,/ ,J 0 6 C \ \ - ~ BLDG. PERMIT # I:~ lj ~ '75' PID# ':'.c:._ J I :; _() D 7- D ,"-.,,/ ,)\.. ~,...... FILL IN THE BLANKS 1. Estimated length of water service 00 feet. 2. Size of water service inch(es) . 3. Location of any couplings from structure 10 feet. 4. Type of sewer pipe. ABS~ PVC Cast Iron 5. Estimated length of sewer line (e:) feet. 6. Clean out (if required), located at structure. -e feet from ------------------------------------------------------------------ ------------------------------------------------------------------ This application becomes / i l _ ~ BY -,')11/ 'f.r::;} It; I-{ i../; j;/ .. .' ! / ======~=========================================================== your permit when approved. DATE: {IIi J7'tJ 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. ;<_ I( ;' " l '/ (/ ...,'-, --"', . ~ .../ DATE PAID AMOUNT PAID ) ..--,...... RECEIPT # /1 (-/ // ( I ';-( / REC'O BY /- I ,""'" ,; / /j/~- 4629 Dakota St. S,E., Prior Lake, Minnesota 55372 I Ph, (612) 447.4230 I Fax (612) 447-4245 AN EQUAL OPPORTUNITY EMPLDYER 1. Blue 2. Gold 3. Yellow File City Applicant The Cf'nler of Ihe Lake Country & dL ;,-./ Building Permit # - PID # '" 3..1 -.2 t... ., - IJ 0 7 ~ r) NOTE: This permit will not be processed without complete information. FIXTURE UNITS Quantity Type of Fixture Quantity Type of Fixture / Bath Tub with or without shower Rough-ins ) Dishwasher J Water Heater I Floor Drain Water Softner If Lavatory (bathroom sink) / Stand Pipe (washing machine) / Laundry Tray (1 or 2 compartment sink) Sewage Ejector ~ Shower Stall Backflow Assembly (RPZ, Double Check, PVB) I Sinks Backflow Assembly Test I Bar Sink Lawn Sprinkler 3 Water Closet (toilet) Other FEE SCHEDULE Industrial, Commercial & Multi-Family (1 % of job cost, $39.50 minimum) Residential, New One & Two Family Residential, Additions & Alterations State Surcharge GRAND TOTAL $ $ ~ ~f'O $ $ .50 $ /op, ~() $99.50 $39.50 This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State Plumbing Code and the amendments thereof. , I RECEIPT NO, ,/tC/flt DATE ATIEST Call or all inspectio s 24 hours in advance. 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245 An Equal Opportunity Employer BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT -4&j.y f/~~ .Jlu, APPLICATION RECEIVED S / 1/ ' The City of Prior Lake ENGINEERING Department has reviewed the building permit ~ S i tJ-;kJnV Accepted / a~ion for construction activity located at Denied Accepted Reviewed ,; "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. II BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ~--t1",j;;~ ~. APPLICATION RECEIVED ,J1/J/1t/ The city of Prior Lake PLANNING Department has reviewed the building permit application for construction activity located at ~J- f 'f /h.J-t'L, ~ Accepted Reviewed by: Denied Accepted with Corrections Date Comments: 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." BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 14J.v ~1WI~ L. APPLICATION RECEIVED ,JJJI/~V The City of Prior Lake BUILDING Department has reviewed the building permit aHPli~ation for construction activity located at W1J- "1h.Jw ~ Accepted I-- ~ied Reviewed by: \~ Comments: 1 .J--.-... ..;.;....TJ...:.....\ \ Date ~- , d.- ~~ v-.... t-p....~. ~ with Corrections , ~~_c~ EA~,~~~\ Accepted 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. II PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS tst~1rc:z NATURE OF WORK -;A' , . ~L USE OF BUILDING PERMIT NO. tN19 DATE ISSUED f/z/~'L CONTRACTOR' ,J...V-P":' NOTE: THIS IS NOT A P RMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT I FOOTING DATE 19/tl1~,. gJ,f}N INSPECTOR .Jf~-"L 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 ~:,..I.o '-"fL<-/~ GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I WALLBOARD I L FINALS 61"'0-/ q~ r2-"2.I-~ I 7.- - ~ '3 - /~ GRADING (Prior to Sodding) f , BUILDING -~~ '7,/ro/CIQ ELECTRICAL I , 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. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS 447-4230