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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
\2-f 1..i lot.
File
City
Applicant
I PERMIT NO. 07. 0 oz.:J I
White
Pink
Yellow
(Please
ADDRESS
.5 'ItJO
'/ !t4tLHvtt?
/vrne.
LEGAL DESCRIPTION (office use only)
LOT z.... BLOCK 3
/:
~J1C
1Ku-.E-
ADDITION
PID
OWNER ()
(Name) rUt-Ie-
)/ Oh1t.-- S
ZONING (office use)
I
'5' L/ . OJ,
-0
/fAt,;
(Phone) ~/- L/sz- 5206
55/2
BUILDER
(Company Name)
(Contact Name)
(Address)
5;tnl e:
(lU/l:r DvtSc /-liW
(Phone)
(Phone) (42 - Z2J - ~&)cfS-
TYPE OF WORK
ORe-Siding OLower Level FinIsh
New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility ConnectIOn
CODE: ~.C. DI.B.C.
Type of Construction:
Occupancy Group:
Division:
o Mise.
A
I
E
IV &> A
I M R
3 4 5
U
II
F
1
III
H
2
B
S
PROJECT COST IV ALUE $
(excluding land)
/97. 300
B
~ Fireplace (I)
I hereby certify that 1 have furnIshed mformation 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 the
abuvc-mcntlllned property and that all construction will confclrm to all eXIStmg state and local laws and will proceed in accordance with submItted plans. I am aware that the buildmg
~'tiCial can re c tlm ptTmlt for ust cau~more. I hereby agree that the CIty official or a deSlgn~;~>er upon the propeny to perform n;;d ms ectlon~ ?
Signature Contractor's License No. Date
Permit Valuation
Park Support Fee
SAC
#
#
a
Permit Fee
Plan Check Fee
Water Meter Size 5/8'"1'"
State Surcharge
I Penalty
IPlumbing Permit Fee
Mechanical Permit Fee
$
$
$ 100.00
$ 00.00
$ .:35. >0
$ 0, D ()
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE tJ'//"f."Et.o
This Application Becomes Your Building Pennit When Approved
LIZ ,. r
~ '::/..rL~
1/ S ~~te1
Bulldll1!! OfIlelal
$
$ I" 7 S. 00
$
. ()O
$
0, OD
$ -00 . 010
$ (J OD. a 0
$ / Sot!) 00
$
$
~,
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 Cllnstltutcs a temporary Certificate of Zoning compliance and allows constructllln to commence Before occupancy, a CertIficate of Occupancy must be
I'~ ~ '/~/07 ~ ~ J~v~
l Planning Director , I Date Special Conditlns, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~ - B~~~~
ry - E! . eering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT -~.I)fr: fIomeS,
APPLICATION RECEIVED I d- - ;;-.'6--0 h
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~~29t) 7ra/~/ h ~O-C/ ~at00
Accepted
Accepted With Corrections
~
Denied
Reviewed By: ~ ~~ Date: //<::;/C 7
I
Comments: ~ oLf ~"' ~ ~.
C-.O. ~ ~- ..y~ fa (f ~
~~ ~.. - UL L.~~ .
~ ~~~ ~fl~
~ d~'
"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."
White - Building
Canary - Engineering
dink - Plannlncr::::.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/~. ), i .
./
(
"
/" ...: ..-
_..."t " "./
.." /"
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
)')
/ (-.....
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~ Date: It/~ 7
~ ~ -4~~. _;2-d-~/~
:;1A~a~) ~ ~ ~ ~
/j- d) J (j
--Iv ~ ~~ c...., tf .~ ~
~
Comments:
~~
.Air Conditioner ~d Other Mecbanical
Units Cannot Encroach into Required
Side Yard Setbacks
'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."
f-.:j
BUILDING PERMIT APP~ICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT -:p//) f t'" No 111 eS.
APPLICATION RECEIVED / C) - 'd-g-O h
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~'5L/cJtJ -Ira;'! h eod ),atUe--
Accepted X Accepted With Corrections .
Denied
Reviewed By:
~
Date:
1- 11-07
Comments: ~ee ,Reven:;e Side for Addition~ltnf(){mationl ~
See A.tt~B11T".,"t'. .1). Gr,"di~ pIau, .2)Br~si(}l1C9ntml.MIW'~s
'-,. :'- .... . . . '. ',- .' :-'<-':t,,-,,,,,-,>'::--,:'-:'-,,
c" _ . _.__. _ . __ _ _ _._ _
liThe issuance or granting of a permit otilPproval pfplans,. specifioations and
computations shall not beconstrue(l tope a P8nnJUOr,oran ~pprovalof,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."
i
Residential Building Permit Checklist
New Construction for Single or Two.family Dwellings in R.1 or R-2 Districts
Reviewed by ~ 7~ Date (5/0 7
Building Permit # PID: Zoning:
Address: 5iot:J TICI1/L ifE.-1-/J Ll'b)e-
Legal: L 2-, 8 :3 Subdivision: c)fCLAJltT @ ClDhtZy UK-6--
Existing Structure? YE@
I. CONFORMS TO ZONING
. ORDINANCE
Existing Nonconforming Structure? YE~
YES
NO
Yard Setbacks: NA I FAIk6fCOMPLlE1) Standard Proposed
. Front Yard (can be 20' if avg. w/in 150') 25' 2-5'
. Side Yards 10'/ ,
25' if abutting a street \3,8
. Sidewall exceeding 50' requires additional side 2" 10' setback + I
setback for every l' over 50' in lenqth 2"/1' over 50' 13 , '7s
. Rear Yard 25' /" t.. '
. Patio Door: provide for minimum 10' deck or sign 10' sidel
statement indicatinq no deck will be built in the future 25' rear ,.fA
. From 100 year flood elevation of wetland/NURP 30'
pond. MA
. Refer in-qround pools to the Planninq Department
. From OHW (Prior or Spring Lake) 75' or setback average of
adjacent structures, but no VA
less than 50'
I Floor Area Ratio: NA I FAILS~~
.30 Maximum
/f'?o
Yard Encroachments: NAI FAIL MP
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line Easements.
AlC and other equipment cannot encroach on interior
side ards,
Standard
Proposed
()tU6
bPS-
-
Tree Preservation{1 ~A11 FAILS I COMPLIES Standard Proposed
. Total caliper incres
. Permit 25% Removal
. Caliper Inches Removed
. Caliper Inches Preserved
. Replacement ~:1
L:\TEMPLA TE\BLDGLIST.DOC
Jan 22 07 02:39p
1-
2 .
3 .
4 .
'-.......- 5.
6.
METRO GENERAL SERVICES
763-428-2968
p. 1
GREEN - FILE
YEllOW - APPLICANT
GOLD. ell '(
FA~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Cj'51..r tf'l7-'I~ t/~
swoNo1J1D-Z6
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: rn C-/RO
ADDRESS: '::;/1 Cj 0
SIGNATURE: \
SITE ADDRESS:
(-5 i=-it) ERAL SER. VjUfi;.IONE: ~!f) 3 -LI-dg-d-, 13g
riVe.
DATE:
IYJ I C-I t1 G L , 4"') /'J. s.s 3 7 I::.:
BLDG. PERMIT #
PID#
FILL, IN THE BLANKS
Estimated length of water service
E;()
feet.
Size of water service
I 'I
inch(es) .
Location of any couplings from structure () feet.
Type of sewer pipe. ABS PVC ~Ij Cast Iron
Estimated length of sewer 1 ine 5" () feet.
Clean out (if required),
structure.
located at
NIA-
feet
from
----------------~-------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
========fJ~/~~=~~~4~=~==========================================
FEES: ..~a I~~~=L ~e~My)L Sewer and water line connection permit.
~. ... Surcharge
(,...."'NtJ Fee- 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.:J~Ar:D
JAN 2 fi 2007. .
AMOUNT PAID PAID WITH
BU1LDING PERMiT
REC'D BY
-
RECEIpT. #
16200 Eagle. Creek Av. S.E" Prior Lake, Minnesota 55372 / Ph. (152) 447-4230/ FAX (Qs-2) 447-4245
~1'"l ~nll";)1 flnnnrtllrllt\./ F.mnlnv~r
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
;2./7/07
I. Blue File
2. Gold City
3 Yellow Applicant
I PERMIT NO. 0; 00251
ZONING (office use)
~rc(t '/A-eo/ i I?
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
I ~=~R r e-Jj e
(Address)
/k~ €> 9-
(Phone)
APPLlC~ fb I
(Name) "/ u~lb,'v "-~('-',
(Adm,,,) i::~,-,~" ~~
(Address)
)/7;0 r,-- I
C~4y
(Phone) Cj!;;:'d -Lf 902 - ~ / OJ/
'0o,~d~ /~lpl CSl'""~
(City) (Zip Code)
(Contact Person)
(Phone)
,
"""
APPLICANT SIGNA TU
DATE ~ ?-cY-/,
Quantity
AP CANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backtlow Assembly
Backtlow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial & Multi-family J % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Rcsidential. Additions & Alterations $39.50
Estimated Cost $
Building Permit #
~.w/~
(Office Use Only)
pplication Becomes Your Building Permit When Approved
,.
BUilding~ficial~ 2/1 L~7
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
I P,;d
Date
I ::C'iPI No
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
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;e:n ~~~y I PERMIT NO~
3. Yellow Applicant ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name PULTE HOMES
(Phone) _
651.452,5200
(Address)815 NORTHWEST PKWY. #140, - EAGAN
APPLICANT
(Name)HEARTH AND HOME TECHNOLOGIES DBA FIRESIDE HEARTH & HOME (Phone)
2561
651-633-
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
WENDY SCHROEDER
(Phone) _651-633-2561
APPLICANT SIGNATURE
WENDY SCHROEDER
DATE
2/8/07
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEATILATOR ND4236I
APPLICANT PLEASE COMPLETE BELOW
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
R. . "",.. .~j-("! I
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.50";"" .1', ,
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(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Paid
tlafu8
IIiJ, Luu7
I ::"iP' No
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Feb 09 07 01:10p
p.2
crfY OF PRIOR LAKE .
REA TINGJ AIR CONDmONINGfFIREPLACE PER~nT
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I ADD~S ,
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LEGAL DESCRlI: nON (I:lm.cc ale oo:)'J
ADDmON
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, (Contnct Person> ',--, ('10'1'~ \,/I-t'---l
I Al'PLICANT S'!' 1NATURE ~2-l-,-\1/;\._J' I,
,
I APPLICA1't'T PLEASE CokLETI: BELOW
! " ~~EW CONSTRUCTiON q REPLA:~fC~ p..lU.TERA.TIONS' 1
\ FUR..'lACE :,{Af ~ AND MODEL [,/ 1'7 f./7 /J / - \--y--\2:.\}, \- - \J, t..1 . _'\L.tl .~ FUEL .J'-\:)'\', -'. I
I FLUE S[lE , RZTlJllN 0.""",0' WP<Jf 1\\ I i)D[' otm'<Jf ])1.. ,7>C' L) I
\1 TYPE OP' SYSTEM Hl'ATING OR PQWJ:7....R PLANT \
. 'PJIUtll AIr PlGJI" ~ Stoam pLEASE NOTE~ I
rllvlty Hol W/I1I:r Air C<lnditioner Uni\:9 \
Mech.nlw Radl~an CaonOl EDC"OlJGh into .
OAtr CondJuonlnll Sj>>Cial Devl~. \ ~~ Sldo YlUdJ " \
OVotlt S)'SlCm DO-lull ~,~C~ . .><J"-""''"'' _
'_ FIM:PLACE h!. \KE Af'.-o MODEL . -.--
(Ph"",) U<;C'-, \ ~'O> L,q ~ -Tl\
! OWl-fER ., .
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APPLICA.'l1";. .IC'\
(Name) ..-':::',' ~y
(Addtc:l~) ~, -
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. '} . I \~'/' ,-. --- \ ~
(Pholle) :l L.O:---' '-l, j' - LJ. ( I
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(11fJ Codt:)
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/
R'li<:l~t1..\, Hell' n~ ~ Ale (N..., Cot1W\1rtlon)
Roit:=.rulul. H((I, Qi Only (New CO[l1.tJ\lc.tlor.)
nK scmmULE
I % of Job ~ Relridrorbl, OBJ FlrqJltlQO
$39.50 nlin~muro
199.50
~~.:lO
~39,~O
Indll$1Cill. comrl, ~lJU 4t. MulrM'llrtllly
R~dcntil\l. Addltitwr & AIUlf1ltiono
Rnldcutllal. AC Onl)'
S39.j{)
~39. 50
r" "' 'J.C--
, Estiml.!fld Cost ~ l) I L I.::::>~~
Buildini P!ll'1Dit I-
~
PAID \NITH
REA'11NG PERMIT FEE
STATE SURCrlARGE
TOTAL P'ERMlT FEE
$
$
S
.P! 1 "1"",>, ,', .,. ,",' ~!li-
l.2.: ~: L:' , ,. ' : ~- : .
(Oillte Ute Onh:
Tl1i. APPIl; loon BctOm~ Your BnlldlDI Permit Wh.1l ^pprowd l E;. oJ (). ZOO I
,_ B ,.,Z
",'I_ '.. om"" .~.,-
14 Ml.lr ~c.e for.1I \Il>~~ 19~) ~'7-9Q50. fn. (9~') 417.4143
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PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~h'!li ~
NATURE OF WORK ,..- DR. ,...~
USEOFBUIL~~ ~
PERMIT NO. DATE ISSUED . ._
CONTRACTOR PHON . · ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING
FOUNDATION (Prior to Backfill) -- qrff7
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
GRADING (Prior to Soddin )
BUILDING ,{ . ' I 'OJ
ELECT ICAL
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.
t-I,( l -1
-r -v?
SIGNED
FOR ALL INSPECTIONS (952) 447-9850