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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
B~ W/a
Date Rec' d
3w 1. 0 ,
(Please
ADDRESS
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0(, .0210 I
ZONING (office use)
~o..rD
141 7'
1\.. N w
LEGAL DESCRIPTION (office use only)
LOT .3~ BLOCK
ADDITION "S"(:./-tc.r
Po~ t=.-rsf /lj I- .}.,' o~
PID;).,!>-lf 7-o33-D
OWNER
(Name)
8v; , Jtlr
(Phone)
(Address)
BUILDER
(Company Name) W''"'S f\A~v'\,..., ~C""""CS
(Contact Name) (:) c....... ,,~ ~ Q. S cA",e, .'elc-r
(Address) R. S 13v..-rJ,,.. ,\,r PIA"Lo.... D"",,,c.. S\';O ft._ ~O
(Phone) bSI- I.{ 0 {, -- l{ " 0 0
(Phone) bl~- 31:.'1- ")ct.ll..(
c.."" ^^N S-SJ ~
TYPE OF WORK ~ New Construction l1(beck OPorch ORe-Roofing ORe-Siding ~Lower Level Finish (g Fireplace
OAddItlOn OAlteration OUtility Connection
CODE: ~I.R.C. DI.B.c.
Type of Constnlction:
Occupancy Group: A B
Division:
o Mise.
I
E
II
F
I
III IV V
HIM
2 3 4
A
R
5
B
S U
PROJECT COST IV ALUE $' ~DI DO 0, 0 ()
(exdudiHg land)
I hereby certify that I. have h.lrnlShed Infllrmation on this applicatIon which IS to the best of my know.ledge true and correct. I also certify that I am the owner Of.auth. orJ7ed ag 'nt 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 le buildIng
official can revoke tlm permit for Just cause. Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the property to perform needed InspectIons
X <i?l ~.L 9, cA-.:..I... I L( S" !;> .3 - '1- 0 b
Signature Contractor's License No. Date
-----
Permit Valuation
Park Support Fee
SAC
#
#
$
$/S$ll, 0 ()
$.
Permit Fee
Plan Check Fee
Water Meter Siz(~/B",~';
This Application Becomes Your Building Permit When Approved
~~
[3uildll1!! Olticial
3/Z3(dlc
Date
Pressure Reducer
Sewer/Water Connection Fee
#
#
fSO(),()t:J
OO(), DO
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ThIS IS to certify that the request In the above application and accompanYll1g documents IS In accordance wilh the City Zoning Ordinance and may proceed as requested. TIllS document
when signed by the City Planner Cllllstltutes a temporalY Certificate of ZOnlng compliance and allows constructIOn to commence. Before occupancy, a Certificate of Occupancy must be
issued r
~~,."";"'~ 3/Z~(~ Ip
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~ ';i\vl. F~@ll""
f.~ 1 ''''.'', '" ",,?, ~,. " ' "
c.el~ 10~ ~jU~i1 ... I e
hite - Building
anary - ering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
vVt: tk'1'1,q IV AI
..30'9,05
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4/77 P/JKKVI6W LAN~
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~
r-
~
Date:
3p3;'~
,
Comments:
See l\'laJilIl ~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Qee" r~~jlff'~"~n', v}$ID
u '" 111.~;:k.1 .. J1 '"
White - Building
Canary - Enaineering
~Pink - PlanFlIiig:,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.
I I
(.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i
'-ri / I'
f
,": , " ,.,- , f".
Accepted ~
Accepted With Corrections
Denied
Reviewed By:
Comments:
~
....
~
Date: 3(2- 3~ ~
See NiaUi File
!
"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."
SeeM~ain File
White . Building
r CRl'Iary . EnglneerllijD
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
v'it: tis' Iv /~) ;V AI
3.9,0.5
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4/77 P/iKKV/6"'V L~)N6:
Accepted
x
Accepted With Corrections
Denied
--
::!Vi9W9d By:
omments:
/lIi/fJ
5c.c A1:,/~ F.-Ie...
Date:
3-28-06
--
"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."
03/09/2006 TllU 12:40 FAX 952 767 1900 GENZ-RYAN
@020/037
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
a{ bottom)
~. ~::n ~il~ I PERMIT NO~ ~ ~ tJ
3. Yellow Apphca.1( . ~ ~(
Lh
LEGAL DESCRIPTION (office use only)
! ZONING (office
I use)
t
LOT BLOCK
ADDITION
PID
~~~e~R Wf)1~maf},n 4- ~me5
(Add",,) J PI .J)r -tt2w
(Phone) &5lC;{J5- 3701
r APPLICANT t:,-- _ r . _ Q
(Name)_C( Ci It.. <--.1_4{)J0
(Address) './ '1.f' .(''', II '\ l-~-1 , Ir fi 1'1
c/v7<()J .AJ. r \ VJ\._ J J
_~ ' (Address)
(Contact Person) --DJl'
B u.ynsvi i Ie 553'?J"J
(City) (Zip Code)
~ ... (Phon,) 4?Jr 7(;;7-/ 0iJIJ
.IVU. DATE 5/q /t!1L...
APPLICANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION w]flLACEMENT 0 ALTERATJONS
FURNACE MAKE AND MODEL LrJ1nox (:rtl / - 3&Pr fJqL FUEL Jlo L ~
FLUE SIZE RETURN OPENINGS INPUT J11J)) OUTPUT 50 If Iff) .
TYPE OF SYSTEM HEATING OR POWER PLANT
'gfu,arm Air Plants 0 Steam
OGravity 0 Hot Water
~CChllnical 0 Radiation
'r Conditioning 0 Special Devices
lent. System 0 (lIbel' Devices
Induslrial, Commercial &. Multi-Family
FEE SCHEDULE
1 % of job eosl Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions &. Alterations
$64.50 Residential, AC Only
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard. II
S,th"" ~
FIREPLACE MAKE AND MODEL
Residential, Healing & AIC (New Construction)
Residential, Healing Only (New Construction)
$39.50
$3950
$39.50
(Office Use On ly)
This Application Becomes Your Building Permit When Appro' ell
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
au PAID WITH
ILDING Pr::-b.
CIlMIT
.50
[lllilujn~ Official
Date
I Paid
L Dat
I Receipt No.
9 2006 I By
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
FAX 952 767 1900 GENZ-RYAN
f4J 019/037
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
at bottom)
~. ~~~ ~~~y I PERMIT NO./_, ':) J(J
J. Yellow ^p~lic'nl ~ ~ _
R2YkU/~U) Ln
ZONING (office use)
LEGAL DESCRJPTION (office use only)
LOT
BLOCK
ADDITION
PID
I ~~~R U)t?i1irrOJJn c;/)/)JY~5 , .. (phon'lt;1-9iJ5 3702
LiAddress) (fCJS P (lizOJ Dr #-:200 f2Jij2J;/.fA $):J:d.
APPLICANT /~ f 1). .
(Name) qe11Z-- 1~-Jl{U1
/'> 2-D } .
. I. ,', f j ,
(Address) .L- (j \! V. H I
\ (Address)
In;
1000
(Contact Person)
APPLICANT SIGNATURE
Quantity Type of Fixture I Quantity Type of Fixture
I Bath Tub with or without shower .3 Rough-ins
) Dishwasher I Water Heater
I Floor Drain / Water Softner
c~ I Lavatory (Bathroom Sink) I / Stand Pipe (Washing Machine)
i Laundry Tray (lor 2 compartment sink Sewage Ejector
/ I Shower Stall Backflow Assembly
I Sinks . Backflow Assembly Test
I Bar Sink I I Lawn Sprinkler
d-- Water Closet (Toilet) I Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1 % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additlons & Alterations $39.50
Estimated Cost $
Building Permit 1/
PAID 1./1.
I3lJlLOIN IfVliH
G Of::
, ...I=?41rr
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
! Receipt No.
I By
Dale
=:=J
I Paid
I DaAAAR 2 9 2006
Iluilding Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I L( 7 7 ~ vi ~ LIIA/&
NATURE OF WORK I-U t, L. t:i'N'S"N ~
USE OF BUILDING , F':A.
PERMIT NO. ~. 02/0 DATE ISSUED 'Z. ~
CONTRACTOR ~Jnt<'18J H~Er PHONE612-:l"'9-?1Ztl
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See LVialll F'ilf
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING ] ~ J 'illY),/. ]
i FOUNDATION (Prior to Backfill)
<.( Rf'I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
::t~~ ROUGH _ INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION 8- .1'/.(J/
ELECTRICA
PLUMBING " S$
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
GRADING (Prior to Sodding)
-.BUILDING
i;LECTRICAL
PLUMBING we...
HEATING
DO NOT OCCUpy UNTIL A OVE 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.
FOR ALL INSPECTIONS (952) 447-9850