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CITY OF PRIOR LAKE
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ZFinal Permitted
D Conditional C.O. Expires
Legal Description
This Certificate issued pursuant to the requirements of Section I I 0 of the 0 Residential / 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use, For the following:
Use Classification ,5 Ie:: ;4 Bldg, Permit No, lJG - ..:5- ("I
Occupancy Type /2 2> Type Construction t 'A.J/" Zoning District /) U ,~) {J
L; It.. i3 J... t -.J tOr Fe y (' '/' r"'! d t i', t-
'/! ")? (f n" j/ I " I' /
Site Address /' ,:7 ,,;' 'I I u I f-- (.,;' / c,. ,,(. -<:- IV
Owner of Building
Contractor's Name & Addres/lJ e I/~ rn (j (I,'; lyi. ;1) '-; S i ? ':? (,
I~'/ r " I f It t / t. A. ,'1~ City Planner
/ Building Official ;1 t
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
Date Reed
s... ;}~-~
File
City
Applicant
I PERMITNO.O~- 5/q I
I White
Pink
Yellow
(Please
ADDRESS
n at bottom)
I 4 ~1"
I:...v:el'V' L",
Nw
LEGAL DESCRIPTION (office use only)
LOT I b BLOCK
ADDITION -S:ctf.cd p",J, hOd t A)j: ~:O~
PID ..l5""-l{))-OI(;.-D
ZONING (office use)
tf50
OWNER
(Name)
(Phone)
BI).- 'J~r
(Address)
BUILDER
(Company Name) We."S Mtl"'^ ~{)'h(.,S
(Contact Name) Oen"';.s P... Scjl~.^eLr
(Address) Q~ I S'45'
(Phone)
(Phone)
hS 1,- L{ ob-l.{ i.( 00
bl~- 36<j- 19~1..(
MIV SS-I ~~
t;o..c A"
;k ~oo
TYPE OF WORK ~ New Construction ~Deck OPorch ORe,Roofing ORe-Siding ~Lower Level Fimsh iXFircplace
DAddition OAlteration OUtility Conneclton
CODE: ~I.R.C. DI.B.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $ I ;01 000.00
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5 (excluding land)
I hereby certifY that 1 have hlrmshed 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 the
above,menuoned 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 the building
official can revoke this permit lilr Just cause Furthermore, I hereby agree that the CIty official or a deSignee may enter upon the propeny to perform needed inspectIOns
<Ve--' /L ~~:.,L.
x
, l.(S' g
Signature
Contractor's License No.
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter
Pressure Reducer I y~
Sewer/Water Connection Fee
#
#
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~Ott~ 6(tJ'te'
S-q-o(.,
Date
$
$
$
$
$
$
$
$
$
--
/5 so. (X)
5"e1~,oC)
2-2->; DO
,5LA ,00
(0 C)~ ,()()
IS a? (1)
p
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. TillS document
;,"'" " ",' '" '''' 0;' """"" ''"'''''''';' " "me"'" e",,'"'' "~~ Wi.:: '"' '''''Wli7i''~:'"' 412:~~"" b,
Planning Director / ~ Date Sp cial Conditions, if any
24 hour noticc for all inspcctions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Main File
White - Building
Canary - Engineering
~ "'lnk - plan"'"9=>
BUILDING PERMIT APPLICATION DEPARtMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
f____/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
;- .~ G
/' ..2__--.
Accepted Accepted With Corrections
Denied
Reviewed~ ~ Date: 0 lit.( /0 "
,
Comments: Jt:,~ n<< ~.,_./ ~ ~ }...la ~
r ;/ .;
~~~~/ ~ / ~~ ~~., ~J.
~ ~~--J~~~
~,
/'
"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."
Main File
C White - ~Uildina ~
Canary - ngineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT i{Jp~~/}/(/)~
APPLICATION RECEIVED --5 ~ ;;L 0- f.c,
WCJptL4J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~d39- Pt2A-hu~ ~
Accepted
Accepted With Corrections /'
Denied
Reviewed By: ~ ~
Comments: ~ /'l...L( ~ ~
I J """
,A.41.- fJ~ t:J.A~..... ~
~,6~
Date: to ({51/) fr:J
. /1b ~u;?
~~~
-
r
~,
"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."
Main File
White - Building
~anary - EnglneerlJ1if"")
ink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
,1/
/V c) 111-~<J
I~ J;:; /1{ :J./tJLO /,M /),-0
roo _ -) ( ~
) " ..
,--,", ',,-Y .0
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity w~ich is propose~ at:
//1) '3 9 - j, a/ck'Ub-L~ (::-d---7C9-
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
fJ11t3
Date:
(-/!;'06
Comments: Sp.e Reverse Side for Additional Information!
Main-IUle
See Attac11rRfnts: I) Grading Plan, 2) Erosion Control Meas~~es
L'
"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."
08/04/2006 FRI 7:45 FAX 952 767 1900 GENZ-RYAN
[4J 022/033
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERl\lIT
Date Rec'd
I. l'ini;
2 Green
3 Yetiow
File
Cil~
Apr1iCi\fl.1
i PERMIT NO". 5/fJ
I \1 ZONING (ClfiCi
us.)
I
I I
(Please lype or pritlt and sign at bottom)
I ADDRESS
I ) J-~- ), 'SC1 P a.X" \\V\eLV
L-I"
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
GINNER
(Name)
CU,QJ~S \rnOJ\\!)__
\ gqs' pr (AZa.. J)r # 20)
(PhOne~ Lo5i-CiOS- 3701 \
I
I
f01N
'3SId-d
(Addr:ss)
EZ\g {LVI
I APPLICANT C-'9,"-"1 'f) I .
(Name) l:::1 c.J; \ L - \ <....LJ-LLn
(Address) 0'lf'U'-'j I !U'\ \:'_~W!I,1 [' /2
l/\I,7\L. v', \ l.-) "?
_ /' (Address)
(Contact Pel'son) _ -K WI"',
(' "(A '7' ---I I', y'\
(Phone) ~D/,- LfJ (-- UCL)
APPLICANT SIGNATURE
1'3 Ltl'nsvi I Ie T>??;~'7
(City) (Zip Code)
(Phone) _05~-70?1- lOOL
7/ DATE ~ ~ . __..~
=::I- APPLICANT ... i" COMPLETE BELO'"
- ~W CONSTRUCTION, \ D,REPLACEMBNh 0 ALTERATlONS -I
FURNACE MAKEAND MODEL _lmnD~ (rJioY~' oo_3.tJP'-Q(1q, _ FVEL(\(d_,_~t1:?~ \
FLUE SIZE _, RETURN OPENINGS L _ INPUT ?'6CW__ OUTPUT [ (jJ/JJ_
TYPE OF SYSTEM HSATING OR POvVER PLANT
~Iarrn Air Plants 0 Steam
jiVlt\' 0 Hot WaleI'
, chanical 0 Radiation
,:irc<:ndiliOning 0 Special Devices ,___00__'__
. en!. System 0 Other Dcvices _-------
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
PIREPL!\CE MAKE AND MODEL
Industrial, Commercial & Mulli-family
FEE SCHEDULE
] % of job COsl Residential, Gas Fireplace
$39,50 minimum
$99.50 Residential, Additions & Alterations
:~64,5() Residenllai, AC Only
$39,50
Residential, Heating & Ale (New Conslnlction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ ____..._.
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit II
$
$
$
.50 PAID WITH
--BUILDING PERMIT
(Office Use Only)
This Application Becomes )'our Building Permit When Appl'oved
Dille
F
I Date
\ Receipt No,
i By
I
j
Ilulldin2 Official
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
7:46 FAX 952 767 1900 GENZ-RYAN
l4J 023/033
Date Rec'd
CITY OF PRIOR LAKE PLUMJ3LNG PERMIT
(Please type or print and sign at bottom)
I ADDRESS
I I i..,\ ~3C\
,
/~ .
\-~ O~y k \1\ tV\! l-y"')
; ~~,~ ~:~ I, PERl\1IT NO.,_. ~/tJ II
J.. Yellow Applic:ml . " "" ~ P
I ZONING (office use)
I
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
\)jP\i)SnnQ nt,
I ~7c15' (:> 1 oz' Dy~- =W 200
(Address)
APPLICANT (l " /1 D t /'. '1
(Name)~- k/jdJ.
7. </0 - , ! I ) I '
(Address) .-'- () \;\' ,-n,.\) (A
(Address) )
\~ .
(Contact Person) "'-'""1\ \ V'Y'l
'A
[.,..-'
(Phone) C[r:.J'2-'lf1 - I (Ju0
BUILI1~\/j(re.. MN
(City) (Zip Code)
(Phone) 0f5d..-7(P7~ f OW
DATE 8'! 31 Ole
I .
e"-?'-.......,....., .-
',:J~:)~) I
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture I Quantity Type of Fixture ,
2- Bath Tub with or without shower I 3 Rough-ins
i ' Dishwasher , \ Water Heater
) Floor Drain i J i Water Softner
2' Lavatory (Bathroom Sink) I \ Stand Pipe (Washing Machine)
~
\ I Laundry Tray (1 or 2 compaltment sink I I Sewage Ejector j
~ Shower Stall I '2.- I Backflow Assembly I
I j BackfJow Assembly Test
! Sinks I
I Bar Sink I I Lawn Sprinkler
'....) I Water Closet (Toilet) I i Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job eost with a $39,50 minimum Rcsidential, New One & Two-Family $9Y,50
Residential, Additions & Alterations $39,50
Estimated Cost $
Building Permit #
PLUMBING PERl\1IT FEE $
8T ATE SURCHARGE $
TOTAL PERMIT FEE $
,50 PAID WITH
RI JlLDING PERMIT
(Office Use Only)
I Receipt No,
I Bv
I -
I
Building Official
Date
I Paid
I Date
1
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
,,~
DEPARTMENT OF Main F'ile
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK M
USE OF BUILDING
PERMIT NO.
CONTRACTOR ~ PHO E r - -71Z,l(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
IICN
INSPECTOR
I FOOTING ./vv'l
FOUNDATION (Prior to Backfill) " ;:> ~ (;
PLACE NO CONCRETE UNTIL ABO E HAS BEEN SIGNED
ROUGH - INS
(tv ~ 9
DATE
/7-(O/<h
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING I' () c; P
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
fl)/7WE AtJIJ tleJuS~'1t(;1c ~ lc v-Jj I
FINALS
~~()
~
GRADING (Prior to Sodding)
BUILDING ;( I lMh\
ELECTRICAL
PLUMBING
HEATING
DO NOT
\Uk
\.-1,/~
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.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted'with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address II/dol'! - /'/.2/{7 Je +~d ~ (k way
Lot Area (N.A. - SEE TABLE) Sq. Feet x 30% = .............. (N.A. - SEE TABLE
***************************************************~********************
LENGTH
WIDTH
SQ. FEET
= 'I Cj ?t1
HOUSE
x
x
x
=
=
ATTACHED GARAGE
TOTAL PRINCIPLE STRUCTURE...................... , -""'1 q~ 9-
DETACHEDBLDGS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.......................
I
DRIVEWAy€,VED ARE~
(Driveway-paved or not)
(SidewalkIParking Areas)
x
o
= ~~)(o
x
=
x
=
TOT AL P A YED AREAS.........................................
P ATIOSIPORCHESIDECKS X =
(Open Decks !4" min. opening between X =
boards, with a pervious surface below, SieE>~. 428
are not considered to be impervious)
X =
.TOT AL DECKS.................................. .... ..................
OTIIER
x
X
=
=
TOTAL OTHER.................... ............... .............'..........
~ 'S~ Y'
Dr-Z,8
o
TOTAL IMPERVIOUS SURFACE I l \ \ '1 O'?
UNDER/OVER (N.A. - ~E~ TABLE) I
PreparedI3y \)(1", 'I<' , Weq,+€1,eY\ Date t5/Z'Z-(00
Comp~y Pioneer Engineering Phone # 651-681-1914
ltc-Z\
Lot _, Block~, JEFFERS POND FIRST ADDITION