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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~~17jIME
ADDRESS
L!77/ ~f ~
L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
c -C(3f
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~f1(
COMMENTS:
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND~CEED
o CORRECT WOfY1. ~OR REINSPECTION BEFORE COVERING
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,
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'O/t>4
File
City
^rplicanl
I PERMIT NO. O(P. oq~ II
, /~P /1.12/ /tH
ZONING (office use)
I White
Pink
Yellow
(Please type or print and sil!;n at bottom)
ADDRESS
j5111
We.s+ A-JE S.f:.
LEGAL DESCRIPTION (office use only)
telSLJ
LOT
ADDITION
PID 2.S: 04-1. 007.0
BLOCK
OWNER .
(Name) Ch ~Q If'-
~ f).C''1
~ \J N\)C- Il
(Phone)
q;)t~ - W - .i~~
(Address) -S ~~
i BUILDER \) ,I n r\ \ . ,., I Ll..L. _
(Company Name) Ku..J ~~~ '\..etV\.OrVe_ \ \t-...\ ~ ~\...o~st . (Phone) -.-b t d.. - I \'1- ~S(J5
(Contact Name) .....) (..,~to...l ~ \~-t'v'V ~ (Pho~e) $-AMc-
(Address) IN.-\ YG.<:.+l...6 R..:1Jl ,3)((' ~A-N MN 5S3Srl-.
TYPE OF WORK 0 New Construction ~Deck o Porch ORe-Roofing
jg1Addition OAlteration OUtility ConnectIon
CODE: M1I.R.c. DI.B.c.
Type of &nstruction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
~e-Siding OLower Level FinIsh
o Misc.
PROJECT COST/VALUE $
(excluding land)
o Fireplace
~ooo.GO
I hereby certify that 1 have hlrnished mforma m on this application which IS to the hest of my knowledge true and COHect. I also certify that I am the owner or authorIzed agent for the
abnve.mentlll 'd p Z~~:;I:ic that all nm uctlon wlll conform to all eXlstlIlg state and local laws and wlll plOceed 1Il accOldanee with submitted plans I .lm .Iwale that the blllldlllg
nttiClal lev. tl ,&01 Ju~ca. FtnthelmOl e, I heleby aglee that the City offiClal or a deSIgnee may enter upon the pl<Jpel1y to pel form needed lIlSpectlllll'
X . ~~S~~ d(jS~o?rr?ct~icenseNo /tJ - 6 ~.5!fn
Receipt No..
By Ci
~
TillS IS to certify that the request 1Il the above apphcatlllll and accompanYlllg documents is III accordance with the City ZonlIlg OrdlIlanee and may pl<Jceed as lequcstcd TIllS document
when signed by the City Planner (OIlStltutcs a tcmpOfi.uy Certificate of Zunmg complIance and allows construction tl) commence. Scfure occupancy, a Certlfi.cate of Occupancy mllst be
issued ~ it- /p _ 'J -tJ b
, ,; ~Director Date
24 hour notice for all inspections (9:;2) 447-98:;0, fax (9:;2) 447-424:;
4646 Dakota Street Prior Lake, MN 55372
Permit Valuation
Permit Fee
'7tJ,()oo, IJ 0
1$ '832..50
1$ ~ql,/3
I $ 35".0 ()
I $
$
$
$
$
TOTAL DUE JI.f'1....~ 0 /1 01-
v,"vvvv ,. , II"
Park Support Fee
SAC
#
#
Plan Check Fee
Water Meter
Size 5/8"; 1";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
,Jo,Jc-
This Application Becomes Your Building Permit When Approved
~ ~ IO/t UofJ
BlIIldlllg Uflicial Da'te
~ --,
L!i/);5, ~
./0 - :J 7-" (0
Paid
Date
$
$
$
$
$
$
$ I
: l4-n9J.d
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Special Conditions, if any
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONING/FIREPLACE PERMIT / ~ 3. 07
FiL-G LI (; - 13/
~. ;;i::n ~::;y I PERMIT NO. /. 000 CI
3. Yellow Applicant l.?' I
(Please type or print and si~n at bottom)
ADDRESS
1577 /
/A/[; II l11/b .
I ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
~~;~~,.~~< ~.. Jlcu_ L~/<; "'/~r~.
- / v'
(Phone) ? .) -;}- p;>]' -;) 7 :l c,
de /~ ~/?>_.:"'~ -;:&r/V SbtJll
(City) (Zip Code)
(Phone) ?r;). ? 7,7- ~ 7 Yv
DATE c) I /o.7~ 7
(Address) J'Og C.. ~ ~/,,,...,,. J ,r
(Address)
(Contact Person) q~~k I" .::? ,'1/ ~i .. ~
APPLICANT SIGNATURE lJ",: '.' ~ 'r____
,.,
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
TYPE OF SYSTEM
RETURN OPENINGS
INPUT
OUTPUT
DWann Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
-.
G /t1 L.-/lt./t::::
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
Building Permit #
HEA TING PERMIT FEE
ST ATE SURCHARGE
TOT AL PERMIT FEE
$
$
$
3. 9)()
.50
4-o,rU
(Office Use Only)
.'
This Application Becomes Your Building Permit When Approved
Paid
,-,~ tit
Receipt No. 5 z..t:j2-L
By/,
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Buildin!! Officiaf
Date
Date I. ] t- 7
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
White - Building
~ - Enqineering
<""pink ~ Plannhfg' )
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
it
Accepted With Corrections
Denied
Reviewed By:
U~
/" /'
Date: /tJ ~9-()-b
Comments:
"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."
LJ.,.-,~hit~ - aun~
J:? / jJ /t ~ rl ,v Canary - Engineering
f"-' . Pink - Planning
....
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BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Ie/ N~S 1'1 v7H I2e noo&'-/ Ale
. /
APPLICATION RECEIVED /0. t. OC,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1577/ we.!::> I A-VC~ s:c.
Accepted
Denied
Accepted With Corrections
~
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Reviewed By: ~ ~
Comments: ~ a-L( ~ /.: ..,. ~ ~ ~,
C/
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JZ5..b-z., <. 4 ....:.. r- tz;., --<.
Date: / t!J/;3/o (..
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"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."
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iL II~ rl ~ ~.I/ ~anarv - Engineeri"b
f' PinK - Planning
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BUILDING PERMIT APPIJCATION DEPARTMENT Ct:IECKLlSI
NAME OF APPLICANT /r:!/N~:::; It-I t/ 7H /<!.6 1/0uEL/ /J~
, /
APPLICATION RECEIVED / (). &-. (, C,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1577 /
Iv 6-'::;T AvE.
,.-. -
~.C- .
Accepted
x
,
Accepted With Corrections
Denied
Reviewed By:
tnt13
Date: 10. I "]',t:)k .
Comments: See Reverse Side for Additional Informatinnl
See Attachments: I )'Gradinl!Plan. 2) Erosion Control Measures
. . - .
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."
CITY OF PRIOR LAKE
Impervious SurfacE~ Calculations
(To be Submitted with Building Pennit Application)
For All Properties Located in th(: Shoreland District (SD).
rhe Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address. \ t; 1"1 \
\.... \. e~lE
\,}<.').e "'.ft'" ~..t.~,! "'"
Lot Area \""2-\ ~""L~ . . Sq. Fe.et x 30%= .............. 3,~B
************************************************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
AND
x
=
x
x
=
.: ,,,':
ATTACHED GARAGE
=
TOTAL PRINCIPLE STRUCTURE...................... \ 41..\'+
DETACHED BLDGS
( Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.......................
DRIVEW A YIP A VED AREAS X .
(Dl'iveway-paved or not) G;,~~ ~t1 X
-
(Sidewalk/Parking Areas) ~ ~....... X
=
=
~a.+
-11-*
=
TOTAL PAVED AREA:~............................,............
PATIOS/PORCHES/DECKS X -
(Open Decks I;''' min. opening between X =
boards, with a pervious surface below,
.are not considered to bi impervious)
.t' . X =
TOTAL DECKS.....,...................................................
OTHER ~~~,~
fro~ De~
=
3~c
7....t:J. X \ ~
X 5RnC!/
=
TOTAL OTHER.........~..................,...........................
tOTAL IMPERVIOUS SURFACE
eVER..... .. .'"
Prepared By JY...~.~+
Company VA11 "'~r. C::'l,.,rl>yi ng . r.,., . 'P. A .
Date \0 3 04'
Phone # (q,?) H7-2i70
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PRIOH LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDiNG AND INSPECTION
SITE ADDRESS 15771 tJ€~1 AI/'F ~ · ~
NATURE OF WORK ALJI.J/7/;-'J4J r ])f'l'/L ALJUIT/,;,J
USE OF BUILDING S1 A 11 , .
PERMIT NO. _0",0(13/ . DATE ISSUED IO/II/a"
CONTRACTOR ((lfJ1r,ttll ft.. Cl),v~7. PHclNE.t/Z "'11? - ~SO'!
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I"ISPECTOR
DATE
FOOTING
-l~
J , ,-(\~
.
J
I
UNTIL ABOVE HAS BEEN SIGNED
UGH - INS
---
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FRAMING
INSULf-\TION
ELECTRICAL
f1IV---)
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
BUILDING
ELECTRICAL
IJ
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l?..I{~
/7
HEATING (U/ r(v/~
...,. .~ I
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted raar ;''"1 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