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pR' CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
¢
c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE - 1 7 !
' X AND UTILITY CONNECTION PERMIT / l
U ; z,
M/ANESo'oP L White File PERMIT NO / �`
2 Pink City / / / n 2
3 Yellow Applicant « //" �l
(Please type or print and sign at bottom)
ADDRESS ZONIN r (office use)
.; Ib 3q - Gli / •) Pe;6c C�A
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID z5 'Z , 00 ,0
OWNER Ct�a— yy0 — Cv13 2
i t o w r 6 ✓S k J ( Ph one)
(Name) S + ‘ . 'd
(Address)
BUILDER t )_ /,
(Company Name) -T V�. 6 r �'Z Pet KA,Me (5, (f f ne) ' / CO 7 344 I ere p
(Contact Name) 1 1 tom" (_O
(Phone) d� 1 1D 342.,r 2
(Address) 700 C61.4. 4)( kal • J F r � % Je 1, , iN AJ S 1
�,�/ 1
TYPE OF WORK ❑ New Construction ['Deck ❑Porch Dee- Roofing a e- Siding ['Lower Level Finish ❑ Fireplace
CI Addition ❑Alteration ❑Utility Connection �f it /� , / , ,/ /�
IY1;Misc. //v C. � /'Vl /V�O 1 J
CODE: LR.C. ❑LB.C. 7�r /�
Type of o traction: I II HI IV V AB c0 000.00
Occupancy Group: A B E F HI MR S U PROJECT CO '
Division:
1 2 3 4 5 (excluding
I hereby certify that 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 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 the building
official can revoke this permit for just cause. Furthermore, I heresy agre - city official or a designee may enter upon the property to perform ll
needed ins 0 +1111°11
re Contractor's License No. Date
Permit Valuation l5� d Go. C 0 Park Support Fee # $
Permit Fee $ c 2S' SAC # $
Plan Check Fee $ / 2-, Y 4 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 7 i Ca Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE / $ / /
This Applkatti'on B co es Your Building Per
_ Ili_
oved Paid -'L/ /CO' Rec; • t No.
Date 'D127 ,.�
J - r r r
Bu
d Official Date
This is to cerify that the request in the above application and accompanying docume is is . accordance with the 'ty Zoning Ordinance and may proceed as requested. This document
when sign the y Pla er constite<es a temporary Certificate of Zoning com lance nd allows constructio to commence. Before occupancy, a Certificate of Occupancy must be
issued, i
4 ( / C
Planning Director V to Special Conditions, if any
24 hour notice for all inspections (952) 447 - 9850, fax (952) 447 - 4245
4646 Dakota Street Prior Lake, MN 55372
.
1
,
,
CITY OF PRIOR LAKE Date Rec'd
(---i;ItIc � ` � e HEATING /AIR CONDITIONING /FIREPLACE PERMIT S-, 6, 1( / / 3 4 . 5r -
. Pi nk File
41 jNNES U�� 2. Green Cit PERMIT NO.
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS /�3 9Z 91-,761 r} b ���G ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANT / / / D
• _ 1 -l'
(Name) ' ( it'll - c--- [O _ (Phone) S g - gig
1
.5 2-
(Address) (I ►� 1 4 0 '
(Address)
/Fr (City) (Zip Code)
(Contact Person) . , (Phone) / ✓" 11a.6
APPLICANT SIGNATURE II DATE
APPLICANT PLEASE COMPLETE BELOW
['NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach
❑Gravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
['Air Conditioning ❑ Special Devices
❑Vent. System E1 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $ 4-
STATE SURCHARGE $ S_ 0 A
TOTAL PERMIT FEE $ 5 I.. $7J
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid 5 / Sz) / tNo / L.. Date `(
Buildine Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
4 pRI CITY OF PRIOR LAKE Date Rec'd
4' HEATING /AIR CONDITIONING/FIREPLACE PERMIT
i ii,
V. a`7
41 Mv>;so ° z. c2«� ccs
` `" F ''` PERMIT • NO. / / r ?
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS NO ZONING (oflicc use)
1 (o39 () PA r K. A L/C i•. , e .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PLO
OWNER
(Name) S +C-u 6 D6 \n r d V S a (Phone)
(Address)
APPLIC � - ^ ! _
(Name) L Pt k( . \. � Z. !"" t\ &p VA c.e 5 (Phone)
(Address) al la 0\ V1/4-7__:71 _ A f]. n lipC■I (..Pc 1C, ,..i(5 5‘.c7) 4 L
(Address) (City) (Zip Code)
(Contact Person) SO.11 - (- s ( i -A • / (Phone) (p ()-'( - t(t-P — 4 a
APPLICANT SIGNATURE -, �� DATE 17-- a 0
APPLICANT PLEASE COMPLETE BELOW
ANEW CONSTRUCTION ❑ REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT 30 (}.1. OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach
DGravity ❑ Hot Water into Required Side Yard Setbacks.
❑ Mechanical 0 Radiation Fireplaces with Box Additions or
❑Air Conditioning ❑ Special Devices
:Went_ System ❑ Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL \--4 • P A - N , l.0 L 5.,[1'6 c 30
FEE SCHEDULE
Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ 0000 Building Permit #
The Minnesota Statutes § 326B.148
HEATING PERMIT FEE $ yc1 5~' "St RCFiARGy "has been changed Ibr one
year effective
STATE SURCHARGE $ — • July 1, 2010, until June 30, 201 L
TOTAL PERMIT FEE $ e-g' -- The minimum surcharge for a "fixed fee" permit
(Office Use Only) is SS, beginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid rif t/ so (0 Receipt No. / L d r// '/
DateNb`,L t By
Building Official Date
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
pRfo CITY OF PRIOR LAKE Date Rec'd
_ - = HEATING /AIR CONDITIONING/FIREPLACE PERMIT
Ic x
41.imvsso'P 1. Pink Fle P ERMIT NO. // / 0
3. c ppl �I ' �i Y�
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
fia 39a,cg-pAi-L A-v-L-1\)i e
LEGAL DESCRIPTION ( office use only)
LOT BLOCK ADDITION PID
OWNER _,,, k r 0
(Name) 5 ' Y Q ^'\. No, 0j6 (Phone)
(Address)
(Nam L L � 4, p c S
e �, ` p FO--1-8. t- `- (Phone )
(Address) c- A 0 O) k Ef VN- In
(Address) (City) (Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE DATE
APPLICANT PLEASE COMPLETE BELOW
[NEW CONSTRUCTION ❑ REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWann Air rants ❑ Steam Units and Fireplaces Cannot Encroach
['Gravity 0 Hot Water into Required Side Yard Setbacks.
❑ Mechanical ❑ Radiation Fireplaces with Box Additions or
DAir Conditioning ❑ Special Devices
['Vent. System 0 Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi Family 1% of job cost Residential, Gas Fireplace $49.50
$49.50 minimum
Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50
Estimated Cost $ Building Permit #
The Minnesota Statutes § 326[3.148
HEATING PERMIT FEE $ "SURCI1ARGE" has been changed for one
year effective
STATE SURCHARGE $ .50 Judy 1.20 until June 30, 2011.
TOTAL PERMIT FEE $ .'yS G The minimum surcharge for a "fixed fee" permit
(Office Use Only) is 5" eginning July 1.2010
This Application Becomes Your Building Permit When Approved Paid . 5-2 4, / R ipt No. 2 r l l / /
Date
Building Official Date 5-' 2 i l,/ j' /
.
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
r i/ - PR
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT . S, 07
y,w,NESO.0P I. white File PERMIT NO . !,
2. Pink City V ` 0 0 0
3 Yellow Applicant / V
(Please type or print and sign at bottom)
ADDRESS /3 Pafk- / Z ONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
BUILDER Aga---/-**Z ✓Ih �` / � (Company Name) � vi. ! " � J ����`� i (Phone) (Contact Name) 7 7i41 (Phone)
(Address) 110 f G 90 —
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteration ❑Utility Conne
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify t. +t I have furnished info mation on this . •plication 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- mentio•.. property and that all onst fiction ' conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c. • e 0 e thi r us aus Furthe ore, I hereby agree that the city official or a designee may enter upon the property to perform necde uisp ns.
X / /f /;G/ ° � — ' Zj 7
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ --J/_ ` 0 6
This Application Becomes Your Building Permit When Approved Paid 7Cfl '�— Re pt No. s7
Date /. s--. ! By
Building Official Date
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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE , DEPARTMENT OF
BUILDING AND INSPECTION
Smoke detectors s h a ll be up
as per the requirements of the IRC
hroughout the house Battery operated Smoke detectors shall be loca
s.
noke detectors may be installed in all sleeping rooms, on each
t
SfiggrIAMYRL /0 & 190 /9/1 /117 � and in halls to sleeping room
TYPE OF WORK /cam` S/D e/ 6Y .9-6-7 j/✓(hibQ ln// S
USE OF BUILDING /S ,glei
PERMIT NO. // . Z 2— DATE ISSUED 4, /9 / /
BUILDER JOH -NSo N rz,6 p PHONE # .5 03 Se
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
OM ,e_6 ::- S /D7A/ GVfHp /NfP. INSPECTOR DATE
rr. -o pi/4s 1 I
PLACE NO C UNTIL ABOVE HAS BEEN SIGNED
I FRAMING i i 1 a 1 sL- /i I
iL -1 v pl -._ . ,48/./ u C C4
`FINAL I 1 I
FOR ALL INSPECTIONS (952) 447 - 9850
att.,1 eatiut Certi 'PQ / 1 3 , era. , fork Was iotAe Okt
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