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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I, White File
2. Pink City
3. Yellow Applicant
/1- d?-OJ
I PERMIT NO.O (-/36U
3s-o~
ZONING (office use)
IS/)
LEGAL DESCRIPTION (office use only)
L01\..3 BLOCK8 ADDITIONWdf!&tbO
+-
~::e~R ~/~/~~/d
(Address)
~/~hL
e;c~ Sr-
(Phone)
9f2- 9Yc:J - 'Y'f'?-Z
.. ~
BUILDER ':4 (a. '
(Name) 0 <S"/c ~M
(Contact Name) r- ..I~~':; yA'.-/'
(Address) ~t:/~ c;,hh7jt;...>
~/.7.<;~
"7 SAZr... 'eA' C r-,.e'
c? //6' ~..,.-/~~
(Phone) 22 -25%' -S/--?"5
(Phone) 9-r,2 - /5% -, {/3:3
Cc..ll ul2- qal- crq 3'T
TYPE OF WORK
o New Construction
ODeck
J)!porch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace OAddition OAlteration
PROJECT COST /V ALUE (excluding land) ~
o Utility Connection
~
o Misc.
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 hereby agree that the city official or a designee may
enter upon the property to perform needed inspections,
2r'JCJ.9 .?~/7
Contractor's License No.
~# .a7 ~&cJ /
Date
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
ecomes Your Building Permit When Approved
# $
# $
$
$
# $
# $
$
$
$ ftJ58.0&
Rece~lo, ctJQ91
By _
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE eA
1I-U; -Of
Date
I Paid
mate {2.-((--o/
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
:;:~'d by fu, Ci"~Planner constitutes a temporary Certificate of Zoning compliance and allows construction to C4fMommence. Before occupancy, a Certificate of Occupancy must be
~1~ . .~t'.r/t-., t1-ICl(()( ~L. '..(l~~C~I(::~~~
Plan I g Director Date ", S ecial Conditions, i any
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
f/i 2)02-
~. ~r~:n ~:t: I PERMIT NO.c.-iV__02>c::?I
3. Yellow Applicant . "'" .J-~.
ZONING (office use)
/C--iSO
350e
W/~L OWSeY-Il!If 5/ S t,J
LEGAL DESCRIPTION (office use only)
LOT ..3 BLOCK _3 ADDITION N I G~ 0 (;V' 5: 12'7"
PID 25 -IOB.- Olfr,-O
I OWNER
(Name)
(Address)
(Phone)
APPLICAN..J;../ ;.4? i '"' .-J,.
(Name) ~ L'q~Cn: ~:7~\. ~~~J/
(Address) 4/ ~,d;,,~L~.. ~L'
(Address)
(Contact Person) ~...;/~~..r'
"
APPLICANT SIGNA TUR
DATE
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FlREPLAC AKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit # 0 1-- 0353
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ 395V
$ .50
$ 4tJ . ,rv
(Office Use Only)
This Application Becomes Your Building Permit When Approved
(J)~ 4-.//2 '02-
Building Official Date
pai~6 . (.t?.J
Date / .
4-fI t/ IJ ?/
Receipt Np. '.1
--rf 5ffrv
By
t_
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
03/ 23/9B~ON 09: 2t FAX 6124474245
CITY OF PRIOR LAKE
@002
LENGTH
WIDTH
SQ. FEET
: '2.3\6 s~
V
=-
HOUSE
x
x
x
ATIACHED GARAGE
TOTAL PRINCIPLE STRUCTURE...................... 2- ~ \"3
DETACHED BLDGS
(Garage/Shed)
.~.
o
o
x
X
TOTAL DETACHED BUlLDINGS............_......... 0
(Open Decks Yo" min. opening between
boards, with a pervious surface below,
are not considered to be impervious)
:3=
TOTAL PAVED AREAS......................................... ~.
'0
o
o
x
D~WAY~AVEDAREAS
(Driveway-paved or not)
(SidewalkIParking Areas)
x
X
P A TIOSIPORCHESIDECKS
x
=
x
=
x
=
TOT AL DECKS........................................................ 0
OTHER PfO~\f,tA
x
X
=
17Z
o
=
TOTAL OTlIER....................................................... I 7 Z S ~ . f:t t
TOTAL IMPERVIOUS SURFACE fropose.d [1,012. SPI:.
QOVER I . 54'6 "g., e-t
preparedBY~d-l~'~ <y({ _ Date 'Z.7IV(NeJ.;6r ZOOI
Company gJ2~ND'f bN?\tlfb12INC-f S'U)lVtirIN6-Phone#952 ltS)' J96t
" ",,'.>v', :
White - Building
Canary - Engineering
Pink - Planning
Tht' (.t'nlt'r or Ih~ I..k~ ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
'i-'-- '. .
NAME OF APPLICANT ~A1.d;'// (!lfrJta~('~t:2~d7L-
APPLICATION RECEIVED 11- C?7- cJ)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at ()
3 so? !L/ljZftJt(J:&cul.~r-
. .
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
/iI18
Date:
/2-10 -0/
.
Comments: See Reverse Side for Addition~1 Inform~tionl
.. ~ee Attachments~. .1) Grading PI(l.n, . 2) Erosion Control Measures
. 3) Erosion Control Plan'
"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
Pink - Planning
Tht" Cf'nlt"r or the t.kt Counlr)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT C!dc~L/ ~~W'---'
APPLICATION RECEIVED 11- C? 7- () )
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: X
3:s-o~ IL.JL12&ttJ&~_ r
Accepted
Accepted With Corrections
x
Denied ~
Reviewed ~tt r
Comments:
I. Up &.4. <3\MO~ &~.Q.C~I'S :l-Wou~ out ~ k,u~
"L. H-.u.~ Tr-c..u58. ~. "'* -J4 t~~o-- ~.kcrV\~
Date: f '2- 27-o(
"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
Pink - Planning
Thr (""nler or rhe t.kt Counlr)'
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:
/
-1' -
,;"."., -
Accepted
~
Accepted With Corrections
Denied ~ ~
Reviewed By: -' ~ /r'/"'?'L
Date:
/2--1 k!1!? (
Comments:
M~~ tM)AM
~~1k~l:~
/-~ ~ ~~~ ~~
~ NYXt~~
"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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ",-s.,~{)8 kJ ,'/ low ~~, Sf,
NATURE OF WORK J.J.ew APd.l~/1
USE OF BUILDING SFJ)
PERMIT NO. 1- :3 DATE ISSUED 1I":2~- 0/
CONTRACTOR PHONE~"~-?~~S3
NOTE: THIS IS NOT A PERMIT OR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
-
FOOTING
DATE
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
FRAMING
INSULATION
ELECTRICAL
IC
~ (2.w(()
r
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
[ r
FINALS
GRADING (Prior to Sodding) A/L? IZ 2:_(13
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT 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 havt"-baen approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850