HomeMy WebLinkAboutBuilding Permit 04-1136
illcrfifirnfc of @rrupnnru
CITY OF PRIOR LAKE
~rparfmrnf of ~uil~ing JInsprrfion
~inal Permitted LJ Conditional c.o. Expires
!
\
This Certificate issued pursuant to the requirements of Section IIO of the [] 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:
SINGLE FAYILY 04-1136
Use Classification
Bldg. Permit No.
R3
VN
R.l SD
Occupancy Type
Type Construction
Ll, B'. HERITAGE LA"\DING
Zoning District
Legal Description
1..045 J.:iERTTAGE ',A~E
Owner of Building
Site Address
ROCK CREEK BLDRS., 16817 ;)W,UTH AVE S.E.. PRTOR l.AKE ':i53r'
Contractor's Name & Address
ROBERT D. HUTCHI~S
J A.'lE KAN S T ER
City Planner
Date:
\ Bui)ding 9fficial .~
/'. ;., i' ( I Date:
)/ 'pOST IN CONSPICUOUS PLACE
,.,...__.---.-...._..'~k.._~_-',--.~~'
'.'__J _iL",;,,-"_-'_.j.,,~;I.t.:_-J.:I'J., ...11' :~~'~_~~~ju.'.l.. ...,': Ji..
~ _i.,~'JI\\d;";;J__' 'iIlL.:..\Ji.4.~~~-' 1 J....J > MLA.IL.....A~... ,- ~~~....
5" 0 g~ 0 000000 " 0 ,. -(")
lI> 0 :x ~ c z_
'0 0 en"Tlz"Tl"Tl"Tl 0 c ~~
g lD 0 s:: ::::jzen~OO Z ;:g
0 n. m mO
)> 0 ::0 ::0 ::0 s:: !!!)>c3:i~ m ;:g m ~"Tl
, :: ;l:l ;l:l ,; z'S;zcz Z en
l'!l , ~ m m en m 9 C/) -"
~ 0 o > Z ~ :::!G)~G) O;:g
t -i -i -i z-
l'!l ~ f,\~ m 0 - zO
~ .... > - o Z 0
I o en o;l:l
S CD -i "Tl -i Z ~
co ;l:l - > (5 :jS;
~ UI ?'- o 0
0 Z -i Z q 0,;
"Tl 0 )> 0 mm
~ 0 )> ~
;l:l 1 Z
, C
~ -i "Tl " "
~ :x 0 ::0 ;l:l ~
~ m ;l:l 0 0 000000
z ;l:l 0 0
~ m m m m 3:"en=:3:" "">
>< z m m ml~>ml
-i 0 0 OC -iOC ,
en ]-
~ ~ z ~ " J:3: mJ:3: " en
~ en m "Tl!!!;l:l;l:l;l:l!!! m 0
~ " :l 0 ZZJ:J:-Z ;:g :x
::! m lD -i >G)OO G) 3: m
0 ::l. (5 C
~ () 1"Tl00 ;l:l ::::j
-i 0 Z -';;:11: - C
0 zcc Z ,
~ ;:t l:ll ~"" 9 m
Z :: m C
~ "Tl
N 0
....
~ :x ::0 C1
m
~ 0 0 0 ('.
C
;:g 0 1': ~
< DODD;)
en m
~ Z ;l:l G)"Tl"Tl0 " ~
)> z ~iih ....
Ro G) ~ m
C cqjqj
~ ;;
~>> ~
~ z >00 "Tl ('\
~ 0 _mm-i_
!T1 ;l:l"Tl;l:l 1 -i
-i-- 1 i
enz z m
-i~ G)
5" ~\o DtDDDD "tl 0 )> -n
z_
lI> :x :IE 0 ~~
al o 0 ~ en z"Tl"Tl"Tl 0 Z c
B 0 !l 000 ::::j en~OO Z m ::tl mO
)> 0 ;l:l ;l:l ;l:l m>C CO m ::tl m 0"Tl
t::l , :: ;l:l ;l:l " -'S;i:Z-i z en :j"
l'!l m m en Z -0- en
, en -i~>~ 9 O::tl
~ t 00> "lI - -i z-
l'!l -i -i -i m 0 - zO
10 .... :!: > - o Z 0
I o 0 en -i Z o::tl
S CD
co ;:a :::! ~ (5 :jS;
~ UI ;:II: 0 0
0 . Z-i Z 0;:11:
"Tl o )> 0 mm
~ 0 > Z ;l:l
::tl F 0 :<
~ -i "Tl " "
~ :x ::0 ::0
~ m 0 0 ~DDDDD
z 0 0
~ m m m "lien 3:"
>< m m '~~m'
-i Z 0 0 OC -iOC
~ Z ~ en :1:3: m:xi: " n en
~ ~ "
~ en m "Tl!!!::tl::O::oQ! m 0 0
" :l 0 ZZ:x:x-z ::tl z :x
::! ~ m lD -i >G)OO G) 3: -i m
::l.
~ 0 () (5 I~~~ ~ ::::j ;:a C
-i 0 Z C
0 3- zcc z ,
~ lD ~"" 9 m
Z :: m C
~ N "Tl '\
.... 0
~ :x ::tl
m
~ 0 0 ~~
c: 0
::tl < OO~OOO
en m
~ Z ::0 G) "Tl0~ ) l\. C
Z >::tl:uo l\ >>
Il- )> G) f!!mm3:G) \ iil
c r ~
~ ~ -"""~
ifi>>>c ' ~
~ z >ooz:;;
~ 0 _mm-i_
rn ;l:l"Tl;l:l 1 -i
-i-- 1 i
enz z m
-i~ G)
\
000000 " ~ )> -n
z_
:x c ~~
o ~o ~:!!z~~~ 0 Z c
5' z m ::tl mo
lI> o 0 ~ -izen CO m ::tl m 0"Tl
~ m>cl!:Z-i en ::!"
000 Z'S:zgz z C/)
@ 0 n. ::0 ::0 ;l:l 9 O::tl
)> 0 ;l:l ;l:l ,; en :::!G)-iG) z-
~ , :: m m en "'00_ zO
1 00> m Z 0 o::tl
~ t -i -i -i ~ Z ::!5:
l'!l ~ > - (5
~ .... o 0 ~ 0,;
S cD ;l:l :::! > Z 'S mm
co
~ UI ,; 0 0
0 - Z-i 4
"Tl 0 > 0
0 > Z ~
~ ::tl 1
, o _
~ -i "Tl " " D~DDDD
:x 0 ::0 ::0
~ m ::0 0 0 3: en=:3:"
~ z 0 0 m ~>ml
m m m m ~3: iri~~ en
~ m m " 0
>< z 0 0 m 0 0
-i "Tl!!!;l:l;l:l;l:l_ :x
:oil en -Z:I::X-Z ::tl Z
Z ~ " ~C')oo C') 3: -i m
~ ~ en m ::::j ;u C
:l 0 1"Tl00 ;l:l C
Q ~ " lD -i -;:II:'; - Z ,
::! m ::l. 0 Zcc m
~ n (') ~"" 9 c
-i 0 Z
~ 0 ~ l:ll
Z m
~ "Tl
N 0
~ .... ;l:l
:x m
~ 0 0 000000 \~
c 0
::tl < C')"Tl"Tl0~ C iil
en m >--0
:i! z 2:! en~~3:C')
Z c"""~ ~ ~\
~ )> C') ~5:5:5:o
c
~ < >ooz;;
)> _mm-i_ II -i
~ z ;l:l"Tl::tl 1 i
n -i-- 1 m
~ enz z
!"1 -i~ C')
CITY OF PRIOR LAKE BUILDING PERMIT, r:--nd~te~i~;~~
TEMPORARY CERTIFICATE OF ZONING COMPLIANq~ OCT 1 2 2004 I!
AND UTILITY CONNECTION PERMIT I i,\
File
City
Applicant
I
I?y
PERMIT NO. o4'w 1/3 ~
,
I
i
--I
I
Main File
White
Pink
Yellow
LEGAL DESCRIPTION (office use only)
LOT
BLOCK 2.. ADDITION l+ E
PID .....
OWNER
(Name) --IWvlL CfIZEt.. IIEs~ q ~f's
(Address) Ib I A. ,
.r- i'll-I LIIE.,s.
L
ZONING (office use)
K/5#
-c'
(Phone)
QS2-. 4}7 -O/S-S
BUILDER
(Company Name) ~AlY\~ A-S A.I3OV~
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK ~ New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnectIOn 0 Misc.
CODE: ~I.R.C. DI.B.c.
Type of &nstruction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
III IV V A
HIM R
2 3 4 5
I
E
II
F
I
I hereby certii)' that I have hlrnished mformation on this applicatIOn which is to the best of my knowledge true and correct. I also certIi)' that I am the owner or authOrIzed agent for the
Jbove-mentlOned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submittcd plans. I am aware that the buildmg
"fflcial can revoke thIS permll for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed mspectHms
x
Signature
Contractor's License No.
Date
Permit Valuation
Permit Fee
TOTAL DUE
Park Support Fee
SAC
#
#
Plan Check Fee
Water Meter
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
This Application Becomes Your Building Permit When Approved
~ ~jwJ
l3uildlll~ Otlicial
/O/:2S/0'/
, Date
$
$ I 0
0, 0
$ 'Z o,o~
$ L(~.On
$ I 00. 0-0
$ 700, 0 0
$ )$00.00
$
$
ThIS IS to ccrtii)' that the reqHest in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as reqHested. ThIS docur
when signed by the City Planner constlllltes a temporary Certificate of Zonmg complIance and allows construction to commence. Before occupancy, a CertIficate of Occupancy mu
IS~ ~ /olzsh c/ ~~ a.ff ~
Planning Director "Date specia~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
04/28/2005 11:15
9524925005
GLOW mG HEARTH t~ HOrv1
PAGE 01
~~ITY '0
HEATIN~.lttJf}JJND ~"
I' ,,"
i~JkAKE ,
,. ..IREPLAl_!~1P~ERMIT
Da:'t'Ehlftec'd
I, P;n~ FII~ 4i..BRMIT 'Nfii77 ' tf
;: ~;:w ;~~I~a~I~;iJ~r~<l :, " . ' l{. -c / / 3 h I
ZONINGCoffice ust)
LEGAL DESClUP"rlONto'rtice"u!e only)
,LOT B10bK
AtmITION
PIi'l
OWNER
(Name)
(Address)
R"Gc. t ('( ee, t ',,, , ., , ""."'~;''' (Phone)
\~'6\'l.1) u.\U\\--. A~~ ~€ '~\~~R..\roJe mr\)
. .. q, ...".,..
APPLtCANT' " ',' ,", " ""
<:::.) -1~~~\dt~~~(~;,~~b~~~fO'6'~ .
<A:dl:li'e~~)
(Contact Penon) -=r \ m ~ \\ \ ~ ~ L . @' _,.,
APPM..CAoNrSIGNATURE f(\ hlroek..
., ,. , ".. .. ' . ~
(Phone)
'MN
4 q ~ ~q a.lfo
55~d.-
J
(Zip Code)
. .~~~t~~r~~~~IpS~r..ID:m~.~~~~
NEW'iCONSTRV .:;rr~~r "'[J~ :, ::,OEMri~t ..,' 1.;;ALWM1trONS<
FURNACE MAKE AND'M()PBL-=ht~c>~ J~.r(O]~ ..; b09C."'TR \:)I\~ F'UBL N, Coos
FLUE SrZE ;RETIJ:RN'~p:im~.t)s .' ;INPUT, OUTPUT
~:E.qF.'SYSW.:eM 11EfA~le~~/p()WER PLANT
tIW,l\:r:it\.j\,jr,Plilttts OSIM
DGra~It:YCJ:Hot.W. ;n:t~
ISl'MCel1tfiitlil i{iliK~~tli~t{j)n'
DAir Cdmnfi~l1ing:@J;:~JJeOl~fi!1e~,r~ ._
o Vtnt.$~tt~iI'i "Iii\Ql~r~Di:lliG!~'
., .
PLEASE NOTE:
Air Conditioner Un its
CannotEncroachinto
Required,Side Yard
Sotbacks
FIREPLACE MAKE AND~M<VDEL
'Ji"Er'&$C:a'EI):ut~
Tnc!ustrial. Commercial&Mlflti'Pllmlly . J%of;jW'~st 'ltesldct'ltiaJ, G8.~ F.iteplacc
,$39:Sl},rttlmit\lJm
Residcntilll,Helulng&AJr:. (NewC15mfl:1jctlol'l) S9~:50Res{dcntial; Additions & Alterations
Rellidentilll. Heating Olily(Ncw Ccin!:l"ructiG/'j~ $'64,M R1!Sidentlal. ACO.nly
$39.50
$39.50
.$39.50
Estimated CostS
Building 'p,et'ltJH #
(Office UnO"ly)
HE~iFING'PERMIT.FEB
"StAtt'SukOl'1ARGJk,
'f(;j'tAL',PERMTrt"IFE:E
.$
.$
$
.50
Th 1!"AppliclltJon ,lJecotrte!l;burl:lUnaih,g :'eetttilr,WhelJ Apptovtd
.,' ." .
Paid
Receipt No.
Btlllilhi~;Ointllii
,Date
---.
9"fp
24. hOlir>notttetorallifffiipl!tti6hY (.952) at41.98S0"tax (.952)447-4245
Ifj'~jjOEllgJ~'C~~lc.A-v~titJe, Ptlor Lakl!,MN 55372
-
lhe ('tnltr of fht I..kt Counlr)'
Main File
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
,
i
(,
/' " li,/
( t" ,.') .i.'/ ,d/
''-- ~ .' ." .: _,.-1 . -",:' i <.~"""~~
I ,.i} . //"~'\,
/ .... ,':", J'
" l
.,
;t
!\ .
./ ./ !
., i
,
NAME OF APPLICANT
f-..-,-' .'
.I
APPLICATION RECEIVED
/ /)
)
,.
/\/;/
. ;:...,"
t,_" ;.
i
I ..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/)I..../c" ...
./ '~-" '-)
/
/}
,.. //..?;
/
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Ifrf/j
Date: / 1- ;< --CJi
Comments: See Reverse Side for Additional Information!
(J1q//\ hi Lc J
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
"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."
Th(' C"t"nlt"r of the Lake Counlr)'
Main File
White - Building
Canary - EnQineering
C- ~nk - P~nninCf:::>
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections
~
Denied
Reviewed By: ~.~ Date: /ol2..~/oY
Comments: ~ PtI 0 ~~ ~~ (J...<J ~,
tA1/1 . ,.. -+- '. '
.~. -/' ~ Is-a -<::J.tL.:rh-d.- ~-n-..., 0, H. W, 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."
Main File
~hite - BuildJiig:>
Canary - Engineering
Pink - Planning
The ("rntt>r of tht> Lab Counlr)"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
~
,?ocI a()fllL IjJp~ CJ-.1U>>..lcE
/ ()- !d-CJtj .
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propose9 at:
JjOL/S- - c}/~cr ~
Accepted
Accepted With Corrections ,/'
Denied
r
~ ~ Date: /fJ/z..s-A>t:f
,
K~~ .},~. ~~-&JL
~ ~ ,~,~ o-v.-~
~ 7:~,{). or h.fj ~,
Reviewed By:
Comments:
AOJ:U~
..~
~
"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."
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by: ~ ~ Date:/t'?-5~Y
Building Permit # PID: Zoning:
Address: fl?'IS; o/tJ1~/ 4/~5J iJ~ ~.
Legal:L/,l/3 l B 2- Subdivision: ~f~'
Existing Structure? YE~ Existing Nonconforming Structure? YE@
YES
I NO I
Proposed
Z'
/2.- I
/21
/ Sc3' 'Ie l)1ftJ).
I CONFORMS TO ZONING
ORDINANCE
.
Standard
25'
10'1
25' if abutting a street
. Sidewall exceeding 50' requires additional side 2"
setback for eve l' over 50' in len th
. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicatin no deck will be built in the future
. From 100 year flood elevation of wetland/NURP
ond
. From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
1 0' sidel
25' rear
30'
tJ~f
75' or setback average of
adjacent structures, but no
less than 50'
1~31
Yard Encroachments: NA I FAIL MPLlE
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line Easements.
AlCand other: equipment cannot encroach on interior
side ards.
Standard
Floor Area Ratio: NA I FAilS
.30 Maximum
tJo.~S"'C:.' ..
J. "\ o. _l.;?;-.~.._.
I\;.J . ~f-"~;'- '"",,,,::- v-'''
~
Tree Preservation:~ N.JI FAilS I COMPLIES Standard Proposed ..
.. Total caliper inc 'eS
. Permit 25% Removal
. Calioer Inches Removed
. Calioer Inches Preserved
. Replacement V2:1
L\TEMPLA TE\BLDGLIST.DOC
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NQV 0 5 2004
~~~~w ~ii;:. I "~..EftMIT NO~-4'Ut~~/31-1
Gold Applicant V~ . UI
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER 0
(Name)_l\f'f K
(Address) J lI'< I ;7
C
--1 e f-' K
\)ll\u+h
(Address)
\-\ ('\ (Y'\ P <:-
\\.J42nUt"
I Le.
(Phone) qS.;> - #7 -D955
C"
"-=> f
Pf I rt-
(City)
u^-k e"
55 ~-7~
(Zip Code)
APPLIC~T
(Name) j i\n \
G'O~dL
\('\('
J33 --I r~){)
(Address) I?, I s f\,lll dl S
(Address)
(Contact Person) ~\\( \.''-P \ \ t:.-
APPLICANT SIGNATURE
'::"~{~t::{- ~I
~;S3""7Cj
.
(Zip Code)
/ .:;L[j)
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure _ feet.
Type of sewer pipe. D ABC D PVC D Cast Iron
Estimated length of sewer line _ feet.
Clean out (if required) located at _ feet from structure.
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOT AL PERMIT FEE
$
$ ~O
$ /'
/"
(3~
pftlO 6f?
BU 11/0
Estimated Cost $
Building Permit # ()4-. //3 (p
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
Date If. '5'. 0 "......
By
Building Official
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
11-12-2004 04:02PM
MATTHEW DANIELS, INC.
423 3017 P.05
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PER.t\1IT
~. ~ ~:~ I PERl"nT NO~. ' f2n
1. Yello- .\~O",^' . ~
(1'1(:= typ~ 01' print and sil';l1 u bottom) .
I ADDRESS
fo-/r ,-JLN.t-1P~-.J.J,.
LEGAL DESCRIPTION (office lJ.SC only)
\ LOT' BLOCK ~ ADDITION
ZONING (office u.s.!)
OWNE
(Name)
PID
(Address)
APPLICA..~ _, ~
(Name) "7 "fttt"J OJ'""]) j;::M j J d~ J . '-:.4J( (I. '
(Address) I~~ {JA Jt}, AJl)(\ 4J ~ ~ J h .
(Address) (j ,
APPLICANT SIGNATURE
(phone) t:S1. Jj~.
qVJJ ri AJ j 1. r. \..tJ. ;;
(Ciry)
(phone) #' 65"1.
..3'1?o
DATE
,
(Contact Person)
Quantity Type of Fixture Quantity Type of Fixture
I Bath Tub with or without shower ! J/ Rough-ins
J Dishwasher I Water Heater
J Floor Draip I~ Wa~r Softner
~1 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
, Laundry Tray (lor 2 companment sink Sewage Ejector
/ Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
.-2. Warer Closet (Toilet) I Other ,"-<::)" ~^ ....." '"'" n
, 1 T
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial &. %vlulti-family 1% of job cost with a $39.50 minimum Residential. New One &. Two-Family S99.50
Residential. Additions &. Alterntions S39.50
Estimated Cost $
Building Permit #
jAi.' !
9'i.~ ';'.
SO '01' JG'
/tJ()..()~~ ~'. i:";., .
..
."
PLUMBING PERMIT FEE $
I STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office U~e Only)
This Application Becomes Your Building Permit When Approved Paid
Receipt No.
DaNOV 1 5 2004 By
Building Omcial
Dak
24 hour n~tlce for.n illSpectiolls (951) 447-9850, f.x (9S1) 447-4245 ..-
,
..
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
i ~~~;w ~l~icanl I PERMIT NO. , ') i/'" / I ~~ ('? I
ZONING (office use)
/ ( '-
I
J
1...'"
'"
LEGAL DESCRIPTION (office use only)
LOT
"""""l
BLOCK :/... ADDITION
/f/../,!:
,i'
PID ~ :: - if '~ C; ,,'
~.
') .-u
{Address}.--'),,' (~..:~~: :)~.,..l)tJ,i"" l
i"~,'."",,r;..,r"C':;' ..,~
(Phone)
,.;..'~./i.r. ...,...... . .... .....,.. / ",.
, .i"f...' . Itt..:.,..:',.,~.
4...,/ {.,~ .~7-
OWNER
(Name) 1<,'( '. t/
.'ir.
1/(,. i '.1 ,*' ':',~
.~.
APPLICANT
(Name) j ,: I? ("
.
:..// - t"
.; . I' I::
(Phone) t/ '.
c'
,
(,
/.
-.. --,. -_.,~:,
(Address) /
',:/Z/ ..
.; ,r! Ie
(Address)
.':} ~.,
:1')' J '.'
"j ",
(Contact Person) . I ,. c ... I <'
.--...
,,' /"
,-
(City)
(Phone) '"/' i; ,
(Zip Code)
"
APPLICANT SIGNATURE
/ .,/1(.
../
,.
.I ,/l
.r:r" ~
~ ...:. ...
,~"~~/>..",,
DATE /-
---'
')
~EW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
....., -f. p'l.' ",L.
FURNACE MAKE AND MODEL /,)~'F J-" I''\. -:? (/t:..:" ,; 11 ;'-" ';'~ ,'., (; (~,~' _" t..,./ FUEL
/
FLUE SIZE .-.~':<: )l/L: RETURN OPENINGS 7 INPUT ;~< :> ~/'(",... {', OUTPUT 7"; . ,
,,d,.
TYPE OF SYSTEM HEATING OR POWER PLANT
[!]Warm Air Plants o Steam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
G Mechanical o Radiation Cannot Encroach into
[:1Air Conditioning o Special Devices Required Side Yard
(MVent. System o Other Devices Setbacks
I . - . -,.... -~~ -.
FIREPLACE MAKE AND MODEL
ApP'LICANT PLEASE COMPLETE BELOW
/",. '.
,.
Residential, Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost 'i Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Estimated Cost $
Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
y
Date
Building Official
~ I
24 hour notice for all inspections (952) 447-~50, fax (952) 447-4245
I') .
, ,
Driveway: NA / FAILS Ii
· Maximum width at
· Required setback
.
.
.
Building Height.
FAILS
Shore/and District: NA / FAIL
Minimum lot area s uare feet
Minimum lot width
Shoreland alterations
1m ervious surface
Bluff in Shorefan NA FAILS / COMPLIES
· Setback from top of bluff
.
.
.
Floodplain: FAILS / COMPLIES
· 100 year flood elevation
· Lowest floor elevation
· Proposed lowest floor elevation
· Elevations 15 feet from structure
.
.
.
.
.
.
L:\TErvIPLA TE\BLDGLlST.DOC
Standard
24'
5' from side lot line or
30' from r-o-w on corner lots
10%
35' Maximum
30% Maximum
Standard
By planning dept.
Standard
908.9' Prior Lake
914.4' S rin Lake
909.9' Prior Lake /
915.4' S rin Lake
Must be l' above flood
elevation for new and existing
structures. If existing
structure was constructed
9/19/90-11/22197 then
additional foot is notre LJired.
Must be flood elevation, or
hi her
907.9' for Prior Lake
913.4' for S fin lake
Standard
832 s .ft. or 25% rear ard
10'
15'
. Si,
~
Proposed
r--
Proposed
Proposed
Proposed
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS tJ M /(lrAErE He
NATURE OF WORK l..J ~,.,
USE OF BUILDING ~
PERMIT NO. 11 (J+ J /30 ~ATE ISSUED
CONTRACTOR Gt.IC, l!RISt.. lJ/l.;,./J4s PHONE . ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
Main File
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRET UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEP
FRAMING ;n
,.,(.
INSULATION
ELECTRICAL
PLUMBING I ('); M;
HEATING (if required)
FIREPLACE
qAS LINE AIR TEST
GRADING (Prior to Sodding
BUILDING' t":"
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
UNTIL ABOVE HAS BEEN
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