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Of-, /034-1 ~ SG LOT BLOCK2 LEGAL DESCRIPTION (office use only) ADDITION PID zS. 4Z 5". 0 zA... ZONING (office use) K./S D OWNER (N ame) (Address) (Phone) (Address) . -t-f>U.IL.\7tf~ (Phone) '15'2--#1 -O':,S"5' (Phone) 5<::.""37 2.. TYPE OF WORK ~ New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace DAdditlon o Alteration OUtility Connection 0 Mise, CODE: ~R.C. OLB.C. I II III IV V A B Type of Construction: Occupancy Group: A B E F H I M R S U Division: I 2 3 4 5 PROJECT COST IV ALUE $ (excluding land) I hereby certify at 1 have furnIsh d mformation on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authonzed agent for the above-mentlo d ro cIty and at all constructIon WIll conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg official 0 e this permit I' Just ca se Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectlOns 8/Za! 04-. 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 ~ ikZ30 2- Contractor's License No. Park Support Fee SAC # # Water Meter I" , , Pressure Reducer Sewer/Water Connection Fee # # Water Tower Fee Builder's Deposit Other $ $ $ $ $ $ $ ~ $ $ rOO I 2..00 t' fJ C; 00,.00 TOTAL DUE This Application Be~ Y o~r Building Pennit When Approved '&/~ -fe-<i}/-- 10(/,10'1 13uildIlH! Orticlal Daft! ThIS IS to certIfy that the request 10 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 constIl.\ltes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be "'~PIM~ /tJ/" 61 See ~~l~!ogMrile 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 See Main File White. - Building .; Canary -:'EngineerTng AJlr\k -~Iannln~ The ('rnlrr of the Like Counlr)' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ,"~'." I y' /...,'Y / I '" (_......A""., "-~ /i': /--: ! ' l ..... I ' ,,' < t~: ~ ./' ~ ,,' . . ,_ ~. ._ h". /. I. ".". .-_.~,;. (,,(4i : ....."" , f /,/ . I , I J,. , i . '_' ' (.,' - ~...._" t'~} APPLICATION RECEIVED -'j !o I.., . . . j' ,/ -' l/ ,It" ,.,' , , ' I / "."./ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: L/I ~,71 '. - ,'- / ,/ ,~./l" t. "., 7."... . , ,. (."'7 C, / / \ c.1 J . , /' "- ,..' /O-.vt-C. . <,/ Accepted / * Accepted With Corrections t ~' ~$ Date: lo/;/ /a L/ / I , ,- ". . ~ . \ .. Denied r- Reviewed By: , . ! , .. Comments: ~ See .' "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." See Main File Thf' ("tnter or thE' 1.1lk<<' Counlr)' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT k!~/~ (~ t?'/2- 3 Ie, tf t B~i'~ APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ~~O;) ~ S,'6/ '1/71 t/' Accepted With Corrections Accepted Denied :&u~ ~ Date: (d jr /r; tj I ' Reviewed By: Comments: SeeMain~ "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." See Main File White - Building J ctanary - Eri~lneer~v Pink - Planning Thr ("('nln of thr Lakt Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ,,-1 /// f:' ,,- J .fA; (:~"' .(:~-~-,i:'", ,..- " H~~ _._.<,-l.--{..::~~.(?~ .-t-li~~._. t', /\ ' t~'_:J>!.,~_.(~~.".~;,,,,~1 '7 ....-". /:;-:;1 '/7 { ,,/ j~~A.,-'(.:;:l- APPLICATION RECEIVED .~."'-~?:' / /' ;.--.- ;- .r; oJ':') I. r " I ,,' .. . /" t.j ;" i' '-~n~,,___' /!...".' l' ; (j The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: .ill;-) / \-~;;<f:,~=./t, c::-;7'>~?;7 .!L,." ,::::-.:iE9-'Y<-k:__ j _.~) (~ ," ....-'/ ".,,..,/ Accepted Accepted With Corrections Denied Reviewed By: - - /) ,"'/}f.; I f j ,I i, ";. , Date: t.,/ Comments: See-Main File "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." 12/15/2BB4 14:5B 9524925BB5 GLmm'lG HEARTH r,j Hm1 PAGE B3 ",'-:" ~ ,,' . ~ D'$itt~~e~' d ~*TV" '171;'.' . . ,:.tTl1N.' ;i:tI.,: :'It.,,.I'ii .4ft ....... '.L~~.~:I.:ri..~,'.'liI. ...... A'l'h.'; '. ", U~~. " '... lWJUl...,I~I.~J.~U . '. . . .. ,. . I I P.J.k l, Gre.. ), Y611_ '. ';!1~ <~t:~',~~~~:\' .. Vn'~x-;j;:~o.~e . fY\N "",,"H0 "',,'_,. ' '.' LEGAl.OESC1UP1'!O,N(tifl'ice'u$cOllly) LOT neCK .A:IJD1TION PI~ (Address) R. O~ t. C i eeK J) -e s \ ~hJ J5 ....<< 110 ~I '1 -:j)ul Ll-\l.. AJ~ ~J 1Jn~(\-1ti~ rn N (Phone) ~l\'1' Oa9Jb OWNER (Name) ~:~;WrG \~W\Y\d- +teCl(k\;+ +\om~ (Addre~s) 10 C) , E \ d G, C\d-aJ)R '. ' Co (Witffi:iC:;'s)', '.' . .' (ContaetPersoti) II r<\ 5 ~\ fY'\~,,, @.:_ AP~i~SIGNA~ (. 6)\\fr\€'''~ (Phone) \.{ OJ.~ . Q d 1 ~ '" ,~orA oJ ffiW 55 &5 d-. ., J.' ((l;lty) (ZipCO'de) ~l1one) ~t1cl.Q 0.1 b DATE ti. \b 0 ~ ". _I", ,.- "~~,, ~l'COlil$tr'RO" , . /.-{ JI'"' "~i, -: ,~_: ((':-;fJ)~ FUIrnA:CEMAKEAWMODEL . .' '''"i--J.~:'''''''' . FLUE.SIZE' HE~,b.~lV~GS:_ ~;e:;mFSYS~:eM C1,..,l~111!IF4.~re:lMt9 CJ~ttv a'M~~~m o Air Cdrii1ltionmg [J'v~ntS,-:~ . ~'. ..~PUT lIE~~~:;G'R;POWBR PLA:N1' . [jJ-SteMt' ,Qi,ftof'W~ '1('0 ~~8Iiiil~n , 'I: iJg~ct$.Ii.1!l~f.~S.~ I'~"" .... ....,.~"'" ~~(j~et,~b~Jb!;8: " P'tiEASE NOTE: AitCondi~orter Units CannotEncroach into RequitcdSidc Yard S~bat:'ks FIREPLACE MAKEANO"M0'PEL bOO ,~lJ!;iSCm:Dl11,l;!E Industrial, Commereial&Multi~F:llminy l%>of;ji'1b"~~$t Rt!i~cl1tial,GasiFirep !3.ce $;j9 S(}'tttiti,ll'nil'tTL Residential, Hcati'ng& Ale (NtwCCltlstt;tlGtiCiI'l)$99'sO ResidenfiaJ, Additions & AI~erations Residential, HeatingOrlly(NewConsttucti.,n~ $64.S0 Rcsidentiiil.ACOnJ,y 539,50 $39.50 $39,50 Estimated Cost $ I. J .14 0, GO Bulldiitg Permit # H$A~'PElUAIl':r-}!E S:rA:tE"StJRCHARGE . T(),[AL-~E~FEE' $ $, $ ~D WITH au' . 'NG PERMIT (OmtelJae 'Oll1y) , .. .' ..' . ...... ..... . This Appn~'tlon'Become)~bil:rBufTdli1g'~eJ'fuh;;WhetT,:i\:pPto~,~ Dirt I..... - - .l....RB.yeCeiPt No, 'D~EC 2 0 Z004 ... a#lldhl~OrnclAl 2olI:bour,n6t1ttfor.atr insp,t!~t1orl!J,t9S:Z'4~7~9850;:Ill~" (95:1) ,447-4245 ttnO(l:E;ltgJi! Ctef~Ay.l!nlle. Prior L.~e. ,MN ,55372 11-12-2004 04:01PM MATTHEW DANIELS, INC. 423 3017 P.03 Date Rec'd CITY OF PRIOR LAKE PLUMBING PER1\1IT l. 81"" F;lc I PER'\-lIT NO~ :, G>W C"y l. Y ellow ,'P9li(2~' a.t bottOm) ZONING ladlec u:e) ADDRESS .)/'1} LEGAL DESCRIPTION (office use only) LOT 1'1 BLOCK cR ADDITION PID OWNE (Name) (Address) APPLlCANT__1 1\ . --:-'\ (Name) ~1f1. OJ7) /W11 ) 11-(1) , ~it Q , . (Address) '-'i'!J._~ (JJlX,k.AJJYl81, ~) 1.- (Address) r . ..3'1.~ 0 SS068 (Contact Person) APPLICANT SIGNATURE DATE Quantity Type of Fixture Quantity Type of Fixture I Bath Tub with or without shower T JI Rough-ins I Dishwasher / Water Heater I Floor Draip J~ Water Softner -3 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) I Laundry Tray (1 or 2 compartment sink I Sewage Ejector I Shower Stall Backflow Assembly I Sinks Backfiow Assembly Test Bar Sink Lawn Sprinkler ~ Wa~r Closet (Toilet) I Other \.!5 I' ,.., ^ - I I f APPLICANT PLEASE COMPLETE BELOW FEE SCHEDULE Industrial. Commercial &. Multi.famiIy 1% of job cost with a $39.50 minimum Residential, New One &. Two-Family S99.50 Residential. Additions & Alterations $39.50 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE I 51 A TE SURCHARGE TOTAL PERL-mT FEE $ $ $ 9q,~ .50 ~ I I ~~tJ.~a 7 ~_ j~~NO . Dal+OV 1 ~ ZUU4 .. By .f ',_~;_~,,'( }, ~'''I\;.''' ' . '0$' - '~i ",' ,'" '--" ~ . , COmee Use Only) This Application Becomes Your Building Permit When Approved \ Dare Bujldillg Omeial 24 hour notice tor all inspections (?52) 447.-98S8, fax (952) 447-4245 ., Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT ; ~:~~~w ~ji~~, I. PERMIT NO{)l./ -" L 0;),' J J Gold Appileant, _ _ ~ t.j ZONING (office use) LEGAL DESCRIPTION (office use only) LOT \<6 BLOCK d ADDITION PID OWNEi: (Name)-1Y k (Address) III <317 C~~. <ct.': K Ditl Llt'~l (Address) \.\-O \Y\-e c:,. LJL. AJ-el) Ue 'S'C (Phone/iS~) -LfL/ 7 -oCjSC: Dr \t.~r l 9. k e (City) 553'7 .) (Zip Code) APPLIC~T (Name) \---1 nD-" G \/" L1 f'l p l. \tl ( (Address) 13\ CS \\/\'6-" c:l S Sw C.c:\ (Address) (Contact Person) M \ (.\r,,{'j.\e APPLICANT SIGNATURE Sk \ (Phone) g C5~) - J 3 3 -- I c).OO c c_.,'S -3,- -7 q ','} VVl \( (',) e e '" ~-' - -I- (City) \ (Zip Code) q~., ;:;;;. (Phone) ~:) -j - <~ 3.::>~ / ;;)DO DATE y-()l APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure _ feet. Type of sewer pipe. 0 ABC 0 PVC 0 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 Estimated Cost $ Building Permit # SEWER AND WATER PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 \ \ Date ItJ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Date Building Official 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd ~, ~e:n ~!~y I PERMIT NO.A&! . Om 3, Yellow Applicant ~ ~ ZONING (office use) sE LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) ~ t'.kJ C/Ce,k, /I cY717' 5 (Phone) 9-:;;;; -' 7"'-17- 09 SS- (Address) APPLICANT (Name) A //6(/// ~ /<J J'~j~ 7/?~ (Address) /;?;/' <;"':5 ~ J '~I /c/ ;.<Jt.~ (Address) (Phone) c? ~:;;; - 7 ~' - (,-;.,2 c? c::;/ ~~~~~ S~~?/ (City) (Zip Code) (Phone) 99-7~?--Qc/d DATE /"'~/ APPLICANT SIGNATURE LICANT PLEASE COMPLETE BELOW (Contact Person) ~w CONSTRUCTION D REPLACEMENT D AL TERA TIONS FURNACE MAKE AND MODEL ?L/~' 5Y't:7/H)<1l/o:??oSc:J FUEL FLUE SIZE ,..:< '/,P//~ RETUR'N OPENINGS / INPUT :? 0 c;/d:::/ OUTPUT 71/ S-cJ c;/ ,J ../ TYPE OF SYSTEM HEATING OR POWER PLANT rCiWarm Air Plants o Steam PLEASE NOTE: DGravity o Hot Water Air Conditioner Units o Mechanical o Radiation Cannot Encroach into ~ir Conditioning o Special Devices Required Side Yard ent System o Other Devices Setbacks FIREPLACE MAKE 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 $39.50 $39,50 Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) Estimated Cost $ Building Permit # HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ ,50 (Office lJse Only) I ::cei~ No Date I Paid Date This Application Becomes Your Building Permit When Approved Building Official 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 PRIOR LAKE INSPECTION RECORD . \ 71 I-\~Illn E DEPARTMENT OF See Main File BUILDING AND INSPECTION SITE ADDRESS NATURE OF WORK USE OF BUILDING .F: PERMIT NO. ~Q34- DATE ISSUED . CONTRACTOR ~ PHONE ss- N.OTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY S P RATE DOCUMENT "/c.J r #t'cJt n ~ I/, /(; 0 FOOTING S.E I FOUNDATION (Prior to Backfill) PLACE NO CONCRET UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING ~ HEATING (if required FIREPLACE ~~ d// GAS LINE AIR TEST 'r ~/" f /,,"V) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ~E/ #jI"~t~p 'f: 4/2AI71~# #t"Y'~~t FI ALS GRADING (Prior to Sodding) BUILDING ~~ y, . V.. t/'t' ,r i, / 135- 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 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