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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
_I Yellow
File
City
Applicant
n at bottom)
PERMIT N001- 4- J
(Please
ADDRESS
.5500
WC)o OLI\W~
Q.\R.
SE:-
ZONING (office use)
lZ- V,
LEGAL DESCRIPTION (office use only)
LOT to ItLOCK
ADDITION
9=-M()
PID 2.'<)- Ol:-/-ri/'O
OWNER
(Name)
N\ t ~Q~y\)
""'00 \}J 00 R
\- \i\. S ~A V.:!) N F-'L.LO"
L u.JN rC\R.. S C
(Phone)
(Address)
(Address)
(Phone) -'P-\ ""2. - ') 0 <6 -() S ~ 0
(Phone)
BUILDER
(Company Name)
(Contact Name)
qq
o
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition .~teration o Utility ConnectIOn
ORe-Siding OLower Level Finish 0 Fireplace
CODE: OLR.C. OLB.C. o Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
M~s,m ~I\\\t
PROJECT COST IV ALUE $ -\ 4 \. ~ ~
(excluding land)
Permit Valuation
..........-. -~._-_.._---~------
Paid
Date
i~~1
$
# $
$
$
# $
# $
$
$
$ .- i 0.-
Receipt No. .'~LB31
By (lAJ t4-'
Permit 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
0,-
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
TOTAL DUE
it When Approved
Date
ThIS IS to certIty that the request In the above application and accompanYll1g documents is 10 accordance with the City Zonmg Ordinance Jnd may pn)cl'cd as rcqucsted ThiS document
when signed hy the City Plannel constitutes a tempor,uy Cenineate of ZOning compliance and allows constructIOn to commence Before occupancy, a Certlficatc of Occupancy must he
Issllcd
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
11:54
CITY OF PR lOR LAKE
9524474245 P.01/01
- -- - - . .
CITY OF PRIOR LAKE PLUMBING PERMIT
f,./.ll 0",'1 l. . 7 - c> <If
t S~w ~. fPERMIT NO. r-j_ 1- / J
,
1 ZONING (.... "'" I
LEGAL DESCRIPTION (office use onlY)
LOT
BLOCK
ADDrfION
PID
OWNER
(Name)
(AcUhess)
Nickolas & Triana Vonfeldt
cell 6
(phon~ 952-329- 714
APPLICANT
(Name)
R C Plumbing
(phone)
Northfield
(City)
952-652-2933
55057
(Zip Code)
(Address)
S9tO Chester Avenue
(Addret;S)
(Contact Person) Rich
APPLICANT SIGNATURE
(phone)
952:'-652-2933
DATE ~- 9- c>7
Quantity Type of Fixture Quantity Type or Fixture
J Bath Tub with or without shower Rou.gh-ins
Dishwasher Water Heater
Floor Drain Water Softner
<~ Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
f Shower Stall Backflow AssembJY
Sinks BacKftow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial. Commercial &. Multi-family 1% of job cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Residential. Additions &. Alterations $39.50
Estimated Cost S
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
it When Approved
\
! Paid
I
\ Date
24 hour oodce for alllnlpeetions (95'1) 447-9850. flu (9S~) 447-4145
16100 Eagle Creek Ave.. S.E., Prior Lake, MN 55372-1714
~ Receipt No.
By
I
TDTAL P.01
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY:
~
r
~",
Date:
//;lY~ 7
Building Permit #
Site Address 55"'0 CJ
Legal: L~ B
Existing Structu~r NO
PID:
~Oc.~
Zoning:
~ S.€:
Subdivision: J.,..J. f. .... ~~ ~ (J:!:
I CONFORMS TO ZONING
ORDINANCE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? No
Is the property located within the flood plain? Refer to Planning NO
Does the alteration include any additional kitchens? Refer to Planning 1-10
Does the proposed alteration include any outside Refer to Planning tJO
entrances other than patio doors?
Is the proposed use of the finished space or Refer to Planning
alteration for anything other than a normal single No
family home (office, group home, day care, etc,)?
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\AL TCHCK.DOC
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 'SSOQ uJOd-C~""-'N C\(L, S,G..
NATURE OF WORK AL- \.
USE OF BUILDING ~s AlA- .
PERMIT NO. t?-1- 4 f DATE ISSUED \/-z.1\-(07
CONTRACTOR l~~'-(~ er~ PHONE In f-z....,ee - D~~o
.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
J e-ATIf l1' I
I F:~UrJ~:-{fI1}I~lor to Backfill) I ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
B .A : UlMER I SEPTIC
FRAMING
I /'
)-1(;"1
ELECTRICAL
PLUMBING
HEATING (If required)
..I ~ff7
L."_..."",
TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~.
or to SocIdln )
BUILDI~G
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