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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
'.M.... ., pOl
~_>. ee '.....aln L 11 t:, File
(Please
ADDRESS
'-( d- \.f 5"
P. r 1::..1.1 ;e..,.,t Lit}_
LEGAL DESCRIPTION (office use only)
Date Rec' d
5~ :J-t"Ob
W/ou t
2 Pink City
3 Yellow Applicant
I PERMIT NO. cJ ~ -5" J-J- I
}.Iw
LOT 19 BLOCK
ADDITION
:s;
-0
ZONING (office lIse)
D
OWNER
(Name)
BiI; IJtr
(Address)
(Phone)
BUILDER
(Company Name) \..Vl'.I\S ,v..,c.1'\1'\
()~^^:s f2-
(Phone) bS' - '1 Db " '-/1.(0 0
(Phone) (,i}-~bG-)Q~l./
MN 5"1
..... ~c. S.,,'-k-
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TYPE OF WORK ~ New Construction D(Deck OPorch ORe-Roofing ORe-Siding 'if Lower Level Finish t&Fireplace
OAddition OAlteration OUtility ConnectIOn
CODE: ~I.R.C. DI.B.C. o Mise.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
PROJECT COST/VALUE $ 130. DDO.DO
(excluding land)
I hereby certify that I have I1lrnished mti)rmation on this applicatIon which is to the best of my knowledge true and correct. I also certify that I am the owner m authorized agent fi)r the
above-mentIOned property and that all construction w1l1 conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
official can revoke thiS permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propel1y to perform needed mspectIons
X ~~L ~LL l'fs-g 5"-1-06
Signature . Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
$
$
$
$
$
$
$
$
L{(). -
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
~ r
~
Buildlll!! Otlieial
(P/IS/O~
Dille
Park Support Fee
SAC
#
#
$ -
$ /55D,--
$
$ -
$
$
$
$
$
Water Meter Size 5/8"; 1",
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ThIS IS to certIfy that the requcst in the above applicatIon and accompanymg documents is m accordance with the City Zoning Ordinance and may procecd as requcsted TIllS document
"','hen signcd by the City Planner constItutes a temporary Certificate of Zonmg compli,mce and allows construction to com~ce", Belo.re 01\,I,p,alJc,' a Cei:,tIflcate of occuP,anc, y must be
lS~ r 6 ,~eo r,-:o lL
' ~ h/lt( 0" ~.d "I~:,/ )l.f.aln rl' _ '
Planning Director I Da e Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
08/04/2006 FRI 7:47 FAX 952 767 1900 GENZ-RYAN
[4J 028/033
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I Pink
2. GrC!n
:; yellen....
~l~ I PERMIT NO" . 6Za.
Apphtatll 1
I
~
/)
I ZO NIN G (office
use)
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
UWNER
(Name)
,Q)f)SrY\OJ'\O
~ gLfS Pf Om. Dr -1=1= 20)
(Phone~ [051- 05-37011
~g(lV\ MN '35/;).;) I
(Address)
APPLICANT C-p.~ -J '1
(NameL~..:l~11 C" icLjOJ\
(Adciress)),,?LO UJ . r~1J~L1 I ~3 ------ 'I
v{ rr\ (A.ddreSS)
(Contact Person) _ T\ _ I
APPLICANT SIGNATURE DATE g/~::3 /0 ~ .J
, APPLICANT '-'! · COMPLETE BELOW .
C' ~w CONSTRUCT10N D RE~LACEM~NT 0 ALTERATIONS " ' I
FURNACE MAKE AND MODEL _llnnO^ CTJ.\D\..J\\'~3.lA~-- octo, ___ FUEL O.{~J ~C\_5_ I
FLUE SIZE RETURN OPENINGS '-..1 ___ INPUT _15 ~CCO OUTPUT ~0-~llU-1
TYPE OF SYSTEM HEATING OR POWER PLANT I
.r~\\'arm Air Plants 0 Steam PLEASE NOTE:
[}Gravity D Hot Water Air Conditioner Units
l' .Mechanical 0 Radiation Cannot Encroach into
irConditinning 0 Special Devices.__ ._____ Required Side Yard
: ent. System 0 Other Devices __' Setbacks
(''{=' "I/j-'-! I -'\ ~, '"
(Phone) _~I~.' / f - ()UU
I
I
i
I
I
------j
I FIREPLACE MAKE AND MODEL m_____._.__~~==" ._
FEE SCHEDULE
1 % or job cost Rcsidenlial, Gas Fireplace
S39.50 minimum
$99,50
$64.50
lndustrinl, Commercial & Multi-fomily
$39.50
Residential, Heating & AIC (New Constnlction)
Residential, Heating Only (New COllstnlction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39,50
Estimated Cost $
HEATING PERMIT FEE
ST ATE SL1RCHARGE
TOTAL PERMIT fEE
Building Permit fI_.. PAlO WITH
..--:fUILDING PERMIT
$
S
$
(Office Use Only)
This Application Becomes YOllr Building Permit When Approved
--,
!
nllil,lin(! OfficiRl
D~te
I Paid
I
I Date
I Receipt No.
I By
I
24 hour notiee for ~11 inspcctions (952) 447-9850, fax (952) 447-4245
"
'-...
08/04/2006 FRI
7:47 FAX 952 767 1900 GENZ-RYAN
l4J 029/033
~)
~/IVNESO'{~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
i: ~~,~ ~~~ II PER.1\1IT NO./-,.. ..,.,
J. Yellow ,~pplita"' , " .., ~ ..,.
(Please e or llrint and sign at bottom
ADDRESS ZONING (office use) I
1 L~J/~5 ))CU(Kvt~v\J Lrf)
I LEGAL DESCRlPTION (office usc only)
i LOT BLOCK ADDITION PID
VJf,nSnna n t"\
[YC15 (~laz6- Dr, #= 200
(Phonc)w'Sl- QOS,- 37 (}::J
EZAg [In fv1 N 65 i ~ ;)
OWNER
(Name)
I (Address)
APPLICANT r: " 11' 1) 'C{'!'\
(Name) llt.- 2-- ~q.J \
, I
J <j ()., - . 1\1 'i-h
(Address) ._1- U \i V, I I /\f U
(Address) J
, J,
(Contact Person) =+<) Y}f")
1,3
~1----7 I {ji':-'
(Phone) .~. _- / I -
B{At111~i( /'! ie.. M rv
(City)
1000
APPLICANT SIGNATURE
(Phone)
'55-:337
(Zip Code)
0f5d-7{j;7~ 100)
DATE '8' 3/0t.u
Quantity I Type of Fixture I Quantity Type of Fixture
'2..." I Bath Tub with or without shower I 3 Rough-ins
I I Disbwashcr I I I Watcr Heater
I I Floor Drain I I Water Softner
3 I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
I- I I LaundlY Tray (1 or 2 compartment sink I Sewage Ejector
I
I I Shower Stall I .2.... I Backflow Assembly
I I Sinks ! I Backflow Assembly Test
I Bar Sink i I Lawn Sprinkler
I
~ ,:5 I Water Closet (Toilet) I I Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commcrcial & Multi-family I % of job cost with a $39,50 minimum
Residential, Nc;.w One & Two-Family $99.50
Residcntial, Additions & Alterations $39.50
Estimated Cost $
Building pelmit #
PAID WITH
Bl)M...DING PERMIT
PLUMBING PERMIT fEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Offic~ Us~, Only)
This Application Becomes Your Building Permit When Approved
I Receipt No,
!
Building Official
Date
I Paid
I Date
I By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
See lVIain, File:
qritP- - ~Uil~
anary - ngmeering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(>>(2/~ ~1U24
S-;;(eo-b
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~h is proposed-at:
I ~ ~ L./'S" ( f)~/'-( f2,U-/ GAJ
~
Accepted
Accepted With Corrections
Denied
Reviewed By:
~~~~
,
MI-
Date:
~ II-s/t; (;
Comments:
S,' ee M,,~,irl File
"".:!Il.J~ ,ll;,..!!' "
"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 I\1ain File
White - Building
~anary - c.nVlneerIn9~
Ink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
{./V (2/}1<)/y;1O/Jf/Yl- [~
5'- ;;(~ - b
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~~ is proposed-at:
I ~ /;( tfrs- ' /-)fh-.,/2.'j/-r {UL/ G;(J
.
Accepted
Denied
K
Accepted With Corrections
~
S~( h1r,"~ r: '/ (
Date:
'-IS- ,().6
Reviewed By:
Comments:
see-Main 'File
liThe 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."
L.
~ ",/f. '.~P 1
~I ee 1vltaln JL JULe,
White - Building
Canary - ~~~n~ering
~ - a n1n~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
" APPLICATION RECEIVED
,J." . . :~,.. ,i J:, "::...
" ,
,
~-,-
C'>'
.
ft,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
I "
r' " ,..,
1/,
I ,-
,. ,
I - .I;'
.,/
Accepted With Corrections
Denied
~
~
~
Date: ~/~~~
,
Reviewed By:
Comments:
See-MaiH--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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OFSee MailllTil(:
BUILDING AND INSPECTION
SITE ADDRESS 14f';I./.r ~,ll:.lliei) ~ jJ,,.J.
NATURE OF WORK }J~ UJ4J'n IAJ/t,l. F;;.;;rN ~))kJ P~ILCH
USE OF BUILDIN .
PERMIT NO. DATE ISSUED &, .3 "
CONTRACTOR N ~"""'.3 PHONE (2, -7"'1 - ~'I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I
-, FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING . d, Y\(1 (fr(~ '~~
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~ ~ tlD"r~(.J/f.N4 I I
, ~ ~~. INALS
GRADING (Prior to Sodding)
BUILDING ~ ~,,~
. ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL AB VE 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