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'U 'U :to. ::E: 0 ::u ::u ~ m ::u 0 0 000000 Z ::0 0 0 ~ m m m m 3l:'Uen~iC"tl >< Z m m mr~)oOm' -t C C oC: -tOC: >:I en ~ ~ z ~ "tl :x:iC m::E:iC " 0 CII CII m .,,!!!::O::U::u!!! m 0 0 c ~ " ::l 0 ZZ::E::X:-Z ::0 Z ::E: ::! m C1l -t >1:)00 I:) ac -t m 0 :::t 0 '"T100 ::u ::j ::u c ~ () -t 0 Z -"'''' - Z e 0 Zc:c: , ~ ;a tD ~"tl" 9 m Z :-! m C ~ N ." .... 0 ~ ::E: ::u m ~ 0 0 e 0 , ::0 ril 000000 CII ~ z ::u 1:)"T1"'0~ c Z >- > >;;;;0 ~ R0- C) ~mml:C) m C ~ ~ _"tl"tl"tl~ ~ ~):):>c ~ Z >ooz=n ~ 0 _mm-t_ \)-1 !11 ::u.,,::o ' ~ ~ -t-- r ~ i enz z ~ m -t~ I:) CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d S-l-O 7- ~ LEGAL DESCRIPTION (office use only) LOT ADDITION .c:. I. White File I PERMIT NO 2 Pink City . /:)? -0 c:..3-7 3. Yellow Applicant . l) l-- ~ I- ZONING (office use) (t -I /; cf4d21U (Phone)(9SZ) ~i.jO ~ 7~Z7 BUILDER . (Name) /{'. J 10//.5 aA/t)ki/di~//V /A/L. .. , (Contact Name) ke,"i/vl M 45 (Address) / J'/tJ ~il (Phone) (& J Z) f{ 6; - 304 J OCf="tZ (Phone) 5J) ~ 2. 9- /31''5 TYPE OF WORK o New Construction o Misc, OLower Level Finish PROJECT COST IV AL UE (excluding land) $ ~/I () ODeck DPorch ORe-Roofing ~ration ORe-Siding o Fireplace OAddition DUtility Connection ':10':) 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 l.operty to perform needed inspections. x Permit Fee $ Plan Check Fee $ State Surcharge $ Penalty $ Plumbing Permit Fee $ Mechanical Permit Fee $ Sewer & Water Permit Fee $ Gas Fireplace Permit Fee $ . cation Becomes Your Building Permit When Approved Building Official Date Contractor's License No. 57//0 z Date Park Support Fee # $ SAC # $ Water Meter Size 5/8"; I"; $ Pressure Reducer $ Sewer/Water Connection Fee # $ Water Tower Fee # $ Builder's Deposit $ Oilicr $ TOTAL DUE >) ~ #~ $ j SDB. CJ4- I Paid /~O]~ 'bt I Recei~tNo aJzO I Date __=- 7. ~_' .. By t;d."c- 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 ~OO'I""' . """""" Cortifi,,,, of Zoolo, ~,II.o" ill' "low, "o=ct"o ""mmoooo. B,"'" o=p,o". , Corti""" of 0,,,,,,,,, ow." . .~~...L'~~ oil-siaL- ~ ~t{41 {'~&"'f8v1~ I PI n Director Date 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 PRIOR LAKE INSPECTION RECORD ~EFARTMENT OF bUilDING AND INSPECTION SITE ADDRESS M1LJ~u\o"" Ave... S. t.. NATURE OF WORK Xv\t__ ~~V"'ocl~\ 4- /::fVA-c.. g~ USE OF BUILDING Co,^""",,~ PERMIT NO. (}2' 05J7 DATE ISSUED S- i-O~ CONTRACTOR K. j W..Us. ~hoc.k~ PHONE (gS/-1l21-/.J7? NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS BUILDING ELECTRICAL PLUMBING 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 a9prcwed. 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 Division of Environmental Health Engineering Unit 121 East Seventh Place, Suite 220 P.O. Box 64975 St. Paul, Minnc;sota 55164-0975 (651) 215-0836, Plumbing Plan Review Application Type or print the following information Project Name SCA C? W'AI Cityffownship P t< \ 0 R L.\;( M I N 1tJ Project Street Address / '? t , Y:) tAL "\ ~ A U I... If the street address is unknown, provide the distance and direction to the project from closest road intersection. Project Information Is the construction for a new project or new building? Is the construction for a food service/restaurant, bar, or lodging facility? Does the construction include a swimming or spa pool? The building will connect to...(check all that apply) Sewer: municipal P<I on-site system [] Water: municipal jlj private well [ ] YES [ ] D<I [ ] NO fX1 [ ] ~ new or revised for this project new or revised for this project YES [ ] [ ] NO ~ ~ Project Owner Name (?r< Y~'D Address I ~ 1') I \ City P ~ \ otc. Phone d t'vU!\ll Y (? u .!..s t- O u. I T HAvE Lk /Vl'NIV State /i11 /1/11/ Zip (area code) '3? >>-'0 /1;:':; For new septic system installations Septic System Designer Name , Address City " State Zip Phone Name />'Ilfl/1( Address (;2 QCfQ City ?,.,.. J I f.,. State /11, /i/ // Phone 65/ Plumbing System Designer V d \ A ~.~ PI be., --.. ...J ..s /J/tJ,;:'t () b i: IJ Oil k i Of;..) r? I ;J (j , L" A iV ;:J 11;1 Zip ~ $")/ ? 91 er '1 48;1 ( area code) (area code) If the project is connected to a septic system or includes the construction of a swimming pool or a spa pool, additional information may be required. If you have any questions regarding what information is required for a plan submittal, please call 651/215-0836 and ask to speak to a plan review engineer. If the plumbing contractor or the septic system contractor is different than the designer, please provide their address and phone on the back of this form. Be sure to include the following information with your plumbing plan submittal: [ ] Plot Plan - a scaled drawing showing service lines, well and septic system locations [ ] Floor Plan - must show fixture locations, pipe locations and piping sizes [ ] Roof Plan - must show size and location of roof drains, plumbing vents and air intakes or windows [ ] Water Riser Diagrams - drawings of the water supply system showing pipe sizes and fixtures [] Soil, Waste and Vent Riser Diagrams - drawings of the waste and vent system with pipe sizes and fixtures [ ] Plumbing Specifications - description of fixtures, piping materials, testing requirements, etc. If you require this document in another format, such as large print, Braille, or cassette tape, call (651) 215-0700, TDD (651)215-0707 or for Greater Minnesota through the Minnesota Relay Service at (800)627-3529 and ask for (651)215-0700. HE-01422-01 \f~ f~Ol~'?37 MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS Plans and specifications on plumbing: Subway Remodel, 16711 Dulth Avenue, Prior Lake, Scott County, Minnesota, Plan No. 023244 OWNERSlllP: Mr. Brad and Ms. Mary Busse, 16711 Dulth Avenue, Prior Lake, Minnesota 55372 SUBMITTER(S): Village Plumbing, Inc., 2999 Yorkton Industrial Boulevard, Little Canada, Minnesota 55117- 1072 Plans Dated: Date Received: May 20, 2002, May 8, 2002 Date Reviewed: June 4, 2002 SCOPE: This review is limited to the design of this particular project only insofar as the provisions of the Minnesota Plumbing Code, as amended, apply, and does not cover the water supply or sewerage system to which this plumbing system is connected. The review is based upon the supposition that the data on which the design is based are correct, and that necessary legal authority has been obtained to construct the project. The responsibility for the design of structural features arid the efficiency of equipment must be taken by the project designer. Approval is contingent upon satisfactory disposition of any requirements included in this report. Special care should be taken to insure that the material and installation of the plumbing system are in accordance with the provisions of the Minnesota Plumbing Code. A copy of the approved plans and specifications should be retained at the project location for future reference. A set of the identified plans and specifications is being returned to Village Plumbing, Inc. INSPECTIONS: All plumbing installations must be tested and inspected in accordance with the requirements of the Minnesota Plumbing Code. As specified in Minnesota Rules, part 4715.2830, no plumbing work may be covered prior to completing the required tests and inspections. Provisions must be made for applying an air test at the time of the roughing-in inspection as outlined in Minnesota Rules, part 4715.2820, subpart 2, of the code. A manometer test, as specified in Minnesota Rules, part 4715.2820, subpart 3, is required at the time of the finished plumbing inspection. It is the responsibility of the contractor/installer to notify the Minnesota Department of Health when an installation for a state contract job, licensed facility, or project in an area where there is no local administrative authority is ready for an inspection and test. To schedule inspections, contact the state plumbing standards representative for your region, or call the metro office inspection hotline at 1-800-926- 6216 (7:30 a.m. to 9 a.m.), or 651/215-0836 (8 a.m. to 9 a.m.) on Monday, Wednesday or Friday. REQUIREMENT(S): 1. The waterline to post-mix-type carbonated beverage machines must have an approved stainless steel double-check valve backflow preventer with an intermediate atmospheric vent installed preceding the carbonator. In addition, there should be no copper tubing in the system downline of the backflow preventer to preclude the possibility of copper poisoning. The specified Watts 9D does not meet this requirement. Please review and select a different model. 2. Verify that the existing 2-inch drain serving the two floor drains and the two hand sinks does not serve any other fixtures. Otherwise, replace the existing drain with a larger drain line. 3. The water piping system shall be disinfected in accordance with Minnesota Rules, part 4715.2250. The plumbing system shall be tested in accordance with Minnesota Rules, part 4715.2820. The ('enler of the L.kt ('ounll1" White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED _.,..~.' i ,>.--/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted Accepted With Corrections ~ Denied ~~~ Date: s- /1 3c'"D 2- Reviewed By: 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." (i~ ~{ White - Building Canary - Engineering Pink - Planning The ('fnlrr of the Lakt Counlr) BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT K"J, vu'/l/s S - !- C?).-- &XJS+ APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /07/ I .AQ~-dL U~ S6 Accepted Accepted With Corrections Denied Reviewed By: Date: Comments: . "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." Date Rec'd CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT ADDRESS t;--- ~ ~-O~ 1. Pink 2. Green 3. Yellow ~:~y \ PERMIT NO./J -015$ Applicant J J ~-71/ / LLJV-t E ZO NIN G (office use) {l- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) ~() 8 "","'A '-I (Address) ICe 7/1 s.B APPLICANT (Name) ALI-IA,vet (Phone) q~;)...- -f-kl- 7~~7 (.5""1 - ~ '?3, .- 9 :3 :5 .3 5"5//3 (Zip Code) (Address) (?eo oA~("" t€.t.=S T (Address) AVE/\IuE <.i=fP.I/I~E .'S (Phone) ML: c: I-I-A,N' 1<: AL (Contact Person) c APPLICANT SIGNATURE AC<P"VIJ...i-E (City) (Phone) DATE APPLICANT PLEASE COMPLETE BELOW DNEW CONSTRUCTION ~EPLACEMENT o AL TERA TIONS FURNACE MAKE AND MODEL c..1I ~ ~ , E'R.. 4g ntEca~9 FUEL N~T ("" ~ <;. FLUE SIZE A//A RETURN OPENINGS I INPUT I~ ceO OUTPUT I tt/,~~ OD (l TYPE OF SYSTEM HEATING OR POWER PLANT ~Warm Air Plants o Steam PLEASE NOTE: DGravity o Hot Water Air Conditioner Units o Mechanical o Radiation Cannot Encroach into ~Air Conditioning o Special Devices Required Side Yard ~v ent. System o Other Devices Setbacks FIREPLACE MAKE AND MODEL FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only Industrial. Commercial & Multi-Family Residential. Heating & AIC (New Construction) Residential, Heating Only (New Construction) cliO Estimated Cost $ 1.;;1 1 '?J '70-- $39.50 $39.50 $39.50 Building Permit # HEATING PERMIT FEE 5T ATE SURCHARGE TOT AL PERMIT FEE (Office Use Only) This Application Becomes Your Building Permit When Approved Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 $ $ $ I:).~. 70 .50 l.;t 9.:;)(') P:Jt I - ~66 Date L{- 3D.~O 0-- May-01-02 06:35A K_J_W;lls CONST_ INC_ (651) 429-2161 P_01 K.~r:JI11Is (. '1{)ilSI1~Il-~~ii(;I-l--;111(:' -- - ----~-~ _r_ _ . ~ -.- 1110 Ii: ~. IIi Whit. a..r l.k., MN 66110 (65t)42S-1393 Fax (6S1)42S-2161 Fax To: /}J (,l. L 1J A:-t /T) G M r A/t!f;L F.XI 95-2- Lj~7 - fZ'tJ' Phon.: 1'5'"2-. 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'.J rr. ;$2('\ ;~~.:J ;;0 "'. ,_. r 1r.z~fI . . --0)0. :",0 0: i> ~ ~ z ~C'II1 lJIlA;=rT'C\-f ~ .~.~ ~.c; : dll :;:;1~~V'.... " Im~ VI OJ III 1'- -i ~ ~ IIIiiiii: ~~;;'~ri(i -........ "'J 0> W - -m ji,'.- ~ ,." INC. (651) 429-2161 "'""'-' ......UI'~Ul.-'HI'I.::J. J..I,Lo. 6'-0. .lr--- r c:::- lJ \) V'l r- ~ c)> OOJZ V'l rrl C---- /O::E n ~ r- r-)>I r- J>-< f'T1 r'l 7" ~ mV'lI . -i < -... ~~)> ~ ---i Z rTIn II cy [---- ~'**' Z [.f)wC I OOZ 0 -i 0 )> 0-. - --l (---- VI (") > >C )> -I ;- m m Z ~ 0 V1 ~ <.n ........ :r: w CD 0 ~ 0 0 Z I'V en C-/) ,/" ""-- I CJi I SK-5d\Ng 4-3CI--Ci? 1:.3,~:JJ om ("t :J ~ ~ )( x m -l> Vl :J: Vl ::t rrJ -I 0 0 > C') "1) C') C') ;{J ,.." a )> ;0 (/] 0 r<1 -I rr1 0 P.Ol r""lJt:.. UeJ 05/08/02 WED 09:53 FAX 6124474245 /l~ :)() 6 6J:?:;/t Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT C)t~~k t2 0 "0. vQ"'J1 /ty if i ~4 ~~~ I PERMIT NO.Ot?--/O 90 I - -1" J. Yello'" "'ppll~1 . , CITY OF PRIOR LAKE 141004 ZONING (otfia: use) Ave. SE (Subway Sandwich & Salad Shop) I " -/ LEGAL DESCRIPTION (office usf only) i LOT BLOCK ADDITION I Is (Add.rl!ss) cl YVl//RY is ~ S_C; ~ . De,J ev- PID' -' 85- 00/- (PhOn~S~ -116 - ?8~? . /0 f? L ; ....- .....-. ,- - OWNER (Name) APPUCANT (Name) Village Plumbing, Inc. (Address) 2999 Yorkton Blvd. Little Canada, (Address) (Contact Person) Hark S. Aldridge (Phone) 651) 482-9169 MN 55117-1072 (City) (Zip Code) APPLICANT SIGNATURE (Phone) 651) 482-9169 612-202-3 20 DATE Hay 8. 2002 Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater d.. Floor Drain Water Softner Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (lor 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly . CJ.. Sinks /I/! It/ IJ Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet (Toilet) Other APPLICANT PLEASE COMPLETE BELOW FEE SCHEDULE Industrial, Commercial & Multi.flll1lily I % of job cost with a $39.~O minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.~O Estimated Cost $ 4865. 00 Building Permit # en Approved $ L(f~ (zD $ .50 $ l4q'~ I ~- paid1JL/ ,I) Date q _ L/- (1-- Receipt NOl/d g/'f By PLUMBING PERMIT FEE ST ATE SURCHARGE TOTAL PERMIT FEE 24 hour notice for All inspections (95Z) U'7-98S0, fax (952) 4474245 05/08/02 WED 08:41 [TX/RX NO 7193] 141004 ::P() 2.-0 cf5 ~ nt-€- 0 wi =IF (J z- oS37 Alliance Mechanical Services 1900 Oakcrest Avenue - Suite 1 Roseville, MN 55113 Telephone 633-9333 Fax 633-7122 ORSAT TEST REPORT ADDRESS {2?11 ?U I v+-L-, av't!: APT._FLOOR_CITY ?i/(JJr Lolc.r OCCUPANJ:......Y];. ~4_ OWNER HEAT LOSS DATE HTG INST. .s- - C.) -"2... Electrical work by 1V.c l ~.<? v 1 e I -ec.... Gas line by A I I " <>"\ VI C. -e 01 -eo C ~ TYPE of HEATI GA_FA-L HW _Steam_Space Htr_Unit Htr_ Other_ GAS DESIGN CONVERSION Make 0~"" r, -e v Model 48 TPE{){') 8 ~ s-/ I Serial/, W 3.. (7 /) '3 S S Input / C> I C) C) 0 Make of Burner Model Max. BTU Rating Make of Furnace Model Thermostat! ~ ?y Valve .3h L VZ b Limit Setting I g iJ Q Fan Settin2f //>1 'C' cJ Pilot Type ,U {'v. C c t- Pilot Make eel y r,' C ~- Pilot Model Pilot Timing S' -.S, -( ( L.W. Cut Off r-- Pressure ~... cl I Input CFH I AD Stack Temp. -:s SO CONTROLS Heat Plug Kind of Liner Vent Size ,/(01"") -f 1-0 ~ Size None Filters SizeJ-.4; X:;)S'r-::2 Cf No. J Chimney LocationInside Outside Chimney Construction Percent 0-2 7 '1 p Percent CO-2 If 76 Percent co /') ~;;~ Smoke Bomb u:::. Wiring 7 Draft (/" / Test Ta2 Door Pressure Y Lighting Instt'....-/ Date Tested .....'J - I;;) - 0 :; Company Testin2.(tJI ,'nnce /17r"t"/-, Name of Tester ) /4/ r; Protecting. maintaining and improving the health of all Minnesotans May 22. 2002 Mr. Brad and Ms. Mary Busse 16711 Dulth Avenue Prior Lake. Minnesota 55372 Dear Mr. and Ms. Busse: Subject: Food and Beverage Equipment at Subway Remodel. Prior Lake, Scott County, Minnesota, Plan No. 023244 We are enclosing a copy of our report covering an examination of plans and specifications on the above-designated project. The plans and specifications appear to be in general compliance with the standards of this department. Please see the enclosed report for additional changes and/or comments. It is the project owner's responsibility to retain the plans at the project location. This review does not pertain to the Engineering design (i.e., plumbing, swimming pools, service connections. sewage systems). A separate report regarding the Engineering Review will be sent. Ten working days prior to completion of the project. please contact Mr. Steven Diaz with our Metro district office at 651/643-2167 in order to arrange for a final on-site inspection. If you have any questions in regard to the information contained in this report. please contact me at 651/215-0862. Sincerely. ~~ Steve Craig Public Health Sanitarian Environmental Health Services P.O. Box 64975 St. Paul. Minnesota 55164-0975 SJC:jlr Enclosure cc: Mr. Al Frechette. Zoning Administrator Mr. Robert Hutchins. Plumbing Inspector Mr. Steven Diaz. Minnesota Department of Health General Information: (651) 215-5800 . TDD/TTY: (651) 215-8980 . Minnesota Relay Service: (800) 627-3529 . www.health.state.mn.us For directions to any of the MDH locations, call (651) 215-5800 .An equal opportunity employer MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS Plans and specifications on food and beverage equipment: Subway Remodel. Plan No. 023244 Location: 16711 Dulth Avenue. Prior Lake. Scott County. Minnesota Date Received: May 20. 2002 May 8, 2002 Submitted by: Village Plumbing, Inc.. 2999 Yorkton Industrial Boulevard, Little Canada, Minnesota 55117-1072 Date Examined: May 22. 2002 Ownership: Minnesota Mr. Brad and Ms. Mary Busse. 16711 Dulth Avenue, Prior Lake. 55372 The following are corrections or requests for additional information necessary before construction of your project: 1. Food and Beverage service equipment must meet the applicable standards of NSF International. Evaluation to these standards by ETL and UL are also approved. The proper sticker must be displayed. 2. Primary food preparation surfaces (tables/counters) must be of stainless steel construction in compliance with Standard No. 2 of NSF International. 3. All equipment must be installed so that it is easily cleanable, that is, either easily movable, sealed in place or having sufficient space surrounding the unit to clean in place. 4. All artificial lighting fixtures located in food preparation areas, food storage areas, dishwashing areas and walk-ins shall be effectively shielded to prevent glass breakage onto food or food contact surfaces. 5. A separate on-site inspection will be conducted by the state plumbing inspector to determine compliance with the Minnesota Plumbing Code. 6. Hollow base cabinetry is not approved. Cabinetry must be on 6 inch legs for easy cleaning, or on solid concrete pedestals. Subway Remodel Food and Beverage Equipment Plan No. 023244 -2- May 22. 2002 7. Any floor. wall or ceiling patching or changlng must meet current codes. Approved: ~~ S~e~e Craig ":J Public Health Sanitarian Environmental Health Services P.O. Box 64975 St. Paul. Minnesota 55164-0975