HomeMy WebLinkAboutBuilding Permit 99-0004
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
6 :398
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1. DATE
/1-;;"-f.9
c; f'(/~
-33?7 S;;'r/^rt;
3. LEGAL DESCRIPTION 17
.:l.v
G'J.. Y A/
C/~/V
LOT
BLOCK ~.2.. _ \~k PID ~.5- 3.5"1- OJ-o - 0
W"rf'~)'fl ~ a dtll 7; fijV
(Address) (Tel. No.)
ADDITION
4. OWNER
(Name)
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER (Name)
\.UWic\\~
~
(Address)
lB'1S'" ?I"z,," ~
~\40. h ~~
~N.,...) ~
Septic 0 Deck 0
Addition 0 Finish Attic 0
(Tel. No.)
40~ -<.{4.00
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
1 O. CULVERT SIZE
Width
Depth
Yes
No
Permit No.
1. White File
2. Pink City
3. Yq09 _ ;to9
CJfJt{W~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
~/~
17. COMPLETION DATE
I hereby certify that I have fumished infonnation 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 confonn 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 pennit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X
Signature
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
SFI4-
'12, ca:>. Od
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV M
Occupancy Group A B E F HIM (R)
Division 1 2 @4
Pennit Fee ................................... $
Plan Check Fee ............................. :1'.
Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o
o
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
'!t:HlJf ...................................:
~~e Reducer :r~:.'................... $ q~ .00
Meter Horn ................................... $ _ _ .~
9~' ,~~.
Water Meter ..Nf)........................... $ --4:--e.r. . cd
Sewer & Water Connection Fee ........... $~fP\ 0 ~ 1""1.6....
Water Tower Fee ........................... $ l r>O .C) ()
Water Tap ................................... $
Builder's Deposit ............................ $ ..fIJ
Other ...........................i.~.;;;....~ 'l' .c:::: C.
Total Due ...~.......1.7. ,:; " 1.. L -. =;;
Paid 5"~3l.-~~e~iPtNo. 34~f>e.'/
Date 1 f'l.Ii {if t; By Jf...1} If
.
Tel ce' that the r uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
s' ed I Y t Clan r c;9~~es ~ temporary Certificate~o . mpliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
, , . V (,CA/L "
. City Planner Oat Special Conditions ~ any
v 24 hour notice for all inspections 447-9850
S U
City:
Sewer & Water Pennit ..
R"37. ;t5
5q~.~
LLCc,. DO q. /~
I uO-"'-tbJ1- t(~,
I J'~ -f~~1~
35.. .<:D '!ft:llJ4!-
State Surcharge ............................. $
Gas Fireplace Pennit ....................... :I'
Thi~~~n Become~~ Building Pennit When Approved.
By ~. ~ Date .1..l.::..L~ -'it;
Certificate of Occupancy
Issued
~f:,t). 0..0
-f--({ JC . ~O
/05"0. t90
~PRI~
~
CITY OF PRIOR LAKE
PLUMBING PERMIT
1. Blue File
2. Gold City
3. Yellow Applicant
9'1-4
#
423-1144
Applicant: GENZ-RYAN phone:
Address: 1;q~5f!O obEjrt Trl, Rosemount MN 55068
Signature: f:!J/J; /1{!/JjtJtdLA/ .
Legal Descrlpti~: ot ~O Block ~. .suqldl!lllll(bltr~ IAksr
Site Address: . ~ ggy .'5Bf/!;!j ;h/"pf) ('J r N tU .. .
Building Permit # qej -f/' PID # d'S -351 - t):xJ -0
NOTE: This permit will not be processed without complete information.
The Center of the Lake COUnff')'
Quantity
I
I
/
~
I
I
I
d
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
FIXTURE UNITS
Quantity
~
/
I
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
.50
$
~p'
[BUlL'
. ,
.., "AIT
This permit is granted upon the express condition that said
contractor. shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
RECEI~NO. _?-I747 DATE
q-1CuJ ATTEST
1-
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) +47-4230/ FAX (612) +47-4245
An Equal Opportunity Employer
~~rPI{iO~< CITY OF PRIOR LAKE
fj ~ '~ 16200 Eagle Creek Av. S.E. Permit No. qq - L(
. Prior Lake, MN 55372
~. __ HEATING APPLICATION I PERMIT
Date __ii/II/qq PID # ~-3~-1- (j)O-D
Site Add:ess 'gaB 7 . ~iJrlna IJ/OI /1/1' IVtv
Lot ;;0 . Block ;;{ . ~d~ition ~~)nwaj./ IA~~r
OWner's Name!AJ;7J7.5IJ1(;nn Jmrne-s
Address l!3t/!) fJII1ZLL Or., ~/ :J/JO. /bOtif) ,/5?51;J-;)
, , J
Heating Contractor GENZ-RYAN
Address
14745 So Robert 'I'd, Rosemow1t NN 55068
Telephone # 423-1144
Furnace Make & Model Unm.x
ModelSize 61g&)3~76
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Conn. Load
Fuel IV a;:r
Flue Size
J./-II
Supply Openings
/1.
4
Output b~ 000
Return Openings
Input 7oIJtJO
,
Edr. .
Other Devices
Cfrn.
TYPE OF WORK
)(
Alterations
Replacement New Construction
Repair
Est. Comp. Date
Building Permit #
erCf -'-I
Est. Cost $
HEATING PERMIT FEE $-. /""
STATE SYRCHARGE $-~/ .50
TOTAL PERMIT FEES $/'\.. Receipt #
('/ PAID WITH
. BUILDING PERMIT
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
City
Contracfor
Single Family
x
Multi-Family
Other
Two-Family
Industrial
Public
Commercial
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with buildina oermit number before build-
ing certificate of occupancy will be issued.
!::!.EAI CALCUI,ATIONS REQUIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
ca];;// ;;;;;:" rev;~ and approval of ~'~//I /eN
C ~l\PPll'ca 'Sign re ' I Date
~"., _ · 3-/7 ~?
. Ildirig , cafs Date
", __.,~-"..;.!~~1'.:~"'1\d;~~hwiii~.."":"\!A~;;:f:Jl~~k.~\:;:~:~":'~t..::t.,:.':\~.,~~;..._.~.
GllEEM . fILE
YELLOW . APPLICANT
GOLD . CIT'f
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. 'ii!P qy-4
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLI CANT: GENZ-RYAN PHONE: 423-1144
ADDRESS: 14745 So Robert .Trl, Rosemount MN 55068 DATE: 3/// / qq
SIGNATURE:~ A'c/J!lJtdIA./ BLDG. P;RMI; # C{y~tf
SITE ADDRE's;;!l!i!l 5,Pr):!j (Nt/) Gr IV WPI D# ;;(5-35 (-() J.() - 0
FILL IN THE BLANKS II I
Estimated length of water service ~l?
/. /I
Size of water service inch(es) .
1.
feet.
2 .
3 .
Location of any couplings
4 .
Type of sewer pipe.
ABS
from structure
PVC / Cast Iron
/1'0 J
~l feet.
feet.
5.
Estimated length of sewer line
6. Clean out (if required), located at
structure.
feet
from
================1*.-==~==============================================
This ~l~c~tion -your permit when approved.
~N
BY ~ . - / --w,.' DATE: ~.- r,,,q~
-- I
------------------------------------------------------------------
------------------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
/' PAID WITH
r BUILulNG PERMIT
AMOUNT PAID
RECID BY ~~
RECEIPT #
4629 Dakota 51. 5.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245
Ai'i EQUAL OPPORTUNITY H.1PLDYER
.....
9g - ! 't(J~
,9,..oScr
'to
White - Building
Canary - Engineering
Pink - Planning
Thr ern... or lhr l.kr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
( 1_ ) ~ ry1 CVY~ Nn/lAf I r
- ~ Il J (" / c;, /
I^ I ;-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33f7
~ r,)" C (~ c~/ c.QJ' .~
Comments: ---"" 'tF- I rJl=aa..M ~'1'" ION I
Date: J/ / J7 /e;f?
I I
I
117T4Ct..JrU~ ~ at'l1~
~ cJSO
q?, /l.p--S
qf'/l.jUb
CJf./Lfo7
.. Accepted
./
Accepted With Corrections
:,oenied
Reviewed By: 1A.1AL'l"'E-R. tH-t1ESVlA.AIITI\J
ON BVIL.(jIN b
P€Rv\\Ii ~ ~8 - IYO~
338/
SP~IIJ~ aLeN CII1...CL-E:..
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."
1~t01
Thr ('rnter of thr Lakr Country
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
( I ) 1)/\11-0 I'"Y' ~/Yl f.JnMf I r
. - - / / / If' I ~ /
"I . f ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,-33f7
Sf n ). 6u~ Crr cJ2.t -/
Denied _
Reviewed By: ({J) L . A
/
Comments:
Date: /(-1'"5-98
Accepted ~
Accepted With Corrections
,. Se.~ ~ ~ -k.r 7(Ci/lAS:,,' S~S'/ 'Surv-&_,. l.;(r:.
11-dV~1
. .
"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."
..
j-' /' 1,-}, ;/1
"f~;lv '-I
, .. I
Th. e.nt.r of lh. Lok. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
II/~'
J' /
i '4
!. ", "
"")./. ~ r '~'l' I ~
. '/-"1#" \ -' {~..
.." (1 ! ;... ,
-'.' '.. /' v
: f
NAME OF APPLICANT
APPLICATION RECEIVED
( / j ill )"1'" )
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.., '-"1
-~} I
." "j {f J _, ,.., Jo'" 'I
/
( ~,r (
Denied
~t;? Jr~
V
t:'7 .-I? A q g:. . I r-
~. -c: -f~e.)
Date:
Accepted
v
Accepted With Corrections
Reviewed By:
Comments:
_~_---_'~_.R _....
1o/-CVtJ/
""~--
",,~,:"'r--
I I
..' ..., .)'
. .. J.
t. :' ,. ~
v
"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."
;'"':'o;'~~'D~' ',.., <!rIWI".!:m'il;tl~~[~A;"f~E' . DEPARTMENT"OF~;:";:>~; ..'
. :::,:<Df ~ sm;:I;"5j'~~~M'~' . c,; . BUIL.DING"ANI;) INSPE~," "
",;~~':i~:{SeE,bTloN RECQB~fi
't~:"~::~{f:;"., . .. . .,....,~~}";~?;}r::)>,::",~:r:.>;r:, ,'....~' \, '.. ".'. . , .:~,;i~i5)::
"":~'::,~,SITEADDRESS . ~~e~ SP'"lV\~, ~~ G-..
, ..\" NATURE-OF' WORK. N~\.U ~s~l'vc1'oV\.
. ":;::~j~~.:::ri;LJS~~:O~E:iBUJIDING~.', ~t:A '
"'."'p. 'd~/.,'.:,.tIiW.'!'~~':N.'.'O:";;)'i!;;::'ritl' I...m~/"V'J;V("~
,.;~5; '~.!"\"".~^t~~,~r~C",',. . ,.... / ",~~T~
ett. ; . 'GtOR:l~i;~;:U5'~v.A.o..~:i ~~I!r ~ ",
-,-- ,.."Li"'J~f.; '-I~':'" ~,"~ '-. :"), -c.
" ... ',HIS~IS'~NOT',.A'PERMIT,.FOR'"ANV,OF",THE:IN
';,. ..'tJ:Rl'JlttHS~~BYfSEPARATE' DdCUMENll .
!~~~!:~~:~~':::::"""+:'t\:(~':.:"f'""L ... ... '(:'~ '~sr>>~tT~~;~:.~;; "'':{''';)/1::f.'. '..,
;,,' ~ FootiNG "'~',. I '
FOUNDATION (Prior to Backfill) I . I
':~iA"C E~ N O\~C 0 NC R E T E' U NT I L AB 0 V E"H A S'rB E E N~$:SI G N'I:'
.';},:;':';'. i/::,;/;:'; '.. R. 0 UGH .. . INS . . . "~'~i~f
l';J';;.>' '.F.~;""'f,~: '. .
S.EWEA"IWATERi SEPTIC' " . ." ~.. " 1 "
'FRAMING" \1 15.r .,.. L. tr-lAf',q,:;'~~..;;;tlPl'. .
JNSUL:ATION' 4 11 ''i.~lcJ::':''~:i:'9r:('flf'~ .;,'
. ELECTRICAl.:., .1. /';.,;'i'~J~l'::>'\,;;
PLUMBING ,'5 u5-:sf' Jo/42~1~~;.;It~,'~~
HE:4'tlt.lG(lf required) . i\'() -SS '1'-7.', '.~~l t.r
"FfREPCACE I . /":1;.,;~~t~;~.i:<,_::' :';( .'
"G~~.~UI~E"A'IR':TEST'1'i'" . ", l<:! ,~;;'" . "":4--,;~~l~ifif'~~w~~e~?::~:
'.~ ':' ..,'~,.J,~~ "'''"bi~l''-4"v''.,:'''' .,,' ". -, -.' -:, . .. , . . _.' ,~>:'.j:",}:~'" "I
itCOVERfNOWORK UNTIL ABOVE HAS .BEEN SIQNED,~;:::
I I
FINAlS'f'
..' 'I,dE:
"GRADIt-JG:;:(Prior<tc)/'Sodding) "::.
"B' .U".:II~'rll:':iG" <1~!i.4\III;Y',;~'~j{' ";.;..~,..., " . <"~""'" ,,'.
:\ ,',', " ,..,_~~ ~,I'J ."..~~~~:~~~'~~:i~(j71:;~~'li.;:\~'-::I~,1t';:"r::::"'~~j:'t-:'~i?~~'-~Y\;;'m~