HomeMy WebLinkAboutBuilding 02-1150
:;- o~o 0 000000 " 0 > -0
Z_
U> 0 :t ~ C ~~
"1J (') 0 ~ cn"z""" 0 C
Cll :!: Z
8 0 n- 000 =izen~OO z m ~ mo
> 0 :xl :xl :xl 3: m>c: c:o m :xl m 0"
0 r- ~ :xl :xl ~ -r-r;3:Z-i Z en :j"
t"'l r- m m cn m Z zCz 9 en
::." t 00> Z ~ :jG'l~G'l O:xl
-i -i z-
t"'l -t m 0 - W zO
K::l ..... > - (') z 0
u, (') cn en -i Z 0::0
S -i " -
00 - > 0 <!\ :jr;
::." en o (')
~ 0 Z -i Z (')~
" (') > 0 mm
~ 0 > Z :xl
:xl r- C .-<
r-
~ -4 " " "
;l.. :t 0 :xl :xl
~ m :xl 0 0 0)(0 0 0 0
Z :xl (') 0
~ m m m m 3I:"cn:!:3I:"
>< z m m mr-~>m'
-4 C C OC: -40C:
::." Z 0 cn :t3: m:t3:
'" ~ " " 0 en
~ cn :IE m ,,~:xl:xl:xl~ m 0 0
" ::l 0 zZ:t:t-Z :xl Z :t
::! ~ m Cll -i >G'l00 G'l 3: -4 m
:::t
~ 0 () 0 ,,,00 ;:0 =i ;U C
-4 0 Z -~~ - Z c:
0 ;:t zc:c: r-
~ CD ~"" 9 ~ m
Z :-! m C
~ "
N 0
....
~ :t :xl 0
m
~ 0 0 rJ
c: ~
:xl 0 I
<
cn m 000000
--
~ Z :xl G)",,(')m 0
Z )>
> >::o::oo~ V -i
~ G) m
C ~mm3:G) j
f:.: < -"""~
> ~r;r;r;c
~ Z
0 >ooz:;;
"-l !T1 _mm-i_ ~ -i
~ ;:O":xl r-
-i-- , i:
cnZ z ~ m
-i~ G)
000000 " 0 > -0
z_
oh :t :E c ~~
::l C/)"z""" 0 c
(fl =izen~OO z z ::0 me
"1J o 0 m
Cll 000 m>C:3:~8 m ::0 m 0"
8 n. CIl ::l"
Q :xl :xl :xl ~ ~'r;z~z Z CIl
t:l ;:0 ~ ;:Ii; 0 O:xl
t"'l " :jG'l-iG'l z-
o 0 C/) mOo zO
::." -i )>0 &1
t"'l )>0 ::l o Z Z o:xl
K::l o CIl -i ::!r;
, 0
S CD :xl -i " o~
00 - > Z ...::,
::." en ~ o 0 mm
~ 0 Z -i
" 0 )>0 0
~ 0 )>0 Z ;:0
:xl r- C .-<
r-
~ -4 " "0 "0 o~oooo
;l.. :t 0 ;:0 ;:0
m ;:0 0 0
>:;, z 0 0 3: "0 C/):E 3: "0
t"'l m ;:0 m m mr-m>m~
~ >< !!! m m ~i~rri~3:
-4 Z C C " 0 en
0 CIl ,,~;:O:xl:xl~ m 0 0
~ Z "0 ::0 Z :t
~ :IE m -Z:t:t-Z
CIl ~G)OO G'l 3: -4 m
~ " ::l 0 C
::! ~ m ro -i ,,,00 :xl =i ;U c
0 :::t 0 -;:Ii;;:Ii; - Z ,
~ () Zcc ,
-4 0 Z ~"O"O 9 -.... m
~ (5 ~ CD C
Z m ...D
0 N "
~ .... 0 '^ ~ -
:t ;:0 1J -
m ~ ~
[;; 0 0 I
c: 0 , 000000
;l..: :xl < ~ to 0
C/) G)""om )>
t'-< m -i
:i! z ;:0 "" >::o::oo~ ~ m
z enmm3:(;)
~ > G) !:"O"O"O~
C
~ < ~r;r;r;c
> >ooz:;;
~ z _mm-4_ ~ -i
0 :xl"::o r- i:
"-l !T1 -i-- , ~ m
~ CIlZ Z
-i~ G'l
~~o 0 o}(o 0 0 0 " 0 > -0
z_
::I: :E c ~~
"1J 0 0 :E cn"z""'''' 0 z c
ro 0 0 =izcn~OO z m :xl me
() n. 0 m m
0 ;:0 :xl ;:0 ~>C:3:~8 ~ ~."
t:l ~ :xl ;:0 ;:Ii; z'r;-cz Z CIl
m m 9 CIl -"
t"'l 0 cn cn -4~>G'l O:xl
::." -i > " - -i z-
m 0 - zO
t"'l -4 o Z 0 ~
K::l U, Cii -i Z o:xl
S " :jr;
00 0 > 0 VI
>:i en ~ 0 Z O;:li;
~ 0 Z -i mm
." 0 > 0
~ 0 > Z :xl
:xl r- C .:<
,
~ -4 ." " "0
;l.. ::I: 0 ;:0 :xl )(00000 ~
>:;, m ;:0 0 0 t
t"'l Z ;:0 0 0
~ m !!! m m 3: "0 CIl:E 3: "0
>< m m m,m>m'
-4 z C C oC:~-iOC
Z 0 CIl ::I:3: m::I:3: " 0 CIl
'< ~ "0 .,,~:xl:xl;:o~ m 0 0
~ CIl :IE m -Z:r:r-Z :xl Z ~ :r
" ::l 0
::! ~ m ro -i ~G)oo G) 3: -4 m
:::t 0 ,.,,00 ;:0 =i ;U c
~ 0 () C
-4 Z -;:Ii;;:Ii; -
0 ZC:C Z r-
(5 ~ CD ~"" 9 m
Z m c
~ N ."
.... 0
~ ::I: :xl ~
m
[;; 0 0 ~
C 0
~ :xl < (j7 000000 "
en m 0
:i! z ;:0 , G'l""'om I a )>
z >::o::oo~ -i
> ......... m
~ G) ~mm3:G'l -
~ C I ~ -"""~ -
<
> () ~r;r;r;c ~
~ Z >ooz:;;
0 }l _mm...._ ).J
"-l !T1 ..,- :xl":xl r- -i
~ ....-_ r- i:
cnZ z ~ m
....~ G) 0.
f
:;- 0 ~'* 0 000000 " ~ > -0
U> :t C Z_
'& (') 0 en"z""" 0 z c ~~
8 0 n. 0 o 0 3: =izen~OO z m ~ mo
> 0 :xl :xl :xl 3: ~>e:3I:~~ m ::0 m 0."
~ :-! ;:0 ;:0 ;:Ii; en
, m m CJl m z'r;-cz z en :1"
, 0 en -4~>G) 9 0::0
::." o )>- Z
t"'l -i -i -i -0 - -i z-
-t m 0 - zO
K::l > - o z 0
CJl en 0::0
S " -4 Z
00 )>- 0 ::!r;
~ crt 0
0 -i Z o~
" 0 mm
~ 0 > ~
;:0 ,
~ -t ,
." "
;l.. :t 0 ::0
~ m ;:0 0 000000
z ;:0 0
;g m m m 3I:"CJl:E3I:"
>< m
-4 Z c m'~>m'
::." CJl oC: -ioe:
~ ~ z ~ -0 ::I:3I: m::I:!!I: " (') en
en m .,,~:xl:xl:xl!:!! m 0 0
Q " ::l (') ZZ:t:t-Z ::0 Z :t
::! ~ m Cll -i >G)OO G) !l: ~ m
:::t
~ 0 () 0 ':!!~~ ;!! :::::j C
-i 0 Z c:
(5 ;:t zc:c: Z ,
~ lD ~"" 9 m
Z :-! m C
~ "
N 0
....
~ :I: ::0
m
~ 0 (')
c: C0 0&
::0 0
CIl < 00000 ,J ,
m ('J
~ Z :xl G)""o~ ~
> Z >::0;00 ) ....:} -i
Roo G'l ~mm!!l:G) , m
~ ~ -"""~ -B
~ Z mr;r;r;o if',
0 >ooz:;;
~ !T1 _mm-4_ -i
;:O":xl '
-i-- , i
CIlZ Z m
-i~ G)
:;- 0 ~~ G\ (\ 0 0)(0000 " ~ > -0
Z_
l/l 0 :t C ~~
al 0 "f::> en"z""" 0 0
8 0 n- o o 0 -'> C 3: =izen~g8 z m ;:0 mo
> 0 ;u ;u ;u t ~ 3:: ~>e:I:Z-4 m ;u m 0."
~ , :-! :xl :xl ~ z'-r;zoz z en ::!"
m m cn m en
.- 0 9 0;:0
::." t o )>- Z ~ :1G'l~G'l
-4 -i -4 z-
t"'l -t m 0 - zO
K::l ..... ~ )>- - (j' ~\ o Z 0
, o cn en 0;:0
S CD -i " -4 Z
CD ;:0 - > ~ 0 ::!!;
>:i crt ?' o 0 I
~ 0 Z -4 0 C) 1;) Z 0"
" 0 > 0 mm
~ 0 > Z :xl H' I
;:0 , o .:< C
~ -f , tr
." " "
;l.. :t 0 ;:0 :xl 0
~ m :xl 0 0 000000
Z :xl 0 0 '"'
;g m m m m J. !!I:"cn:E!!I:"
>< z m m m'~)im'
-4 0 0
::." cn ~ oC: -4OC: r
~ ~ z ~ " :t!!l: m:t!!l: " 0 en
cn m ~ .,,~:xl:xl;!!!:!! m 0 n
Q ~ " ::l 0 zZ:t:t Z ;:0 Z :I:
::! m Cll -4 >G'l00 G'l !l: ~ m
:::t
~ n () 0 \f' .-,,00 :xl ::::j C
-f 0 Z -~~ - z c:
(5 ;:t Zc:c: h;
~ CD ~"" 9 -\
Z :-! m 0
"
~ N 0
....
:t :xl
m
~ 0 0 D
e: ~
::0 0
en < 000000 \ ~
m t
~ Z :xl QUID ~ ~
> z >--0 ~ iil
At G) en;:O;:O
0 .-mm
~ ~ -"" 0
zr;r;r;
~ Z ~ooz=n
~ 0 _mm-l_
!T1 ;:0";:0 , ::!
-1-- , I:
cnZ Z m
-I~ G'l
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ALLd
3/S
LEGAL DESCRIPTION (office use only)
LOT L.t BLOCK :J ADDITION
8- 2/- 02--
I, White File
2. Pink City
3 Yellow Applicant
PERMIT NO. 02 -f/5?J
ZONING (office use)
e/
PID z,S-3f3Z- 047-()
:T~
OWNER
(Name)
fh dJo,,~j u Co.- sY,
(Address)
(Phone)
/'
/
BUILDER . Ib { G
(Name) me. -4/ d o-c:::;.f'
(Contact Name)=.)- c/,p. euttLLS<.J-
(Address) 7G:,(~ ( '/" cAJ-R-'"$
~
/,
OPorch
ORe-Roofing
ORe-Siding
~tility Connection
([)OO OJ
,~ -
\X(ireplace DAddition o Alteration
PROJECT COST IV ALUE (excluding land) $ ~7 /
TYPE OF WORK
~ew Construction
DLower Level Finish
DDeck
(Phone)
(Phone)
/'
~iLf~ - nO
- L, 3';2 ~ tbo \..
o Misc.
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 u n pj'perty to perform needed inspections.
x
Signature
Permit Valuation
Permit Fee
Plan Check Fee
$
$
$
$
$
$
$
$
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
B e - ~X7 f.c>
~ - dlO-l'');2-
Date
Contractor's License No.
Park Support Fee
SAC
#
#
Water Meter
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
q ~ J'Z-/O V
$ Cj '-1St'.
43()~
'3
IV'O
I Paid ~~50,,//
Date ,/ If ...- d z.--.
ing doc ents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
oning c pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
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
White - Building
Canary - Engineering
Pink - Planning
Thr Ct'nler of Ihe Lab Count!").
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
?leLJtJ/lI/Jt-J:) (!.,I)/l/Jnz...
g ~ z,/ -d Z-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,3/52-
808 WCl'T' j}ZA/ L-
jl/yJ
Accepted With Corrections
v
Accepted
Reviewed By:
f2-0 {+ .
"5 cc- p<.J\/V J
Date:
8;;r0
Denied
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."
".P!IB^ 8q IOU IIBLls UO!P!pspn[ 8L1llo S80UBU!PJO
.JaLlIO .10 8pOO S!L11 lO SUO!s!^o.ld 8L11 180UBO .10 8IBI0!^ 01 AIPoLllnB 8^!6 01 6U!WnS8.1d
SI!W.l8d .UO!p!pspn[ 8L1llo 80UBU!P.lO .I8L110 AUB lO .10 8pOO S!L1llo SUO!s!^o.ld 8L1llo AUB
!O UO!lEIO!^ AUE '!O IEAOJddE UE JO 'JO! l!WJ8d E 8q Ol p8nJlSUO~ 8q lOU IIE4s SUO!lElndwo~
pUB SUO!IBO!l!08ds 'SUBld lO IB^O.lddB .10 I!W.l8d B lO 6u!IUB.l6 .10 80UBnSS! 8L1l...
I. 19yfJ
-\1 J. <11 r'l
l~~l-a do. . k- :SIU8ww08
-fJ a c:I :A8 p8Ma!^aCl
pa!uao
:aIBO
suo!pa.l.l08 L1l!M paldaoo'tf
~
paldaoo'tf
:IB pasodo.ld S! L10!L1M AI!^!PB UO!pn.lISUoo .Iol UO!IBO!lddB
l!WJ8d 6u!PI!nq 84l P8M8!A8J 8AE4 SlU8WllBd80 6U!UUEld pUE '6UP88U!6U3 '6u!PI!n8 8L1.l
/1 I
~._'~)
j
,/ _J,I
I
--7 "
- .'. /
/'
03A1383C1 NOL1'tf8Ildd'tf
.IN'tf8Ildd'tf ~o 3V\1'tfN
.';/ /
,/
. /
/ .~; 1'/
lSI1)1~3H~ IN3Wl~nfd3a NOI1"~l1dd" llWl::I3d ~Nlalln8
6U!UUeld - >jU!d
6u!JaaU!6u3 - ~Jeueo
6U!PI!"a - al!4M
,Uluno.) ~".'I .1I11 JU J.JIU,).) ,}IU
~~
o
..
.
White - Building
Canary - Engineering
Pink - Planning
Thf' C"nff'r of Iht' I..kf' Counlry
'I:'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/leOtJ/tI/)L.-D (!AJNJ77L.
g . 'Z'; -a Z-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3/52- 1308 ~/ 77?HIL- NrJ
Accepted
>(
Accepted With Correcfions "
Denied
Reviewed By: A11J3
Date: 1- Lf -OJ...
Comments: See Reverse Side for Additional Information!
Driveway Must Have Concrete Apron
,?ee Attachments: 1) ,Gradi[19 Plan, 2) Erosion Control Measures
3) Erosion Control Plan
"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."
From JECHEEXC
PHONE No.
612 8926396
Sep.242002 6:46AM P01
Jlate nec'd
<:ITY ()F PRIOU I.I\KE
Sli',~VII:H AND WATER PEltMIT
~. ~~~i,';:~ ~i,:~. I PlfiiMIT NO.OZ - / /So I
,. (it.hl ^I'I,h,... __ _
I ZONlNGe;"'"~J
. .---..-..... .... ....-'-. ...... ...--------..., ...______.__... _. __u___._.____"=..._"_._
LUGAL DHSCJUPTION (olllcr. lIse ollly)
LOT ~} Hl.()~:~ A.. ^ I?~?JT10N.'.n~~_.. .5)0 v1it PIn
I :::::~ \1J~J1:~~-~~6h- ~C~~~~=-:-._ ----=- (I'h":~) 1521 (I,~? /0 () I -.. -- ]
--- [^.-.""') .__-~_?!1fl~J~~y._~=-:=~~) ..:-.=J
_(':'JeM~C tYI)e C1.~...c.rjJ11 and &1RI\ ~~. l~.;").~.!~__.... . . __
[A nnRJ1,SS
-.M5..~oL-Ml.~ .C( + TbaJ~ I
}/ lJ __._.
.----....~--...,~..._-_.... ....__....___." ......__.H.. ......__ ..,..___...~.,..___........,.._____..,...._..__......,___..,..
A )>}>LICAN1'-'T ( f- " 7
(Namc)_--d e.c.:~__-:,)'~.. _______. '_ (Phone::) . .1-1;; 1(20 '15":~ ...___
(^ddl'C~~) J...3lD.--Jo..hvL-fla_c._e.:....___. ....-.."B/D(JJtl;~_M.N...___ 55-4.1/
(Adrhcs,) . ((.iry) (Zip Colle)
(e""e.e,"e",,,,,) ~L:r~_~~ __ (I'hone) JM rJ;1f) 7'i,s b
APPT:'~~~IGNA}~URP.~"L~J;#~_~_,._ _. _ DATfLtJ-.2 7.'~
AI-PLICANT I. L~^SE COMPLET,t; BELOW
.~-"-~"-----sI;'~, llf w~'ter sc~v'lc,:e -. 'i;i~iles, -...
Location of llny cllupJings fl'(,)1l1 structure ...~ tect.
. Type of :;ewer pipe. 0 AilC LJ PVC 0 Cast Iron
Estimated length of sewer line _____ feet.
_"____...__.._ CIc:1:l1_ nut (i~'._n:411ir:c.I) l~c.~lt:u a_l,,~.::.::=..fect from..s.lru~.t~urc.
.~
)i'EF. SCJ-lI~))ULI';
Rcsidcnlilll f.llwer unci waler line::. CUIII\cdiO!1 $35.50 Illdllslri~J, Com'.1 & Multi-family 1% of job cost wilh 8.$39.50 minimum
Sewer connection ollly $17.50 Water connection only $ I 7.50
EsiillHllcd Cusl $ ~l ~7 'i~_ JJ~ilding Permit # ~..J!Z:.:u.,Q)
SEWl.m. AND W ATlm. PERMIT J'EI-:
STATP. SURCHARGE
"OT AL l'Ji;UM IT lrJi;ll;
$
:Ii
:Ii
, .. PAID WITH
BUILDING PERMIT
fPiiid~' /\
E~. - '~-ij-~=t:--
j
(omtt II.. Ullly)
Thl, A "p 1 1'::;';;'-;;'0 01 ,; V np, D~.II.'... .".01" Wi",;A,;;;;;':'l
-.. Jl~{'im~'- -. -. ---. -ii~'--^'-"
. ---.. --.--
24 hour notie:e: (OJ-..II iIlNI'.,<:llons (9':;2) ."'/.9!1SU, fax (952) 447.4245
,
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~1~w ~l~icant I PERMIT NO. -~ -' ( I S ()
ZONING (office use)
3152 BOBCAT TRAIL NV/
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
MCDONALD CONSTRUCTION
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/18/02
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants o Steam PLEASE NOTE:
DGravity D Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
DAir Conditioning o Special Devices Required Side Yard
DVent. System o Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEAT N GLO 6000TR.OAK
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% 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 & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildinl!: Official
Date
nam-25.
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~.= ~:y I PERMIT NO. ") /' II ro]
l Yallow Applioant . _ _ ./. J I... _
IX, tv
ZONING totf1ce lISt)
----l
i LEOAL DBSCRlPTION (oftit:e use only)
I LOrOY BLOCKO~ ADDITION W; IJ -S 00~+t\
PID
(Contact 'Person)
; APPLICANT SIGNATURE
DATE
Type of ixture
FEE SCHEDULE
Industrial. Commercial & Multi-family 1 % of job cost with a $39.~O minimum Residential. New One & Two-Family $99.50
ResidentiaL Additions &, Alterations 539.50
,
Estimated Cost $
Building Permit #
...
~~
PLUMBING PERMIT FEE $
ST A TE SURCHARGE $
TOTAL PERMIT FEE $
.s.o
(Oftke Use Only)
Buildlna Om~ial
I Paid
,
I
I Date
LO'''l h 'lnM
J l-J 1 ,~ eutE'
14 hour notice for all tlUlpectlon. (952) 44'''-98!O, tax (951) 447-4245
, Receipt No.
IBy if
i"
.
This AppUcation Beeomes Your Building Permit When Approved
DAte
_'__ _ .___.__'_ _~ _ __--. _ _ _ .__.---".-::.... -,' rl'.J.UK. LAKE
. .'
@OD
CITY OF PRIOR LAKE
HEATING/AlR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
~; ~I;.~. ~~~. 1 PERMIT NO. '~!!5u j
J. Y..II"" Appllcl1l' . o~,
(1'!..~,,,
ZONING (o~ ~J")
~('IJ~~ r .F
AJ, L.u r
'J
I LEGAL DESCRIPTION (offic~ U~1: onlY)
LOT
BLOCK
ADDmON
PID
I OWNER ~
I (Na.m~) -.J??C .
(Address)
C~y.3. f,
(phone) ~;s;;:>. ~'7~o (
A~PLI CA..N'J., 0
(N~m~) GcJAJ./r C / /l"": c1 ()j,/1
(Addt~ss)~/c) e;;~^-) A}~
(.....d.drus)
(Conracc Pe.'-SOh)
(Phone:) ~Cd) - ~0 d. -:::L .'
m.....t::. _'_ .__S~;;J#
------v (dty) (Zip Corle)
(Phone)
A PPLICA.."N"T stGNATURE
DATE
A::; -/7---0 do
APPLICANT PLEASE COMPLETE BELOW
fEW CONST.RUCTION 0 RE:PL^CEMENT 0 AL TERA TIONS
FURNACEMAKEA>lDMODEL ~..h< C''1Mf'~ FUEL ~~
fLUE SIZE ::S!~....Rl/G:. RETURN PENTI'lGS . /r INPUT /~__OOCJ OUTPUT ~-O.OO
TYPE OF SYSTEM HEATING OR POWER PLANT
I>LEASlt NOTE:
Air Conditioner Uni~s
Cannot Encroach intQ
Required Siele Yard
Setbacks
OWIl."'1Il Air Plnni;s
o Gr'aviry
-B1=iieehank~l .'
~ir Conditioning
~nLI System
lHREPLACE MAKE ANU MODEL
o Stearn
o Hot W9.t~r
o p'~di1itlon
o Sp==ial Deviccs
o .Orhcr D~yic::s
~
Indl..1~Trial. Commen::ial & MUlti-l"arnily
FEll: SCH:EDULE
1 % of job c;ost F-esidcntial. Gas Fireol:>.c::
S39.S0 miniriwum .
$99.50 Re5idi:n':i::I, Additions &0 il.ltc~a.ti"r.3
S6'!-.:5Q P,".sid':n.tl~l. AC Only
S35'..50
R"sid"ntiai, HC>l:c['ng &. i.../C (New Consmlcriun)
Resld~'ltiiJ.1. H~lln.g Only (Ne..... COnSLI"'JctiQI;:)
S:09.50
:!:3:J.Sl"J
Es,im~t<:d Cost S
Su.ildi'ng l''''f11}it #
HEATrnG PERMIT FEE
STATE SURCHARGE
TOTAL PERM!"r FEE
$
$
$ ...:..-
.50
/$;0'."'
10... o"-''''-'''~'
(Om.:.: Us. Only)
Thi3 ^f:plkatloJ:! Becomes Your SUildit1g Permit When Approve.d
. j Receipt Ne.
iEy a
:Bl.liIdlng Omcial
Dale
f?'il.id
LCOOT25.
24- hour notj.:o for "II in~pedibn~ (,952) .;47~9SS0, (u (.95:2) d.47-4::45
TOO~
HIV Cl3110H.LNO;)
9LZ909tTS9 XVd ot:SO ilH.L ZOOZILT/OT
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS '"3 (52.. ~t)<3. CAT (l1A1l.. N.w.
NATURE OF WORK 'S,~ S."'\\.1 ~I""-
USE OF BUILDING ?F-O /
PERMIT NO. 12 /1150 DATE ISSUED 81Z-if C)"l..
CONTRACTOR t-1.C.\)ON~~ G~,.. PHONE 't5t -4~l.-1"O'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL AB VE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING 1 '
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I LATI4C::: /c;:;r.....cc..o. I.::?--'~ -~ I
I
FINALS
(
'1 2
,
~tt
GRADING Prior to Sodding)
BUILDING ~d) +-0 ~- -<:2.?
ELECTRICAL
PLUMBING J -/0 _
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850