HomeMy WebLinkAboutBuilding 02-1260
Qrtrtificat! of ODcrnpanry
CITY OF PRIOR LAKE
\ri 1Dtpartmtnt of Jiuilbing Jn~ptction
~ Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances of the
City of Prior lAIce regulating building construction or use. For the following:
Use Classification SINGLE FAHILY Bldg. Pennit No. 02-1260
Occupancy Type R3 Type Construction VN Fire Zone N/A Zoning District R1
Legal Description L3, B3, WENMANNS FIRST ADDITION
Owner of Building Site Address 15245 JEFFERS PASS
ContraclOr'sName&AddressCOLLEGE CITY H0l1ES, 7920 LAKEVILLE BLVD., LAKEVILLE 55044
r{!
ROBERT D. HUTCHINS ^.V
Buil~g Official ~\1
Date: 'I \-': - / -1. - \"'\ \ ,
\, """
POST IN A CONSPICUOUS PLACE
City Planner
DON RYE
Date:
5" 0 D~ C') D~DODD ." 0 > -(')
Ul 0 :z: ~ 0 z_
~ 0 0 ~ en."Z"''''''' 0 0 ~~
~ 0 !l 0 0 3: ::jzen~OO z m ~ mO
g > 0 AI ~ AI 3: m>c: C:O m ;U m (')""
:1 AI AI " -r-~il:Z"" en
hl r- m m m Z -0- Z en ::!."
r- 0 0 en en ....2'5>2'5 9 o~
~ .... .... > Z "'0 - .... z-
~ > -I -f m 0 - zO
to ~ 0 en en o Z 0 J'\ o~
S CD .... ." .... Z
AI > is ::!~
~ UI -~ is 0 'f-J
0 Z 0"
0 Z -l "- mm
." > 0
~ 0 > Z -~ JI
AI r-
I'"" 0
~ .... ." "'0 "'0
::to. :I 0 AI AI
~ m AI 0 0 c:; 000000
Z AI 0 (')
~ m m m m ~"'Oen~~"'O
>< Z m m ml'""~)oOml'""
.... 0 0 0C: -IOC:
ilIil en
~ ~ z ~ "'0 :z:~ m:z:iI: ." (') en
en m .,,!!!AlAlAI!!! m 0 0
Q ~ ." ::J 0 ZZ:Z::Z:-Z ~ Z :I
::! m CD .... >C)OO C) i: .... m
::t
~ 0 () is " 1'"".,,00 AI ::j ;U 0
.... 0 Z \,) -~~ - Z c
is ~ .1\ Zcc I'""
~ lD ~"'O"'O 9 m
Z m r"" 0
~ ."
N 0
~
~ :z: AI
m "-
~ 0 0 .j) "-
C 0
~ < 000000 /)
en m >0
~ Z AI C)."."o~ -J ~
:> Z >;0;00 -i
Ro C) ~mml:(i) m
0
~ ~ _.,,"'O"'O~ ~ C'
~ Z ifi~~~c ' -.l
(') >OOz;; ~
~ _mm...._
!"I AI.,,~ I'"" -i
-1-_ I'"" c::. i
enz Z m
-I~ C)
,
L
5" ~) 0 ~ O~ODDD ." 0 > -(')
~ z_
Ul :z: ~ 0 ~~
U ~ en."Z"''''' 0 Z 0
CD 0 i- ::jzen~OO z ;U
g () !l 0 0 m mO
AI AI m>c CO m m
:> ~ ::tl _r-):3:Z-l ::tl ~"
tl AI ::tl ~ Z en
hl r- m m z ZOz 9 en -"'0
r- (') (') en ~ ::!G)~G) 0::0
>- t -I -l > ~ z-
hl -l m 0 - zO
K:l ~ ~ > en ~ (') z 0 0::0
cD (') -l Z
S -l " is ""'" ::!):
<Xl ::tl 0 > ('\
>0 en ~ (') Z ~ (')~
~ 0 Z -l mm
" (') > 0
~ 0 > Z ::tl ~
;U r- 0 .-<
r-
~ -I " "'0 "'0
~ :x: 0 ::tl ::tl
>;, m ::tl 0 0 .00000
hl Z ::tl (') (') ~
m m m 3:"'Oen~3:"'O
~ >< !!! m m mr-m>mr-
-I Z 0 0 (')c~-l(')c
>- Z 0 en :x:3: m:x:3: "'0 (') en
~ ~ "'0 ,,!!!::tlAl::tl!!! m 0 (')
en ::E m 11
"'0 ::J (') -z:z::x:-z ;U z :x:
::! ~ m CD -l ~G)oo G') iI: .... m
~ 0 ::j ;U 0
(') 0 r-:!!~~ 2:!
~ -I Z C
0 Zcc Z r-
1:; 6 ;:'. lD ~"'O"'O !oJ ~ m
z :-1 m 0
C '" " ~
~ ~ 0
:z: ::tl
m
~ 0 (')
c 0
~ ::tl < 000000 N
en m
~ Z 2:! C)""(')m l 0
-..t >
Z >;o;oo~ -i
Ro :> C) ~mmil:C) m
~ C _"'O"'O"'O~
<
:> ifi>>>o
~ z >(')(')z=r;
..., 0 _mm-l_ -i
~ !'1' ::tl"AI r- i:
-1-- r-
enz Z m
-l~ G')
~
5" 0 ~rt C') 000000 ." ~ > -0
Ul :z: ~~
~ 0 0 0
en"Z""" 0 0
g 0 !l 0 3: ::jzen~OO z ~
::tl ::0 ::tl m mO
~ > 0 AI AI ~ 3: ~>cil:i~ m ~ m 0."
r- :1 en
r- m m en m ~r-E~~~ z en ::!."
~ t 0 o > z 9 o~
-l -I -l "'0 - -I z-
-f m 0 -
lC ~ ~ > - o z 0 zO
cD o en en _o-
S -I " -I Z CJ1 o~
co AI - > is :j!;
~ UI ~ o 0
0 Z -I Z ~ 0"
." 0 > 0 mm
~ 0 > Z ~ ...t:
~ r-
r- o .
~ .... "Tl "'0 "'0 U)
~ :I 0 AI AI
~ m AI 0 0
Z AI 0 0 000000
~ m m m m !I:"'Oen~iI:"'O l.-)
~ z m m
0 0 mr-~)oOmr-
ilIil en OC -lOC <"'
~ ~ Z "'0 :z:~ m:Z:~ ." (') f\ en
en m "Tl!!!;:a~;:a!!! m 0 (')
Q ~ ." 0 zz:z::z:-z ~ Z :I
::! m -l >C)80 C) iI: ~ (;, m
~ 0 is r-::!l~~ i!! ::j 0
.... z C
~ is lD zcc Z r-
Z m ~"'O"'O 9 m
~ N " ...p 0
~ 0 () """
~ :z: ::tl v-
0 m 0 C
~ c 0 ~
;:a 0 N
< '" ~~
en m 000000 ,
~ Z ::tl C)"'"TlO~
> Z >;0;00 ::-...siil
Ro 0 C) enmml:C)
~ ~ C"'O"'O"'~ ~
~ Z ~~~!;c
0 >ooz;; ~
~ !"I _mm-l_
AI,,;:a r- -4
-1-_ r- i
enz z m
-I~ C)
5" D.lliij. 0 C') 000000 ." 0 > -C)
Ul 0 :z: :!E 0 Z_
u 0 ~ en"Z""" 0 0 ~::1
CD 0 3: =izen~OO z z ;U
(j 0 !l 0 m mO
Cl :> ~ AI ::tl 3: m>C CO m ::0 m 0."
tl ::tl ~ -r-~3:Z-l en
hl r- m m Z zCz Z en ::j."
r- 0 en Z ~ ::!G)~G) P 0::0
:.. t -l > Z-
hl > -l -f m 0 - zO
K:l ";'l (jj en o Z 0
S CD 0 " -l Z 0::0
<Xl -l > 0 ::!):
>0 en 0 0
~ 0 Z -I Z 0"
" - 0 :> 0 mm
~ 0 ~ :> Z ::tl "-'
::tl r- 0 :<
r-
~ .... ~ " "'0 "'0 -t
:A. :x: I 0 ::tl ::tl
>;, m c::, ::tl 0 0 0,\0000 l..A,
n, Z ::tl 0 0
~ m !!! m m iI:"'Oen~3:"'O
>< m m mr-m>mr-
-I Z 0 0 OC~-lOC
>- Z 0 en :x:3: m:x:3: 0
~ "'0 "'0 en
~ en ::E m ,,!!!::tl::tl::tl~ m 0 0
~ ~ 1J ::J 0 zZ:Z::Z:-z ::0 Z :z:
::! m CD -l >G)OO G) iI: -I m
0 ::::t 0 r-:!l~~ ~ ::j ;U 0
~ 0
.... 0 Z Z C
0 ~ V\ ZCC r-
ID ~"'O"'O 9 m
Z m 0
Cl "
~ N 0
~
:x: ::tl
m
~ 0 0
C 0 " ~
~ ::tl < 000000 h
t-< en m tv ~
~ z ~ G)""om 0
)>
:> Z >;o;oO~ ~ -i
R- C) ~mmil:(i) m
0
~ < _"'O"'O"'O~ f'.,l
~ :> ~):):):c c-.
Z >OOz;;
""l 0 _mm-l_ ~
~ !11 ::tl"::tl r- -<
-1-_ r- iC
enz z m
-l~ G)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3. Yellow Applicant
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK ~ ADDITION
Date Rec' d
q... I()-~
~s\\A@,tvl-Js
, @dot. PIDdS-:3
I OWNER
(Name)
(Address)
(Phone)
BUILDER ^-\--\
(Name) c..o \ \ ~ q.e...., (~\ '-tu \J YY\-C..S
'.-1 \
(Contact Name) E=dc...:\\E- S\-\\\AOrd-
(Address) ~20 Le\t.llFl' l<-
(Phone) ~62.~.l.oq09
(Phone)~\'L' ~.~
V\ 'llL- \\ 560\...\ Y
TYPE OF WORK
o Deck
OPorch
ORe-Roofing
New Construction
OLower Level Finish
o Fireplace DAddition OAlteration
PROJECTCOST/VALUE (exc1udingland) $ d3-=t-
o Misc.
ORe-Siding
OUtility Connection
~
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 offi 'al or a designee may
~t on t?perfor ne edinspections. \ 9Dq q q
Contractor's License No,
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ \00. 60
Mechanical Permit Fee $ OO..,D
Sewer & Water Permit Fee $ S.So
Gas Fireplace Permit Fee $
Water Meter Siz /", I";
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
-,g~oV'
This Application Becomes Your Building Permit When Approved
~ ~r
~O lCi~ J..;
'/";' ",
Date
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
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occu ancy must be
i~ ~~ fI'4~ Jk ~ ~
PlannIng Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
Tht' Ct'nltr or IhE' tlkr Counll"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/
I
I
.,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
- //1-'-
c.
f
Accepted X
Accepted With Corrections
Denied
Reviewed By:
~ltF Pe7pT
An-MHiilJ
Date: ~ I , "/o?""
,
~d,,'.~.s
Comments: It eJtt a
.
A....c... ~.s
S"E.T 8J1re1<-.S
fkJ~
~~i4Jor- e~~
/IA/Ir ~ Z 4( , bJ, cn-/i
,
Lt,.J~,
S2ttJlE J~b
On, lfew~ -A r
"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."
White - Building
Canary - Engineering
Pink - Planning
Thr Crnlrr of the Lakt Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT fbJ/Lere C; It ;J/altte~
APPLICATION RECEIVED q -/ ()..... 0<.
Accepted
Accepted With Corrections
Denied
~~~
,r'~.i.._ ~ ~~
Date:
9/;G/D~
,
~-~,
Reviewed By:
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."
White - Building
Canary - Engineering
Pink - Planning
Thf' (".-nlrr or Ihf' I..kr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT flLJllerfG ,(? i 11 j/o/11e~
APPLICATION RECEIVED q -/ O~ ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17;{t/~ ~ ~
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
mJB
Date:
1-:~OI-02-
Comments: See Reverse Side for Addition::lllnform::ltionl
See Attachments: 1) Grading 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."
,
~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~.:~ ~~~ I PERMIT NO.,/~':<.,_ /. J iO I
J. Yellow Applicant . _ L~/ , .
ZONING (office use)
(e l
Ii mfx( T(ct.{
LEGAL DESCRIPTION (office use only)
,Q BLOCK d-- ADDITION
OWNER 'J., b K"
(Name) /<.U:... b ,c (, ,
J
(Address)S ) lei II rn
fX\.+1
{>I Tft.t1 ,
(Phone) ifs2" 4JD-2D21
PI' iO (
APPLICANT H P
(Name) I.
(Address) 3lnD
Pi 'pt \.i\/() { k..~
DODD RD
(Phone) &S /-3&s.
(. C\ f")
City)
J34D
~t;;
(Zip Code)
, (Address)
(Contact Person) L 1 ~/t/\. ticl \D VJ:tl/1
APPLICANT SIGNATURE
(Phone) S (/.- 1"YU.. ,
DATE
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
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 $ I q b. L'D
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$3q ,5D
$ .50
$ -40, IJ()
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Oct. 23, 2002 9: 39AM
GENZ RVAN PLUMBING AND HEATING
.... No. 1 9 1 6 .. . . P, 111 1 5 .
DatI:: Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
1 Illue Pile I PERMIT NO g,
1. Gold City - /_ /,J /.
3. Yello", Applicanl . ~ cr- lQ _
ZONING {office: use)
LEGAL DESCRIPTION (office use only)
LOT
IShn
OWNER
(Name)
(Address)
APPLICANT r fl j I.A .&f\
(Name) ~)l JtI 1" ~ ~"-"""~ ~
(Address) ~US ~0 {Ln\rt..Jr2;:1 ~
(&ess)
(phone) Los I -. Lfl-~ .- I ! lj L/
ifn~~ 5so~
(City) (Zip Code)
(Contact Person)
(phone)
APPLICANT SIGNATURE
DATE
L
PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fro:ure
1 Bath Tub wirh or without shower ~~ Rough-ins
, Dishwasher . ,. . . J Water Heater
\ Floor Drain - r2.. I ( Water Softner
Bl..\ Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
\ Laundry Tray (lor 2 compartment sink Sewage Ejector
i Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
9-; Water Closet (Toilet) Other
FEESCBEDULE
Industrial, Commercial & Multl^farnily 1 % of job cost with a. S39 50 minimum
Rc;:sidcntIal, N~ One &. Two-Famdy $~9 50
Residential, Additions & Alterations $3~50
Building Permit #
Estimated Cost $
PLUMBING PERMIT FEE $
STAlE SURCHARGE $
TOTAL PERMIT FEE $
..50
~"-
!
:-"""""\':
(Offitll Use Only)
This Application Becomes Your Building Permit When Approved
{j~0:)~~
,~.., ...:.
paid
:Receip[ No.
Date
Bulldlngqffitird
Dl,lte
24 hour ,.otit:e for .ll inspections (952) 447-9850, fax (952) 447-4245
<"'" V..._'_ .....'\.... ........v... J..'1o.4k V.....-1..."..~<.J
"-J,"'~ v.i. 11.'\.lI,)J\ ....\.I.\L
"lLJ v U.!
Date Ree'd
CITY OF' PRIOR LAKE
SEWER AND WATER PERMIT
~. ~t" ~,~ I PERMIT NOV')\ _I ) /" h
, Cold ...1>911....,. L./ 0<. _~...9
I
I
ZONlNO(c;Mce usc)l
!
i
a~s
! LEGAL DESCRlP110N (otl1ce UJe only)
lHLOT'3 BLOCK 3 ADDITION GJC?n SIYfGIl/10 (r..s1 11dd<-~ PlD
rOWNER /" j I f'.___ , L.
! (Name) CAJlAl~" ~1 1'V~~
I (AddIess) ---;ci~() ~~~ ts \ vJ
l. (Addten)
I APPLIC~ ...... _
i (Name)~e-X /0 U~i
I (Address) 3 3 -, S W 7 c) --+n --S-tr~
I (Addleu)
(Conta.Ct: Person) ~)oJl\d.y S ( I'"'C\~
~...PPLICANTSIGNATt!R.E ~"'t1'l"t.~_~
(Phone)_q'S).:%f-6 YOO I
/..jevdIe. S~yt/ j
(City) (Zip Cod.e)
(Phone) Eo? - 7YV - s.:::,- <eo ::> "
l~ d~__ 8:>"-0 Yc::.
(City) (ZIp Code)
(phone) ":307-7....(',,/- SS't., ~
DATE {<.:J- (__<::.1-;(,
I
I
- I
I
I
I
I
J
APPLICANT PLEASE COMPLETE BELOW
. Si~ of water service ~ inches.
Location of any couplings from Structure -==- feet.
Type of sewer pipe. 0 ABC ~VC 0 Cast Iron
Estimated length of sewer line ..:, () feet.
Clean out (if required) located at -..::=.. feet from structure.
I-
I
L
FEE SCHEDULE
Residential sewer and water line COMcotion $35.50 Industrial, Com'l & Mvlti.flUllily J% of job cost with a $39030 mirlimum
~wer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Pennit #'':'':-''
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
:50
(omce t:.e Only)
,
I This Application Becomes Your BuUdine Permit When Apprond
Paid
Receipt No.
J
8uildilli omal.1
Pate
Date
BY" ~'"
%4 hour Rotlte for a\llnsptttion. (~5%) 44''/.9850, fax (952) 447-4245
"..~;.
10/07/2002 13:07
5077445565
BADGER EXC
PAGE 02
~I .. . iii' . .... w v L f'l.l. U.j,...".,. J .. _ .. oJ
.... ,I. .. to.) J .r l\.l.lJA'\ ........\1:..
~lJl.I...
D.tl Rte"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(l.k~ MIC or 'priat __ u.r ac Ilattom)
I ADDRESS
I \ 5 ~4~ ~-ER-r.s
I LEQAL 02SClUPl'ION (olllalll_"''')
l.__LOT'3 BLOCK 3 ADOIT10N WC'11 SIY)G 111""\5
r OWNER. " L
i (Name) (:0.1 ~,
~~c1~es5) --,::i~o
f)..jS
~: =~ S-l PERMtrNO'Ol-(Z&O I
- ] I ZONlNGOM.---;;'-l
(r oJ 1 ,qdch.~ PIO
~~
'"'~ 1S {vd
(Ad~]
(Pbone)_ ~ 'S ).:- ~ '1-, ~oo
/., cJ::.e v c' { (e. ss"v 1t--I'
(C11Y) . C.,
"'PPLlC~ e rL1;;::::;:v.:;.
(Name) \~ 0; d~~ 1( rc. t.J~'i
tAddz'CS.) 8 ~ (S' W '7 d --4c1\ S-1r.ecl-
(A~)
(Cantaa Pez'on) ~ S (' ~~__
~PLICANT SlONA'T't,.au: ~~_ _~
(phone) ~cY7-7YV- S~-Cc.~"
iv~ d0..4 s-so YG.
(City) (~tp Code)
(pho"e) 30(- --''''(''''(- SS-~~
OAT! !~",- (_.~~
. APPLICANT PLEASE COMPLETE BELOW
Size of WILer service ~ inches.
19c:ation of my couplings frcm struc;twc -- feet.
Type otsewcrpipc. 0 ABC [!g"PVC 0 Cut Iron
Estimated length of lewer line ~ 0 fed.
Clean out (ifrequlred) located at - feet from stnleture.
FEE SCHEDULE
Resid~nti.I"wI' and ....ater line QOMcotlon SH.SQ Indusl2'lll. Conl"l &. Ml,/Iti.rarnily 1% of job 100. with. S)9.'O mirlirnlUn
St-II/lff COllftccrion only S 17.50 Water cOIlIlec:tlon only S 17,'0
Estimated Cost $
BUIli!lnl Pmnit N.~:: '.
SEWER AND W A Tn PERMlT PEl
STATBSt.TRCHAROE
TOTAL PERMIT rEI
S
$
S
:.so
lom~ t;~ Ollly)
This Application 8e"olD.' Yuur BuUdlnt P.,mlt Wh.n Appr''''',d Pa
Bullllil' om..1
Date
Dale
J. Ile\&r nottce for .\lln""'llo... ('5J) '.'.9ISO. tal
PERMIT
GENZ RVAN PLUMBING AND HEATING'" :""."""""No,j916'P, 11 1
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
(fb.s~
OJ-~/&00
~ =Vf E~t ~ PERMIT N~ (j() - Cl {'u::"
I ZONlNG(o...._> I
t~~-;:; ~
LEGAL DESCRIPTION (office use only)
LOT. ADDITION Hi-.i
frY J/rs - lJ.Ju0 'S
PID
&= (1 V II If::{
Cl rY ~~
(Address)
w.
(phone)
q52 - L!(Q9 -lcRtYD
'-/
VYl
APPLICANT .
(Name) . 0L;/l =t. - (l ~ ~
(Address) I U r u ~ b a n\r:).e V7 T
(Address)
(phone) LPS; I - l.( ~ -S -. ( ( '-f L{
Ilfl...l J vZ. t)~ {11/lJTI A In r- 5S0(~
(City) (Zip Codc:)
(Contact Person)
(Phone)
DATE
APPLICANT SIGNATURE
APPLIC
, . NEW CONSTRUCTION
FURNACE MAKE AND MODEL J ....0 Jf\.X'\ D 'J...
FLUE SIZE RETURN OPENINGS
TYPE OF SYSTEM
<S.,wann Air Plants
OGravity
o Mechanical
~ir Conditioning
OV cnt. System
LEASE COMPLETE BELOW
o REl'LACEMENT 0 ALlERA nONS
GZ.b (Q ~l.Y.~ 'DD FUEL ^- 'nT. &t c;
10 INPUT r OO{ (j 11 b OUTPUT q ~ 600
HEAnNGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special DevIces
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of Job cost ResidentJal, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions &: Alterations
$64.50 Residential, AC Only
$39 SO
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit +#
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
t:,;,~~~\(e' Use ,Qnly) .
2 ',~:'::.)'~Ii$ Application Becomes Your Building Permit When Approved Paid
Date
.50
!RI,:J OIA.
1:1/1 ..-.:,U fNlh .
~-~~'~'~ .':'~'l- U r1
..\";,,.1 '"''
Receipt No.
Buildlng Officl:.ll
n.te
By
OCT ? 5 2W'
2.4 hOUf notice for 811 inipec:tions (9S1) 447-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS \ S Z. Co(s TEFFEk..s ~~sS'
NATURE OF WORK \<.- \
USE OF BUILDING 5F. D.
PERMIT NO. 02---;2&0 DATE ISSUED 9/1"/02-
CONTRACTOR GoLLE""EiE CI-rr \-\~~.zs PHONE '152 -l("""9~o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING \.V/~~ I ~ \'oI!~tB2-
I FOUNDATION (Prior to Backfill) I pi/D .-'0 - '< / I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/1 -""2.0-
11-< r;
\.0c...,
11- -) '1
I~~
GRADING (Prior to Sodding)
BUILDING f"(-t"""lf /.Mil-; I ~~ I~ 0'7
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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