HomeMy WebLinkAboutBuilding 06-0045
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CITY OF PRIOR LAKE
~tpartmtnt of ~uil~ing JInsptttion
OJ Final Permitted
D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section lID of the [J Residential / D International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classification ~SI//Gt..t:. hll'/ / L.y' Bldg. Permit No. te<, u(.; 4-5
Occupancy Type
/<3
Type Construction
Vlj
Zoning District
R.I
Legal Description
L./
C I /
,
i ;; I / ( U -<" 0 ;C E 'Cil-t ;z;..::;
Owner of Building
Site Address /-?775 Ice: IV":::/ 11r:; 7ZJ'J ~ i C.
Contractor's Name & Address c,Oc.(..LV e/2 0.::: ./ Icle9 {-. /';dIN :::"/ A'Elv r"k/1C1 uC:;: _~~,D7 /
Ie (..' IJ OcT LJ. H() TV-! / IV.5 /1 >/:'::~ity Planner .J/-I;vE K.rllv'!: I e: K
t Building Official
Date: .f :; (~ Date:
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I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF WNING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
/22-9..{)S
I. White File
2. Pink City
) Yellow Applica..
PERMIT NO. 0& {)D4 r-l
\ Le {\Sl
ZONING (ofu UJC)
f2-J
LEGAL DESCRIPTION (office use only)
LOT I BLOCK t ADDmON ~UI n
OWNER
(Name)
\?Jy- \AU
LI /cJ (if
(Address)
BUll..DER
(Company Name)
(Contact Name)
(Address) L'
PID2..6. 4-/.3. (Jul. 0
O-lW\.p ~
.f\.Q.{ JC( 1 )
(phone)
0S;j-d3q - q,qb
Gr\
G~liJ ~l C"{\~~hll^
O~.e. (i",ex{jl~
~ /In
(phone)
(phone)
q S d - lS'b. () [3l,f)....
q S;) - (j G1 0 .. ~ b 3 0
Sb Df-
TYPE OF WO~ New Construction ODeck OPorch ORe.Roofing ORe-Siding
OAddilion OAlteralion OUtility Connection 0 Misc.
CODE: ~.R.C. DI.B.C.
Type of ~ction: I n m IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
OLower Level Fimsh
~Fireplace ro
379.900-
"
PROJECT COST IV ALUE $
(excluding land)
) hereby certify that) havr furnished information on this application which is to the best of my Icnowledge lrUe and correct. ) also certify that) am the owner or authonzcd agcnt for the
above-menuoned propeny and that aU cOllSlrUction will conform to aU existing stale and local Jaws and will proceed in accordance with submilled plans. ) am aware that the building
official can revoke this permit for just cause. Furthcnnorc, 1 hereby agree that the city official or a designee may enter upon the property to perform needed IRspcctions.
X ~1~11/\ ~~ IllS- I')-/J~(*OOS-
Signature Contractor's Liamse No. Da
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Park Support Fee
SAC
Water M
#
#
Sewer/Water Connection Fee
#
Water Tower Fee #
Builder's Deposit
Other
TOTALDUE~ /./700
T1Us Application Becomes Your BuildinS Permit When APJII'OYe'
~ ~t1J Iw ~J?c?"
Building Official Oa
Paid o. 5Z/87/
Date
"
nus 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 consuuction to commence. Befon: occupancy, a CertifICate of Occupancy must be
w~~
1/17~(P
Date
Special Conditions, if any
Planning Din::dor
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Distrkts
Building Permit #
Address: /317 S
Legal: L / , B /
~ ~ Date/f3jtJ6
PID: Zoning:
~(j}.JS 1:J-/thV ~' AJ~.t,
Subdivision: t()~ ~
Reviewed by:
Existing Structure? YE~
Existing Nonconforming Structure? YES ~m.__..___
@
NO I
- . -'-"-.: -'-"',"-',
,....".,...,
-----._-----~;:
I CONFORMS TO ZONING
ORDINANCE
.
Standard
25'
10'{
25' if abutting a street
~-
.
. Sidewall exceeding 50' requires additional side 2"
setback for eve l' over 50' in len th
. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicatin no deck will be built in the future
. From 100 year flood elevation ofWetf~nd/NURP
and' - -
. From OHW (Prior or Spring Lake)"
10' setback +
2"/1' over 50'
25' -
1 0' sidel
25' rear
30'
,1,11.
75' or setback average of
adjacent structures, but no
less than 50'
flJA--
I Floor Area Ratio: NAI FAILS@MPLl~
Z 2.%.".:,_-_ _(,
.30 Maximum
~-~?~. t~~~f;t~*~~}f.~~~:~.-:;,..:
lree:Preserv-atlcm __N ~.. FAILS f COMPLJE$d;
.- Totafcali erfn . es
.' P'ermit25.%. Removal
.- Cali eclnches Removed.
.. CalierJnches Preserved
.. Relacement
Standard'
~;1
L\TEi\tfPLATE"BLDGLlST.DOC
n . .. ;;"_-::-,~,".:'~' .: _.,
. ", .1;<~ ~';} :-:'~
, 'I \ ~';.n':I'"-"'l, ,,-,,:;,~...~
Ii
White - Building
C-CallA!l.. - =n9In~erl"9:>
Pink - lann ng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
, ....;1 ,~~-.I;
NAME OF APPLICANT
APPLICATION RECEIVED
qEK.OLD 8/205.
/2,29.05
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/3775 ~N5/;VqTDrJ AVE.
Accepted
>(
Accepted With Corrections
Denied
Reviewed By:
IWJ6
Date:
/-S-Ob
"
Comments: See Reverse Side for AdditioniJl1nfQrmationl '
"
,
'.
See Attach~nts: 1) Grading Plan, 2) Erosion Control Measu~s.
"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 - Plann~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
<; i f
.' : ~_ i '-
1..(.
I~
/
,/ r-.-
",' ~..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-' I i / ,/
,../1 . '"
/ / /-
,,-.~
Accepted
Denied
Reviewed By: ~
Comments: ~ t:L.Lf
Accepted With Corrections
~
~~6~
~ Date: I /I ~jy ~
~. 0:;- C)-tf." +
~ LJ- }J~'
IJ
',. C di. d O"'<'-}, W'lf ." ., .
tl.\B."vn tioner~f:l . . :wJe1" ii'ieCna1'11C[,-"
Units Cannot Encroach into Reqllired
!~],y r.tF:: ...~tt1r~:d f~.~ (: tl):::lCI~s
"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."
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted is 30 Percent.
Property Address
/377C; thf5/1Jh/iJJJ )VPJlW Rc
Lot Area / I, 31 j sq. ft. x 30% = .............. S ~'/13 ( q
************************************************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
A TT ACHED GARAGE
x
TOTAL PRINCIPAL STRUCTURE......................
Z~44-
(tev/f6:? I-ZP-?J6
DETACHED B~DINGS
(Garage/Shed)
x
X
TOTAL DETACHED BUILDINGS....................... N/J
DRIVEW A VP A VED AREAS
riveway-paved or not)
~~arking Areas)
27 X tr
X
=
!o1(
ztX4-
104-
TOTAL PAVED AREAS.........................................
771
PATIO~R~CKS
(Open Decks I. min. opening between
boards, with a pervious surface below,
are not considered to be impervious)
10 X 4-
X
4v
X
TOTAL DECKS........................................................ 40
OTHER
X
X
TOTAL OTHER. ......... .............................................
)III
6/h3
Wo.9
/2 -z...f-~5 ~y/f4:J I-W-l'~
TOTAL IMPERVIOUS SURFACE
6m970VER
Prepared By ~ ~:
Company ~Iu ~ !J.~
L\HANDO UTS\IM P ER vious .doc
Date
Phone # (1(2) J32 -?tJ~O
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
at bottom)
~. ~w ~:~ I PERMIT NO.
3. Gold Applicant
ZONING (office
use)
/l Ctv..-L-
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK I ADDmON
PID
OWNER
(Name)~f;yUU
~,1
(Phone) q Set d 31 Cf J 7 to
13 [)( nJ LA' ~;
(City)
SS30b
(Zip Code)
(Address)
/ L1 1.,/ d- 'n .tAd c (J )'1-- L.n
(Address)
APPLICANT S '
(Name) ;\\X~f(2 5",,)(( A-v A-1l ( 1 ~
(Address) ~;;}-) 310 l!?oOAQ 6-v~
(Address)
(Contact Person) ~ t- / 0 b ~)
(Phone)
SM~
(Ci )
q~d - ~qO'- Y ;}Lf J
S5 )':r9J
(Zip Code)
(Phone) q s;} - ~ q 0 - '1 ~ Y ,
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure _ feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line _ feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
0..:.....:_.... hmA:....
n....."'"
In
D:te
I Receipt No.
By
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~~yv- CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
I. Blue File I PERMIT
2. Gold City NO.
3 . Yellow Applicant .
ZONING (office
use)
LEGAL DESCRIPTION (office use only)
LOT I BLOCK I ADDmON CU I
PID
OWNER r7
(Name) D I( \ACL
(Address) (a
~
(Phone) q SJ ~ d ~q - G\ 19 (0
Sj301.o
(Phone) ctS} \'1~~ ()Y~1 D
Jo '( elM SS3S~
(City) (Zip Code)
(Phone) q<s} '1tfq 0"1 \If 0
-fi uJCr 1)}
APPLICANT S
(Name) O~
(Address) ---.:aJ 0 O~
()\f( tt: Cb0\YlA-CTtf2.S
l~(J QvJ~
(Address
(Contact Person) -.to \J
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
T e of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavato (Bathroom Sink
Laund Tra 1 or 2 com artment sink
Shower Stall
Sinks
Bar Sink
Water Closet Toilet)
e of Fixture
Machine)
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 $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
I Paid
Date
I Rece;ptNo.
By
CITY OF PRIOR LAKE Date Rec'd
~.:., ~:~ I PERMIT NO.
3 . Yellow Applicant .
ZONING (office
use)
\UV'fi.
E.
LEGAL DESCRIPTION (office use only)
LOT \ BLOCK
ADDmON
E 5/-vt- s
PID
OWNER Q
(Name) 0 ~Ul.Q
~A
(Phone) q S J. J 3tj ~) Cij k
(Address) I y lP (
GL-tr n 5 . /)..l
55 u~
APPLICANT (
(Name) 0b \Jt1k
m f Gtt L CY\1l2At5fti2-.J (Phone)
q S d-- L11'O- C> Lf'-1 0
(Address) .1").. I 0 f\ 5 I ~ - r n
o v L-Wt~rvrvf
(~ddress)
(Contact Person) Yo V\.
tkl-l
JtJyj,/J/\
(City)
(Phone) q S"d-
s~ 3>S^
(Zip Code)
y C1~ ')'-/'10
APPLICANT SIGNATURE
DATE
APPLICANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE: Air Conditioner
Units and Fireplaces Cannot Encroach
into Required Side Yard Setbacks.
Fireplaces with Box Additions or
Cantilevers to the Outside of Buildings
Require a Building Permit.
FIREPLACE MAKE AND MODEL
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
I This Application Becomes Your Buildin!! Permit When Approved I Paid
I Receipt No.
01/19:06 THU 16:05 FAX 952 890 2753
STOCKER EXCAVATING
4,1] 001
~,
~w~
. .r''VNE:50~''''
Date Rec'd
CITY OF PRIOR LAKE
SE\VER ANDyV A TER PERMIT
I Cr.~{"I F;l~
2 Yell,:O"f Cil)"
) Cold Al';-:li-:.r.nl
~J'ylrT NO. ~/iiIJ!j
I I ZONIN~_IOrOC"") j
rplc.L~e type or pr;m ...nrl $i[:l1 at D(l:10m)
i AJJDF...E5S
13775 Kensington Ave
,...-.--
1 ADDITlOtoJ
Windsor Estates
PID
I
952/758~:'~:~,) _ I
-'-"l
j
-
LEG/...L DESCRIPTION (,'(l1c~ u,e only)
LOT 1 BLOCK
O\VNLR
(Name).
Gerold Brothers
(Phone)
(Addre$~) _~_!.:.9. BOX 128
(f.dd1'~~$)
N~w Prauge, l~r 56071
(Ciry)
APPLICANT
(Name)
(Phone)
952/890-4241
STOCKER EXCAVATING COl1P.~r{, INC.
(Address)
12336 Boone Avenue
Sava~e, tfrl
55378
(Ciry)
(Zip Code)
(.,\,j,jre;s)
Curt
i (ConL3.ct P::r$on) _' . . . (phone)
~.PTICANT SIGNATUR'c. (1/1-1/- J ltJeIu-;\ If PATE
APPLICANT PLEASE COl\lPLETE BELO\V
same
(~ /P~O ~
. _r .4~
Size of water servicE.: inches.
Location of any couplings from structure _ feeL
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at _ feet from structure.
~'I
.J
Estimated Cost $
FEE SCHEDULE
$35.50 Industrial. COP)'! & Mulli-[<lmily I";" of Job CO$t '.'lith a S39.50 minimum
$\7 Sf) Water conne.;tion only S 17.50
Building Permit /1 ~"-~
Resi,1=nti;].1 sewr..r and water lin~ connection
Si;'m:r connection only
SEViER AND \1/ A TER PERIvHT fEE
STATE SURCHARGE
TOTAL PE'RMIT FEE
$
$
$
P~lb WITH
BU\LD1NG PERMIT
(Oni.,. ll~. Only)
I Th', APpl'''''"" n""m':~".",_~mldi"g I'en"" Wh:n App'",""
I Buildin~ Olliti;d DHt
~
24 hour notice for all inspection~ (952) 447-9850, r:,,: (952) 447--4245
/;-rn:~~~
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t-,"' DDR'ESS __~- .___---- ---- . ,_ONll' G ,offi" "'"
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CI'~l(T 01.i' PR10R LAKE. rt.UMnlNG PEHJvUT
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!~f~~~Ain ..~~~~:;z----.~~-:.~-~:..-(Phon::...35 z. - 7i2. .: j~,/ m=l
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I ,'PPU(:" NT SIGNA TUR!' ___ /'?~ ~C -oA:- DA IE ___..Y.-~-ZLJ.:(.)-r", --
. .-.--,.---.-..-..-----.--...----.---. -...-----..----- ..------------.-------.--..-=-'
A.PfLtCANT PLEASE COi\rrLETE BELOW
\-Q11:;Wthy ..~_._"'_ TYr;'ofFii~iu~'e -..~-.-.-T-.Ql)~nOt.\' 3-------:rype (JIf1.;;,itu;-:;;-'--'-~
I.=--~--I Balh Tub with orv;ilhml1 .,Ii;;;;cr----'------r-- l<o.ugn-.in-S-. '-:-----------'-.-..,,--.~
I - l-.--j~'''h,:;--.---_.---.-------L--r-. I'W,"" He;:lcf---------
1'_-'-- ----t-Fl,w Dr.'n --.------------- .J______________1 \II atoiS,;n;;cr.------ ------
r....--=-~t~--f~~.;;,;;;;Ok)----. ~~.~~=~_..~.\==:-~===.]~~~~~,d Pipe~V';;>'.Shin. g M~.C..h;~~~~O['_----l
\ ,.____ ._-1.'0 'I.J. .nunCir'YT .\':l'Y (\ . o...~ .':' (;0!TlPzrt.lT,C'~~1-~~5.--.-j--.---....----~' ~~.~'.,^:.~f .~~ EjeC.._:2.!-__.. .-.....- .....----- '
.__'- L- Sb(lW~i St;:lH Bac!dlo'li\/ N;sembly ~
I . - / 1 Siok'-----------------.------- -------...--- L';'ckft;;;;;A,,;r.>blv h"-"''-''-
I.--...-.-.~..t .. ,...-.--.".--...--.,---....---..-.1-"..---...-.--.---- oJ ...-......--.
\._____.---.-.- ~ar S'"" __----------.---1--.-.-------. }-""'" Spril\i< 10'-._----- .------1
,_~- Watc:~t (T~il"-L-,-.---_--.-L---.------ Ct1l.'r ---::--------'
F'f:Ii: SCHlrf.)1jl.Ji:
lntI1.\,Hi,'I, C,)1T)n"~r~i~J ,?.'. ~lulli.f~.;"[liIV I?";' of in!) t;(1~\ \\.';111 ~ $39Sl T:\!nitm:ll'l
?csidcnt.inl. New One & Tw,)-i-:}milv
Rt~idc;nti;d, Arldi[ion~ &. Altcr~,'i,on::
l;'l9j(j
tlq~O
E:~ljm'\t~d Co",', :l;
e'J.ilding F"',)mll II __..__--.-.-
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Pl.U1vl,Bft"K; PERMIT FEE
ST ATE S URCHi\P, C'r E
'H.H'Al. f'm:,Rl\fll'll' fF.,f,
...
.~
$ '==-=_":~=~AID WITH
~,
", ___._._... BUlL01NG PERMIT
(O1(:,(~ U<r: Oll.Y)
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952,:1.<1'7/.-\21.15
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ern: O'F rRIOR LAKE
Hf~ATfN'G!AJR CONDrnONINGf~'JRF..fJ..JACE P]{,Jll\;IIT
Jiil\tc Rcc'd
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L_.!:.c~ E,_OCR AD1?ITJON
.. .,~.._...........__-..._-,.__,_4__-.....
-----_._-~
PiD
-...------.
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A,PJP1.J1CAN1' PLEASE COt."U"I~E'I1\, 3ELO"~V
i ---'l~~l CONStFJJCTl'C1'l --'---eIREiCAcmIfRNT - [] /\L TERA,nON;S .-. ..---"'-'-
i f!.jj:;,~jACF. MAKE A}1D HODEL J~ ,~_Yo~....,./@'.--'!c:..~. dTv<-.-- ------- BrEI. _11..~__. --.--,.-
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HEA11NG OR POV,TP.R PLANT
OStMfI).
nHr'iWCl~r:;:
o Rildi2!ir.'lJ
o ~,pl'dAI DtW;CC~ __..____,__.._.___
o (rth~r rl",.l'~~l
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TYl?1? OF SYST7i.M
FIF.EPLACf,MA.K.S 1\:1'JD MODEL.
._--_::::::::....~~~:..~-::::-:.~.::::::::::::~~~...__._----
Rc~jdcl)~i~l, H~-<!.il1g &. I'.IC (f";~w C~I(]$lnl-:,\0n\
Rl'o,lrlCI111:}1. HP.1~Jinl\ Only (Nc',,, C(1n~tr\l{.::I{)Il)
n:'!i',5,Ci-{E,mn.,!!',
J % n.f jnh r.()~t R(':~idr.l1t lil.l, all;; Fil'epl!:lce
~,3'j'yl m!nlm-nnl
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.~VL50
UIr.Ill~rxb', COlT\n,lcr;)i~f, &. M\lJrH;'jlI'Mly
~(~t,~" ~O
RC'!1'ident;,~l, ..~dd!1ic.n", l.. Alrt:ration,
P:r.,~idNlI.il'J, ... C Only
:l:;\IU~}
~JI}.S{J
e.~tim"~r-d CO".! :t
B',~IJrli!1,g -rr.m1;t #
,. ----
HHATilNG rc)~}vfJT fEE $__~..~: 50
STATE 3URCfV\.RGB. $ co PAID WITH
.'.._--~~-~.
fQ.i:ti"~ UI"" 0:ll}'} Tefl' AL n:RM:IT J?EE 5..___ ~3L.a-WlD'NG PERMIT
I Tn<' ^Pp\;"""' !Woo." yo,;,n;,'.I.,.i;;;;;;;;;.""~" APe"';;''"] :~_=-~. . R0Ceii?1!}'D~_n_-'-'-!
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l(r.~M 1rr..r!.~h C:r~~k^."ci:lfr~" {l',il.lil:' [AlIke, MN 6$;J,72
03/21/2005 11:41 7537857138
.&.4.' 1Ito""....-.- ....- --' ~. - --..
BOULDER CREEr:
PAGE 131/01
CiTY OF PRlOR LAKE
REA TINGI AIR C ONDmONINGIFIREPLACE PERMIT
Date RK'd
~TIm;:~~ I
I ADD~ ..~ / ~~(\'?~~ &n~ ~
LEGAl. DESClUF110N (otr.ce \DC only)
I. ..... "Jo
,,0... 0.,
J.l'_ ,."r-
LOT BLOCK
ADDmON
PID
- I
7~v~
(phont)
q 50'-7':.S'C - o-3'j
I~= ti:.-U rr{cL&iiJS
LA~)
APPLICANT(t d - r ~ riff . 00
(Name) l: II1'\. ~Or ---I=-L/1)-1~~~ ,. (\~
(Addral)~Lr\-r~ Sf- V\L---
(Mdltn)
(ConUct Penon) U. ~A '\
,
(Phone) 1 0 ~-1~0 ,~o- ~~(
~~
( . )
t:::-.n <-(-:;:
,...) ")~
(Vp Codt:)
APPLICANT SIGNATURE
..@J
APPLICANT PLEASR COMPLETE BELOW
[]NEW CQNSTRUcnCIN REPLACEMENT 0 At TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETt1RN O~WNOS INP1JT OUTPUT
~ OF SYSttM HP.AllNO OR POWER PLANT
(phone)
DATE.
~/d(-G
... Muld-FamU,
PLEASE NOTi:
~ ~~.ra Air CondltiODtf UnitJ
~ll1lon Camot EJ1aoach Into
Sp<<ial [)CYtod Requlnld Si.de Yard
o Other J)r-.-It'tl ~
J/AI1&-[D /PCOO~r2--{)cJL .
FIE SC'HEDlIU:: ~..;f- r Lf~ o0-x.
1% of Job em Raldellw. 0.. F~~ ~ \
~ J iii SO lIliftnnum
)99~
)6' ~
E'Jfim.-d Colt $
JI.~tial A.dd!llanl ~ AI\l!rIOQns
R~eDt11l t\C 0uJ,
Buil~ Pmnil" 1-/6
~,.)Av~
119,0
$39.30
ItmdmtiaJ.. Hcatint a:. NC (N- ConJtNCti~)
kmrJerrt1&1. Htlltl~ 0Nr (N"" ~)
~ otk:dl
o.tt
s \ /'
t ?
~~.ID WITH
NG PeRMIT
I:R 2 ~ 2006 I; No
I
J
HEA TIN G PERMIT fEE
STATE S URO,tARGE
TOT AI.;rERMIT FEE
(OC!ict u. ow,)
Tho ,\JIPlk:ltioII Bccolftft Your ~ Pwtllltt Wka Apprvnd
14 h.r nftn ''M-.I i~lior-~) ..,.~ [e,J: ~) 441-44'
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS I~?,?r KBJ.rIi.Jts TliJ AV~ /!Le.
NATURE OF WORK ~1tJ CO,JS""'c.)7~ ~ ,." tt:!fiJ,'r,." ...y.0t!t"1I:)
USE OF BUILDING . IJ.
PERMIT NO. ., - 004-5 DATE ISSUED I
CONTRACTOR Dl"Sr, P ONE,n -19d. "<I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE /
I FOOTING ~t/'l ~~~6
I FOUNDATION (Prior to Backfill) I ~ I / /;10/:;0
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/ft r r:! -
COVE N~~~lo'f(UNrIL A , OV A~ BFEN SI~NED
IlArN,. / tfGtlS"c~~A~ VI/tv; I/1,J/ 3}7}ta I hll! IllIl1~w I
, FINALS
GRADING (Prior to Sodding)
BUILDING ~ <6 -\ ,0 L<
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
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,
3. 2-8 roe
FOR ALL INSPECTIONS (952) 447-9850