HomeMy WebLinkAboutBuilding Permit 99-0085
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
...
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
IY~o~
1. DATE
1}-I-crt
o 0."\ CJ.N-.cl 1S~0-l:~ 1t~. S. E.
32,....
PID r-- 1/5'- 007 - 0
~\SD
3. LEGAL DESCRIPTION
LOT \ l tt ~ ll'2- of-lot \2.. BLOCK
Oa.K.tQ.v-.6 ~
ADDITION
4. OWNE'Y"n""..\ It'l\"jo 2Jz..n.~\A lo!!~ss~f.2f Dr E..AL,...~ J!ll. NO.q "42..-'-",03
, John ~1t\.~4 -p "it" \.)'4 A-,.,ni\.~ AU," BuU. lI\~F-L.~ GX..1 ~U
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name)
t>>..uf<:\: 2~W
(Address) (Tel. No.)
lb~3S-~er br EJ.~4\~~t'\e. h\Al qiz..."~03
7. TYPE OF WORK
New construction)r(
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Sq.Ft.
Width
No
Depth
Yes
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. 3.3 -00!3~
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
ILlOt,OOD
17. COMPLETION DATE
I hereby certify that I have fumished 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 me . ed property an 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 offic' c revo is it for' st . Furthermore. I hereby agree that the city official or a designee may enter upon the property to perf!!..rm yeerJe.d inspections.
X ~(qq
Signature License No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION $ 14.~.~....
USE OF BUILDING
S~\")
r
TYPE OF CONSTRUCTION: I II III l'^-Jil
Occupancy Group A B E F HIM -W- S U
Division 1 2 Q)4
Permit Fee ................................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o
COPIES
o
Plan Check Fee ............................. $
ll\ 0"2 .'2e::>
7 I to. to{ 1
-'I.'S6
Amount Brought Forward .................. $
Park Support Fee .~r.~d:............... $
SAC ...C.r:e.JI".:::-:........................ $
Collective Street Fee ....................... $
Sewer Tap ................................... $
-I ,. $
Pressure Reducer ..?/.8.................... $
Meter Horn ................................... $
c:;1. t.
Water Meter ...+~..C;,;;,l'.;J:..:.......... $
Sewer & Water Connecticiin=ee ........... $
Water Tower Fee .('.':'~J.I..-h:........... $
GaS~lre ce Permit.. $ Water Tap ................................... $
This 'pp. l ~~-~~....:~;I~i~~.~.ermit When Approved. Builder's Deposit ............................ $ \ 15"00. ~ D
By "E:. Date 'Z -(7-90; Other ......................................... $
Certificate of Occupancy TJ;;I D7..:;;-".........i'\.............. $ .~ I~ 5 -,72=-
Paid ~:;> ,15,-1 r Receipt No. '3 L(--r2L./
Issued
Date<')- ~~q 4 By 01.tcu
This is to~fy th. thef.eqUe. in the above application and accompanying documents is in accordance with the City ZOning. Ordinance and may proceed. as ~uested. This document when
signed b t C':P ner co '!1uj,es.! '.ll'.P'JOrary Certifica[4cJ zoniic/rPlianZ/:;/IO'fS C09S]ructiqn to~o~mence. ,-~fllre occ~an~ a Certifiqat7 of occupa~ust be 'ss .
. .' _ 7lAl' I ..~ a . W i:1'1<<11/ i/Y-tfo..:n(J'n (.Vt.l' ft(M)l.rfo i ._
'\ rty Pia r Date · Special Conditions ij any ./~ U)q
II 24 hour notice for all inspections 447-9850
City:
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ..1.1.~.p'(?'G5..... $
Mechanical Permit Fee 'i1.:f!?~?...... $
Sewer & Water Permit ./J.If..:t;fl.f:?.... $
L 00 .00
t ()(J .f') 0
)S-.r::rO
T
-0-
-c -
t.ls. 0 (;
l 25".00
-0.
-0 ~
~ TIME
CITY OF PRIOR LAKE ~t~~
INSPECTION NOTICE SCHEDULED
ADDRESS \ 4D 2.. 6aU a.hd ~
OWNER CONTR.
PHONE NO. PERMIT NO. '1q_ O~
o FOOTING o PLUMBING RI o EXlGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
~ING o WATER HOOKUP o FIREPLACE RI
SULATIO~ o SEWER HOOKUP o FIREPLACE FINAL
o SITE ~NSPE ION o PLUMBING FINAL o GASLlNE AIR TST
o MECH FINAL 0
Cu~jv1MJ
I. -_____
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. /
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~R
o CO E
C~MENTS:
/y~
\;/
Inspe::tor:
R REINSPECTION BEFORE COVERING
OwnerlContr:
tALL 447-9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~~ REQUIRtENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
V INSNOTI
T
DATE TIME
SCHEDULED . 2,:00
OA-K {..,AND
AOMf!4IENTS: r'
~ .... c 9<." iUll
-:th.<.W ~~~.- + n< ~
fiv01<K'h ~..AL~ ~~IV.'r\..<.
~lJ...\ l ( (j I) -t ~,") ~
(0 \ \1
~A\)NM.~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J4~oz
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
PLUMBING FINAL
o MECH FINAL
\~cJ:cA
/
qr;-85
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
r{i.
.-I
DkoRK fA SFACTORY, PROCEED
LORRECT" TI NO PROCEED
o CORRE W RK, ALL FOR REINSPECTION BEFORE COVERING
Inspect r:
OwnerlContr:
INSNOTl
'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~.~
TIME
'1 ;fz)
ADDRESS \ ~(..c2
Dc...k.-l.I.-c.l. B<.e-cl?...
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA T19t<1. /\/"
'il FINAL N V~
RJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~-6C:;
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(J ~Vl'2l \ p~ Gv-a..-\~~~ r\.1...j
G) S.xJ- ~ uL.-o-r....) ,- .
(~ Uav- d--.- S ~c.c..- dvl~ ~
(~) ~a~ ~,__ ~cJ2
\A-v~
C1t--
~
~l~r.?
~ 0
-
----
o WORK SATISFACTORY, PROCEED
-~
J> 1:::Lt ~
,..-/
-
C~ 0 r f/J
~
o CORRECT ACTION AND PROCEED
~CT WO~, ~ALL FOR REINSPECTlON BEFORE COVERING
Inspector: In Owner/Contr:
CALL 44l;';;;OR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE RE'rfUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
jf,i~ v~,."""~~~~~~~.jj1,,..,..:~~-:;1:I'" ,"'."..",...._ .......'r"".."!"~'.~:;(..;. ,~~ _ ,. .~(if'*}.?ioi,,,')W~J!...,...1I';~,:')."f;,,,'!P';"'1!!'i'
.$.
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Occupancy Type Rl SD Type Construction VN . Fire Zone N / A Zoning District R..~. ...._1
Le aiDe . t' L11 & N1/2 of L12. Oakland Beach , ~.
g scnp Ion. -- :.
)i -t~~ it f\ 14602 Oakland Beach Ave. S. E. I'JI...~.':':
~~-:J~ Owner of Bu' ding - ~iteAddreSSI ~:
ft~i contractor's~q..h".'_" David i~mbJld 10535 Parker Dr. Eden Prairie, YN. i~.._.-..'..\ ~
(... " S J \) ~" K
(~~, R herO' Hutchins 1\. Y City Planner Jenni Tovar ~:. r
rt;,. :i Lj BU~'ldin Official I \ J:'
)~ ,......., I f \ Date: . ~
\ "1'. Date: I ,l~ _ \ l'
..: / /" ~ IN A CONSPICUOUS PLACE t:
, .
~~ t TIt.'T'" T JTt T T Tf TJ1:.IL _..... ~ ~.oft.
t ~. ......._._~ _ , -~,'-~ir-''''''''''''''' '~.,~'Oo":,.......~"'~"7'T.~ ...........~c.......'"""".~~,....,..... ....~
~...I~,~.~~~..'I~~~~.J:. t --'1"'-" t ,. .:0,.. ",.:r
[", ~ iIIl ... . '. . 'lot 'ill ;i< , . .. .' ,. lo' . . , , .~ ,~....
~---_.._---~-- -----~-~--~ ~ ---
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time ofisslHlnce this structure was in compliance with the various ordinances of the
City of Prior Lake regulating building construction or use. For the following:
useclasiiii~ Familv
B' ':- Permit No
99-0085
Tht' ("t'nlt'r or Iht' L.kt' Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D"ht l!) ~i\o ,-,")
2 /1 (i C
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections
/-
Denied
Reviewed By:
~J ~,,----,*
I
Date:;<-11-1 ;
Comments:
\ . ~l ~ \\ r;C\r--e ~;~ J4~~
2. fv\~~lAk1 VL hl')c:..(~ ~JN:Jr
s t.1-e~ ~L-~'[Cut-e e.,9UI'~ ~~ ~uwl)~~--ch 1:~
0
"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."
. ~---~ d~' -~'T-"~---~--~~ ,---~..
06/14/1999 10:04
612-8947972
LAKESIDE PLBG
PAGE 01
. Cfn'lll'r or tile 1...lI.e CCl~lIlry
'CITV',:'OF PRIOR LAKE
PLUMBING PERMIT
APplicant:.Ltik.,. r:.d'.e. ~m"-~5' iJ.Iekl-/A';'
Addres.: -::t::;..-; ~ ,'"ra." .flv<.-
Slgnature~~'L~~'~'. ~
Legal Descnptll'in: Lot ---1./ f IZ610ck .Sub OflKUM/D 1$€rI4fi.
Site Addreia: J'It-fYJ II-~ K.150,
BUlldingp.ermlt#_ qq-A5 _PID# Z5-115-007-O
NOTE: This permit wIU not be processed without complete information.
iJ b J ..1 A_D' JJ .', FIxTuRE UNITS
1'(f"'1"l ~ (;f -- ,fAQ'lt?r "'J 1M"'"
Type of FIxture
1. BJ",'
2. Gold
3. Yel\\)\Y
J4le
Cily
AI'PIiC&D\
# qq~5
.Phone: MIL. -=:y9//-- 'Jj,O () .
~V;(J
Quantity
Quantity
Type of Fixture
I
I
l
2-
L
~
I
I
Rough-ins .1~ B"",tk. fl. U). ~(J
Water Heater
Water. Softnern '"
r I r-;''''\G'
Stand Pipe (washing machine)
Sewage Ejector
Bacld10w Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other' '- ~ \
D. !J.1'~ I-b Sp ~...hJ...s t p'.e J:...
Bath Tub with or without 8h~wer
Dishwasher - 0 wt\ ..e.,.~ .
Floor Drain
Lavatory (bathroom sink).
-
Laundry Tray (1 or 2 compartment sink) . .
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
~
'i
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 mil1lmum)
Residential, New One & Two Far:nily
Residential. Additions &. Alterations
state Surcharge
$99.50
$39.50
'~
(.. ,~O ~,e.~\A\1
~\\,.O\t\G
$-
$ CjCj fj()
$
$ .50
FEE SCHEDULE
GRAND TOTAL
$
/ae
This petmit is granted upon the express condition that said
contractor, s\'illll comply ill all te$peets with the ordinances
of the St8te'Pi~bjng C c and the amenJim%;ereof.
.. . o. -" //4. DATE
. '
.A'ITEST
Call for all ~ pections Z4 hours in advance.
16200 Eagle CreekAv. S.B., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An EqUal Opportunity Employer
11-035
Th~ ('rnlrr of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
DA ~ ~ l:t;; ~J '-,J
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/.!:f.k'J2. (')t:lj<UIN.l::> &1lOf ifIJ~ ;qu~_
Accepted
v
Accepted With Corrections
Denied
Reviewed By: JJIft-TEIl t=I-IItI!S""J'lNN
Date: 2./ ~3 /'1'1
Comments: RVIVDF~
~"'S'r
BE
C'CUcJtI€VF.P
70 ,qAJO At--,.,}f:,
s,,~~
L..Ifi" L.., IU €s
t:lS ""-1Ic.t+ As TKAcnCAI
~ '/lJn,t'Uolftr"",.J OAJ R.~v~ ~/l:lc.
:r. T" Ie;
l?E',...M.M EN bE' b
7W~'" -r,.(~ CY./~TMl(. J L.t gt'l vIet:: "Rf.
..c"uwt.E:b
To A
II
J SE~\.\lc.1\
,\
S~E ~~u.l-M~: /. ;:;..114'- r:.1tt40/Aj~ J~'Ec.T1t'JtU IAJFYutMl4rlDN
1.. E't'tD< t"AJ ~.oTfl.JJL fI1.e.,.<.M es 1. CAAf::m,J'_ 4/IJo EitO$/&J C,AJ71t.Dl- RAN
"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."
If^
-.''',......
DATE RECEIVED
/o~e/~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
lo/ta/91
8OtC!/-f flV6. S.B.
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
~
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
/4~O2-
~/1Kt..../1ND
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~v/o tegM8ot...-O
7. TYPE OF WORK
New Construction 0
Fireplace 0 Septic 0 Deck 0
Alterations 0 Addition 0 Finish Attic 0
W,It / t;:i;l!!... H t;:." C/~
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
17. COMPLETION DATE
Yes No
I hereby certify that I have fumished 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
"bjlding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to~rm needed inspections.
~\ Signature License No. /'- Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
USE OF BUILDING
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
/'
Pressure Reducer .......................... $
70.00
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Meter Horn ................................... $
Water Meter ..........I.~~.................. L2.:5V.OO
Sewer & Water Permit ...................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $
Certificate of Occupancy
Water Tap ................................... $ _
. .. .-/IZS: 00........
-.J.....".....'OI..:>> ....................'.. ............................ $'... . ~
Other ......................................... $ <:'J./,.,;-. 0 O~
Total Due .............................. $~O. 06
Paid /5D.O 0 Receipt No. 3UJ ~6
Issued - ~-~
Date/~/~ By ,
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinan~e and 'ay proc s requested. This document when
signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
This Application Becomes Your Building Permit When Approved.
By Date
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850
N
~
~_ O'~f ."--
.l4~X ~\. C'-TV.OF fJRIOR LAKE
J-. 7 - .-.
~- ~ . :t62~:y~.~CreekAv.S.E. PermitNo,aCl-mX-S-
~'P~.i:;i.,'.;ef MN 55372
HEATlti(i APPLICATION I PERM1T
. Date g/;, 1/Q'j PIO, 33--((')- 00,-0
. Site Addr~ss . If?;/} ~ ()&L.t9~ Pfk;; lIvi 5l fl. lS 0
Lot 12. Block AddftiGn ()eiK.(a.tttd ~ck LDtr I./-,J lf2 .
Owne"sName O/irfltJ f:m /JtJU')
Address. JiJ3)~ f!th~j!7e OI2(~?;i
Healing Contractor '. RON 1 S MECHANICAL
Ad~~. 12010 OLD BRICK YARD ROAD
Telaphone.' 445-8585
. fI;?b~oJIY7t1D
furnace Make & Model L?J.;/J/J"I TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Condilloning ,r/ .:.I llw rJ 5!/1'-
Vent. System
w
(!l
<I
a..
f IJ ~'tJ IM-tl.f 1'8
..J
<I
U
H
Z
<I
I
U
W
:::E
(J1
Z
o
a::
SHAKO PEE
Mode! SiZQ
lot), tJO iJ
Conn. Load
Fuel N If'
Flue Size
Supply Openings
HEATlNG OR POWER PLANT
Steam
Hot Wzer
Radiation
Special Devices -
l_fNIJCX. mil f~u~m.Jr..;j/L
CKhero.v~.s -
. TJ(JhJJirP /iJ h'4<J/lJ"j.Jr
TYPE OF .WORK
Replacement ..... New Construction 'X.
Return Opeflings .
lnJ)ut fOlJ.oIJJ Output 4o./XJIJ.,-
(T)
In
~
In
In
""
""
N
,-i
LD
Edr.
Clm.
Alterations
I"-
In
In
,-i
Repair Es\. Comp. Date' ~ --.............
Est Cost S _.~.' . BUlldlng:~il' . ~M f ~ ")
HEATlNG PERMrrFEE'- ~.~" .. -~. -" '.-/
'...':;~. _.. ..r-' ~ .
STATE SURCHARGE $ .~ .:;}~.. ~ . S. UfL,JAfO WITH
?'_~~- . , DING PERMIT
~ .
(7)
(7)
(7)
,-i
"-
(T)
N
"-
(T)
~
TOTAL PERMIT FEES $
Receipt II
~ ~~ ---
~-I' ".
t~f.~R!e
1. G1cel> a ly
3. Yell"", CO!nraclcr
TYPE OF STRUCTURE
. Single family
)(
Two-Family
Indu strial
Public
Multi-Family
Other
Commercial
Fee Schedule
Industrial, Commeiciaf & Mulli-Family
Residential, Heating & AC
Residential, Heating Only
Res.idenlia~, ~as Fireplace
Res.identiaJ, Adcitions & Alteralions
Residentiat; AC Only
1% of job cas1 ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this applicalion.
The price of your heaUng permit includes one rough-in and one linal inspection.
Additional inspections w~1 be billed af $35.00 each.
House HaalingTes1 Record must be submitted with building rermit numbe-: before build-
ln9 certificate of occupancy wi. be issued.
HEAT CALCUlATIONS REOUIRFD wlIh number of supply and rebJrn openings 1is1ed 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
APPUCATIONS MAY 8E MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PAIOR 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 herebv_ apply for a mechanical systems permit and I acknowledge that the
information above Is complete ~fld accurate; that the work will be in conformance
with the orginances and codes of the city and with the state boHding/mechanical
. codes; 'that !his form does not become a permi1 until signed by the BUILDING
. OFFICIAL; l~l the work wilt be In accordance with the approved plan in the
. '08... Of Ill! "'~iCh reql.lir.es review and approval of plans.
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BlMing Offical's Signature
. Date
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Date
lohn Oliver & Associates, Inc.
Civil Engineering
Land Surveying
Land Planning
201 West Travelers Trail, Suite 200
Bumsvllle, MN 55337
(612) 894-3045 . Fax (612) 894-3049
March 25, 1999
Dave Rembold
10535 Parker Drive
Eden Prairie, MN 55347
Re: Elevations for proposed house at 14602 Oakland Avenue SE, Prior Lake
Dave,
As of this morning we had a crew at the address listed above, We shot the elevation of
the existing top of block as 918.94 feet and the walkout top of block as 911.25 feet. (Plan
shows 911.2 feet) These elevations are using a benchmark ofa spike in the south face of
a power pole at the northwest quadrant Seven Acres St. SE and Oakland Beach Ave. SE,
elevation of 913.45 feet. Atthe time the slab is poured please call and we will set up a
time to collect the elevation.
~Sr:tfu7JJO~
~ ~ Bertelsen, PE
t~ohn Ohver & Associates, Inc.
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The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
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APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
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Accepted With Corrections
::::::ed By: 0 {)1 JC/lW1 Date:
Comments: * k d..D 1fcud b Jev'oJ)6/1
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"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."
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