HomeMy WebLinkAboutBuilding Permit 99-0116
~'.'j ...~., .~'
,*,~.. _1!-.1.,~~~':~\,~~th; F-?',"". .;<:?
i,.,; :~V~}:<~"~j ...,'It, ~,)' ~ iJ'o. i"
, .:~r~
.-:, i~~'1'-i;~~ ~yr
Qrerfificau of ~ccupanty
CITY OF PRIOR,~~F.
J)tpartmtnt of ~uilbing 3Jn~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 Lake regulating building construction or use. For the following:
Use Classificatiol1
Single Famil v
Bldg. Permit No. 99-0116
Occupancy Type
R3 Type Construction
VN
Fire Zone
N/A
Zoning District
R2
Legal Description, UL R ? r~ l\rnTJ<l to '" ,. 1 c:: to A if (H to inn
Owner of Building
~i'-Address ~404 SDrim~ Glen Circle NW
Contractor's Name & Address , Wensmann Homes 1895 Plaza Dr. 11200 Eagan, MN
Robert D. Hutchins """.... r' PI Jenni Tovar
" IV\ Ity anner '
Building Official .
/1-'; tJ .19 Date:
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
.3 yO if
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ..A
tzr FINAL /1
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
f1-JJ3f1
5~ 6~ Ct.
()
CONTR.
PERMIT NO.
"... ()\\~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~
~ C.O.
~~
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INIiNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS 3010 4\ S r""J G- CA\
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
1=I)NSULA TION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
X PLUMBING FINAL
}lLMECH FINAL
COMMENTS: ~
~~p ~0V~::~
.-----
(~
?\"o
\,.,) c...M...
P t-t,.l
~
rLnA\)
CI "'-.;:
f~<:.
o
~::;q, W~
'1'1- Hlt,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GJ,SLINE Alu-r~
)1 .J:f"'7 j") ~~
~
Cci-fu l'f-/~
\-\~
(\) >J \ (\ ~~ t\.... {3,,~
('3) -:t;..Ci~ (j.1J. ~Lrti-') +-~. U~,
~S~ U~
U
o WORK SATISFACTO
;Zco ECT ACTIO AND R ,
ORRECT WORK, N BEFORE COVERING V
'/\.
Inspector: I
CALL 447-9850 F~R THE NE INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREME~ FOR YOUR PERSONAL HEALTH & SAFETY!
INIiNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED k,/cJS- d ~ 00
~Vh~ 6/ey7
CONTR.
ADDRESS
, ~'J()4
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
(f)MH~
5*~
/
/
,......
~ORK SJrISFA T
o CORREC~CTI
o CORRECT W
PERMIT NO.
91-//&
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
A ,~EPTIC INSTALL
PLUMBING FINAL
~ ] ITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
V~(/~t~/
U
~~~
..~
~
R REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL 4471230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE~UIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
T
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
jo/r-y'"
OWNER
ADDRESS 3Yot.! $PR.INr.. CLeJJ CIIl.C.LE:
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)l(. FINAL
o SITE INSPECTION
COMMENTS:
~~~ t)'(
~
~U~Y\.
IS
PERMIT NO.
CONTR. tAiEtJS,tlA.AAf,.} J,../~s
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
91- Ij(D
)( EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
1/ z., I 't~ / ,.)S(lU:T1cvJ
,
Op~An~^,A<...
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~~
,"" VRer.lContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INIiNOTI
/
.l2ATFRF~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White File
2. Pink City
3. Yellow Applicant
I ~t~,,~ ezu
Permit No. qq - 0 I /~-
ffB 2 3 1999
, IlIRECTlONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
rJ</lJ~
1. DATE
,)-2;1.- '} 9
\(:f-.
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
r; J",.Iv
S /Jr~..N ~
3. LEGAL DESCRIPTION f7
LOT r BLOCK
ADDITION t: I v N I..J a rf r
,
(' /rf J~
/)/LJ
12. NO. OF STORIES
PID ;J,f- .1..$1- (J 0,;' - 0
&l #d/ 1',' D)V
,).
jJr
13. TYPE OF CONSTRUCTION
4. OWNER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6, BUILDER (Name)
/AJ~/VfJn I:;/\;-v
J.1 0 '" I'.r
7. TYPE OF WORK
New Construction V
(Address) J'r
II ') f I' /A 2 ,.. 1./
SLti tf ~{)i.l (d.'4N
Fireplace 0 Septic 0 Deck rdI
Alterations 0 Addition 0 Finish Attic 0
(Tel. No.)
tS/- ,/Olr /y'~/)O
.7'j-7(,1:4
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
K /) OocJ ():.J
17. COMPLETION DATE
Re.roofing 0 Porch 0
Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft
9. PROPERTY DIMENSIONS
Width Depth
1 o. CULVERT SIZE
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
:uilding ~an revoke this;7or jUr~erebY agree that the city OffiCi y ~~e may enter upon the property to pe:?~ :;~~ i"?;ons.
- - 7 Signa~ License No, Date
"
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
~r::A-
SURVEY
PLOT PLAN
COPIES
o
q~n.(!)D
o
TYPE OF CONSTRUCTION: I II III IV<.1.>
Occupancy Group A B E F HIM Q S U
Division 1 2~ 4 tJ
Permit Fee ................................... $ ~ 3 . 2'5
Amount Brought Forward .................. $
Park Support Fee ........................... $ ~ 5'6 . ~
SAC ......................................... $-1,.f),t:::::r) . ~
Collective Street Fee .... ... .. .. . .. . .. .. . . .. $
City:
,C)4C{. ':)..')..
q~^
Plan Check Fee ............................. $
Sewer Tap ................................... $
q $
Pressure Reducer .~..................... $
Meter Hom ....~.t.tl......................... $
Water Meter ...0........................... $ I ?5. c:i':)
Sewer & Water Connection Fee ........... $ J '";2... C) GJ . ('CV"'\
Water Tower Fee ........................... $ . 7 00 ~
Water Tap ................................... $
Builder's Deposit ............................ $ /. 5-rx:> _ ex:::>
,
Other......................................... $
~ rrJ (,rl
Total Due .............................. $...1...1 'v"l~
Paid / / 1:) - Cj) Receipt No. 3L/7f:>f
Date ~-/D-L(9 By (jKu.J
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 at requested. This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
}
, ~~\
~~
State Surcharge............................. $
4~.c>lS
Penalty ....................................... $
l OQ .O~
I tJ (J rV'\
S$ .so
Gas Fire ce perm~n.. .................... $ lI{) .00
This .. eco Building Permit When ~p~Jtd.
By Date 2. 2(, - '1'7
Certificate of Occu~ncy
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447.9850
/(CI -{"llh
Tht Crnlrr of 'hr Lakr Country
~ tJl/... 7h.\"
""\'0 1>~ I'"
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT I;\}( tl C_ {l'IO (( II
APPLICATION RECEIVED ~ - ).~j -1 ("{
f.-Ic11lt ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
?) lj('q :~~) (ll \.j (c (t 11 (C\CU....- t\ C,_)
Accepted
v
Accepted With Corrections
Denied
Reviewed By: JJJ/lL-n=A E"J.{ftBf'4.aN,.J
Date: '3/ z h~
Comments: ~Toj(M w,,"",e.(.
KUNO~
JI'1usr /,3.:: (!..";uE.,.IF-.6 "TO AN./')
~~{... ~ bE
L4r l-IAJ~'" As
tI1cJCH A.s ?/tAC. Tf~A L _
3€E:. 1^,FDtt.~ ON KetlEA.SF ~"\~
--
SEt:: A~: I. h-udL (.1f(r4L\INt. hHPErneIU JAJ~~,.j Z_ ~~4~/~ RSN
~. Eita.s/Ol\J C ONrftOl- ~tl.E.s
tJ. EnOtfOtU (1~L i?1fJA.J~
"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,"
~/vv\
r-I
o
,
Cl.
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Pelmit No.
Prior Lake, MN 55372
qq-//(;J
HEATING APPLICATION I PERMIT
Date &-:..\i-C1C,\ PID#2.5 -3'5/- oOB-Q
SileMdl9SS 5lk)'4- ~Jr,n~ bJQ.NN Ue Cl c
. ~.
lot B Olock 2- Addition GtCJNWI\"TEC2- \Nb~ \
O"""'SN~m.IJ~~~~f''- ~UL~
Address ,
HealingConlractor ALLIED FIRESIDE dba FIRESIDE CORNER
Address 27QO N. FAIRVIEW. ROSEVILLE, MN 55113
Telephone #, 651- 6 33 - 2561
FIREPLACE IL, .
1Ml1e~ Make & Model .U CL:t- N lcl.o TYPE OF SYSTEM
. C I ---K.r.......,- -, 'G Warm Air Plants
Model SIZe" ~ I_.J.--! ( Gravily
Mechanical
Air Conditioning
Vent. System
'lit
IX)
IX)
IX)
('I')
('I')
\0
r-I
Ll)
\0
Conn. Load
Fuel ,~ .l0u....~lue Size
HEATING PERMIT FEE ~
STATE SURCHARGE $
TOTAL PERMIT FEES $
~
OJ
c:
~
o
u
OJ
'tl
Supply Openings
Return Openings
'I""
Input,
(/\
OJ
~
'1""
LL
Cl.
\0
r-I
Edr. ,
Clm.,
N
r-I
Altel alions
C\
C\
I
"
r-I
I
Cl
::J
ct:
Repair,
Est. Cost $
Output ~~ ~ I DO l)
-- .I
HEATING OR POWER PLANT
Sleam
Hot Water
Radiation
Spedal Devices
Other Devices
TYPE OF WORK
Replacement New Construction '.J....\L.
Est. Compo Date . S; -_.)~.- C1 C1
I \C'{"J ' Qj Building Pelm~" ~ q9- / / (p
" PAID WITH
.50 BUILDING PERMIT
Receipt" .
R..z..
TYPE OF STRUCTURE
I. !'ink
2, (j'ttn
1 Yrll...
File
- 01,
COnlrK'or
Single Family
Two-Family
Industrial,
Multi.Family
Other
Public
Commercial
Fee Schedule
Induslrial, 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 Ihe bollonl ollhis application.
The price of your heating permit includes one rough-in Bnd one fklal inspection.
Addilional inspections will be billed at $J5.00 each.
House Healing Test Record mllst be submitted with buildina IIp..,nj, number belorB build.
ing certificate 01 occupancy will be issued.
HEAT CALCULATIONS REOUIREQ with number 01 supply Bnd relurn openings lisled pe
room with CFM's per opening. New slructures or additions send IIoor plan with supply
and return locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 B.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply for a mechanical systems permil and I acknowledge thallhe
information above is complete and accurate: that the work will be in conlormance
wilh the ordinances and codes 01 the city and with the state buildinglmechanical
codes: that this rorm does not become a permit un Iii signed by the BUilDING
OFFICIAL; thai the work will be in accordance with the approved plan in the
cast' ik0~~~' :Di;..~~pproyo' 0' p,a8 _I =t _ ~ q
p'j~ Sig i.' B/ID~t/q~'
Building OHicars Signature Date
:'\,
. {ict ~<"II b
n. ("~.,.. of lk Lalt. C".'I'J
White - Building
Canary - Enganeerlng
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT I;\}(, ['{ S ('l10 (.t ( I
APPLICATION RECEIVED:.), - }-,3 . q I'f
. I
f-k:~1ltl' S
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is. proposed at:
':)tlctI St) t~tt'.J ~(-etl LL\CJ..L f'Jt.0
"
Accepted
t/
Accepted. With Corrections'
Denied
Reviewed By: . JJIIL-rF'.A f:1-{It~""tL..J...J
Date: 3/Z./9fi
Comments: ~oltM ~
Il.JNoFF ....U$~ U C,.J\JE.,IF-.b 71t A~.()
~.. ~
L4r l-IA.J~~ ~
McJC.H ~.s 'OtAC.TI~~ -
....sa IN~ t!JN REtJ~E ~
'-
~f:l: tl''fTtlIU#....~: I. h'..,dL ~MI.IAJI. IA.V?r:1 .;_,\.1 W~f1,.J ~ ~,...J6 ~N
~. fit.a:.""'^' C ONnt.Oc.- ~ ~AS"IC..E.s
4. 6tszs N!MJ (J.,...rnlDL' 1?14"-'S
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. II
T
. .~!..
. . " .
. . . . . .
" BUILDING PERMIT APPLICATION DEPARTMENT Lt1J!,CKLIST (CON'Tl'
, .
"
. ,ENGINEERING COMMENTS
. . . '.' .. . . .
. Surface sto~water dr3inageflowing to the perimeter of this lot to and from adjoining properties . .',
niustbe conveyed to the' road~y andlorto the rear of the lotm drainage swales withiii the
draiIias!e eaSements. All bare soil . areas . mUst be' protected from eroding into neighboring.
properties thr~u:ghtlie IDstaIlation'ofpronerlv installed silt fence or bales. ,The silt fence required:.
. by theerosioncon1r91 plailmUst be installed prior.to any .e3rthwork being started. .'1ne rock .
construction entrance mustbe installed at the time ofbacldilliDg of the foundation.' .
.. ~ ~ ... <
. .
....
. . .,"
:..
.....
.:
BOSION.DOC
FEB.23.1999 8:12AM
GENZ-RYAN
NO.???
P.1/4
..... - ...a
ftlLOll . ."'-CA1n'
..... . CIT'
CITY OF PRIOR LAKE
SEWER AND WATER .t"ll.I:\MIT
NO. ~q.CJ 1 ( Cp
NOTE: Se~er and Water
contractors must
be registered
with the city.
APPLICANT: ~- ~~
-.- '"
ADDRESS: ILJ74'6 S .12cb.ud:. ~~ DATE:
SIGNAT~ ~~...........~ ~ . -' BLDG.
SITE ADDRESS: 3YDY .JJp\I\,"';'~ ~.~ (\}~ID#
FILL IN THE BLANXS
PHONE: 4:J3 -II L/ t./
:;>./~/qCj
PERMIT i
~ ~ .. ell ~
1- Est.imated lenqth of water service L\O feet.
2. Size of water service inch(es) .
3 . Location of any couplings from s~ructure feet.
4 . Type of sewer pipe. ABS PVC >< Cast Iron
5. Estimated length of sewer line YO feet.
6. Clean out (if required) I located at feet from
structure.
This
==---=____~~.:sz::r:z:::lc:;'tc=z:::;.:z::z:
-.
it when approv~.~, ~;1
DATE: 7-/2-':) /7:F
. " . (
BY
==========~~:~=~=========
======~---==~==-~~~======~=========
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 ~ust 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
RECEIPT #
AMOUNT PAID ;~
REC'D BY fL.() /IJ .
PAID WITH
BUILDING PERMIT
. 4629 Dakota. St. S.E., Prier Lake, Minnesota 55372 I Ph. (612) 4474230 Fax (612) 447-4245
Nl EQUAL OPPORTUlIIITY EMPl!)YER
MAR. 3.1999 2:24PM
GENZ-RYAN
NO. 075
P.1/10
Tha Cfdltr or III Lab Cnnl"
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: (d,...IJ...nJ::I - R~S"'
Address; -1.!d.J~ $. ~ ~
signature:~~~ .
Legal Description: Lot 8 Block 2.. SU~WM~ U..)eJ1J\:-
Site Address: 340'-1 ~ e..~ ~. ~
Building Permit' W-( /t,:::.J . PIC # (;;'::)- 35/- oOf:-Q
NOTE: ThIs permit ,-",:iIl not be processed without complete information.
FIXTURE UNITS
I. Blue File
1. Gold Cily
). YaDow Applit;:lllt
# 1q-!(~
Phone; Y::l ~ - \ I 4 l..f
Quantity Type of Fixture Quantity Type of Fixture
\ 6ath Tub with or without shower ?> Rcugh.ins
Dishwasher I Water Heater
, Floor Drain R.\ Water Softner
;;L Lavatory (bathroom sink) I I Stand Pipe (washing machine)
I Laundry Tray (1 or 2 companment sink) Sewage Ejector
I Shower Stall Ba.cJdIow Assembly (RPZ, DOUble Check, PV8)
1 Sinks Bac:kf1ow Assembly Test
Bar Sink Lawn Sprinkler
Q.. Water Closet (toilet) Other
FEE SCHEDUL.E .
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Resident/ai, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39,50
$
$ qq.'50
$
$
.50
GRAND TOTAL
$ JOe ,00
PAID WITH
BUILDING PERMIT'
Tnis pennlt Is granted upon the etpress condition that said
contractor. shall comply In all respects with the ordin:lnces
of the State Plumbing Code !lnd the amcndp1epKrcof.
~u:.lt'r. O. 3/'-f/<.{r DATE
ATrEST
MIT
advance.
16200 Eagle CreekAv. S.E., Prior Lake, Minnesota 553721 Ph. (612) 447-4230 /F~ (612) 447-42~5
An Equal Op~ortunity Employer
CITY OF PRIOR LAKE .
162.00 E.gle Creek Av. S.E. Permit No. W -//0
Prior lake. UN 55372
HEATING APPLICATION I PERMIT
Date ~/qq PJD. d5~35l-608-()
SbeAddress ~'-\D~ s.~C\ ~\.l..r\ ('~ \\.)w
. ~.
Lot. ~.BIock:;,l, ,Additim~ ~
OWner'sName ~
Address 1 ~ t4 6 rp \ Q.))..,Q... ~.
Hellllng Contractor ~ -R'-J (iJ\
-...J .
Address l4 7~ ~ S. '"R~ ~Q..r -\-- -r r ,
Telephoneff L+~3- \ '4Y
Furnace Make & Model ~ 'i-
Model Size l;'J.~ ~ ~/3 -1 s:.-
Com. Load
4"
Fuel
Supplv Openings
Flue SlzJVA--t. ~~
1 \
4-
Relum Openings
Input ~~ OUlpull.oq,QOO
Edr.
ctm.
Alterations
TYPE OF WORK
Replacement
Est. Comp. Date
Repair
Est. Cost $
HEATING PERMIT FEE $
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
KEAllNGi OR POWER PLANT
S1elm
Hal Water
Radiation
Special Devices
~
OU18' Devices
New Conslructlon v'
q~-(ltO
Building Permit.
qq . 5"0
.50
J 00 _ 00 Rece1pt'
STATE SURCHARGE $
TOTAL PERMIT FEES S
~ PAID WITH
BUILDING PERMIT
TYPE OF STRUCTURE
1.Au
2. (j",
3. Yell..
File
CUy
ConIrM:Ulr
smgla Family
Commercial
-v'
3
D
;;0
Two-Famll>>
Mum-Family
Other
I-"
\D
\D
\D
w
Industrial
Public
Fee Schedule
rnduslrlal. Commercial & Mulli-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Rrsplaca
Residential. Adrlltions & AlleraUons
Residential. AC Onlv
1% of JOb cost ($39.50 minlmum)
$99.50
$64.50
$39.50
$39.50
$39.50
I\l
I\l
0'1
-0
3
Remember ID add the Slals Surcharge 00 the bottom or this applicatIon.
Ul
(T1
Z
N
I
;;0
-<
D
Z
The.price or your healing pennitlncludes one rough-ill and one Onallnspecllon.
AddilionallnspecUcms will be billed al $35.00 each.
House Healing Test Record musl be sammllted wlth bulldll'Q IWIDil Jl!IIDbm before build.
ing certlrlcate of occupancy wII be issuetl.
l:IfAt CALCULATIONS REQUIRED wIth number of supplV and re1urn openings IIsled per
room with CFM's per opening. New 5fluctures 01 additions send loor plan wllh 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 Han business hours Bfe 8 a.m.. 4:3D p.m.
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) - CALL C1TY HALL
447~230
I hereby apprvJor B mechanlcalsystsma permit and I acknowledge that Ihe
information above is comptete and accurate; thai the work wlll be In conformance
with the ordinances and codes ot lhe citv and with the st.I. buildlngfmechBnleal
codes; that Ihill fonn does not become a permll until signed by the BUILDING
OFfiCIAL; tha~ Ihe work wIll be In accordance with the approved plan in the
case 0' all work which reQUJres review and approval of plans.
z
o
IS)
-..J
lJl
3&qq
i 1/-99
Date
-0
lJl
"
I-"
IS)
'.-I
Applfcanfs Signature
(]1&A /
Building ~I's Signature
~~,'-~\-~~~~~
~
n--.......
~.....'
.~~.'!'!'.i.~.
/ n ./.:. l! t./>
, . . ,
.
The Center of the Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
aUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT :
APPLICATION RECEIVED
(rl {
if "/
\ ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, '\
"
j
.' ./
} { t ~ J ''-...~
<'\
Accepted
t/
Accepted With Corrections
Denied
~~Ur~
comme~~ ~
~4~'
Reviewed By:
Date:
~ ~ L~L:n
Vlj~.~ \1Y;1~
~ -~7 q::[ 4
--
"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."
qq -c'llh
The ('tnltr of Ihe Lak, Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHI;CKLlST
NAME OF APPLICANT ! \. tC tit S Vv1Ll ill {/l
APPLICATION RECEIVED d - d.3 - C( q
I-L~w s
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3l{oLJ SflL(VLj (C{-ei/l C~'LcJL NL0
Accepted ^
Accepted With Corrections
Denied /1
Reviewed By: !)i-.f! ~
Comments:
Date: ::L - 2 c.. ~9 9
I. ~~~w"'- ~~ ~l;u~
'2. SCY~ ~)VLu.!J ~t--' ~_I~~~ ~
"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,"
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ Cf-l r~~MV\Ct Q\~V\ (\ r.
NATURE OF WORK f!-Ph' - (\c:D-t~+tl.l.Ch'(rv1
USE OF BUILDING SFA-
PERMIT NO. j3 - n 11LP DATE ISSUED
CONTRACTOR .~FA \~~\'\AD.-v.V\.~-P
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPf10FY
~ -d.~-9{
DATE
FOOTING
1"~ {,..-
FOUNDATION (Prior to Backfill) I ~ ~ 7 - 99' 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
(ty ~ 1d.Lf-I'1 q
l~l
~o')tS~cp1
~~/a3Iq1
i gid3Jq(j
, "
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/.Ii:
7tJ /Z.""/fl'
~ J1-ad-~<f~
{Jf)(,h's).,,,, "" '\i ,1., "
(/. IN J_ -.!~, ,
OCCUpy UNTIL ABOVE. t AS BEEN SIl.;N%O
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 (612) 447-9850