HomeMy WebLinkAboutBuilding Permit 99-0121
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QLtrtifirau of 03rrupanry
CITY OF PRIOR LAKE
i9~partmSJlt, of ~iuil~inll/3Jn~ptction
A 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:
SINGLE FAMILY 99-121
Use Classification ~ldg. Permit No
Occupancy Type R - 3 Type Construction VN Fire Zone N / A Zoning District R 1
a1 .. L 11, B 2, MAPLE HILLS 2ND ADDITION
Leg Descnptton
14082 BLUEBIRD
Owner of Building<;ite Address
Contractor's Name & Addr,... SUNSET llOMES, MAPLE GROVE, MINNESOTA
ROBERT D. HUTCHINS~, City Planner JENNI TOVAR
Date;
Date:
.;'....:.,..~:....;.~ 'i;;"',-,-.i. ;L~,;:}:..:;-ti; "~'~ 'c >: :,~. >.-~":.. "....
CITY OF PRroR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
ADDRESS Na8''Z.. i3~utE'l3,t2./) 1itAiL
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
p( FINAL
o SITE INSPECTION
COMMENTS:
A~!'ACE..h"" lA. iO
DATE TIME
U/7/00
PERMIT NO.
CONTR'<\""..J.sn- Ho~s
7'9-17-1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
IS
K EA1. a. f:"6
~ EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
}lI( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: W~ ;rJv...~
rlwner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
YOf;~
SCHEDULED tI. /~O
/5LI}6~RO
/-I.T
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq - / 2-1
o FOOTING
o FOUNDATION
o FRAMING @J
o INSULATION
FINAL
~ SITE INSPECTI
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
,
soD " 1~6B
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~Lo
~~ 15:v_!C'
d- - 2 ~~II Q-L
~
/:t;:V
..,.......
....
JrwORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT", CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr:
'-' J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
JL/of2-
SCHEDULED 1;1~~q~
[lw581;:20
3f~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
91-/2--/
o FOOTING
o FRAMING
o INSULATION
'Ji( FINAL
I'D FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
~MECHANICAL FIIV/fL-
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
f( .1:M/N ~I'tS t..I~~
OOMMENl:S:
(~ Y\ V\{JJ P:;' ~V\ e..R.Jyr IY\- a... ~
(JJ Rnd ~ -tv ~ b~ ~rJ 2 ~~
~ Y7 gAt~ ~ ~ ICb)A. a.i.L rl~ \\
,tJ ~ - -eKOSIl'"Nl Cc:mifr~ -+-~
~
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1.1r:~
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~ L-vrc-
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II~
o WORK SATISFACTO~Y, PRoclID
o CORRECT ACTION ~ED
rRECTWORK. AL. R aNSPECnON"FORE covemNG
(Inspector: I Owner/Contr:
CALL 447-4230~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Cu~
r
Tt::>
q- (-7~7
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
..._......OT
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV.
DATE TIME
~ 3',0-0
/'-1-082- Bt-UbB/K!D 7iZ-
SCHEDULED
CONTR.
PERMIT NO.
AD PLUMBING RI
o MECHANICAL
~ATER HOOKUP
e~:WER HOOKUP
A 0 SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
C3Mg7NTS: U u ~ PVC-
lU~1\; _ ~L L-o'pY'{-- l
\ <9 '5 ......-I'K +
U (
S~ ~+)~.
l2-tu1T-€ 4, \A.~ ~ b~
25~
Inspector:
CALL 447
v:..., 'k.-
.
o v<.-----
qq-/2-1
o EXC/GRAD/FILLING
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
<::1.)
Gv~~
Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUl 'M 'NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
,uTn-
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
~bj99 ..2 : 00
/ij082. gLUE-I3/,.e.D //~.
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq - /2 /
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
11.. 0 SEPTIC INSTALL
r PLUMBING FINAL
~ SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS: r")
(t) I <11fT \_ J-rUr- W~t-
\.0o.:tz: ~ ____ ~
~W
r U
-
f'~
VLw[)
EINSPECTION BEFORE COVERING
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
T
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
.. 2., 1999 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 fl j 6
L!ill ~:J.L2Jj.1 ~ j y- rJJ:-a\
3. LEGAL DESCRIPTION /)
LOT /1 " ~LOCK .~
ADDITION ~Y"'\Q..,p \\0, 'l-\ t \\ .e...- ...~ ncl
4. OWNER ~mr)\ (') (A dress)
SUN\c.,p.~ ~y\~.",,""'"
5. ARCHITECT ~e)
t='~h-() L-.~\.t2 \ 1",
6. BUILDER (Name)
1. DATE
.~-d.~-Cf1
1'<-1
PIDcJS -343 . 0;).0 -()
4-0-u .
'"' (Tel. No.) ,.1
" .~ )~.,q l-()'U'i
""" '" ,
%1t)(T':, Lt~ br"f
(Tel. No.)
~\,li q\, ~ ~ O<1i Svf'
(Address)
~~~ U;e;"v)oC-
7. TYPE OF WORK - H~lace 0
New constructi~ Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
(Address)
~~, S,,-~I~,.J v
Septic 0
Addition 0
Deck 0
Finish Attic 0
9. PROPERTY DIMENSIONS
Width Depth
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
10. CULVERT SIZE
Yes
No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. C(q -0 I'd- /
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12.<~~tJ\Orl\
13. TYPE OF CONS,RUCTION
\ U(.,r) rl
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
I hereby certify that I have fumished inform. 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 men. rty and that con truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 . al can revo~n. e . f . st se. Furthermore, I hereby agree that the cify OffiCii '7 (;gnee may enter upon the property to perform neJdll(j i"p.ectiOns.
X ~~ . ...;.---- ~? 2yz-3f97
~ignatu'e C/ - . License No. Date '
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
F,ont
Back
BUILDING DEPARTMENT VALUATION
Side
Side
USE OF BUILDING -f< ec;. illFL
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMITVALUATIOt-$ I ,~.r.>?"'l
Amount Brought Forward .................. $
Park Support Fee ........................... $ ,9,c.., -() . t') ?)
SAC ......................................... r r':) <:;;() . t) C2
Collective Street Fee .. .. . .. .. .... . .. . ...... $
Sewer Tap ................................... $
r;l 1I $
Pressure Reducer ..fB..................... $
Meter Horn ........T........................ $
Water Meter ..:18..'........................ $ I 2.5 . () CJ
Sewer & Water Connection Fee ........... $ I i'2 n (j . n.L.::L
Water Tower Fee ........................... $ 11 M . rJl"l
Water Tap ................................... $
Builder's Deposit ............................ $1r-sf'10 .OCL
Other ......................................... $ /'1.-01
,6Lf{. 7 I
Total Due .............................. $
Paid ~ 4/ ~ q, Receipt No. .3 tJ7 i 3
Date 3 ~ -qq By ':\ k1 A )
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 requMted. This document when
signed ~~ity Plar. ,~e const~utes a temporary Certifi~e of Zoni'Jlj9'il!"pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~-'A.A... ~ r")_l,_Vf"1,
"'-J Cit>, a e, Dale Special Conditions ff any
24 hour notice for all inspections 447-4230
TYPE OF CONStRUCTION: I II III IV LJ?
OccupancyGroup A B E F HIM ~ S U
Division 1 2 (f) 9 5'? 2
Permit Fee ................................... $ . c;-
/D 22.~"2.-
S~. (')n
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ~.P.:.rt.:.o.n.l... $
Mechanical Permit FeeNP.:.1.'1.:~J.~.L. $
Sewer & Water permit~:~..:P.I.7..L.. $
leo, (') ()
IDO.DO
~t:; .s-O
Thi
By
uilding Permit When Approxed.
Date '2. Z (i, -11
Issued
0\
City:
\\ l 0\6\
~r/ i \y
'b or
~lm..~
~.1)
S
'T
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
t..Js.QO
~
,.
Job Address /1/012- 1?u.tEBt,ep
Heating Contractor ?LYMou rJl J./EArIN4
Name of Tester 1J1W. S':arrl:.o
Date h-Z'1'- '1'9
Percent 0 L/ - I D ~o
Percent C02 1 - f 0-;0
Percent co 0 70
Stack Temp. 31 S~- 325"
/
lfli-O /:J. /
TIM ("fill.. or III. Lak. e...lry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
I /
NAME OF APPLICANT t...-::' I. /. I ~(t. II t" I'} c{ ...L/
APPLICATION RECEIVED2!J (-I/ti tj
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/LI(Jf~ . 6{u.lf.L'..~1C;( d1~
Accepted
Denied
Reviewed By: JJALt:&.1l. EHnF....NI41\/^'
./
Accepted With Corrections
Date: -4:J,!99
Comments: Kw.w,Ft:" ~r Be.
CO,.,)&.IE-yEl'.. ~ "'AJO ,,'-,.)(_ J)aAJAJat:.~
A..,() '-"TIL-ITV EASI="Mf'JIIT' ~ MuGU ~ FhAGT1t:I1L _
~~ INf'IJAMATlQ...J oiJ Re:lJEUE. SIlL.
:SE~ h,....bIM~: r MiUA~ (lAADlIIJe. ~OIU I~tttnw ~40",s' R'tI'J
3. EaQi11D~ ~,u"I'"/lDL. r'1EASc.l~ '1-. EI{.<C~~1lD1... 'R.",J
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."
. . .
. BlTILDING PERMIT APPLICATION DEPARTMENT .LI::lECKLIST (CON'TI .
,
. ..
.. ENGINEERING COMMENTS
- .. . -., . .
Surface. stoimwater <Irainageflowing. to the perimeter of this lot to and from adjoining properties . .
must be conveyed to the'roadway and/or to the fear of the 10tm. drainage swaleS withiri the
drairiaS!e eaSements. All bare soil. areas . mUst be. protected hUU' eroding into neighboring.
properties ~ou:gh the installation .of pronerlv installed silt fence or baleS. . The silt fence required
. by the erosion .contr91 plai1 nllist be installed prior.to anye&thwork being ~kled . The rock .
. construction entrance must be installed at the time ofbackfilIIDgofthe foundation... .
. ;.
....:
. .'~
. ,
. .' ...-- .'.. .'
":- .
'.' . .
BOSION.DOC
Sent By: PLYMOUTH PLUMBING AND HEATING; 612 5331121;
May-17-99 2:08PM;
Page 3/4
-.. . .....
"IlLLO- . APPLIC".T
GOt.D - I:ITf
CITY OF PRIOR LAKE
r SEWER AND WATER' PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
NO. q" - I Z. I
MAY I 8 1999
APPLICANT: -Q:lL.{ viti) u" ~ ~ (UtM..~,tt
ADDRESS :(~ ctb~ 'a.D 1I.t,A.l .
SIGNATURE:~- 00
SITE AODRESS:~
FIT....L IN
PHONE :~-4~Sl
A T:S: : n.::L.7 - q<f
BLDG. PERMIT #.3J-I2-1
~PID* 25-3tf3-dZ-()-O
THE BLANKS
1. Estimated len9th of water service ~()
feet ."
2. size of water service
inch(es) .
3.
Location of any couplin9s from structure feet.
4'(
'Type of sewer pipe. ABS pvc Cast Iron
4.
5. Estimated length of sewer line f1()
feet.
6. clean out (if required). located at
structure.
AJA feet
from
==~~~==~~~==~~~~~~;_=_==~==~=;~====~~_a==_~~=~~C~~~~=~~~~#===~~==-
This apPlicatio~b;C~S~it when approved.
BY ~ ~ DATE: S//B/tf'1
- '
_~=_~~~s~~~=~~==~~~===~==~-=*==s_-~~=~=~~~-_&~-===~-~=-~~=====-=;~
FE:S:S:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
'l'OTAL
* Fee for either sewer or water individually is $20.00 plus
S .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the buildin~ permit card at the ~ime of issuance
to insure that no dupllcate sewer and water permits are
issued. -
DATE PAID
RECEIPT #
AMOUNT PAID .~ ~
O..\~~~~
REC'O BY~~T
( ~~\\,Q"\
16200 Eagle Creek Av. S.E., Prior Lake. Minnesota 553721 Ph. (612) 447-4230 I FAX (612) 447-4245
An Eql.Ja) Opportunity Employer
..... ':-;--;-r--;,"":'""'l.' '-.~--
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ew" ~'-n ~~",." ~:~"~'t'7:~~~~~:,"'" -:::~t_\",,~~~Ji';*:~~;:~' ;,~iJ.::_;~;:"",:; '>'~ '., <:~~'~'~W:i;-\)i'~$r~~iY.'W~~
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White - Building
Canary - Engineering
Pink - Planning
Th~ ('~nl~r of Ih~ L.k~ Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT.
APPLICATION RECEIVED
I'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
...
.r .,.
,
,
"
Accepted
~
Accepted With Corrections
Denied
~~. .~. f, /O/C~ Date:
~V fj: v
Comments:
A,rpyvvd) M ~ hUM 7IreeiJ.
Reviewed By:
3-{-Qc;
"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 -0 I J- /
Thr Crnltr of the Lakr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~/ LI/I.5.LL 1/(5''11t1-. J/
~/)'-I /ct'J
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
!'yO f~ I5Lw ~1 C( d1.aJ
Accepted
Accepted With Corrections ~
Denied ./J. J
Reviewed By(Ij)fZ-/",
Date:
'2 - 2L( -?fer.
Comments:
I, SccO r }). -{t-u..S pv. ~~ ~ _
L' if"\~'VI.. k,'",- I)-ClSCc/\-"- ~
5. e~ ~ ~{f~ h~~cnis
"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 Me
16200 Eagle Creek Av. S.c. Permit No. qq - 12.. I
Prior Lake, IIN 55372
HEATlNG APPLICATION I PERMJT
Da18 4-a.~.-qq PIO' ~-:3A-3-02.0-0
,
Site AdrtftS ~ J..l 0 ~~. ~I un '^; r-r\ ~ r-"O.I~ \
lD1 . I ( Block Z Addition. MAPLE Hlu.,... z.~ AODN.
Ownen Name ~Il,^ ~+ +\.n1l\A1}.c-'
III
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Address
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C')
III
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ro
Conn. load
Fuel Ah8.. ~~ 'flue Siz..
Supply Openings
Retum Openings
Cl
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Input .
Edf.
Cfm.
Alerllllons
Repair
Eat. Co6I S
Output
TVP~ O.F WQf'K
TYPE OF STRUCTURE
J. Pl1III - fill
1. Onm - Oty
3. Yellow . C'Htr8ctDr
Single Family
Commercia'
~
Two.Famlly
InduslriaJ
Public
MtJIlj.Famll~ .
Other
Heating Contractor . 0 i (.1 t\U) U ~ 11 A~~ \i\Li..
Address ''lq~ \AJ;r\~~fLd Anf .ll. ~~Ullatrt:. J..tJJ,-~,),'f1
Tel.phone # 00 (:l. )C;~ ~-.L\. ,",,S '/ ,J '
-. J L-t.t\MO'4t .
F~naca Make.. Modal r:.,':).",,~11"-~
Model SIze ..3.S.CIY' ~,l J
Fee ScheclJle
Industrial, Commercial & Multi- Family
RHidlriel. Heating & PC
Residential, Heating Onti
Residential, Gas Flreplac:e
Residential, Adcitions & Allerallons
Residenll8l. AI; OnIV
1 % of job cost (139.50 minimm)
$i9.50 .
'&4.50
139.50
$39.50
$39.50
Remember to add 1118 State Surcharge on ,he bonom 01 tta application.
The price 01 your heating permit includes OM rough-in and one finallnspeclion.
TYPE OF SYS1EM
Warm Air Plants
Gravity Addilional inspections wRI be biDed at $35.00 each.
Mechanical House Healing Test R<<orO must be submitted wlth lwikiDg PJDJi1 "fl...roy,r before bUld-
Air Condlllonflg , ,1'1'1 ~:'i "J.4r ~ "-'I ing cer1ificate of occupancy wi. be issued. .
Venl S,stem h.~1 .J\rllJ... \i.IA'l ~.5Tlit\
. t\ HFAT ~A'r.' u ..T"'t,l~ ~J:nr 'I~Fn with number of IIJPIlIV and mum openings lilted per
HEATING OR POWER PLANT room with eFM', per opening. New struclures or addlions send floor plan . supply
S\8am and relurn locations shown. HEAT lOSS CALCUlATIONS, PAYMENT AND
Hot Wale' APPLICATIONS MAV BE MAlLED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Rsdlalion CREEK A.VE. S.E. PRIOR LAKE, MN 55372.
Special Devices
Other Devices
New Construdion X.
Replac8mlnt
_ Est Comp. Date .
Bulding Permit. .
HEATING PERMIT FEE 1
STATE SURCHARGE $
TOTAL PERMIT FEES $.
..
>-
aI
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C
Ql
CJJ
.50
qq-/zl
PAID WITH
l BUILDING PERMIT
ReoeipC fI .
City Haft IJustness houn are 8 8.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (AOUGH..fN AND F1NAL~ . CALL CITY HALL
..47-4230
.1 hereby Ilpply -'Qra. mec:h~,~~. .y~'.ml,p~r~!' .~ndl..llcl<n.OW!~~g! t~.al.~e
information above II comp"'. Ind accurate; "'It the wort wiD be In cDltformanc.
wUh the ordinancee and code. 01 the city and with Ihe .tlle.buUdinglmechanlcll
codea; thallhll form do.1 not become a permh until atgned by the BUilDING
OFFtCIAL; thai the work will be in accordance with the approved pllU\ in the
cue 0' all work which requires review and approval of plana.
, A '"
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L.J
Bultdng Oflical'. Signature
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Sent By: PLYMOUTH PLUMBING AND HEATING; 612 5331121;
Apr-29-99 1 :53PM;
Page 4/5
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CITY OF PRIOR LAKE qq~IZI i ~ ~
PLUMBING PERMIT PPNo. ~q (;)... p~
APPlicant:~ Q Pho~n' .1~-tJ~,
Address: ....~ P\f1I"r'"'\ ~ ~
Signature:. ~ n4';, ~-~ -qC(
Legal DescAp~n: Lot II -- ~ / Block 2.. Sub tjAPLE ttJU, z.~
Site Address: l~~ ~'lJ~.~\n&.. '1'""
Building Permit" qq -12-1 PIC # 25 - ~3 - 02..0-0
NOTE: This permit will not be processed without complete Information.
FIXTURE UNITS
n. c..... ./ ,... LaiI. C.."I17
Ql,Jantity
.\
i
\
\
i
(
Type of Fixture
Quantity
Type of Fixture
Rough-ins '/4. ~:l..~
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backllow As6embt)' (RPZ, Double CheCk. PVB)
8ackflow Assembly Test
Lawn Sprinkler
other
S
$
$
$
.50
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory '(bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
. Water ClOset (toilet)
I
f
$ -..
This .pennil is gnmlccl upon the express condition rhar said.
contrKlor. shall comply in all respeca with the ordinances
of me State Plumbing Code lnd me am&me~heTCOf.
~JrI'~O.~ ~ DATE
~ ArrEST
. Call for all inspections 24 hours in advance.
",r PAID WITH
BUILDING PERMIT
16200 Eagle CrcekAv. S.E.. Prior Lake, Minnesota 55.372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunil)' Employer
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
qq -{) (~I
CITY OF PRIOR LAKE
Impervious Surface. Calculations.
. (To. be ~ubmitted wtth BlIilding Pennit Application) .
For All Prop~~esLocated in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Pemiitted iii 30 Percent.
Property Address /4t;,gt,.. !3Wcl'5/;;0 ~L
Lot Area /'2./ 1"/4- Sq. Feet x 30% = ........~..... '57~4-,2-
*****.****************************************.*************************
.- " '.. .
LENGTII
WIDTIi
SQ. ..t'~~L
HOUSE
AITACHED GARAGE
x
x
x
==
==
==
TOTAL PRINCIPLE STRUCTURE....._........._... /94-9
DETACHED BLDGS
(Garage/Shed)
.... x. .
x
TOTAL DETACHED BUILDINGS..............._..... pA
6 x Z~!>}) - 5"() =
'~3.'
x
==
4-X't4>
==
eo
TOT.AL PAVED AREAS.........................................
7/3;'1
/"
P ATIOSIPORCHES/DECKS
(open Decks ~.. min. opening- between
t ."" ~s. with a pervious surface below,
are not considered to be impervious)
x
x
=
=
x
==
TOTAL DECKS._
gA-
OTHER
x
X
==
==
TOTAL OTHER......-...-.... ...._.............._....... IV"
TOTAL IMPERVIOUS SURFACE
~OVER_ . ... ... ..
Prepared By ~ 7L:.
Z~~~,7
I /~9/, :3
Date ~ - / $-~9
Company
1Zv,,l ~ a'..'
. ... ,. ./ ..
Phone # 452,-J/J/,Ip
DEPARTMENT OF'..'
BUILDING AND INSPECTION.