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HomeMy WebLinkAboutBuilding Permit 99-0179 (- "'A~:-:~":~'!'~^~:\S~~' ;:,{~:'7ft'...,;~" 7-- ~"-"'.' ',~,.~ ~' .};1~r</< -?':"';"-'.~{', _'<7i"_,',,:-~_;/~f~; -~ .~'". -..~~;:'""T::'1;J .... - \~H'-. ADDRESS /u,tb 1 / BLIND DATE TIME 7~5m ZJ~312 / / L/C- ~ CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED OWNER CONTR. PHONE NO. PERMIT NO. q1-/79 ~?6 %GI 't1wlIllfoeIS. %&.~ O:llueOJlId. QL g KJ / -L lS313:lNVt'4l:l0;jIBd' C:o IUIIOJlId. C:0:lIUIIOJ9d. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP ,4 0 PLUMBING FINAL X MECH FINAL COMMENTS: L . B. 7 - 3 - Q Ct-) ~()f ~.f ~~s C--rJl fZeeu\J'tcJ (JVblA5t k+-- o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o EX/GRAD/FILLING IV 0 COMPLAINT rr }t( FIREPLACE-ftt- A. .1, /0 FIREPLACE FINAL o GASLlNE AIR TST o IIleQ , UO!loedsulleul;j , ~ pa\Olldsul pez",nSSllJd eun n~. IIJOSSllJd spunod &Wll iiiQ . . .4.. ./ ~ - IIJOI8ul5!SlSJelsel. I:U" OI::l~3n JOlll8JJUOO 6u!l811H. -?,P'/ /PfET /67Y/.o.fUppvQOr. , #l!WJlld. '25 +n ~.~ Ok- NSPECTION BEFORE COVERING Inspector: Owner/Contr: CALL 447~850 FOR ~ E NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQ~S ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE DATE TIME ADDRESS / ~Ce, 9 J SCHEDULED 8~31-~9 A, L 3L nJ./J (A/<..E T72 I OWNER CONTR. PHONE NO. PERMIT NO. 99 -/79 o EXlGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o // ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT ~~K. CALL FOR REINSPECTION BEFORE COVERING Inspector: ~I . Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI _._-~.._------_._._.._. DATE TIME CITY OF PRIOR LAKE 7i}j-'i 1 INSPECTION NOTICE SCHEDULED :1:00 I ADDRESS ~q\ 5\~ L~~. OWNER CONTR. PHONE NO. PERMIT NO. C(q -/79 o FOOTING o FOUNDATION o FRAMING o INSULATION A ( ~ ~ FINAL .'Vt-'f o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL OtrECH FINAL COMMENTS: \~l(.J OGc:.n... Ol,""', ~ .Ja. D t" (U ~ tx.\ ~'r~ ~ (iJ ~d oL& We; ~~ ~~~ _ ~ fw~ ~t' ~ i fA DC'- <1)'" C-Av i ~) ~stv~""- li~_-~~'--'-~ ~-~ ~ C{), +v 1-I-q~~) ~ o EXlGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o o WORK SATISFACTORY, PROCEED . ~RECT ACTI D PROCEED ~RRECT WO K, C FOR INSPECTION BEFORE COVERING Inspector: Owner/Contr: CALL 447-98~O F~ T\ EXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIR~ ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTl -'~-'~"'-,._-,..~_._~ - fl I ....... f PR\OR LAKE erNe OCT\OM M01'\CE ....~~. \NSP co\' ~ "E.~tl\"t \'\O'./~ ADDRESS -_::-----;;.--:: /. ~~G ~\ d _"'~ "\.:~u,,,~ . --W;.. s C-.-cJl. ~ .~,no O.....:A., ... ~E. N . .- p\-\o \ L o fOO~~~"t!.o}l (JV<i;lASt ~1 fOu o , ~ 25 +0 ~.f' Ok- Inspector: . Owner/Contr: CODE REQ E NEXT INSPECTION 24 HOURS IN ADVANeE~ TS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTl _.^'_.._;~,.._._'-,.-.,_.....'"."-_._--~~._...----"'_..-.-.- ~ME~M _ y +v /Q, ~ ~1' 'G ~ t e-& U \j~ ~~L 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 SCHEDULED ~t,I/1''l OL :.3l) / ~ 0 9 I BL/N 0 L.K:.. _ '7/<::.. CONTR. PERMIT NO. 99-/79 / o PLUMBING RI o MECHANICAL o WATER HOOKUP o SEWER HOOKUP ^~EPTIC INSTALL I'd PLUMBING FINAL o SITE INSPECTION o EXC/GRAD/FILLING o LKSHORElWETLAND o COMPLAINT o SEPTIC FINAL o FIREPLACE o k r ;o?--;...s. Wc--tL l* ~ ~.7;. , /'( l_ -,~:jLo Lt "Y - r-'K Inspector: I Owner/Contr: CALL 44/-4230 FOR fHE NEXT INSPECTION 24 HOURS IN ADVANCE., CODE U"" ARE FOR YOUR PERSONAL HEALTH & SAFETY! ~"..,. I "T"- DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE Gl-fD/~ 2. :?L) /V(Pq I eLlA/a Li::.. / /< . SCHEDULED ADDRESS OWNER CONTR. PHONE NO. PERMIT NO. 99 - /7 e?J o FOOTING o FRAMING o INSULATION o FINAL o FOUNDATION o DEMOLITION o FIRE PREVo o PLUMBING RI ~MECHANICAL WATER HOOKUP EWER HOOKUP . 0 SEPTIC INSTALL o PLUMBING FINAL o SITE INSPECTION o EXC/GRAD/FILLING o LKSHOREIWETLAND o COMPLAINT o SEPTIC FINAL o FIREPLACE o COMMENTS: /~iL !/?/) I 4GLV-e,.v /:-:n I J~ ~ -~~~ ~ JI(~ ~~ ~- ./ / / , WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WOR~AL~ ~R REINSPECTION BEFORE COVERING Inspector: \ Owner/Contr: , V CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! T DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED gfi SI'1 J.;fi M ADDRESS /1." 8t-JJ.JJ) /..Ad 70- OWNER CONTR. j!,LN1fY t1Js:rzlld.l~J PHONE NO. PERMIT NO. h -/7l o FOOTING o FOUNDATION o FRAMING o INSULATION ~ FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL ~ EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: ~ J<. CJK ;1~ 1..1 <!J~1ffjtfJ~lf~ t11~ .51(.."- n~ CltV7l t- 5.1 /)4m X WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING Inspector:l1~ Own~r/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTl c PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS JkL, <i I ~,,~ LaJ~P Tr-. NATURE OF WORK New Cr17AC;~tVcJfc::J"V1 USE OF BUILDING SFD PERMIT NO. arer - \ ~,9 DATE ISSUED "3 -'24-97 CONTRACTOR ~r- WO)r O~ -* . NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPEfTIONS BELOW THE PERMIT IS BY SEPARATE DO::t~o~NT DATE I FOOTING I' I Y \J Ilf'-I" q, I . ' I FOUNDATION (Prior to Backfill) I a I I L{-~-C(1 I PLACE NO CONCRETE UNTIL Aal6vE HAS BEEN SIGNED ROUGH - I~ Ii"} ~ ~ SEWER I WATER I SEPTIC v FRAMING~ 1Z-1\1"(G~f21!iill r INSULATION / I) ~ \ ELECTRIC~L ) PLUMBING /" . HEATING1(if required) ~ i - 5-U)~ ,~ !ro. ry FIREPLACE /J.t. f1) 1/1.r; 1'1 \l GAS LINE AIR TEST ~:\. ~ (/ ~ 5-~-lfl ~,u... 'I. ~.t..~~ c;,u,. 11 c.,.1.-(, - 14 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED WALLBOARD I I FINALS W.E. 1'J ~t>. m <(,311J GRADING (Prior to Sodding) BUILDING -r C.O 70 1/4~ ,Y; 1 ELECTRICAL PLUMBING HEATING DO NOT R', I~ 17 ~ MJ 7 lie t/rcr I ff) 1/;sj['/ - OCCUP6V UNTIL ABOVE NOTICE HAS BEEN SIGNED 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 qc; -/79 Tho Conlor of tho Lob Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 2b/LU'1LI &wslc ~ 3-11-99 J APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /t,b71 &Lncl ket Trad Accepted Accepted With Corrections --<' " Denied -- ')/J Reviewed By: (,! ()~ k- L1'. '- I Date: 3-:2V-9 ~ Comments: I~ So~ ('").. ~ +T1..QJL~ F elL uJq/)......1- g::t~ ~ 7 cQ... MQ.,'Vl~~,^- 2J..oS\C/vL W~ \ <. ~ oJ L Q:1tC~gIA~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." 1'~..AW~~~'.i~~_"jIM.I'i~.lif~,'i<:~'~A:\:ti~~i~~'\';f!~';;;';"t';;,;o1t'Y"'~"'!I' ',,",,'-" '~-" ',;, ,':.--'<f"'-', '" '0(,,"\' ",. White . Bulldlhllt Canary . Engineering Pink . Planning Th. C.nl.. or Ih. Lak. Counlry NAME OF APPtlCANT BUILDING PERMJT APPLICATION DEPARTMENT CHECKLIST if I {( r? ( I I/c/I '",I. 'fIJ I Lf ..j../ /:.-.;..;j 9 ~ APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /1e6 tj / i/I ilcl JCl et 7rt2l;( Accepted Accepted With Corrections. v "/;. Denied Reviewed By: ~. Date: L,{- 2-~ Comments: ~'t8(~ '"""~ 10~ ~U#~ ~1-~'1, "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." ..~ .---.T- . t?~-/7Y fl. White - Building Canary - Engineering Pink - Planning tf' The Cenl.. of the Like Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT If 1(( r?(l (I(/I~/' ffjIL{~' APPLICATION RECEIVED/" /1- 9'1 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /~6t11 6((/leI j~b Y;'a_J Accepted ./ Accepted With Corrections Denied Reviewed By: jJ!lJ=:r€tt. Ct-tRe:.s""ANI\J Date: 4-/71'19 Comments: J'(vNoFf' ft1.J5-r 15E feiU~o,JUi '/0 (.}.v~ Al..t7N (" /)ltl4t JlJYlt".J:: &1> 1.l.D.!.:' TV WE ME'..vT"i. A.!.. MrJC.H 14<,. ~c A L , tiJl1!1fl CuJltJEIlS. ..JEll. e ,.., E (.J.J..AS Ell.. AiV () i) , A ^" E t:! L. '" s fA.. AR.E Awl4ll.E: """,.,.. UlA/AJAGE' J:>oe..s NOI fO'-L.oW 'THE R EMt. ~o Da. A-IN Au F- E,q ~ E: Mf:...n-. 5E.E:' 1I\Jl='"It.MAT1o^J OIoJ REJEIC.c;.E S-,bt=. ?;if.. ~ L. ~..J A-.,,,ct..J AT" TH e. -ro~ ~f' "'f..-/E. .5L..o?E:'.. MI'f't" ~E R~Is.e:b A-~ McJo.( ,.c:::. .. ~ ';"r - 10 Hfd> L.A-TEIt.I A '- DIlA,,,,AC. te:. DAl'o1~Eb CoAlCIlETE +>AAlEI..~ I"W:S, 1>~ R€PAIR-€.~ B ." -riot E. 3 vU..o~Q... 5.ff. A-7TAtHME.v""-' /. F.:.J~If.AOE l~Ptc:nOIU~F.IfN4-L/oAJ z.. aAlfb"I.IoM ?L-~ 3. ~I)SI()1U CCJIoJT~OL MfA.~vllE.s 1. Ca.OSIOJJ c'''AJ'TLoc... tt.41J "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." 101^ APR-06-99 TUE 03:55 PM JERRY GLA~ER 612 452 4218 P.02 April 6, 1999 City of Prior Lake City Hall 16200 Eagle Creak Avenue SE Prior Lake, MN 55372 Dear City of Prior Lake: This letter is in regard to the building permit we have under your review for 16691 Blind Lake Trail, which is lot 5, block 1 of Wilderness Pond. We understand the natural drainage of the lot does not flow along the drainage easement and that it travels across the natural slope of the back yard. We acknowledge this is the way the yard will drain and give the go ahead for Yorway Construction, Inc. to commence building pending the approval of the permit. Sincerely, J~r.~ Z)~9'~ Jerome E. GlaserlDiane J. Glaser DATE RECEIVED MAR I 11999 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 /'- (p c; J /J l-~a L~~ ~~ J 3. LEGAL DESCRIPTION LOT...5"'--- BLOCK ADDITION Iv ~~ f) ~ ~ p ~ 55 (N~e) ~ IJ:Z AN .~ (Name) I I /I-"\. oL , E' ,.. ..f (Name) 4. OWNER .~~ ,'r "t 5. AR<;<t!!TECT rt<~b 6. BUILDER \!dr1-...J ,4- '-of 7. TYPE OF WORK New ConstructiQP1l"'r Chimney CJ Misc. C vj TI/-- Fireplace~ Alterations CJ ,~,~~_"i (Address) G- &1.("- (Address) (Address) 1t<1'-. f Septic CJ Addition CJ Deck CJ Finish Attic CJ 1. DATE 3-lf'~11 1Z+50 PID 'U3- ?~-/?OG-O A~ ....-- ,.,f"a -~J .. D~ c cJ IV" (Tel. No.) t;.S- /-- Lf-Jftt ~ S- T J '-/ (Tel. No.) <-j 'f () ." 4 lr. 0 '- (Tel. No.) 8'if: ""1 ~~y M. (p tJr-ll.jt> '1 Re-roofing CJ Porch CJ Re-siding CJ Finish Basement CJ 8. PROPERTY AREA OR ACRES Sq. Ft. ? II 00 () -L 9. PROPERTY DIMENSIONS Width Depth 1 O. CULVERT SIZE Yes No 1. White 2. Pink 3. Yellow File City Applicant Permit No. qq -( it:[ 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 17. COMPLETION DATE I 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 buildjpg oIIicial can revoke .tt:is permit for just cause. Fl.IIIhermore, I hereby agree that the city official or a design~e may enter upon the property to perform l:l.eeded inspections. XL--" ~ ~ . .. . --;?~;) ) '''I 2: r F'1/'~ /r--<1 l' ~~ -- Signature _f~T - . - _. License No. Date SETBACKS: Required Actual Front BUILDING DEPARTMENT VALUATION USE OF BUILDING 'j Yb Back FOR ADMINISTRATIVE USE Side OFF STREET PARKING SPACES REO. SPACES ON PLAN Side PERMIT VALUATION IO~~. t')~ TYPE OF CONSTRUCTION: I II III IV ~ Occupancy Group A B E F HIM '-R' S U . Division 1 ~ '\ 2 ""J"- Permit Fee ................................... $ ~. <.. '") 91 '7 .1.{7 S-S. SO Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... $ It)O. c>O J Od . 06' 3s . S-O ~D. 01' City: ~~ Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ \ $ Pressure Reducer ..?/~.~.................. $ Meter Hom ........ \~........................ $ Water Meter .'2/a........................... $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ MATERIAL FILED WITH APPLICATION SOIL TESTS CJ ENERGY DATA CJ PILING LOGS CJ PERCOLATION TESTS CJ PLANS & SPECS CJ SURVEY CJ SETS COPIES PLOT PLAN CJ f1~{).oO / () SV . Cl IS' '15. t9C> I ~S' ..-00 I. 2C>C> CJ? . ") rJ l') - c:o WaterTap ................................... $ Builder's Deposit ............................ $ /. t!)() CJ ~ e--eJ ., Other ......................................... $ TO:LJJfi.........~.~...:,.... L2320. 72- Paid '3 W'Il~Pt No. ~ +~ ~?-- Issued . Date /1;/ (J(tI! BY.-11.1 0..1.1.. . This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdin~nc~nd may proceed asUqO'ested. This document when sign he Ci I ner constitutes a temporary Certificate of z~omPliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued. /' ~l-,'- ny lanner . Date Special Conditions d any ur Building Permit When wPro~%> Date '3-2~ 't - 24 hour notice for all inspections 447-9850 T I. Bille Fll. l. Gold City 3. Y~UDW Appij~1 # qq-/7q Phone: 4Y'7~lc73L/ Vr-inr L~ CITY OF PRIOR LAKE PLUMBING PERMIT Applicant: ~Q.."arer P\urn\)\f'q Address: ~("r~~~_ Slgnature~ Cf~ Legal oesc~. Lot 5-Block_ Site Addl'ess: 'ln~ q) R \ iM ~ 1rci I Building Permit # qq- 1'19 .PID# 2.5-338-005-0 NOTE: This permit will not be processed without complete information. FIXTURE UNITS Th. C....- of ,". LIMo Coli"'" I '\()<~ SUb~S J/"d Quantity Type of Fixture Quantity Type of Fixture I Bath TlJb with or without shower ......'1 Rough-ins I Dishwastler I Water Heater I Floor Drain Water Softner ~ Lavatory (bathroom sink) I Stand Pipe (washing machine) I Laundry Tray (1 or 2 oompartment sink) Sewage Ejector d. Shower Stall Backflow Assembly (RPl, Double Check, PVB) I Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler ~ Water Closet (toilet) Other FEE SCHEDULE Industrial. Commercial & Multi-Family (1 % of job cost. $39.50 minimum) $ Residential, New One & Two Family $ Residential. Additions & Alteration $ State Surcharge $ .50 GRAND TOTAL $ This pennit is granted upon the: eltpte~$ conditiQlI th.~ said conr.ractOC', .haJJ comply in all respects with the ordinances of the State Plumbing Code and ~he amend7~ thereof. ~hNO. 5,/7, DATE r ~ . ATTEST Call for all inspections 24 hours in advance. .--- //,~O~V.\l>t( fQU\~O\~ 16200 Eagle CreekAv. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-4245 An Equal Opportunity Employer CITY OF PRIOR LAKE 16200 Eagle CreekAv. S.E. P8,mitNo. qq - (7q Priar Lalca. MN 55372 - HEAT1NG APPLlCAll0N I PERMIT -; Data ~ - :;t J - '\ G\ PIC" 2.5 - 338- OOS - 0 0.. . SiteAddress \ \n~ ~ \ ~\~'-,\ \.J'\\~~'rCl\ l~. ~ Let 7) BIocIc \ Addition, \..l ~ \ ~....hi S. ~ d. ~ ~ g Ow"er's Name . ~ Q~ w v.. '" ~ O~S Addre. \ ~ ~ ~") ()'^ \l~~~ \. ~ " ~ HHIlng Contrador ~ ~..-('J .{\ ~,... -1- () ( · Addre.. \ \0 ~~\.\ \.~ \\': ,uN. f\v L ~(', Or"'LJ.t\\o.l Te'.phone' , "" ~ 1- ~ \ d ~ Furnace Make & Model f c... r y ~ \. - Model Slzl ~ A - \ a~ Conn.load ~ '\ ")"\\0 Fuel, 1\\ <\\- FlueSlze ~ 'I ~VC Supply OpInfngs ,~ '9.. Return Openings ~ 'nput \~O .OtlO Output ~ ~_ 0 ~O a: o Il: I- W E Edr. Cfm., ,c;SQ TYPE OF SYSTEM Warm Air Plinta ~ Gravfty Mechenlcal A'r Condlllonin~ Vent. System HEAnNGORPo~RPuun Steam Hot Water Radiation Special Cevices Olner Devices Replacllllent TYPE OF WORK New Construction x E[ Allendions ..-l If) , CD . Repair Esl. Comp. Cat. , Est. Cost . ~ C\ t\C\ ~/ BuDding Permit" en ~ HEATING PERMIT FEE $ l:e STATE -SURCHARGE , a:: " '. - -. ., ." '- & . TOTAL PERMIT FEES . , ! _ .i-:t +.~.~ ~":"'.'~',~.. - -". '. .~. I ~3:~~-y'., -" , .1- I ~~4!~I~~~'~ ..: ~~'=.~' ~.- .50 O\C\. \\ q rPA'DWITH~: l B.UILDING .PE~ RecllpU , . - : ':'i-_.~/'_: -, .~ . I .~-t.;! ....;-. :,:...- TYPE OF STRUCTURE J. Piak - Fits 1. GRaI - City 3.. YcDow - ~."" - "1 Single FamUy Commercial x Two-Family Industrial Mufti-Family _ Public Olher Fee Schedule Industrlal, Commercial & Multi-Family Resldental, Healing So. AC Residential, Heating Only Residential, Gas Rreplu:e Residential, Addition. & Alterations Residential, AC Only 1% of job cos1 ($39.50 minimum) $99.50 $64.50 $39.50 $39.50 $39.50 Remember to add the State Su rcharge on tne bottom of lhjs appUcatlon. The price of your heating permit Includes one rough-In and one final Inspection. Additional inspections wID be billed at $35.00 each. House Heating Test Rec:ord must be submitted wIth 1,1' '1'1011:",,, ,,,'\,,,,Il ""'I"~" before build- ing ~enifioate of occupancy wi! be issued. HFAT r.AI r.1 U AT/n~~ ~F'" IIRFn wiIh number oI8Upply and return. openings listed per room with CFM's per opening. New sllUctures or acldilons .end floor plan wlth auppJy and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 18200 EAGLE CREEK AVE. S.E. PRIOR LAKE. MN 55372. Ctty Hall business hours are 8 a.m. - -4:30 p.m. ALL WORK MUST BE INSPECTED (ROUGH.JN AND FINAL) - CALL CITY HALL 447-4UO I hereby apply for a mechanical systems permit and I acknowledge that the inlormallon above Is complete and accurate; thallhe work will be In conlormance with !he ~rdlnances and codee of the cily and wilh the state bulIdin~mechanlc.1 codes; that Ihis form doe. not become a permit unlilslgned by the BUILDING . OFFICIAL; (hat the work wI) be in aceordance with the approved plan'n the ~:~r~.".,~n:.dlo 519 .~/~.- -' '. .~li;"Jqq. <8wirdlng Offlcal'i Signature ' QaU - .- f I .-. ,. . " ::- . '.J' .~. --. ..: . " "- .-" GREEN - FILE YELLOW - APPLICANT GOLD. CITY CITY OF PRIOR LAKE NO. qq- /79 SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the city. APPLICANT: IL! '~i':'. ~ ... I.,/~ )}IL ADDRESS: ~ .ij~ ~ . ~ SIGNATURE: ~ SITE ADDRESS:p.,~ riM. FILL IN THE BLANKS 1. Estimated length of water service ~~ PHONE: -'/-,1 J -\. U / '/ DATE: 6-1/ -- 99 BLDG. PERMIT # qq-/79 PID# .2.5-339- 005-0 feet. 2. size of water service } inch(es) . 3. Location of any couplings from structure feet. 4. Type of sewer pipe. ABS PVC ~ Cast Iron 5. Estimated length of sewer line '-f~- feet. 6. Clean out (if required), located at structure. feet from ------------------------------------------------------------------ ------------------------------------------------------------------ This appl ~;~n becomes your permit when approve&:> \N\1'r\ ~\\ BY ~/? Sft"ft?9 DATE: ,tI~\~GI'Ei" ------------------------------------------------------------------ ------------------------------------------------------------------ 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 must 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 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245 An Equal Opportunity Employer T