HomeMy WebLinkAboutBuilding Permit 99-0201
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Q[ertifirQu nf ~rmpanry
CITY OF PRIOR LA}{F.
~ 11\tpartmtnt of }8uilbing 3Jn~ptction
~YFinal 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 Classification
SINGLE FAMILY
B' Ig. Permit N~
99-201
Occupancy Type
R3 Ty~ Construction VN Fire Zone N / A
L3, Bl KNOB HILLS 3RD ADDITION
Zoning District R 1
Legal Descrir':"n
TRAIL
TOVAR
\1;-."; .
Date:
( /
;" ~
Job Address r~ /,.{v"',., i~/)l"rJ
Heating Contractor ~6/JlVIlR
d': J..
4~ (-'{'I
7
Name of Tester
Date
Percent O2
Percent CO
Percent CO2
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input
(/
q
"3(,0
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~k"~-2 2.: ~
ADDRESS .45t!3Q #tJI'1MfIV4BI"eD
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
~INAL FJ~.
o SITE INSPECTION
COMMENTS:
~-
(0v~
CONTR.
PERMIT NO.
99-20/
O,JLUMBING RI
'J8' MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
Il- ~~ ~ -hliL
~~/ - h
(L() 0 r v.ll /lAnA
Wc:k ("'_-(~ V 1/
~\((, w -fr.1..LC.I, ",., ctJ.r /~ I
vt..c.e..4Vc.-& ~ ~_ C.....,'.~
I~~J!::
~ SATISFACTORY, PROCEED ~
o CORRECT AND PROCEED
o CORRECT NO K LL FOR REINSPECTION BEFORE COVERING
~:-.~11 ~...
~~~
Inspector: Owner/Contr:
CALL .Jr-9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~ /
CODE REQul'I(l!.MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE 7-Z-Qq 1{:"S6
INSPECTION NOTICE SCHEDULED
ADDRESS Lj 5 at; ~~rd Tk-
OWNER CONTR.
PHONE NO. PERMIT NO. r;Q - tot
o FOOTING m.m~" o EXC/GRAD/FILLING
o FRAMING o CHANICAL o LKSHOREANETLAND
o INSULATION TER HOOKUP o COMPLAINT
o FINAL EWER HOOKUP o SEPTIC FINAL
o FOUNDATION o SEPTIC INSTALL o FIREPLACE
o DEMOLITION o PLUMBING FINAL 0
o FIRE PREVo o SITE INSPECTION
CClMME~TS:_~ U M f VC
~-1jT~ l( If..- ~
Gt..~ or- Inl::)
~U~ ~~ (~,
Cx~
-
~
No L"'f"
k.s
~~h..
~
C:rr~ 4- ~
~
-.
Inspector: Owner/Contr:
CALL 447 423J FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQ'wiEMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY Of PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
4n/11-M
ADDRESS "'5" r/l/,,*,,'AI~8JA1l -r;r
OWNER CONTR. f/f')( ~ (!nU!:r
PHONE NO. PERMIT NO. 9'- Z-D/
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
X EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~,:" 1<;' Ok'
CVA~" .\;J QU/lAnDA.h4L
t41AIAI'MIAI ~Icr- J:""~ vA.rt:u.,.. Sob.o.e:D
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~~. Qwt:ler/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
INSNOTI
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
QATER~
~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. ~6~ESS Hu W1VY1 ( bird TIZ.
3. LEGAL DESCRIPTION 4
LOT 3 BLOCK /
kPJ/J A 1:tLJ../ ~~ I't/ I} d-/; 7;'(/#7
ADDITION
1. DATE
3 --I~~- <J9
~\
PID ~-3 <Ie; - 003 -()
(Name)
7;u~ JlIY/ h7,:::>
5. ARCHITECT (Name)
k r e.I, <;
6. BUILDER (Name)
(Address)
'it; 7 TAt? -' <.. <".4-ff1P;;"o
(Address)
/J.9/ O,~""'()~/c./ <;~rl"&',Pvn?
(Address)
(Tel. No.)
q?~ -;j.o9 ~
(Tel. No.)
l,I~s- - )") K7
(Tel. No.)
4. OWNER
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
QQ-20(
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
i
13. TYPE OF CONSTRUCTION
.5'q / F;, _ jf.'
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
/}Q/~p Co Pf c,Z. '(</7 ~ e;<:" ..St{,Jt;p..o1"'P 41'('...../0/'7
7. TYPE OF WORK Fireplace a Septic a Deck a . Ae-roofing a Porch a
New constructionpl Alterations a Addition a Finish Attic a Re-siding a Finish Basement a 16. PROJECT 90STNALUE
Chimney a Misc. / ~ en/?
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DiTE
Sq. Ft. iW Width /"d..O Depth if;(; Yes <~-.:.ti9J 7 '-;" - ~Cj
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
:uildin~icial can rev~ust cause. Furthermore. I hereby agree that the city OffiCi4t: 9i~e may enter upon the property to perf~rm:23 ~~ns.
~ Signature- . . ~icense No. - Date'
SETBACKS: Required
Actual
Front
Back
FOR ADMINISTRATIVE USE
Side
Side
SEATS
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
USE OF BUILDING S-ffi
OFF STREET PARKING PILING LOGS a PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS a SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION 11~.~.l!O PLOT PLAN a
WaterTap ................................... $
Builder's Deposit ............................ $ I; c.)t)I"J . ~
:~';;~~~.::::;ti::::~;~;~;~o:~~f~S. ' ~/-=-
Issued :2 h ~Ii ~
Date 0/fJ I,~I By l.
. .
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 reques d. This document when
signed ~porary C~t~ t&r~ffliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
C~y PlaIlner Date Special Conditions n any
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I II III IV tV,)
Occupancy Group A B E F ......\ I M iii' S U
. Division 1 2(Y 4 'Z ~
Permit Fee ................................... $ 'I ?~" 7.. .
~~. tfl
q 1 . "'r"f,
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
I (i I:':) ". 00
100 .C)O
3S" . s-O
l/O.Ot
Sewer & Water Perm~ ...................... $
Gas Fireplace Permit ....................... $
Ii . Beco~s Y<:>ur Building Permit When ~prov~.
~ Date "z;-2..<r:...q 7
-, .
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
~e" $
Pressure Reducer .......................... $
Meter Horn .......I:fi......................... $
Water Meter .... 7t>........................ $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
City:
\
v'j'--
~~
24 hour notice for all inspections 447-9850
RSD .DlS
10 S"n .(")"0
46.00
12~. (")-.()
I. t2 (PC) .(")1'1
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1 (9tJ . ~1S
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permil No. qq- 20/
Prior Lake, MN 55372
J"YPE OF STRUCTURE
I Pin.
2. Grttn
1 Y.llow
c..,
C
Fi.. :3
aI, I
COIllrK'O
Ql
I
\C
\C
o
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to
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HEATING APPLICATION I PERMIT
Dale . ~ -? 9q PID '. 25 - 3Lft:f - 00..3 -CJ
Sile Address (;;09 4/'//.W~~.c -r ~
lOI 3 Block I Addilion ,KNOB filL"- 2ND
Owner'sHame ~fJ" .W~~ ~~ -
Address
Healing Conlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address. 2700 N. FAIRVIEW. ROSEVILLE. MN 55113
Telephone' . 651-633 -2 5 61
FIREPLACE
IMmIPJ3 Make & Mode' -ll-PDJ- #oJ ~u
Model Sil~ _ ~7I1_
Conn. load.
Fuel
lCx..-. ,
Flue Size
Supply Openings
Relurn Openings
Inpul OUlpul .) 7. 00<)
Edr.
elm.
TYPE OF SYSTEM
Warm Air Planls
Gravily .
Mechanical
Air Conditioning .
Venl. Syslem .
HEATING OR POWER PLANT
Steam
Hal Waler
Radialion
Special Devices
Other Devices
TYPE OF WORK
New ConSlIuclion
x
Alleralions
Replacemenl
Est Comp. Dale
Repair
Est. Cosl $
/ /OJ.~
Building Permit II .
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
(dC;/Ci'9
qq-ZO/
"-
PAID WITH-
BUILDING PERMIT)
Recelpl . _
Single Family
. Two-Family
Industrial
Commercial
Fee Schedule
Induslrial, Commercial & Multi-Family
Residential. Healing & AC
Residenlial, Healing Only
Residenlial. Gas Fireplace
Residential. Addilions & A1teralions
Residential, AC Only
Multi-Family ~
Public.
Other
1 % or job cost (S39.50 minImum) it
"'"
$99.50 ,
fD
$64.50 III
$39.50
$39.50
S39.50
....
0.
fD
n
o
,
:3
fD
,
Remember 10 add Ihe Stale Surcharge on Ihe bollom or this application.
TIle price 01 your healing permil includes one rough-in and one /lnal inspection.
Addilional inspections will be billed al $35.00 each.
House Healing Test Record must be submilled wilh building ",p.~",,, ""mhFl~ belore build
ing cerliricale or occupancy wiD be issued.
HFAT GAL.CULATIONS REQUIRED wilh number 01 supply and relurn openings lisled p
room wilh CFM's per opening. New slructures or additions send noor plan wilh supply
and relum locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND ~
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE N
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall business hours are 8 a.m. . 4:30 p.m.
O'l
!AI
!AI
,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CAll CITY HALL
447-4230
Ql
Ql
Ql
fl
I hereby apply ror a mechanical systems permit and I acknowledge thatlhe
inlormalion above is complete and accurate; that Ihe work will be in conrormance
willi the ordinances and codes or the cily and wilh Ihe slale building/mechanical
codes; Ihallhis lorm does nol become a permit until signed by the BUILDING
OFFICIAL; that Ihe work will be in accordance with Ihe approved plan in the
case or all work which requires review and approval of plans.
~~
~~
~- Building-Oflicars Signalure.
6/),/1'-
Dale
G,/S/qq
Date
"tl
,
o
1..1
MRY.25.1999 7: 05RM
GENZ-RYRN
NO. 730
P.1/2
MAY 2. 5 1999
CITY OF PRIOR LAKE
. PLUMBING PERMIT
Applicant: ~J2. - Ru a..J"'\ :
Address: l~'""14~ ~. ~ 1- Ir \
Signature; ~ ~
Legal Description: Lot ---3 Block I SlJb~ h Hi) I R'-~
Site Address: w~~q ~ . ~ .~ .
Building Permit # qc;- 20 J U PIO, ~?-34q-003-0.
NOTE: This permit \'I(i11 not be proce~ed without complete information.
... \ ..
FIXTURE UNITS
I. BI\18 Ale
!2. GIld Cil)'
3. YcUuw AJlPUCIIII
~ qq-zol
Phone: U ~.9: - II Ll4
n. C",ln fit .1. Lllik. ClIIIll.17
Quantity Type of Fixture Quantity - Type p1 FixtlJre
~ Bath Tub with or without shower 'f Rough-Ins
I Dishwasher I Water Heater
J Floor Drain /<1 Water Scftner
3 Lavatory (bathroom sink) I Stand Pipe (washing rnacl'1ine)
J Laundry Tray (1 or 2 compartment sink) Sewage Ejector
I Shower Stall Backflaw Assembly (RPZ. Double Check, PVB)
I Sinks Bacl<flow Assembly Test
Bar Sink Lawn Sprinkler
3 Water Closet (toilet) Other
FEE SCHEDULE .
Industrial, Commercial & Multi-Family
(1 % of job cost. 539.50 minimum)
Residenlial. New One & Two Family
'Residential. Additions & Alteratian5
State Surcharge
S99.50
$39.50
$
$ gg.60
$
$
.50
GRAND TOTAL
.
$ ICC.OO
'This permit is granted upon tile e~p~5 condition that said
contfnclor. shall comply in all respects with the ordinances
of the Stilte Plumbing Code lUld thc ilIT\c]1dmen}$ thereof.
'- l~- 7~O. 5Iz~/~q DATE
~ A TrEST
Call for all ins ections 24 hOl1TS in adv;mce.
;
.~
r PAID WITH
l BUILDING PERMIT.J
16200 Eagle Creek Av. S.E.. Prior LOLke, Minnesota 55372/ Ph. (612) 447-4230 I FA.."( (612) 447-42~5
An Equ:1l Opportunity Employer
CITY OF PRIOR LAKE .
11200 Eagle Creek Av. 5.E. Permit No. qCj- zo /
Plior Lak~ UN 55372
HEATING APPUCATlON fPERMaT
PID. 25 -344 - ()03 - 0
Address
TIt,phone'
CoM. Load <
Fuel nA-+ -C..,Q.~ Ru. SIze
Supply Openll\Qs , Iq
8
h"
Retum Openlnga ,
~Input J~~.rx:nOUlpul J ~7. rrr'I
r' J
CfEdt.
N
z:
~crm.
~
TYPE OF WORK
E
~ AftetaUona
lSJ
r-:.. Aepllr
R&placement .
Eat Comp. Date
BuUding PermK .
qq. SO
,_ .50
S 1e;C).oO
\TI Est. Cost . ,
\TI
9::: HEATING PERMIT FEE .
If)
~ STAlE SURCHARGE
r .
~ TOTAL PEAMrrFEES
TYPE OF SYSTEM
Wpm Air Plant.
Gravfty .
Mechanical ~
AIr Cond.lrJnlng
Vent SVBtem
HEAnNGORPO~RPuurr
Staam
Hot Water
RadIaIJon
Special Devices
Other Devices
New Construclion , ~
qq-zo/
f' PAID WITH
I BUILDING PERMIT
Receipt.
TYPE OF STRUcnJRE
I. PI'"
1.. am-
1. Van.
tI.
c:1IJ
- CamIndaI"
Single Famlty
CClmmercial
~ Two-FunDy
Indua1rlal
Multi-Family
Pubic Olher
Fea Schedule
Industrial. Cmlmercial & Mull-Family
Residenflal, Heating & AC
Residential, Healing OIlIV
RNldenliaf, Gal Fireplace
Residential, Adriitions & Alterations
Residentfal, AC Only
1% of lob cost ($39.60 mlnlmum)
$99.50
$64.50
139.50
$39.50
$3Q.50
MAY 2 5 1999
R&memb81to add the Stale Surcharge on Ihe boltom 01 this applicalion.
The. price 01 your heating permit Includ&s one rough.in and ooe finallnspecUon.
AdditlONlllnsper.tions wi be billed aI $35.00 e8llh.
House Heating Tes' Aecord must be aubmiltad with blJltftrnn flAunit number before bulld.
ing certificale of oocupancy will be issued.
.,r:-.T r.AI r.I " .l"lnr..r~~F"1 llAFIl with ~be~ ell supply and relwn openings 'bled per
foom willl CFM's per openIng. New slruttlUtls 01" addition. Hfld floor plan with supply
and rltum locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372. <
City Hall buarness hours are 8 8.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL). CALL CITY HALL
447-42.30
I hereby apply ror a mechanical systems permit end l acknowledge Ihallhe
inlormaliem above is complele and accurste; Ihat the lIIork will be in conformance
wilh Ihe ordinances and codes or 'he city and with Ihe state building/mechanical
codes; Ihallhis form does not become a permit until signed by the BUILDING
OFFICIAL; 'hat the work will be In accordance with Ihe .pproved plan in the
case of all WDlk which requires review and approval or plans.
5JuJqQ
. Dale
5'/2-5!CfQ
aate
~
--
41-N)
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 in 30 Percent.
Property Address 4'5i09 \\~~~t"".....'Dt~~ ~~\, \b~~, 6\oc..k..'
-.J \(~c)6 ~\\\ ~.o A.'Oo.
Lot Area . \ to I \ e'7 Sq. Feet x 30~ = .............. \.\-, 2>~S . S
****~*******************************************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
x
=
=
ATTACHED GARAGE
~'2- ~V<;~ \I~
=
TOTAL PRINCIPLE STRUCTURE...................... -3 \ \'
DETACHED BLDOS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.......................
@iV~W1ylP~AREAS
(Driveway-paved or not)
(Sidewalk/Parking Areas)
\1 x~ = '5\0
2... x \ 0 = -z..o
~.~ x 'Z.> = --z..\~. 5
"2.. "'- . _ \ "-
TOT AL PAVED AREAS.........................................
1t;B. ?
P A TIOSI(6RCH~/DECKS
(Open Decks W' min. opening between
. boards, with a pervious surface below,
are not considered to be impervious)
\0 x \"7-
X
=
V?,......,.
=
x
=
TOTAL DECKS........................................................ \ ~
OTHER
x
x
=
=
,:
TOTAL OTHER..... .......... ...... ..................... .............
TOTAL IMPERVIOUS SURFACE
. .
3~9CS.S
~VER 8<00
Prepared BJ 0....--. q<,\.....1 Date 3 - \"2..- "I "1
Company \J.p. \ \ eo ~ \l R..-!e \ .~ Co.pl\.. Phone # ~ 41 ~ Z. '710
1r -dOl
Thr ern.,.r of thr Like Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~~)
3 -J3'1f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4~?if ~/yl:U;cL /k'.
Accepted
Accepted With Corrections X
::::::ed Bv(2fJ ib ~ .,;k
Comments:
I. ~ ~ -hnoa.[) ~rAcu~~ G:1r.
:2., M,Q~lA~~ O-o~'C:n^-- ~
s. ~al1 a~ ~
Date: "3 -LCZ -77
"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."
/'"- ,. ~""I
f I
I
/
'. '..
Tho Con Co, of lho Lab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
lit' 'f
1,-- I /,.. ( ,
,f 7" l
,(, ,.-,
" / (\"T ! .
-~.
(I;
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,,<
.' (' I
,/
/ / /
" ,/ ,/ i'
/ .//-' r'
'..
I
,'y'"
; I\.
''1,./
/ l \ .
Accepted
~
Accepted With Corrections
-~':l"'"
Denied
Reviewed By: /0\
Comments:
Date:
~ ~ 2-to-Af1
'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."
GREEN - FN..E
YEllOW - APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
~
20
S.w. No. Cf - /
NOTE:
Sewer and Water
contractors must
be registered
with the city.
<-'Yh-u~
Pcf7-5" /Y.Y'
6-- // - J?9
PERMIT #!f!!- 201
2 .
Size of water service
Estimated length of water service
11/
inch(es) .
1.
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC ~ Cast Iron
5. Estimated length of sewer line ,~~ feet.
6. Clean out (if required), located at
structure.
feet
from
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 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 lV/Pi/L~ [r
AMOUNT PAID
RECEIPT #
REC'O BY
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
437- I/1Y
1'/ . dL/')
Th. ern It, of th. tok. CO..lry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1/ /' { /
iJ{J-(lllf (&UV--t.
;;; .~ 7 -'it:;
--' ",-I...:) /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,< .
4:~'C-f f-Itt I J II tt /11 tj 1.2 ( ~ CL TIt.
J
Accepted
./
Accepted With Corrections
Denied
Reviewed By: WAL.-rett EH'(€'SM1tNN
Date: 3/Z1 /~1
I
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~- E~SIO^, I' -'2lJm(l~C;:tJttES
4-. E~".s,o^" CON T~L K.<4N
"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 4 S89 ~uVV\\M\v..~ l,~J \ \.
NATURE OF WORK ~ew ~s~~cJd-\cJY\
USE OF BUILDING S~\)
PERMIT NO. Cf <=) - 20 (
CONTRACTOR . (rJYll WnllA.A
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE ISSUED ~-2S -91
I
INSP"^, I t-\-~~
, FOUNDATION (Prior to Backfill) I ~), 1,/-2')-91
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
--
rr; V '1/2/11
9 w'//~'/
, FOOTING
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION ~~~ 1''?Jl-~~
ELECTRICAL
PLUMBING
HEATING (if required) . 0D iF f '-/ /1 t
FIREPLACE ~,\.~ ~1r ~IO..q') ~- I
GAS LINE AIR TEST ( /J) &/f,lqq
COVER NO WOR'VUNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~
lfV
l
(o~l, Ci)q
v
(p.1- liQ
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOV:: HAS BEErJ SlqNED'
NOTICE V
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.
rv
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~XV
u, ~,
\
8, 'tY 11J
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850