HomeMy WebLinkAboutBuilding Permit #99-0312
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(~...\1 Owner of Building C:i'~Address 3409 SPRING GLEN CIRCLE
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<<";'.;:' Contractor'sName&Address Wensmann Homes~ 1895 Plaza Dr., Suite 200, Eagan, 55122 :1 i!
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(*~,;~, Robert D. Hutchins ~ City Planner Don Rye r ....1
('- :i Building Official r :-
'>\!!: II "'"I J. Q 'I Date: 1 .
\ ' ~.- Date: . et I \
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Q[trtifira1e at ~rrnpanry
CITY OF PRIOR LAJ(F.
Jltpartmtnt of ~uilbing Jn~ptttion
gJ 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 afthe
City of Prior Lake regulating building construction or use. For the following:
SINGLE FAMILY
Use rl'..ifi...;nl'
99-312
H'.:;. PermitN"
Occupancy Type
R2
Zoning District
R
N/A
v
Type Construction
Fire Zone
Legal Description.
L25, B2, GLYNWATER FIRST ADDITION
.:..
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
ADDRESS.J.!:f.!2J SPit. ~G. aLoe...! C.1t
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)a, FINAL
o SITE INSPECTION
COMMENTS:
~RA~(.. IS (')1(
DATE TIME
/fl/Z7/97
I ,
PERMIT NO.
CONTR. I~EtJSI'1IfNN f/I'J"~
n- 3/Z-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~uRC>&))( ~s. ~"f'loI\tAl.-
)t.. EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
l( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: to /~..
Owner/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
ADDRESS
::3 <,10 ,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION/1\)
'8" FINAL ~
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
/107J-1'9
S~6~
CONTR.
PERMIT NO.
i 0{ - .31.2
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~
V
~ C.O.
~~
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
/1l.R\ Owner/Contr:
,
CALL 447-9850 FqR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~
ADDRESS
3~09 SP/C?IN~ 6c-6A1
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V -
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
. 0 INSULATION
NPr )5 FINAL ;ee //II.~P.
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
A~EWER HOOKUP
1\ LUMBING FINAL
{1 ECH FINAL
COMMENTS:
(\).h~ p~ ~iY\UY, ~
(~~ ~ W r.5CA
C3L &os;{V1 ~~A L
(4) ~v<. ~5 {j.{
(B ~O~Jc ~ ~V
\0u--~ ~
(W- ~
u
- -
~3 w--
qq-3/2-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~
~ k<;.l~
EINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-98SJ FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
.
Job Address 3tfO'.5WJ~~If'"
Heating Contractor (j;,;~-Y17~;r
Name of Tester ;? " (~
Date 7;A:J~
7
~
V
$~
..
Percent 0 L..
Percent cO2
Percent CO
Stack Temp.
/
DATE RECEIVED
. 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
3 Yo 9
...
SPr,'Pv'
f7
3. LEGAL DESCRIPTION
LOT :J. 5" BLOCK
ADDITION G Iy/V Wa f"r ,S"-
4. OWNER (Name)
5. ARCHITECT
(Name)
6. BUILDER (Name)
tJ~ /V.s IT)lI N A/
/J()/n f' J
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
r: /~ /v
C / f"(" /-(
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C{q- 3/L
~
t(,1I'11; u.N
(Address)
(Address)
1. DATE
7-7-')9
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO, OF STORIES
PID ;15"-3.$1- O.;l..$"-O
10. CULVERT SIZE
Yes No
Side
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Address)
11'15" I'h12"'- Dr
S l.i /1 < JOI) CII!./~/VS.5I.;1;)'
Septic 0 DecIUJ Re-roofing 0 Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
7. TYPE OF WORK
New Construction V
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
(Tel. No,)
~ Sf- "-Iolr't'(tJ(}
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALUE
tf' 0000 crt)
,
17. COMPLETION DATE
I hereby certify that I have furnished infonnation 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building Off..J i ial can revoke.,s;ze 't for ju~use. Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X AI ~ (?' . ~ 3{,"1~ 7'/ l. /~S S" 'Y-? -'1 ,
- / /J ignature License No. Date
-
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~t-- f-1-
FOR ADMINISTRATIVE USE
8ack
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV c;J/'i'
Occupancy Group A B E F)~ I M lW' S U
Division 1 2 (Y4 3"-
Pennit Fee ................................... $ R - I . ';l C).
Plan Check Fee ............................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ...................... $
Sc.{ q - 22
l.( lo . (0
l 00.00
100-00
35.$0
40.00
ace Pennit ....................... $
This 'B~em Your Building Pennit ~1)e9t~P~~'
By _ Date -Y:f5 ~
Certificate of Occu ancy
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
SURVEY 0
COPIES
92J)CD.~rJ
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
~t1 $
Pressure Reducer ...,..................... $
Meter Horn ....~f"......................... $
Water Meter ...16........................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
A~o.on
( 050.o(l
L/6.00
L iJ.6 .00
Il~OO .00
l10C).0l')
City:
\)\f\
~~
WaterTap ................................... $
Builder's Deposit ............................ $ 1.5'"00 . 00
Other ......................................... '1'.
Paid T~ /71":. "if.:;iuu.~:;,~~:m~Z 7
Datet! :lb.. 9q By (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 as requtsted. This document when
sign~y -k1J!. City la er constnutes a temporary Certi!iCjlte of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
'- 'k' ~-f~"~.
'<Y' "il9 Planner Date Special Conditions ff any
Issued
24 hour notice for all inspections 447-9850
!~\)
I~ HEATING APPLlCAnON I PERMIT
CSj
~I ~/QI Jqq PIDJ 2.5-351-~Z.5-()
~ - ,
I~Addr.N 34CR S\1!UAA 0,.\ Q n ~ l\)w
'6:;J~ Dtock. a- Ad~blon (\-i~,n UJ Ctk.tA wes-t-
~''''Nam8 \A)rn~Qnn \-\omeS
I~reu l<gqF=) r-p)0Jl.,Q, ~R, E..n.ann
lalfno Conllactor. G,... p ~- R u 0J'l \oJ
tLJ74?; ~.%bu+-Ti-I
laphone', 4 Q'?, - II LJ 4-
rn6Q8 Make & Modal .h Q f\..n ()Y..
IdeISI~. (h';1~~J~-16
. .-
CITY OF PRIOR LAKE
18200 EBgf. Creek Av~ S.E. Permit No.
Prlo r Lake, MN 55372
99.3/2-
Idresa
"It. load .
el N A'1 ,P;"SFfu8 SIze
ppl, Openings . \ I
turn Openings . 4-
u11~ ,CX'n Oulput ( d').(Y'()
~ v
TYPE OF SYSTEM
Warm All Plant.
Gravtty
Mechlnrc.t ......---
AIr Concflllan(ng
V.ol. Sptem
HEAllNQ OR POWER PUNT
Sleam
Ho' Wals,
Aadra1lon.
Spedaf Oevices
4-11
z:
a:
)-'
0::
I
N.
z:
W
l!l
.
Othe, Devices,
TYPE OF WORK
"8tlDna
L
0...
I.Dlr
~-
~;csl S
New Conslruction
v--
Reptacemen1
Est. Comp. Dale _
. Building Permit" .
qq .50
99'-31:1-
'tf1ING PERMIT FEE $
(J'l -
(J'l
~ESURCHARGE .
~
l\!.lPERMITFEES $
0::
0...
a:
( PAID WITH
I BUILDING PERMIT
.50
/ Q:).. ()()
Recelpl' .
TYPE OF STRUCTURE
r.1Iak
:Lfh
J. v..u..
ftk
0'l1
CDUKiDr
Sinale Family
Commercial
~
MLIlti'FamUy
'Olher
Two-Family
. lndustrial_
Public
Fee ScheduJe
Indus111aJ, Commeccial & Mulli-FamllV
Residential, Heating & AC
R e&ldel1tJal, Heating Onlv
Resldenlial, Gal FilllpJac8
Residential. Ad11ilions & Alterations
Residenlial. AC OnlV
,,. of lob cost (139.60 lfIinlmumt
S99.50
$64.50
139.50
$39.50
$39.50
Remember 10 add Ihe Stafe Surcharge on Ihe bottom of this application.
Tila price 01 VOU1 healing permlllnckJdel on8 rough.ln and 011& final Inspection.
Additionallnspeclfons willlJe bglBd al $35.00 each_
House Healing Teal Record musl be submilted wilh }ll..~r"" DiIIIIlil ",~~l\PIl' belore buid-
ing certilicale 01 C1Ccupancv wJII be issued.
w~nr,AI r,1 U ATln~~ RI=OI IIRJ:1l with numb.r ol.UPfIty and relum openings 1!s1ed per
room wilh CfM"s pel opening. New IItruclures or addillons sand 'Ioor plan wllh IUPPIv
and relum Iocalions shown. HEAT LOSS CAlCULATJONS, PAYMENT AND
APPLICATIONS MAY 8E MAILED m THE CITY OF PRIOR LAKE. 18200 EAGLE
CReeK AVE. S.E. PRIOR LAKE. fAN 55372.
Citv Hall tluslness hOUfS are 8 a.m.. 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply 'or a mechanical svslems permit and I acknowledge that the
in'Qrmalion above 15 complele and accu'aI8~ Ihalthe work will ba In confo,mance
with the ordinances and codas 01 Ihe clly and wllh the slale building/mechanical
codes; Ihat Ihls lorm does nol become a permit until signed by the BUILDING
OFFtCIAl: Ihallhe work will be in accoldance with the approved plan In 1he
(j.g work ....ch requl".. .....w .nd .p",.val of plans.
lnIn >-11 ~ . L u_:N1 , . !,t9." qq
11./ A"PI~ ,- / Dfte-
+/Zk /qq
Building OHieal's Signature I Date
RPR.21.1999 12:46PM
GENZ-RYRN
NO. 660
P.3/10
.....~';fib f
~_.~
tGLD . erTY
CITY OP PRIOR ~
SEWER AND WATER PERMIT
NOTE:
NO. qt?-3/L
Sewer apa Water
contractors m~st
be registered
with the city.
APPLICANT: ~- ~
ADDRESS: \4"lL\6 ':; _ t ~ O€..R,..+ J r I
SIGNATURE~'-f1'V' ~ BLDG. PERMIT # CJ9-3/2...
SITE: ACCRE:Ss:~Cfl...a~fJr\'np. ~ OJR NWPID# 25'-357'" oz.S"~o
....J
FILL IN THE BLANKS
401
PHONE :_L4 'd.~-Il L/ 4
OA TE: 4 l Q' J C\ Cl
1.
Estimated length of water service
III
Size of water service inch(es).
feet.
2 .
J. Location of any couplings from structure
feet.
4.
Type of sewer pipe. ASS PVC)( Cast Iron
I '^'
Estimated length of sewer line ~~ feet.
5.
6_ Clean out (if required), loeated at
structure.
.feet
from
==--=~~-========_;~====~=~~a=~~=~======~=~~~===================_~=
This application becomes your permit when approved.
8Y
D~TE:
========-~=~~=======~~-_..._-~~~=========~~==========~~~=========
FEES:
$
$
S
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* ree 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 building permit card at the time of issuance
to insure that no duplicate sewer ana water permits are
issued.
PAID WITH
OATE PAID , BUILDING PEAUQUNT PAID
RECEIPT #
REC'O BY
4629 Dakc[a St 5.E.. P~cr ukQ. ~ir."escta 553i2 I Ph. (6121 44;4230 I Fax (6121 ~74245
RPR.21.1999 12:46PM
GENZ-RYRN
NO. 660
P.2/10"
TlI. C"II'ft' *' ,... LIlia Ca_..,
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: G,~ - R.~ G..r'l .Phone:, ~';;l~- II L) 4-
Addres~ _ 1'-I14F!) Sc ~blf+ Tr'
Signature; ~~ ~~~ ,
Legal Description: Lot ~6 8loclc. ~ SUb~ lunLUcrle.r west
Site Address; ~0CL..5.~ ~U.J\ (\ ~ NW
Building Permit # Q1-.31Z- . _PIP # 25- .3S-I- (J ZS - () .
NOTE; This permit ~i11 net be precessed without complete information.
FIXTURE UNITS
I. .. PO-
1. Galli QIY
3, "t'cII_ Appli_
99-3/2-
#
Quantity Type of Fixture Quantity Type or Fixture
\ Bath Tub with or without shower J 3 Rough.ins
1 Dishwasher ,I I I Water Heater
I Fleor Drain I /<..1 I Water Sonner
~ Lavatory (bathroom sink) ) I Srand Pipe (washing machine)
I I Laundry Tray (1 or 2 compartment sink) I I Sewage Ejector
.,
I I Shower Stall I I 8ackflaw Assembly (IiPZ. Cauble Check. PV13)
I I Sinks I I Sacktlow Assembly Test
I Bar Sink I I Lawn Sprinkler
:l. ,. Water Closet (toilet) I Other
FEE SCHEDULE
Ind~striaJl Commercial & Multi-Family
<1 % of jab CaSt. $39.50 minimum)
Residential. New One & Two Family
Residential. Additions & Alterations
Srate Surcharge
$99.50
$39.50
s
s qq.SO
$
s
.50
GRAND TOTAL
$~OO
This permit is gnnlc:d Qpc3n the express condilion lh:u SOlid
contr:lctor. sh:dl camply in 311 respects with the C1rdin:lnccs
of lhc SI:UC PlurnbinB Code :and lhe m1cndrnc:nLS lhereof.
RECEIPT NO.. DATE
ATTEST
ClIll for :lll inspections 2~ hours in adv:mce.
PAID WITH
BUILDING PER~/JJT
16:00 EJgle CreekAv. S.E.. Prior L:1kc, ~Iinneso(~ 553i2/ Ph. (61~) -I4i-4~30 / FA.X (61~) +';'i4:!~5
.1.. ~...,,~I n.....n....'''' :..... 'I:'.....".I'"',,~.
qq -3fL
Th~ ('enter of thr L8kr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t4-1j 1 lAJrns l/}1ftuJL I-brnts
Lf ~ -q1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3lfD'1 ~VUf bW!t/l (!L.
..J
Accepted
Accepted With Corrections ;>L
Denied
Reviewed By: (liJ/~d
/
Comments:
\ . S~ .J- +)--ee'S. p.e! J.eu~~ p~
'2 . M~~ lA.. ~ ~\ V\.. &~ \'t1h ~~t--erl
3 \ ~e~ oj l Qtt~c.J-Jl&.. ~~
Date: q -is- -"'ley
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."
0(( ~3fL
T"~ (".."If'r of .tw L.k, CO""'F)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
· I .r /it-'
l.-I ';" l/lJt: ( 7 S Ill(1tA. l t
L1 -Ll Li1
. J
ft-ll-tf S
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3l/0q ~L{ll1 b/~{/7 {i L.
.J
Accepted
Denied
/
Accepted With Corrections
Reviewed By: ;,J"'LTE:1t. E'wlt.~"5~1
Date:
I I
4/1 ~ I r,
I
Comments: R/JAlnt=t= t!:1u.s...-r 8&:
Ce,v.JE.Yro 70 ,J:f",,/'} /lLaA1(. Dtttj,"'t4t:J:
A 1J('} VTIf-lrV EAl;E..rt1EjJr<::, ~'\ ~ As 'P~Ac.TI('''''- _
sa: INfi,tt.~t4ntlN 0,,", ~E. K~ut=LsfE sIl1f-
.SE"F AT'T'r.K"'MEJJT;S: ,. n~Al..-CR.46E' LNSPeCTlDtJ LYF..ttIlt4~ 7. ~"'0IA.l(:, P'-ItA.1
3. f:"R4S\O.v c.i\JTttQL Ml04svru:s
t.J. ~O~"JAJ eON17l.o l.- .;{IIAJ
"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."
.~~ Vlrt" ('....
,~"
c - .....
-",;'
The- ('enler of the- Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
. /. ,
"'"'r-"f::r:"",:,~__ \ I"
<1::::::-:;: ---t. \ \/.
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J ~ J -I
'i( (,
I
f,... ::,: i ,. /)
I
:, { I
c.
Reviewed By:
v
~
~~~
Accepted With Corrections
Accepted
Denied
Date:
L{ -{ L(~~c,
Comments:
"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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CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. qq - 3/2-
Prior Lake, MN 55372
TYPE OF STRUCTURI;
I Mot
1 limrn
), Yellow
File
Cill
C......
Single Family
_ Two-Family
Induslrial
Multi-Family
Olher
Commercial
Public
R. 2- Fee Schedule
Owner's Name
Address
Heating Gonlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address 2700 N. FAIRVIEW. ROSEVILLE. MN 55113
Telephone # 651- 633- 2 561
FIREPLACE '\.
IWmQIIP Make & Model ~CJ.J- N ~
C;L-, sa--rf2.....-
TYPE OF SYSTEM
Warm Air Planls
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Sleam
Hal Water
Radiation
Special Devices
Model Sizo.
Conn. Load
Fuel NO-k lx"':)Flue Size
Supply Openings
Return Openings
Input
Edr.
Oulpul ~:.) ~ , ("1. ,( '\
- ./ I
Other Devices
Glm.
TYPE OF WORK
~
Alleralions
F1eplacemenl New Construction
Repair,
In-r~4- C1 Y
QQ-3/Z-
Est. Cost $
Esl. Comp. Date
\ l C1''.. ex.) . Building Perm~ It
HEA TING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
(' PAlDWITH
I BUILDING PERMIT
.50
Receiplll
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residenlial, Additions & Alteralions
Residential, AC Only
1"10 01 job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember 10 add the Slale Surcharge on Ihe bollom 01 this application.
The price 01 your healing permit includes one rough-in and one Iinal inspeclion,
Additional inspections will be billed at $35.00 each.
House Healing Test Record musl be submilled with buildir,g PmmilIllHDbm belore lJUikl.
ing certilicale 01 occupancy will be issued.
1:iE.& CALCULATIONS REQUIRED wilh number 01 suppty and relurn openings listed pe
room with CFM's per opening. New structures or additions send lloor plan with s~I...
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CnEEK AVE. S.E. PRIOR LAKE, MN 55372.
Cily Hall business hours are 8 a.m. - 4:30 p.m.
, '
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply lor a mechanical systems permil and I acknowledge that ,1.8
inlormation above is complete and accurale; Ihal the work will be in conrorro.~c
with Ihe ordinances and codes ollhe cily and with Ihe stale building/rnec~ ~l(
corles; that this form does not become a permit until signed by the BUILblN
OFFICIAL; lhal the work will be in accordance wilh the approved plan ir-' (hE
ca9@'\Df all woCk whic/1 requires review and approval of plans.
\ \ ~ ___C"C....4
(}-4 _
- - 0 te
(pI ~ 'Jqq
Building Oflical's Signature Date
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3L/r"A ~1"\1 QeAA Q.r-
NATURE OF WORK Y1-e,A u Qm1~.J1'0d,,-oV\
USE OF BUILDING 3F.4
PERMIT NO. '19 - ~ I Z- DATE ISSUED LI - /5 - ? ~
CONTRACTOR .1.J 9V\~~,^\^ WO'Wt€S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING ~~~-II-\~\t>.~'1-\-'\'\ m:r I 4-.~1~ATE,,~
FOUNDATION (Prior to Backfill) I \1\,).~ I S-S-'c,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING ~ (,-;.v ,
INSULATION t, ,L-. /JJS 7/~ 1/4" :il.8'. / gqf. 7-1(,,-0;'
ELECTRICAL I
PLUMBING kf) r'V.J~/':r I .
HEATING (if required) ( /17 L.t,. 7 /I~ bi
FIREPLACE .~':\\ (Q '$!t 7~7U1 '
GAS LINE AIR TEST Ar,<S) ~ "M-"
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
YJ[,
i. J' i .
1::8 /'\f-
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
loj"b 7 /9?
/I-~3- ~,
~
C(v"
V '/J I I"-~O~
OCCUpy UNTIL ABOVE HA~ BEEN SIGNED
NOTICE
,"')O~q
'-
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
T