HomeMy WebLinkAboutBuilding Permit #99-0315
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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 Oassification
Single Family
Df.:,' Permit No. 99- 315
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District R2 SD
Legal Description. L28, B2, Glynwater First Addition
Owner of Building
CliteAddress 3415 Sprin~ Glen Circle
Contractor'sName&Address Wensmann Homes, 1895 Plaza Dr. ~ ~a~an, Minnesota 55122
,..'~- Robert D. Hutchins A... C'tyPl Jenni Tovar J....
I ...... . {.. .; --l J anner .
~ ~~. ~
\ ':!'''~r Date; / /- ~ ').l!' Date. . . ~
t~:~ .... .....'"""'.-.''"''', ...;-~..=~ :;;~~:S::~:E.~~ . ~7~.~t~ -,".~I
14 ~.:.a.:. ..:a;;.., ..~. ~~.~ .:~. ..,~ .'!A~.~ t ~~ . 'A.. .:;ili:~..~.....~. .'~.~..~, ..~a.... .~"
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- .. ...... ~ -.. ~ - ~ ~ - - ~~ . - ... .. ~ - - ~ - -
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
II '01,"3- 1~
ADDRESS 3 <y / ..s
~~ b~ ~_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9 ~ - 3/5
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TIOfkn
J8 FINAL \CI
o SITE INSPECTION
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 GAS LINE AIR TST
o
COMMENTS:
~~
v
~ C.O~
)f.. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
.'.--.---r
DATE TIME
~~ zwv
..34/5 5P/i!-IA./g G"Ge:1J
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~EWER HOOKUP
LUMBING FINAL
MECH FINAL
99-3/S-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ~ '
- ~ hMJ. r~ ~~~N" j"-. ~
~~ w: ~..(.U .~ I
/;f r(OS""" G,..?r,,( /~~~-
(A} \\O\~ t~ 'S'~'.''''''G Lcl.- ~
lSJ ~\lL ~"V~ ~ C7V' drk,.. l~
. \~ c:o. ~
;;';~\M.~ ~ ~~
tl- I-q,.
-
t 7-r.l c;,~ +~
.
~ . ~~~ <;,~_,J~h? D ~ ~
llWORKSATIS ACTORY, p~~ f~
o CORRECT ACTION AND PROCEED
~RECT , CALL FOR REINSPECTION BEFORE COVERING
(,nspector: Owner/Contr:
CODE RE lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 34IS ~ rr~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION..I^-
f'!:. ~~NAL r rs-
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
r.:1~J PrA
~ ~'Y-/~Q.
U .J
SJ. C-4.- 1vU$
~sl Loor:.t
CJ/;791
TIME
10 =:b
~- 3/5
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
At.u~ p I")\..(~
f
~
~~
~
/
...... ----
----- "
/\
0/U.
<'.' WJ
~
1 - 'lr
I {~
L
o WORK SA TISFACTOR ,
o CORRECT AC
.A:;tORRECT
------/
-
INSNOTl
'S ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
"/19/"
ADDRESS ~ .sPA.1 NG. 6tr" I C rllc. r-&:.
PHONE NO.
CONTR. bJbJ~l4N,.J Utl~1I!:
PERMIT NO. ffJ - .3/~
OWNER
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 GASLINE AIR TST
o
COMMENTS:
(!vtt.BI3o~ OK
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: h~J. ~ '1'~ontr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
'"
.
Job Address -c3Y (~. ~fts)n
) 1;.-- .
Heating Contractor . /'Y jli.1ff/Jf
Name of Tester ~ P ,
Date WHtJ
Percent O2 I f .7
Percent co 0.
tj$
~
Percent C02
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
MIl
9.
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
jy/.s- S /'1'1'/vF
3. LEGAL DESCRIPTION V
LOT ~ Y BLOCK
ADDITION ~ /yN t"..)t:l1f'r
4. OWNER (Name)
C/~N
C ire/!
I. White File
2. Pink City
n1c4oL, AFr(~
Permit No. qq - 3 IS-
qt1-312
1. DATE
~- 7- ??
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
;)..
/ ~r
PID ~j. :J.:r)- ()~I',O
qe;l/J'1',o/V
13. TYPE OF CONSTRUCTION
~Sl- -yot V<j'fJU
(Address)
5. ARCHITECT
(Name)
(Address)
jAddreSS)
if? 5' fl ~2.e;... I)r
E~911/V /1J/V .551;)~
Fireplace a v Septic a Deck a
Alterations a Addition a Finish Attic a
6. BUILDER (Name)
tJ f'NS' ;"~N/V
IJom e l'
7. TYPE OF WORK
New Construction ~
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Re-roofing a Porch a
Re-siding a Finish Basement a
SEATS
16. PROJECT COSTNALUE
f.;1,OlJO ~
17. COMPLETION DATE
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. 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
bUil~fficial can ~ok1iS pe7t for just cause. Furthermore, I hereby agree that the City official or a designee may enter upon the property to pertorm needed inspections.
X ~,;z, ~ .J(""7(,/~ /YSK' Y'-7-99
rI f/ Signature License No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
BUILDING DEPARTMENT VALUATION
USE OF BUILDING ---.:JP1+-
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS a
SPACES REO. PLANS & SPECS a SETS
Actd. 2poO;fur (OJrlU r~ SURVEY a COPIES
SPACES ON PLAN
PERMIT VALUATION ~~ .1')(')0 ,0 d PLOT PLAN a I
TYPE OF CONSTRUCTION: I II III IV GV
Occupancy Group A B E F HIM tV S U
Division 1 2 (!) 4
Permit Fee ................................... $
City:
Plan Check Fee ................. ............ $
8~1. 7~
55::l. 'Y\
4.~ .~O
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $ I D{) . (')(j
Mechanical Permit Fee ..................... $ 1m .C)O
Sewer & Water Permit ...................... $ 35'. '50
Gas Fireplace Permit ....................... $ (to .00
This ~~ecomes ~L 'r Building Permit VIP_en &1~ro~d.
By ~ -y-- (;1\ Date Lf' L) . '1!
Certificate of Occupancy
\ ~ J;\f\
~1
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
~.. $
Pressure Reducer ..~...................... $
Meter Hom .... ................................. $
Water Meter .~............................ $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
~~,oo
10'E>0 ,O~
4S.00
~Jt15.0~
I. ;]"O.c:>O
. "nO .eJo
Water Tap ................................... $
Builder's Deposit............................ $
Other ......................................... $
Total Due .............................. $5hti'-/. ,~'t
Paid "5t,9t..!. 5"'7 Receipt No. ?E:"SZ> 7~
Issued ., J
Date .q -,lfc -q f By .
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
Sign~y City lanner constitutes a temporary Certificate of Zoni~. ~ccompliance and allows construction to commence. Before occupancy, a Certilicate of Occupancy must be issued.
. Jdd~-~
Planner Date Special Conditions d any
24 hour notice for all inspections 447-9850
T
0/(-3/5
Tho C..I.. 01 I"" 1.IIb CO..lry
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
mnL.DING PERMIT APPLICATION DEPARTMENT CHECKLIST
Lt~ I. t~l YluJ{ CL f{6Jlt.l S
(j -q -11
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for,construction activity which is proposed at:
?) I/'S 5, ltlt'tel (") It' (/) (~L-.
,r j
Accepted
/
Accepted With Corrections
Denied
Reviewed By: jJALJt(l ts.fI/Fst'ff4NI\J Date: l.f-.iJ(~/??
Comments: SLE. EIJIL1)IA1b ff:-~tffrr :IF 99- 31Z I ~"'01 ~If/AJt. (;I..G..-J ('1,R.. )
.. -'
Eil; C'=.'f&1 "1.:AJT.5
IAI Fo~ "fA7iol\l
I
f 1/-rnqlJ/1f1E.ur...
"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.""-,
/-~ .-n;l":~'--'. ;--~~-:~'1- .--: . '<;-:~0ii1:~'t."';;:,~t:;;
/',/1
I
Th. ('.nl.r of Ih. Llk. Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\ ! Vi f f (t
,
,
....
I
{ il/ "
/;/f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
f i
~~
, I ( . i
j
I /
t..,
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
/~_t~~~
Date:
l-(-I L{ - q1
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."
qq-3(~
Th~ {'rn.fr of the Like Country
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
lA}e VlSYvLa~LK.. fhrws
L( -q 41
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3L/ 15 5/YlJyzy1 {0/el/l t!i.-
,
_____I
Accepted
Accepted With Corrections
~
Denied ,/'j
Reviewed BY:(& &
-~:k:..
~
Date: LI-/~ -77
Comments:
\, ~eQ ~p~ cr4-3\2
+;;, Q\()....As. . SQQ,C9., S 0 r~~ j etc L'
( i, {) ,
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
..' -, .,,^, "T.--.....----..' ..----- --^, .........,----...,--.-,---.-----.
~ CITY OF PRIOR LAKE
~ 1&200EIo'eC....kAv. S.E. Porm"No. QC;-315
.. Prior Lake, UN 55372
HEAllNG APPLlCAnON I PERMIT
lie ~ I~I J qq PID, 20- 35/- Oz.g-O
8 Add,ess ~L} i~ Sc JU..fin. ()., \ a n m 1\)w
I ..:<~ Block ~ ~d~Jtlon, ~~ \J,n U) ():i lJL wes-l-
vn....Nllm.. u)~~rnQnn \--\n meS
')1Qf) r-pl~ fdR. ~o..ao.n
.lIno Conlte.cto,. Q,JJ..YV2.. - r:< u o...n U
dr.u, 147Lf~ S"- ~W+ 'Tr /
,.phon.., 4Q?'- l/Y4
mace Make I Mod,1 ,k D J'\J1 n\[.
Ide' SIz8 O:.r;p.(;)~J~ - '16
- ,.
'dress
"n.load
81 N ~ , P;~~FIu8 SI18 4-11
PP'v Opening. , '1
tum Opening. 4
",tl ~~a:n Outpu,.f ~, Cf"C)
r.
n.
lY'E OF SYSTEM
Warm AIr Plan's
Grawky ,
Mechanical ...---
Af, CoIKf.bnlng
Vent. System ,
HEAliNG OR POWER PLANT
Slum
HOI Waler
Radfatlon
Speda' Devices
Olha, D.v1c.es
irallonl
TYPE OF WORK
New Colls1(uctioR "....---
pall
. Co5' S
Replacement
E$1. Camp, Dale
Building Permit "
qq. SO
AnNO PERMIT fEE $
~TE SURCHARGE $ ,50
~AlPERMITFEES $ J(X)r 00
qq"3/5
PAID WITH
BUILDING PERMIT
Receipt II .
rYPE OF STRUCTURE
L .....
1. tire
J. Yd...
1'iIII
aIr
CcIllrKloDr
Slngle Family
Commercial
v/
D
-0
;0
N
I-'-
lWo-Famlltf
UuYtl-Famllv
Indu slrjal.
Public.
'Olher.
I-'-
U)
U)
U)
Fee Schlldule
Induslrial. Commercial & MullI-Famllv
Aesldenflat. Heating & AC
Residantial, Healing Onlv
Residential, Gas Fireplace
Resldenllal. Adlflfiona & Allorations
Resldenlial, AC OnlV
I-'-
1% of Job oos' ($39.50 mlnlmlJnll
$99.50
$64.50
'39.50
139.50
$39.50
I-'-
CSJ
-0
3:
(j)
1"'1
Z
N
I
;0
-< -
D
Z
Remember to add the Slale Surcharge on th~ ball om of this applica1lon.
The price 0' your heating permillncludes 01\8 rough-In and onlt final Inspection.
Additional inspections will be billed al US.OD each.
House He.Ung Tut Reoord musl be submlnect wllh 'vtl'cilnl'l "'II', ,.,11 nIJl!!lJ\"" belore buDd-
Ing teltmcal. 01 occupancV..,;;11 be issued.
ur::aT r.41r,1" ATlnN~ RI=(ll IIRr::O with number o'liupplV and le1urn opanll\gS Il&led per
room wilh CFU'. per oP81\109. New sl,uclural or .ddillons send Iloor pJan with ItJpplv
Bnd relum locallon..hown. HEAT lOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAilED TO THE CITY OF PAIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall business hoUl'$ are 8 8.m, . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CRY HALL
447-4230
I htlrebv applv for" mechanical 6vslems pe,mfl and I acJcnowredge that 'he
in101matlolt above is campisi. and accurate; that the work wIll be In cOllform.nce
wilh Ihe ar.dinanc8~ and codes of 1hlt cltv end wl1h lhe slate building/mechanic..
code.s~ Ihal Ihls lorm doe& nol become a permll unlit signed by the BUJLDINa
OFFICIAL; thai 'he work will be In -accordance wllh the approved p'an in the
0:; ~.n~~pp.ovso DI ;s~ 1/ qq
~ ()' Appllcanl's Signature - Date .
z
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Building Omeal'. Signalure
Dale
APR.21.1999 1:09PM
GENZ-RYAN
P. 1/10'-
NO. 666
CITY OF PRIOR LAKE
PLUMBING PERMIT , ~ - 315
Applicant G,~ - ~ Q..n ,Phon.: 4~~- I '~4
Address:_ 1~/4? ~ ~~+ J(-I .
Signature; ?1\.4"'1'1..('\ ~~o...ru
Legal DeScription; Lot .:l~ Block ~ _SLlb~ ll.Jl'lwo.te.r W~5t
Site Address: ~4 J 5 ~_~~.n (' ~ '" IJ..) ,
Building Permit # 9q -3/..5" prD#. zs- 3S/-0ze-t:)
NOTE: This permit ~i11 net be proc;essed without complete information,
FIXTURE UNITS
I. ..
'- CilIcI
3. \'cIJa",
11I1-
Chy
App/ICUlI
TIl, c:...lrr ., ,... 'LDIte C.M~'...
Quantity Type of Fixture Ouantity I TY!:le of Fixture
\ 8ath Tub with or without shower 3 I Rough-ins
I I Dishwasher I , Water Heater
I I Floor Drain i<-I I Water Softner
d-, .1 Lavatory (bathroom sink) I , Stand Pipe (washing machine)
I I Laundry Tray (1 or 2 compartment sink) I Sewage Ejector
I , Shower Stall I BaclcflQw Assembly (RPZ. Double Check. PVB)
I I Sinks I Baclcfrow Assembly Test
!
Bar Sinl< I Lawn Sprinkler
~ Water Closer (teile!) I Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum) S
Residenrial, New One & Two Family S99.50 S qq,so
Residential, Additions & Alterations 539.50 S
Stare Sl.lrcharge S .50
GRAND TOTAL $ 100.00
This permit is ~tcd upon the express condition IhOlt SOlid
contr:ll:tor, sh:lll camply in :all respects with Ihe ordinilnces
of the 51:11<<: Plumbing Code :znd the: :amendments thereof.
RECEIPT NO. DATE
,AI I!:,) I
PAID WITH
, BUILDING PE;"IT
C311 for 311 inspections 2~ hours in advance,
16=00 E:l~le Creek Av. S.E.. Prior L.1ke, ~linnL':so[a 553i2 / Ph. (612) ..J..;.74~30 I FA..~ (~12) ~i-424.5
- .
.~~ 1='!"1l:!1 n",.n",,"i,.: J:~nln\ll"-
APR.21.1999 1:09PM
GENZ-RYAN
NO. 666
P.2/10
_. ....
.....LIlI. . ~
GaLlI. QTY
CITY OF PRIOR LAKE NO. qq,., 3/ S
SEWER AND WATER PERMIT
NOTE: Sewer a~d Water
contractors must
be reqistered
with the City.
APPLICANT: ~- ~
ADDRESS: \4,L\? S_t~oe..R...+Trl
SIGNATURE~~ ~ BLDG. PERMIT '# QQ"'3IS
SITE ADDRESS: -3L115 '?-,9r\"",Cj ~ \ €.fl 0; R NWPID# 2.5- 3S'J -oU3 -0
FILL IN THE BLANKS
40J
PHONE: L..l ~~-IILJ 4
DATE: 4l Q.\ J q ~
1.
Estimated length of water service
II/
Size of water service inchCes).
feet.
2.
J. Location of any couplinqs from structure
feet.
4 .
Type of sewer pipe, ASS PVC )L
1\ ^. I
Estimated length of sewer line ~l~
Cast Iron
5.
feet.
6. Clean Qut eif required), located at
structure.
feet
from
=.===========-~~=====g=~======N~===================_~========~~~:=
This ap~lication beco~es your permit when approved.
BY
DATE:
======~~~~======~~~-===-~==========~=~=================-~~~=======
F!ES:
$
$
$
35.00
.50
35.50
Sewer and vater line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharqe.
* Sewer and water permits issued for new construction must be
recorded on the buildini permit card at the time of issuanoe
to insure that no dupl1cate sewer and water permits are
issued. PAID WITH
I. BUILDING PERMIT
DA~E PAID AMOUNT PAID
RECEIPT #
REC'O BY
4629 Dakota Sf. SE.. P:'!or Lake. ~innescta 553i2 I Ph. {6121 44i4230 I Fa.~ (612\ 44742%
s-
TC
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Parmi! No. 99 r 3 /S-
Prior Lake, MN 55372 . ,
HEATING APPLICATION I PERMIT
Dale R~'-7tf PID" 25 ~.35/- 028 - 0
Sile Address ~~) c~ I~'.A 66. ... GA.J.- IC 25D
lOI 28 Block Z Addilion {/ Ga /1/ /11I,4 ~R.... W 6-ST
tJ~
Owner's Name
Address. 2 7 00 N, FA I R V I EW ,
Telephone #. 651- 6 3 3 - 2561
FIREPLACE
IWmtIlIP Make & Modlll J-I-tl.b./ JJ (;(..:,
,d'- 730
Model Sil~
Conn. Load
Fuel
Flue Size
TYPE OF SYSTEM
Warm Air Planls
Gravily
Mechanical
Air Condilioning
Vent. Syslem
HEATING OR POWER PLANT
Sleam
Hol Waler
Radialion
Special Devices ,
Supply Openings
Return Openings
Input Oulput_ d 3, 00)
Edr.
Clm.
Al1eralions
I
Repair
Esl. Cosl $
E
iii
Other Devices
TYPE OF WORK
Replacemenl New Conslruction
)c
Est. Comp. Date . .f".q- 99
/ IOJ.LJJ Building Permit" CJ9 -3 10
HEATING PERMIT FEE $.
STATE SURCHARGE S.
TOTAL PERMIT FEES $
,50
/ p~\O \N\1'\-\
R.C.~\\.O\NG PEf\l>A11
JYPE OF STAUCTURI;
I. Pink
2. G'ttn
l Ydlow
)>
c:
File 10
Cily I
Conlroe" 0
~
I
\D
\D
o
en
Single Family
Commercial
, Two.Family
Induslrial
Public
Mulli-Family
Olher,
Fee Schedule
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Induslrial, Commercial & Mulli-Family
Residential, Healing & AC
Residential, Healing Only
Residential, Gas Fireplace
Residenlial, Additions & Allerations
Residential, AC Only
, 'Y. o' job cosl ($39.50 minimum)
$99,50
$64.50
$39.50
$39.50
S39.50
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Remember 10 add the Slale Surcharge on Ihe boll om 01 Ihis epplicalion.
The price 01 your healing permit includes one rough-in and one linal inspeclion,
Additional inspections will be billed al $35.00 each.
House Healing Tesl Record must be submitted with buildina nf'!rmi' number belole builc
ing certilicate 01 occupancy will be issued.
HEAr CALCULATIONS REQUIRED wilh number o. supplV end relum openings lisled J
room wilh CFM's per opening. New slruclures or addilions send floor plan wilh supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND en
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE ~
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
Cily Hall business hours are 8 a.m. - 4:30 p.m.
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All WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
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I hereby apply lor a mechanical syslems permit and I acknowledge thatlhe ~
inlormalion above is complele and accurale; Ihal Ihe work will be in con'ormancE
wilh Ihe ordinances and codes d. Ihe cily and wilh Ihe slale building/mechanicl
codes; thallhis lorm does not become a permit until signed by Ihe BUILDIN(
OFFICIAL; Ihallhe work will be in accordance with Ihe approved plan in Ihe
case 01 all work which requires review and approval of plans.
447--4230
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Building ONical's Signalure
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PRIOR LAKE
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INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3L1 \~ Sp\\ \Ac..., ~\~ .k~ ('Y.
NATURE OF WORK N6-J Cp1A-SSlhk1-~~,,-' -
USE OF BUILDING S r=/Ct
PERMIT NO. qq - 3~ S- DATE ISSUED tj -15 -19
CONTRACTOR lA.\eAA.c..I6.^-~lA-. l~ 5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING ~ I L/-;).7-Cffl
FOUNDATION (Prior to Backfill) I \J -5. I S--04.~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
SEWER I WATER I SEPTIC
FRAMING ../-tt--, ~ _ .,hAq (/f) i'/JI /1'1
INSULATION ~/,//',~ (fp L?P elt3/', V
ELECTRICAL v V
PLUMBING .f1 /gJ~/"''j
HEATING (if required) ( ;7
FIREPLACE tJD ~.\,.
GAS LINE AIR TEST ~~ -6qf ? - '7 --lj
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS I.
IN'~ (III q.f If 1
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OCCUPY UNTIL ABOV: HAS BEEN .iIGNED
NOTICE
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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