HomeMy WebLinkAboutBuilding Permit 99-0320
DATE TIME
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
#1/ 'If
,'?: 00 PI"1
ADDRESS Jr..JtJJ!) 13,.u~tJ.,1l..b MJ01L
OWNER
CONTR. tfln71!tJTIf~r lItDTUFns'
PHONE NO.
PERMIT NO.
91- lZt:>
~ EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
"~AOE IS I1rf~gLE..
(! ull g~ IS t1Pfft..4rIt'MJ At-.
I1A'JJTt4'Al SUI thJ:.f VA./1"IC- 'S:U> 1$ E'S71:I(JLl~HEf)
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:!J ~~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
->~ ~";"'k.~""~""W!;o-' "t-'-""';.
':~"'''''''''I' "'-~",~~~4t;;'.p' "c4,jF"~""",~_,'"
BVftNt!!J.,.ILLE
Heating & Air Conditioning, Inc.
12481 Rhode Island Ave. So., Savage, MN 55178 . 894.000$
Ors1at Test Report for JoW J~ cy 7/-.
Address /-y" ~ A '~'''j~City ~ ;.~ l,o.c..,..
Occupant M',.(}/,.. ~
Date of Install 'i5 * ::z 7 ~ 40
Type of HT. F/A ~HW I Space HT Unit HT
-Other
-""
Make _/<K 'fA d'\'
Model ~:5k'Ail6 '/d ~ y I
Serial ~ ~ i .a U,.:SCf l
Input ~$ 00 0
,
Pilot Type Cf / I'J oJ
Pressure ' . :i. r:
m~&f.FH ~ )f
Stack Temp ~ g:)'
Date Tested
Company
Name ofT ester
C02 8..J
02 ~
CO 0
f<. V -,(:1'"1
.8 /I[l:f): L;'>~f~,
C/w7
1
- .
~ 3:30
/4--030 BLU613/k!.D
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
/I.. 0 SEWER HOOKUP
r X PLUMBING FINAL
o MECH FINAL
~MMENTS:
C~)G~\Nt- ~~
f uJ.L VLw~
(')
f ~ A11J
DATE TIME
f9-:32-0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/.
/ I
o ~K SATISF ! T
/CORRECT AC ,'a :'A
o CORRECT WO FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUI~TSARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
. .
SCHEDULED
DATE TIME
~
4:00
ADDRESS
/Q{)30 BLUEL3/eo //c-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
~OMMENTS:
k) E-n,s ~ e1Y"
/yfj ~
~~
~ ~ ~ ~~Y\.eCr;'~~
_SO~ 0J -tYU~ J
V ~ 11A2~^ ~
hM~ -~~ r~J.O
( ~) ~-\. ~ ~'~(..J,^-~
tj,( M& 2- ~ ~ 4./f- lher ae-__
(to) &drJ J1u.jJ. Mt-CVfJn,~ ~- hdl
~~ flU
~ .-
..~ L.,O..
o WO~SFA" I UK'. .""...Q
OWNER
PHONE NO.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
XMECH FINAL
~
~tr uX-
~\~
9t1 -320
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~,~
-
--
10,. f-Gff J
~
~RRECT A
~ CORRECT ,CA L FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL J7-9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/1/3/17
, I
A.T_
ADDRESS
/40.3e 13 C U 68 I RLJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Cjt;- 32 0
.6 ~X/GRAD/FILLING
f1 0 COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
Jiif ~()Q/..7-e.-6-G5
G
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o P FINAL
COMMEN
~
a~ .f'I_
k~(&"r
.
rtvrc-f--
/
// ~I a
~RK SATISFACTORY, PROCEED Y"I ~
o CORRECT. TION AND PROCEED
o CORREC r ,K, CA L FOR REINSPECTION BEFORE COVERING
,
Inspector: I Owner/Contr:
CAl ~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'-'
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT (In -3-/7"\
Permit No. - n Ll)
APR 1 2 1999
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.SITEADDREi~03o 13!utiJ;~ -M tVB
3. LEGAL DESCRIPTION
LOT ~ BLOCK::J --
A~ jj, II ;:JJL-l. - II UJton:
~ame)
1. While
2. Pink
3. Yellow
File
City
Applicant
1. DATE
tj/~J~9
'.~I
(Tel. No.)
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height)."V . (Width)
'-.. 110
12. NO. OF STORIES
1..
13. TYPE OF CONSTRUCTION
(::JlJ(,I.L fA>>.,,- 't" ~~
14. FLOOR AREA APPORTIONMENT USE
, 'if t;1
(Depth) "/2'
PI~:J.5 -3Lf?1 - () I~-o
ADDITION
4. OWNER
(Address)
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUIL907Jt.-J.J., iNape) /J ~ -h /')(Ad~~ss) ?-'I~S- 'It, ~ ~jflel. No.) / _,,/ 15. NUMBER OF OCCUPANTS OR SEATS
/'lJll-et.fr~' .l)A~LdnfT -rP!'~.iA r...>!f>>.2-I?2i. OCCUPANTS ~
7. TYPE OF WORK. Fireplace 0 Septic 0 Heating"::' Plumbin~ Reroofingo Porch 0 SEATS
New constructio~ Alterations 0 Addition 0 Finish Attic 0 Residing 0 Finish Basement 0 16. ESTIMATED VALUE ,
Chimney 0 Misc. .., I '-I1~
B. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. 2 '3 ~g 0 Width-;f:' Depth /"':1, I Yes Q;) ~/q r;
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 0 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
building 0 lal ca revoke this permit for Just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform n~~ fspections.
X A _ / ~ . - 141t;~ '//ltl;j<;
- Signature Ucense No. Oate
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
:il--D
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
I q'1 t"Y"Jn. C) 0
.'
o
Meter Hom ...................... ............. $
Water Meter ...I.~I........................... $ ~~ e:;-o .f"') C-
D Sewer & Water Connection Fee ........... $--L1 ;;t (') r') . (') C-
D WaterTowerFee ........................... $ ~ ()rJ. U.C
Water Tap ................................... $ .
Builder's Deposit ............................ $ I, J-., C/() . ei::
I
Other ......................................... $ - ~ L-L---
Total Due .............................. $ I i"1 (
Paid ,"7t:f6.z...-Z- ReceiptNo. ~<--16 os-
Date 4/Z'i/tf't By ~
This is to certify that the request in the above application and eccompanying documents is in accordance with the City Zoning drdinar<ce a~ may proceed ;& requested. This document when
sig~']'\er ~=:mporary Ce1t;il: :~Pliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~~ g'ner Date Special Conditions ~ any
24 Hour notice for all inspections 447-42309:00 a.m. '10:00 a.m.
TYPE OF CONSTRUCTION: I II III IV V
City:
Occupancy Group A BEl H R M
Division 1 2 3 4
Permit Fee ................................... $
I. I 3'd. . '2.S-
7 35. ~ 7
74 . so
I on .(JO
lot) ,00
sS.~_
,~~~~
V,(\
.~
.::::: Check if
Deferred
Plan Checking Fee ......................... $
State surchar~e ............................. $
;'- ":..T..?,\~....................... $
S~...j-+tJ.............. $
QheI-.....~~~...................... $
Subtotal............................... $
Thi~~"omes --2-ur Building Permit When Approved.
B~'_~ Date f/-/~-fj
Certificate of Occur%cy - -
Issued
PLOT PLAN
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Ucense Check Fee ......................... $
Pressure Reducer ..J..'.I.................... $
~_q). I"\f''')
I () e:;-o .1\("")
70.en
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: /A//,;ht Ph/?7/. /~~(/
Address: ~Y~///'/t1/J' ///L
Signature: /~/7~A .~/?/7Jd
Legal Description: Lot 4- Block:2.. Sub MA PlA5 HilA." 2ND
Site Address: /"'?/i2_~tJ A///t:?h~d _ h ,e., /
Building Permit # qq-.:3Z0 PID # 2.S-.34-..:~ - ()/3- 0
NOTE: This permit will not be processed without complete information.
1. Blue
2. Gold
3. Yellow
File
City
Applicant
#
QQ-32.0
Phone:
The Cenler of the Like Counlry
FIXTURE UNITS
Quantity
Type of Fixture
Quantity
Type of Fixture
Dishwasher
3
/
7
(
.'~
J
,
J
I
s
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Bath Tub with or without shower
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
~~\O :~~t-A\1
\-eu~\N
$
$
$ .50
GRAND TOTAL $
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
OfthOSt~~~~h7q~~~
Call for all mspections 24 hours in advance.
16200 Eagle Creek Av. S.B., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
'r-
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
qC;,3?1)
HEATING APPLICATION I PERMIT
~~ 5'"-qq PID # .2S-;:;;c.t3 - 013-0
Site Address \ l.\ (53/:) ~\\ll 'r-x-& '\\tX\\ f9 -,5: Ie /
Lot 4- Block :z. Addition /'1APL6 #1'--'0 Z~ /lOON.
Owner's Name ~\~\~~oAA- Bc~
Address dv\~c;- 0.\.0 ~ S"\ E . 1J\.~ rnl~_ ~ h\f
. , \J
Heating Contractor ~tji~\J ~~(V1 \ A-1 L
.; .
Address \ ~t.\ ~\ ~~&- 'I..4-VlrvI fa Nnl!..L ~
Telephone # LtllA---rctLt-OOD~
Furnace Make. & Mode,~f?n JIi ~
-=::3~~d-O~'
Model Size C\ \ ; oa:>
Date
Conn. Load
Fuel CYt't)rQ \
Flue Size
Supply Openings
q
L\
Return Openings
Input Q \ . tv:i:L- Output II. ()CX)
-. ,
Edr.
Cfm.
.1. rink
2. Grttn
J. Yellow
rile
City
Contractor
TYPE OF STRUCTURE
i Ltqlto
Public
Multi-Family
Other
Single Family
x
Two-Family
Industrial
1"10 of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember to add the Stale Surcharge on the bollom of this application.
TYPE OF SYSTEM
Warm Air Plants
Gravity Additional inspections will be billed at $35.00 each.
M.echani~~1 , J House Heating Test Record must be submilled with bl.Iik!1ml oermit number before build-
Air Condlllomng -Bru tir'\;- ~~. cJ!O ing certilicate 01 occupancy will be issued. .
Vent. System ' , ~-~
I::lEN ~P.LCUI.ATIONS 11EQUIREQ with number of supply and return openings listed per
HEATING OR POWER PLANT room with CFM's per opening. New structures or additions send floor plan with supply
St@am and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E, PRIOR LAKE, MN 55372.
Special Devices M A- htr.WNio.....
. Con'4.T. ". ~ ..
Other Devices
Alterations
Replacement
TYPE OF WORK
New Construction
x
Est. Cost $
Est. Compo Date
Building Permit #
CJt!j-3ZCJ
Repair
HEATING PERMIT FEE $
~T A TE SURCHARGE $
TOTAL PERMIT FEES $
-----
PAID WITH ~, '1
.50 l BUILDING PERMIT
Receipt #
Commercial
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
The price of your heating permit includes one rough-in and one final inspection.
City Hall business hours 'lre 8 a.m. - 4:30 p.m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447.4230
I hereby apply for a mechanical systems permit and I acknowledge that the
inlormation above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case 01 all work which requires review and approval of plans.
~s&
Building Offical's Signature
Date
~~7/t:p9
, Ddte
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. P9rmi\ No. CJ9 - 320
Prior Lake, M N 55372
HEATING APPLICATION I PERMIT
Dalo ~""1A 5'"-'lq PIO # 25~3'-1-3 ~OI3-0
Site Address \ \.\ C53IJ ~\\U ~& ~\\ 1Sl,(5: ,e I
lot 4 Block 2- Addition H/1PL,E /-IICC- 2/VO /iOD/v'
Owner's Namo '{'("'\...\~\~~o!--\- ~~
f\ddrus dJ\~ S- ~ \.0 >e, S, E . L.s\~^- (~,~. tin htf
~ u
Healing Contraclor €S5 (j \ \ ~ ~ >t-, ~ \, A1 L
Address \Ck\.\ ~\ \fL~&. T-~\tlryi fb~\L. ~
Telephone fI -LIJ l~-fGt+-ooD s"
Furnace Make & Mode,.J~rvfi.tJ-
~~KA-\JD~~O~
Model Size ~ \ . A C')O
. -
Est Compo Oale
Building Permil #I. 99 - 3~
r-"PAID WITH
.50 lBUILDING PERMIT
Conn. load
Fuel Nt\ ktl \
Flue Size
Supply Op9nrngs
q
y
OUlpul {1, ()DD
Relurn Openings
Inpul q \ : f:'M
Edr,
Clm.
TYPE OF WORK
Alto rations
R9placement
Ropair
Est Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
TYPE Of SYSTEM
Warm Air Plants
Gravily AdtJ1li{]nal ins~ctions will be billed al $35.00 each.
M.echanj~'. .B J. House Healmg Test Record must ba submill(l{j with buildino oermit number belora build-
Air ConditIOning ru (r\"\- 'S'Lat~ t1'.rO iog cer1ilicale of occupancy win be issued. .
Venl. System ' / ~-~
HEAT CALCULATIONS nEQVIRl;Q with number of supply and re1urn openinys lis led per
room wi1h CFM's per openiny. New slructures or addilions send !loar plan with supply
and return localions s"own. 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.
HEA TlNG OR POWER PLANT
Steam
Hol Waler
Radialion
SpecialOevices M A- (3rr WNfO\..
lon'~T. '\,-S-r
Other D9vices
New Conslruclion
x
Receipl #
TYPE OF STRUCTURE
l. rink
2. r,.....
). Y<1low
:::3:
:I>
-<
I
N
lTl
I
co
CO
-:l
C
[T]
Hie
Cily
CDflln~...
i 4 ql to
Single Famify
Commercial
x
Mum-Family _
Other
Two.Family
Induslrial
Public
.t:>
Fee Schedu!s
N
Induslrfal, Commercial & MuUi-Family
Residential, Healing & AC
Residential, Kealiflg Only
Aesidenlial, Gas Fireplace
ResidenliaJ, Additions & Alterations
Residenlial, AC Only
1% 01 job cost {$39.50 minimum)
$99.50
$64.50
$39.50
$J9J){)
$39.50
CD
C
;;0
:z:
Ul
<:
......
r-
r- -
[T]
::c
[T]
:I>
-:l
......
:z:
p
Remember 10 add Ihe Slale Surcharge on the bollom ollhis appolicalion.
The price 01 your healing permit includes ona rough-in and one rinal inspection.
""Tl
:I>
:x:
:z:
9
Cily Hall business hours are B a.m. - 4:30 p.m.
CD
-
N
cc
co
.t:>
CI
co
N
<.T1
ALL WORK MUST BE INSPECTED (ROUGH-IN AND ANAL) - CALL CITY HALL
447.42.30
I heretty apply lor a mechanical systems permit and I acknowledge that the
information above is complete and accurate; thai the work will be in conlormance
wHh the ordinances Bnd codes of the city and with the stale building/mechanical
codes; that lhis form does nol become a permit unlll signed by the BUfLDlNG
OFFICIAL; lhalthe work wHl be in accordance wilh the approved plan in the
case 01 all work which requires review and approval or plans.
-0
CI
-
4J:;f.Si"" . ..
. BundinQ orr~al's sidilBlUr9 .
Dale
5/zfc,/qc}
, Da(a '
05/03/99 MON 12:38 FAX
141 002
QftI!. - I'tIL:8
n:u.ow - AI'9'\.lCAJIT
c;oLD - r:rr'f
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. QQ-320
",
NOTE: Sewer and Wa~er
contractors must
be registered
with the City.
APPLICANT: D4) Me.chanical/Stocker Excava~ing
,PHONE:
890-4241
ADDRESS: 8247 Ji~st 125rh St.. savage. MN 55378 DATE: 4-30-99
SIGNATURE: LJ~ /;I;,(~~;:; BLDG. PERMIT # QQ-3Z0
SITE ADDRESS: I 14030 Bl.uebird Trail PID#: 25-34-3- 0/'3-0
FILL IN THE BLANKS
1. Estimated lenqth of yater service
feet-.
2_ size of water service
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of se~er pipe. ABS
PVC y
Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
~~*====---===~====~~==~====---~=~~~:~---=---===~==~~~----====~~~~
::is app~* permit ::::, appr;hh9
--
~~~---~=~~~~~~~~~~==~--~-----~~--~===~~~=======----------~---==
FEES:
s
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* 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 building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. ~
DATE PAID /~~~(( AMOUNT PAID
RECEIPT # \~O~ REC'O BY ~
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 4474245
An. Equal Opportunity Employer
qq - 32:0
Th. C'R'.r or th. Lab COURlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT AfPI.ICATION DEPARTMENT CHECKLISt
NAME OF APPLICANT }llrfh: (,..,t<::(C( f r)\():). tC'11 (~{ If) (
APPLICATION RECEIVED ll- 12 -1cl
Q
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: .
It fO 30 &:w. t.li~'l ci IK rJ L
",
Accepted
./
Accepted With Corrections
Denied
Reviewed By:
. ,
J.VI!IL~
,-
CHltc;".."t1.vl'ol
Date:
I I
Wzz..jf't
) .
Comments: .i?uAJoFF Mc/sr iIe a<JAJvCycl)
r(') ANl':J ~'-<JAJr~ DIf~(A./A(,E:
..&Lb 11T'l-IT't Ei'kEME'~ t'< (l<{rJcH If!.
~LTt('1{L. ,
SEE INFo~~,q."o,.J
0,.,) RC.JEA5.f
SIbf;'...
2{f: A1'TAC.H"lENTs.', I. Fii'Jt1L. (!"'AO~ 'A,)~T'O,j INF'o~"''''nDI\J
Z ' (;{{ .'UW,I t..
PLA4U
3. EIi!.D.s,'h.l CONT4.oI)L.. MEASc.lltE'S
1. LRQS'bAJ (?....uT"-Oc.... RAw
"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. Pennits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
; I
,..- I
..1.. , .".,.....
-'<!"o-.'- --"".t-L
(
('l
~'I.."./
Th. C.nl.. of lh. Llk. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTM~NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.;-
I
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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Accepted
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Accepted With Corrections
Denied
Reviewed By:
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Date:
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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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Thr Crnlr' of lhr Lab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT M~+fe.l~kd + tSr()S. ~OVtS+ ]Y1C.
APPLICATION RECEIVED L( -(2 -qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/L{030 ~{QJAOL V. vJL
Accepted
Accepted With Corrections
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Denied
Reviewed By: () OfL;A J
Comments:
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Date:
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3.
"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."
...__._~.._...~4'..__~ I
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /4030 bl~'l-& \te&.i\
NATURE OF WORK new ~~~t-uct'M/\.
USE OF BUILDING S- F 0
PERMIT NO. 99 - "3-:Z0 DATE ISSUED 1../-1 ~ -1fi
CONTRACTOR M;\:\e\~\ c..e.dt- K~. ~,
NO'fE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION (j{ ) ~).;.> //'11
ELECTRICAL V
PLUMBING '\\) l?vZ\ ., q q
HEATING (if required) J ~M I ~h~,-
FIREPLACE I
GAS LINE AIR TEST 11f,f.W,A'-r~~ .eh} h~~./f1
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
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OCCUpy UNTIL ABOVE l's
NOTICE 1J
I FOOTING :LH. I s- b~
I FOUNDATION (Prior to Backfill) h-.". 1.5 ~- J\.I-~' S--J') -c; 9
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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BEEN\ ~IGNED
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