HomeMy WebLinkAboutBuilding Permit 99-0331
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( . :~ I Qrtrtificuu of (JDcmmtnry ;~.('
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:.~ CITY OF PRIOR LAKE~.#\
't 1Department of 'uillUnll 3Jn~pettion ~,ol~
l'~! I 0 Final Pennitted 0 Conditiolll!,lCoO. ~pires,
I "\.~!. This Certificate issued pursuant to the reqUi~nts fJ Section 307 of the Uniform Building .Code
.' ".? : c~rtifying ~hat at the time of issua~c~ this structu ~i! was ~. ompliance with t~e various ordinances of the
"~; : CIty of Pnor Lake regulating buddzng construJ::m ote. For the fOllOWI~g:
;'1 . Use Classification SINGLE FAMILY ~ - ',., Bldg. PenrutNo 99-331
i :'~.~:" Occupancy Type R3 Type Construction ~ Fire Zone N I A Zoning District R2 SD
~+(r L14, B4 GLYNWATER 1STfADDITION
.;..... Legal Description "'.\.:,
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Owner of Building
C\iteAddress 3423 GLYNWATER TRAIL NW
Contractor's Name & Address WENSMANN HOMES 1895 PLAZA DR. EAGAN MN 55122
'R n.B.;;' 'R 'T' 11-....Hl.IT..C T N c;:
Building~
City Planner
Date:
n;'''11\TT 'T'(HT /! ~
Date:
1.;.', ".",,,,,.,,";':"';';;',i,,'c';'2;;' *'~~'~"';',,",'~'\~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 34 z. '3 <;\~ f'\ wc.J-(A... Tit...
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULAT~ k
FINAL
~ SITE INS CTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP 11
,;2(PLUMBING FINAL i,'1
'j;1{ MECH FINAL r"
\I,;;;~
TIME
'1:7'{)
~'1- 33J
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(.) ~ J""^ ~M UNVn
(i) SuA .\v R.cLS \J 'P.e^- 0 ("~\'() ~
(3J~ Ck.~ ~4n. ~
(V fw(- ~h\n~ rl~ {v~<---1~ .
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RE COVERING
Inspector: ner/Contr:
CALL t47.;;;J FOF d NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE R~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
101'" { o,c; 2.- '. 30
34-2~ 6tLVNVV~/t:-Kl12-
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CfQ-33J
o FOOTING A.,S--:.LUMBING RI
o FOUNDATIONA ~~ECH RI
~ FRAMING 0 WATER HOOKUP
)(INSULATION A- 0 SEWER HOOKUP
o FINAL 0 PLUl\llaJNG FINAL
o SITE INSPECTION CIWICI.;M FilII
COMMENTS: ~.
~ ~ 6'^-'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ --h~
~Ln--
...
~~~
j
~ .~O+- Y.Jr::Y
//
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/
REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CAL\. 447-9850 FOR T E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE~ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
QATE R~ CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
APR I 3 1999 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
3Y,2,3
~ ~/ /VuJ
3. LEGAL DESCRIPTION (/
LOT I Y BLOCK 'Sf
~ j.sr
ADDITION
4. OWNER (Name) (Address)
1. DATE
.Ij-/~ - 99
12:2.. S 9
PID .:J.5'-.J.S":l- O~?- 0
~
(Name)
~~
IJ~
7. TYPE OF WORK Fireplace 0
New Constructio~ Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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~icial can revoke~s penni,t!1 just ~e. Furthennore. I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections.
X /:J~ ~ V ~ 3''1-7'/~ 1'7"51' .y-/.2-99
, - #ature license No. Date
5. ARCHITECT
(Name)
(Address)
6. BUILDER
(Address)
/8'/S ,11J2..(;.. 0 r
{' ~ '''/V /IIN S5/~)..
V Septic 0 Deck 0
Addition 0 Finish Attic 0
(Tel. No.)
(Tel. No.)
(Tel. No.)
~.51- ~O t - y~()"
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
q. a~32-q
-t. . I d' II 1. White
f1If1N r,f.,;{/ 2. Pink
. 3. Yellow
File
City
Applicant
Permit No. CfCf- 33 I
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
,) .;J..5. c "cJ "j
17. COMPLETION DATE
0,"-,
,
FOR ADMINISTRATIVE USE
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~").~ .<:90
;"
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
"SPA.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 2~
Pennit Fee ................................... $-4sL? - ~
Plan Check Fee ............................. $ 98 ? .1:( 7
1("2.56
State Surcharge ............................. $
Penalty ....................................... $
I DO . 06
lOb .01f
7S . ~n
Ga~Fire e Pennn ....................... $ 40.~
Thi ~~co~ Your Building Penn it 'If-en ~~rd.
By ///- - .. ~ Date ICe.
'-L. .. - y
Certificate of OQl!(Jpancy
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ...................... $
Side
City:
'\ .rill It\
J'P:\v- ~~,~
()( ~~
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
/. $
Pressure Reducer ..q~................... $
24 hour notice for all inspections 447-9850
Meter Hom .....~.T................ ....... $
Water Meter ...1'if)..:...................... $-L)"5 ~O
Sewer & Water Connection Fee ........... $ I.? f')C) .C":)l:l
Water Tower Fee ........................... $ 'I !rt~ .~
Water Tap ................................... $ "
L~ ~..- ....~..
Builder's Deposit ............................ L- _ ~',,-
, -
Other ......................................... $
Total Due .............................. $ 1PK'53. ~J
Paid '2"'>.3..1,.... "'l..- Receipt No. "1 r II L-
~ ,h
Date 4--/-su /~ #( By ./;r I
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdina~ce and may proceedl~ requested. This document when
s~'9n City P er constitutes a temporary Ce1fi~te of Zon~mpliance and allows construction to commence. Before occupancy, a Certiticate of Occupancy must be issued.
J~ .::t.. 'l~ '~
City anner - Date Special Conditions n any
,.... ..
~~
{ 0 ~ ..(9.l3.
45..APl
...
,.
Job Address 3'tt-3 Clt"wwf.,./
Heating Contract~~-460-
Name of Tester /I.?
Date Y~7~'i
Percent O2
o
Percent CO
Percent C02
Stack Temp.
-t
/;~
Combustion air is adequately supplied per
UMC Sec. 606
Input
/
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Th. C.nl.. of Ih. Lob Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DI;PARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
: \ I
, ,
r ;;._ ---.-.I
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~~-~-c:P~
Date:
L( -Lc; ~t=H
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~331
The Crnlrr or the L.kr Country
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
vVbNSMAf\J HOMES
4-/f3/qq
, I' I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted ~ Accepted With Corrections
Denied /J /J;? j ~
Reviewed By: (kfC C~/.J;;;;;
Comments:
Date:
c.j ~( '1. - 7 7
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."
QCf-33/
Tltt' Ct'Jllrr 01 tilt' Lake- Co..,''''
White - Building
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPlJC.ATION DEPARTM~NT CHecKLIST
NAME OF APPLICANT v V ENS t-I r\ I\j H 0 M c S
APPLICATION RECEIVED 4-/{ ~/ q q
I . I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'342.3
Q.. V4J wt4rEA. ~ .
~
Accepted
./
Accepted With Corrections
Denied
Reviewed By: .lJ.l",,,- 'TEA. fJ<JteES".,.1II1\J
Date:
'I/z..z./"
I .
Comments: --.SEE Zl.JIW'~
?E~,.,rr- #- f?~ 3z., I ~YAlw"'TEI{ 7;..)
.. .,..,
~a.
O~E'JJTS
I tJr::otttl1.,qno^,
,
~ /.I rnUJI tf4 E AJ TS
"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."
~,. . CITY OF PRIOR LAKE .
i ~ t62DO EBgle Creek Av. S.E, perrnll No., qq... 33/
Prior Lake. UN 55372
"
~ HEATING APPLlCAnON I PERMIT
)aw.4/Q.\lqQ PlOt. 25-:352-- Oz..~...O
lli-Add- }~t..j'J3 P:. hKYUJ..)cdtJL ~ ~u..l
21 .' ~ BfDc:k 4- AddlloR 'P.' ~ 1l 'lrr:l1Jl, -:30~
own.r"sName \k..'~' t\o~
Address. I cgq? ~ I Q...IZ~ ~ ~.
Heating CantradOr . ~~- ~o..Y\.-..J
Address 147LJ5 5. <RD~ ~i
Telepho~e' L\ ra~- \ \44
Fumace Mak. & Model .h..t..rLn.!b~
ModelSI18 .QQl.c03JLl- lCD
Conll. load
Fuel r\11.fdn Fkle Slzl
Supply Openln;.. Q 9..-
zRetum Openings. j Q
~'nput m.an Output. Q \ c:fj:)
N ~ '
~Edr. .
lD
Clm._
TYPE OF SYSTEM
Warm Air Plants
Gravny .
Mechantcal ......--
AlrCaRCIblonll\g .
Vent. Sysllm .
HEAlINQ OR POWER PLANT
Steam.
Hot Wallr
Rad1a11on .
Special Olvices .
-
OlhllT Devices
1YPEOFWORK
E
n..
..-i
N
~ Mer.lIon,
,/'
Replacement New ConstNction .
I Repair. Ell Comp. Dale -
~ Est. Cost .. . _ Bundlng Permit.. qq.. 33 /
~ HEATING PERMIT FEE $ Cj q .50
a:: . ,. PAID WITH
& STATE SURCHARGE $. .50 BUILDING PERMI1
.' 1m <5 .
TOTAL PERMIT FEES $. .0 _ R~ceip' I .
I. lUlL
LUre
l. Yen...
ns
Otr
o..aaw:-
TYPE OF STRUCTURE
Single Faml\y ~ Two-FamUy.
Commen:lal
Industrial.
Fell Schedule
Industrial, CommercTaI &MulIi-FamUy
Residential. Heating a.. AC
Reskllntial, Healing Only
Residential, Gas Fireplace
Residential, Adctltions & Allerations
Residential, AC Only
Public
Mum.FaniIy .
OIher
1% 01 lob cod ($39.50 mInimum)
$99.50
$64.60
$S9.50
$39.50
$39.50
nememb&f to add the Stale surcharge on lhe botlom of this apprlC8llon.
~
The,pries 01 your heallng permit includes one rough.in ~d 01\8 linalIn&pectlon.
Additional inspedloM will be billed at $35.00 each.
House Healing Tesl Record must be submitted wl\h Wikim {'IP~I. "".'mhPr befol& lJuitd-
ing certificate 01 occupancy will be issUed.
~"T r.." r.11l 4TIONf: '"'~(\\ IU:JFO wilb numbel 01 supply and return openings listed per
laom with CFM's per opening. New .'ruc:lurH or eddl,lons send floor plan wfth aupp\y
and relum locaHons shown. HEAT LOSS CALCUlATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 Elts. J:
CREEK AVE. S.E. PRIOR LAKE, MN 55372. -
Cily Hall busTness hours are B a.m. - 4:30 p.m.
All WORK MUST BE INSPEClEO (ROUGH.IN AND FINAL) . CALL CITY HALL
447-4130
I hereby apply '0' a mechanical 6V6tem& permit and I ar,\mowledge that the
information above Is comp'ele and acc:uralej that the work wil\ be In conformance
wUh the ordinances and codes 01 the city and with the slate building/mechanical
codes; thallhls form doss nol become a permit unUl signed bV the BUllDlNG
OFFlCIAL; that the work will be in accordance wUh Ihe approved plan [n the
case :21 a o.k which re ires review and approval of plans.
~.-
c:.. ,~ :.,. 41,;)1/~9
~E~~ . D~
Builring fffal':l SignalUle Date
APR.21.1999 1:12PM
GENZ-RYAN
NO. 666
P.9/10-
I
CITY OF PRIOR LAKE
. PLUMBING PERMIT
Applicant ~'Z.-- R\..NOJ\ ~Phone: LJ~~-ll4~
Address; lL:l'7c...f 5 S. 'Ro bv\j.:. ~
Signature~':rr.1"~~ .
Legal Description: Lot ) 4 ,Block. Lf. sUbQ/unwn-:l-~ ~
Site Addre~s; ~4:;l"3 t1; l~ ' I ,~ ~~.
Bunding Permit # ,PID #' :25" ~z. ... Ql/I"'O
NOTE; This permit "(ill net be processed witheut complete information.
FIXTURE UNITS
I. .. RIa
2. Gold CIr
3. 'Y1l1la1l' Applblt
c/t1-- 33 /
#
Tllr e,n,.. 'If ..r Lilli c.u"'IY
Quantity TYJ:le of Fixture Quantity Type of Fixture
l Bath TLlb with or without shower Rough-ins
I Dishwasher J Water Heater
I Aoor Drain Rl Water Softner
4-~ Lavatory (bathroom sink) \ Stand Pipe (washing machine)
I Laundry Tray (1 or 2 compartment sink) Sewage Ejector
J Shower Stall Backflow Assembly (RPZ. Double Check, PV6)
I Sinks BackflolN Assembly TeSt
Bar Sink Lawn Sprinlder
3 Water Closet (toilet) Other
FEE SCHEDULE .
Industrial, Commercial & Multi-Family
(1 % of jo~ cost, S39.50 minimum)
Residential, New One & Two Family
Residential. Additions & Alterations
State Surcharge
$99.50
$39.50
$
s QQ.50
s
$
.50
GRAND TOTAL
sJOo.OO
Thi. permil is Sr'lll1lCd "pon the =preu condirtan Ihat sllid
COnU'llClor. shall c:omply In all respects wilh !he ordinances
of the Stllte Plumbing Code ~d me :uncndmcn15 thereof.
_REcm,/'iO 0.. ~ APR 2'0 ~qq~ATE
/y~' \ ATTEST
Call for nIl insp,l1ions 24 hours in adv~c:e.
PAID WITH
BUILDING PE.'~. "T
16200 E:1gIe CreekAv. S.E., Prior Ln1cc, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 44742~S
An EqW1l OPfJQl'tuniry Employer
APR.21.1999 1:12PM
GENZ-RYAN
NO. 666
P.10/1~' --- -
..... . PILK
YlLUHr . ~IIT
GOLD . QT,
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO. 99-33/
Sewer and Water
contractors must
be :r:ec;istered
with the City.
APPLICANT: ~ Ul.JZ..- ~~ PHONE: L:\~~~\ \yl\
ADDRESS: 14745~. ~ober+ Irl DATE: Y/~' lq9
SIGNATllRE:('_'l~ ~ JLDG. PERIlI'l' .qq.331
SITE ADDRESS:~Q~lunLU~PID# ~5"35Z"'OZt:J-O.
~
FILL IN THE BI.-^NKS.
40'
1. Estimated length ot water service
,feet.
2. Si2e of water service I' , inchCes) .
.
3. Location of any couplings from st;ructure feet.
4 . Type of sewer pipe. ASS PVC i.... Cast Iron
S. Estimated length of sewer line '-40' feet.
6. Clean out C if required) I located at feet froll!
struct~re. -
=====-=========.::::!!!-==::o::::!===-====;:::====-:::=:==-,-:...;===a::=====-===;;;:::=---===;;;;;::l!l!!'===-=::::Il=_
This application becomes your permit wnen approved.
BY
D~TE:
~==~~---~===~===~===-===-~===_3===~==~~===~~=___~==a~====_===-~==
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee far 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. ~ PAID WITH ..
BUILDING PERMIT APli 2 3 :99c)
DATE PAID AMOUNT PAID
RECEIPT # . REC'C BY ~~
, 4629 Dakota St. S.E.. Prior Lake, Minnesota 55372 I Ph. (612) 4474230 I F~ (612) 447-4245
Al'f EQUAL OPPOlmJNrrY E.\o4Pl.CVER
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Cl.
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Po/mil No. qq - 33/
Prior Lake, MN 55372 .
'lit
IX)
IX)
IX)
I'll
I'll
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HEATING APPLICATION I PERMIT
X1/Q Jc~; PID' 25-352- Ozq - ()
I . .
Site Addross ._~)l'k) 3 ~k.\" !'_;ld," .' /"...(' ,€ 2-50
1./
Lol /4 Block. lj. Addilion. 6/.-V/l/WAT6~ !S6lf7H
Ownor's Name L~j: lo..b0.4.. ...,... lhh',H'
Dalo
r-I
III
\D
Address.
HealingConlractor ALLIED FIRESIDE dba FIRESIDE CORNER
Add/ess 2700 N. FAIRVIEW, ROSEVILLE, MN 55113
Telephone' . 651- 6 3 3 - 2561
FIREPLACE
~Wlll9 Mako & Model ll'Ai A.J r;, ~
Model Siz~ &, o..."i..' 7\1 .
~
QJ
I:
~
o
U
QJ
'0
Conn. Load
Fuel (C~
TYPE OF SYSTEM
Warm Air Planls
Gravity
Mechanical
Air Condilioning
Vonl. Syslom
Fluo Sizo
I,..
Supply Openings
Aelurn Openings
Input Outpul ,) It'li)
HEATING OR POWER PLANT
Sloam
Hal Waler
Radialion
Special Devices
VI
QJ
~
.,..
u.
c:r
'lit
o
Edr.
Olher Devices
elm.
Alleralions
TYPE OF WORK
Replacement New Conslruclion X
Est. Camp, Dale J7JJI~
//~u.' Building Permilll 19- 33/
"
o
m
m
I
m
r-I
I
01
:J
c:r
Ropair
Esl. Cosl $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
( PAID WITH
I BUILDING PERMIT
Receipt II .
TYPE OF STRUCTURE
I. ri nl
2. l;,..,,,
J. \,,,110'"
File
Ci'1
ConttKlor
Single Family
Two-Family
Induslrial
Mulli-Family _
Other
Commercial
Pub~c
Fee Schedule
Industrial, Commercial & Mulli-Family
Residential. Healing & AC
Residenlial, I Jealing Only
Residential, Gas Fireplace
Residenlial. Additions & Alleralions
Residenlial, AC Only
1% of job cosl ($39.50 minimum)
$99.50
$64.50
$39.50
539.50
S39.50
AUG I 9 1999
Remember 10 add Ihe Slale Surcharge on Ihe bollom ~Ithis application.
Tlte price of your healing permil includes one rough-in and one Iillal in spec lion.
Additional inspeclions will be billed al $35.00 each.
House Healing rest Record musl be submilled wilh buildir]g rlF'IOn~ number belOle build-
ing cerlificate 01 occupancy will be issued.
HEAT .c~lWl.ATlONS REQUlRI;,Q wilh number 01 supply and return openin!JS listed pe
room with CFM's per opening. New slructures or additions send floor plan with supply
and return localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 553 72.
City 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
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-/ ' Dale
8/;9/99
Dale
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permil No. CJ9- ~~/
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
9~-5()/qq PID# 25~35Z-02..q-O
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Lot /4- Block. ~ Addition
Dale
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Site Address
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Owner's Name
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Gt.-VNW,qT6~ .sOUTH
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Address
Heating Contractor ALL lED FIR ES I DE d ba FIRES I DE CORNER
Address 2700 N. FAIRVIEW, ROSEVILLE. MN 55113
Telephone # 651-633-2561
FIREPLACE
1MJWal9 Make & Model IJI'4J ,J (;w
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q::: Model Size. (ot.XDj}?__
~
.~ Conn. Load
ruel (c:r....-::) FluB Size
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
Supply Openings
Return Openings
Input Oulpul d), ().:J.:)
Edr.
HEATING OR POWER PLANT
Stearn
I~ot Wator
nadiation
Special Devices
Other Devices
Clm.
TYPE OF WORK
Alteralions
Replacement
New Construction
~
Repair
Est. Compo Date
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Q9-..33 /
~PA\O \'l\111
\ BU\\.O\NG PERM\"
Est. Cost $ I J CU. f~)
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Permn /I
,50
Receipl #I
TYPE OF STRUCTURI;
I. Pink
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1 YellDw
VI
Filt fD
Cily "0
CDftlllC lor I
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I
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Single Family
Two-Family
Mulli-Family .
Olher
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Commercial
Induslrial
Public
Fee Schedule
Induslri;!I, Commercial & Multi-Family
ResidenliiJl, Healing & AC
Residential, Healing Only
Residenlial, Gas Fireplace
Rp.sidenlial, Additions & Alterations
Residential, AC Only
1% 01 job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
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Remember to add Ihe Slate Surcharge on the bollom 01 this application.
The price oJ your healing permil includes one rough-in and one Ilnal inspection.
Mdilional inspections will be billed al $35.00 each.
Ilouse Healing Tesl Record must be submilled with lluildina Derrnil number belore build.
ing certificale 01 occupancy will be issued.
HEAT CALCULATIONS RE(;WIREO with number 01 supply and return openings listed p'
room with CFM's per opening. New structures or additions send 1I00r plan with supply
and return locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
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City 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
441-4230 ~
I herp-by apply lor a mechanical syslems permil and I acknowledge that the ~
inlormalion above is complete and accUlate; Ihallhe work will be in conlormance
willi the ordinances and codes 01 Ihe city and wilh Ihe slale building/mechanical
codes; thai this lorm does nol become a permit until signed by the BUilDING
OFfiCIAL; lhal the work will be in accordance with the approved plan in the
case of all work which requires review and approval 01 plans.
..-;
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, - -1?W~ture
tJiuilding Officars Signalure
q !Jc.J/ '19
., Date
/0/&/99
Date
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P'RIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3~2..3 Gl~~
NATURE OF WORK N€J-::J ~d-(~
USE OF BUILDING Sf A
PERMIT NO. q q - 3"3 ( DATE ISSUED q-/~- ctc, .
CONTRACTOR -0')~\..c..-..~ I^- . ~5 I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PE~~T IS BY SEPARATE DOCUMENT
De;.IG P7Z9 VV ~,;4-1" INSPECTOR DATE
, FOOTING {/ (~s~r 'J I . ~ /u
FOUNDATION (Priorto Backfill)~A d;jl Irl-91 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.~ r
flqh~<
SEWER I WATER I SEPTIC
FRAMING ~..t. . @ /~/4'1
INSULATION ~.~. ftP /o/t:/1~
v
ELECTRICAL
PLUMBING
HEATING (if require~/ A... /~/fl) nv
"'7'"' ~/) . \ f\x '\
FIREPLACE v 'V
GAS LINE AIR TEST n,,/A/ ~. /;p, fP 9//.r/f'1 (
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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It 1/41
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
I J.. -<< 1. '-f !:f
/{;. -3'o..!i.'l
III } '1 '-' /11M
J y) t I // t I f /
OCCUpy UNTIL ABOVE H~ BEEN/ SIGNED
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