HomeMy WebLinkAboutBuilding Permit 99-0958
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r:;!. QLtrtifica1e Of (JDcrnpanry f~:
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:~. CITY OF r~OR LAKE <4
-~.:; Jlepartment of tr)Suilbing 3Jn~pettion 'I . ~~C
l:~ . ;sJFinaI Permitted 0 Conditional C.O. Expires . ~J
-~ ' This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
~~. I. certifying that at the time of issuance this structure was in compliance with the various ordinances of the
,-:. i City of Prior Lake regulating building construction or use. For the following:
~ . . Single Family . 99-958
,,"I Use ClasslficatJol! ~Idg. Pemut No
"-..
"\:' R3 VN N/ A
~ " Occupancy Type Type Construction Fire Zone Zoning District
"-~'(
- Legal Description W 1/2 of Lot 1. B 1. Glvnwater First Addition
" ~~-, ,,~,'.
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R2SD
Owner of Building
'lite Address
3515 Bay Knolls Drive
Contractor's Name & Addresr Wensmann Homes, 1895 Plaza Dr., Suite 200. Ergan, MN
RJbert D. Hutchins
<""D Building Official
Date: h, t, a~. Id - n - 0 )
POST IN A CONSPICUOUS PLACE
City Planner
Jenni Tovar
Date:
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I~:i/-() I
ADDRESS "g,Ef5' &, ~ol)~
OWNER CONTR.
PHONE NO.
PERMIT NO.
qq - Cf.S13
o FOOTING
o FOUNDATION
o FRAMING
1 .9I'NSULA TION
~ FINAL
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 GASLlNE AIR TST
o
COMMENTS:
5~l
rS;~u. e-- (~,() r
cl t9~e Jfde
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ t\'.l ~J Owner/Contr:
CALL-:::F:l THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
!I-)M 1#1
ADDRESS 3 57s I! 7. / R ,(7 J3a, y ~1Is P':
(
OWNER CONTR. W UJSfrlI1/If)
PHONE NO. PERMIT NO. 99- 958. 59 f;b, b I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t&.EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Crllh ~,ce;O t'
f:H~~ (9 It::-
. .
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~~ '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
SCHEDULED
DATE TIME
~ 9:io
ADDRESS 3~/~ Ba.\I ~J1~
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'i'i-Cf58
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
AD SEWER HOOKUP
~LUMBING FINAL
r Ii MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~ ~+-u.\;
+v-~
CALU-9::.
lJ..at:.
P Ld,{
~ oV-
.W")
~ :-u..r
V
/
./ --
~SATISEF,TOR ,
~~~~CT AC ION D
o CORRECT WO SPECTION BEFORE COVERING
Inspector: 1\ Owner/Contr:
CALL 447-98'0 FOR ~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUI~ ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
35/5
SCHEDULED ~
8/1 V KNOLGS
r
CONTR.
/.'/5""
OWNER
PHONE NO.
PERMIT NO.
qC; - 968
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION . ( ^-
,}(( FINAL N ...,-
/0' SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~PLUMBING FINAL
rMECH FINAL A
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
- "tlro\ ?-eA &~.hce...r, Y\~ J~~ _
~~. . (n~cO L-~~e( """('1 dM~r~
~/t ~S"'T hA C/ l \ OY"'\ C/l..()oYl~
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,- \ II "::>.\- G.4 ClA__ ts No -r CYY\o....S ( t --*~
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Inspector: Owner/Contr:
CALL 7-9850~ I 1I~,)l"'c~tION 24HOURS IN ADVANCE.
CODE ~I?QU/REME~ARE FOR YOUR PERSONAL HEALTH & SAFETYI
.~--- INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
#, I:/~
ADDRESS ..35/6/ /~ /'91 Z/ 23~V ,K/I/()L.-t.,S
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'Y9 - 9,S'e,. 5~
~o , ,,/
~OOTING u:\\
FOUNDATION (BJ
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~o MECH RI
~WATER HOOKUP
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:
1/lltle-- b~ hJfJ - /?~' ~
~ . I~/{ T {'K./f'~ .~(7~
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/~~ J!4:1f Tvt~C"IC" ~ ~ ~
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~ORKSATISFACTORY, PROCEEDf~ ,_~ + e.o.cJ.-. o---<-JL-..
o CORRECT ACTION AND PROCEED ~ ~o-e<.. ~ .
o CORRECT WORK, CALL FOR REINSPECTION 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
;i;;:'1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2, Pink
Yellow
File
City
Applicant
Permit No.
qq.q~
, 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 /J
3..s/f" '--) ~ ~ k NO II J' D /' / II f
3. LEGAL DZ"CRIPTION '
LOT W ~ of loT I BLOCK
ADDITION. C; Iv^" t.J ~ r l' r
,
1, DATE
g 'f'~?9
1<25.D
BUILDING INFORMATION
11 , SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
I PID ..)S-ffo - 00/-/
/ sr At?' ,1,'1/ o/v
13, TYPE OF CONSTRUCTION
4. OWNER
(Name)
(Address)
(Tel. No,)
14. FLOOR AREA APPORTIONMENT USE
5, ARCHITECT
(Name)
(Address)
(Tel. No,)
Fireplace Ll
Alterations Ll
(Ad~ress)
/195 r'jt62~ Dr
54/ t-r ~() II (tIC 14)0/
Septic Ll Deck LlV Re-roofing Ll Porch Ll
Addition Ll Finish Attic Ll Re-siding Ll Finish Basement Ll
(Tel. No,)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
6. BUILDER (Name)
tJ( N.J", q/V)o/ )J 0'" {'J"
t S 1- 'YU ~ . 4/~ (II
7, TYPE OF WORK
New ConstructionV'
SEATS
16, PROJECT COSTNALUE
Chimney Ll Misc,
8, PROPERTY AREA OR ACRES
Sq,Ft.
9. PROPERTY DIMENSIONS
Width Depth
10, CULVERT SIZE
Yes No
17. COMPLETION DATE
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 I construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 2JJI;ial can revokeihi permit just cause, Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X L J ~ ~ /YS",f' t!-S-? ,.
. / / Signature License No, Date
f/
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
Ll ENERGY DATA
Ll
6~,4
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 8/IOOd .00
PILING LOGS Ll PERCOLATION TESTS Ll
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $ ~ S""D . C)O
SAC ......................................... $ I 0 '5'(":> . Of'??
Collective Street Fee ....................... $
Sewer Tap ................................... $
1" $
ppelUnmabltyl'ng' ..p.e..rm...I't..F.e..e....~.... '.~.'.'Q.~."I!.'. ........ .... $$ Pressure Reducer ................... ....... $
~ 1.~o I () 0 . 0 0 Meter Hom ................................... $
oq..lk:"'fl I DO .06 ~ Water Meter .l.'~............................ $ ?. SO. Qd
Mechanical Permit Fee I..~ l:?lf......... $ I '2..
ff 1.$1 '3t:; 6 Sewer & Water Connection Fee ........... $' 00. 0 C
Sewer&Waterpermit~.U; ...?J...... $ . 40' S Illltl,jLqq WaterTowerFee ........................... $ - 100. () (;)
GM~.md.f.~ ..........~.... $ . OD vi WaterTap ................................... $
This ~ ,g2me Ing Permit ~n_?!ov~9 Builder's Deposit ............................ $--.l.i t;""(j(") . 00
By /F?~ Date X- Other ......................................... $
~~ ~
Certificate of Occup~cy Total Due .:""i..()..;,;................. $ !!.. 01- .0 J
Paid 7~..,-. ; Receipt No, 3(, p(p 9
~ A~ .
This is to certify that the request in the above application and accompanying documents is in accordance with the c~::on~g ~~n~Zd may pr:~d as~ment when
signlJPbl ~he c1rl1ann. er constitutes a temporary Cer:!!M~te {Z~~ compliance}9d allows cons ction to comm:;ncf' Be~r1..11f~upa~a \(.ertificate o. .f~ m~\~.
~VLvJ.M. y.; ~ ~, ~O /. :'....~~ ~('
- &y Planner - Date - ,'" Special Conditions ~ any . -
7-1" S . Sf")
LI,q . ~
4b . SO
Plan Check Fee ............................. $
State Surcharge ............................. $
'70.00
24 hour notice for all inspections 447-9850
~
.
Job Address 35')5$. .,/kJV
Heating contract~)!4/~ '
Name of Tester ?': ;1/y /. ,
Date :;- 7&-~
7
tp
eo
I~~
.:-i-.~-
Percent 02
Percent CO
Percent C02
\
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input
DEC. 14. 1999 4:58PM
GEi : r:;
NJ. 163
P.2/17
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it
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PiIa
Ory
Applicw
'l'Iw CIII.... 0' III. LIlIU! CD"'.'"
,IN 3 t
Applic,3 ,t_. 6!t..V\ Z. -t<~~,"4...I("L
Addrec: I ! ; )J:
Signat ~~ 1"- ,~
Legal Lsc: \ _~ I
Site Ad res 3515 BA:Y.K..~t{~~,
_~CZ9~j?5.tJ
#
C/9-9SfL.
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Phone; { ,..;:::, I -lJ.?_ ~ ~ IIl...L.lL
. I
~~V~)J-- ~r\~
SIJt' _~11 LuMeL I c:..r:
BUildin::>e
PiD ii. 25-35D-()OI-
NOTL.I1.
,[ ccmpletc infoi' .,tion.
_ _ l.
Quantity T ype o~ :xt'
I Bath Tub with or wit' ",1
i Dishwasher
, Floor Drain
.;, Lavatory (bathroom nk
\ Laundry Tray (1 Oi' :J'"
l Shower Stall
\ Sinks
Bar Sink
~ Water Closet (toii"_
,..
'-'
~ Jpe of Rxture
,....
ROIJCjh-ins
r
Jl
..t
~._--~.._--~.._.;--,...,
! Water r<;;atc '
Water Sc'~r '
Stand Pipe (o'c:~hing machine)
Se....ngc E:jc.="x
, GaddlDv, t., "01'1 (RPZ. Double Check, PVB)
-
Backflow h~Li',bfy Test
Lawn S..,--k
. ~\ ~
FEE SCHEDULE
Industrial, Commercic.
(1% of job cost, $39.5:
"
..~
rot.
Residential. New One & we
Residential, Additions " ile
State Surchar;:: e
r.,"
$
$ ---- -
~ 0
-- -/~i*.\O t~RM\\
~ J.~\J\\.O\N
"'J('"
...J,:
,aId
I'}) [Re-
i ~'~ DEe I 5 1999
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16200 Eagle Creek Av. S.E.~ r; ~...
147...J,nn / F '( (612) 447-42:1-5
CITY OF PRIOR LAKE
, 1ii200 Eagl. Creek Av. S.E. Permit No.
Prior Lake, MN 55372
..~)
ql/.-t(SB -
l'-
T"l
"-
ill
a.: Da!e I t..-\ I ' _ __ __
S~8 Addless 35\ S R:n- '-'? /Lno( I ~ 1XL
(T)
~ lei 'Block t Addition r ~l ( W'""'\ Lln T (7 ~ I &;-
. - - u
2 Owner's Name. t) \Q Jf)~n ~e3::...
Address. 1 ~s- "F'fa."7 n \)(L SrG? 2m ~AN
Heming Contractor ,~z - e... t'A 1/1
U ,-
Adifress }LJ.1lr~ ?n i.t.,IaYLr TtLL fo~~ JJ/lr S9'ln'\)
Telephone", \oS\ - \...\ 1.... ~ - 1\ \J,l.{..
Furnace Make & Model IjJ.YI Yl6 Y.
HEATING APPLICATION I PERMIT
.- I: .dC\~
Model Site 8-tr2. 2-loG:~ -is'"
TYPE OF SVSTEM
Warm Air Plant.!!.)(
G1BVllV
MechalllcaJ
All CondBlonlng \l
Vent. Sys1em
Conn. Load
tr Fuel NIH. ~ Rue Size
T"l
lD
(\j
(\j
(T)
rl
In
If:
Supply Opent~9
/?J
h
\_~
HEAlING OR POWER PlANT
Sleam
Return Opening:;
H~ Wa:ltr
R:,jdion
__.1-,;: 'ri.~:UL
,...!; ;......:'li... ;c'-~
tr:: Edr.
f-....J
z:
~ Cfm_ u
Other Devices I-h I .rv-., no' ,::;'1' '.?
TYPE OF WORK
x
~
~ A~era!lons
[[)
;;. Repal,
R9plac9msnt New Construcl~n
Esl. Comp. Date
IJ) Est. Cos1'
IJ)
~ HEATING PEAMrrFEE$
<::t
'; STAl'E. SURCHARGE $
u -
~ TOTAlPEAMITFEES $
qq,95e;
Buldlng Permh II
.50
. ~~pp..\O\N~~ -\
\ BUll-PING f'" ,...11
.
Receipt tI
TYPE OF STRUCTURE
1. ftU..'-'. All
1. 010:': ,i DIY
J. y~ CaantIar
SIngle Famltf .
Commercial
k
MuItI-Famltj
Other
Two.Fam~v
Industrial
Public
Fee Schedule
Industrial, Commercial & MullI.Family
ResJdBLltia', Heating & AC
Residential, Heating Only,
Residential. Gas Fireplace
Residenllal, Additions & Alterations
AesidelltiaJ, AC Only
1% 01 lob 00511$39.50 mlnTmum)
r--' - -- - .-
$99.50 i;-- ; " ~r :
'.,' l
$64.50 ,j,:'
$39.50 i, </ i
$39,50 ::\'
\
$39.50 : \
u
,__:-J ;;
:11 .
'II, j i
. i I
DEe I 5!1S i i I i I
i [);
.~- .. - -.)1./
Remember 10 add Ihe State Surcharge on lhe bollom of ltis ~ppncalion.
The,prica of voor healing parmillr,.,;iudt";;, on!:! rOll:]!,
AddillooallnspacHolls I'<~I ba billed ai $35.00 ~cicL,
HoUS& Heating Test Record must ba.Bubmlt1ed wiih hi.llld'ina 05 rmll number before build-
Ing certificale or occupancy will be Iss~d.
. ....:iL': 1.r{~t3 f;, \'-';
,...,it;.,~n.
HEAT CALCULATIONS REOUIRED wllh number of SL'PPly and raluTn oper,r!llJS Ils1ed per
room wilh CFM's per opening, New slructures or addrtio;,s SQnu Hoor ":;ailnti: :,uppiy
and return locations shown. HEAT lOC'~ r~!(,ULATIC''i'" 'J '\'11 em AN"
~") ;.:: ~; ; ,....
r'~S f.~.
CREFK J,'f' <::: r::: nn:np ~.
; 'p tJ....
~rtt II",) w.:.iiH;SS il0l.U" oia b il.l ii, - "i.;,;v r" ".
ALL WORK MUST BE I~~S.PECTEO (flOUGH-I:J td~G FlW,Lj , Gp.lL CITY W,U.
447-4230
.'&;
I hereby apply for a mechanical systems permit and I acknowledge thaI the
InformalIon obolfe Is complele and accurate; Ihallhe work will be In conformance
wllh the ordinam:es and codu 01 the cltV and wllh Iho 6tllle bulldlngfmechanlcal
codes; thai 'hls form does not becom& a permit until sIgned by 'he BUILDING
OFFICIAL; that the work wllJ be In accordance with the apprGved plan In Ihe
case of all work which requires review and approval of plans.
u
12/1y ~Or
IZ!::/qCj
, Date
OCT. 1.1999 8: 23RM
1.
2.
3.
-----.. 4.
)
-' S.
6.
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GENZ RYRN 6513226147
NO. 077
P.5/5
..... . .... '
ftUOW. ~
IIGLD - err.
CITY OF PRIOR LAKE No.-.!L..Ci --C/66
SEWER AND WATER PERMIT
NOTE: Sewer ana Water
contractors must
be registered
with the city.
APPLICANT:~- ~4&~ P/.hct- ~ PHONE:
ADDRESS: 'L\-r\..l~ ~ ~1&x..A..r "T"'IU..- ~~DATE:
tdSl- 4~ '3 -"4'-/
10 / I /CJ q
, ,
BLDG. PERMIT # QQ-QS8
PIO# 25-3SD - 00 I -I
SIGNATURE:
SITE ADDRESS:
.?8 ~ M'I ~ lIe.. lKL
FILL IN THE BLANKS
Estimated length of water serviee ~()
I ./
Size of water service inch(es).
Location of any couplings from structure
feet.
feet.
Type of sewer pipe. ABS pvc~
11- '
Estimated length of sewer line ~~
Cast Iron
feet.
Clean out (it required), located at
structure.
feet
from
-----------------=,,;;;;;;;,-------------.......----..---________. " 1,_---_.,,----
This ap~,tiJYU" be~qUr pe";'it when approved.
BY ~ ~ DATE: /0 I 4- Iqq
. ." - . . .----~--.- . I
--------.:::!!!:~~===_=;;;;;:iiiiilii:;;----..,____________
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 buildinq permit card at the time of issuance
to insure that no duplicate sewer and ~ater permits are
issued.
DATE PAID
RECEIPT n
AMoqNT PAIO ,. ~\(\ ~~\~-,~~~.\L
REC' 0 BY ~\\..O\NG
. 4629 Dakota St. S.E.. Prior Lake, Minnesota 55372 I Ph. (612) 4474230 J Fax (612) 4474245
AN EQUAL OPPOIm.INm' EMPLCVER
Thr Crntrr of Ihr Lakt Country
qq~958
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ W6AfS M/tNN IioHG5
APPLICATION RECEIVED e / 6 / 'lq
I '
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.35t$
B"q-V Kill 0 L-LS
/
D~
,
Accepted
Accepted With Corrections
~
::::::ed By: (2l ~~
Comments:
Il faa& cd\ tlfk-ho1 ~f) ~
Date: B i8 - 1" \~
"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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Th~ Cl!nl~r or Ihl! L.kt Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT,
APPLICATION RECEIVED
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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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,
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Accepted,
~
Accepted With Corrections
Denied A
Reviewed By: ~/-\r ~ ~ ~ ~
Commellts: . .
'~~av&... ~~~~ to C-L9 ~ ~J~V\,~ ~I"
%~ (~~. {;)~..d.-.\-- C)v~ pLwvc<o,_
~ C~~,^~Ar l~ AoM~L. '
Date:
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"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."
r;CJ-'lS8
White . Building
Canary . Engineering
Pink - Planning
Th. e.n... 01 lh. Lak. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT -
APPLICATION RECEIVED
~ ~vE A/:: ILl I-f IV ,IV Ifo /'-1 65-
8/ tb / qq
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,~~;:: /5 13;L1V' Klv 0 LLS DK!- .
I
Accepted
.,/
Accepted With Corrections
Denied
Reviewed By: t.,iAtrEA 6.i1l.E OlfI/4A1AJ
Date:
I I
KI/81?'
Comments: KI)NOFf= r'\\\JS-'
aE"
r.~.N&'(E:D or.. AND AL..!JI.J(., fUlf1.tNA~E
f VTlr...lr't ~ME,<oJ'T5 AS' lI1uu-t "'S P/?rlfC.r,c!ic- .
SeE INl='I)IlM~ oiJ l..fvE.R.s[ _~~Oc .
~ A.."A0-{""f:tJT'"<:.: I. F;,.,;fr.... r;A.,qo~ /,u<,PG.dl()1U.-IAJ~ollftf~ ~. IiA.JIII/)~Nr. PiAN
3. CR.os..oiV Co1-lrll.o'- MEA~ulU:S
cf. EtuSIDN (',uJr~L. Pc..AJ<J
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."
_" ___o~,.__..~___~.~.___."...._
PRIOR LAKE
,
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INsPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3S-/::;- 'k, l<Vl.d~ tD--
NATURE OF WORK f'JJ2.u.j ~~~f'ul"lt~
USE OF BUILDING SFA-
PERMIT NO. Q'i-<7$'P, DATEISSUED fJ-If5-'7:CJ
CONTRACTOR Lt}P,.CI'^'~'~ ~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
... INSPECTOR,
C. ~_Il
FOOTING t.,,'\'''':~/Av. '- '- ,r.-\.\J I ~b I f () -v -1C:
I FOUNDATION (Prior to Backfill)~;{Qad'I~' \b-1>-'Y\ (f!J IA--. /6 ~13~"7/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC(M fA r /(; -. f31~
FRAMING _ ~ pg I~Yn
INSULATION IJJI"(7" <f,JJ z.,/,./"o r;;}) /1~rA
ELECTRICAL v (/ .
PLUMBING (;]) /;<110 lJ
HEATING (if required) 1I~",r @) ~.r',4u C/J3 ;j~J~'/)
FIREPLACE' . lr, A]5, 1/d'//H '
GAS LINE AIR TEST (l.(p I/;Y /00
COVER NO WORK UNTILL4BO~E HAS BEEN SIGNED
~.BD, I I
,-
FINALS
l\rS
DATE
t \ ~C;. ~
GRADING (Prior to Sodding)
BUILDING "'1UJ -rv 6/1 /01/
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
J 1-- J.7-D I
. \
..' , /) 11 \
\ / I ~ Iv'
EEN \SIGNED
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
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