HomeMy WebLinkAboutBuilding Permit 03-1073
VoRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. !lIP ~- / ("-.c,Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
uaNOTJ
~AUG-07-2003
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11:18 CITY OF PRIOR LAKE 9524474245 P,Ol/01
CITY OF PRIOR LAKE .IW1LlllNt7 f.IU<lVlll, _---- .... ~i~\""<"'; u
TEMPO~~ ~~Ct=~~~:1~:Gl; ;OO;'m
PE T NO,
B
I Whi\t Fil~
:t. PlIlk citY
J Yclll;lW Applicltll
(Please <ype or vrillt ancl ,iJlll at boltD~
[ ADDRESS
It.t IW Dmrnff't'L
Ave... - Bllrdi.GI~:::Jh9p~ I
ZONING (offi.....)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
[OWNER
(Name)
(Address)
Pill 25.194-- (104-.0
(Phone)
JiTTJl.DER ~
(Name) ~ri+- ~ H a3ler I== - p.
(ContaaName) J(e: ViVl h.'jnr).-,
(Address) 10
TYPE OF WORK
o N~w Construaion
(phone) ill SI-'105-/IPtt)
(Phone)C\L+. Z/.J) I
OD<<k
OPor<h
DRe-RooMg
DReoSid,ng
OUrility Cooneclion
DAddition
OAlterarion
OLower Level F$Sh /, ) L _ 0 PiT"Jllace
Addci- ~I~ \.S !IIIMS fO..--
PKOJEcrCOST/VALUE (cxciudingland) S
000
I heTeby certify that I have furni,hed informaaon on tIli, lIpplication whi<h is to the best of my kno...le~ true and cartect, I also certify that [am the oWllet Ot
authorized agent fur the above.m . ed prQPeny and mat all c:onstrUCtion will conform [0 all mstitlg state and locallaw$ and will ptoc:eed in aceordancc with
submitted. plans. I am awar at e building offi~ia1 can rev'oke d1is p~it for just !:ause. Furthermore, I hereby agree that the ciry official or a designee may
enrer upon the property t er n~ded inspc:c:cio:D.s.
Permit Valuation
Pennit Fee S
Plan Check Fee S
State Sutehuge S SO
Penalty S
Plumbing Permit Fee S
Mechanical Permit fee S
Sewer & Waler Permit Fee S
$
mas Your Building Permit WheJ1 ApprDved
fJ -("-03
DaII
Coli
Contrl!:tot's Lic;cnse No.
Date
Park SUppolt Fee # $
SAC # $
Water Meter Size 5/81'; 1"; S
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # S
Builder', Deposit $
Other S
TOTAL DUE tllM:>~ ~'~",/..'(Nt.. S:1Q 27
I Paid
Date
I ~ceiPtNo.
Th.iJ is ~o ce:rtJ.fy mat 1111: request 111 me -above application ~d ICCOmpJnying documenc; i:l in accordance with the City Zonb1g Cretin,",e! ed may procecd 1:1' rll'quest!:d. Tbis documelll
whet1 $igned by tM CIty Plannu conJrit\.ltCS a tcmponry Ce.nificatc ()( Zonin. compliance and allOWi COl'lsuuroon to commence. HtfQrC occupMiCY, a Cmit'iclte of Occupancy multDe
d!Ued.
Planning DirectOr
Date Special Conditions. ifan)'
,.. h,,"r notice lor all inspeclio,," (952) 447-9850, tax (952) 441-4245
TOTAL P.Ol
~~
While - Building
Canary - Engineering
Pink . Planning
Ihr (-rntrr of the L.kt (.'ounlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ''-I I 8 (') Co \.<.{ ~ ~....
APPLICATION RECEIVED ~ -(5 - qy
Av.e
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted )I
Accepted With Corrections
Denied ~
ReviewedB~~
Comments:
Date: ?;-I t..{... Q.."""3
I. FiM, \J,oti~\"CQnOlA.q
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
MERIT MASTER FIRE PROTECIION
Letter of Transmittal
1027 GEMINI RD. EAGAN, MN 55121
(651) 905-1600 FAX; (651) 905-1601
Date: '3-/5--03 Project
~10
To:
~ 0/) Prl~ L$L-
Ilo2.CD~~AVl... a;
Pr-iOr uuCe" MN 553'7 "2...
Proj, No:
Attn: fhM.,Q... 'fuJun ~lr-frt.,r
Re: Bu.rcii~ ~
We are sending you:
The following items:
Shop Drawings
Specifications
)<AllaChed
Under separate cover via: ~r.
Prints
Letter
P~ns Samp~
Change order
Copies
Dale
No.
Description
.
These are transmitted as noted below:
For approval Approved as submitted
Resubmft
copies for approval
For your use
Approved as noted
Submft
copies for distribution
Per request
Retum for corrections
Retum
corrected prints
For review and commenl
Return
corrected submittals
For Bids Due
Remarks:
Copy To:
Signed: ~oll 'J I e.J(.f: 'l:ZlP
MERIT MASTER FIRE PROTECTION
Letter of Transmittal
1027 GEMINI RD. EAGAN, MN 55121
(651) 905-1600 FAX: (661) 905-1601
Date: '3- 12-03 Project:
~10
To: ~Of\ \)"..
.lJ" iar Ul~
IlJi2. SQ~le.. Cree[L M. 5<=-
PvioY \...tllQ.-J HN 553'72-
Proj, No:
Atln: 5ld8' ~it- Dopf-.
Re: BlA.Y""'dtid- Proper-tieS
We are sending you:
The following items:
Shop Drawings
Specifications
i-Allached
Under separate cover via: MaLQ.,
Prints
Letter
Plans
Change order
Samples
Copies Date No. Description
I f'Jlda. P.Py,.."..,tf- 1\ ~ .
()
These are transmitted as noted below:
For approval Approwd as submitted
Resubm~
copies for approval
For your use
Approwd as noted
Subm~
copies for distribution
Per request
Retum for corrections
Return
corrected prints
For review and comment
Return
corrected sullmillals
For Bids Due
Remarks:
~b.
IS
~ with ~r
apprtNUt ·
onc..L- ~ app.
Copy To:
Signed: "tn~, .l!1f". Z1..JfJ
?~--~
p,l
J"f~
.(\Ve ..
Anthony Louis Center
l-GOO-PlItll Parlews,' }lE II.( (W CCMWo(f'Il.C d' ./j-ut" Nt;
Blaihl. MeN 55434 P ti<.v'o/L /...fW..(( 13 c.- [j (). "1!.
Phone: 76J 7H 2~g~ 5)]71.,
Fax: 76" 757 2059
Date: ? -(1-<J 3
To:
IS 0 D~ 1-( \-t;g; N 5
Company:
Fax # 'is;}''- tr<f7 - <,,0. 'is-
Phone #:
Re'
5 ~ .LJ../.a:r<./J.%J. J1.I6.2::'I)(;!J
/20 S ( P f!rttrr'.A)
From:
Anthony Louis Center ~ P ~ L. ~e..-
Fax: 76-3.. 757 Ze59 ";' 9~- 2-- '2. 2. 6 - S ( 7 J
Phone: 163757 29\Hi, 9'5":J- -2.L-&, - '!'-/'/O
If ~ (number of pages including cover sheet) Pages are not received, please call the
telephone number listed above,
Memo: fJrJA<:e PA-)( J1ActL. 'T() Mb' /K..s..co,0 ~
-n-fC ~ C PAr-:. b'S /f..lt; <:" (6.t-.L6?1.. ,ni/J7vi?- Yov /
r- A-x:f:i: fx..").- :;.16- SJ,.fl - 12,..<;~_,,_
"This inf9nnation has been disclosed to you form records protected by Federal Confidentiali'y
rules (42 CFR .Part 2). The Federal rules prohibit you from making any further disclosure of this
informalion unless further disclosure is expressly pennined by the written consent of the per .on to
whom it pertains or as otherwise permitted by 42 CFR Part 2. A general authorization for tl e
release of medical other information is NOT sufficienl for lhis purpose. The Federal rules re ;trict
the use of the infonnation to criminally investigate or prosecute any alcohol or drug abuse
patients. "
File nnme: 927
p,2
~ul 30 03 03:33p
A"~hon~ Loui. C.nt~r
(7&3)757-2059
",.2
REQUEST FOR INSPECTIONS
PC~AemcAHJ;'I.l~a::oMP.fUl\T"~~1It1IJ1OMl
TO: RETURN TO: Civi,ion of Ucel'1$I"ll
MN Dep.;lrtment or Human ServiceS
444 L~1aY4111e RoIOCl
St. poul, MN 55155-3642
FAX: (651) 2117-1490
FROM: The Deportmenl of Hum.n SerJice" Dlvl~ion 01 licensing
OA.TE'
Prior to Issuing a license, verl'IClItlon i6 'squired thai a !:Kilh,. I, In compliance with appropriate state or
local codes for hasllh. bu~d1ng and 1..1. P......... r",.,lo In.tructions sheel for Instructions on how I"
requesllOe necessary ;n6poctions. When the inapeel;o", 8'e completed, re!um 10 the Licensing DIvision
wll~ 8ny ord. ra ""oched, A copy 01 orde,. should aloo be retained tly the f9Cillly,
NAME OF FACILITY:
ADDRESS:
PROPOSED USE:
NAME OF" CONTACT PERSON:
PHONE NUMBER:
Area of facltly to be una;
Numbers and age ranges '" p;lrtlci;>>nls;
'. Docs the '"cdity pi<ln 10 serve handicapped .ndividuels?
TO:-Slltte Firl'M_hal ,,, "'-".--
444 Cedar, Suhe 145 Lo CA-L-
51. Paul, MN 55101-5145
FAX: (651) 21So0525
F.~!3:~!"Ic::~!,;"l)$.e..~~r..
f7;26 /-~ 1f/tL-
--.--".--". ~
FIRE CODE REQUEST: A fire inspoClion 1& required for all proposed feclllti...,
I ~ Tho facility meet" the requ;romenb 01 tho fir~ c:ocIe,
I J Tne l.cJllty does nol mc:QI requirements 01 the fi,e code and csnnot be occupied until order. ere
(net
[ J The facility doe. not meet reqUirements, b~ma lemponlrily be occupied ~pendlnZIeIIO" of
order1l unt~ ~ ~ ) .
Signature of Flm Inspector: h.,~ o.le: f!. 20 (? 3
Gommenhl:
"",_It fot HtNlld\ IntlMit\1on Dr BulkSlng J"~peclion. GH ,e\len._ _lei.
~;~,:'
-..
--.-------.-..---
-.-.----..-.-...--
;?'d
2910-1<;1':-1<;9
,
~',
!>~H~!lO~.l IJO'llMJ
~dE[:[ E002 81 JnH
p.3
Jul 30 03 03:32p
R"~hO"~ Louis Cen~er
(763)757-'2059
~, I
TO: Loc;ll Health Insp,ctorlS."illrian or till! Mlnnuoloi Department of Hfllth
HEALTH REQUEST:
[ ) Lken...d
I ) Not Li~...d
( ) AppuC8~on ''''' or mailed
[ J No orders lle~s.al'l' sllime of inspection
[ ) Mujor orders issued
( ] Minor order. iss~ed
[ 1 Major revisions: nnded before license can be IRued
$lgnet~re 01 Health Ill$plclor:
0'111:
Comment:
........-......-.....................".......--................-....--....-._..........u..........__.................._....._..............
TO: Local Building '''''lHKtor
BUILDING CODE REQUEST:
r ) NOI eppliceble: fadlity 1oc8~ in 8 flOl\ocoded .raa of Ilet.,
SI9n'in~'e of L0081"--'" -.' --
Olllcial:
Dale:
Title.
An inspection is required for ell proposed laciliUes I """tOld in a code area whictl iovolv.. nfIW
cO"'lruction, major 'enovaling, or change in occvpancy I.e. :v1Y fOClllty not cUITer.tly uS,ed 10' lIle
propo:ied ....ag..
l\A"Faeillly meet. requirements
I ) Fecilily doco nol meet ,equiremert. end cennO! boocc~pled until orders arll m91.
DATE
odIIlnspeClOr.
unUl pending c;omplellon of
\
I J FsclJlly does not meet requi",menta. but rr,lIY
ordll'3. Date
Certificate N~mber:
1273
Comments
C'd
2910-1Se:-IS9
SI,HHI~Ol::ld \.101I:lMI
~de:t:1 e:002 91 'nl:l
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /4-/80 eAJ /7/'-16~--E
NATURE OF WORK ~ tV
USE OF BUILDING ~ J
PERMIT NO, ~ - fE24- DATE ISSUED f!; /o..s
CONTRACTOR .~_ ,(.Dc...'L PHONEt
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
I r.:..:....._ I
I . --.. ~ (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
R I SEPTIC
FRAMING
INSULATION
ELECTRICAL
I
IR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I :spew~~ I JI/JV/ I &--/(f'6
. FINALS
/ (~, rf':::,
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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,
FOR ALL INSPECTIONS (952) 447-9850