HomeMy WebLinkAboutBuilding Permit 03-0183
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QIrdifirafr of <IDrrupaut1Z
CITY OF PRIOR LAKE
~rpnrfmrnf of ~uilMng Jlnsptdion
JZf Final Permitted [J Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Un~lorm Building Code cert~fying
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 Classification
SINGLE FAMILY
Bldg. Permit No.
03-0183
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
Rl
Legal Description
LID, B3, THE WILDS SOUTH
Owner of Building
Site Address
2897 BOBCAT TRAIL N.W.
Con"actm's Name & Addre" WINDWOOD !</o~?'
(II
ROBERT D. HUTCHINS
Ir __ Building ~ial
:X-7rr _/5 ,
14311 EWING AVE. S., SUITE 200, BURNSVILLE
DON RYE
City Planner
Date:
DATE TIMe
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~''2.'1-o'"3
ADDRESS '2j!) '(7 ~/AC~~
OWNER CONTR.
PHONE NO. PERMIT NO. 3- /87
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
11/.-
'- \.-
+.,. c t' LJ ~ .t.-:-( Il
-oC-
plWORK SATISFACTORY. PROCEED
d- CORRECT ACTION AND PROCEED
o CORRE~CR . CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
,"""'n
DATE TIME
CITY OF PRIOR LAKE c..C., -O,?
INSPECTION NOTICE SCHEDULED JO:OO
ADDRESS 28<1'1 ~M~. T...
OWNER CONTR.
PHONE NO. PERMIT NO. 3-ca~
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
$FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION )'CMECH FINAL 0
COMMENTS:
A. (It.~J;t"' fLow."t. ~~ -:r---- J
~ Sullr.:> Dac.1c. \",~ ..b ~ 1(",;
?~..LL.. 'S,..L.- ....It. () . -
"f. ~.....Q tl- T {lLl..b fH-~J.-cf-ft.-
T~
Q j;C)
J.a 8~c-oJ
(2)Jau... D-..e. ~t"lu~:-
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
J< CORREr3f.K' CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Con!r:
CALLV 7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
OISNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
{p-I"-o~
i:': e,.,
ADDRESS
~'1'7 'Rob\:- ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-7 - / fa?
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
)(.PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
,.~~~",.,
)... /-I^^k. t.Jp-,-d.J".{I""".t ..\......y
Q.., ~J.. 0 +- Fl,...v- :r;::...A
o WORK SATISFACTORY, PROCEED
)<fORRECT A ;nON AND PROCEED
o CORR~V RK. CALL FOR REINSPECTION BEFORE COVERING
,
Inspector: Owner/Contr:
CALL 7\ 185 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~MENTSARE FOR YOUR PERSONAL HEALTH & SAFETY/
HUNOT>
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
l~<1l
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
COMMENTS:
f ?IlbDf-~ - 0"'-
MEA-
DATE TIME
~)
1-::n&.AT """'~Jl(r.L NlA)
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
():,.-() 1'i<3
o E~FILLlNG
o C~'NT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
, ~l-.L- .-r..,..:) kr ~~ l-J..4JOCL.A.flt.
.
.:::..5U4\4) PI )'^"'~ \-l(Y'~ 1"D 'Oe,k1k,:rr1:L..f:
~~.('-. ~<".l'X O\J...
,
~/") <;,.,() OJ.. "IR fj:. =-
o WORK SATISFACTORY, PROCEED
;;s:: CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'nspecto~k.f ~ OwnerlContr:
C~'LL~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
;/-3-63
I PERMIT NO. 03-0/831
\. White File
2_ Pink City
3. Yellow Applicant
(Please type or print and si2Q at bottom)
ADDRESS (),~'17 ~~ ttJlA..J
LEGAL DESCRIPTION (office use only)
LOT 10 BLOCK ,,,? ADDITION tJ.JU....." 5~
ZONING (ofliceuse)
IZI
PID ;;>",-,,~7- (}(o4- -0
~- -, . ., -' -- -
OWNER-.-O ~
(Name)~' <l- .n....._ (Phone) CJ5~ <?< '=t I :3 In::;.
. '
(Address) 1~'-I~'7 <CoR~, r--4o...t-: ft~'i ~+, J /l1/U,~<o:J.Lf
BUILDER l' A . J I I
(Name) fA /..{A/'l"'f n ~ ~ (Phone) 9..5' {1. '? "J... &) e I.j If 5?
(Contact Name) ~.A ^~JlP j ~-ullJ,J~ A .J (Phone)_'l.c;~ fi5" ??l.f4g xlD:).,
(Address) 143/1 Eu~~.S;nco. ~,/fJ!lJS..:;.so6
, ' ,
TYPE OF WORK
~ew Construction
DLower Level Finish
ODeck
o Fireplace
OPorch
OAddition
ORe-Roofing
ORe-Siding
DUtility Connection
o Misc. PROJECf COST/VALUE (excluding land) $ ! <: <" /),F) n
J t
I hereby certify that I have furnished 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 r-."'y....,) 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter;j .,'ZtQperty to perf,rm needed inspections r d J 9 ? I 1;:, ZJ /0..3
Signatur Contractor{;ticeflse No. ate
I Permit Valuation
I Permit Fee
1 Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
1 Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
lJ>'o. DOO.OlJ
144/.75
'137./'-1 '1
90.00 1
I
I
I
1
1
loa t 00
10". 0 8
35S0
40.00
This Application Becomes Your Building Permit When Approved
~.:f~r--
Building Official
'1/'O/(Jg
~e
OAlteration
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$ I
$t}, fd3tJ. 3 9 I
f:fstJ, 0 rJ
/2. 7'5, 00
300. I'D
70,00
1200,00
700,00
15o().00
~A1A~ 't'W"'OJ
I Paid ii K h -5 '1 . ~ ::;
I Date ~ -dJ/'-(),:')
I Receipt Noi/3 '7"1'';
BVU'
-?A..:;; 1'-;
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 requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
~
Planning Director
I Water Meter Size5/SV
I Pressure Reducer
1 Sewer/Water Connection Fee
1 Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
#
#
02;o~j' /f?~ d/ ~ ~
Date Special Conditions, if any
24 hour notice for all inspections (952) 447.9850, fax (952) 4474245
,0
~\
White - Building
. L'anary . ~ngineer,"~
PinK - I'lannlng
Tit.. C..nl.. nf I".. I,a... CO.IIUI'}"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
\ \ i i ~ : '-'\,\1('.,.-"-'
\.1 \1 i f\,J L../ v'.j _J'I\-, L)
H' , '\r-"-
(- if'.' 1,_" ("'.
I . ..../t t_____
APPLICATION RECEIVED
:7 - -:;;;-(..,-:::<,
L.- _.1 .J'~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/' c..-:c., . :} -4 e'~ (~; r~ If J.!., i . -'r.:) D- I ' I' "j"";\')
~~ (./ I I ;r-/" .1--" 07 \ ~ l,:...../f \ . t... I'. Of
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
Am!)
Date:
2 -/4-03
Comments: SF'F' Rev.ef!'>F' Side for Additional Information!
S.ee.,Att"rnmf'T1ts' 1) Grading Plan. 2) Erosion Control Measures
"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."
~1
White - Building
Canary - !;!1gineering
I"'l'mk - f'lannmc -,
Tht (',nlt-r of lhf I.akr ('(Iuntry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
\\"1 ,(,"\,/ (\'"
, ! I -,.' V \ j Co> ' U
'-, -;;> 0 -:;?
L --_'- ~
H ' t' \ c:.~,
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
C'CG6/\ (
? (".(-:' -1
,--C)} /
I
. Il~A I L. 1\) ~V
Accepted With Corrections /'
Accepted
Denied
o
Reviewed By: ~ ~f-- Date: 01/;0 Ids
comments:,' lJ/!~. S-/ ~kd, ~ ~O-l~d
~ ..a ."/J.. ~ ../~ /.: ~, oN I rv--.c ,~, - d--cJ.t
~ V
~ 'In /2. o. fAl.
"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,"
$~~
~e - Buildinv
Canary - I::nglneering
Pink - Planning
Tht (",nltr of lht 1..1l, Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
.WINDWOOD HoMES
2-3-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ZecA 1 SOt) M ( 'll2A1 L f\J vJ
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
~
~~
"':f~/-J Date: "x/;%;s
o.Lf a:t::f;;:d.Jl ~ -~ .
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,"
("'Hila"
,
,
(Plcu~ me or otint and ,9jPl13.C lJo((om)
I AI{I}RESS'
1 ~ ~ 0.., () air;, \.,V(~
LaqfL DESCRIPTION (office ",e only)
LQ'f\(::, BLOCK 3, ADDlTlON \.-.\.; \ ~ ~ -'c()'V\ \-\"
I,
OW1)lER
(NiirTIC)
.~ ~ t\.~ \A \)~~ ~~trU.~
,'-'-:, \, {,.-.....:.\,,\ \\ oJ,- '::,
(A~dfeS5)
A!ll'~rCANr N\ '^ I ~.
(l'{aTc) , ' \<<.:.1,;: n. i ,"',,.... -\- Y\ l.,
(Al,idICSS) \ ~ ~ ~ CJ \.j \;, \ L lJ '" 0\'\/ 'I.....
. \ I (Add,m)
(Cl/n(aCl Person) [\J t.A V\ '-\/ S '--" '< ....\.....
AFfPCANTSIGNATURE 0f\V\t\I-\:6 <..1.\,\",
, ,
~IO . 802
P.i
Datc Rce'd
L ",k fll. I PERMIT NO'3' 10 '::1
1, Cl~" C.rt ~---- <:s \..J
J. '(ell~.... ^rpliu..{
Buildillg Pcrmit 1/
$
$
$
,50
(PllOIlC)
0,^~Y"\ !>\\, \~
ZONING (OmCCU1t')
1'10
,,\.0._ ';?(\~-~\\\.\ ~
c; S")Cl\o
(Phone) ~ S :.~,. '-\ \.\ l- ~ \ d. \.{
(l., ()- \.I.,\ll.. ~i~0 SS::"d,
(Cily) (Zip Co~e)
(Phone) q ~:>. - '-\ V, f. '>5 \ \J '-\
DATE s- \\-3
APPLICANT PLEASE COMPLETE BELOW
'j ..:g]NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FUJZIjACEMAKEANDMODEL c.c..v"';.(~ (V1 V p- IO\) fUEL N C1I \-
FLl)~' SIZE &\[ c.... RETURN OPENINGS ~ INPUT \ ()~, tl'1:l~ OUTPUT 0.. <., <J m
TYPE OF SYSTEM HEATING OR POWER PLANT
.~Varm Air I'lnnts 0 Steam
OGravity 0 Hot Water
o Mcehallleul , 0 R.dlntion
~ir Condllloning 0 Sl'eci:l.! Devices
~Vent. System 0 Olher Devices
Fll\E~LACE MAKE AND MODEL
- ,
.'
I'LEASI, NOTE:
Air Conditioner UllilS
CJnnot Encroach into
Required Side Yard
Selh,eks
FEE SCHEDULE
1% of job cost Resil.!enLi31. Gas Fireplace
$3 9.S0 minimum
$99.50 ReSldeuti,l, Additions & Aliorlltions
$M.50 Residenti,l, AC Ollly
Ind\151~iat. Commercial 8:. Multi.Family
Relldent,s1, Hesling & AlC (New C:onSlr\lellon)
Rc~jd~fHj:l.I. HC::01ting Only (New Construction)
"
Estimated COSl $
!-lEA TING PERMIT fEE
STATE SURCHARGE
TOTAL PER.I~lT FEE
(Ollic~ Use Only)
,
Thll Application Becomes Your Building Pcrmlt When Approve!' -. rcl ~drc:
:; [ L9 lID IS;
~Dat.
Ouildlng omdal ~atc U, llR 1
24 hour nolke for nlllnSI,c.ctions (9S2: -4-47-9850, fAX (952) ".47-4245
By
$J9,50
$J9,50
$39,50
PAID WITH
BUILDING PERMJ'T
Receipt No,
Oy ,
tf/
11: 31AM
MATTHEW DA~IJ ELS, H,C.
423 301 7
P.02
Dale Rec'd
en)}: OF PRIOR LAKE PLUMBING PER \1:T
" '
\'
,
"
i
: . '., !i I
(Pleasc ~ or pnnt ud nen OlC bottom) II I
ADDRErSS I I, ,i :
V,?91 ~ u:L '- I, -'l..l .: , A . .J.)v.
Ii, yu<-u-~ ,
LEGALiDES!:ON(Officcu.<eonIJl I
I I 'I .'
LOT I~ BLO Ki...3 ADDITION, .:>v.JJ..0 \j~ . ceO
I I '
~~~~ ' )) u+::ti HI ) I (Phone 19s-a, "ii'q~ 'K#~
1!(Addres~ '1o;,~ ~,\4>., ~A;d/:),~
I ! I"', U Ii
: APPLIqANt ~. ". I:~
(Name)lfbJ~ ~.::f')' "-4111 I (Phone) (,5"1 'i,-~.I-3'1.~n
(AddresS) ...JSl}. ~ _kA__ ~ / h . ~VlJ rt J J I i lA, \..tI.:;) ..s:s-068
I '(Address) ! q" (City) (Zip Code)
'Co"", +> : 1lx , "" l' ik4" ~ ') _ ~"~l '-"'iZ _J., \ -,,,'"
APPLI I ANT SDNA TUREJh ~ r"iP'~::DL__ --,--,-0 J J.I /J~ DATE ~..,L/A3
1 I ' , AllpLICAN~ P~EASE COMPLETE BELOW I I
Quanitity: Type if Fixture I \ Quantity 'fype[of Fixture
.tJ 13, ath T,U,b With or w (hout shower !...3 Rough-in:
/ I j)ishwasher :: 1 . Water He lte
I I ~Ioor iOrai!1 1 \ Water So: tn(,r !
4 , [:,avatOJ:Y (Bathroon ! Sink) I 1 Stand Pip' ()'lashing Machine)
I I Laundry Tray (lor 2 compartment sin~ : Sewage Ejjector
I I Shower Stall " Backflow ^'1sem~ly
I i Sinks I; Backflow A~semb,ly Test
I l~ar Sink : Laml Sp' inkjlcr
-.3 I l'Mater Closet (ToilE1t) Other I
, I I: "I
I I : FEk SCHEDULE I :
IndustLI. domr.ereial & Multi-famHy Iii'. o,job cost with. $:1950 mmimum Residential. Ncw On ,& Tlo-Family S99,'O
I ' " i Residential. Add; lion ; & AI,.,",;ons 539.50
Estimated frst 1> I Building Permit # I
l! I PLUMBING P~RMIT FEE $ q4~ - ' PAID 1M
'i STATE SURCHARGE $ .5 ) BUILD' rv1rH
1 1 TOTALPEro.nTFEE $ /111I111 A.f- ~" ' ING PeRMlr
, (orne. u,. Only) , !
Tltis tppucati ~n, Becomes Your B11lding Permit whei Approved ffl ~ @ ~ n lVi1':tT'Pt No.
! Bulldin~ omclaJ :; v." : Lp~ ? ~ ~~ j! I r
:z.4 II ,ur nOlic. for all inspoctions (952) 447-985 I, fn (952) 447-4215 '1
. I By_ '1
I,Bl\l< F;I.:
!. c;.~" CL~
} Y~ll/)"" ,~pphe~~1
I ~EjR.t"I~T NO. 3 - (5$3
1
ZONING (office "'<)
PID!
i i
~:37
, I
I
I
I
I
I
I
I
I
I
I
.
J
1
1
\
II
TOTAL P.02
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
4 +03
i ~:w ~ii~, I PERMIT NO.a) -? -- Ol:'~ '"2. I
3. Gold Applicant ~ 1I./
(Please tyEe or print and sien at bottom)
ADDRESS
1..9~7 f.!,o(!,Cd, Tit.. N, t.V.
ZONING (ofliceuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) t.V ~tJw (; e., HO/>1.€ S
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT
(Name) I) fl..-cS tIi:A.-~ C
(Address) I <0 /I J Yo ,Pc L-J 1A/Y9- '1'
(Address)
(Contact Person) I.S I..\. 'T e. H
APPLICANT SIGNATURE r 9-.n.~-kc
u
(Phone) q.rJ. .n1--C?O'
LIt Vi.
(City)
S-TTJ <{ <.{
(Zip Code)
<\j--,,-- L
(Phone)
DATE
'fll/Of
n ... ./-
APPLICANT PLEASE COMPLETE BELOW
Size of water service J inches,
Location of any couplings from structure - feet.
Type of sewer pipe. 0 ABC ~ PVC 0 Cast Iron
Estimated length of sewer line L{ D feet.
Clean out (if required) located at --=:.- feet from structure.
Residential sewer and water line connection
Sewer connection only
$35.50
$17.50
t-<>
Estimated Cost $ S' /) 0 .
FEE SCHEDULE
Industrial, Com'l & Multi.family
Water connection only
1% of job cost with a $39,50 minimum
$17.50
BuildingPermit# 03- DIg?
$ ./
$ /" .50
$ ./
/
fl1
ptrlO ~'
&//0
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
--
Building Official
Date
I~
I fJal1- -1-- 07
24 hour notice for all inspections (952) 447.9850, fax (952) 4474245
05'01/03 14:17 FAX 7635530887
GUYERS BUILDERS SUPPLY
141001
Date Rec'd
--- --.----.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGfFIREPLACE PERMIT
;~" ~:~ \ PERMIT NO. 3- /0 ~
~. Yd\~"" ^lPfIhC;Blll t>...J
(please: me or orint and SteIl a.t borrom.)
ADDRESS
ZONING (offia""'>
dRV
~obQ.Cc..\-
T 1"0.'1. \
LEGAL DESClUPTION (oll,e,"-,e 0011')
LOT
BLOCK
ADDITION
PlD
~=R 0,~6wCC)J
, (phone)
(Address)
APPLICAN;>,
(Name) l ') U'I (" .. '-,
(Address) f.J '-J 0 5 I ~-5 -t-h.. iT r.J r:::....1I U ;-
(Addtt")
(Concaa Person) bor'\
APPLICANT SIGNATURE \0~ /31(~ ~
(Phone)
f/<rMO()~h.. S5""YY /
(e'ity) (Zip Code)
. (phone) 710 3 - tf, '1V- Y6,{. "3
DATE .5-/ /
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION _ 0 REPLACEMENT 0 AL TE.M TIONS
FVRN.' ,.." MAKE AND MODEL - '=:"J '{ d' \ U I It::, \" b 0 () FUEL tUer... "" (},c,,,
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
DGfUvity
o Mechanical
OAi! Conditioning
OVen,. SyStom
FIREPLACE MAKE AND MODEL :, c) Pe.... I 0 ('
o S'eam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot E.ncroach into
Required Side Yard
Setbacks
\':)T/o06
Residential Heating<< Ale (New Constnlction)
Residential. Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Rcsidt:f'tial, v....s Fireplace
$39.50 minimum
$99,50 Rcside't1tial. Additions & Aller.llions
$64.50 Residential, AC Only
S39.50
IndUStrial. Commercial & Multi-Family
SJ9.50
$39.50
Estimated Cost $
/()(?()~O
Building permit #
REA TlNG PER.MIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
S
$
.50
eUll~-4ID ~
~G '1'J-/f
p~
~-i1I'J-
(Office Us, Only)
This AppUcation Becomes Your Building Permit When Approv ' .
Boilding Offici.l . Oa" ~~ j'~ 0 I':! rn ~
~,:y - II LUUj 11
24 hour notice for;l.l1 inspection! (9 7.9850, fax (952) 447. 12- ~
Receipt No,
By {r
/I
By
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ZSCl? 1So.acAl ~i L N. W '_
NATURE OF WORK ~~ c.o~~~O~ ,
USE OF BUILDING S.~l::). . .
PERMIT NO. tJ3 - 0 / ~3 DATE ISSUED
CONTRACTOR PHONE - - ClefS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~.JCTOR
L .W)-
I FOUNDATION (Prior to Backfill) ~ I
(j.J c-;;-,. p'LACE NO CONCRETE UNT IL ABOVE HAS BEEN SIGNED
r~' J/_J! ROUGH _ u-IS
' SEWER / WATER / SEPTIC ,fib I~ ~8
FRAMING I (fu~ I tf~ (L/
INSULATION' ~1 V 0/ -~ I I
ELECTRICAL I ?-L5 ~/- /IS I
PLUMBING Vr$t.ld. ~<r- U AA ~~ I
HEATING (if required) I'~ I U vi {j;
FIREPLACE i}" {l...f.+ I S/7/~
GAS LINE AIR TEST ~ \ lh i' I
COVER NO WORK U\ifIL ABOVE HAS BEEN SIGNED
./STh<<D ICJJirJMSJ.s7lMS I ~~ 1E;9 I
FINALS
I tel<.. 6.5'& h
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I /~ 6-"",
i tm
I FOOTING
OATE
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i
I
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GRADING (Prjor to Sodding)
BUILDING "lw...:. .t-t) ~- ( - 0'7.
ELECTRICAL ~ ./
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
I
I 8-29
I
I
I {p - I~
BEEN 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.
FOR ALL INSPECTIONS (952) 447-9850