HomeMy WebLinkAboutBuilding Permit #03-0055
<ll~rfifitaf~ of @ttupaut\r /\
CITY OF PRIOR LAKE
~rparfmruf of ~uiIMug Jfusprdiou
iiFinal Permitted C Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section 307 afthe Uniform Building Code certifying
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. Frr the following:
Use Classification
SINGLE FAMILY
Bldg. Pennit No.
03-0.055
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District _
R2
Legal Description. L2. B3, DEERFcELD SEVENTH ADDITI.oN
Owner of Buildin2"
Site Addcess 17337 RIVER BIRCH LANE SE
20860 KENBRIDGE CT. ,'I.AKEVIU>E 55044
DON RYE
City P]anT'~
Contractor's Name & Address _ D.R. HORTON,
ROBERT D. HUTCHINS t1f'/
Building Official
Cj Ii, {)"l,
Date:
Date:
....
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7-((
ADDRESS
17?Jl 8.1_huh
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-:5-5)
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
,.,if"PLUMBING FINAL
D MECH FINAL
D EXIGRADIFILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
COMMENTS:
V Y C"LMgJt{
("bfr/ap"
D WORK SATISFACTORY, PROCEED
)lfCORRECT ACTION AND PROCEED
D CORRECT ~~", CALL FOR REINSPECTION BEFORE COVERING
Inspeelor: IVY/ 1-ll-d7 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
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r~ ..~-~~. - --_.~-~
."1"." ,.. -.-.... --T- .
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7],]7 ~j,,_h
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)TfiNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
.-B"'1III!"CH FINAL
COMMENTS:
1--VO"\.I{ r c;,~
r.-~
/~~~'S
a tlP rrJvIt (
'~p ~r7
{)JAqr r.c:c........{
DATE TIMe
7~L(
? -.a-
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
1L___ S),.J )L
~ ~/-CJ3_
o W~SATISFACTORY. PROCEED
;T'CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: # 7 -J-/11J. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
I I
, ... -- r
I I
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
tl-IL-c/?
ADDRESS
/7337
rZl ~/bf-c. i-t
OWNER
CONTR.
PHONE NO.
PERMIT NO.
5 - .>s-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
Try_S
COMMENTS:
.s::d-d~
-----~
-~
-
~
(
\ / (/1('"...,
~ L---" ~ -
r?)
/-71-,
~
./'
I
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ q - (L-dJ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETY!
IN,,,,m
r- ~
T~- T
~ FiLe- -...J
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or orint and sign at bottom)
ADDRESS
/1331 R,vu !31;ck kf\.Q Sf?
I. While File
2. Pink City
3, Yellow Applicant
11-/0 -0 )--
1 PERMIT NO. ()3 "00551
. i~~~ DE~~t1~1 (office use only) f\ 0
u:fTj. ~ BLOCK ,3 ADDITION' \1jP.v.'I111 L ~
OWNER
(Name)
(Address)
PID
(Phone)
BUILDER'\0 ,\
(Name) (\ J, K.. nn.......-t-nn -r.;, ( .
(Contact Name) \-{\\.& LDolnf\~/<jy.
'2/)B(cO /({AAbv,dAe. C*. (sic. iW
(Address)I~~A/\ 11/ . M I\Y c:)q) i.J..<./
,
TYPE OF WORK
~ew Construction
o Misc.
DLower Level Finish
I/..
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~ignature ~
DDeck
I ZONING (offi" use) I
(Phone) q52-Cj.!O~ -7..aQ9.
(Phone) '1s2.- 1-11('- Lf737-
DPorch
ORe-Roofing
o Fireplace DAddition DAlteration
PROJECT COST IV ALUE (excluding land) $ (3 ~/ A I
$
$
$
$
$
$
$
$
fY'cDOD. 00 1
.'taz.... ? 5 1
SA{o. 7i 1
43.50 1
1
1
I
I
I
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'~r-"J and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware th the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
e upon the property ne ed inspections.
Ik
100,00
100. ao
1.fo.oo
This Application Becomes Your Building Permit When Approved
~ ':/.ub
Building Official
/~I/oz.-
Date
I
I
I
$.57ClPJ.04-1
/) ,
I Receipfflo. q-"3 tl7-;
BVO' .
c?()~O q'~f
Contractor's License No.
Park Support Pee
SAC
#
#
ORe-Siding
Dutility Connection
/1119/02-
f Date
$ <;::\'50. aD
$ J~. 00
$
$
$
$
$
$
Izw.Oo
700. 0"
-
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. ,.
~ =1~1-J
Planning Director
I-,------------~--
I Water Meter Size 5/8"; 1";
I Pressure Reducer
1 City SAC and WAC
I Water Tower Fee
I Builder's Deposit
1 Other
1 TOTAL DUE
#
#
I Paid S 7'fA .CJ~
I Date J-1/.Cy
xk~
;2~)
/.;:J/.;1lftz.-
bate Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
fEE (YlAJ~ FILE
.
.
White - Building
Canary - Engineering
Pink - Planning
Th~ ("t'nln of Cht' I..kf Counen
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
D R HORTON
APPLICATION RECEIVED
11/19/02
The Building, Engineering, and Planning Departments have' reviewed the building permit
application for construction activity which is proposed at:
17337 RIVER BIRCH LN
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/YJ1B
.5a /YJc"'~ '::,"/(
Date: !). -;( -01
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,"
1.1
~~
)
~6 w(AIAJ Au:
Thr C,nltr of Ih. l..k. ('ounlry
<:"'White - Buildiiig)
Canary - I:ngineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D R HORTON
11/19/02
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17337 RIVER BIRCH LN
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
Comments:
~ :f~/-J
~ fi?~
Date: I~j;t...-
.~
"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."
.L ._ .~..__.
~~~
c~~ FlLS
/'
Tht ("f'nll'r or lht I..kf Counlr)'
White - Building
Canary . Enaineering
(liTiik . PlanniriQ')
aUILDING PERMIT APPLICATION DEPARTMEf\!T CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D R H(I~TON
1 J /l9/f1:>
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17337 RIVER BIRCH LN
Accepted
~
Accepted With Corrections
Denied
'"""'
Reviewed By:
~..:
~ ,/2;-;
....~
Comments:
vI"f
- .
'?71~. .)
Date: /.;..4/ ~ "Z..-
-;t~J
.
"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 BUILDING PERMIT, Date ReC'd"
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. While
2. Pink
3. Yellow
I /-10 - c )-..
PERMIT NO. I
File
City
ApplicilI11
(Please type or orint and sign at bottom)
ADDRESS
/1331 RIver h,;J\..WCh.,Q SF
ZONING (ollice use)
~k1~~3 DE~~1W7 (office use only) t\
LC'IT(l. '" BLOCK. -:; ADDITION I j'lph,J J.. ~
r ---- ~ - ~ --- ~-~-
OWNER
(Name)
(Address)
PID
(Phone)
BUILDER'l0 . \
(Name) ,\ j, K. I)nr-hvl -r:;;., {
(ConlactName) 1-1.\\./0. WOV1(\(I'!~
(Addressj'2.o9,00 lc:<AAI::)V, dlle. C*. Sk.I'CV
LA1:'n~AI\J . Ml\Y C::;91lJ..Y
TYPE OF WORK
o Misc.
(Phone) q62~ 9,~ - 7c;309,
(Phone) '):;2.- 2:U..,- c..f7 ~2.
~ew Construction
DDeck
DPorch
ORe~Roofing
ORe.Siding
OLower Level Finish
o Fireplace DAddition OAlteration
~~.nJECTCOST/VALUE (excluding land) $ f31/).fA f
DUtility Connection
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 property and that all construction will conform to all existing state and local laws and will proceed in accordance with
sublIDtted plans I am :7 ~I1ding official can revoke thIS penmt for JUst cause. Furthermore, I hereby agree that the CIty offiCIal or a deSIgnee may
~upon the property ne d inspections
X /) A u.."J .,., IL'L c:;?DQ..f) L;r,c;-, / 1/1 AI 07_
..... - _ Sl_r~ Contractor's License No I Date
I Permit Valuation
J Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
Park Support Fee # $
SAC # $
) Water Meter Size 5/8"; 1 "; $
I Pressure Reducer $
I City SAC and WAC # $
I Water Tower Pee # $
I Builder's Deposit $
I Other $
I TOTAL DUE $
Paid ReceiPt No.
Dale Bv
I ~
This Application Becomes Your Building Permit When Approved
Building Official
Date
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 I
Date Special Conditions. if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
Dec. 3. 2002 9:06AM
GENZ RVAN PLUMBING AND HEATING
No.6204 p. 31/39
Date ReI:' d
CITY.OF PRIOR LAKE
SEWER AND WATER PERMIT
(?Iease_ ~ or PtiJlt mt1siJon<OollOm)
I ADDRESS
JF),~30
~ ~w ~;. , PERMIT NO. .3 -5.::) I
1. 0nId App6l'11.11t
Kt'ver B/yaA
LA S'E
stR
. ZONING(~_u'"
LEGAL DESClUPTION (01lla: 1UO only) .)--... n
LOT BLOCK AuJ.JwON cL) ee/he Id
PID
OWNER
(Name) D"
(Addles.)
2.0~ J<ey,e>i<..I!:l6e Cr Sn:.Jr.r-.
(Addzos.)
(Phone) _
La~~ I lie.,
(Clty)
qo.;2 -q 85- I X' ,",^
V)~U
(Zip Code)
:u.......+-........ f'n'i'....-- u____
APPLICANT
(NlIII1e\ Genz-Ryan Plumbing & Heat.ing
(Pho.u.e)
651-423-1144
(Address) 14745 So Robert Trail Roeemo,!nL MN 55068
_ (Addmo) (City) (Zip Code)
(Contact Person) _ "R.m~ f11) /\ (phone) 651-.423-1144
UCANT SIGNATU~ J ....<..a'-1?1Q.::#f;ciu ..i JS DATE Ld~'1 -U;y
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
feet.
o Cast Iron
R.esidentlal sewer and water line cODnect:1on
Sewer connection only
FEE SCHEDULE
$35.50 Jndustrial, Com'l & Multi-family
$17.50 Water connection only
1% of job d!stwitb.. $39.50 mmimum
$17.50 \,
Estimated Cost $
Building Pennit #
SEWER MID WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
....--
/'" If''lQ:,,,,, . f
_':"";".'.' ""l Il
-'-.- '. "'~.."",
,
(OnItt Use Only)
I Thi. Appliution Beco",e. Y Oil. Building Permit When Approved
L.
lI~;ldiog OllldaJ
jlaR
"
., Pltic:!' ~~ Rcceip<No.
l!f~:~ :~ :7't Iii ~ I Y
~ B 2nrr.~ /~t.11r
;y85O, fax (952) 447J1,1j415 &, ,j
;l4 hoor notice for .11 inspemon. (95Z)
I I
-_.~-~.._-_._---
Dec. 3, 2002 d:06AM
GENZ RVAN PLUMBING AND HEATING
No.6204 p, 30/39
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
~ ~t E- I PERMIT ~O_ 1- .55'
(Please tvt>e orDrml and SJm at bollnml
ADDRESS
/133/)
ZONlNG (olDc....)
e'vev ~yah Lh SF
~
LEGAL DESCRIPTION Cofli"" "'" ollly) '" _ /7
LOT BLOCK ADDrnON <-LJe"erne/d
Pro
OWNER
o-am~ DR Ho~ton Custom Homes
(Address)
(Phone)
%2 -q 5<.;:' -78DD
~~D KeV1B.e.lDGe. C, Sre.IDD
41.JuvilJG ~...fN ..5E6l.J4
APPLICANT
(Name) ~Q........_llr"''''' 'P1~J.mh.""""':: It ~.........:
(Add.tess) 14745 So Rohert Trail
. ~ Address)
(Contact Person) - / ~ -eYZi. In
c ...-J,,, -
APPUCANTSIGNA~/V~
Qllantity
(
I
/
8
I
.a
(phone) ~"'_"?~_' ,Id.
Rosemount
MN
55068
(Zip Cocle)
(City)
651-423-1144
10 --/--60
APPLICANTPLEASECO~LETEBELO~
I Type of Fixture Quantity I
I Bath Tub with or without shower Rough-ins
Dishwasher , ' I Water Heater
I Floor Drain i I Water Softner
1 Lavatory (Bathroom Sink) "' I Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 c~.u,..... ;'uent sink , I Sewage Ejector
I Shower Stall I Backflow Assembly
I Sinks I Backflow Assembly Test
I Bar Sink I Lawn Sprinkler ,.
I Water Closet (toilet) I Other.
Type of Fixture
'.\
FEE SLl1Jl.uULE
industrial, CommercIal & MuJo.f8lDlJy I % of job cost w,th a $3950 minlmum Rcs1denttal, N~ One & Two-Family S99..S0
Rcs1dClltial, Additions & Altetations $39.50
Estimared Cost $
BuildJIig Permit #
$
$
$e-~
. . LtOWIJ
~'" ~9 .
1 '
by
24 boor notice for .11 in'pectioD5 (952) 447-9
if'
J
.-.r.
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
1[?,1
.50
(OftIce U'e: Only)
, Tbis Appliation Becomes Your Building Permit wheu Approvod
I
Blilldiog Omci.l
Date
I I
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
.Ai?~95
(Please me or Drinr and shm at bottom)
ADDRESS
/7??7 gL/t'-/ ~C/ /~ .c:;;~
;~" ~:~ I PERMIT NO. 3 -5 ~
3. Yellow Applicant
ZONING (office use)
LEGAL DESCRIPTION (olliee use only)
LR'?LOCK ~DDITION
PID
~~e~RD.';\. Horfon (luJom Homp_....
(Address)d{)g(g() ~hric\cy-, (H.; Lo.kevi /(p_ Mt\')
APPLICANT 1\ II. t M h-
(Name) II.LVOI'1 e~. la.. (Phone) 1051-.</5:2..-0<775
(Address)3&5{) ~enr'l/.be('~. 5J@, #j j.~Qa.tJn /i5~
(Address) V (City) (Zip Code)
(Contact Person) Je.f-Prp- Z;mmpr.rn Gtn (Phone) to5/-t.j(j(). ~7'7~
I fJ.4/,__~().~ DATE
T" v ------- -----
(Phone) 9561- q ';?!5 - '7.:27.2..
550~J..1
APP ICANT PLEASE COMPLETE BELOW
f0NEW CONSTRUCTION 0 REPLACEMENT 0 AL TlORA TIONS
FURNACE MAKE AND MODEL 'Br~~~VlWUl" [') FUEL ,uedul"\'). I
FLUE SlZE tlJ'cla.sca "EL RETURN OPENINGS J.l. INPUT IC,OI>O OUTPUT 5u:,.tJO 0
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
~ Conditioning
~ent. System
I FIREPLACE MAKE AND MODEL
o Steam
o Hot Water
o Radiation
o Special Devices
o .other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential. Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Official
Date
$ 0') .,~ ~,~:"
:J~~rti1 ill ~'~r :,:';!TH
~,J'N . 1,"' ~""N'C "":1
LTy ~/
eyate
(Ollice llse Oaly)
This Application Becomes Your Building Permit When Approved
24 hour notice for.1I inspections (952) 447-9850, fax (952) 447-4245
III
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
I. Pink
2. Green
3. Yellow
File
City
Applicant
(Please tvve or -print and siitD at bottom)
ADDRESS
17337 RIVER BIRCH LANE S.E.
LEGAL DESCRIPTION (office use ouly)
LOT
BLOCK
ADDITION
OWNER
(Name)
D R HORTON
(Phone)
(Address)
APPLICANT
(Name) ATJJF.DFTRF.STDR DRA FTRFSTDF HEARTH & HOMF
(Phone)
ROSEVILLE
(City)
Date Rec'd
I PERMIT NO. .~~
ZONING (office use)
PID
651-633-2561
(Address)
7700 NORTH FAIRVIEW AVENUE
(Address)
55113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
(Phone) _651-633-2561
4/29/03
(Contact Person)
BRENDA HUSTON
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
EJlJltAID Win.,
DING PI:FiM,
I r}'" [0 ~ U Ili ~ -J'IJReceiPt No. '17"
1I1 paMAY - 1 2003 /BY /Iv-,
-/ YJ
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
o Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
OWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
OVent. System
FIREPLACE MAKE AND MODEL
HEAT NOLO SL-750TR-C
Industrial, Commercial & MultiMFamily
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
'i:
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
Date
24 honr notice for all inspections (952) 4471!Jl}iO, fax (952) 447-4245
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
..
.
Job Address /733) p,v (!,,.'ir<"
Heating Contractor If//'~ nta'H
Name of Tester ~ i
Date 7P#?
. fg.71..
fio/nu
~.'"f?
3(P/~ ?
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately suppiied per
UMC Sec. 606 VLf
input ~f{. tJD1J
Iii
DEPARTMENT~~~iJ_ Fli.1" ,
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 17~' ~velC ~/ieeH LANi SE.
NATURE OF WORK . N~W ~srJtJJerliJN
USE OF BUILDING ~ F: A. a
PERMIT NO. ()3 - OI"JC\-t:) DATE ISSUED a/I' /...
CONTRACTOR TJ&~_J/..~.lr.r.~. PHONE.!SI- ~z.
NOTE: THIS IS NOT A PERMIT FO~ ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I
I FOUNDATION (Prior to Backfill) Nu;v.. I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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I FOOTING
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
GRADING (Prior to Sodding)
BUILDING (I-c",p
ELECTRICAL
PLUMBING
HEATING
DO NOT
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INSPECTOR
DATE
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COVfR NO WORK UNTIL ABOVE HAS BEEN SIGNED
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NOTICE
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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.
II
FOR ALL INSPECTIONS (952) 447-9850