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Home My WebLink AboutBuilding Permit 03-0383 QJrrfifirafr of <IDrtupaurlJ CITY OF PRIOR LAKE ~tpnrfmtnt of ~uilbinB cIDnsptdion ~Final Permitted 0 Conditional e.O. Expires This Certificate issued pursuant to the requirements afSection 307 of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances afthe City of Prior Lake regulating building construction or use. For the following: Occupancy Type R3 Type Construction SINGLE FAHILY VN Bldg. Permit No 03-0383 Use Classification Fire Zone KIA Zoning District R1 Legal D",cription Ll 0, B4, THE WILDS SOUTH Owner of Building Contractor's Name & Address BRENNER Date: d/l , Building Official c;eNSTR.. !~ /t I. V Site Add<ess 15279 WOOD DUCK TRAIL.N.W. P.O. BOX 1314, LAKEVILLE, MN 55044 DON RYE City Planner ROBERT D. HUTCHINS Date: '~'_.~-""",,--'-.:':',,"-",-,.'~- ..:........: ._--~'''-~-''''''''''''~ . . .... ADDRESS 15"2, 7'1 OCCUPANT HEAT LOSS SOLD BY Electrical Work By TYPE OF HEAT ~,.... - ~ ~ ....-,~",..~~~?J>.y: '#~''''~~~*,~V''''~1li~~~~:-6?~~'I~'V~''' ~_ ~~ -/ JOB# 7010 V-/",OC/ DATE HTG. INST. HOUSE HEATING TEST RECORD /)[,.1(, r: Tr ,AJl1/ APT._ FLOOR CITY f"e,Io(,t, SUBURB rI'-'NER It'''TALLED BY A /I,'., t71 Mrr h . Gas Line By .,4. 1/. :..,,+ Mtpr". GA _ FA 1-- HW_STEAM_ SPACE HTR. _ UNIT HTR. OTHEF' <:::J "- ........ 0 1/ /~AS DESIGN MAKE~T"q ,.. Model -;'.,-{'Itt14t1ffl/g'f'Or:: Serial J,.,o}1f 1r;'I~' INPUT. a.a:IIJ THERMQSTAT Valve IN '''I r f&C; f (J Limit C e. ,.ct ../ ,- N Limit Settinn ~ '10. P Fan Setti n- f-,lhf>c/ Pilot Type - /{ 5 ]; Pilot Make Pilot Model, Pilot liming LW. Cut Off Pressure $' '5 _'.iI.C. Input CFH I"OCO Stack Temp, Cf r I' CONTROL!! Heat PI": Percent CO2 Percent O2 Percent CO CONVERSION MAKE OF BURNER. Model Max. BTU Rating, MAKE OF FURN'~" Model. Vent Siz-O )" fc 7,",rt/c KIND OF LINER Draft Hood Filters 'j Size II;~.... o:-..J:1 , " Chimney Location Inside '.. Chimney Constructio~ ....... SIZE NONE Regulator 'S 11; - :3 '" Number x " Outside "-J. ., ~ {,.7 7." o SmOke Bomb Draft Door Pressure X \, ""-. y, .l( )(' 'Y Wi( C' TestT?~ Lighting Inst M- ~ /J-f/ ~ v ~~ Date TeQ+", " -- CITY OF PRIOR LAKE INSPECTION NonCE DATE TIME ADDRESS ~/.77/03 S :30 / S;) 77 VVl'X'dl DIJL-I:. Tf.,Ii CONTR. Rrltll'1er [",t151. PERMIT NO. (:) 3 - ~ gJ SCHEDULED OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ..a"f:lNAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL /12<E~ILLlNG -0 C011'/ltilNT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: (;r...",,& - (;) ~ (ulb &r-- oe ...... f)<:WORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING I~_.:'- - Inspecto~~ ,.~/Contr: ..- CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEA.LTH & SAFETYI msNOn " "-.. .,... " []ATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED cr-'/-m / ADDRESS l :, L/~ (J_ ),,;;e:l QUc/:7 OWNER CONTR. PHONE NO. PERMIT NO. ~~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 EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AJR TST o ".J-""'- COMMENTS: c;f'+-e:. cf"~~1l-- ~ \ { L X WORK SATISFACTORY. PROCEED )21 CORRECT ACTION AND PROCEED o CORRECT OR, CALL FOR REINSPECTION BEFORE COVERING Inspector: _ Owner/Contr: ~R THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! uaNO" --....,.- . CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. SCHEDULED K~ 7 ~ IA/Mdrfor.ll CONTR. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION p-RNAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL IiI'1IECH FINAL COMMENTS: -fir) ........... {J Add ~c-I"tt.v$ --f/) )... /~ J,~U'7VT--"" {'t'~~:, (,/.."{ll' I . ~ (,..." { q:.rii:f. a;P'Yva I 711...", ~ rl ~ <(,..,..'j ',' "$+ If. '{-c "",,(7 l/l1 f: I ()r5q.f- ~c~w I DATE TIllE k-).C-t/) 7- '18"3, o EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o CI//oJ/ / / 0"1 cl,..",// - JII.,...,j.,,( /O~'ll-t!) :> o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT ~R'J1ALL FO~ REINSPECTION BEFORE COVERING Inspector: V VY" '6.....)..l fI7 Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! IN''''m - T'. CITY OF PRIOR LAKE INSPECTION NOTICE DATE nME SCHEDULED 8-1"'03 :2!30 ADDRESS J 5 ~ '7~ I J~ DLds,. OWNER CONTR. PHONE NO. PERMIT NO. '3 - 383 o FOOTING o ~OUNDA TION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP ]i( PLUMBING FINAL o MECH FINAL o EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: l. ~ (t.,,, (\~ o WORK SATISFACTORY, PROCEED )('CORR T ACTION AND PROCEED o CO E WORK, CALL FOR REINSPECTION BEFORE COVERING ( _ Owner/Contr: o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. lREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY! INSN017 .-.-- .,.."- CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS I 5z.-7Q OWNER PHONE NO. \r 0 FOOTING k l!' FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: DATE TIME SCHEDULED ~ ( ~J\tJLl,c CONTR. PERMIT NO. o PLUMBING RI 1- 0 MECH RI ~ WATER HOOKUP SEWER HOOKUP ~ PLUMBING FINAL o MECH FINAL I. r _.~.-: WvP"'L. ? VV ~--.39,.3 o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL ~T G-k'Z 1~ / ~ORK SATISFACTORY, PROCEED \~ o CORRECT ACTION AND PROCEED o CORRECT WO;; CjLL 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! INSNOTJ __m"~_._-'---'---'-----r"--'---'-'----r--- r CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec'd .3-/1- a3 I. White File 2_ Pink City J. Yellow Applicant I PERMIT NO'(E-Q383 I (Please'!vpe or print and sign at bottom) I ADDRESS /.:SZ 7'1 wtrJO I)UG/Z {72.A-1 LN. tV. ZONING (office use) 12/ LEGAL DESCRlPTION (office use only) OWNER (Name)_ LOT It? BLOCK 'I ADDITION 71ft.. W/UJ.5 50lJTl( A~21Z CovSC J;,r_. / PID25-3eZ- //5-0 (Phone) (Address) ~~~~~j(fMI~ ~Cr (Contact Name) ra71 LJ~/).J'K (Address) IttJJJoK IJ/'I; I-A-;::"WItL-2../ Mdl JSOW (Phone) ~~5Z-ll z..-77()f (Phone) alZ--7~7-tJ3r&' TYPE OF WORK ~ew Construction DLower Level Finish ODeck DPorch OAddition ORe-Roofing DAlteration ORe-Siding o Fireplace DUtility Connection o Misc. PROJECTCOST/VALUE (excluding land) $ Z& 3, L/(J() 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 submitted plans. are that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may ~teru e operry to pe2te~ /ILZS ' Z/){} tj '0 Lf g 3 .3 -j/!-rJ 3 Signature Contractor's License No. Date Permit Valuation 7J, 3lJ(){) O!' I I Park Support Fee # $ ~~O op I Permit Fee $ i q/x'.~J I I SAC # $ /J-7.f.oo I Plan Check Fee $ fJJ'I,),,(, I I Water Meter Size 518"(1); $ "300 00 I I State Surcharge $ fll,{l) I I Pressure Reducer $ 70.00 I I Penalty $ I I City SAC and WAC # $ I J-oO,Oo I I Plumbing Permit Fee $ ID{),oO I I Water Tower Fee # $ 700 ,Of) I I Mechanical Permit Fee $ IOO.df) I Builder's Deposit $ J S-Oo ,00 1 I Sewer & Water Permit Fee $ 15"'.s0 I Other $ I I Gas Fireplace Permit Fee $ 40.0D I I TOTAL DUE ~JI1A,Ql ~-.J~O] $ 'I. 447. f?I I - , , / T~ca~ Your Building Permit When Approved I Paid <-j'ijijr /./5' / I Receipt No,'t,kfU 0'-1 I Date /./_ /t.!- -{ Bv . I ~-U-03 () 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 WhenYfllig d by the PI ner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. J"4-r~ (2"."d aJI I1(J1-<'S 0./- If...-Jotk Date 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 5~~ +1....NU01.... CITY OF PRIOR LAKE SEWER AND WATER PERMIT Date 4- -Z4- I 0=, Fil, I PERMIT NO. 0'" . 07 a.3 2 Yellow CIty .) '--' () 3. Gold Applicant _ (Please tvDe or mint and si2ll at bottOm) ADDRESS /.'.~):;;19 Woof) fk/Ck tJ(f} fL ZONING (office us,) LEGAL DESCRIPTION (office use only) LOT /0 BLOCK 4-' ADDITION -rilE tJJ 11...1),5 <:..()[/,J-I PID OWNER (Name) :B-1< E;A) /iJE~ r:nAJs '7'/€/./ G IIIYU IN G PD f?Jox 1:::)J.j .J....I9K~\JII....LE (Address) (City) (Phone):t3i:P- ;ff'r-?-7J'oy !i5 ()-7'-'9 (Zip Code) (Address) APPLICANT (Name' h AJ 111 (.,.Jf I1;JJ=: :T.A) C (Phone) 'l~ -2-33 -) d lJo (Address). J.:?)J) J1J11R.fiS S77PFET Sf)/J.k.D,Il,FE 55379' (Address) (City) (Zip Code) (Contact Person) \)1)1,) AJ IE: J!J( ,})) L/.L/!f-IJJtf; (Phone) 95 t?-t9d.3- ) t:llJ 0 APPLICANT SIGNATURE ;?k~:Ly/tilJ~~ DATE -'J/,g~)IJ...:;' - / / APPLICANT PLEASE COMPLETE BELOW Size of water service r inches. Location of any couplings from structure -- Type of sewer pipe. 0 ABC 15{1 PVC Estimated length of sewer line ;:; () feet. Clean out (if required) located at ~ feet from structure. feet. o Cast Iron iential sewer and water line connection connection only $35.50 $17.50 FEE SCHEDULE Industrial, Com'! & Multi-family Water connection only 1% of job cost with a $39.50 minimum $17.50 SEWER AND WATER PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ ~ /' ~./ v1 PI \ 0 orf' ~ I tlU\ (; ~V \J Estimated Cost $ Building Permit # ():? -03B;1 Becomes Your Building Permit When Approved Paid Receipt No. Datc By '1 Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 CITY OF PRIOR LAKE r~ ~ @ ~ U illlt]-t~'1 Rec'd REA TING/AIR CONDITIONING/FIREPLACE PI< ~ifR 0 3 2003 ~ #c:?~O 8'[ I,Pink File Il~' --- 2. Green City .c..n.lY.l.J. J. r~v. 3. Yellow Applicant (Please ~ or orint and sim at bottom) ADDRESS /-'5:;< 77' ?-Jc::oc/ LZcA />-. /U~ ZONING (office use) 3 - 3 ~0 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Address) g~~ 0://7-5 //?<"C ~c9"< /0 &% /.5/</ (Phone) 9..::::?/ - ?U - 7,.; ~r ~//U ,~AJ .5:~ZJY/ OWNER (Name) APPLICANT/'? I / I L ./Jf ~ ./- (Name) /;////~ /./Le'c..~/C~ (Address) c~~ ~A/A;,/~ ~. /':? (Address) (Contact Person) all/ 4///U/ APPLICANT.5IGNATURE (Phone) c:.:::.~/ - 0d - ~7?:;t'- c;.q~ 5-i;?~. (~) (~J (Zip Code) (Phone) ~ DATE APPLICANT PLEASE COMPLETE BELOW ~EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL flu,tf-lIJ'r ~{l} ~(JtI;K, no FUEL Va.; 'Ll ~ FLUE SIZE .'bI1!- RETURN OPENINGS <l INPUT I t'lO, /J8r) OUTPUT j2,he-D TYPE OF SYSTEM HEATING OR POWER PLANT 'ia'Wann Air Plants '[jGravity o Mechanical ~ir Conditioning ~ent. System 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 FIREPLACE MAKE AND MODEL 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 & AfC (New Construction) Residential, Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ III"7tf( J Building Permit # (Office Use Only) " .50 ;7? This Application Becomes Your Building Permit When Approved ~ i~~ ~ U \11 ~~ II Building Official Date RP~ 0 7 2003 U II _l: . 24 hour notice for all inspections (952) ~y-9850, fax (952) 447~:~~_ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ PAID WITH BUILDING PERMIT Receipt No. By f ~\ ~e -~~) (;anary - Engh'~\::11I iY Pink - Planning Till' ("('nl... <If Ih..I..kf Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED B JV6 N rJ '6' t<- C,; 0 tJSTr2- . 3-17-03 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /5Z7Q WOOD OU (!AL {ltA I L NvJ Accepted Accepted With Corrections <'....---- Reviewed By: lid ()2L Qnc' v 4.11 1101( '5 Date: :1 -28--03 Denied Comments: ot. II a"1cJ cJvt S "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 ~g ("'ink - Planning / Th~ ("..nln of Ih.. I.ab Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED c? II /-:- I., C Ie:.:... I (I'. -/ J<;... L v j _d j .. -:/.. I ~I C 7 ,- ,'- -.-'" '-' The Building, Engineering, and Planning Departments have reviewed the building permit apPlicati~~ fO,r ~on~tru~tion activity WhiCh. is :roPo_~~d at: , ,) I'.) i- JCI l V Ii (U I..J lJ C!'::""- - I /&/\ I "- (,I ~ Accepted Accepted With Corrections Denied Reviewed By: Comments: 0"'1< LA/o-I /U<V\ i c? 'rfJ~/-I-/ / f~ 1" Date: () VI ('/ 1.,,. ).4 r Mt>K Ct+ "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." Thl' ("I'ftll'r of Ihl' I..b ('gU,lIry W_hj~e_, - B~lIdln9. ~ ......Uii&r" - cl~~MlleerlrliJ> Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT BIle N~Jf"R.. C,010-5'Tf;::.... 3 - 17 ." 03 APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /5 Z 7C) L,vGOD o U C-IL -n:.-f\ I L... f\Jv0 Accepted )( , Accepted With Corrections Denied Reviewed By: .M4 )"2, Date: 3-3/-03 Comments: _ See RAver!':A Sine fnr Additional Information! See Attachments. I) Gr~rling Plan, 2) Erosion Control Mp.~Sl11"p.s "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." PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITEADDRESS ~." WMd~ul.. T,..i I NATURE OF WORK n~o":S~ USE OF BUILDING S. a F. O. PERMIT NO. fL5-03f!B DATE ISS.!JED l- ~ r. 0 .., , CONTRACTOR U'~~r r~T ~.C PHONEQ.l, .~1' NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT /:l,iSPECTOR I FOOTING \ijI 'f) I t.f - l7 I FOUNDATION (Prior to Backfill) I ~ I l.{ /"7 $CD3 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS '7Z,L4- 4/1)- · '\ p", (" -~ DATE SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING @ (p-~ HEATING (if required) f\\ 4 FIREPLACE ~ I J GAS LINE AIR TEST t;;\'Ft (f' R 6 ~J ~ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS /f1f1 ,"- ~p 1.//~t83 GRADING (Prior to Sodding) BUILDING 1-(w t}fI-r \ 'lb.~1 {) '> ELECTRICAL PLUMBING HEATING DO NOT f.1,1.0) c>f --4 - YI2 .9 -,'<- f/L1/7 c;,~ u . r/':J 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 ~----'.T~-----""-'.- CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Ree'd ; :;,:" ~:~ I PERMIT NO. ''2 -30 d I J. Yellow Applicant :/ ~ (Please type or print and si2Q at bottom) ADDRESS 15279 WOODDUCK TRAIL ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) BRENNER CONSTRUCTION (Phone) (Address) APPLICANT (Name) ATJ.TFD FTRESTDR ORA FTRESTDR HEARTH & HOME (Phone) 651-611-2561 (Contact Person) BRENDA HUSTON ROSEVILLE (City) (Phone) _651-633-2561 55113 (Zip Code) (Address) 2700 NORTH F AIRVIEW AVENUE (Address) APPLICANT SIGNATURE BRENDA HUSTON DATE 5/16/03 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL FUEL DWarm Air Plants DGravity D Mechanical DAir Conditioning OVent. System INPUT HEATING OR POWER PLANT D Steam D Hot Water o Radiation D Special Devices o Other Devices OUTPUT FLUE SIZE RETURN OPENINGS TYPE OF SYSTEM PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks . FIREPLACE MAKE AND MODEL HEAT N GLO SL750TRN-C Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 $64.50 $39.50 Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) Residential, Additions & Alterations Residential, AC Only $39.50 $39.50 Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE F C~ .50 . ... ..13UI!;,-11() 11.? 1" I ~I L~ 'IF . . " i I;. fe" Ie'. ,1 11o/e ,..~'f1.t I ~. C) L.;' U " 11 1/ ,..., ~, , G" '-,,1,f.- 1a'ill MAY 2 1 wa6 RtmFtNO It D te - r ~I /'l--- 0)' L.---7/ L -- I /I 24 hour notice for all inspections (952) 447-9850, fax (952) 4474~- - Building Permit # $ $ $ (Office Use Only) This Application Becomes Your Building Permit When Approved Buildine: Official Date 05/13/2003 03:33 ~ ~~E "'J""NE~O"{'" 3528347372 LAKE SIDE PUJMBWG PAGE 01 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT T, Blu~ Fllor 1. Gald City ] 'ftllo~ AprjJ~'"1 I PERMIT NO. 6 -3~31 (Pie an: fV't)e or prine and sim at bottom) I ADDRESS /5 ;;. 7'1 Woodl Dt..l.c.Jz. 1f'C<..'L I ZONING (offi,,",,,) I /lJw LOT LEGAL DESCRlPTION (ollice use only) BLOCK ADDITION PID OWNER (Name) &rt!.nft-er- Horn eJ (Address) APPLICANT (Name) (Adelres5) (Conract Person) (Phone) f 5.)- -f':;>;7 - 77<1 '-( Po/30)<. ,-",LJ (Phone) q.s J. -87'f .7&UJ L/Ht..,s:':ii:. ,~':.~u. ~ 1+.., (Address) '.'''.)'' "":"'"'' -::0: Savage, ,V1N 55.,' ij (!, fr -e-,- /'11 t.Ii ~ I J (City) (Zip Code) Yli' ;;-!:J7'T-7?tv (Phone) ~ kt/ /?1u~ DATE 5/,3/03 APPLICANT SIGNATUu Quantity :;;J. I { < I . / / APPLICANT PLEASE COMPLETE BELOW ~ I Type ofFi"tu~e I Bath Tub with or without shower Dishwasher I Floor Drain Lavatory (Bathroom Sink) Laundry Tray (1 or 2 com'partment sink Shower Stall I Sinks Bar Sink [ Water Closet (Toilet) Quantity ,3 I Type of Fixture / Rough-ins Water Heater Water Soflner /00" 0'-//.. Stand Pipe (Washing Machine) I Sewage Ejector BaCkflow Assembly I Baekflow Assembly Test I Lawn Sprinkler . I Other ..J. s /1~.s.J, ;1: ~ c ~i.. <~ /.{"".u b.' bY.> -:; FEE SCHEDULE Industriai, Commerclal &. Multi-f.mily 1% of job CO" with a $39.50 minimum ResidentiaJ, New One 8< Two-Family S99.50 Residential, Addition! & Alter.tions $39.50 Estimated Cast $ Building Pennit # PL1.ftvlBING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ S PAID WITH BUILDING PERMIT Re:eipt No. By rr Date 24 hOUT kotlc:t: for nil inspections (