HomeMy WebLinkAboutBuilding Permit 99-0842
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QLertifirau at OOrcupanry
CITY OF PRIOR LAKE
J)tpartmtnt af ~uilbing 3JnS'ptttian
~Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the lime 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:
SINGLE FAMILY
Use ClassificatioI'
Bldg. Permit NC"
99-842
Occupancy Type
R3
Type Construction VN
Fire Zone
N/A
Zoning District
RISD
Legal Description
L3. BI. NORTHWOOD OAKS ESTATES FIRST ADDITION
3055 KNOLLRIDGE DRIVE
.,ite Address
Owner of Building
Date:
ContraclOr.,Name & Addre.. DAHLE BROS.. 9304 LYNDALE AVE S.. BLOOMINGTON. HN
ROBERT D. HUTCHINS rityPlanner JENNI TOVAR
rv Bf'ijd!ng Official
h . I/ly,\ .4-. / I {j I Dare:
V ( I POST IN A CONSPICUOUS PLACE
-
DATE TIME
SCHEDULED ~ /; / r
l::.V\t>ll f{..(~
..J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 1OS~
OWNER
CONTR,
PHONE NO,
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
11 ~ECH RI
n A TER HOOKUP
II SEWER HOOKUP
n 0 PLUMBING FINAL
o MECH FINAL
COMMENTS:,1 I, I
3 t;r .L-~_ 'tv
I'~T~ k. ~.
~,~ <:;'~/fih ' 4/t-
p.fY { ':iA
GY~./ dA--
C\G\ . 't.l.{ z..
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
PVL.
I~
Owner/Contr:
C ,LL 447-9850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
E REQUIR 'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
JNSNOTJ
I III
----,._.._._--------~.._-_._---~-_.-
;w TIME
CITY OF PRIOR LAKE II: &v
INSPECTION NOTICE SCHEDULED ~5.
ADDRESS ?,() !;5 ~"'- 0 116 d..:f.- ~
OWNER CONTR,
PHONE NO, PERMIT NO. 9'1-tt/L
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION{@DMECHRI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOK~P 0 FIREPLACE FINAL
~NAL ~LUMBING FIN 0 GASLlNE AIR TST
o SITE INSPECTION ~CH FINAL 0
COMMENTS{fJ) 9~' -, -' ~.J_
r~~~-h A-~ ~~d4~~~
--P~kl ~ ~~,I4J'J.4~
A&....d~I-<!,ffJ)T~ ~ ;'I>,,"p *=
JK- ~ ~ ~ nA, e,.;,~, ~,JJ~9~)
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"IJ.---, ../ ~ n ~ -IA:W. ;" .P...:::r~~ -...P- f/
fj ,d"Y~ ~{.I~ 0'77 ~ ~:',:. ~
/11 C!::-J9 Jt"/1'" , ,
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o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
7 CORRECT ~K. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
4<.,v!ri
c,(VI/cru
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
I III
---,.-----...-..'.-.
II
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
4';(}DJ
OWNER
~~!:iC:;-/:':llj ()( LI2 (I)(] p;-
91-084-2-
CONTR,
ADDRESS
PHONE NO,
PERMIT NO,
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 EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~
FrL-G
('AAb b
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~OR REINSPECTION BEFORE COVERING
Inspector: ~ .\ Owner/Contr:
CALL 447-9850 FOR rLE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
I III
~~
DA Tt= ,8t=r.t=l"I=Q
"7 /"1 /CJ9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS _ -8' '::'055 f\
";:'-'~ K,^lJl\~\JCF- lllL.
3. LEGAL DESCRIPTION
LOT 2 BLOCK \
ADDITION ,AJ C:fL;++\VV {iC,r} ()4/( \ 1') k.. ,/H
1. DATE
[, _ '2. <;; -"\"'\
If! 16.0
PID 2.5....3tO() - 1JtL3-0
f.....u..,L fl..rJdI}-;fA
4~R {~
,.->,-\..-.\....--
(Address)
(Tel. No.)
-....
(Address) ((.I;t~ ~o~~
(Address) --rm:1'Io.)
"\~<I.- ",-...1_\L ~~~<.". eeb-bBb",
'f,1.. ~\.-
Fireplace~ Septic 0 Deck 19 As-roofing 0 Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
5. ARCHITECT (Name)
3r.\-.. bin.r/l._".')
6. BUILDER (Name(
\)~\~ps-r~
1. White
2. Pink
3. Yellow
file
/ City
Applicant
Permit No,
BUILDI INFORMATION
11. SIZE O/1S UCTURE
(Height) LWl2lh) (Depth) . _
).. - J:"bA., . '> J '.K" .so 0-
12. N':)J STORIES "3-
1WPE OF C~TRUCTION
A....\~ ~ . to
/0 0 14. FLOOR AREA APPORTIONMENT USE
~J:3J'l
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNAI.UE
I scr. SOD ve
9. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
W;d~h "l(/ Depth /'-li' Yas No ~ II - (l' - c.,'1
n on ttlis at' licatio which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
. .nstruction i to all existing state and local laws and will proceed in accordance with submined plans. I am aware that the
r just caus e~, I hereby agree that the city official 0, ~sq.; may enter upon the property to perform needed inspections.
License No. Date
,
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
PERMIT VALUATION ~~.I'\ t""J
USE OF BUILDING
s,::'.o
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 234 _
Permit Fee ................................... $~l .? h
I'lL.] I
ACl.O 0
City:
Plan Check Fee ............................. $
State Surcharge ............................. It
)
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS Ll
SURVEY 0
PLOT PLAN 0
SETS
COPIES
~......I'l(")
IOS'O .00
-.l" $
Pressure Reducer ...~Ut..........."..... ,'I'.
1/,>, I'l ()
Penalty .......................................4:
Plumbing Permit Fee ,f1....8,iZ-:.... $--/-1.,(') . C) (;)
Mechanical Permit Fee '?J.~...#.t{k.. ~ I ~f) .0 t'J
Sewer & Water Permit f..?.:..~,1..~.. $ '3S-. SO
Gas Fireplace Permit ,'1f.:,~,tfk:.. $ 40.0 C>
This ~~loJf}3eoom~ur Building Permit When ApproveQ.
BY~_- Date If') -/q-q9
Certificate of Occ~cy
Meter Hom ...........\1...................... $
Water Meter .....~........................ $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builders Deposit ............,............... $ I. S-ClC> . t'lC>
.
Other ......................................... $
Total Due .............................. $
Paid '7'7 'b 4. if r. Receipt I9l; jlj '5 <I
Date ///2..3/tiq By jfp/L-
in the above application and accompanying documents is in accordance with the City zoning'Ordin/nce and may proceed alrequested. Tlfls document when
. a Cer1iffi'te fZo i omPliance~.and IIOWjC:~~ctiO~=::st. Betoreoccupancy.aCertificate{"Occupancymustbe;ssued.
I~ .br>c.r~ I(.~'<:~
Da Special Conditions n any ,
Co, "'~ )/_J
~f.J/ ,
jl/(I/((I
Issued
Thls~sto .~~~requ
slQn l;/j1j~er
( - y C~y Planner
24 hour notice for all inspections 447-9850
I )C;,{) 0
200.00 ,
lOt:) .00/
rz '764. 4-'"
7
..
.
LP Gas N\,-tural ~s ><
Job AddressOO$ ~~\\ ~
Heating Contractor
Name of Tester
.
Date
Percent 0
,
Percent CO
Percent CO
,
Stack Temp.
Pressure
Input
111
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White - Building
Canary - Engineering
Pink - Planning
Th" C"nl"f of Ih" Lib Counlry
8UJLDlNG PERMIT APPLICATiON DEPARTMENT CHECKLIST
NAME OF APPLICANT
[...J //l/( E
/.;/,/:'(,5,
APPLICATION RECEIVED
oj /7 / r? 9
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~ Q S$ K/V(J{ L. K'IDG;E: DIe::.
Accepted
./
Accepted With Corrections
Denied
Reviewed By: I.J..,.,.,.Q
~~t1f"_'M,a,tJ^1
Date:
lo).z7/gj
., ,
Comments: _ 'i)a7.L.J~WA.'I" CAN r1NLv af".. A ri'1A'J..IMvM or: 7t.1 f€El t+T .,-,...,e:-
~O~P~R-r'" klt.Je:._
Dal~/F".IA-""
I-\.IJ -.1"
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'BE: Co~s.!t<vu-m uNTIL-
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5e:e. l1JFol(VV\A"'rlo,.,.J a.....I -r~ Rt;I.J&sE 'SICC.
JJ '-,... fY./Iolr ~ CAI 'f"HF_
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8/lr1e'"
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L.o"'l MiJS"'f E:t::. EJte..C~
.14-'- !ME.
tor..r:
0': DIc;,"Ir...H2.i3'CD S~Jc.....
;leE A'l'iAu..\M~ ~ I. f7~AL- G..n.A-l"lf:: lJo..1~p&-.r"'IO...J JNFoIiMr1"'IO~ z~ Qr1.AO,l\J&, PL.-AN
_~ Ct2n<;,,,,,,..j C.AA-l"lno,- Ml="'A<:ulLt:S
Lf. Eft.o510~ c.o,...,;n.oL- R..r+/IJ
"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,"
;pA
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ThtCtnlrr of tht Lab Country
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKL!SI
NAME OF APPLICANT
.--,- ~
/.. /
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
$.l?sff
~
/
'- / ,/
-,..-'
c.
/ '//'h
Accepted With Corrections
Denied / ] A
Reviewed By: ~?;J7, :;)~ Date: /(f/(,t1/f?
Comments: Me und ~ ucra:;:edi J).3 J~)d.L c..ca..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,"
MEEN - FILE
YELLOW - APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. q1-842-
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: ~ ~ PHONE:
ADDRESS: /tJlf1I'lPU,:C/j1 ~=,,}j~. DATE:
. ( '\ ..../ ./'c-J 8i.-IJ{J,"1tJ,7r"..f S!5tfz,o
SIGNATURE: '-....Jat?_~ _ _ BLDG. PERMIT # 99-84-2-
SITE ADDRE~ 5{;-:;-S-~..e/iJ1/ PID# Z-...."5-3{oO-003-0
FILL IN THE BLANKS
Rtt.;- LI/'/9
/2-/5'-79
1.
Estimated length of water service ~t7
/u
Size of water service inch(es).
feet.
Ute 2 0 1999
2 .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC Y-. Cast Iron
5. Estimated length of sewer line ~~
feet.
6. Clean out (if required), located at
structure.
feet
from
================================================
es your permit when approved. . /,
BY C~"'V' ~ - DATE: 12-/Z_01 q 1
===========r'=====================================~================
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 building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
AMOUNT PAIr;. PAlO WITH
e01tC\ltl ?r-,,,:.!\T
REC'D BY
RECEIPT #
16200 Eagle Creek Av, S,E" Prior Lake, Minnesota 55372 / Ph, (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
.~~XPRJO";<,
~ "
.f... '1-
iJ '"
CITY OF PRIOR LAKE
I. Blue
2. Gold
3. Yellow
File
City
Applicant
PLUM/JING PERMIT PP No. -3q. 842-
Applicant:fl/'/,....c"~...."'....""'~.- P/( Phone: cr/- ,c:,V,r-. h,.,;C}r-
Address: f/<,??A;",p// me(::: /7-_ f".yc~ ~-c, /' ;> .)
Signature: C'-~Z ~~u~
Legal Description: Lot.1 B1o.ck / , Sub g,/a::-~vc?u>./ C?r~.
Site Address: 10?7- M<Pt?//~,.., a/,</.-
BUildingper~it# qq-f34-2.. PID# Z.5-3faO-003-0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Tht' Ctnltr of lht L.kt Counlry
Quantity
<'?
/
/
Y
/
/
/
3
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
5
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
/
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$
$
GRAND TOTAL $
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av, S,E, Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
crrv OF PRIOR LAKE MC
lUOO &gle Creek Av. S.E. P.rmit No, qt?- t3 t/- L
PrIor 1II1a!. MN 55372
Fuel 1)/\ r Flue Size
. i'1
Supply Oponings
Retum Openi.. /0
Inpul 11.('" Ouipul
Edr.
Clm. 1400
.c" A
10j)
TYPE OF WORK
TYPE OF SYSTEM
Wum Air Planls
Gravity
Mechanical
Air CondliDning
Vent System
~
lI"
HEAllNG Oft POWER PLANT
Sleam
HoI Waler
Radialion
Special Devices
Other Devices
New ConstrUl:lion
R8pU
IWpIlICl8lI1ent
Est Comp. om. ,
Buldlng Penn. .
A.MarlOnS
Est. CDsI $
HEATJolG PEJOOT FEE $
STAlES\R:tlARGE $
TOTAl. PERIoIT FEES S
.50
(
~.
q9- Bc/Z_
~
L tilttn
J._
TYPE OF STRUCTURE
COt,
"--
Single "-miIy
CarnIne.....1
Y T....."-mI1
InclJslriaJ
HEATING APPLICATION' PERMIT
DO ,..,1-0'"\- nu PIl._ZS<300-()()3-0
Sil8Addlllss'lO~ 1o(.....11...:ck. C\,. ,e/50
" -
lot.3 IIlock / Add.Ion_If/Ot<.771IVOOO 0/-1,<..5 I sr
OwntlfsName. fLl..lL. ~r"~ "t.....<-
Ad<<_ 4~nA L.1~.k.L_ Au ('.
HelllirlgCo- tJ. l.l...... i\..~.. f'_L-
,
Add.... 'J III 1.&.1 i-u;.+'" < 1-
~
Tale""""". 'if<Ll) 4. =-0 l
Fvrnl1l:8Maka!Model (roll, L...........><
Model SilO (2.<\. d,l)
.
Conn. Load Gi. 2. "4 2...
Fee Schedule
Indu.lrial, Commercial & M....J'ami11
Residenlial, HeeIng & AI:.
Residenlia~ HeaIhg <lnI1
Residenlia~ Gas FlI1lphlC8
Residenliel, "." IS II. AIlefdons
Residenlial. N;; Only
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MulIi.femi11
Public Olher
1% 01 iob co.l (139.50 ~_,
S99~r2r?'i"-""f7;c'; ,
. ls \:: .~_-_ ~ ~.- ,~
:~~ I H_..- ~- ~ 2000 -
S39.~.\\ II . ' .
" '., ~
$39.51\ UL-------- --_,.....
Remember 10 IIdd lhe Sla18 Svn:ha1ge an I!uI bolIom oIlhis applicalion,
'-_._-"-_._~'-_.-
The price 01 yout healing perm. InciJdes one rough-in and one final in.peclion.
A_anal in.pec:Ii...... wil be biled at $35,00 each.
House Healing Tesl Record mus1 be .ubmitted wfth "'0\<1;"" IlmIIIiI "'n~"" be/ant build-
ing cerlirlCele 01 occ....anc:y will be issued,
t!.W r.A1 rJJLATIONS "'FnlIIRFQ w1ll1 number 01 SUJlPl1 and relllm operings listed per
room willi CFM's per opening. New slruclur.. or additions .end lloor plan wilh """PI1
and relum locations shown. HEAT LOSS C" ~'. ATIONS. PAYMENT AND
APPlICATIONS MAY BE MAILED TO TIlE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE_s..E. PRIOflLAKE. MN 55312.
Cil1 Hall business hours _ 8 am, - 4:30 p.m.
ALL WORK MUST BE INSPECTED (RDUGK-lN AND ANAL) . CAll. CITY HALL
441-42:10
I hereby appl110r a mechanical syslems permil and I achnowledlla \hat lI1e
in/ormalion ebo... is comptela end accurale; Ibellhe _rll wiI be In confo.menCll
wilh lhe ordinances and codes 01 the city end wilh the slala bulklnglmechanical
codes; Iballhls form d....s nol become a pllfl1111 unlil signed by lha BUIlDING
OFFICIAL; Ihallhe work will be in accordence with \he epprooted plan In !he
~a.e of w rk which requires review and approval of pilUle.
,,!, .. ...Jj Ol-03 -00
( , 0_
\:: 01-03-()Q
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CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. PermilNe_ qC;. f!42-
PrIor Lake, MN 55372
HEATING APPLICATION I PERMIT
Dale -3-.'fa -00 PID. 25-3&0-003-0
S~eAddre$S .3cSS' ~iIAt1 K!,",I.. AA.LI).e R/s:Q
Lot ..a..... Block I Add~ion tV OIT7-UI/ 000 OIl K.S I ~
fj,u.;, ~
OwnUf's Name _
Address .
HealiIMJ ConlraclO1 ALLIED FIRES IDE dba FIRESIDE CORNER
5511J
Address. 2700 N. FAIRVIEW. ROSEVILLE. }IN
Telephone'. 651-633-2561
FIREPLI\CE
~ Mallo & Model .Jk,. J AJ (;t-,
Model Siz~ ,-S", 7S1l7l!...
Conn. Lead
Fuol !fl..1f
Supply Openings
Return Oponill\lS
irIlJlll . Oulput ~3. rlXl
Flu. Slzo
Edr.
elm,
TYPE OF SYSTEM
Warm Air Planl!
Gr avily
MllChanical
Air Cond~loning
Vont. Syslem
HEATING OR POWER PLANT
Sloam
Hot Water
Rodialion
Special Device.
Oilier Devices
AlleratiOll!
Replacemenl
noPE OF WORK
New Conslruclion
"v
Ropoi,
Est. CosI $
Esl, Comp, Dale
Building P.rm~ .
//Ni/h
flEATING PERMIT FEE $
STATE SURCHARGE J
TOTAL PERMIT FEES $
.50
l/-!,.a)
19-64-2-
( fl,l).IO \f-J1i\-\,.
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IYPE OF STRUCTURE
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Slnglo Family .
Two-Family
Induslrlal
MuHl-Family
Pub,e Olher
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Commercial
Fee Schedule
Industrial, Commercial & Muhi.Family
Residential, Heoting & AC
Residential, Healing Only
Residential, Ga. Fireplace
Residendal, Add_Ions & AlIerations
Residential, AC Only
1 % cI Jd> co.1 ($39.50 minimum'
$99,50
$64 .50
$39.50
$39.50
~9.50 I'M 3 O.
Rernembef \0 add lhe Slale Su.charge on lhe bonom 01 Ihis application.
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The price 01 your heating permh includes one rough-in and onollnal inspection.
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^dditional inspections w"l be bined at $35,00 each. CJl
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House Healing Tesl Record musl be ..ubmitled wilh huild!nn llllIDiI "'''''"''' belore build, ~
ing cerlincale 01 occupancy wi. be issued. -.
~EAT CALCULATIONS REQUIRED. wdh number 01 supply and relum openings Ilsled 1M
room wilh CFM's per opening. New sIruclures or additiof\8 .oend lloor plan wilh ""IlPlY
and relurn location. shown. 'IEM" LOSS CAlCULAllONS, PAYMENT A.ND
APPlICA.TlONS MAY BE MAILED ro THE CITY OF PRIOR lAKE, 15200 EAGLE
CREEK AVE_ S,E, PRIOR LAKE, UN 55372,
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Chy Hall busin.... hours ara 8 a.m. - 4:30 p.rn,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND ANAL) - CALL CITY HALL
447-4Z30
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I hereby apply lor a mechanical systems permit and I acknowledge thai the ~
inl<>rmalion above is complete and accmate; Ih.1 Ihe work wlll b. in conformance -,
with Ihe ordlnonees and codes 01 the clly and wilh Ihe slate building/mechanlcol
codes; Ihat Ihis form does nol become a permit unlil signed by the BUILDING
OFFICIAL; lhat the work will be in accordance wilh lhe approved plan In the
case 01 all work which require.. review and approval 01 pllllls,
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Build19 OIfical". Signalur.
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Thr ('"nln of lhf t.ktCounlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PEFUI/lIT APPLICATION DEEARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
P,qHt--6 g.eaS.
/,/7/'19
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
X >( Xx. KNOu..,e/D€?6 DIZ-.
305''')
Accepted
Accepted With Corrections X
Denied
Reviewed By: (;!J)rfi..)-
Date: Jh-fq-~'1.1
Comments:
/. W al1 Cl-~~ ~~
"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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PRIO,R LAKE
-
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS3r'l~~ k\.^Otl,,\,~_ O-r-
NATURE OF WORK ~\ ('rIlAdhlrS:'TI'-'
USE OF BUILDING S~ 1')
PERMIT NO, <49- "f5C(?-
CONTRACTOR 1::2,., \" \.... '\Sl--A~.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCU~~/NT
I FOOTING I . '"~~1) I "j ""'!;
I FOUNDATION (Prior to Backfill) I V1J ,2-11f1' I"
PLACE NO CONCRETE UNTI~ABOVtlHAS BEEN SIGNED
ROUG~INS
SEWER I WATER I SEPTIC / /)' ~(!.' /ou
FRAMING V_ vy "J.. \ v ~
INSULATION ( ~ .;>/o.<YIoQ f). 'Ih/co
ELECTRICAL v...,
PLUMBING /~';N( /J) lXT .
HEATING (if required) ~j- V {~
FIREPLACE ' 1'." q/7/&rl! ~
GAS LINE AIR TEST (,f, RJwtIf, ~ .,' 5/1 liP (j
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
GRADING (Prior to Sodding) _ W t/
BUILDING T:t.e, iO ~VI jl1\) fJ+, ?!t~!rt) ~.\/A--Y
ELECTRICAL wlf:v-l616. _' ,
PLUMBING Y1" .?/;.1/1?
HEATING vJlll/fh-. ,;;/U/"o
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 llervice cabinet is available, card shall be placed near main entrance,
DATE ISSUED
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Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
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