HomeMy WebLinkAboutBuilding Permit 99-0867
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
16'10Cj wlkntSS
&
TIME
la:w
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAM'NG
o INSULAT'ON
o FINAL
o SITE INSPECTION
AD PLUMBING RI
~ECH RI
ATER HOOKUP
P. SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/PO' ~. J& Ao 'fV0
," _~ ~ - fJ()
~ cJlA-
_~ MoliVl
"'l4 - ffo 7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~<o..'be -t ~ ~ bO(
fk
o'vL/
tv (.ytA-rte
TORY, PROCEED
AND PROCEED
FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CALL
CODE
INSNOTI
ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
~IT-r--
'T'.'...........-...-.--....-.
DATE TIME
CITY OF PRIOR LAKE ~ 10 :-~
INSPECTION NOTICE SCHEDULED
ADDRESS lloq (nq kJJdPA /IlP~ 1L
OWNER CONTR.
PHONE NO. PERMIT NO. '1Cj - fcO 7
o FOOTING 0 PLUMBING Rl 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLA'NT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 )iEWER HOOKUP 0 FIREPLACE F'NAL
o FINAL ~LUMBING F'NAL 0 GAS LINE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
$J"J';"~~~~kL.
~t::;~Z:-~j., ~.
~/~C,
-~
o WORK SATISFACTORY, PROCEED
;r$ CORRECT ACTION AND PROCEED
I 0 CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
'-T-T.-
CITY OF PRIOR LAKE
INSPECTION NOTICE
seliEDULED
DATE TIME
~2A1 to Cho
ADDRESS 'loCI {.q k.l; ktef'nr<;<;" Tv-
OWNER
CONTR.
PERMIT NO. "'1'1- 60""
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING @
o INSULATIO '"
~INAL
o SITE INSPECT'ON
COMMENTS
.j...,
o PLUMBING R'
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING F'NA~
~MECH FINAL Il.J::5./
,
o EXlGRAD/F'LLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLtNE AIR TST
o
~
~ ~...,T-'P
@$~t:~e%
r--
~",,""
~ (lD~~
)i1WORK SATISFACTORY. PROCEED ,-d--,
o CORRECT ACTION AND PROCEED
~CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
'nspector: ~ / OWner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
-"'I~"'T'-
~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS J ~'1 (oq
OWNER
DATE
TIME
SCHEDULED I @-Q ~ -i?l I JII')
\J ..l&.uI1\aS~ (r-
IIndwsCfrt ~I JyJlrw&
PERMIT NO. 99,.... 'B!o 7
CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAM'NG
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH R'
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING F'NAL
o MECH F'NAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
br..uU - alC-
X.WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL 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
~~
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Permit No.
JLJi~ I 3 :999
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. S'TE ADDRESS
1. DATE
l II <19
!2-/5
P'D,J5-j/R- (J:l/ ,0
L White
2. Pink
3. Yellow
File
City
Applicant
qq -'6 i(J "7
BUILDING INFORMATION
11. S'ZE OF STRUCTURE
(Height) (W""'l (Ileoihl
,
12. NO. OF STOR'ES
\
6. BU'LDER (Name)
cr ("\ i=a.
7. TYPE OF WORK
New constl\lctlo~
Chimney 0 Misc.
a. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq.Ft.I<\'O:;l.~ Width(,d.109Dep'hlol.-::,c..\ Yes No Y/I""Jiq
1 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. I am aware that the
building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official o~ a designee may enter upon the property to p~rform ne~ed 9pections.
X ~, . .~L.. K lY\., ~n r acc::4'OOL1~ . -") J \ q
'Signal~ license No. Date
Illoq
3. LEGAL DESCR'PTtON
,I
t;:
e...r-ne e-
LOT
0]\ BLOCK
IN ,tnexr"'~""s. 'rbC\d ""-
(Name)
(Tel. No.)
ADDITION
4. OWNER
(Address)
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
(Address)
(Te'. No.)
la. 440- 4<5
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Ill>
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re.roofing 0 Porch 0
Re-siding 0 Finish Basement 0
17. COMPLET'ON DATE
)
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
MATER'AL FILED WITH APPLICATION
SO'L TESTS LI ENERGY DATA LI
PILING LOGS 0 PERCOLATION TESTS 0
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
LI
USE OF BUILD'NG
~f:~
PLANS & SPECS 0
SURVEY LI
ItI'd.OC\:?,Q)
.
PLOT PLAN
TYPE OF CONSTRUCTION: I II III IV V
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Occupancy Group A B E F H IRS U
Division 1 2 3 4
I, '2'l1-j .'2~
8'/3,21
State Surcharge ............................. $ q I . Oe> ^ Ad ~
I'eMlOt.....E.P......................... $ 4D ,ex;' CD'( Illtjtj~q
Sept~ System .~.~........................ $ I 00, 00 01~1
Other .....?1.~......................... $ 100 , OD ~I
_" .S.st.IA,)................. $ ::SS . S"o ./1 l\I11\~1
ur Building Permit When Approved. /L.9A~ \~l\OV{4
Date '7- )~-'l~~ tI
Permit Fee ................................... $
--~1iI11! U.u "..oct t=ee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
~ "
Pressure Reducer ...~..................... $
Meter Horn ....... ...ti....................... $
Water Meter ..~........................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Plan Checking Fee ......................... $
By
Certificate of Occupancy
Issued
24 hour notice for all inspections 447-4230
SETS
COPIES
ASD,C?o
t rp~O , (')(")
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qS",OD
( ?!:.CJQ
'I ? Or'l ,60
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.JobAdd,... /&>7<;'<:; & tfd~,,-"('q
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"Permit#
.Gas Uno
Pressurized
Inspected
"Percenl c~
"Percenl O2
FinallnspecUon
~
Q!!!
Pounds
~
Ii!!!!
PERFORMANCE TEST
C;,)'Ct>
{.?%
.Percent CO Cl ?""
.StackTemp.~YO
Date
CjC! -S;(o 7
Tht' ('tnlfr of Ihl' L.b Country
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Avtdtr<;frli1 r-OJ'"\It'( \\..f--rbY\llk'S
APPLICATION RECEIVED ,-13-.qg
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IldttoCJ \,Uddt'VIIV'S'::l 1m; L 'S~
.
Accepted
Accepted With Corrections ~
Denied
(21ij- Date: {-~q-'7J
Reviewed By:
Comments:
~r'r.Q a.Xl .:t~c-~ ~~
"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."
I I.
.'1".... '.-, ..-... -.........,
"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."
r/
,.ltz-
Denied
Reviewed By: ~ W~-t Date:"" ,
comIts:
/ L- ~ ~ VW,e0.^&kl/;. 0 6f)u :)!.\V"l)~
{'A'~~T ~{V'~ en lv\.",\B,/~Lev- 'S\~ ~d< ,
Accepted With Corrections
'v
Accepted
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
!" t ,{ '.'. i ,J, . r,',
! tr f L~ 1 \ \'j I ( I ,~I \ \j .I ,)
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NAME OF APPLICANT
APPLICATION RECEIVED
;//
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
White . Building
Canary . Engineering
Pink . Planning
Thr C"tler of fhi!' L.k, ('ounll')'
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qq -2(c 7
~~~
Tit.. C~nll" 0' Ih, Lak.. COUnl1'}
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLlCATIQN DEPARTMENT CHECKLIST
1 _. I
NAME OF APPLICANT rtl1der<;(';Vj r-c~n\ (\\..~b\,ytRS
APPLICATION RECEIVED -j - 13 -qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I (c%,cl \\J,ldtnv~c) !'(o; L 'S~
Accepted
./
Accepted With Corrections
Denied
Reviewed By: WAL..TF-:.-t. ~1l!:~Ml'tAM~
Date: gJ'3o i rt
.
Comments: Ro""''''' PWs.... B€ eo.....€.....lI
.
10 AIJO AL.ONC. DaAIJJw.t; ~ vn~lrY
E'A~E.NlE.~ Ac; r"t\olUol Ao; Prl.acr It' AL
DA.....t4GEO
f't'JAJc.R!"T"F"
W~(..K P,A.....EL.'i
\NIL.L.. aE
i'<.ULAC.€'D
B'/
T).(~ 811IL.OFlt.
PltloR '-0 F,IJAt. S,c,1J or:'t:".
SEt JAJFoA.MA'TIO~ 0..3
il"fF I?EufJ'ls E 5,DE
...-€~ A7't""A(w~E:'"n:s: I. h/J,qL C.~4l)E' lAJ5,.;-c..noN JIJ~ORflI\A-T""IOA.' Z. ~(tPJOIAl'.. t=L"A\
"3. ~a.o~,o'" c.....,raoL fI1EASvRC'
if. ER.oslo~ CtJ,JTR..tH_ rt-1+^-l
"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."
I T I
. :--_..._-.,,~"~-'_.~
'. .. . . ... . ~... .
:.. .,.~t.:.'.:""~}.~.::a' ;.~.~1..~~~';":';.:,..~:. ~'...~..':"" .:.";:.:; '{::....:. .
. ':" ..:.-.,.....:.-i.!'l.~r;......;~.t.~-.~~_.~a.~~....~_~:t:"i....".~.,._. .:
........: . '.-:.~"",'~..!.'.!.':.,.':. '.: "1:. .~fIf;"._..-",~",~ .... .'..: _....
TYP~ OF WORK \. J
Rtl;>lacemenl. N.... CanstrudiDn ~
EsL Comp. om
,0 ~ !Iu1d"mg Panni:: _~ 'j b 7
I, _
$, .59
$ R0C8~'"
~~
$"
llOO
1/
TYPE OF SYSTEM
Warm Air Plarns _
Cbvity
Mechanical
-
Air eondltionin;! ..::.
Vent. 5yst.", _
H5ATflG OR POWER PlANT
SIIIIIIII
HOI Wa.r _
FWf.... _
Special Oavieas
other D..i::es
Re:nembe! 10 add the SlaIa 5\l~b8flle on 1IIe bo1I"", 0: lhi.! appi::clion.
The priee 01 your heating perrnil il:ludes one rwpb-in and lIIIe tilsI ins;sec:ticn.
AO:itional inspedions d be bled III S3S.OO ll8CII.
HO'.:se Heating <est Reconl musI be submilled witillllli!l!i!Jg ~~ boIore bulI~
ing .~ 11"_ or =upan::y wiD be issuecl
I:E!l ("AI n IlJmDNS ft!,""OlJI;:!;r) wIlb numbat 01 su;>;>ly and re1um. ~ &sted per
">el!ll wIh CFhI'.- pet openin!j. New sInI:lUfes Of eddilions semlllcor ~I... WiIIr ~y
and -.. Ioadions sbown. HEAT LOSS CALCUL..lJ10NS, PAYM9IT AND
AP;>UClinONS MAY BE MAIl:D 10 THe CITY OF PAlOR ~ 16200 EAG!..!:
CnEa< AVE. s.~ p~ lAKE, MN S5372..
ClIy Hall!um- bo"" an 8 1.111. . ~:30 p.m.
All WORK MUST n INSPEC'ta) (ROUGH-IN AND RMAL)- CAU. CITY HAll
4(7_0
ieal system~ pennlt and I acknowledge I!lallh.
I and accurate; lbellll. "Wark will-bt in comrmallca
. of lhe city atIc1 with !he ~Ie bWldinglmechanic:ll
01 become a ptlr1Jlb urlll, signed by the BUILDINS
I be in ac:on:l_ wlIh thl IPJinwed plan in the
IrK rwvi_...d applllVal of p11llL ,
.' :~. ~ ~1>io'
" Doli.. _.
~J - "':7': ~.... I.
I hent>y app
.inlonnatian I
with lb. anti
codes:; 1hBl
. OFFICIAL.;
case of ell
It
Lr'\4
1-
F9 &hedule
In:h!sllial, Carnm!lrciBl " Mllf1j.FamBV
rlesi:ienlial, Heating & AC
Resi:lenti21. Healin9 Only
Resido..nli21. G2S ;:;~Ia""
MfliQential, Additions & Ahr.tiOll$
"'sidentiel. At Only
Singlt i'amlly X
Commercial
T~Family
lndusirial
10k o~ job
~~.50
S6'I,;o
539.50
E3e.;o
$32...50
?uili:
Mun;.F..",11!' _...._
c-.her
~
(S39.50 minimum)
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I Y ~t- PRIOR LAKE
6200 Eagle CTeek A.v, S.E. ;oermt.
Prior Lake, MN 55372
No.
91-0<;(67
TYPE OF STFIUCTURE
1._
:u.....
~'kIl..
.
l'llo
c;;".
c.o:....
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
REC'D BY
DATE PAID
RECEIPT #
AMOUNT PAID
Fee for either sewer or water
$ ,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,
individually is $J.7.:ff'/1Jl plus
*
Sewer and water line connection permit,
Surcharge
TOTAL
35,00
.50
35.50
$
$
$
FEES:
==============~==================================================
your permit when approve~l._ I
DATE: 4~(J7j
BY
This application
------------------------------------------------------------------
------------------------------------------------------------------
from
feet
()
6. Clean out (if required), located at
structure,
3. Location of any couplings from structure --- feet.
4, Type of sewer pipe, ABS____ PVC >< Cast Iron
5, Estimated length of sewer line ~~ feet.
inch(es) .
L
2, Size of water service
feet.
FILL IN THE BLANKS
Estimated length of water service ~-;<
1.
APPLICANT: FiNflL Gf!.ff/JE -I/lJr
ADDRESS:/3J5%S;1J;j S~=
SIGNATURE: ,;$-1Llt,
SITE ADDRES; / /216'1 tUd~ -1JIAt./
PHONE: 7.5P-23- /~ O()
DATE: .L// YCJO
/
BLDG, PERMIT # tJ1-~{,-J
PID# 2.-",>-318 -02./-0
NOTE: Sewer and Water
contractors must
be registered
with the City.
r'!-~1
S.w. No.
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
F-.
-
U
GREEN - FILE
YELLOW - APPLICANT
GOLD - CIT.,
_.,.....-.... -." ,,-_.---_.._~,~._...-
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372 / Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of the State Plumbing CodeJ\d the amr~hereof,
REC"Ir191i.3i (fQ DATE
TIEST
PAlO WI"
BU'LD'NG Pi::. "vlIT
GRAND TOTAL
$
$
$
$
$99.50
$39.50
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
FEE SCHEDULE
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower ~ Rough-ins
Dishwasher r Water Heater
,
Floor Drain Water Softner
,~~ Lavatory (bathroom sink) l Stand Pipe (washing machine)
I Laundry Tray (1 or 2 compartment sink) Sewage Ejector
\ Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
I Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
3 Water Closet (toilet) Other
FIXTURE UNITS
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: C 1e';)"Y 1, _'0-",+, P,j.... 1-+ t~
Address: I~()~~/ I. '1~'17aj'::"J, -
Signature: ,'7/;~ '_.<1, . <A
Legal Descri~tion: Lot d I Block---1
Site Address: /(1'1//7 cU i tel", I n, Sf' TV { .
Building Permit # ' q 9 - () 067 PID # d S - 3 \!S'-o d. L::.C
NOTE: This permit will not be processed without complete information.
Sub (A I '\0 ~ rYl. ~ Ybrd.>
ThrCu'rr of lhr Lakr Counlry
Phone:
'~
~~
9?-OYf67
PPNo.
File
City
Applicant
1. Blue
2. Gold
3. Yellow
I,Pink fl" '"
1. Gr.r. ell' lD
CITY OF PRIOR LAKE ::J
MC }. "tellO'll c....._ ..
16200 Eagle Creek Av. S.E, PermilNo, 9.0. - ()~b'1 TURE ID
'<
Prior Leke, MN 55372
SiI19Ie Family Two-FllIl\~ _ MuIIi.FamIly _ ." r
HEATING APPLICATION I PERMIT - ....
-,
lD
8.5- 3\ ~ - ad. 1 - C) Commercial_ Induslrlal_ Public ()Iher en
....
Dale PIO . c.
lD
Sile Address ,'1(,,9 11. j1/tW.u~A p Fee Schedule n
0 I
Addition \ 1\, lder N ~ -;p~ -, i
Lot <2L Bloc~ \ Induslrial, Commercial & Multi.Family I % of Job cosl ($39.50 minimum) ::J
lD I
-,
{}", ~,__ ..Jz.. .~ Residential, Healing & AC $99.50 ..
Owne", Name Residential. Healing OnlV $64.50
,
Addre.. Ras:-deIl1iaI, Gas Fireplace $39.50 I
Aesidenlia~ Addilions &. A1leratioos $39.50 i
H<laling ConIraclor ALLIED FIRESIDE dba FIRESIDE CORNER JUN 2 8 2000
ResldenUal. AC only $39.50 i
Addrns 2700 N. rAIRVIEW. ROSEVILLE; HN 55113 !
T eleohone . 651-633-2561 Remember to add lhe Slale Sultharge on lhe bollom oIlhis application. I
j
FiRE?LACl! ., OJ ,
1iIJ7JW1Il Make & Model r/.b eJ" /oJ (d., TYPE OF SYSTEM '" i
The prica 01 your heating permil inclUdes one rough-in and one Iinal inspection. ~ ~
$[,. 7sn?e. Warm Air Plants OJ
Model Siz8 Gravilv Addilionallnspeclions will be billed at $35,00 each. '" I
'" I
Com. Load Mechanical HOIJse Healin9 lesl Record musl be s1Jbmilled wilh IIlliIl!iDllIlllUllil JlIIdItl befoIe buld- :: I
Ak Condftloning I
ing cerlirlCale of occupancy wi! be issued. OIl I
60.01 .... I
Fuel Flu. Size Venl. System .,
!:\fA[ J:<A\.CULATIONS REQUIREO with number of s""",yand ""urn opanings listed P'" i
Supply Opo.-.ings HEA TlNG OR POWER PLANT room wilh CFM's per opening. /few sLroeluT.. or eddilions send Iloor plan wiIh fUPI'ly i
Sleam and relum ""'a6om chown. HEAT LOSS CALcutATIONS. PAYMENT ANO I
Rehnn Openillgs HolWall>r APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, '6200 EAGLE I
I
Radialian CREEK AVE. S,E. PRIOR LAKE, MN 55372. <-
Output ..)~..," c: !
Inpul Speci31 Devices ::J I
City Hall buslness hour. are 8 a.m. - 4:30 p.m. N i
Edr. , ..... ,
0Ihe1 Devices ALL WORK MUST BE INSPECTED (ROUGH-I/f AND FINALI- CALL CITY HALL a I
a I
elm. 447-4:130
'"
TYPE OF WORK I hereby apply for a mechanical syslems permi! and I acknowledge Ihal lhe :: I
AJleralions Replacement New Cons! r,",lion }j information abo.e is complele and accurate; lhallhe wor~ will be Ln conlormance;;g f
wllh Ihe ordinances and codes or Ihe cily and with the slate blIMdinglmechanlc..' I
, iPp' codes; Ihat Ihis lorm does not become a parmi! unUl signed by the BUILDIN<:
Repair ,Esl. Comp. Dale OFFICIAL; lhat Ihe work will be in accordance wilh Iha approved plan in the
I
Esl. Cosl $ J fCA/Y.) Bulldklg Permit. _ case 01 all wor~ which requires review and approval 01 plans.
, .
."
HEATING PERMIT FEE $, 0>
'7/'" '"
Dale lD
STATE SUA CHARGE $ ~
-
TOTAL PERMIT FEES $ Receipt'
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS J.l.ti1J l..) 1'\clQ.lV\e.~C) 1;,
NATURE OF WORK "t\kv.J C6v1....<:;huc.t,O"V"\.
USE OF BUILDING S F C)
PERMIT NO. '1'1 -8<" DATE ISSUED 1"]-~1-7~
CONTRACTOR
NOTE: THIS IS NOT A PERMIT F R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCU ENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNT L
ROUGH -
SEWER I WATER I SEPTIC
FRAMING 1 &
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE I
GAS LINE AIR TEST ~. r:, ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING Tit'''' , Qb
ELECTRICAL
PLUMBING ...r"-
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
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
~here no service cabinet is available, card shall be placed near main entrance.
"'':;'':.~ = .--- - ;
/6, z. -0
/0' J. Of
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
I I I - ------ -_.~-------~--"~_._._._.-.