HomeMy WebLinkAboutBuilding Permit 99-0917
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Type Construction
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QLertifirau at OOrrupanry
CITY OF PRIOR LAKE
:Ilepartment of :iiuilbing 3Jn~pection
)1final Permitted 0 Conditional C.O. Expires
.. L1, B5, Raspberry Ridge Second Addition
T ......,.. n...~. .~"....
. .
_ . 15111 Appaloosa Trail
'!\t;~ Owner of Building ,/ _C"'" (1....1...1-....
(:~ ~ Contrac,or'sName&AddressJ & K Holll"s, 16056.Karmony Path, Lakeville, MN 55044
~t.:~c-.... Robert D. Hutchins'-- .?t.-, , .;.' PI Jenni Tovar
~:.-;:_ . IC/ -/ , / I Ity anner
, -: / / BuiJding OfficIal 1/ .i,.7
1.J"f ' Date: (., /q 100 Date: '!l~
~~: POST IN A CONSPICUOUS PLACE i);-
'"'I
. _ t .-..-.................... . :__L.. .__ _1,_"._~~____,..._ .- - . -- -'~ :.;.:
- - ........ ......_..,.,...- ..~..,~'IIiIl":.._~~..... _ .,....wol!.'!'_......'!'......': :.,.-,'.......:, --, ,..~.,,....',_.,,S::..,,__. ........ 0:')"
~ ~.':.i1.C I.~' ~,~~~~1f. t.':A('t~t Jllt"!"*y~,I...t~1 ~'~1ft~~t~ t.:."" I~r
_ _~~....~""~_ ~ ~ __J<~...~w_ _~_ _;110;_ _~i;:..... _~_ ~.~~."" J .-'- ...'iiI' I _""- ~~'''.:..... ~,,~,
This Certificate issued pursuant to the requirements of Section 307 of the 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, For the following:
Single Family
99-917
Use Classificatioll
Bldg. Pennit No
Occupancy Type
R3
Fire Zone
N/A
Zoning District
R1SD
DATE TIME
CITY OF PRIOR LAKE 11-1 e~~ q:.b
INSPECTION NOTICE SCHEDULEO
15111 A,ppa.kQsa.- -
ADDRESS IlL
, ,
OWNER CONTR,
PHONE NO, PERMIT NO, ~-"l17
o FOOTING o PLUMBING RI o EXIGRAD/FILLING
o FOUNOATION o MECH RI o COMPLAINT
o FRAMING N'fATER HOOKUP o FIREPLACE RI
o INSULATION o EWER HOOKUP o FIREPLACE FINAL
o FINAL PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
/J) C~ ~
()) ~-""'?r~~
(V ~ ~L .'fO...d'
&J AaLJ rj-~~ ~^
^
t"ill
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~ ~
vy \ ~/J
~
. O,...woRK SATISFACTORY. PROCEED
~CORRE T N ANO PROCEED
o CORRE R . CALL FOR REINSPECTION BEFORE COVERING
Inspector:
CAL
Owner/Contr:
/,/
447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
EQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
II
. ,
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
A I <""(,
ADORESS I Sill P~(j5d I-
II
OWNER
CONTR.
PHONE NO.
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
.0 JNSULATION(\)r
~FINAL /'l
(0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
^- [Jl'LUMBING FINAL
/"' R' MECH FINAL
~I~~
e.sc:;~q(7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~ Q ~"" 1~'i.(:j~&v1~~~-
.~ ~s-k.QQ. 'f MJ <-VO:;~ ~()
,,.\) C~D.Ii.- Ay, LI'N {- ~r (.1v~
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----
--------
o WORK SA
~~RECT
l5Y'"~RECT
RE COVERING
THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
INSNOTl
II
I
CITY OF PRIOR LAKE
INSPECTION NOTICE
. SCHEI?ULED
ADDRESS 15111 A~s"- T/2..
OWNER CONTR,
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
~INSULATION
FINAL
o SITE INSPECTION
c;OMMENTS:
(.J t=,k& p-e..-
.
(Z) S-d r.....rI
-I
~
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~V\.UVIV-3
1'1--<<S
'Per
,
/~;!~
TIME
Crt
-h.
Ar
q~_cH7
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~." f of-
dU&~
,
1-1-2oGb
FACTORY, PROCEEO
ECT ACTI ANO P CEED
RECT WOR FOR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
CALL 447-9
E NEXT INSPECTION 24 HOURS IN ADVANCE,
ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CODE REQU.
II
INSIVOTl
. ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 10'\1\
OWNER
CONTR,
PHONE NO.
PERMIT NO,
o FOOTING
o FOUNOA TION
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 EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~GA.SLINIU\IR TST
1/' "'~ \) ~
Ir<-tE
COMMENTS:
---
---- ~ -
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l(~~.~~:~ ~~.)l.\)
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--y ~
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0----. _____
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ALL 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 & SAFETYI
INSNOTI
II
~7;~;;9
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3 L~G~ ~E~~'PT'ON A f r~ . \ llilS Q -r n:,j\
LOT I BLOCK ,r:;:'
."
Sec:and
(Address)
ADDITION
14. OWNER
5. ARCHITECT (Name)
('!hUf.k G-u~ ((47 I
6. BUI~DER \ I (Name)
J c ).l <N0'fl'I e:, lIne
.
Fireplace CI
Alterations [j
Septic 0
Addition 0
OeckLJ
Finish Attic 0
1. White
2. Pink
3. Yellow
File
City
Applican!
1. DATE
l-~8-99
.K</S.o
PID R d..'\30 l-{l\ '2 "2.. a
. .4<:kl. i +i trr\
Side
City:
~
(Tel. No.)
(Tel. No,) b 1"Z. - ;
RRI -su,cRl
(Tel. No.) Ie f 2-
8't I -3068
Re-i'oofing 0 Porch 0
Re-siding 0 Finish Basement CI
Permit No. -.!Z.q - q / L
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width~ t (Depth)
.. r:;'-, IAn
12. NO. OF STORIES \
Mu O-i-;-LP ue....\
I 13. TYPE OF CONSTRUCTION
.1l e.u)- ~''::L'''~.f'_
I 14. FLOOR AREA APPORTIONMENT USE
. lit; ).jq.;.-.x - (!.r~ <.J) LUl.
'8'_.:>,_~. /1. PfJl/V .
g :>':+-1-" (I I( ('>!
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS!..IA-
A/A-
SEATS
16, PROJECT COSTNALUE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
(Address)
L~ kdal", *"''' p,'o"",;"""""
(Address) "-I
1100Sl:, N.o..'("~,-\ "c...~
1...cLl<.e\J, lle... '5~e>44-
7. TYPE OF WORK
New Constructio!.k'
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES /90 PROPERTY DIMENSIONS 10. CULVE~ 17. COMPLETION DATE
Sq. Ft Width Depth Yes ~ " If) I ) \ q q q
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
buil ing official n revoke this Pjrm,l it for jU;tt se. F.urthermOje, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~.4.,.v.tl ~V,,~ At..A'1h1Zv--> fO.eo d.o / 31'1;>' / d-. J -::4 oe;-Cf!1--
' / Signature (] 0 License No. Date
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I ~l.fl(X\.ClD
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due ..................,........... $ 1.4~
Paid '7~t5.'J / Receipt No., .3~o 2-4-
Date !3h~/~ By-1~
that the request in the above application and accompanying documents is in accordance with the City Zoning Ordina~ce and may proceed al'requested. This document when
C.iJI'!lpm. er c9'lst,ules a ,Q..,.v,v" certifi&'1lilj~g compliance and allows construelion to commence. Belo, re occ,u,pancy, a ~rtjficate of Occupancy must be issued.
. '-?'. ~JJ/l.D/l _.d4WLl'1l7 (fA h..b t I W'jO"'A-] ?,,,,Jr 'f'-..ai <;
City Planner ate Special CQ(ldltlons n any
Front
Back
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.s~D
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...................... ......... ........ $
PlulT'bing Pemtil Fee ,11..~,11.1...... $
Mechanical Pemtit Fee ~.1.:1j.7....... $
Sewer & Walerpemtit..'111fJ,......, $
'IOcQ .'2,?"
(''1').4./p
(..,.- .5"0
I or~ .f'Y"J
I fl{') .f) 0
oz<;' .F;'1':)
This
By
Issued
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......,..............,..............,.... $
Collective Street Fee ....................... <r
Sewer Tap ................................... <l::
:f t' $
!:ole
Pressure Reducer .......................... $
Meier Horn ............\...................... $
Water Meter .......5 .t~.................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Side
II
24 hour notice for all inspections 447-9850
PLOT PLAN
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o
~So.Of'">
/Dc;,-rl ~
qr,e;\M_
I 25'". ~
II '/J\61'60\-
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........" ...--
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11"11111111 -
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i
,
Thf('rnlt'rof Ihf l.akfCounlry
White - Building
Canary - Engineering
Pink ; Planning
eUILDING PERMIT APPLICATION !2EPARTMENT CHECKl!SI
NAME OF APPLICANT
APPLICATION RECEIVED
1_.
. .
,
r
/ (;-
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
" ,/ ',~':- / / .I
/~// 1'1// (t' /,{
,//, {// L...-,
Accepted
v-
Accepted With Corrections
Denied Il A
Reviewed By: LJ- t};< ~
Comments:'*" hlL- und- f'Llf1/16T
.
51 de Juyd.
- i
Date: 9)- J <1- 91
L--YlC/ M.ch ; 11 rID r l JJ vrrd
"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."
qq. ':;-1/
White ,- Building
Canary - Engineering
Pink ' . Planning
llo,.C:..nl..ofth.. uk.. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
J ~ J:::. /.-/0/"'1 E 5
/' /Z8/99
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5 /J / /!P?rJC COSA /K'/lIL-
Accepted
./
Accepted With Corrections
Denied
Reviewed By: JJIII'1'~R EI'I/lE<;,..../IIIN
Date:
, I
'ir1t1/Q9
, f
Comments: R""orr: ,,"vS'1' ~
,
c.O,)v!:'f'E:/) 10 A "'0 At.OAl~ !:)/?fI,AJIt'L ·
1)T"H...arY EA.s.€ "",e,.",n
-n>
o'!F'PAuooS'I 'Tit",,,,,
Surt'\ P PV""'-P J41\cJ5-r" .BE. .
c....."" rrf\ "T'o t..'ST1~r. bRA.A,) J.l.E:
LJ.,~ ,
SEE; 1.oJr:e~M'In-.J
0'" REJ~R!~ SlOE,
:5E:E: ATT"',.......E""""" I. r,.JA<- /!,IIM>/': /NsPEer,....., /~,."...4~""J z.. &1I4t>ANc. Q",~
'3. EIto<.o,.} c..o"''rll.o<... ,o(~E:S ll, Era.s,Q'" t'.. .,F"1IJL ?,.,.,,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,"
I r
.1
,
i i
~1
99- CJ/7
Tht' ('''nll'rof lht' L.kr Count!'}'
White - Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,
J ~ J:::: HoH6S
7/28./9'9
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/5/// ,q,.o,.o/lL,.OOS/7 /K/1ff-,
Accepted
-/--
Accepted With Corrections
Denied ) /
Reviewed By: ~r /. j} A--
i I~ - - f//
B -l.{ _4c..
Date: ( /
Comments:
(. RecuJ cJj cdr-~ ~~
~
"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,"
II
..,
.
II
J
.
Job Address
/.>/'// ~P'~ 1~
Heating Contractor AIR MASTERS. Hie,
Name of Tesler 7~L~,....
;tJ-/~ -9y
/i
o
7
J?,,5.
Date
Percent 0,
Percent CO
Percent CO,
Stack Temp.
Combustion air is adequately supplied per
UMC See, 606 ..ke- 5
Input ;;> r-:/fiI#
.
\
II i
._--------_.._~------_.----------_._--------_..-----------.------
,.--..-....--..--"-
.._."~_."..,~,...
~- --,"...-.---' .....--
Oct. 14 1999 02:45AM P01
.~~, ""'ll. ''If'"'''l"----...--''".--.-
"
FROM Panasonic TAD/FAX
PHONE NO. :
"-.--"'".~--"._' -'"
- ~ ~ . -... - - - - - - - - - - . . - - . - - - - . - . . - - - - - - -... " .
10/loIi~g THV 14:13 FAX al.24474245
CITY OF P~IOR LAKE
IaJ 001
~
'-ht ('flll,r elf '10, r."t t:'llInlrr
CITY OF PRIOR LAKE
PLUMBING PFJ:lAIIIT
I. 'Blue FiI.
jt a..~ Oht'
3. YoIloVr' AJlPuoam
# ~.: '71 7
Applicant:.
Address: -
Signalur.;~
Legal Description: Lot I , 15.5
Site Addr.lls: 15'111 A '1'7 \00('"
, , - \
Building Permit # """'-"7 .PID# 25.304 -OZZ-Q
NOTE: This permit will not be process.d without complete information.
FIXTURE UNITS
HESSIAN PLMG, SERVICES. INC.
9601 Jefferson Trail W.
Inver Grove Heights, MN 55077
(&Ill 68t.8252
,-~f
&.Kiet56/2h/ .€/066 21l'
I Quanlily Type 01 F'lxture Quantity Type 01 Plxlure
I I Bath Tub with or without showlIr ~ Rough-ins
I , Olshwasher ( Wall.r Heater
I Floor Drain J Water SOltnr.!
~ Lavatory (bathroom sink) Stand Pipe (washing machine)
-....
I laundry Tray C" or 2 compartment sink) Sewage Ejsotor
I' Showar Stall Bilekllow Assembly (RPl, DoUble Check, PVB)
{ SinkS E1aokflow Alllismbly Test
Bar Sink Lawn Sprinkler
.;l. WIlter Closet (toilet) Other
Industrilll, COnlmereial & Multi-Family
(1% of job eost, $39,50 minimum)
Residential, Nf.lw Ona & Two Fltmlly
Rlteidenlial, Additions & Alterations
Stale Surcharge
S99.S0
$39,150
~fl-\O ~~t",,~\~.
\.v>..\\,O\~
$
$
$ .5D
FeE SCHIDULE
GRAND TOTAL
$ _._Jr Y
~-\\(
~"'} 1-
6" \ IJ...,.
J.\..~j
30(.. F
This permit is granted upon 1hc e...proslli condition lhat said.
conlrnclor. ~hl'l11 CQl11p in ell rc:spcc:t. with lho ordinnnl;.cl.
of lho Stale Plumbin ~l1C IImCUldm,~I)IJ I.herCQ(,
, ",//4/10 DA1'B
;---- . ATI"BST
Cali (nr ell .
16200 Eagle Creek All, S.E.. Prior Lake, Minnesota 553721 Ph, (612) 447-4230 I FAX (Ii 12) 447.4245
An Bqu.' oppo"unllY Employer
" "_.. . ~ . - - .. - .. . .
. . .. .' ~ w ~ . . .. -
II
"
HEJl11NG APPLICATION I PERMIT
0110 1- Z 2. . q q Pili Z5- 304- oz.z.-o
ShAlldNtI IS/II ~~"'" //JI1J.... j~",/ ,,cIS.!:),
l.ClI I IIlDck 5 Mdtia" /C;:IsPo....:'ODv I'I!IO~e 21010 :
Oimol', Nama :s ~ k t-f Hili eli' '
Md,_'l,OS-(" .1iA+tVl1M1tJ MTrl LklcttJll.l.f 'MAl 5S~I.{Y
HeolIngCantrK*' 1I[jl.. IMJ 1m. ~ r HC- ,
Ad*- /1''10 c:../fLAXlt! Al/t. ""/Oy
T..Jilanef (./2. -l()f- ~'1 ~ z... .
L,.tJ1i PY: __, .,
F..... ...... 6 Mod.. It 0 iJ /'I ~ 3 -,7 ) TVPI: OF SYSTBI
W_ Ail PlanlS
Gmvily
WedllIlicel X ( IJ /1'''' -
Ak r-d~J,RAl;iX: L1n, II/AUi
Vent. ~ " .
HEATING OR 1'OM!IIl'UlNT
$tam
Hot Wit.
RadilllDA
Splcie/O~.
Madel Si..
com,l.Dod
CITY Of PRIOR LAKE
1 aoo Eagle CreeIc Av. S.E. Palmi No.
I'rtor La", MH 515372
9t?~ 9/7
TYPE OF STRUCTURIE
L .._
I._
J._
Singl. Femitt )(
CommIfCi8l
Two-FlIIIliIy
~u",....1y
Other
Inlluslrial
P~fc
Fee Sdledule
.; Induoltlel, Cammen:lal& Mul" Famjly 1 % 01 job cast (139.5G minimwnj
, Residanllel, Hen.g & AC '99,50
Relidenlia#, Hlllling Only '64,50
1l8llidentfllf, GIs fhplaae $39,50
Aes1damf.r,Addlianl & Merdono '311.50
~ I J R...;...ti8l, AC Only S3lI..!iO
.A/r/,./~~ ","! ,
. rri;'( Flemembe,lll add '118 SI8le Surdlarge on 1!Ie _ alII.. ..' "'.,...'n.
,. "Lj
FUll /lid h9:1 Fl.. Size
5/ \l'"'Ml
SlJAll~ Openlo1g1
Anr.Opoml.
"'put '11' il'T"\
1:<Ir,
CIm.
A.arllion.
J'!J
1
OUlpUl. I. il'1-'H1
Other o..c.
YYPE OF WOfW(
Replacolmaf1t
>(
New CaJlOlIUClf<ln
Repoir. Esl. Camp. Dafll
&t. CaliS ~ t1l IkIlding P.,miU
HEATltIG PERMIT FtE S
STATE SURCHARGE S
TOTAlPEf\MlTFEES $
.50
~q A q 11
',. Pt.\O~
. BU\\.O\NG p!':-RMIT
Aec;e;pl ,
'Th.. pIlae <II JtlllI ~eeting perm ;nctude5 ~ne !OIJ"'.in ond one linal inepeclian.
AddlianaI inepedi""" will be billed eI $35,00 each.
rtOilae HealingTesl Aeccrd must be .slJ:lmllted witt ~1.11 . - ,,' am:mI ~ I'~ ~,II' before tI.JikI.
1119 oerliliclile 01 aac:upency wil ...iscll8ll. "
-... ~ a' N' ~ ~". 11lI''''''''' _r alllUlllllY and ""'II apeninll5listad per
"'am wllh CFtII\,., openng. NOW sfl\jct..... al .cIdlIions sand ...., '*'" w!llo ..,.,11
8Ild return ...,',.,. """wo. HEAT LOSS CALCUlATIONS, PAYMI:NT AND
AP PUOOlOtlS MAY BEMAlLED1OTHEarvOFPRIORlAKE.1ti2llO EAGl.E
CREB< AVE. S,E: 1'AI000l.Al<E, MN 56372.
City Hal bush_ Ioours are 8 a.m.' 4:30 p.m.
AU, WOAK MUS.T BE INSPEC'mJ (1'IOUGtt-IN MID FlNAI.I- CALL ctI'Y ~
447...
I ~e..l:Iy.pply ll>, " meooal1icel 1)181....' pelmit and I _nowledVe _lhe
inlotmatian all_ is complete ...d ac~; llta! "'" _It! wi. ba In canl..m.....
....l~ the ordinances a nd codes 01 111" city and wilh lIle _. buiklingfnMchanical
cod..; ..... IIIla Io,m dollS not become I poI,mll unlllligned by ".. BUtLD1NO
OFFICIAL; IhaI. "e wallt wiI!J>e In aCCOlllanOll wi'" lIIe Bp",aved pl.n'in the
a._ 01Ml..... whict\ hqpr",. ,me. and .1".....1 01 pl....
q. Z..z. -C} '1
tflZ,o;:,1
Dale
BuldirigOlllcoll's Sigl1e1ur1
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~ - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT .
SW, No, 99- 5 f;Z
ADDRESS:
NOTE: Sewer ana Wa~er
contractors~~st
be registered
with the CifY'
,
PHONE: b C/ ~.c/ d' t7 Yo
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"'I-/<~7'
,
PERMIT if.-fj f.V.?
25 -304. 02.2tO
APPLICANT: a~ ~
f//~..s-~ ('U !>.J 15/1''/ DATE:
SIGNATURE: ~~ ~#- BLDG.
SITE ADDRESS: JS/IJ~..:.'~~IDif
v v ;Ie/SO
FILL IN THE BLANKS
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1.
2.
3.
Estimated length of water service ~
Size of water service I // inch (es) .
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1
fr~m
I
teet.
Location of any couplings
from structure ~feet.
pvc ~cast Iron
"
.Sf)
4.
Type of sewer pipe.
ABS
5.
6.
Estimated length of sewer line
feet.
(if
Clean out
structure.
required) ,
located
at
feet
===::::::===-!!!O!.!:="""'=====~_______==========:;;;;==::o;;::;:::========::;:===========::::::::====- i :==:.=<=
This
BY
es your permit when approved.
DATE: ~/2/99
=~===::::::====== ==========----~=========;=======:;;;;~=~=========~=~:===.
FEES:
$
!?
$
35.00
.50
35.50
water line connection permit,
Sewer and
Surcharge
TOTAL
I
p,.us
T Fee for either sewer or water
$ .50 surcharge,
individually
is
$20.00
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuallce
~o insure that no duplicate seWer and water permits ; re
.lssued.
DATE PAID AMOUNT PA?'~\O~~~~
RECEIPT if REC'D BY \~U\\,Q\~ .
....--.,
T
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph, (612) 447-4230/ FAX (612) 44'. .4245
An Equal Opportunity Employer
,
W 39\1d
9NI1\l^\l8X3 NOSNHor
B92:2:1Sto
2:1'1:11 8661/L2:/9B
II
PRI.OR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS IS III Ii pFUI OliS.a... -bJ
NATURE OF WORK tJt'I., ~u...1-t",,--,
USE OF BUILDING 5FD
PERMIT NO, C)'T -'117 DATE ISSUED 8-L/-9. "i'
CONTRACTOR J -+ k ~o" I"!',
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR , DATE
I FOOTING I V21~ I ehJi'i
,
, FOUNDATION (Prior to Backfill) I (f[) ?,Q/f'1 I
PLACE NO CONCRETE UNTIVABOVE HAS BEEN SIGNED
ROUGH - INS
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FI~ALS ,
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Ill!) \/(#1'1
OCCUpy UNTIL I ABO~E .Y~~
NOTICE 1]
SEWER I WATER I SEPTIC
FRAMING
INSULATION (tJ
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE '
GAS LINE AIR TEST
.::.T,') .
th,
'%
IU1
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
j
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BEEN
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
II I