HomeMy WebLinkAboutBuilding Permit 99-0948
-~, ~'i>L
~i!"~. ..jlij l:,I........--"'"" ~"!':?'" ~\
~,.~~.~~. -,~~....,.':_~...~':.,.. ,;",~W"'Jl~" ~'
QLtrtffiraL. J!' (@rmpanry
CITY OF PRIOR LAKE
1Department of ~uilbing 3Jn~pection
~inal Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Unifonn 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
:t_-.:,.'. i
IJ..>. :
IV" I
..;_ I
(.>1
(. "(:
(~.~~!
(r:j
(~~
(, "
II
If~
I. "
(~ :~
(~- I THE WINDWOOD CO.. P.O. BOX
-I Contractor's ~"'..... 1', . ............".. "
r~.
i:'~ ROBERT D. ngHU~;~INS r::;::r( rllyPlanncr JENNI TOVAR ~p.:,-
(~- '1;"YJ Ita Dal<: I,
I~~; Oal<: , :b'
~ ':~ ~, ..;;.~~-;7. _0 ..,,:....,~~ P,O:I:~~:;~:~;~:~~_ ~ :-~. ._..... ....,~)
~ ~ c.a.: I'~ , ~ '~Jij I ':6;,0 1,,04:' I ~~. 1 ..~ I ~I ~~I '~""'I~' 'if 1 'lIf I~ 1 .:Jilo.. I,:,~ r
~~.1'~~A ~~ _.1Il11Lli'_ _~ __~=---_ '~~ =" J~ ",,_A:_ _'i<_ _~~~
Use Classificatiol'
99-948
Bldg. Pennit No
Occupancy Type
R3
Zoning District
R1
N/A
VN
Type Construction
Fire Zone
I..":"...ln_...."...".
L 1, B 3, KNOB HILL
THIRD A1)DITION
4n06 HUMMINGBIRD TRAIL
C;t... ," ....,....~~
24329, APPLE VALLEY, MN
Owner of Building
I,'
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
TIME
~ ~:fLO.
ADDRESS
4(000 HUMf1INClBII<O
I
OWNER
CONTR.
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
A ~ PLUMBING FINAL
o MECH FINAL
COMMENTS:
W~ ~ <HL..-
f~J
IJ '- '-;(
v
~
Qt;--94PJ
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~
//7
/A'\/
~~: R. ROCEED
o CORREt ~~T~~ IN ND P OCEED
o CORRE ~ T WOR~ L R REINSPECTION BEFORE COVERING
Inspector: \ Owner/Contr:
CALL '447-9850 Fok THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~NTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOT/
~ ,I
. ,
DATE
W
ADDRESS ~tt lI!ljJf.Af"/~j;,r/ ?rt:l/./
OWNER CONTR. M;'du//.J7/ ~~
PHONE NO. PERMIT NO. f9 _ 97(j!?-
o FOOTING 0 PLUMBING RI ~R!'.OIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
~G 0 WATER HOOKUP 0 FIREPLACE RI
o ULA TION 0 SEWER HOOKUP 0 FIREPLACE FINAL
FINAL 0 PLUMBING FINAL 0 GAS LINE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
" PRIOR LAKE
~"ECTION NOTICE
TIME
SCHEDULED
COMMENTS:
L:o--J,h/7,y' IS" ~K.
\
.;
~
~
.;
1;
I
----
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE2Z REINSPECTION :ORE COVERING
Inspector: ~ ~,",,~",",ontr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
II
. ~.- -"".--.-..-.-...- -- ..----~.._,,_.--.-~..~--.--..----~.- -..___.___.__.._.._____......__._..__.___.._u._...____.._
I ~
SCHEDULED 1/;1~
4&0G::> ~c.J/<1.Ml~~ I/Z-.:J
CITY OF PRIOR LAKE
INSPECTIDN NOTICE
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~INAL 0 PLUMBING FINAL
/D SITE INSPECTION 0 MECH FINAL
COMMENTS: -<::"-'0<r I ~
TIME
A ":t.
C:f~ - or 46
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~'."~
-()~ -~ ~
If5W.~~-"- ~ ~ )
/J --'
-
I
c.. tf{. JJ.
U;4.1.1ft .v
):()vORK SATISFACTORY, PROCEED
/ 0 ~ CORRECT ACTION AND PROCEED
o CORRECT~O LL 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/
INSNOTl
li
:1
I
:1
I il
II
,-.-----...-----.-.-. ---..----...-.~.--..-_.-----.~T-.--.-.-. ------~----
~
,~~
. ,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEOULEO
AOORESS ~
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNOATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
..[] ~CHRI
j. ~!.TER HOOKUP
{'; EWER HOOKUP
~LUMBING FINAL
o MECH FINAL
COMMENIS:/\ " .1
tJ'?' ~~ 40
.It( 1W ~ ~
C; ~ Al'L Ok.--
J..c.:cwr 1 1Aew{c ~
fife
.-- AJ b
t
L:>c~
L:"'<lK 11'- .~.
.,:,.. ~ 1';_ ~lP-
riA IiA ~1Ywr
G~
~
TIME
\0 ~"lo
q,Q-Q48
o EXIGRAO/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
1u (~
c:..5\A-
o ~RKSA~CTORy.PROCEEO
vz{ceRREC ACTllN AND PROCEED
o ceRREC ~ WJR 1?,CAL FOR REINSPECTION BEFORE COVERING
Inspector: ! Owner/Contr:
CALL k7-985 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.
CODE +QUltMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
V '",Non
II
I ,
!II TIME
CITY OF PRIOR LAKE JJ;~
INSPECTION NOTICE SCHEDULED
L.~J
ADDRESS (;,
OWNER R.
PHONE NO. PERMIT NO. ~~- '14'(
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
~D SEWER HOOKUP 0 FIREPLACE FINAL
o LUMBING FINAL 0 GAS LINE AIR TST
ECH FINAL 0
COMMENTS: ,() IJt2Jr ~ 1.$ fJ.-.-/
~ +:=vltI(...o ~ ~/hUA' fir<< 1:1:.:;
& ~,~~€!::.F/~ . r-r
~'or ~
~~VL 1~
8 ~ Will. WrL-
c_o~ ch y:... / -C/O)
o FOOTING
o FOUNDATION
o FRAMING
>i!ULATIOIiI/Ill
NAL /VrI
ITE INSPECTION
~~
V
r-e.U,v..e jj
&.",~ 'F-- .
o WORK SATISFACTORY, PROCEED
o CORRE1@CACNANOPROCEEO
~-X, R~CALL ~R REINSPECTION BEFORE COVERING
Inspector: '- J Owner/Contr:
J ---- -
CAL 447-9850 'OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE 'b'dENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSl'iOTI
II
.-------,--
'i
'i
I I
~1
QATF RI=r.FIV1=Q.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
AUG - 4 \999
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
2 SITE 4~S~ rt/II"""'M /AJ6~/M / M-1 L-
3. LEGAL DESCRIPTION
1. DATE
(3/ '-1-/&11
tel
LOT
ADDITION
\4, OWNER
5. ARCHITECT
/
.3
~
PID ?#:;-.~t./4- 0/&-0
BLOCK
KNOA lit u-
(Name)
(Address)
(Ter. No,)
"The WIRd'.''OQd ~"\I I",.
(Name) P.O. Bo~
(Name) MtJtJi", 'vailoy, r"l~dfOolyl", &~~l,l
9,1r.t)t/~d~
(Ter. No,)
6, BUILDER
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
I, White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq - qt/f1
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13.TYPE~R~
14, FLOOR AREA APPORTIONMENT USE
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJEC:r~g.sTNALUE
I~;PIJ
19,PROPERTYDIMENSIONS I 10, CULVERT SIZE 17,COMPL;~~A.% T~9
Width Depth Yes No '/3Jf7
is application which Is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
nst Ion will conform to all exjsting state an~ local !aws and ~i11 proceed in accordance with submitled plans. I am ,a~are hat the
se. Furthermore, I hereby agree that the city offICial or a deslgn.ee may enter upon the property to perform ne~ed sp 'ons,
- - 7-f1f 7 ff ~~
license No. oe)i - I
Amount Brought Forward ,................. $
Park Support Fee ........................... $
SAC ......................................... <I:
Collective Street Fee ....................... ~
Sewer Tap .............................,.,.,. <1'.
Pressure Reducer ~tL...............,... :.
Meter Ham ...S/......,.,................... It
Water Meter ..:/8........................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......... ............ ..,...... .... ....... $
Total Due ......,.,..................... $ 7."5.3 0.11
Pa;d '76Jt;. '11 Rnce;pt No, 3~ 'l--~I
Date 1. J--J '1 By A,Jt(-
that the equest in the above application and accompanying documents is in accordance with the City Zoning 0 nance and may proceed ~uested. This document when
PI er constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
. '1 J-cr ;J'j.
C' Planner Date
x
~.
(/
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
-
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
SFD
PERMIT VALUATION
/"<b ffn. c<:d
TYPE OF CONSlRUCTlON: I II III IV ~
Occupancy Group A B E F...tI I M ~ S U
Division 1 20) 4
Penn;t Fee ................................... $ I. (')(,,2. .7.r::
(n '1,() .I./(b
(;7 . ~
C""o
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ...,................................,.. $
~11~f.qq
: fc~
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ............"....... $
ICJO.<XJ
(d'; . or)
'3'S'.S'D
C/o .()(')
Sewer & Water PermIt ...................... $
Gas Fireplace Permit ....................... ~
ThiS~I~ti.i?~e s Your Building Permit When Approved.
By ~', Date {} ''{In-'1''f
Certificate of pancy
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
a~.otj
I D5t'J .em
LIs. oD
1;15.00
~. 2M .t?411
r-,t)(').{){')
1.,':;00 . (!)t}
l
24 hour notice for all inspections 447.9850
Special Conditions it any
~_.~.--.....- -
II'!!'
.'
'~, """"..,..,~.",...~."
!I\IllIII!I
~'II"I. 1/1111.......""111'11-----'- III
"......-~. ~
.~~.- ~-
~
~'
~et
White - Building
Canary - Engineering
Pink - Planning
I
Tht Ctnltr of tht Lakt Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/
L
/ '
/'" ....,;;
,.
/'/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I
./
i'
i....,_-
I
,1-,_
Accepted
V
/I
IjJl ~
Date:
g... 9-1,
Accepted With Corrections
Denied
Reviewed By:
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."
.'
III' ,
I
i
I
I
I
,
I
I
'I:: '1'-
- rn
U
1 "
99- 9c./t
The Ctnltr of lht Like Counlry
White - Building
Canary - Engineering
Pink - Planning
eUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
tvlNDwo()O ~.
6,/4-/ ClQ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L,i(p 0& /1(//'1 n //v 6j 8/,e. D ""1Z.-
Accepted
Accepted With Corrections
v
Denied //174" A--
Reviewed By~Jf,lz,. /
Comments:
I. P '}r. 4 J Q ~-tf-e..cL-(
Date: B -( (,. - 't 7
~~
"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'" ./'.
//
rJr? 9L/r
Thr Ci!'nlrr of lhr L.kr Counll')'
White - Building
Canary - Engineering
Pink . Planning
6UILDING PERMIT APPLICATION DEPARTMr;:NT CHECKLlSr
NAME OF APPLICANT
APPLICATION RECEIVED
jl//IVD IVC.CU
6/4- /t?CJ
c.. () ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction a~tivi\y which is proposed at:
dfr{if '1Y~~(V( /NqC:/KU. -;-Z
i . E' } .j
Accep1e,rl_\~th~.cliOn~. 'V.
."', if~; .'" ' I~r)!l
" ." ','it)'~ I' , "/' r /&'
'1 "("'J-' I
N. t i'I' ~. " /
Reviewed By: 'rfl.~ ~.II'~"MAAI..J v' Date: ~1Z./19
./
Accepted
Denied
Comments: It,,,,.FF "'''5T BE. /!o",,,EVED
,
To ANO AU>NG. Di2A'AlA<:.g:. 4
1'~ILfrv ~'::MF-4..JTC.
A, MtUW ,..~
rw*T~,.A,="
Non;, --ritE. &\E~FJJ(.'I'
n\lEf FLO..u
ELI'''~YON
of
'so.t.
ON
TJ./E.
S,n,r;}" LilT LIA.JE:.
LJW'LL.I
'..IIl.L
/
AJEEI'I/-r^
'NFo/tl'\ovr,o.U
BE r..1t('\o.8\,',u
/? iff-.
0" RE<iUSE ~/IlE',
.7 .7
/'
.,4.d
.._,.'
AT
hAJAL
t::AAOE',
sa:
., 1. y
>/
,
./ /....'
C" ,
/".1 "
.'
"~
j~ )//~
SEE A'rf1qtHME'.rTS: I. F."...t'lL(..'Q..bE' 'AJ,<PEC-TIO&J /AJFolI.."'HTldAl Z. ~t'lOIAtG. 1=l.AAJ
3. f"LO'</OA' t'''HT4oL. MEt'l......(.E'~
4. CR.OS'OAJ (!"AJTICo,- R."AJ
"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
'"
,.
.Permit#
'JobAddress 'I~0I4 ,~~/~/r..J
-.
*HeatingContractor -:::J.AJ\!.~>'lr U-J:,
"T~tersJSjgnature ~ ""-D
Ill!!ll
:urn.
Pounds
~
.Gas Une
Pressurized
Inspected
.Percent CO2
EI::E:::lI:'()OVb,NCF TFST
(.,. I
$,7
.Percent co
-A-.
~ro
.Percent O2
.Stack Temp.
Final Inspection
Date
"
,I
.... ...J..." ll._P_'__
OREE. - .....E
YELLOW - APPLtCAtfT
GOLD - CITY
CITY OF PRIOR LAKE NO. c;Q-9t.f8
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: Ott cS J/& c)L ( ,
ADDRESS: I i. /I Y :>0 (' { i:-.J LV.A 'I
SIGNATURE: ("~1"- (:J_~.D.L..
SITE ADDRESS: l/ Go (, JI",-,,^ "" ".....J C.
liL Jl....
PHONE: .P 9j, -t ~ 0 6
1///'17
" ,
BLDG. PERMIT # qCJ- '1t/B
flle/ PID# 25-3<1-9- o/h-O
DATE:
/?;c;..-,. n
FILL IN THE BLANKS
1. Estimated length of water service
J'O
feet.
.,
2. Size of water service
I
inch(es) .
3. Location of any couplings from structure -
feet.
4. Type of sewer pipe. ABS PVC X
5. Estimated length of sewer line jO
Cast Iron
feet.
6. Clean out (if required), located at
structure.
--
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This appli~t~on.tfco~$.-~~ permit when approved.
BY /V/., DATE: o/~~/qq
------------------------------------------------------------------
------------------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $t1.50 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 PAID ,ojl'"f';-\ ':I
f>-\O' ,~,' ,...",
REC'D BY <.f r-.\'C\G r \-
\~\)\""-
RECEIPT #
4629 Dakota St S.E., Prior Lake, Minnesota 55372 I Ph, (612) 447-4230 I Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPI1lYER
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permil No. qq - '1t/B
Prior Lake, MN 55372
HEATING APPLICATION f PERMIT
Dalo 9/aQ/'71 PID' 7-=;-3tP?- (J/lt,- ()
sneAddross 337<1 ..1;:,..,,,,,,,..., /f)u~ ;:;Lf
/
lol L Block 3 Addilion, K.NOB /fIt-I...- 3.eo
-Vn.k. (l""..k
V
Owner's Namo
Address
HoalingConlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
Address 2700 N. FAIRVIEW. ROSEVILLE, MN 55113
Telephono' 651 - 6 3 3 - 2 561
FIREPLACE L.fOJl./:'-/<torj
~1I'!l Make & Modo' f!,>"r
Model Size ~J.lw.' t I G;...s
I -
,Flue Sizo /
Supply Openings /
Relurn Openings I
Oulput I ;:)1 D,"O
I
I
I
Est. Cosl $ ~)~t'l') ,"
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES ~
Conn. load
Fuol
lnpul
Edr.
Clm,
Alloralions
Repair
H'M "C"
1--aY)l(U- TYPE OF SYSTEM
Warm Air Planls ,
Gravity
Mochanical
Air Condilioning ,
Vent. Syslom
HEATING OR POWER PLANT
Sloam
Hol Wator
Radialion
Spocial Devices
Other Oovicos
TYPE OF WORK
, Roplacemenl
New Conslruclion
x
, Est. Comp. Date
IOII/w
C/q-C/qp,
/" ~p.\B~~~tt ~
'\ eU\\'o\\'"
Receipl ~
Building Perm~ .
.50
TYPE OF STRUCTUR~
I rink
1.(ml'l
), Yellow
file Vl
City ID
COltlrKlor'C
I
N
III
I
III
III
Single Family
Two.Family
Induslrial
Muki.FamHy
Olher
....
....
Public
Commercial
Fee Schedule
o
o
~
."
Induslrial, Commercial & Mulli.Family
Residenlial, Healing & AC
Residenlial, Healing Only
Residential, Gas Fireplace
Residenlial, Additions & Alleralions
Residenlial, AC Only
1 % of job cost ($39.50 minimum)
$99,50
$64,50
$39,50
$39,50
539,50
"l
ID
III
....
C.
ID
n
o
"l
:l
ID
"l
..
Remember \0 add the Slale Surcharge on the bollom ollhis application,
The price 01 your healing permit Includes ona rough.in and one final inspection.
Mdilional inspections will be billed al $35,00 each.
Hou"e Ilealing Test Record musl be submilted wilh lll1iIl!iml RtiIDiI ~""'''''. belore bun
ing cerlilicate of occupancy will be issued.
I:lfAI ~l AT IONS ftFOUIRFO with number ot supply and relum openings lisled I
room with CFM's per opening, New slruetures or addilions send lloor plan with supply
and relurn locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAilED m THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 5S372.
(II
"
N
Cily Hall business hours are 8 a.m. - 4:30 p.m.
(II
IN
IN
00
00
I hereby apply lor a mechanical syslems permit and I acknowledgo Ihallhe 00
inlormalion above is comple1e and accurale; Ihallhe work will be in con'Orm8n(~
wilh Ihe ordinances and codes ollhe cily and with Ihe slate buildinglmechani(
codes; thallhis form does not become a permit unlil signed by tha BUILOIN
OFFICIAL; thai the work will be in accordance with Ihe approved plan in the
case 01 all work which requires review and approval of plans.
~.fip 1/bA'-.. .--..
'/7 Ap"Pmnrs S~""~ ",
K~,--X{/ I flJl/CT;f
. v ~ Buildirig'OIfi<1al) Sign-a~
All WORK MUST BE INSPECTED (ROUGH.IN AND ANAL). CALL CITY HALL
441-4230
q/JPIIf?
, 'Dete
q'~eh'1'
Date
iJ
o
....
HEATING APPLlCAnONJ PERMIT
1/- }q-qq P'IO. 25-.34Q- O/ft;- 0
SleAddlllt. t!{oI'J!o .J.!0n'1fYl.-U1fJhtrd. Jr. NY.. ' FooSchedur.
lo! L B:.d L Addif.on. kYIIJn Mil .~d Induslrial, Commercial & Mulli-Family 1% 01 job-:ost \S39.S0 minimum)
Ownll's Name, uJtndJ/tM~ fJ()'flJlkJ _ :::~::~~II: ~::~;~'~~~ ~::~~~ @fRi D~o.r~J~' ~
Mdl8ss 1ORtlli'A~1 l1iJllb ,flJlhr. 111/\/ S51,at/ Residential, Gas Filepla," \J9.Sq (I!'
. /I, ~ /, , , ()) J l.o" ~ "--11'J.A Residenlia~ Addillens & AUer.tIc.. 139,50 !' ,I NOV, 9 1999
HeahngContraclo( ,.bI)fJ~"IVI, lilt'JlfT r . _ Residenhl. AC Only 139.50".\,1
Md,e.. )&J}k4J (l1).AAJru I1d. II k, If> j #.w'ml/UfJ..I:-IYlfP8'W~-
Tllephot1l' /o.'5/-ti;f!j- 51':5'7 (J .),) Remember 10 acWlhl Slale Svrtharlllanlheboltcmol1hluppllCatIlln;------ '-'-
. ^-en n IJ){
FUlnace Mille' Model, Gdlbll:!f'-I1lttIr TYPE OF SYSlEM 1M ",ice 01 you, healing plfmillnclvda one rOUllh-in and cntI rnallrllpec:II-
l/'tl#J/i . W3Im Ai, PIanla
!.lodel Sile J.I4i'~> Nl fj Gravlly Addilionalln.p,cllonJ w~1 be bilecl a.l t:li.OO eech.
Conn. load Moch...1caI ,MrY-P/J 141 V- ' Heuse Healing Tesl RecaR! mull be .1brilIId wilh UiIlllng IIIIDlI ~ be/aI. bul6-
. I _, I' 5 (t - N.t Condlllanlng - lng ce,tilicat. of a<<Vpancy wi. be l..veII.
Fuel !VfITlTdr FNI SIz.' Ye~ Sysllm
, 'IF liT rolll r,I" 4TI,nllll'l "IF"I "~,,n will........ aI .UAJ'Y and mum .........'" bled...
Supply Openlngl c:< / HEAllNG OR POWER PlNfI loom wilh CFM'I pelOpI""'g. New slruclUlft Of .ddiUone send lIaor plwl will ~
q _ Stoun, end IIlvln lacallons shown. HEAT lOSS CM.CUlAl'OIlS, PAYMENT Nfl)
Relll,n Oponlrql Hal WI'. APPUCAlIONS MAY BEMAIlEDIOTHEClTYOFPRIORlAKE.ll2l1l1 ~
. ,19'L!r . _. AA7\ '. RIdlalIan CREEK AYE. S.E. PRIOIHAKE. MN 55311.
InflllV~ DIY) CU',- II'f j nrx J Spochd O~" .
~
UI' ur rrll"" LIO...... Me ,1
1&100 ElgI. enlll Av. S.I!. Pennil No. qq 0 q ye
PrlOIlI.... MN 55312 .
0011
Edl, ,
elm.,
OIM' Devic..
lYPE Of WOIlK
~
Allerallonl
R.plle.mltt New ConslNCtloll
Repair Ell Caft1I. OM .
Ell. Coe" BuDdlng Pllmll _ q q --- c{iff!
HEAliNG PEANIf fEE' !tJI.5f) ~~
STAle SIJROlAAGE , .50 ~,~lN(iP~RM\T
TOTAL ?6'J.lIT FEES, {per, tlf F.~",. .
....,,"'... n4- ~....,.t ,~, I"~
Single Family
/
...
...
"-
...
..
"-
..
..
r-fomilr
M....F......
Olhlr
CommelCial
IndllSlrlaI
Public
...
o
..
'"
..
L/
Cily Hall bu.ineu hours arl 8 I.m. . 4::10 p.a
All WORK MUST 8E INSPEClED (ROUGH-IN AND FINAL). CAll CIn HALL
44J.4UD
IlIIleby apply lor. mlchanlcal 'Yltlm. permlllnll I .cllnawledg. lhalllll
InlOlmaRan Ibow I. campI.,. ud .ccu....: Ihlt Ih. -' wi. b. hi CDIIIatm-
with \hI ordln.nc.. Ind c""" 01 1M cIIr Ind llIiUl lhl I1I1I bvlldIntIh"echenlcel
code.; lh.t Ihl. 101m da," nol bleaml' ptlmll unlll Ilpd IIr 1M BUILDING
OtflltIAL: Ihlllhl walk will b. In IccOfd.ncl wlllllh. .ppraved plUlln ...
6., Ql..all wo,k whIC~qUI'" .evlew IIId Ippraval 01 plllll.
A);/lnl b~ II-fl-n
""~~~ 0"
rc:lM(/{/f/tA-- }{ It q /qq
~o4J c~.~;pIIa - c_
~
o
...
CITY OF PRIOR LAKE
PLUMBING PERMIT
APPlicant;~/?//,#// M//P7/T~/"'
Address: Z/\ /%I/n/..f"f..-? ,...-?-,,/ '"
Signatute: /7A- /7/~ ~07 /7/;;' ,-
Legal Desctiption: Lot I Block 3 Sub KNOB 111/.--I...- :3,e.o
Site Address: /-/Hi~ -?I.//~~/~////-;,,/,/ ,~ -:/z..J
"
Building Permit # QQ-9'-1-18 .PJD# 25-34'9-01(rO
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
~U/~~/~~ lHU IJ:14 rAA 6124474245
CITY OF PRIOR LAKE
Hit (.~"ttr.., I~ I..., Cl'Iulur)
Quantity "
Type of Fixture Quantity
G Bath Tub with or without shower ...:;f
/ Dishwasher /
I Floor Drain
I 9' Lavatory (bathroom sink) /
I / Laundry Tray (1 or 2 companmenl Sink)
I / Shower Stall
I / Sinks
I Bar Sink
I '--~ Watet Closet (toilet)
FEE SCHEDULE
Industriel, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surchatge
$99.50
$39.50
GRAND TOTAL
@001
\\~
#
Phone: /-~-->- ~/ Z /
1. Blue-
2. Gold
J. YelloW'
file
Cit)'
^rr1iClUlC
q~jltfg
Type of Flxlute
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing maChine)
Sewage Ejector
Backffow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sptinkler
Othet
$
$
$
$
.50
AIO wm:\
'~ f' '-.l'" DE.i.MIT-,
\..lit Q\' \,,;4 (
1-
This permit is granted upon the express condition that said
conlmctor. shaH comply in all rc.'ipccts wilh the onJin.1nces
of the State Plum~'n Co<.lc Al"Jd the amcndm'll!; thereof.
- ~,.d,/2.4-1'99_ DATE
,_ A~T
Call for all . spec lions 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 1 Ph. (612) 447-42301 FAX (612) 447-4245
An Equal Opportunity Employer
I I
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS q(p(')(() H()(,4Ifw-','W:'I6t-eO \h:-_
. II' , u
NATURE OF WORK No",\ ('~n.)l~
USE OF BUILDING <....FD
PERMIT NO. C, g . "! LIp, DATE ISSUED f3 -/(.,-9'i
CONTRACTOR <.A......,L.)"...i ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
GRADING (Prior to Sodding)
BUILDING 1t-j;.)..1 I! 00 (JJ. t-IID/UO
ELECTRICAL
PLUMBING
I HEATING
DO NOT OCCUpy UNTIL ABOVE
NOTICE
, FOOTING(rAl) I J&-:r, I '1-~-9<J
, FOUNDAT'ION (Prior to Backfill) (W) I ~ I I /6 ~ to. Ci;~
PLACE NO CONCRETE1:INTIL ABOVE HAS BEEN SIGNED
ROUGI;:i-v;INS I
, SEWER I WATER I SEPTIC (lV' ~ V "/2-.if9~
FRAMING 1\1.- 1/1 ~~
INSULATION \ . A-fA 1/;J_0A.1Q ,
ELECTRICAL I I) \I I "\,
PLUMBING I ~""JIlI'f" I
HEATING (if required) I J4~/~.f' I
FIREPLACE . VJ (/1;/6 iJ I . /0<>/9"] I
I GAS LINE AIR TEST ~ F.', I VI.p. 11.12~A9 I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I~ I I
,
FINALS
~~
1
't' /8/J /tJD
4/?7n
0~
" \ k> ,fJ
H ,S BEEN SIG~ ED
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.
, .
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
II I