HomeMy WebLinkAboutBuilding Permit 99-0986
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CITY OF PRIOR LAKE ,:~i
jJBepartment of Jiutlbtng 3Jnspedton "'0 ,-
o Final Permitted 0 Conditional C.O. Expire.
.
;
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:
Use Classificatior
Sin2:1e Familv
99-986
Bldg. Pennit Nn
Occupancy Type
R3
VN
N/A
Zoning District Rl
Type Construction
Fire Zone
Legal Descriptior
L7, B2, Windstar
Owner of Building
<;ite Address au? q PonrhTi PlJ '1'r~; 1
Contractor's Name & Addr'" Wensmann Homes. 1895 Plaza Dr., Eao;an. MN 55124
Robert D. Hutchins"tilY
Jenni Tovar
Date:
Date'
CITY OF PRIOR LAKE
INSPEC:rION NOTICE
SCHEDULED
ADDRESS <+'-12.'1 ?"^,Oll'''.' 1IlA,l..
OWNER
DATE TIME
/(/nl"
,
3:De
PHONE NO.
PERMIT NO.
CONTR. \J~^,(,^, ANAl J..!.,,<fE <;
'l'1- '18ft,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)I(FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~E IS
4aPTAKIJ".
CvlC.J,n.""
IS. Dl>f;1l.4T/o.,,.,_
'!if EX/GRAD/FILLING
'D'\cOMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
XWORK 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/
INSNOTI
II
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
II f?of/1. /l T .
ADDRESS
44Z'1 PONO~'ID/L./
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-980
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION ~
FINAL '15/"1)
~ SITE INSPECTIO A
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 AIR TST
o
COMMENTS:
~ '--0:56-- H <-b
/J14re-- e>VT Co~
,~ ~.$lf(
~ORKSATISFACTORY. PROCEED
o CORRECT ACTION AND P CEED
o CORRECT WOR 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/
INSNOTI
II
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4L(~"} -f/oNO View
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING t1a'\
~OUNDATIO~
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
iD MECH RI
lir WATER HOOKUP
?Jil SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
?-'i'-''j <jJ 'f~
_91- ~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COM,MENTS:(7J -/l""P, /,_^~-r"':"'" .~o uJ..:r.......,
j~. ~A'A_ ~~ ~, ,
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o yWRK SATISFACTORY, PROCEED
rt CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
f3t.r.
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
/NSJVOTl
II
n~?'f
~ ~
'PcCNDV(~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 442 '1
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
,\ 0 SEWER HOOKUP
/-'10 :;&'pLUMBING FINAL
o MECH FINAL
C+>"'IIt'IfNTS: I' ')
lJJGH" LArk: ~
(~
YV~ ~
Puil
4
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Inspector:
Owner/Contr:
TIME
tz:ao
tj? ~ 9f;(,
a;... or~t5
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
gALL 447-9150 F 'IR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQU_V WTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
II
---'.'-.-.--
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
&~~
DATE RECEIVED
8/11/99
r 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
~"'~'" ~<>-....A~."~"", 'r
3. LEGAL DESCRIPTION
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.9? - q'f3(o
LOT
-,
PID
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BLOCK
AODITION l",'__~"""~'
4.0WNEf:l (Name)
~\.."....'.~-......-.~.......",,- ,~~~
5, ARCHITECT (Name)
~ v... ""'-'<'-
6. BUILDER (Name)
1. DATE
""'-6 \~ \'\."
.e/
BUILDING INFORMATION
11. SIZE OF STRUCiURE
(Height).~ , {Width\. \0 (Depths 0
12, NO, OF STORIES
~
(Add,ess) /[39::') pu')2/T De., (Tel. No,)
~~""''''- I...~\ - "'~\o- "-~~<:)
(Add,ess) S61c). -I (Tel. No,)
13. TYPE OF CONSTRUCTION
\...>...3~u~ '- \.c..."--'---
14. FLOOR AREA APPORTIONMENT USE
"",,\~
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
s.. '1>0. ",^.c
7. TYPE OF WORK Fireplace CI Septic LJ Deck LI Re-roofing CI Porch 0
New Construction~ Alterations 0 Addition 0 Finish Attic 0 Ae-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
Chimney D Misc. '>.\.n~ \. I ~ ')~C)
8. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE I 17. COMPLETION DATE
Sq, Ft. \ l.?- ",S- Width \ \:" Depth:,,<:> \0 Ves No_ ~"\......., ~ \. \. /~"'I...."
I hereby certify that I have fumished 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 or a designee may enter upon the property to pertorm needed inspections.
X '-'\~.- ~~'-"--'-r--<.~_c- \"':s~ ""~'":\'''''
Signature License No. Date
SEATS
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
. BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REQ,
SPACES ON PLAN
PERMIT VALUATION ?l~ .OcJ
USE OF BUILDING
<;~D
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
s U
City:
Permit Fee ........................... .... .... $
1.1srh.. .,
'101.71
100l.DO
v
~ I~~~r, 1\1\
~\~\\~
Plan Check Fee ............................. or
State Surcharge ............................. $
:::~:~.~~~;;~~~j{'t?il'P.::::::: : 100 , 00
Mechanical Permit Fee r.?~....... <I: In"'. 00
Sewe, & Water Pe",,' ff..1!k........ $ ~S". '5"0
Gas Rr ce Pe""it {1/;/IJIf.......... $ '(0.00
~~IS oomes;b Building ;:.";itg~e;z,r-'rt
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS a
PLANS & SPECS a
SURVEY 0
PLOT PLAN a
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ,...................",.................. $
CoUectiveStreet Fee ....................... $
Sewer Tap ................................... $
I" $
Pressure Reducer .......................... $
Meter Horn ................................... $
"
Water Meter .....l........................... $
Sewer & Water Connection Fee ........... $.
WaterTowerFee ........................... $
Rc;o.oa
, 0<:;0 -00
(0.06
'"2.';0.00
")()O.oO
'700.00
Water Tap ................................... $
Builders Deposit .....,...........".....",. $--1.: <)00 .00
Other ......................................... $
Total Due .............................. $ e7~
Paid f; 2. /34- ,# Receipt Np,. "3 (g 0'5 "f-
Issued / / JiJ%t
. Date B 7_7,/0/<; By /~'-----
This is to certify th t the request in the above application and accompanying documents is in accordance with the City Zonin~ Ordinance and may proceed al requested. This document when
sign C" Ianner constitutes a temporary Certi~te of Zoning compliance and allows con ruction to commen~e. Beforepccy, ,P<\.nc~eJricate of Occ~~ncy mJft be issued.
- - _~-L-~...&f'L <;~~ \ Ct:M !~~ ~(~..f'\~
City Planner Dale Special Conditions if any
Certificate of Occupa
24 hour notice for aU inspections 447-9850
T
..-.--.-..-...----
"'i'''.', II
Thf Cfnltr or lhf lib Counlry
rjr; C)f V
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;r/.:..IV~ /ll//NM HOlliES
y: II( I c;1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L/L/-zc;
P()NLJVrb vV
77<-
Accepted
./
Accepted With Corrections
Denied
Reviewed By: 0.1.<"<11. &"GS."'/NAJ
Date: X/U./H
Comments: 17.,..nO<
,
1"11.1$,.- BE: (InAJuf..f1'~J\ -'TjO., ANA ~N~ DI(A/..JA6E. ~ VnC.1 TY
.f4sEJ'lE;JT3 4s "',,<.Ii "'S PII.Acnc" I.. ,
i. SE'€ JA11Y:J1l,..ltru:u,J /)N RElJ'EJUE SUJC.
.$~F A1T04t'~......r...,r': /. h..J~,- ~...~ !;oJsPEcn (J,v INFo~~.v
z. ~Il.IU~'N~ R.AN 3. EItOSlo/IJ
f..O,J-ra....L ~fA~as.
t.J.. f'hlc"ft)).J e o,J.llo(.... PLlitU
"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."
rt
-
~-_....+
._~--"'- ---,--,"
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.
/~~ .....
,
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The ('enlrr of the L.h Counlry
White - Building
Canary - Engineering
Pink - PlanninQ
6UILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT,
APPLICATION RECEIVED,
1/ '/
./
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/... ({ " '" /
" l '
.....-- j
, --
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
4~~
Date:
"D r 2s-q&j
Comments:
A-/C ~-~ ~ C4V-tfj~
(' ./f~ PA/J.!, A/'o/~ ~ CV\. ~'ii/~~ ~t-cf2e ~(~
?-t.{ ~ I!vv~ COvtA,~ v..~ dX
\R-C)-&J 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."
~~
Cjc;- 980
White . Building
Canary - Engineering
Pink . Planning
Th" Clenlt'r of Ih" L.b Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
fY&NSM/lNN HoM6S
6/11 /qq
. ,
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L/lfzq
.
PONoVr6vV I1Z..
Accepted
Accepted With Corrections
/
Denied / ~
Reviewed Bif'j) ~ ~
)'
---
Date: Q- ?4--ttJ
Comments:
I. R1'O~ a.. ( \ "tto..c.W I-k...J2 ~
"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."
1,1
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CITY OF PRIOR LAKE
, 182110 EIIOIaCfHkAv. S.E. PermhNo. 99- 980
. Pllor Lab, UN 5~72 '
HEATING APPLICATION I PERMrr
Dale~-IR-Oflt plDIt 25-33(0- 017-0
SlIeAddJ8S1 44 'Z. '" +>n~'D\J\~LD~,Q - ILl
Lo\ -=:l Block 2- Addnlon LU\N~AlfL
Ownefs Neme l ~"'>JV'OJI"'-""" ~e<.....
Add/8ll5
HNllng ConlrllClllI GENZ-lflAN
Address 14745 So Robert TrI, Rosemount NN 55068
Telepllon&' 423-1144
f"-
CD
'<t
o
z:
i
I:
FurnllC8 Make I Modo' I PllVNCl....' _ TYPEOFSYSTEM
Modo! Sim r-.. 2 ?.Q2IL\- \'Z.~ ' :::IIvAir Plants
Conn. Load Mechanlcal
_ "Air Condnloning
_ 11161 ~FlueSI;te .5 V8111. s,stem
SupplY C.' . ','7' ':'n__~__~:.::..,':""::~~I"-QII_I.~.~:~_~~ERPlAHI-
Relum Openings B ~ .~:~:~c==- 0' -~~'-----
Radl8l10n
Spedal Device.
z:
(I
>-
0::
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N
z:
W
U>
Inpull"'2'50l10 .0utputJooaSD
Ed"
Clm.
Other Deviee.
E
CL
'<t
IS)
CD
TYPE OF WORK
)l...
.
Replacemerrt
E&l Comp. Date
Naw Conslructlon
Alleralions
Repair
. _ BuDding PermU q1'7
lflL\~ 7 - 9$1?'
.50 / ~p..\B~~?-~\\
lo~ \ ~U\\.Ok'
R_IpU
ITl
lTli
1Tl-
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CD
..;
19 ..~
~-,
(I'
,
I
.
E5l, Coil $
HEATiNG PERMIT FEE S
STATE SURCHARGE $
TOTAl PERMIT FEES $
, 'I
L~--"-~"-
I. FiDk
1, llnoD
3. ~.....
fil&
City
Ooo>a_
TYPE QF STFIUCTUfm
Single Family
Commercial
')(. Two-Famlly ,
Induslttel .
Multi-Family
pubnc Ollt.,
Fee Schedule
Induslrial, CommeJNI & Mulfi-Femlly
Resldenlial. Healing & AC
Resldentiel, Heating Only
Residenllal, GIIS F.eplace
AllII!dIn1i8~ Adtf~ione & Alleralions
Residential, AC Only
I % of job cost ($39.50 minimum)
$99.60
$64.50
139.50
$39.50 AUG I 9 1999
sa9.60
Remembet 10 add \he Stale SUlChatge on the bollom ollhl. applicalion..
The price of YO'J' healing parmll inclLldilS one 1O\lglHn and one llna! inspec:llon.
Addllionallnspectionl will be billed al $30.00 each.
House Healing T..I Record must be submllled wilh IllliIlIinll pmmiIl!lII!lIlI1 befo,e build-
ing cerlllical8 01 occupancy will be issued.
J:lE,!\l CALCULATIONS JjEQUIREO will\ number of supply and ,elum openIngs IlsIed pE
.oom-wIIh CfM'a.pel opening. New. .$lluctutes or ",dblons eendlloor plan Wilh 8UPflly
'__. <:,-,-<!!lu.-"'~~-',' tA~lll'A11QNS;.l'A'lMEtf[Af\lD .-' - -'-=-,
APPUCRIONS MAv'8E MAllED'1'CHRE'CIlYOF-PRIORt:AKEi-1jiZOIJ t:1\~L"- ,
CREEK AVE. S.E. PRIOR lAKE, MN 55372.
ClIy Hall buslneae lIoula ere 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED IROUllH-IN AND FINAL) - CALL CITY HALL
441-4210
I hereby apply lor II mechanical ey.lems permil and I acknowledge thai Ihe
Inlormalion above la complel8 and accurale; Ihal the work will be In conformanc.
wilh Iha ordinances and codes ollhe cily and willi the stala bulldingfmacllanic.
codes; Ihel thil lorm does nol become a permil unm ,!gned by Ihe BUILDINI
OFFICIAL; IlIat Ihe wori< w1l1 be in accordance wllh lIle epproved plan in \he
caae 01 all )'Iork which require. review and apptoval 01 plana.
~-\8.-cf\
Dale
B Iz.. 7/1'1
Date
l
.
~g Olllca!" Signature
RUG.20.1999 10:12RM
GENZ-RYRNI i ' '
NO. 558 P.2/3
pqo,-/~Z ~
, '
, '
--PILII
YILLOW . ......, ICI,IrT
GOLD . aT'
SIGNATURE:
NO. 19- 9f3ro
Sewer ~nd Water
'contractors must
be reqiste:t'ed
with the city.
PHONE:
'~
r t<..- fJ.d;I.msi>>1T DATE:
(p<::H.,f 7 3.,-11 Lff;.!
~ ~ ~ -'=19
SITE ADDlU:ss:
,BLDG. PERMIT * 99-98b
LIt! J;..,~V"'t..tJ.)"(J.. ,e/ PlOt 25-33(0 - 017- D
'~~h IN THE BLANKS
1\' .
Estimated length ofli',..ter service UD
'I I ".
Si2e of w~ter servii~1 ineh(es) .
,I' '
Location of any cc~l, I inqs from st;ructure feet.
Type of sewer pipe. I\.BS PVC)( Cast Ircn_
' ,
Estimated length of'lI"~wer line ~I
Clean Qut (if reqp~red), located at
structure. " ,
feet.
1.
2.
3 .
--. 4 .
-) S.
6.
feet.
_feet
from
===;;;---.--.--'-----2:=====~:::====_1' I ~====~:ii;;J..~.-__===~=====:c.-----';;;;;Io:lII~----====~
Thi.s apPlicat~~~ rour pe~it when approved. ,
B\' ~~j/J:jj.- DATE: B/zo/qq
, r- ,,~j . -',
:::'~---~::!i--"'l~:::::-~::n-::::o:-:::::::---
:! I
* Fee for either sewer' ;r water individually is $20.00 plus
$ .50 surcharge. I""""
*
Sewer and water perm~'Js issued for new construction must be
recorded on the buil '~9' permit card at the time of issuance
to insure that no d ~icate sewer and water permits are
issued. '
ii,
"
II'
,'111
AMOUNT PAID
/- P.MD wITH
r BUILDING 'PERMIT,
DATE PAID
'...-
RECEIPT #
REC'O B\'
1
'I,
'.1
, 4629 Dakota 51, 5.E. PrIor Lake, M r I Fla 55372 I Ph. (612) 4474230
~i r ,II/. CppOJmJN!1"Y ~I'l.OYl:R
:1 ,
, '
I Fax (612) 447.4245
I i I
RUG.20.1999 10:12RM
GENZ-RYRN ' ," ,
NO. r~'} I~ t~
CITY OF PRIOR LAKE
,R ',UMBING PERMIT # qq-C;P,h
Applicant: ) ~ 'Vfl- f.UA9'u Phone: (6/- u'2.:&"-1 I lftJ.
Address;---.liJ rJ r;;...Jt""""J.o-r-rIt_ ~~V'Y'71.nT" tMllJ~~
Signature: -J ""----
Legal Descriptiq! I ~ot _..., Block Z. C;up t JJ ',,",Pb.TAA...
Site AddrellS: ,I 'lU'2.O, ~.....'D,Ili'a'::'/Pl e(
Building pennit/ J 99- 9f!?(P PIDI# 25--.330- 017-0
NOTE: This per, 1 I V(iII not be processed without complete infonniltlon.
,
FIXTURE UNITS
I. 1I1Me MI.
.. Got. ell'
3, yen... "IIPD_
l"IM ee..., fit.... t...1 Cealt11"J
Quantity Type of Fixture ,1, [ Quantity Type of Fl%lure
l ,
Bath Tub with or without show~ 3 Rough-ins
\ Dishwasher ,II I Water Heater
\ Aoor Drain ! I Water Softner
4 Lavatory (bathroom sink) II Stand Pipe (washing machine)
\ Laundry Tray (1 or 2 comper!,,~,t sink) Sewage Ejector
\ Shower Stall I Backllow AssemblY (RPl, Double Check. PVB)
\ Sinks i I Backflow Assembly Test
Bar Sink ',Jr Lawn Sprinkler
?J Water Closet (toilet) ., other
'ill
FEE SCHEDULE .
Industrial. Commercial & Mult[-Fllllll
(1~ of job cost. $39,5D minimum' .
Resldentlai. New One & Two Fan il J
,
Residential. Additions & Alterallolll ,
"
Slate Surcharge '
$99.50
$39.50
$
$
$
.50
GRANO TOTAL
$
,-~~~~W'?-~\"t
\ fQ\j\\...)l. ' _
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CIl1l fo~ ~ . dons 24 hours in advance,
16200 Eagle CreekAv. S.E., Prior L....J, ifinflcsota 55372/ Ph. (612) 447-4;230 / FAX (612) 447-42~S
~ ~9\1aJ Op~gtt\lnity Employer
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Job Address i'I/'! ~1/Y<J ,Few
Heating contractor~" s - / Ilrl!-N
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Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp,
Combustion air is adequately supplied per
UMC See, 606
Input
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Oat. /IJ-,/\'" qq
Sit. Address W,.:>q
lol '7 Block
AOON
Z- AddiUon
/I"IIN06Tf\-te..
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Owner's Name
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AddIess
Healing Conltaclo, ALLIED FIRESIDE dba FIRESIDE CORNER
Address 2700 N. FAIRVIEW. ROSEVILLR. MN 55113
Telephone 6 651-633- 2561
FIREPLACE
~IQ> Make & Model . J.t--.r N Gv.
Mod.l Size. 10 CUY1k-
Conn. load
Fuel fr.~~
TYPE OF SYSTEM
Walm Air Plan..
Gravhy
Mechanical
Air Conditkmlng .
VenJ. Syslem
Flue Size
Supply Opaninys
Relurn Openings
Input
Edr.
HEATING OR POWER PLANT
Steam
Hal Water
Radiation
Spedal Devices
Outpul ;) 7. DX>
Other Devices
Clm.
TYPE OF WORK
Al\eratlons
Replacemenl
y
New Conslfuclion
Est Comp. Dal9 _ JQ-/I-qq
Building Perma 6 C;c;- 9R0
,50 ~~~\"~~~W.\\
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Receipt #
R9paif ,
Est Casu, J/no ,>:1
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
TYPl; OF STRl,LCTURr;.
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1_ Grern
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City
Con~lttor
Single Family
Commercial.
Two-FamHy
Multl-Family
Public Olher
Inuuslrial,
Fee Schedule
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Industrial, Commelclal & Multi.FiIl11l1y
Resiuenlial. Healing & AC
R"sidenllal. Healing Only
R"sidentlal, Gas Fireplace
Residential, A<kllions & Alleratlons
Resldentla~ AC Only
1 % 01 job cosl (139.50 minimum)
$99,50
$64,50
$39.50
$39.50
$39,50
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Remember 10 add the Slale Surcharge on Ihe ootlom of this applicalion.
Th" price of your healing permi! includes one rough-in and ono (mallnspaction.
Addilional inspections Yl'ill be billed al $35,00 oacl1.
House Healing Tesl Record musl be submilled with build inn ll.QlIIllIllWI1Ilm: before build-
ing certilicale 01 occupancy will b. issued,
HEAT CALCULATIONS REOUIAFfl, with number 01 supply and 19lurn openings lisled p.
room wilh CFM'. per opening. New structures or odditions send Boor plan wfth supply
and relum Iocalion. ohow,;, HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16100 EAGLE
CREEK AVE, S.E. PRIOR LAKE, MN 55372.
City Hall busin..s hours are 6 a.m, - 4:30 p.m.
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ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAl). CALL CITY HALL
441-4230
I hereby apply for a mechanical syslems permit and I acknowledge thallhe
Informalion aoove is complete and accurate; lh.llhe work will be in confotmance
wllh the ordinences and codes 01 the cUr and with Ihe slate buildingfmechanlce'
codes; Ih.t Ihis lorm does not become a permit until signed by Ihe BUILDING
OFFICIAL; Ihal the work will be In accordance wilh the approved plan In the
case 01 all work which requites review and approval of plans.
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Bujltiing Ollical's Signature
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- Date
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4L17Cf Q,w:.I.llie.uJ II
NATURE OF WORK t-je.~ r ~.^I,.... "'L______
USE OF BUILDING 'S~\)
PERMIT NO. c,C;-"'1Bc.. DATE ISSUED ~'LJ./-99
CONTRACTOR \J~c:;~ l~~ ">
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING(rN) lb-. I 9 c1-j'}
I FOUNDATION (Prior to Backfill) ()~A 6-+. 1-7-1r (@ I h. ;-9 99
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. cSEwE~1 SEPTIC fA) I t:i, 1,." '1 -99
FRAMING- ~ ,,J!G- #J1." lD-13-q~
INSULATIO~,l.tf'4l"",..?oIv ~. \b'I~''l~ WI I It> - r5'-11
I ELECTRICAL I I
PLUMBING (t1) I~, rD-c3'1~ I
HEATING (if required)(N) I t?1, I D ! 3 I; I
FIREPLACE " ~~. ^ '-./ I ~-k'" lO - \~ -01 I
GAS LINE AIR TEST ~~. ~,17, k'lf" I oiL m I /0-(2-/'11
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
I PLUMBING
I HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
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(t-JO-C1q
SIGNED
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.
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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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