HomeMy WebLinkAboutBuilding Permit 99-1001
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CITY OF PRIOR LAKE
jDepartment of .uillling Jn~pection
AFinal 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 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 Oassificatiol'l
SINGLE FAMILY
Bldg. Permit Nn
99-1001
R3
Occupancy Type
Type Construction
VN
Fire Zone
N/A
Zoning District
R1
.. 1.6, B2, KNOB HILL THIRD ADDITION
Legal Descnptlon
Owner ofBuiJding
~iteAddress 4'i~'i HUMMINGBIRD TRAIL
ContraclOr's Namc & Address MW JOHNSON, 17645 JUNIPER PATH. LAKEVILLE, MN 55044
.:./
JENNI TOVAR
Date:
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 4- 5 3 5
~ t ThLr-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
AD PLUMBING RI
o MECH RI
~TER HOOKUP
"- c::[:>&wER HOOKUP
..... 0 PLUMBING FINAL
o MECH FINAL
COMMENTS:
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TIME
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'fq- I (Ji) I
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
L\c !I've
~Fr~ - No
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Inspector:
OwnerlContr:
T E NEXT INSPECTION 24 HOURS IN ADVANCE.
CAll
CODE
INSNon
II
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4535..
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
AD WATER HOOKUP
o SEWER HOOKUP
'II( PLUMBING FINAL
/[] MECH FINAL
AOMMENTS: ,,\
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(~~ ~[P/l
B ~4-tA.
b~
~lt..12
~-
DATE TIME
# Z;OO
A.
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qq-IOOI
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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/h r J., Y< t- ('~ _ "1'
n
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Owner/Contr:
CALL 447-9850 FOR HE NEXT INSPECTION 24 HOURS IN ADVANCE.
~DE REQ.l UIREME1rs ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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-----_.__._----~~--_.
I I
DATE TIME
CITY OF PRIOR LAKE ~
INSPECTION NOTICE SCHEDULED Z:36
ADDRESS 4535 Sk
I
OWNER CONTR.
PHONE NO. PERMIT NO. 19-/()(J/
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTION ,)(MECH FINAL 0
COMMENTS: ~./# r;f1t ~ dn-trt___
h l' ./
---f2) JZr~ A~
X'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
,/J''z0,
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
f/VSNOTJ
II
I I
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
1-/H.[pa /1:-10
OWNER
~LJ
CONTR.V
PERMIT NO. qq-_~ ~60\
ADDRESS 4- 5 3;
PHONE NO.
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION ~ 0 MECH RI 0 COMPLAINT
o FRAMING ~ 0 WATER HOOKUP 0 FIREPLACE RI
D,INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
V'-' clNAL 0 PLUMBING FINAA.. 0 GASLINE AIR TST
o SITE INSPECTION ~ECH FINAL,. 0
.cOMMENTS: f/PoTw Door ~.~ ot.L-
W ~\V\3\ 'Pe-v- G~~.'vI~. d.a.tJ-r
{7J 2h1 illY\&. -\yU;; ~ ~f ~
\~ ~aV'd.. .5tM. {.Qrf -5Y'r\l(WC ~
/W DroS;llY\ ~~.
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/)~ ex. (.t\Y\uve...fv
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g lJll0lc . ~ ~ t-z.-v~
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I~ n~lJ,,,, tJ t't\r,~1- +es.r
o WORKSA'irJFACTORY, PROCEED
~c RREC AC ION AND PEED
ORRE T W ,A FOR REINSPECTION BEFORE OVERING
,-
Inspector: '\" ~ ner/Contr:
CALL t7-9r FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
II
I I
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS A:535
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o ULATION
FINAL
~EINSPECT
SCHEDULED
\-\ lLvt\W\ . '1;, b 0' J
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: Strr
.P - ,;)- ~_" 4"'1 lul7it"")
~ - _tl J.. i- ~
Ct1j tJ ~ "...- .P
DA-e
~;g2
TIME
Ar
~- tOo I
o EXlGRADfFlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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Id~ --
I'
~
(- {~
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"-
-
-
)tI WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S:::O~ECT WO~R REINS::::/::::FORE COVERING
"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
, ,
INSNOTl
I I
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
6/lz-!QCj
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Pleas. Print or Typ. and sign at bottom)
12. SITE ADDRESS
<-IS 3'" H'-A"""""'.~ hir--d IY'4r I
3. LEGAL DESCRIPTION -
(,
1. White
2. Pink
3. Yellow
File
City /
APfJitant
Permit No.
,
i
97-100/
1. DATE
7/~l/q1
t&
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(He91l) (Width)
. !:Ie.. <<;'<./
12. NO. OF SCRIES
(Depth)
..,...,
PID
.2-5-3'-1Q- 012--0
LOT
;J
ADDITION
IL......,l.,h', I I
BLOCK
:Q.~
13. TYPE OF CONSTRUCTION
/o.kuJ 11" W'-L
14. FLOOR AREA APPORTIONMENT USE
14. OWNER (Name) (Address) (Tel. No.)
H I~ J .:\",1-"", ,,,'" IJc.'-l.r SL."'-:~ p,.,~ x-')..-17.lo
IS. ARCHITECT (Name) (Add~ress) t:./T:-~:~p (Tel. No.)
16. BUILDER (NL.) (Addr ss) (T) No.) 15. NUMBER OF OCCUPANTS O!jloSEATS
~ ~ OCCUPANTS So ":'IlL H::_1 "_
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0 SEATS
New Constructlo~ Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTN ALUE
Chlmn.y LI Mise Il?O uD 0
18. PROPERTY AR. EAORACRES 19. PR7~lMENSIONS Il.{;l' 1'0. CULVERT SIZE 17. COMPLETION bATE
Sq. Fl. J.:}. rDO Width D.pth E V.s No I;J-O (:ole,!.\ ~ c1i!=
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authoriz&! 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
bulldl~ia~ can revOke~iS ~it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X---fi:j(j~ .Jl.J...QJ '/;;LJ 1"77
~v-e...... Signa license No. Dale
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Side
"ok
BUILDING DEPARTMENT VALUATION
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LI PERCOLATION TESTS LI
USt: OF BUILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 1 P(), /Jf'>c), Ol!>
SETS
COPIES
Sewer Tap ................................... $
License Check Fee ......tt................ $
Pressure Reducer .~.................. $
Meter Horn ................................... $
Water Meter ................................. $-L:lI::" L (9-~
Sewer & Water Connection Fee ........... $-1_ '200 . ~n
WaterTowerFee ........................... $ . 719'" .t=)-"
Water Tap ................................... $
Build.rs D.posit ............................ $--'.,../')0('), r~Q
Other ......................................... $ .
Total Du. .............................. $ -,G( ;.!.~. ~
Pood ')C}?- <I ell, R.ce~DtN 3(" 2-/0 _
Oat. 4'/;5/io/ By ! j{
fy that the request in the above application and accompanymg documents IS In accordance with the City Zomng Ordlnanct and may proceed requested. This document when
ner stitutes a terJ1Xlrary Ce~ ZZonlng compliance and allows construction to commence Before occ~ncy, a Certifica of Occupancy must be issued
ner ~J Special Conditions Wany
_~~D
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F H IRS U
Division 1 2 3 4
City:
Permit Fee ................................... $
'ItPJ7,ZS
rr;Z/~.7(
-
'UJ. DO
1.00 .00
Leo e(j (';;;.D~ ,li,V
m.M lPr.oI4~
t1n.rm 0110
Plan Checking Fee ......................... $
State Surcharge ............................. $
_ .f../"...........:.'tl:.l.0L. $
Sor'~R""t~m ..tl!~1:..'l..q~r.'??1 $
_........?..to.!.....tCf.~t(!?.1. $
~__._~ ...6.f.....rf.~Lq;/. $
ThISC!:i]ti~~.~Buildlng P.nn" When Approved.
By 7t>' Dat.!?>-2C;-'ifl
Certiflca.te of Occupancy
Issued
PLANS & SPECS 0
SURVEY 0
PLOT PLAN
LI
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... 4'
~t:J .f'Y)
10.9':> .(!)D
'tS.~tS
24 hour notice lor all inspections 447.4230
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White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
-'---~
.-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/
I
, .
/' - !..~.-"'-'
I
i f-'<-_
~
Accepted
Denied
,/
Accepted With Corrections
Reviewed By:
(J /Jj. J0a-U
vV?1
Date:
q --1 ~1
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."
qq-/oo/
Th~ Crnltr of lh. L.kr Counlry
White . Building
Canary - Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEeARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
M W 00HN60N
6/ /2 /qq
I I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
45.'=15 HUM M IN 6 B/ 1<.0 TR-
I
Accepted
Accepted With Corrections _ J
? ----
Denied
Reviewed By: rf! q~~r Date: ~ ZS--"Z-?
Comments:
J. ~J ~j)jJ /yJCL~Lj lu,~~-
"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 ._,._~_.~_._--~._--_._---_._._----"_._-"-_._.".._.-_."._,,_.__.__._._~_._"~_______..,..____A"____ I I --
. .. .~'. "
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White . - Building
.c~ Canary "- Engineering
Pink - Planning
T"~ ernl" of 1M Lab Co.....'"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
II".}
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JQHIV6Cf'j
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
LjS ::s 5 If U /V! Iv/ ( N 6 B / 1<.0 77~
I
Accepted
./
Accepted With Corrections
Denied
Reviewed By:
..
W1fLTf:./l....
EwltE..c;.MAAI,v
. ,
Date: 5t./Z3/99
Comments: .J?u",..l" o^1us",
B l" 1'0,"0),0(0,
.
'10 ANO ALDAJ(. 1)n,qIAJ"r_~ ~
f~r/LI r""'l'"
f="As.t: oMt:~T";
AS
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,"s
P.t AC'TICAL .
No ~.us;-r It \.x.:n .,.u
J3r-fhJ/TY j 5 In &.t'_vlt
wtf;.l'Ai
20 hE....
of
7M~ "",,"0 ON T'Hf:,
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(I AIl.ll.' AC.e: l-I U..L <
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<:... ,<1""'A~IoI""f:">'-S: I. (.''''..<.. blVlOt: 'AJSI'8Cr,."" 1,'FMI4A'f'M^, Z. G.t~D,.ot, ?"..AJ
'1. Efl.Cl~ID.u Co.AJlfto L (\Ar.A~dA~
'f. Fl2.oSlIu..J ChAJTtt..OL R..4,.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
, ,
~~
(/9-/Cc'1
TM OUlllI'r 0' lhr uu COllnlry
White - Building
Canary - Engineering
Pink - Planning
.B.UILDtNG PERMIT APPLICATION DEfARTM!;NT CHECKLIST
NAME OF APPLICANT
/IC/'"/f.--<:: 6V C#rlSr;;
~/2 &/c;c;
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4' 4' if &- !5'c. {/675~/c: U ,7L
.
Accepted
./
Accepted With Corrections
Denied
.Reviewed By: ~JitL.'n:li. [J4.t~'\"",,~J\J.0
Date:
, ,
~ I""
Comments: R,,^,oFF
r"\u":,."';"'"
13!i:
(!o.vvEyC.O To A"-IO
ALoNG. DttA,..uAc.C
,
{' OTIL.,T"Y EAsE ME"N'T5 AS If'\ol"'c...... As PtVlc.ruAL.
rnl>Js...Au~TION llFH!,'._~c
M16'- Alo"" €..,JrER. "-".f1So LoT'
Ffl.o..
I'A((ll.iAf.L Utc-J.5 PMk"wAY.
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('.....t.R.E.<:: Wllw<' PANtEL.!.
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fh\oll.. 10
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<lEE J~F.Il...,t:lT~,.J
ON -ru€
€!-~JE...Il!ir: SlalE
"!:u.. Al'Tl'ICHM.f""AJTS ~ I. h.JAL- f-kAOE JA15.PEeTloAJ 1~~oR-MAr-'<LJ,J
2. t:!ltllfj,,,st, PUlAi
3
&051l)"-' L'a.....rt>''- I1<ASvIlE5
tJ. En.DS 'Oill Co ~'11( 10<... nA tV
"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
CITY OF PRIOR LAKE
. 16200 ElI9le Creek Av. SO!:. Plrmlt No. C;C; - / 00 I
PriOt' Lakll, MN 55372
HEAliNG APPUCATlON I PERMIT
Data ,\- '\,-<\(\; . PlOt Z5-3if.Cf- 012-0
S"Adcbss '" 5 ~ S' \\~""M;"\~;-(\ \Y--~ ,\ tel
Lot \0 Block d. Addition \\"'" \, \\. \ \ ""\ ~ {\ H
DwnlfsNaml. '" W ~ D'n",... r)y--..
AddI&8S \1~~S ~v\,,",~0\- ~"'+\ \....1u~l.llD
Hoating Cc_, .\'\. {~ {\, r- ~ Y'\ \.
Addrlss \\n"~('" 'W~\t~~vl V{'; V""~I.\K.t,
ToIep/Ionel ~'-\~ - \ \:l."'\
.
Furn&C8 Mallo & Model c.".....,;.,-'"
Medel Slzo ~ ~,,- a'\ I:l
Conn. Load 'S ~ ~ '-\ J
Fuel. '" tI. \- Flue Size
Supply OpInlngs \ ~
~
s /}
lYPE OF SYSTEM
Warm Ail P\anIs X
Gravity
Mechanfcal .
Air Cclndttionlng
Vent Sy~em
HEAlING OR POWER PLANT
Steam .
HOI W8I8r
Radiation
Special Devices
Relwn Openings
lnplll '1'l...a~
0U1pu\ '""'\ \ . (%C)
Ed,.
elm..
\ "'''' ~
Otllor Dovices
TYPE OF WORK
.~.
AII11ratfans
RlplllC8ment New CcnslNction
Repair
Est. Cost $
HEATING PERMIT FEE r
Est Comp. Ollle
S '). t\ '\) "} Building Permtt .
o.,l.\- /00/
~ ft.\O VI\"f\-\
eU\\;.O\NG pe.r.\'-A\\
RllC8ipt . .
STATE SURCHARGE .
.50
. TOTALPERMfTFEES $
. .:~;. .
__e..K,,:;:,....,. -'..
- ~<;!i.i\~.h:'.,.
~;; . ~~fl;.~~:;~-'
_. _7-
/i,' - -'-:~~'~~.~~::Y~~~': :~~~:~~~ti, ~-,':J '"
-~ ':. '..
,..-'. ':".;.:' ...:.:
JVPE OF STRUCTURI;
1.-
l.. o..c.
3. Yellow
-
a",
c--w
:z
o
<
Single Family X
Commercial
Multi-family
Public Other
Two-FemHy
Industrial
.l>
.....
\IJ
\IJ
\IJ
Fee Schedule
.....
N
ISI
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"1l
3:
Industrial, Commercfal & Multi-Family
Residenlial, Heating' AC
Residential, Heating Only
Residential, Gas Fireplaa>
Residential, Additions & Alterations
Residential, AC Only
1 % of job cost ($39.50 minimum)
$99.50
$64_50
$39.50
$39.50
$39.50
3:
1'1
-i
;0
o
D
H
;0
Remember 10 add the Stale SUlCharge on the bottom 01 this appflcation.
The price or your healinO pennillncludes one rough-in and one rlllal inspection.
AdditiDnel inspections will be billed al $35.00 elIch.
Houee Heeling Test Record must be submilled willi .".;I~~",.lIItm!l """'''''', before bund.
"0 cettific8le ol---'~.-"Y wifl be issued.
~r:AT r,B' r",' <<~n"'~ qCf'llfPC" wilh number 01 supply and I81Um openings Ilal8cI per
room with CFM's per opening. New strucIures or addltions send ftoor plan wltIfsupply
and retum localIons aIIown_ HEJO' LOSS CALCULATIONS, PAYMENT AND
APPLlOOIONS MAY BE MAILED TO THE CIl'Y OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRlOR LAKE, MN 55372.
CiIy Hall bueine.. hDUIS are B am. - 4:30 p.m.
ALL WORK MUST BE INSPECTED IROUGH-IN AND FINA4 . CALL C1TY HALL
447-G30
I hereby apply lor a mechanical systems permll and I acknowledge thaI the
inlormadon above is complete and accurale; thaI the work wHI be in conlolm."ce
- with the ordinances and codes of Ihe city and wilh Ihe slale bllildinglmechanical
codes; thatlhis fonn does not become a per'!llt until si{lned by Ihe BUILDING
OFFICIAL; thallhe work will be in accordance wilh the approved plan in Ihe
case of all work which requires review and approval of pi ens.
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AppI.~/~OnalUl8
-<2%t.!~i..;
Bl1ifjhll otfical's SlgnalUre
"1l _
\ \-~-\~
Date.
i 1/4-/q4
Dale
.....
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FROM WENZEL MECHANICAL 612-452-0367
(MON) 09.20' 99 14: 12/8T. 14: 12/NO, 3561851699 Pili
MUll . .u'
ftLL~ - ~C~
COLD. CI"T"
C!TY OF PRtOR LAKE
S~WER AND WATER PE~IT
NO. CJt1~/OO /
NOTE:
, se....er anI! Wa~er
contractors must
be regis~ered
with, the C'ity.
APPLICA.NT:.:....lj./J'~ mu,IVI!IJPI4/ PHCNE: &,5/':"~~-/fil,5
AQDRE5S, ,/96'7 JhAH"7"'..eL €AGAA/ 55/2.2.DJ\.TE: '9-;JO":'9'9
SIGNATURE;~;fl'I bf., r.;LliM.JMJ BLDG. PERMIT # ?'9~/OO /
SITE ,ADDReSS: L.f53'5~:;;; PID# Z5-31t4- OIZ-O
, /(/
FILL IN THE BLANKS
1_ Estimated length of water service
feet_
'2. Size of wseer service
inchl.es) _
4 .
Type of sewer pipe. ABS
PVC
\fIIIT\-1 ,
, fe~O oS,.=",~,\"i
( OING <
Iro~eljl\..
3..
Location of any couplings from structure
Cast
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
~========~~===~=========~==~======~=====~======~============~====
This
BY'
=-==---====~==========~~===c===~=============~============~~~===~=
FEES:
$
$
S
35.00
_50
35.50
Sewer and ~ater line connection permit.
Surcharge
TOTAL
'"
,Fee for either sewer or water individually is st'.sn plus
$ ,50 surcharqe.
.
Se~er,and water permit$ issued for new construction mUSL be
r~cordeQ qn the building permit carQ at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
AMOUNT PAID "u~~,~
f>-\V >j"r. €,?I'J\\'
REC'D BY / .1' I"\\NG \'
\ ~v(....-
RECEIPT #
4629 Dakota St, S,E.. Prior Lake, Minn..ota 55372 I Ph. (612) 447-4230 I Fax (612) 447-4245
AN EqUAL ....,..,......1"11 JMTY EMPLOYER
II
..
.Permfl#
..
'"Job Addrr"
.. Heating Contractor
"Teslers/Signatur.
'"Gas Une
Pressurized
Inspected
"Percent CO2
"Percenl02
Final Inspection
, ,
J .......,.-/
,
METRb AIR
Q!!!
Time
PERFORMANCE TEST
6/1%
7,/%
.Percent co
.Stack Temp.
Pounds
~
colD
();)..("
Date
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS LjS~s ltu\M\M1,,~101t-~ n.c.~ \
NATURE OF WORK to.-1Q.U.) Cov..sk,,~~,~
USE OF BUILDING 'S.~~
PERMIT NO. Cf7 - toc)[ DATE ISSUED 8 -Zt;'-9~
CONTRACTOR MIJ .J.I-...." ""-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
-
I FOOTING ~) M, C)- 21-11
I FOUNDATION (Prior to Backfill) (tV) I ~ , I 10 -11- 99
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGJ;I - INS
SEWER I WATER I SEPTIC Ii}) 10/7 If"
FRAMING r I ')I' (I 0J5
INSULATION 1-
ELECTRICAL
PLUMBING @//.;;J ) /3 / '\ "i
HEATING (if required) _ I~ I;;,,) ItJ} 11
FIREPLACE /17 /h/tfO If?/ I fd ,,;;//3/"4 I
~l=t"~--16r'-1 I GfdJ /;y';II!f4 I
COVER NO WORK UNTIL A{OVE HAS BEEN SIGNED
l WALLBOARD I
FINALS .
Ci>r- t./zr/ OCJ
f?+..
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL
INSPECTOR
-
~/ a.I~ Io~
, ~/Julull
OVE HAS
DATE
(2- '27-crQ
9fivM
BEEN SIGNED
NOTICE ~
This card must be posted near an electrical service cabinet prior to rough-in inspections .n
and maintained until all inspections have been approved. On buildings and additions \l \Y
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
" ,