HomeMy WebLinkAboutBuilding Permit #99-1005
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I : CITY OF .r'MOR LAKE -
.~' _ - iltpartmtnt of ~uilbing In!iptttion
~_ ~inal Permitted 0 Conditional C.O. Expire.
(. 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
99-1005
Use Classificatir'~
'~ldg. Pennit N"
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District R 1
Legal Description
L2. B3, Knob Hill 2nd Addition
14321 Robin Road
Owner of Building
Site Address
Contractor',Name&AddrCS' Anderson Family Homes, 16186 Main Avenue, Prior Lake
Rob!rt D. Hutchins
h Buil~ Official .... -n
r jJ . 0 - =Jd ~ UV
. City Planner
Da":
.Jenni Tovar
Date:
POST IN A CONSPICUOUS PLACE
~ TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~ ,(. Ii'1 1f:'Jx,
ADDRESS 1432..1 ~t.~ Rd
OWNER CONTR.
PHONE NO. PERMIT NO. 1q- 1005
o FOOTING o PLUMBING RI o EX/GRAD/FilliNG
o FOUNDATION WECHRI o COMPLAINT
o FRAMING WATER HOOKUP o FIREPLACE RI
o INSULATION ~SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
'CO' ~&....L.- 40 'P Vc.
\H ~~, \;L ~- r--JO
WO ~
l1 _
~
t Qk,,,,, rrt..T rrY\ ~ c...k'
\-z,\~vh-. ~ ~
M.cu.AA- +- ~. -k-, c ~x...-
r.-.o f~ u..l'~ ..>(.,,-1 .\ ,- _ I
'P..s~ ~ lAc.....JL CJ k.ol"-- -n, ~
~ Uv.,;~ w.;... ~
D~K SATISFACTORY, PROCEED
~ORRECT AC ON AND PROCEED
o CORRECT W CAll OR REINSPECTION BEF7 COJ')ING
Inspector: Owner/Contr: (!.L ~
CAll 44~ FOR THE NEXT INSPECTION 24 Hrp;(..S IN ADVANCE.. r
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
II
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1432/
eab;... ~
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
A [J ~R HOOKUP
~~_':.~~.BING FINAL
o MECH FINAL
,/:ATi / TIME
'~'f1 C;:kJ
~lm'5
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Q C:C4! O~L +~K~~?,S r "h.)., ?~qLo.r
(1,) &lL~.h Dr) ~ ~7Ji- ~
~~ tz.,.:::r;' -
( ~~. LJ.ill-.. ~
.v ~ ^,-,. -u /'-(f~d.t~
\~ /o...n; fL-
(~~.A-V\
lJIA-
o ORK SATISFACTORY, PROCEED
CORREC ACTION AND PROCEED
o CORRECT R~' C L FOR REINSPECTlON BEFORE COVERING
Inspector: . Owner/Contr:
50 ~ THE NEXT INSPECTION 24 HOURS IN ADVANCE..
UIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
II
CITY OF PRIOR LAKE
INSPECTION NOTICE
,
SCHEDULED
DATE TIME
1/ h1f/1 2.31')
I I
ADDRESS
/4_52 I ICOS! N eD
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATlqN~
FINAL ~
o ITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
A \lI,PLUMBING FINAL
"l:r' MECH FINAL
qq. /[;(;5
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~. firu..Q o~ G%IY\UXI'h.~ ~j -J-
( SGYl Ovv. ~" ti"w: ~ au ~ 'f n;.~
( Er/F,~()h (1J,Jy.J (~<;..,~
\~ tJ1^--
~
C!~
----
---
r
C.O~I ])
~
7-1-?4crt? ")
~
----
SPECTION BEFORE COVERING
Owner/Contr:
CALL THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INS/'iOTl
CODE ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
II
I I
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
EJ~T~ 'M-
ADDRESS
(43ll
Kob.k-
Ed
OWNER
CONTR.
PHONE NO.
PERMIT NO.
9<1-1(05
o FOOTING
o FOUNDATION
o FRAMING @
. D~SULATION
~ FINAL
o SITE INSPECT
COMMENTS: ~ti
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
+ 1hLS'
~ A,...t- k> ~ 'i:
A.~~
e::J ~ +0Lk, J ..J" / - -hJJ
~. ---
- ~
r~ 4, (lO~ ~~)
\. p,(). ~ .
~)J__~
~-~o=/- f:/~.
I
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORhC~L FOR REINSPECTION BEFORE COVERING
Inspector: r;:J' 1'" ~ Owner/Contr:
J
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
I 0:;;;. 1.3, )qqOJ
DAIE RFr.I=J'lr::n
e /13./11
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
I~;}I QJ'">lo.n oA.
3. LEGAL DESCRIPTION
A-
'--P~'_OC_J.dlt.D VV\l) .1)<;"),""1-')...
LOT
S
d-~
PID 2.5~33q- fJ/O-O
{l&&ili",,,, I .
13. TYPE OF CONSTRUCTION
BLOCK
\~-U
ADDITION \IA,'\nl,o,
4. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
(Address)
(Address)
(Address)
(Tel. No.) 440.4sos
Ibl8b \'Y't;l..1\ Q.Ve. Pnor lDv~
OCCUPANTS
~
7. TYPE OF WORK
New Construction )it.
Chimney ['] Mist'
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I 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 confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building officiel can revoke this pelTTlit for just cause. FurthelTTlore. I heraby agree that the city official or a designee may enter upon tha property to porto~d~.. " " ..
X . ~~A/lA ~ Q '-{fYI/'! vA.J .J '\. ~
, Signature V d License No. ale J
fO.tyU tlj
{btwI.s
Fireplace LI
Alterations 0
SepticLl
Addition 0
Deck 0
Finish Attic 0
Ae-roofing 0 Porch 0
Ae-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
I. White
2. Pink
3. Yellow
File
City .,,1/
Applicant
Permit No. 99~J005
1<./
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Tel. No.)
14. FLOOA AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
SEATS
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES Rea.
SPACES ON PLAN
USE OF BUILDING
SFD
Side
MATERIAL FILED WITH APPLICA nON
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY LJ
SETS
COPIES
PERMIT V ALUA TION
I 17\ .C>E:>D . &')
LJ
Sewer Tap ...............................,... $
Pressure Reducer .~~.(.................. :
Meter Hom ................................... ,<I:
Water Meter ..j8.......................... $ /24;.-
Sewer & Water Connection Fee ........... $ /-'7~-
WaterTowerFee ........................... $~~_ -
Water Tap ................................... $
Builder's Deposit ............................ $----1Sa::>. --
Other ......................................... ,It:
Total Due .............................. $~ ~~"'" '1'-
Paid '7306;.9t- RaceiptNo, 3<905S
Date 4~ /t; 'f By ~
rhls is to certi~ th~uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a~uested. This document when
q. . Ian constitutes a temporary Certiji..ca~of Z'f!J1-in compliance RnPAllows c~nstruction to co~mence. Before occupancy, ~ Certificate of Occupancy must be issued.
. '.DV1 ~hI~.~ ."tL U>'lJi' cClMAMfl <UcO<<L.h 10 (.,r.h~~
, City tanner ' &te' Special Conditions if any - -,- ,--- - -
TYPE OF CONSTRUC110N: I II III IV V
Occupancy Group A B E F HIM A S U
Division 1 2 3 4
City,
Permit Fee ................................... $
q<;l']_ zS-
~rl1. 2./
,,,", . c;e;
~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing PelTTlfiFee ....~. $;/tJc5.... $-f/M .0(5
Mechanical PelTTlfi Fee ... "f'/O(J.;.. $ l bO . eO
Sewer&WaterPerrnlt ....~.~1(!)l . $ < ~.. ,c;'C)
~. - _[..-1-..
GaSiRir lac~~pe fi... .. ..... .!... $ "1 V'~
Thi fi~ s YOl,lr BuildIng Pennit When ~)?roved:
By . !/I, Date R .2.;-- 't
I..",r .
Certificate of pancy
No+:P.
Issued
24 hour notice for all inspections 447-9850
PLOT PLAN
Amount Brought Forward .................. ~
Park Support Fee ........................... ~
SAC ......................................... $
Collective Street Fee ....................... $
ADD. f<Y'>
I O<'S'el .(")'0
q~t07
'7iY~.,,~:~:-;---C;;~-"~C'
;~_~~..._,...;,.:;",,", __""""~.'_"""''''--''''' ..,_ 1 . I ____'''''_
"-~'.''-'-f.'"''','Ii_'-'"'."-,.~;,,,.,..;~~,.',.''/''''_''':-.""~-~,,,j...~
'@~X PR10t?('
Cl. '7
'I--. .".
iJ rn
/" .'
/
././ /~ .r--
Tht Ctnln 0' tht Llkt Counll')'
White - Building
Canary - Engineering
Pink - Planning
elllLDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED.
',/ / / // I\,... \//
"
,.--: -'
"/ /
/'
/' I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
./.1:; ..:_: I
, '
" '
..!--'
Accepted
/
Accepted With Corrections
Denied /l /7/.J "-
Reviewed By: U<~' ~ Date:
Comments: Ai t U flIt ~ Ire ~{cXleI
lJ/~ 7/ '71
I n 10 i sdt '1(W1cf 5
v
"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."
99-1005
Tht' Cp'lll!'r of Ihl!' L..kt Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILOING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~1V?J6;eSON FA/'v'JIC- V
8/ /3 /qq ,
I ,
IioN6S
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
JI~3z-1 /COBIN /CD
Accepted
Accepted With Corrections
Denied 0////) ;/
Reviewed By:\Ja ~.
r
Date:
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."
I;
--,-- -.---------------. --_.._---_.
('}9 - / () CS
ThO' <:..n'.., of Ih.. l...... Counlry
While - Building
Canary - Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKlISr
NAME OF APPLICANT
,/)/vt/ckS:o/v ~/-I/vJIL V /fol'/ES
,
8/ 13 jC;r;
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~3z... I
I?Of5f/V /C".LJ
Accepted
./
Accepted With Corrections
Denied
Reviewed By: j, 1,._1<:1<.
...
CI-l/tl'"<I"I'AAlJIJ
Dale:
I I
8/Z:1/91
Comments: 'i?..oJo~,,"
Mu~r
lJE
C~"'...Jo.J Era
.
70 AND ALONe.. MAIIJt1G.E r;
l}T1L1TV E:A'S.I=',^"E"~T.s As V'iuc..... AS
PttAc.nc.Af
J)th....E"u.J......... {IA~ 0"'("""" 'Kc
~ MAJe,.....,,""" ~
204 FcF'r A.- rrlE:
f'ttopE/(TY UNC.
5I:€. , ,J(cl\......,q.1"/o.v
ON ;((\JE./L'H: .s.~E.
NoTt THf" ~ .....FJtr:..coc'( OvF-Rf=L.W CL..c.vlQ.nol0 DF CjSD.~
o"j T...tE tJO~TH
S'8E
Lor
!-liVE:
WHICH
u\ILL J./t411c..
70 BE
a1l.AbE.D IN
1/.,-
""'uE:.
F,,,.>-. e~ROF.
_SEe. A-TTAr...IMCAJT'S.: /. hAJt1l... blq,,~ INS'ECTICN INFDa~Ann.u Z. c'AAOINf.. R-A~
3. E/lL))IO,.J C cuJ'TltOl- .0EASuI'tE~
<I. EI1.....L't'4^-, f!nAlTn. 0'- R,.,,, 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."
\
Ii
.... ..L .......L......___..
CITY OF PRIOR LAKE
I. Blue
2. Gold
3. Yellow
File
City
Applicant
PLUMBING PERMIT PPNo. ~'f-/OOS-
Applicant: (' Lt"":Fn1AJiV'h-A" {:lj Lunbln'IT ~hone: L/t.../J-1(1,z{)
Address: JJ:i.1JD l L )hi1qoJlld':L~__
Signature:_4~-.-J-1LfI~
Legal Des~riPtion: Lot 2.. Block ~ c> "'---K/Vot$ /f/a... 2M:)
Site Addr"..' I L.I.~ 7_ i R..*'iC\ ~ /LI
Building Permit # q9- /OOS- PID # 2&:;-.339 - {)/n-n
. .
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
Thr Crnlrr of lhr LakfCounlry
Quantity
I
I
(
3
1
I
t
~
Z.
Type of Fixture
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
.50
Bath Tub with or without shower
Dishwasher
Floor Drain
.5
f
/ p,b.\O wrr\-!
, e\JILO\Ne F [: ,: .;
This permit is granted upon the express condition that said
contractor, shall comply in all r~~~ with the ordinances
of the State Plumbin...o:o.i and ~ ;r}"d~~s thereof.
. __'/zr.//~t; DATE
~ '~1TEST
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372 / Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
Lavatory (bathroom sink)
Laundry Tray (lor 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
Call for all i
l~~'~~~ CITY QF PRIOR LAKE
. u ~, 16200 Eagle C,eek Av. S.E. Plnnll NO~ "\ - \ t> IJ S-
P,lo, Lake, MN 55372
. ' HEAnNG APPLlCAT10N I PERMIT
'; Dall C\-d.d -'\<-\ PlOt 25-33Cj~OIO-O
CL
Sku Address \ '\:,"), \ ~ 0 "0\ ~ ~ l ,Ie I
~ Lot '). Block::' Add~ion '\<. '" a \n \-\) \ :;ll\.~
" - -
~ Owner'sNamu t\.". ~'~l\A -\= ~~,\.\,
Address \\0\ 't;l...o lllA-:.... A \/-l- (J /; ~v- ~ \ (~
Healing Conlraclllr ~~ {~ ~~ r- -l Y"\ I... -
Address. \ \n l\ ~ C'\ \..t l... \ l ON.. f\ y l V('; lY' ~ ~ ILL
Telephonet ~~I- ~ \~'"
Furnace Make & Model C ~-n \~ V"
Model Size f \'\ V- Q 9. r-.
Conn. LOad" S a "\ '-II
Fuel t\\ G\ -\-. Flul Size S. II
Supply Openings \S"
Relum Openings ~
Ll' Input\ ~ . Ot'i\) OuIpu(\ \ l\ t\..'\
H
<I
o Edr.
Ll' I '-I1v\ S-
t;J Clm.
E
TYPE OF SYS1EM
Warm Air Plants X
Gravity
Mechanical ~
Air Condkloning
Vent. Syaem
HEA~GORPDWER~
Sleam
Hal W&1ar
RadJallon
Special Devices
Other Devices
Repl-.nanl
TVPE OF WORK
New Construction
~
~ Meraliona
['0-
"
:.:. Rspalr EsL .Comp. Data
......Ed:CosI$.l,"\(jt\~ BulldingPermU ~~- \t)'{)~
en. ~ - ~
~"~EA!INGPE~rT.FEE$ : (/ fl~\ot:t~~J '.
gj: STATE SURCHARGE $ .50: e\.l\\.O.\~
CL :.---::
lJr TOTALPEAMrTFEES ,.
R8C8~ /I
_"1-
".",
a~,:;- ;.',: :. "X".;.,.':~:.>c-L",<'_ ~:":'-:'; ;;<~,~"
TYPE OF STRUCTURE,
J. Pink Fil=
t. 0.... ~
3. Yellow O:mm.I:ror
Single Famly X
Commarcial
Public
MuUi-Famlly
Ollie.
Two-Family
Industrial
Fee Schedule
Industrial, Commercial &. Multi.Famlly
R811iclanlia', Heating &. AC
Residential, Haating Only
Realdenlial, Gss Fireplace
Residantial, Add~ions &. Allemons
Residential, AC Only
1% of job coel ($39.50 minimum)
$99.50
$64.50
$39.50
$39.5D
$&9.50
Remember 10 add the State Surcharge on tha bottom of this application.
The price 01 your heeling peTm~ includes one rough-in and OIle linal inepec:tlon.
Addilioll8llnspeclions will be billed 81 $35.00 each.
House HHIlng Test Record musl be aubmltled wllh '" 'ill'1.... IlIUIlll ftll",n,>f beIDre build.
ing cert"ic8Ie of occupancy wili be ieaued.
I-lFAT C:AI mIl ATION!ll'lFnl URr=Tl with numbe, 01 supply and return opaning& listed per
room with CFM's per opening. New strucMes or additions sand 1100' plan witIr supply
and return Iocatione shown. HEAT LOSS CALCULATIONS, PAYMEIIIT AND
APPLlC,l\fIONS MAY BE MAILED 10 THE CITY OF PRIOR LAKE, t6200 EAGLE
CREEK'AVE. &.E. PRIOR LAKE, MN 55372.
CiIy Hall ~sin8SS hours al8 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
I hereby apply lor a mechi!nical systams permit and I acknDwledge that the
informallon above Is comple'e and accurale: lhat the work wlfl be in conlormance .
. with the ordinances and codes of Ihe clly and wilh' Ihe stale. 'building/mechanical .
co~es; thal1his Iorm doe. not becDme a perml! unlll.signad l!Y the BUILDING
OFFICIAL: thallhe work will be in accDrdance with the approved plan in the
':;\d"~-:--'~~-)'~ '1~>
" ,\ ~~naJ.SIg - .. JIij" Oal, .
~.. " :.....' '?3'tfr-
~ -,--- BUlikliug Ofj":1II~,"._ .......~..natUrfL a . 0 18 '
., .
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09/07/99 Tlm 07:49 FAX 6128902753
STOCKER EXCAVATING
1aJ002_
Glleb . flU.
T~ . UIOUC.o.,
GOI.P .. ern'
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT.
NO. 99- /005"
NOTE:
Sewer and Water
contractors must
pe registered
\lith the City.
~
APPLICANT: DC Mechanical/Stocker Excavating
PHONE:
890-4241
Q-3-'1C(
SITE ADDRESS:
~~l7R DATE:
ADDRESS:
SIGNATURE:
BLDG. PERMIT II q<(-/005
1<./ PIDII 25-339- 0/0- 0
FILL IN THE BLANKS
1. Estimated length of water service
feet-.
2. Size of water service
inch (es) .
3. Location of any couplings from structure
feet.
4_ Type of sewer pipe. ABS
PVC-x-- Cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
~~=========~~=~=~======~=5=================~========~=~------====
This apPlicati~~ your permit when approved.
BY ~t/n DATE: 9/7/9"1
=========~=====~~====~====~================~===------==
FEES:
$
S
S
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
Fee for either sewer or water individually is $20.00 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 AMOUN'r PA:zyr~~S. ()E.~\A\'t
RECEIPT 1/ REC/D BY \fl\)\\'O\\
..
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opponunity Employer
. ,
."
.Permit#
.
'Job Add,... .L'Il,J / )2/lJ., I .",
METRO AIR
-Heating Contractor
.T eSlert;/Signature
-Gas Une
Pressurized
Inspected
.. Percent C02
.. P~rCf'nt 0,
Final Inspection
I d
Q!!!
Time
PERFORMANCE TEST
8,3
7,1
.Percent co
.Stllck Temp
/(A
Pounds
Pressure
()
L'fS
Dale
PRIOR LAKE
INSPECTION RE'COR'O
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS \q~2\ R..t.,:", 12..J.
NATURE OF WORK fJe.>.>:l ~ /
USE OF BUILDING SP[:)
PERMIT NO. 9'1- l()()~ DATE ISSUED 6 - ZS- -CZ, '7
CONTRACTOR ~r::..t1-."'-- t;.. < t
'. .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT ( ~
, FOOTING I 1N'?UOR I q\yA~E"
~fr' FOUNDATION (Prior to Backfill) ~~;;:I~, ~-7-~) I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
SEWER I WATER I SEPTIC
FRAMING \ R)
INSULATION ~
ELECTRICAL
PLUMBING
HEATING (if required) !'P>
FIREPLACE
GAS LINE AIR TEST N\J,..- t!n-, \0-\-91
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'~:.J'~IlI;W I I
FINALS
yy"f
~.
f}G!JGH - INS
fYf~o/~
!O _ /1~cJ"j
/ 6 - / 3-'7'7
~ /0/"/"9
fr-t. I b - 13 -IJ'7
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
w-J,q.cr1
. ~/ 3O/t:Jl)
, /
t>> //12)('1/'<'/
M
OCCUPY UNTIL ABOVE HAS
NOTICE
II- J.'t-~1
BEEN 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
II I