HomeMy WebLinkAboutBuilding Permit 99-1337
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;~I CITY OF PRIOR LAKE:4;
--;;~i Jilepartment of ~uilbing Jn~pection A:
,e(Final Permitted D Conditional e.O. Expires -AI
"
This Certificate issued pursuan, 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 afthe
City of Prior Lake regulating building construction or use, For the following:
Use Classificatioll'
Sinl!le Family
~ldg. Permit N" 99-1337
R2SD
C~"wr"'_ J Type
Type Construction VN Fire Zone N I A Zoning District
.' East 1/2 of Lot 2, Block 1, Glynwater 1st Addn
Legal Descnptlon
R3
Owner of Building
.C:,teAddress 3505 Bav Knoll H Drive
Contractor's Name&Addresoo Wensmann Homes, 1895 Plaza Dr., Eagan, MN 55122
Jenni Tovar
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
',;H I.or
ADDRESS
3~O~
~
OWNER
PHONE NO.
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TION
)'l"'FINAL
o SITE INSPECTION
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 GASLlNE AIR TST
o
COMMENTS: St- T
'S;Su.e. C,O.
Jo~e- ~I')-e.
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~' CALL FOR REINSPECTION BEFORE COVERING
Inspector: 1$ - \JO-ut Owner/Contr:
CALL 447-9850 FOR ~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS :1, 1)(') c;
~\'I ~~s
I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING a'\\ 0 WATER HOOKUP
o INSULATION K.W~R HOOKUP
o FINAL UMBING FINAL
o SITE INSPECTION MECH FINAL
., ) ~:1..~ TIME
~ b:~
qg -/337
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTSfJ) ~ ~ ~rr~.
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORf~ALL FOR REINSPECTlON BEFORE COVERING
Inspector: n I Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 3505
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
. D,)NSULA TI~NI II\-
11& FINAL N n
o SITE INSPECTION
SCHEDULED
Sa.\A fuu,l(s
t
CONTR.
PERMIT NO,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ,$EWER HOOKUP
,fr"Allil ...,.~
MECH FINAL A
_lor _
~
TIME
IO:Q;J
1'1- 1337
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
<;'OMMENTS:
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iEWO SA-tSFA TORY, PROCEED
o RECT AC PR 0
ORREC(T ORK, C OR REINSPECTION BEFORE C
Inspector: ntr:
CALL 1.w7-9850 I OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R'>wUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
"'J lNSNOTl
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NOV I 6 9J3
CITY OF PRIOR LAKE
I: BUILDING PERMIT,
I! tT"EMPORARY CERTIFICATE OF
ili- ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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
.J5o S- jJ~y k/VD I/f Dr i tJ (
(Address)
/i'iS- I/~~#- Dr
(t>. raN Ih/V O~/;)~
Fireplace 0' Septic 0 Deck 0
Alterations 0 Addition 0 Finish Attic 0
3. LEGAL DESCRIPTION
LOT fQfT ~ DFi"r ~ BLOCK
r; Iy/Yw",-r~r
ADDITION
14. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
W(NJ"'~i/VN
t.Jomu
7, TYPE OF WORK
New Construction~
1. DATE
/I-/~ - '1 'i
J
IS r
Pia )r- J5V -()/J,;J. - 0
,4,./,// r,-o/Y
I. White
2. Pink
3. Yellow
File
City
Applicant
(Address)
(Tel. No.)
J<1l1u,J FILe "''''- 133b
Permit No. qq - 1337
BUILDING INFORMATION
11. SIZE OF STRUCTURE
{Height) (Width) (Depth)
12, NO, OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
Chimney LI Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have furnished intonnation 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 thaI all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
~Uild~icial can re~s pr~rthermore, I hereby agree that the city onja; a;jnee may enter upon the property to peYi_~te~ 1'79ions.
~ - /1'5ignalure license No. Date
If
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
oS P,1:I
TYPE OF CONSTRUCTION, I II III IV V
Occupancy Group A B E F HIM A
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee .............................~,
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Amount Brought Forward .................. $
Pari< Support Fee .... .... ................... 4:
SAC ......................................... ot
Collective Street Fee ........<:\-............ ot
Sewer Tap ................................... $
... of
Pressure Reducer ........!................. 4:
Meter Hom ..............,..~................. $
Water Meter ................................. <I'
(Address)
(Tel. No.)
(Tel. No.)
6,1- '1u{, -/f'/PP
Re-roofing 0 Porch 0
Re-siding Ll Finish Basement Ll
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
1'2.4.=0
s U
City'
I{)()/. "'2..S
C,"'f1.{.71
lP"2.DO
(co. C)V
/Q?, eJO
'7S" . 613
lfO. oC)
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS Ll PERCOLATION TESTS Ll
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
Ll
8'rb.oe
I /"') .,-0 . CI2>
10 . CJ:7
;,l 50 . 0Cl
Sewer & Water Connection Fee ........... ot
WaterTowerFee .........................., LJ.. '2 Of) . c::J!/
Water Tap ...........................,......,$ . 700. OeJ
B'ld-O't -()- $' 3-
UI e, s epos! ............................ ,
Other ......................................... $
Total Due ..................,.........., L!J.l J <f 'if2-
Paid Recei~J..tt'. SG. S~ .,
Date /L -2""5-'1' By {d>.
Building perm1't ~en AJ?proved. a,.
Date (-7 <"...17',
. -, -
Issued
This is to certify that the request In the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
sl~he?fY 1anner constitutes a temporary Certificate of Zoni~~Plian~d allows ~ction to com~nce. Befl~e~~~ certifc:e of Occupancy must be issued.
:::;:;><=-1t A.-" , { .2..'1- <... PeL... ."t5;-_ (' \VI ~ J ~ ~. ~ ,~H"r1A.<"
- "Ry Planner - Date =.J ,. - - Special~ondilions ~ any
24 hour notice for all inspections 447.9850
..
. Job Address 35"OS- ,a., ;lro)//
Heating Contractor ~,!/ f?yGU"
Name of Tester f( ~ C ' v
Date "7 ^ 17 -ee
Percent O2 '7
Percent CO ~.
Percent CO2 <t;
Stack Temp. I f3P '"
Combustion air is adequately supplied per
UMC Sec. 606
Input
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9c? .- /3.3 7
White - Building
Canary - Engineering
Pink - Planning
Tht' Cf'nttr of lht lIkt Country
BUILDING PERMIT AeE.l.ICATION D!;PARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
W6NS Mrr NII./ HOf1W
1/ //fp /99
/ I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,:3505
RAY KIVOLA./S OR-.
Accepted
x
Accepted With Corrections
Denied 2
Reviewed By: ( c.,P
~
Date: 1/ - '2 ~ - { 7
Comments:
~
(f) fY -U- q 7.. r376
~.
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,
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"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."
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Thr Crnlrr of lhr t.kr Counll')
White - Building
Canary . Engineering
Pink . Planning
eUILDING PERMIT APPI"ICATION DEPARTMENT CHECKLlS,,\:
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"'_~" "_..i
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t" '-.-, '-..-'"
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Accepted
v
Accepted With Corrections
Denied
Reviewed By:
~)A-r~
Date:
L \- J-4 -'7~
~
Comments:
fWw~ 5'~:L' '10 ~ ,,~L4hf\""""
~ ~_ r J'Vlhi._~ {)~~~ ~l
~6.~ \~G:t- ~ r~V\~ L{,~ 14JJu.
"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."
9Cl- /3::' 7
White - Building
Canary - Engineering
Pink - Planning
ThO' C..n,..r of I",. LIIb Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
lYE tV5 f'-1ri NN HOf'1W
11//0/99
/ I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3:::;05 RA V KN()LvS OR-.
i
Accepted
/
Accepted With Corrections
Denied
Reviewed By: WALrfll.. b.ltt,f'''''''.I\I,u
, ,
Daie: 1I11"1/'1'l
, I
Comments: ,.SE:E: Ruo~()."(,,'~"" 4F 9'1- 1:!.3<; (~S"J R.." K.JDU-< illl..o/E.) FOI
.
lA,IFad.M.A-Tk)1\.J r^oNI....~_~.( a.rrIl'tt..HM_~.l"nC
~
"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."
DEC. 14. 1999 3:02PM
GENZ RYAN 6513226147
NO. 152
P.3/5
1..
2 .
3..
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5,
6.
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_LOW . ___..
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. qq-f337
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: Ge.nZ - (l U ~ . PHONE: ..l."SI-U 7 'Z..,. . /I 4<+
ADDRESS: I~"L./." c;..., flrJd-.o- ""-"'.-l:"::' ~~~E: IZ/ ry Iq~
SIGNATURE: ~ n. BLDG.. PERMIT j/ qq-/337
SITE ADDRESS: U ":I.,<F-,C P-Av. I( J'Y'J/I <... f)fl- PID# Z5 -3S1J - 0 O"Z--- ()
NOTE:
FILL IN THE BLANKS
Estimated length of water servioe Lf{)J
feet.
size of water service
f"
inoh(es).
Looation of any oouplings from s~ructure
feet.
Type of sewer pipe. ABS PVC "X
1'0'
Estimated length of sewer lin~ ~
Cast Iron
feet.
Clean out (if required), located at
structure.
feet
from
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This
BY
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------- - ----~
._--------------------------------~-
FEES:
$
$
$
Sewer and water line connection permit.
Suroharge
TOTAL
35.00
.50
35.50
* 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 buildin~ permit card at the time of issuance
to insure that no dupl~cate sewer and water permits are
issued.
DATE PAID
RECEIPT j/
AM U D "."".\
o NT PAI - \",,,,\~ \'"~\:;,p,,'i
REC'D BY ~ \\\.O\i'\G
, 4629 Dakota St 5.E,. Prior !.Joke. Minnesota 55372 I Ph. (612) 4474230 J Fax (612) 4474245
AN EQL1AL OPPORruNI'IY EMPLO'I'Dl
CITY OF PRIOR LAKE
, 16200 Ellsle Creek Av. S,E. Permit No..
PrIor LBke, UN 55372
\ )
tI" '-/3~ 7-'
JYPE OF STRUCnJRE
I.IW - '\ ftlo
t Gno 1 a.,
J. Ydl_' c.ncaor
Dale
- S~e Addreu
1DI Block Addftlon
Ownefe Name 1,.iJ ffllWYl(l VI VI ~f'5-.
Ro. c:::: Pb 2.OL C()e, <"T'" ~
Helling Con/raclOr (Ap.n Z. - r2A ULYl
Addf81lS IU1U<" Srn ((.nblD -r'RJ _ R"Ufl?'flJ""
Telephone # I n S-\ - L\'L.~-I \ ul.../
FurnaoaMaka&Model f .Q~v. 1\'PEOFSYSTEM
r> 2J WI/m A1f Planls '{
Model SIze l-, n n~- ..., S' GI8Ylly . ,
lIechanlcal
Air Condllonln~.k.. Z 'f"!.. 1l>,..1
Venl. System
HEATING OR POWER PLANT
Steam
Hol Waler
RadlltloA
Speclel Dwlcas
AddrHl
CoM, Load
Fuel. NJtrGwFlue Size ,
SUPP!v Openings
I~
f
R'ell.rl1 Opanlngs
Input 1.<:;, f\1ifl
Oulpul '10.mD
Edt.
O1her Owlets (' _ ^ Th
'[;:.Ir,.r.h ~ "
,
Cfm,
TYPE OF WORK
Alteratlona
)(
Repair
Aeplacem enl
Esl. Comp. Date
New Conatructlon
Est. Cas! $
HEATING PERMIT fEE r
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Pennb II
r PAID WiTH
.50 H3UILDING p:::;, '.' I
Receipt.
Slngll Family . A... ,
Commsrclol
'-<
D
:z
N
CD
N
1Sl
1Sl
1Sl
. Two- FamDII
. Industrial
Public
Multl-FamllJl
OIher
Fee Schedule
Indualrlol. Conmerclel & MUltl-Fern"1I
Resldendal, Headng & AC
Resldenda~ HHllng Onlll_
Rllllidllllda~ Gal Fireplace
R asldendal, Adllhlonl & Alterations
R...ldenUal. AC Onlv
1 % 01 Jm cosl ($39.50 mlnlllU1\)
$99.60
$64.60
$39,60
$39,60
$39.60
N
N
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JAN 3 I 2.000
Gl
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Remember 10 add \he Slale Su !'Charge DB \he bolfom 0' thIs IIpplic;a.Jlgp.., _ ._ c'
L.__.. "'.
The. price 0' your heating pe,mH Includes OM rough-In and ona IlnallnspecUon.
Addftlonallnapeellona wiD be bIlled al ~5.00 each,
House Healing Tesl Record musl be subml\led wflh ......lI1nl"' JlIIIDiI """,/- before buill-
Ing carflficate 0/ . ....,"'lCV will be Iasued.
HFAT I':AI 1':.11 ATIOIIIIl AI=(\IIU:lI=n wfth number 01 aupplll anclllllum openings listed per
room wlth CFM's pef openlog. New IlrucfurQ or IIddlllons send 'Ioof plan with aupply
and relum looaUons shown, HEM LOSS CALCULATIONS. PAYMENT AND
APPUCATIONS MAY BE MAILED m THE CITY OF PRIOR lAJ(E. 16200 EAGLE
CREEK AVE, S.E. PRIOR LAKE, UN 55872.
City Hall buslnesa floonl afa II a.m, . 4:30 p. m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
447.../1230
I hereby apply for a mechanical syslams permit and I ecllnowledge Ihat 'hll
Inlormalloo above Is cOlllplelllllnd accurate; Ihst \he work will be In conformance
with Iha ordinances and codes 01 Ihe cllll and wllh Ihe slale building/mechanIcal
codes; Ihal thle form does nol become a permit until sIgned bV \hll BUILDING
OFFICIAL; Lhat 'hll work Villi bllln accordance wUh lhll approved plan In Il\e
casj ~~ a:1~&vjIlW and ~pproval 01 Pla7f tR 'Of]
d:ioo
Date
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BUll19 Officel'. Slgoalura
JRN. 28. 2000 2:24PM
GENZ RYRN 6513226147
NO. 350
P.3/17
JAN 3 I 2JUU
CITY OF PRIOR .LAKE
. PLUMBING PERMIT
Applicant: r:".,-,~ ~ 1'-'( ~Y"'id1.rr,.. ~...,...
~~~:~~~; 1~1)~ w V rf' -:-r 1'-' r -
. Legal Description: I5St.. \ Block-
Site AddAlss: 3E::os fJ...." Y II ~J j~' nl'?
Building Permit # C/t; ~/3 '3'/ .1"10#
NOTE; This permit ~i11 not b'e processed Jithout complete information.
FIXTURE UNITS
1._ Filo
2.. CloI4 elf
.. v..... _
# q9-/332-
Phone:.L..-~I- L1?;<, -II r..tlJ
1llr en.... ~... L.b c-..,
Sub
Quantity Type of FllCl1..Ire Quantily Type of Fixture
2- Bath Tub with or without shower Rough-ins
I OishW85her I Water Heater
I Roor Drain ILl Water Sotlner
.3 Lavatory (bathroom sink) I Stand Pipe (washing machine)
Laundry Tray (1 or 2 compartment sink) Sewage Ejector,
\ Shower Stall Backlfow Assembly (RPZ, Double Check, PVB)
I Sinks Backf10w Assembly Test
Bar Sink Lawn Sprinkler
2- Waler Closet (toilet) Other
FEE SCHEDULE
Ind1J5trial. Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
ResidentIal, New One & Two Family
Residential. Additions & Alterations
State Surcharge
$99_50
$39..50
s
$
$
$
.50
GRAND TOTAl
..-"-\
\0 \'11 \ : ',. ,XI
?p.:..'G\-'~'
,$ . gn~
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,)
This pe""it i. granted upon rho ""I""" condition ,hat laiel
connclOr, .haIl CO~I' I P. ts with tile ordinllllco,
of tho S!a'" Plumbing amendment! thereof.
- ~/'Z-/(JO DATIl
A.l,I..I::.~l
Call for all i~ctions 24 hours in lIdvance,
16200 Eagle CreekAv. S,E., Prior Lalce, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-42;1-5
All Equal Oppo~unily Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av, S.E.. Pwmit No. q q -/337
Prior Lake, MN 55372 '
HEATING APPLICATION I PERMIT
f&/oo PII)' Z5-;J5(J-OOz.-o
I' .R"..
S~eAddr..s . ~07 PI'Q'_ -!f....tt.- 7M~ I!-ZSO
lot Block Addillon 1167ES I1NO t3CiU/JO,s
- -
Owner"g; Name I. },,"'.....-i....... _ ~J
v
Date.
Address
HealillgConlraclor ~,LLII!D FIRESIDE dba FIRESlDI! CORNER
Addtess.2700 N. FAIRVIEW, ROSEVILLE, MN 55113
Telephone', 651- 633 - 2 561
FIREPLACE
~tIIl Nake & Moder tJ-,,, f JJ c&,
I( Mod.r Size
""
Q 'Conn, load
Fuel ~
"\r 15bIL
Hue Size
Supply Openlngs
Return Openings
Input
Ed,.
Outpul --:>.3 oro
CIm.
TYPE OF SYSTEM
Warm Air Planls
G. avily
Mechanical
Air Conditioning
Venl. System _
HEATING OR POWER PLANT
Steam
Hot Walaf
Radiation
Sp.dal Devieos
Olhe, Devices
TYPE OF WORK
New Canslrucrion J.1..,
Alia rations
Replaceme'll
Est CDmp, Date
';>'~o.:>_..u
Repair
Est CDs( ~
Building P81mU .
_ ~LNlru
'ClQ- /337
HEATING PERMiT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Receipl ~
TYPE OF STRUCTURf:
I. Pii..l
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CaIDll'lc:.... OJ
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Single Family
Commercial
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Two-Family
Industrial
MulL~Family
Public Olhw.
Fee Schedule
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Indusllial, Commercial & M"I~-Family
nesiden"al, Healng & AC
Residential. Heating Only
Residential, G.... Fireplace
ResidenCial, Additions & Alterdons
Residential, AC Only
1% 01 job cost {$39.50 minlnllln)
$99.50
$64.50
$3950 . 2 0 2roJ
U9.50
$39.50
nelOemblll' 10 add the State SUrdlarge on lhe boIIom o'thi, appIlClllion.
The price 01 yoor heating permil include. one lOugh-in and one IInal i,....,.~'-n.
Addiliooallnspections will be billed at $35.00 each.
Hoose lIealing Tesl Aecom must be sllbmiUed w~h bl/ilrnn~ I!IUIlilIlWIlllllr belofe buld-
ing certijicala 01 ~~ ':-. '1I:y will be Issued.
I:lfl\I CAlClJLATlOIII!: REQUIRED wilh number 01 sul'\llY and retum openings Hsled pa
room wilh CFM'. pe, openln9- New structures or additions send .00' plan with supply
and relurn 10callons shown_ HEAT lOSS CAlCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAilED TO THE CITY OF PRIOR LAKE, 16200 EAGlE
CREEK AVE. S,E. PAIOR LAKE. MN SSJT2_
C~y Hall bllSin.s. hours are 8 a.m. - 4:30 p.m.
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All WORK MUST BE INSPECTED (nOUGH-IN AND FINAl) _ CALL CITY HAU.
447-4230
I hereby apply lor a mechanical system. permit and I acknowledga Iha\ ,he
inlormalion above Is comp'ete ami accurate; that Lhe work will be in conlormanea
wilh Ihe orelinane.s and cod.s 01 Lh. cily and wilh Ihe stale building/mechanical
cod.s; Ihal Ihis form doe. nol become a pe,mil unlil signed by Ihe BUilDING
OFFICIAL; Lhat the work will be in accordance with the app,oved plan In Ihe
case 01 all work Which requires review and approval 01 plans.
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AP"Ii~
Buildin!iOllicafs Signalure
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS JS"C")e:)" &'1.- ~L~
NATURE OF WORK f'0e-J c.~
USE OF BUILDING SFA-
PERMIT NO. q '7 - I -""""3" DATE ISSUED t " :- ? ~ -<l '7
CONTRACTOR
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING I (jfJ /~9h<J I
I FOUNDATION (Prior to Backfill) I .r;J! /z/j'O/cfCj I
PLACE NO CONCRETE UNTIL: ABOVE HAS BEEN SIGNED
ROUGH - INS
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PJ-1'/ l,
(}/ ]/1/~'V
f'!~ I!J
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INSPECTOR
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
DATE
.;;lz+~
.5/t6/w
""ul.P6
5 1.4'-~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
, ~eARf) I
FINALS
tVr>
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE
NOTICE
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HAS 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