HomeMy WebLinkAboutBuilding Permit #99-1374
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SE HEATING TEST RECORD
ADDRESS ill.? iq ) , Lk' '--APT. _FLOOR
OCCUPANT :.p-, r)/n: '1WNER
HEAT LOSS - 0 EHTG. IN~T..7 - ;( / ~ / '7
SOLD BY ;= /]1/7/ INSTALLED BY ,-,
Elo."I.al W..k By , . - - .. -"" ';.. Uno By /I a;/././ j(/ /U
. ./ .. " ,
TYPE OF HEAT GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
eJO?7 2/ f/t'
..-
CITY ..;/ SUBURB
MAKE
Mod.1
Cd. :SAS DESIGN
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IT 1//1l/ //0'/')
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V v/ -- -,-,
CONVERSION
S...iol
INPUT
MAKE OF BURNER
Mod.1
Mo.. BTU Rating
MAKE OF FURNAf'.
Model
'- /
X
/
/
.. 0 CONTROLS
THERMOSTAT r - !".~ H, 'Plug
Valye ~~~
Limit 19' r./ '
. //0-'
Limit Se"ing ./ /-'l ~-
Fan Selling - --r-,' #/#.4\
PII.t Type /iL..P /,t.4 /' -.. --
PII., Mako ~- -7 A .--..-"",/i?#'
Pilat Model ~ - - /1 -
PII., Timing <' I. ,-S~_
L.W. Cut Off --.,....- -
7 <:-/" .
Pressure ..-J,./ ~#t'-
Input CFH ..P 7 ,.-
SYOckT.mp. -;tAg"
,
Vent Size
KIND OF LINER
J- II 11
T SIZE NON.
A14f.f/ J'2--. L:;--;;Y--
, '/ -
Draft Hood ;', -e:--. Re,ulotor
Filter. siuHv1';.. K ~umbet
Chimney Locotion Inside
Chimney Construction
Outside
v
"'., . ..........
~\
V'\,
(
Smoke Bomb
Draft
Wiring
Test Tog
/ " Lighling Insl
7" -" -V-J -/.2-/
, ~//7 ./~
V g/7.h7/Pft:7~.-/
"~./ -
Door Pressure
Percent CO _() '"7 :?"
P 2'~ '/0
ereenl 0 /) )j' $ ~
2 .. Yo
Percent CO /Y"
Date Testltd
Company Testing
Nomlt of Tester
Form 235
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~trtifira1t at OOrmpanry
CITY OF PRIOR LAKE
1lBtpartmtnt of liuilbing 3Jn~ptdion
plI Final 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 afthe
City of Prior LaJce regulating building construction or use. For the following:
Use Classificatior-
STNGT.R F~Y
Bldg. Permit No,
~71.
.
Occupancy Type
R3
Type Construction VN
Fire Zone
N/A
Zoning District
R1
Legal Description
L4. B3. KNOB HILL 2ND ADDITION
Owner of Building
lI:.,te Address
14349 ROBIN ROAD
Contracto"s Name & Address CR PARTRIDGE.
6?-.
14696 LANDAU. PRIOR LAKE. MN 55372
ROBERT D. HUTCHINS
II / t3~~fficial
rity Planner
JENNI TOVAR
Date:
Date:
POST IN A CONSPICUOUS PLACE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
. SCHI<OULED
ADDRESS
F/3<1'7
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING Ii:J\
o INSULATION I.V
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: r...<<' /' ~
DATE
TIME
A,T;
'19-/3'/ '/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
kf ~ ~_~~If~
I~ .f~"-1 ~
~
((..?R~ ~.~))
, ~/
"-:::. -- ,~
---
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i6 WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
--
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
OWner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
/1-/4-0
ADDRESS /4 349 R)(~;'n RO?rf
OWNER CONTR. Ct:_ /?;ti:n;/o<"
,/
PHONE NO. PERMIT NO. 9 9 - /3 74-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)!(FINAL
o SITE INSPECTION
COMMENTS:
c1
I
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
j1( EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
) (
) /
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspecto~/;1" ~ Owner/Contr:
CALL 447-9B~;-FOR ~T INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
6f;,1f;D d ~ 3{)
ADDRESS ~I ": eo.,._.../v\
OWNER
CONTR.
PERMIT NO. 9' 9 -1'=17 t./
PHONE NO.
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FilLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING rJ'h 0 WATER HOOKUP 0 FIREPLACE RI
~NSULA;J;I~r. f1 0 SEWER HOOKUP 0 FIREPLACE FINAL
INAL .r; '0 A~ ~LUMBING FINAL 0 GAS LINE AIR TST
o SITE INSP CTION (y""- MECH FINAL 0
)<OMMENTS: t?a+,li ~ ~ (3 OVL
(1J f-!wJ) reA ~,Vle1"YIY() c:tPd
C2l ~J cWldl +y&1; l:>e'\ d(7JI~IP~
( 3J C'erv-WJ-J.. /'h. L) iA ~Jw W cQL v
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o WORK 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/
/NSNOT/
TIME
DATE
CITY OF PRIOR LAKE ,~ L _ /r,
INSPECTION NOTICE SCHEDULED ~
ADDRESS /d-~4-1 ~6/ /\I eo
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
^ 0 MECH RI
~WATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
z:SI)
qq-/374-
o EX/GRAD/FilliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
COMME"lTS1 . ..
~. ~. 40 P'fc.
," ~~ k.. ~ -~~
,A~'~k.. dw i v ~
~ g:. A""-.. o/A...
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F,('X
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S1Yo"f -'
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o ~SATISFACt RY, OCEED
~~~~CT ACTIO ;20
o CORRECT WORK, ~ JR INSPECTION BEFORE COVERING
Inspector: / Owner/Contr:
CAll 447-98Sb Fa/THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1 434Cj
l<o6.V\ U
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 D~WERHOOKUP
,. PLUMBiNG FINAL
o MECH FINAL
COMMENTS:
11) ~ M..,J:i: G.y(
(2);- Ce:'AI!_ .~~ ~
~ f:"';,71/ ntJ1, -fkh
W~
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~
(~ I~
O!J...-.-
-
fLJLt
/
~l / TIME
(. ~ H:-~
CJ9. 137'1
o EX/GRAD/FilliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS liNE AIR TST
o
.
h.k.
t-t.rn4
f/ frr Arc ~ S"S'
SFACTORY, PROCEED
CTION AND PROCEED
RK. CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspe r
C LL 447.1850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C ~DE RE~UIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
V ,","on
~~ !i~)~:~~;: ',reM;g,~~:t~~~~~ OF
U --.. -AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. --.!Zq.. /3 ?i-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12. SITE ADDRESS
Ilf-::;.i..f9 ~ ...:r',ItA. ~A-h
3, LEGAL DESCRIPTION
LOT '-t
ADDITION ~
1. DATE
\\~2-'3-~1
,R./
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Heig~ '" (W~ ""'2..-' (Depth)tJ..t.t-'"
12. NO, OF STORIES
:2.:-C;~.;.-:-. . J
13. TYPE OF CONSTRUCTtlN
V\~ {"- '..-~
14. FLOOR AREA APPORTIONMENT USE
:s
"2-~
(~ess)
~l ~t"'ur-"
(I('Qdress)
PID 25-3~l1- orz..-D
~ r-h l'"rY\.
BLOCK
~l\
(Tel. No,)
4r~~
5. ~HITECT (Name)
(Tel. No.)
(Name) (Address) ,,/ /A b
\ -b , ' /-nrt'
. ~ e....:, ~ .' ..2-> ~l'1j.10At./
(Tel. No.)
L{'-M-\~4b
6, BUILDER
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTF
c... ~ '?-A:T
SEATS
7. TYPE OF WORK
New Construction-~
Chimney [j MiS!
18. PROPERTY AREA OR ACRES 19. P';kE~TY ~~S~NS 110. CULVERT S.IZE 17. COMPLETION DATE
Sq.Ft Widt Oepth ......., Yes @ -::'-3'-DV
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 struclion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
~~r~ se. Furthermore. I hereby agree that thL(::i~~!r a designee may enter upon the property to Pi'irm :;?d i~ions,
UcenseNo. Dale
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Ae-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNAlUE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
Front
Ba'"
Side
Side
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION i 'AI] /'n:l. C'YI
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
sF .L..J
USE OF BUILDING
PLOT PLAN
o
TYPE OF CONSlRUCTlON: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~i~~~~~...1...~...~..~... $~? 2 c)
& '{'i. q(.
~o ..:;0
Amount Brought Forward .................. $
Part< Support Fee ........................... $ ;::J'5:0.1!:O
SAC ......................................... $./ 0 '\D .&0
City:
Collective Street Fee ....................... $
Sewer Tap ................................... $
S~.. $
Pressure Reducer .......................... $
Meter Horn ... .... ...... ...................... $
Water Meter ................................. $_' :l<;" .t)Q.
Sewer & Water Connection Fee ........... $/. "")./')1"") ~OO
.
WaterTowerFee ........................... $ ~(') .00
Plan Check Fee ........ ..................... $
State Surcharge ............................. !t.
qS./')/")
Penalty ....................................:;;.$
Plumbing Permit Fee ..9..9..~.I$l:... $ 1/')("). ~
Mechanical Permit Fee 1.1...:./.511: $ 1~i1 .rJt!)
Sewer & Water Permit 9.9...:.!. ~ Z 1:: $ ,Js T 60
Ga~Sire lace Perm~ .'1.'!..~.M.7.1:: . 4{j, Q ~
Thi A I; '~com..QYour Building perm:t"('n ^'1,e~
By -i~ -~ Date -
CertiicateofO~
~
Water Tap ................................... $
Builder's Deposil ............................ $ / ~CJn ..00
Other ......................................... $
Paid ~;:lt;7qi.........~~~~i;;~~~/~~ J_
Date 1/ l.{'{'J. '2/1 By {MA.,/
uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a/requested. This document when
constitutes a temporary Ce~f zOl~ complian~rcows construction I~e. Before occupa. ncy, a Ce .. Ie of Occu nCYc musl be issued.
,~ 'TT Jt\(1 ('LV .ew,AAl4~ Ij)
nn 0 e Special Conditions ~ any
Issued
v
24 hour notice for all inspections 447-9850
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Pe.mil No. 99- /374-
Prior LBke, MN 55312
HEATING APPLICATION I PERMIT
Dale 2-2-"\-00 PID' Z5-33q. 01'2.-0
SlIe Address l4'34<l e.i"b,n Roa.d . f?. {
Lo! ~ Block 3 Addlllon J:::N0J3 Hli-L 2 ND
Owner'! Name C.12.. iav+ridQ(j /-fomes
u
Addle&! 1t..fuHID t..a.Mau.., I..t>.n. ,mfJ( ~
Healing Conl.BClorRcv" Ib.iirf1Ul ~ fIG
..J
AddleS! lJ3l>3 A-IlYllU*' f.lvL U. r...-II'\. 1\ VtUUM
Telephone' lrl1-- 9fl.-llUU
('~
Furnace Make II. Model "iKf'AVOql'Jl/f.A
Model Size
Corm, Load
Fuel tJc..-r, ~SFlu.Siu
Supplr Opening_ 'Z 0
Return Op.ning" ( 0
Inpul Sir, e>e1D Oulptll J I; od()
C)"
Edr_
elm.
174\)
TYPE OF 5YSTE~J
W.rm Air Planls J
G..vllr
Mechanical
Air Condllionl!19 X
Ven!. Sralem .
HEATING on POWER PLANT
Sleam
Hol Waler
Radiallon
Special Devicaa
OIhel Devices
Allelawns
ReplaC<lfl1enl
TYPE OF wonK
N"w Conalf\lclion
x
Repair. Eat Compo Dale
EsI. Coal. 1t7ooo - CI 0 Bulldll1\l PermU
HEATING PERMIT FEE' qq.:;;\)
STATE SURCHARGE $ .50
TOTALPERMITfEES $ 100,00
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BUILDING PERMIT J
necelpl .
.
TYPE OF STRUCTUIlE
1. Gr~ll
l_ T-c_lew
(il,
Cu.adar
Single Fall1l1y .
Commeroiel
A
. MuUI-Fsmly
PubNc Olh"r
"
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III
I
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Two-Family
Induslltsl
Fee Schedul"
Indu91r1e~ Commercial II. Mulli-Famlly
Residential, .Iesllflg &. AC
Residential, Heallflg Only
Residential, Ga. Fileplace
RealOOnllai, Addillona &. Allerellon.
ResldenUal, AC On/)'
1% 01 job 0011 ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
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Rememberlu edd Ih" Slale Surcharge on 1118 bollom 01 Ihle eppllcallon. ill
I
m
The pdce 01 your he.ting permillncludes on. fough-ln and on" rmallnspeclfon. ~
-
Addilional insp"cllons will be billed al $35.00 aach. ifj
House H..Ung Tesl Record musl be submltled willi IwiIIIInI1 JmlIliInt'rnI1Ar beror" build. po
lng cerlllk:ela 01 occuI",ncy will be Issu"d. .' . ~
. :;0
I:lW J:iA!.CJ.LlATIONS Rt=OIJIREJ! wllh numb"r 01 supply end ",Iurn op"nlngs Ils1ed pE
roorn w~h CFM'a per opaning. New slruclura8 or add'dIOl18 und lloor plan wllh 8\lpply
and ,ilium localions sl1own. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY 9E MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
CII}' Hall bullin.s. hour. a'e 0 a.m. - 4:30 p.m.
ALL WOnK MUST BE INSPECTED (ROUGH-IN AND FINAl) - CALl cm HALL
441-4230
I hereby apply lor a mechanical syst"ml permll and I acknowledge Ihallhe
Inlolm8lion above is compl"l" and accurall; Il1ltll1a work will ba In conlormanDl' U1
willi Ihe oldlnencea and code. ollha clly and wllh Ih" alai" bulldlnglmechanlcal J>.
codes; Il1allhle lorm does nol become a permll unlll algn"d by Iha BUILDING I\)
. OFFI~IAL; Ihal the work will be In accordance wllh Ih.. approved pIAn in Ihe ~
case 01 all work which requires review and approval 01 plans. ....
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FILE No.688 03,-01 '00 AM 11:28 ID:D & D MECHANICAL
FAX:6128904650
PAGE 1
CITY OF PRIOR LAKE t ~i;:,. ~u_
PLUMBING PERMIT , 99 - /374 .
/4fJplleant:-1)+-D rhF" J..t. ~. Phone:$q.,,- 8'.;) ~~
:~~:t::: 7p~/~1 . 7~~~ :-~~-- _~_LJ~_
Legal Descrtptlon: LOI L/: .. ~Iock . '? Sub KIJ()A (fjt-t... 2~
Slle Address: I L/..3 1./ 9 ,q~ &;;;L? ,e /
Building Permllll 99 - J.3,., <./ PIO II 2.5 -33q - 01'2--0
NOTE: This parmll will 1'101 be processed wlthoul complete Informallon.
FIXTURE UNITS
TIw (....'ttal 11l.1.....(~......"'
Quanllty Type 01 Fj~lure
~ &tlh Tub with or wllhoulshower
I Dishwasher
I Floor Drain
.s I LavatolY (bathroom Sink)
I I LaundlY T,.y (1 or 2 compartment sink)
I I Shower Stall ,
J? J Slnl(a /
I E1arSlnk
..3 I Waler Closet (Iollel) I
FEE 8C:HEOULE
Industrial, Commercial & Mum-Family
(1 % 01 Job COBI, $39.60 minimum)
Quantity
Type 01 FI~lu,,!
...3
I
Rough-Ins
Waler Healer
I Waler Sollner
Stand Pipe (washing maclline)
Sewage EJeclor
I ~,.:.':., Auernbly (RPl. 001..111. ChQ, PVB)
I Back'low Assembly Tesl
1 lawn Sprinkler
I Other
L
Resldenllal, New O"e & Two Fsmlly
Resldentllll, Addltlo :Allerallons
Sial. BurcherI' :;<~,,?).
,..
<<', .
~.)(G > . \ "l~~
(- 0.'{
~,,\ . oJlJ..
\)1,' ...-
$99.50
$39.50
$-
$ _'19..5(;
$
$
.50
fd.~
p~
GRAND TOTAL
$ -' ~() .Od
f"'"' PAlO-WITH
l BUILDING PEm,\IT
Thi. perrnit ia &rantc~J UpOfI lhe e:r.l)ress cnn~lliun lha. fniid
"unlrlctnr, IihaU cflnlJ,ly jn ,II telpect. wllh the ardlnan(,:ca
nf the Suue Phlmbiua d .moRJhtIO?U thel'e(1r,
R 3lfA/fJO DATE
--, ,
A'ITEST
Call for ull ir ecliono 24 hour. in advullce.
16200 Eagle Creek Av. S.E., Prior LaJc:e, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 44',' 4245
An Equal Opponunily Employer
~
-
CITY OF PRIOR LAKE Me
162(H) Eagle Creek Av. S.E. P8"nil No. 99-/374-
Prior Lake, MN 55372
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Address
B.alingConlradot ALLII!D fIRESIDE db. FIRESIDE CORNER
Address 2700 N. FAIRVIEW. ROSEVILLE. MN 55113
T.lephone" 651- 633-25 61
FIREPLACE I
MlJtI!J Make & Model rl..Jh;1- A.J C,f.
...
CIl
CIl
CIl
<'l
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'"
...5L _"1.'llm?
Model Si,e
Conn. load
Fuel ((y.uJ
Flue Sill
~
'"
'"
Supply Openings .
Return Opellings
Input
Edr.
Output. Ao. f'XX)
elm.
TYPE OF SYSTEM
Warm Air Plant.
Gravity
Mecilanical
Air Condmon Ing
Vont Sy.lom
HEATING OR POWER PLANT
Sleam
Hot Water
Radialion
Speciol Device.
OIher Devices
L
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AI.... alio".
Reptaceme nl
TYPE OF WORK
. New CollSlruction
00
"
"
'....
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"
L
'....
U.
Repair
Est Comp. Dalo
jjmn)
Building Permt #
Est. Cosl $
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HEATING PERMIT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEES $
. 1',6//0)
, , 49-/374-
.50
r PAID WITH
tauILDING PEX""T
Receipl #
I P'illk
" Gottn
J, Tel...
AI<
Cdy
C_..
TYPE OF STRYCTURI;.
Single Family
Commercial
Two.Family
In<klstri,,1
HEATING APPLICATION I PERMIT
3-.,)3-00 1'1011 26-339- 0(2-0
Site Addrus f(/":fr,p; a ~ ('f:?"" .p III
. ,
Lot ~ Block 3 Add~ion, t:=/I!OB 1t1C--c.... 2NO
Owne"s Name (?~p !h",r..l;AJIP"
o
Fee Schedule
In<fuslrial, Commercial 8. Mulli-Famlly
Residential. Heating & AC
Residential, Healing Only
Residential, Gas Fireplace
Residential, Addihons & Allerations
Resldentia~ AG Only
P Wlic
Multi.Family
OlhO/
1 % of job casl (539.50 minimum)
$99.50
$64.50
$39.50 \ . ~ 3 C9Xl
$39.50 '
$39.50
Rernembe, 10 add lhe Slale Sureharge on ll1e boltom of thIS application.
The price of YOU' healing permit Includes 008 rough-in and on.. llnaI inspllCtion.
Addilional inspecllons will be b~led 81 S35.00 each.
House Heating Tesl ReeDrd musl be submilled wilh !',old.n" IlAIIIIiIIIl!lIIbIlr be10fa bIJiId.
ing c erlifica\e 01 occupancy will be issued.
liEAI CAJ.C.ULATIONS E'FOlIIl'''n with number 01 supply end I8Mn Oflenlng.1Is1ed pe
room willi CFM's pe' Oflening. New slruclures Dr additions send 1100. plan wiIh IUl'PIy
and return locations shown. HEAT lOSS CALCUlATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR lAKE, MN 5537Z.
Cily Hall business hours are B a,m. . 4:30 p.m.
All WORK MUST BE INSPECTED [ROUGH-IN AND FI/tAl) - CALL CITY HALL
447-4230
1 hereby apply lor a mechanical systems permit and I acknowledge thallhe
inlormalion above is complete and accurale; Ihal the work will be in conlormance
with Ihe ordinances and codes af Ihe dly and with Ihe .\alo buifdlng/meclllnlcal
codes; lhallhis lorm does noll>ecome a permi! unlil signed bV Ihe BUILDING
OFFICIAL; that the wDrk will be In accordance with Ihe "ppmved plln in Ihe
case 01 all work whIch requl,es revIew and approval 01 1'1 Ins.
/) "
~,_ /l I-h..-hr. . ib/,~
ApptiC2J)frJi'fl:ture' " Dalo/
~ 3/2-3/00
Buildinfl OHicaf's Signalure Dale
__,,__.,_._____. ..._......__._"____ ,'___'_ ,. _.._.._.______.e.___'____,.,
GREEN - FILE
YELLOW. APPLICANT
GOLD - e,,"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.W.No. 11-/374-
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: L~g ~C~ 11' "d
ADDRESS: tf4;;:" - ~Jfq ~. ,4,41
~ - ;pt-.
SIGNATURE: L L....-- LL-...-L
If "/1
SITE ADDRESS: III .'3l./.<r f<J,t.:, /2/.
PHONE: If") - fj 'f N
DATE: /7.- 7-.C_ 9?
BLDG. PERMIT # 9q-/374-
PID# 7~~.33q - 0/2.-0
FILL IN THE BLANKS
1. Estimated length of water service ~p
feet.
2. Size of water service
I
inch(es) .
3 .
Location of any couplings
Type of sewer pipe. ABS
from structure
PVC ...-- Cast
feet.
4 .
Iron
5. Estimated length of sewer line
J/A
feet.
6. Clean out (if required), located at
structure.
feet
from
==========?ifj-= - ===================================================
This applic' comes your permit when approved; I'
BY DATE: /2/7.-0 q0
/ ' . ,
=========1F=======================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
Fee for either sewer or water individually is $t?~ 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
RECEIPT #
.. """ ~ \
AMOUNT PAI~~~I:\r'
REC'O BY _,<,\\\\_0\\'-
,'1
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
S~1
99-/374-
Th~ C'nl., of Ih, J..k, Counlr}
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT .APPLlCATION DEPARTMENT CI-l.E.CKLlST
NAME OF APPLICANT e..e. ?/1KTRIOGb
APPLICATION RECEIVED /1,/2:3/ C)'7
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4349 ROL3/N Rd:).
Accepted
Accepted With Corrections ~
Denied ~
Reviewed By: (/f! rfl....r
Comments:
---
Date:
/ /- ??-fJ
ikJall aH~ ~~
"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."
"7'""''''~~~",''~ ,/-.0.,1 .~~
--
-~.,-""....,..,.
~ ~ "":,1I"1"T,' ~"';;<,'~ ".~__ _,~ -, "'~r."'~t.-~..,".
,
,,/- ,-: /' --:' /1"
. >,',. ,/~-~
Thr Ctnlrr of lhr L.kr Counlry
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(! ' // .
/ ..>,./ /.: 7-;(.- ./ .(,j Gy E-'
./ / /7 "j' ~-; c.:;
',/L~-."" .,/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J,:/ ;, /C-'?'" .~" / , ,')
_ ...r.'J.f ,.., ",//<.1 I"~,L/
.-' / / J.... ,..L~..' . T
~
Denied /) /J/ J
Reviewed By: I} vrJ/ ~Jt/(Ll/j
Comments: If f{ vV>/t Ce'u1nd
Acceoted With Corrections
Accepted
Date:
};)-J &J<jq
. ~
) 01 ~dt. ucoC/:;
I
lhCY/Jt:<ch
~
"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'/"
...
9q~/374-
Th.. C..n'u or Ih.. L.".. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUlLDINr. P'=~MIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
(:-,,f::::'. ?/7~.c:Tkl UGiC
/1/23/91
, I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4349 /'2C6'//1/ /2D.
Accepted
./
Accepted With Corrections
Denied
~o"icnAn3rf ~'" t...!ALT,fjt E"oc-~_.aAJ,J
. ...............>.;..... L-'J. ....~ .,~
Date: lJh9/"
,
Comments: SEE INF'''''''''''''''''.,.} o-v rJ.lE R"J6(sE. 5,cr-
-..sa. th-r.nr..,~. 1..o....-..h___.41.. (:OMF' 'AJ<;P€r.'nrl,.J 'AlF'=l"II1rNrdr-JO.....:J z. ~(iALJ/.vr.. P~.J
~ Cn_........1 r...",.-nOL V'1u:J~.Jflr;::c::
t../. &o'St/'JAI Cn....x-n.'bL- R A-^\
"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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS l!:I.,?q"j ~h:1II U),",",.O
NATURE OF WORK' I\l..<" (\ .dIAo.Jl::.''''{..\lrJ---\. ~
USE OF BUILDING 5;'Fh
PERMIT NO. Cj'q- 13'171 DATE ISSUED 11-.2'1 -91
CONTRACTORCR. ?~d~p ~W\.€.."
NOTE: THIS IS NOT A PERMPr FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
I FOOTING rj)/ l2/1~/t{1
J.
I FOUNDATION (Prior to Backfill) I (/h }z/-c;aJ( \ (;p ~.::;i'i',4q
PLACE NO CONCRETE UNTII/'KBOVE HAg/BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC (2) Jdl>_",!,?q
FRAMING W C'--- 1/ n 5
INSULATION 11f) .d,jtAJ
ELECTRICAL I':-x
PLUMBING i/flJ) sh/oo
HEATING (if reqUired)tf/(x/~;;o.(J/J# ()b I
FIREPLACE l. L ,f)JP; . W~.I ~
GAS LINE AIR TEST K/Jl(t/tJ/oo Ql~~((tll
COVER NO WORK UNTlLVABOVE i)s BEEN SIGNED
I '87" ".1.ifItr I I
FINALS
L- L L./
DATE
~t~-
GRADING (Prior to Sodding)
BUILDING 1CJl 1'b ~I"I '1\1)
ELECTRICAL
PLUMBING
HEATING
DO NOT
If. 1<1. c/1J
-
~. ~//~/017
~ (j:J., (, /,;.. 3/ n
OCCUpy UNTIL ABOVE 'HAS BEEN
NOTICE
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