HomeMy WebLinkAboutBuilding Permit 99-1391
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CONTR, /
PERMIT NO, 10;/ j30/
! I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE.RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
522-7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
{j~EWER HOOKUP
n LUMBING FINAL
o MEcH FINAL
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V71
DATE TIME
9'S~,tV
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Owner/Contr:
- NEXT INSPECTION 24 HOURS IN ADVANCE,
lNSNOTl
ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~?..:7
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
h-os + ff
CONTR,
PERMIT NO,
p.. 0 PLUMBING RI
~CHRI
A WATER HOOKUP
R HOOKUP
o lUMBING FINAL
o MECH FINAL
COMMENT.: 0 .1 .1
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~AT TIME
3'2.1 4:Cb
C:
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/39/
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK S TI FACTORY, PROCEED
o CORREC A :1'10 NO PROCEED
o CORRECT K, C LL FOR REINSPECTION BEFORE COVERING
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Inspector: Owner/Contr:
C?A.'_I_l7-98 0 FC)R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE Ul EMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
~ZJ:>/ol (/:30
52-2-.7 ~s'f f1,1t-l! CcR.,
ADDRESS
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS:(]
tr-~-~ . -
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MEcH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
qg -(39(
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECT/ON BEFORE COVERING
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Inspector:
. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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/z/2/99
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,-9.9'/39 /
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12.SITEAIlDAESS 5:2"':r1
1. DATE
LOT
'1r4<;""t J.. I
BLOCK
(: ....Os;"t' ? ,;,....-C
~,/...S,
I ) -':29 - '" 9
(",'...de S.f:.. S"~.lff
/..Ja'"). 9 .5 Cokt- (., ~ ..,1:'1 ':/':
PID ~S/o~dol ~
I I
~~:'.;~~
BUIL*ORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
ADDITION
4:OWNER (Nam.)
Cb.... Bt'...~H4...J
15. ARCHITECT (Name)
e. BUII.OER (Name)
(Address) p,.. "-Q",
(,. 5').4 1-1..,. 1,./ P L Uf..
(Address)
~ K ~ (T.1. No.)
C. I ').- ~16~ -a8l"'l.
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
o w U'''' t.> '^ 1'( d ~ ~
c:. D -403 --Cl ~1 '".l.
SEATS
7 .lYfIit5-OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New ConsttucliOn""'" Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT CCSTN ALUE
Chimn.y" Mis<:. ~Q(, CleO
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLEllON DATE
Sq FI Width D.plh Yes No J; t I '2 CXlO
I ~.r~y certity thaI I have furnished intonnation on Ihis application which is to Ih. b.st of my knowl.dg. true and con.ct. I also c.rtity that :-:;" t~ own.r ~r authoriz.d ag.nt for
the above mentioned property and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. lam aware that the
buildirtO ~ can revo~e this permit for ~st cause. Furthermore, I hereby agree thai the city official or a designee may enter upon the property to~"~~" J, ",.'. I.
X e:t. ~~ J .17 ~ _~"- _fJ..;.~~_ '<1
~. Signature' I License No. Date
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
.5F/J
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ':::l 01. . 000. 00
PLANS & SPECS 0
SURVEY "
SETS
COPIES
PLOT PLAN
"
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
OMsion 1 2 3 4
P.nnil Fe. ................................... $~111 , 2 ,
97J. :2\
State Surcharge ............................. $
Penalty ....................................... $
I f\'? . Of)
Amount Brought Forward .................. ~
Park Support Fee .... .... ................... of:
SAC ........................................."',
1I1 C:;.\c. Q.eJ... \- ColI.ctive Str..t Fee ........................
'$It.. ~"'""O ~u.u..\-sewerTap ...................................:
-tl: "1 -1').'71/ Pressure Reduc.r ........................., ·
4 s; !!!
City'
"'0
_t"l
Plan Check Fee ........ ..................... $
Sewer & Water Permit ...................... $
::~1:a:~~:fr..............I~i~~.~e~iIWh.:~Rr~v: 0
By ~~.. Dal. n - (,,-"~
Certificate of Occupan
160,00
100 ,t:>O
'15' SO
MeIer Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Plumbing Permit Fee ....................... ~
Mechanical Permit Fee ..................... $
~
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $ ',<r DD . 06
Other ......................................... $
Paid T43~i.:"~....~~~~i~;.. $ ~:/~' 7fo
O{J
/2'>"
o
_ C>-
Date
By
Issued
ThIs is to certify tha the request in the above application and accompanying documents is in accordance with the City Zonin Orelin ce and may proceed
signed lannJt constitute~ a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certifica
. ~ 1~/~1"4J~ <::Y)l ('.lfYkAM~ ~.J
City Planner Date - Special Conditions W any
24 hour notice for all inspections 447-9850
._-_."._"_.._~ ---~-_._--,~,_.,---_._----_.-
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av, S,E, Permit No. ., q -13 q (
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT
Date ~.- /:;.-v<l PIO # 7~-tJC.()- D/Z-O
SneAddress 5"'2.~.:1 ~v,,;,\ P.,;:'r C':'ll(" S;C;- pi-
Lot _ Block Add~ion -r V'Cl."-\ L.., R ~. S, 4h '2 "I
Owner's Name DC) '" u', ~ L._ g e....'I "14,.,..}
fa IN-\' C~;:'c.L.: 5,6.
Address
.;-~ :2..., f"-hn. \"
jc-/ ~
f L..", k,.
Heating Contractor
Address
s ~~ 01. b(",~
C. (J..-l/rJ 1-0' d' 7L
Telephone #
Furnace Make & Model l ~,.,,.J..~
G.. ~/O AIR CONDITIONER UNITS CANNOT
ENCROACH INTO SIDEYARD SETBACKS,
TYPE OF SYSTEM
2 Warm Air Plants F_t 'A.vl G...I..,
Gravity I
Mechanical
Air Conditioning L.c ",IV.. ,c - 'i ,-..,
Vent. System VAN -~,::.
HEATING OR POWER PLANT
Steam
Hot Water
Radiation 'H- Fl....,. 14....,-
Special Devices
Other Devices
Modei Size
I?S' Aiu
Conn. Load
Fuel N..T G'c.s Flue Size
Supply Openings 20
Return Openings 9
Input /Z.S',o"" Output
Edr,
Cfm,
2" PJ)c.
IIS..."o
TYPE OF WORK
Atterations
Replacement
y
New Construction
, ,
Repair
')"" ,\. t. '] 0 -t't. /::l"" (J
J .
1q-j 3Q I
r~1 ~ (j-
r3~() I vO
Est. Comp. Date
Est. Cost $
Building Perm~ #
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
,50
Receipt #
'V
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
City
Conttactor
Single Family
K'
Multi-Family
Other
Two-Family
Industrial
Commercial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39,50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough.in and one final inspection.
Additional inspections will be billed at $35,00 each.
House Heating Test Record must be submitted with huildinn JlJlli!lil number before build-
ing certificate of occupancy will be issued.
HEAT QAbQ.Ul ATlON!'; RFOlJlRFn wnh number of supply and return openings listed per
room with CFM's per opening, New structures or additions send floor plan with supply
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 55372.
City Hall business hours are 8 a.m. - 4:30 p,m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850
Fax: (952)447-4245
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
50
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12/09/99 THU 15:53 FAX 6128902753
STOCKER EXCAVATING
141001
~ PR/~O
o;e ~
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5 ..1\ ~)
"r;-- ~''"'17'-' [" ,CITY OF PRIOR LAKE.
"'e, c' 15 ,'SEWER AND WATER PERMIT
... ,~. 1
GIIIWI ' ......
n:l.Lo. ~~..,
GOLD - elT'
NO. 9'1-/.39/
NO.TE:
sewer and Water
contractors must
be registered
with the City.
DEe - 9_!
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APPLICANT: DC M"chanic:a~iS[ocke.r Excavacing
_PHONE:
890-4241
ADDRESS: 824~0 ~L. ~v""'e... ~
SIGNATUR~ f~...' ~a/~~
SITE ADDRESS: 5227 Frost poine Circle
~5~:LDATE: n./ I()/~q
BLDG. PERMIT # 9'1-1$9/
.PrDiI 2S-()(gtJ- OIZ.-O
FILL IN THE eLAN~S.
1. Estimated length of water service
.feet'.
2. Size of water service
.inch(es) .
J. Location of any couplings from structure
feet.
4, Type of sewer pipe.ABS
PVC i(
Cast Iron
5. Estimated length of sewer line
feet.
6. clean out (if required), located at
structure.
feet
from
=~=====~=~==~====--==~=~=====~==~~~==~===~~~==~-=====~==~===~===~~
'Chis applicatio s your permit when approved.
BY ~ ' DATE: IZ,/IO/qq .
============~J===~==~====~=~===~========-==================~======
* Fee for either sewer or water individually is $20.00 plUS
$ .50 surcharge.
$
S
$
35.00
.50
35,50
Sewer and water line ccnnection permit.
Surcharge
TOTAL
FEES:
'"
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of ~ssuance
to insure that no duplicate sewer and water permits are
].'ssued. -
~~-,
AMOUNT PAID /" fl~\Bn ~E.?-~~ j
f ..U\\..V"...... ,.
REC'D BY "e -
DATE pAID
RECEIPT #
16200 Eagle Creek Av. S,E.. Prior Lake, Minnesota 55372/ Ph_ (612) 447-4230 I FAX (612) 447-4245
AIl. Equal Opportunity Employer
",.....""
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Thr Crnlu of Ihr 1-.11., Counlry
While - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
8t:.RJ~ Mil N, DO N
/2,/2./ C)q
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5227 F/206T PO/NT Clfr2CLS Sf;
Accepted
v
Accepted With Corrections
Denied
Reviewed By: ~'-""&r.
E'::1nE.SvW.AAl^ J
Date: /z/ tin
Comments: f. u'"tlln>< i'\"ST BE: KAIS ED ~I "...1 I,) 'T~ mE: FiAJA/- "'IIAlIE:
.RF.....~,,.;IAJr.... t...1...au....<
(2"......",. cJCrE'.E1l <J FE",.,.. 'AJ ;.JE:"~Hr_
ST"t\4.... l.A1Il4-rF..D
RvAloFr Mu<, IV ~vE"'~^ "Tn AAlti AL.,,.Ju -.
P/(oPFATV LlbJi"-::
1'15
J'l1Ut'..w As
rnALTICI"U. _
~~ JAlFo41:MA'-'t"uJ ON T:H~ Re\Jm~E: .sl"~
5EE. ~"'M~: I. h.J...... GIlR(\E. 1^1(p>~......1 I.JF.'''''A'-'~,' 7, ~O$'ON
('~O.....~O, M~o!:oc:.
,
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"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction, Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~~
q9-/3CJ /
Th~ ('~nlf'r of lh~ L.kt Counlry
White . Building
Canary . Engineering
Pink . Planning
IDlli-DING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
BERJ:;, t1 It N, DO!\1
Iz/z/qcj
I '
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5227 FR06T POINI C-/I2C-t..A~ Sf;
Accepted
Accepted With Corrections
1<
Denied - f
Reviewed B(t!iJ(/l-. ^J
j
Date: (2- (.., -'?'7
Comments:
I. M41"'~o.i", r..t~t('tYI Q."",{.", \ /".+,'\\ +0.1= \0;;. ",~\cI.t,\,,,,l...cA
2, '$",i a.\\ \oo.re.. s.., \ q,.-e.c..s
"5. ReD..c\. Q.\.L a-tt...c.l..cl ~c....d <DOh
4, C1e.vc~'\\Q)A.. c.~\-~ \"c.o.. t l '~
o...'^-~ <I. t- -h'v...J !noh,rt'
eo D" ; ....wl a..t
(I",j.... r;co.. r-.
fa uv..J..oJ. C CI\A i IA S fpQ.d,,~
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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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Tht etnler of tht I.akt Country
White .. Building
Canary .. Engineering
Pink .. Planning
~UILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
8El~ q t'J ri lA..!, DO rJ
/2/12/9(7
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,!5'227 ;:-/<!. [I 6T PCI/'v T c/lc:CCS SE.;
Accepted
Accepted With Corrections
~
Denied
(1IA" ~n.-J Date: I ~ - ,,) '3-<1 P
II . . .
Comments: -I( klr- .Init f'OhVII_,t f..ft1cmu..c.t1 10' SI'r)-t.Va1fi<::;,
.. N-lDrt ~LlnJ k:1.PJ/o.Ji7J..... C?-.vf-. pr'),o/' tv ftJuwfcd1a-. tJi151?drd},
+- D('jj( ",iru, IOCu..frM tv /.;( rlt.-trm'''-ld Lc.tc1 ~ '(hv<;..t ~ tNd-
,S I niJu..J SvfVHV
~ ~ii)n.JL (~ t"'.1d.J rvrl bff':r ,k fv Ct., dr/, s~
a,t)A d~tiVh 17 ,cJraJ-- pu Do,AJ p~- fICl.1r1.{JrruhJy
Reviewed By:
"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,"
CITY OF PRIOR LAKE Me
16200 Eagle Creak Av, S,E, Plllmil No, 9 9 - / ?"{II
Prior Lake, MN 55371
HEATING APPLICATION I PERMIT
QS- (JbO- ()J,9-o
Dale _ SII. m PIO'
Sfte Addre~ -5;;t~'7 2lrost ./ll.J
"Trod L
~.J
lol _ Block _ Mdilioo
Owner'sName ()Jh~ //'
Ad dross
(( L S ~ ;::;)q
HealirJgCootracl<J' !<LLIED FIRESIDE dba FIRESIDE CORNER
Md,RS. 2700 N. FAIRVIEW, ROSEVILLE, MN 55113
Telephon.' _651- 63 3 -2 5 61
FIREPLACE .
fMntlll!l Mak. & Model tko";.) C (;,
Model Size ,q ~A-rr r.
Conn, lead
Fuel
r'rlrd
Flu. Size
Supply Opening.
netlJm Openings
Input Output Cir) (L'?
Edr.
Chr.,
TYPE OF SYSTEM
Warm Ai, Plan..
G,avity
Mechanical
Air CoodiIionlng
Vent System
HEATlNG OR POWER PLANT
Sleam
HOl Waler
Rodialion
Special D.vieos
Other Devices
TYPE OF WORK
New Construe,;on
'x7
AleralioJls
Replaeer11im'
Est Comp. Dale
Repair
Est. Cosl $
II()Om
Bulding Perm~ .
...-hlb
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
, ,
99-15q/
.;::~{{
Recelpllf.
TYPE OF STRUCTURE
1.1"lr,\
1. (iin:ft
!. Yena.
rn
..
:J
...
.....
01, '"
COC*Ildor '::
Single Family
."
...
'1
..
Ol
....
a.
..
n
o
'1
:J
..
'1
. Two-Family.
InWsirlal
. MuIlI-FlIR1iIy
Public OIhe,
Commercial
Fee Schedule
Induslrial, Commercial & MuIli.FllI11i1y
ResidenlJal, Healing & AC
ResldentiaI, Healing Only
Residenlial, Gas Fweplaee
Residential, Additions & Aleralions
Residentia~ AC Only
1% 01 job COt!! (139.50 mir1irnum)
$119.50
$64.50
$39.50
$39.50
$39.50
MAY I I 2000
Remember to add \he Slale SureMrge on !he oollom 01 lhis IflJlIicalion,
Ql
u.
~
The price 01 your healing penni! includes one rough-in and one hi insp9clioo.
Ql
r.>
r.>
Addilional inspeclions will be billed al $35.00 each. ::
II)
House Healing Test Recorll musl be submlted with ...,;~ IlmIDiI ",,"",..... belore build.!:
ing cerlilicale 01 occupancy win be iss\H!d.
I:IEAI CAlCUI.ATIONS REOUIRFn rih nvmber ol s\lllPly and relurn openings IIsled pe
room with CFM's per opening. New s1ructll,ee or eodditions sencllIoor plan with 11IppIy
and relum Iocaliolls shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRlOFllAKE, 16200 EAGLE
CREEK AVE. S.E, PRIOR LAKE. MN 55372.
I
~ I
~I
~ 1
r.> I
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City Hall business hours are 6 a,m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-lN AND FINAl)- CALL CITY HALL
447-4230
1 hereby apply for a mechanical system. permil and I acknowledge thallhll
Infcrmation above is comDlele and .eeurale; Ihallhe work will be in conlormlnce
with the ordinances and codes oIlhe eily and wilh lhe slalll buildingfmecl1anlclll
codes: Ihatlhi. lorm does not become a permit until signed by Ihe BUILDING
OFFICIAL; Ihallhe work will be in accordance wilh Ihe approved plan In Ihe
cas. 'flail work which requires review and approval 01 plans.
~..d~ ~ .-rh,t>>
ApplicanI'I SijI'4~e " Dall
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02/24/00
THU 11:28 FAX 8128902753
STOCKER EXCAVATING
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CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO, 99-/39/
NOTE: Sewer and Water
contractors Illust
be re9istered
with the City.
APPLICANT: DC Mechanical/Stocker ElCcavating
ADDRESS: 82f West US.? t::c:.~
SIGNATURE.:~I;:.~ _ ....
SITE ADDRESS: ,777 11...~.. "_4_~ ....-.J.-
,PHONE: 890-4241
~~'H.LDATE; 2/24/00
BLDG. PERMIT *
PIDII z.5-orcD- OIZ-Q
FILL IN THE BLANKS
1. Estimated length of water service
feet'.
2, Size of water service
inch(es) .
). Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
pVC y
cast Iron
5. Estimated length of seWer line
feet,
6, Clean out (if required)~ located at
structure.
feet
from
-====:;;;;====-==:;;;;:;;;:_!Z!!Z'==:;;;;;:===:=!II!!=-=::=;;;;:;;;:===='iii'======----::c: __." _ _===__====::::;;:;;;;= -----;a';;;;==
This applicat3P3M~es your perlllit when approved. I.
B'i /f~ DATE: 2/2-4-/00
~~===*-===~~===------=-=-------=----====~==--------~======----==
FEES:
$
s
s
)5.00
.50
)!;.5Q
Sewer and water line connection perlllit.
Surcharge
TOTAL
* Fee for either sewer or water individually LS $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
AMOUNT PAID
~~~~^\\ -
~ \,\.O\~
RECEIPT :I
REC'D BY
16200 Eagle Creek Av, S_E.. Prior Lake, Minnesota 553721 Ph, (612) 447-42301 FAX (612) 447-4245
All Equal OpponunilY Employer
~~
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: A ~\J~(}cr P L\JM.P,lllJc(
Address: ls.? 1 t;:l ~ 4wl:'"Yl I ~ 1.._~
Signature:. ~41A.L ~
Legal Description: Lot I ru e:l- L BlockRLS ~'( Stl'",
Site Address' - c; J..ll. C:~ "/)IIS\ b t-
Building Permit # C:ZC)- r~ql PID# :::J,~-O{"O -Ola-6
NOTE: This permit will not be processed without complete information.
I. Blue
2. Gold
3. Yellow
File
City
Applicant
PPNo.
Phone: (" I)
t<,~ M"'\
c;c;- J _W /
l.f32.. ]1/'j
~v-.l ~tq
Tht' Ct'ntrf or lht Lab Countf)-'
FIXTURE UNITS
Quantity I Type of Fixture Quantity Type of Fixture
'd.... Bath Tub with or without shower ~ Rough-ins
I Dishwasher Y Water Heater
:L Floor Drain Water SOJtner
L{ Lavatory (bathroom sink) \ Stand Pipe (washing machine)
{ Laundry Tray (lor 2 compartment sink) Sewage Ejector
I Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
:l.... Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
.3 Water Closet (toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
,
GRAND TOTAL
$
$
$
/ ,50
$
I---~tr
L
/
$99.50
$39.50
This permit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
, of t~e State PIUmbing~Od and the!!/J.d1nts thereof.
f,' - _R ~O. .~~ DATE
--LAg-r::vfv" ; :,\.rll~ J h.. ATTEST
&1 for all inspec(ons 24 hours in advance.
16200 Eagle Creek Av, S.E, Prior Lake, MN 55372 / Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
-
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June 1/, ,WUU
Poor Lake tlmldmg and InspectIOn lJepartment
Re: Bergman Residence at 5227 Frost Pomt errcle PrIor Lake MN--1<.oot
Framing Corrections
Dear Sir:
The completed work was inspected on this June 17, 2000 and all corrective
measures were completed as directed.
The roof will now support the loads required by 1997 UBC Minn,
Amendment.
Very truly yours,
Richard M, Greenlee P. E.
( Minnesota # 9952 )
a.M.B. NO. 3067.0077
ELEVATION CERTIFICATE E>cpiresMay31,1996
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL. FLOOD INSURANCE PROGRAM
ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement, This form is used only to
provide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to . .
determine the proper insurance premium rate, andlor to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR),
Instructions for completing this form can be found on the following pages.
SECTION A PROPERTY INFORMATION
FOR INSURANCE COMPANY USE
POUCY NUMBER
aUlLDING OWNER'S NAME IJ
1) '" II'- D ~.,. '" !/>NJ-.v-- .
. STREET ADDRESS (Induding Apt.. Unn, sun..!.ndI"l Bldg. Number) OR P,O. ROtITE AND BOX NUMBER
5'2.:z.."1 ~IrO~+ .po~v,J. c..~V',,..Ip
OTHER DESCRIPTION (Lot and BloCk Numb8rs. etc.)
"'fr.2.At:T L .. {t.. L..'7.
I
COMPANY NAIC NUMBER
No.
t..9
P .rioV'
STATE
L.a.~1L , Mi"'lI\
.SECTlON B ' FLOOD INSURANCE RAT.E MAP (FIRM) INFORMATION
ZIP CODE
55 '31 'l..
CITY
Provida the following from the proper FIRM (See Instructions):
t. COMMUNI1Y NUMBER 2. PANEL NUMBER 3. SUFFIX <4. DATE OF ARM INDEX 5. FIRM ZONE 6. BASE A.OOO ELEVATION
(In AO Zones. use depth)
'2:104;'2. 000'2.. c. \\- '9-~' 9oB.9
7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): ~NGVD '29 0 Other (describe on back)
S, For Zones Aor V, where no BFE is provided on the FIRM, and the community has established a BFE for this building s~e, indicate
the community's BFE: I I I I I I,U feet NGVD (or other FIRM datum-see Section B, Item 7).
SECTION C BUILDING ELEVATION INFORMATION
1, Uslng.the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best
describes the subject building's reference level --1....: ,
2(a). FIRMZones Al-A30, AE, AH, and A (with BFE). "The top of the reference level floor from the selected diagram is at an elevation
of I I I qj II Dl,lQI feet NGVD (or other FIRM datum-see Section B; Item 7).
(b). FIRM Zones Vl-V30, VE, and V (with BFE), The bottom of the lowest horizontal structural member of the reference level from
the.selected diagram, is at an elevation of I I I I I I,U feet NGVD (or other FIRM datum-see Section B, Item 7).
(c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is u...J. U feet above 0 or
below 0 (check one) Ihe highest grade adjacent to the building,
(d), FIRM Zone AO, The floor used as the reference level from the selected diagram is u...J ,U feet above 0 or below 0 (check
one) the highest grade adjacent to the building, If no flood depth number is available, is the building's lowest floor (reference
level) elevated in accordance with the community's floodplain management ordinance? 0 Ves 0 No 0 Unknown
3, Indicate the elevation datum system used in determining the above reference level elevations: g NGVD '29 0 Other (describe
under Comments on Page 2). (NOTE: If the elevation datum used in measuring the eleirations is different than that used on
the FIRM (see Section B, Item 71. then convert the elevations to the datum system used on the FIRM and show the conversion
equation under Comments on Page 2.) .
4, Elevation reference mark used appears on FIRM: 0 Ves @..No (See Instructions on Page 4)
5, The reference level eievation is based on: ~ actual construction .0 construction drawings
(NOTE: Use of construction drawings Is only valid if the building does not yet have the reference level fioor in place, in whicl1
case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate
will be required once construction is complete.)
6. The elevation of the lowest grade immediately adjacent to the building is: I I IClIO ~ I BJ feet NGVD (or other FIRM datum-sea
Section B, Item 7),
SECTION O. COMMUNITY INFORMATION
1. If the community official responsible for verifying building elevations. specifies that the reference level indicated in Section C, Item 1
is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "Iowesl
floor" as defined by the ordinance is: I I I I I I,U feet NGVD (or other FIRM datum-see Section B, Item' 7),
2. Date of the start of construction or substantial improvement
FEMA Fonn 81.31, MAY 93
REPlACES All PREVIOUS EDlTICNS
SEE REVERSE SlDE FOR CONT1NUAnCN
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS EQll~"IA.\. (Lt-.
NATURE OF WORK ~ 0ft1s40LkOY\.
USE OF BUILDING ~
PERMIT NO. 9'-1~~1 DATE ISSUED ~
CONTRACTOR ~~ ~~~MU\ .
NOTE: THIS IS NOT A PERMI. FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUM~T
EI<l.~IO\'\ ~\\ ~ Vu-;Q~cA. "B-t.(;;l-e.. L..-7~t~ s.rv"-~) DATE
I FOOTING I,~ .. (~ I 'l.\1Z\Y<1
FOUNDATION (Prior to Backfill) I V)) :;/d.-Y I
PLACE NO CONCRETE UNTILIfBOVE HAS BEEN SIGNED
ROUGH - INS
(~. ~ 3/~, lu?J
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(p (10 !!!TJ
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL /l .
PLUMBING ( .r.P my A,
HEATING (if required) C/ I / -(
FIREPLACE r~ "Br'.-Sll/O'P \
GAS LINE AIR TEST (;;)/7- I 0 . 0 0 .
COVER NO WORK UNTIL A190VE HAS BEEN SIGNED
I I
ile\p.\:i.OAC0-k~,., 13e\O!-e ~oFO FINALS
/ GRADING (Prior to SoddinS!>,7'- ~ _ Z - Z 0 -Of
L--y BUILDING'(.C)!~ tDlM>ll7D ~. ?/u!~ ftrr, d,/cM/lJ/
ELECTRICAL ~ , J
PLUMBING /iJ '7/0:/ c;eJ .
HEATING (/ . - tf:r q I "Ulv'1J
I
DO NOT OCCUPY UNTIL ABOVE HAS BEEN ,SJGNED
NOTICE
r
llV\laf
This card must be posted near an electrical service cabinet prior to rough-in inspections
llJ1d 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