HomeMy WebLinkAboutBuilding Permit 03-0181
___"___>~,_,'~,,u.-,-._.-.,-._.___,">.^__..,___._....,....~.. ~~_nn___ _ _~..~."_.. ._.".,,--,_=_.~~.-..-,..,_....,.....___~ "_H......,-.~____,__.~..~"".~__._.._..~~......__~ ~,.__ ..
DATE nIlE
CITY OF PRIOR LAKE 10-1-07 110
INSPECTION NOTICE SCHEDULED
ADDRESS ~,\ i,ola~
OWNER CONTR.
PHONE NO. PERMIT NO. "{ - I <?l{
o FOOTING o PLUMBING RI o EXIGRAD/FILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
%fINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
( (
/)t' -4 f'5
1./ .
. J r:\
L \ lY7 ~ i --V-\ -l. \p
_ r/ WORK SATISFACTORY. PROCEED
frcORRECT ACTION AND PROCEED
o CORRE I ryq.. CALL FOR REINSPECTION BEFORE COVERING
Inspector: . / Owner/Contr:
l"V
CAL 4 I '98 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
\
CODE RE 1REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
uaNOn
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
r;.27-Q"'<.
(j; tH
ADDRESS
~{{ --s.b ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
s-~ lar
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~UMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
~"-"-;~
Ql,..,J- \"'0. -#0_
'2 . (IJJJ ~.- M1 t 'J
"') ,
~o+?l~
,
. ~47- q9J~
o ~SATISFACTORY. PROCEED
)"'"CORRECT ACTION AND PROCEED
o CORRECT . CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
7.9JJ.6FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
QUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'''''"'''
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nME
SCHEDULED
10-1-03
ADDRESS 5(9/1 &tr-..c., f T r I
OWNER CONTR. D"e,dvl?Ot
PHONE NO. PERMIT NO. ~') .~ -{ y /
o FOOTING
o FOUNDATION
o FRAMING
';-=t" TION
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~ft.vt.....,..LUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
hl't.tk. - /"y IC
L-urf., R/9~ ~ I? JL
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspecto$ ~ ' Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
-_._-_.__._------_._-~--,----_._-----_.---..-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
/-,;y7,-03
(Please tv1?e or orint and sign at bottom)
ADDRESS ZONING (officeu,,)
; ~i:i:' ~:;, I PERMIT NO,l'}?, 0 / fY/
3. Yellow Applicant U....) d
'7x>1I
1??oA/'KI
.,
-r~d_
K.J.W
LEGAL DESCRIPTION (office use only)
RI
/os
PID,;t5/ g8~- 0 '73~
5\ ~vt;_ ./
(Phone) ~ !:J - ,=?d-'8 - 5/0 ;;----
6.:p. At If .')JJ I/Y
"
LOT I i BLOCK:> ADDITION
,
LJ I (,I')) .5 ,t/Tc.,./
OWNER "f-...~_.
(Name) l1::o/b!tJi>'-'
(Address) 10> YO
BUILDER
(Namp\
(Contact Name)
(Address)
TYPE OF WORK
DMisc.
tbcrt4do,
~.
54.~_
(Phone)
(Phone)
DPorch
ORe. Roofing
DRe.Siding
, ,
,/1 t<='8
'Jy~ tit-
DAddition
DAlteration
Dutility Connection
<;~U
~
/'
~ew Construction
DLower Level Finish
DDeck
o Fireplace
PROJECT COST IV ALUE (excluding land) $
Z "''l OliO
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 conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to pe orm needed inspections.
x
,
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
1ic51~/l)Oo.tJa I
$ If? ~3. 3S" f
$ 11 5'1./;> I'
$ /20,50 1
$ I
$ IOt).oo I
$ /00, OD I
$ "3~S'O I
$ 40.00 I
This Application Becomes Your Building Permit When Approved
~4'~
Building Official
~~.?
'11 'Z-'f
/-~O'-O~
Date
Contractor's License No.
I Park Support Fee
I SAC
I
I
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE Mt,W/)
#
$ 850,0C1
$ /1-77;.(J 0
$ 300.00
$ 70.00
$ I 2.00. DO
$ 700 . 00
$ ISoo,oo
Paid
Date
~2.7J.Jf
'2 ~z-(J~g7
I
I
I
I
I
I
I
I $ I
2-1'1-03 1$~Z33.5.3J
II
I ReceipfNo. #39/0 I
I Bv..,..j...., I
U
#
Water Meter Size 5/8"(/[";')
Pressure Reducer
#
#
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 signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
"s~ ":f~~ .dji103 ~6il ad .../I~.,_-r~
Planning Director Date Special Conlfltions, if any
24 hour notice for all inspeclions (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'f6J~X PR/O.\><
~ '7
'f-.. 1"-
i] [T1
White - Building
CanarY .. Enaineering
Qiink . Plann~
Thr (-rntf' of Ihr I..k.. Counll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections /
Denied
Reviewed By:
~
Ae.
~~.~,
fl -
)(u:tJ Jd Date: .;2/;,1 ~ 3
I
//".~ ~ ~
~
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."
~~
White - Buildinll
'- . I -anarv - t:.nglneerinQ""
Plii" -"""'nlng .
Th~ Cfnlfr of lhf L.kt <"ounll'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,-,~~--
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,1
if
/~~:.-~:,~:-:>
C'< i {
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/iJ7-B
Date:
.2 -/LI- 03
Comments: _See Reverse Sirle for Additionallnfnrmrl,tinnl
:If: IrJo.+(" 5uvI l (
t:, lis /'" Dr,'v( '-II&.. V 5(rv,'u. M vS -r
h4V<" fori 4-1 lOi/U / n Dr"VL\,vtW
I
C;:pp Attachments' 1) Gmoing Plan. 2) Erosion Control Measllres
"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."
5~';;
rWhile . BuildiriCi)
Canary - Engineering
Pink . Planning
Th~ ('~nl~r of the L.h <."ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT I1f~A~ C/HJAJ~
APPLICATION RECEIVED / - ;;J "7-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity w ich is proposed at:
i5JII ~/
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~
If3d
7~..0
a...d
Date: ol/~ 3
aZTo-.t2JJ ~ - ~.
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."
TO . d ll::llOl
..---,
~.,. ""{..-',
....;":......-~~'-
('-/ ;/r' "'~7
1--' \_
" ..
CITY Of PRIOR l..l..KI PU':.-fBr:'o'G PER.\fIT
D:.:.~~ :<:;'':
, - \~L..-.;; ",
.~
... ,/
... ,,,,,.,
" I"..,,~_,,','/
-'--~
Jl..~ ,~.,~
P ER..'.[iT :',(1)-=3 ~
- ---..:.....::..-
.. '.....1 '.,;-'
: 'f..I.,... '..11..;),..
- - r. :-:: :
- .~ . -.-.-'-
I -" ';'.~ L: ,-r":":'~: '"1::" ";'1""'::: I..":,! : l"::: lC o,f"':\":;: r:::
- ''. '7"'\ .':::'--___
-'- '-. "-' :-:'"~ .;'
] () //
"'/;( I
y!jCI/;1;J ,
1~
,f
-
-'~" -
::;>':', ~.~'. ~ ::':<.:::-"':.?7:C1;"; \,;I:':;::J::': ::-::,'-)
'-~ '.\'~'I ::?
,;.- "
,.;....:...:;.:.:.:::'
;: Co;: 1::':
.l:- -,r-~"""
. ,_'1.-., ,1_.1
~~s
I )#;1/!J,d&k:if
-'-
i ::~v;:::,~
_,:?~:i_>.'''' I /;) //i4, f)~'1
,'-. UfA,. II (l'iJ (
'. .'.....- ,r 7
" . ,..... 8tfO U/tfl-ter ~:I'/(_
\' ,~._. __._ r '..
',.:'.;::::.:...:: ::-::::.;;:)
,~~.~r.= (/;/;2'. tfc?cJ ~ ;J/~1 /
) ,.A') ..... /4"'/-1
~ (;'/,J,( .:5 .) J.) "'./
(,:''':''':''-::;:1
IC:::.")
(:::: '':.:t..:.:';
Cd::3:A'
l_..:~::i:)
AJaM~ I~;)J
i
( "-r[- "-.'- '._".l-."-r.
, .":'.:':_ L..:'..J l .J~L,'I.., .....:.'\....:.
,:' . ",' .' ,-",:,,"""':',;;;",;~FE.E. -c.=C"Dr'LE.'::i:'L~";~~'{="~~~5;,~rf,ili.t~'~~'i~"~':'" .
" ... ". .,'. .. ' .' .'. .,.1' ..:"li",'/''''" ,::'.'-0.<:. . V '. "",~'~~G~~"1I,~"l'l." ,10,' ",'
[(',~u::~::.:.l. CCI7:;;;<:~::41 &. MUldwf:.r.,ji',t 1% o(lc;o C;J:>[ ......it.'1i1 S39.50 minimui.'1 R~icc::tti:1l. NC'.~ One ~ ,r'.vo.F:unily 599.';0
. . ._.,'."'-''':'~ir)~,;.t<'?J RdicC::tii31.-"Adc(cons'& A!:~cn:i . S:i9.50
. '" -, ,,,,~.,,:,.5-~';"';;(,t::Io~:~~I.'I\.~:~~~"
E~::';m~t.~~ Co.:s;;: S~. ":"J~" 8uildinz P:"""::1.ir:;:'~It4~~,.t~-, ./illl--
, ',~'JI';$';r$.zIT.',\~~~':.~~~,t,j;t~~.:~~{... .....
p f..UMI31NG'pERlI,UT"FEE ~ -;s ,,'Z:;~~.,ztf;f~iq;;"~ kIh..
.' ',:..:;:~~rs,S.~...9:l:,~gi1:}~)~SflaJlol ."il", "...JllIlI!50 "~"'G;'~'1f
,rOT.-\L PER.~III' FEE _ ,$ "",,"'~,h' .,...",..,.....,.'.",.;..., '. b-~
1.1~~....'.~ ""11'.' :\l.-"~~jIjo.~~,~,.- ," :,'Uj,;....... ...::. I~I ~ .<:'] r~
(Offioect;;rcOnl:w' "'~~l'.:;,:'~.'_;~:l~':l:'~I~:,L~~..;, ~"t~~'>.:;'f.o~~~t'!l..~~}'~":'.'~' 'I
Tim ,,-ppl;ccion B<com,,=, Your Euildi,,:: Pena;' Whe" Approyecl I' ~,li @. ~ n m.~ II Rec::pt No.
8"n"in~ .offici,1 0><< ~ "3 ~ ;A-
~~ ~ JiS" ;j By U
:. hdtU. n..\t;1o:1t iur ~1I inJpcCClQn~ 19::':) .&.J:;...9 _ : (3ot'l9S:) ..u7...J:Jd'
t.~IJ:':''' (: r:...
)..
I
'j"
~I
/
I
,
1-"-7""
1
1__:?
TO/TO'd
lL..
Jv11M~
C'.:..TE
,-\P?UC."':"T !'lE,-\SE CO;\IPlETE BElO\"
T~p~ (Jf Fl.'ttur~
EJ:~ Tub l....lch ur wic~VJu{ sMc"'~:"
Dl.sh\.....:J,::;hc::-
T~pc: Q( fi:t::urt!
Q'J:.lndr"'l
,;>
I
I
i' RJu::h-ln~
i W~r;~ f-ic:1'e~
I Vv :;r.~;" ~"r6~::"
I Sc.i":id' P:;:'~'f ',.V~;,in:! ~[~C~'lr:>:)
I 'SC:'.V:J.~~ EiC"'::.~::\)r
I Bo1Ckrlow Assembly
"';"",'''d "Saclctlow Ass"mbly T <:st
"I L"wn Sprinkler'
1':.'/h"'~=1" IOthc::- :~~~~':N~~i',:-,l"'.,"i.;",.< ,..
I fi"Gr On!n
1 L.1'i~rcrl (8:lrhrcom S'II~!\.)
lJ.umir:.' rr:l;--oll or : ~:cm!=:J.r.r.l~:tt ~Ini..:
Si1owc~ Sto1ll
Sinks.,. "
8u Sink
vi~rc~ Clo~et (T'lile:l
,.--.-
/
,....
I
I
". ..1
I
..,~..:, ,.
.,....:.
. <" .i.'~',."
,
,
'.'.-1
,o:'::~!"i"ln,:~I) '!,l'
"-'""'.'
"
-=:J
I
.__J
..........,.",
.. . .'..' '.' ". '. .",~.., '",' .",:';'L.,.., ....-,c"'...,....;".,.,."" " ,.:, Iii>
..... ""..',~Jf., ',,"."" "'~""'~~"8N'rEi~~~.J:i'~.
moc:-t'l-dl::leJ
OL-.c.\
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Dllte Rec'd
~', ;;:\0 ~l~~~ I PERMIT NO. .~ - IV' I
(Plea.~c I:YUC ,Cjt, 'Print' wd MI!Il at bottom)
ADDRESS
,"',
;: tf,
)'" '
. '...tl1
(J.:;\i-,,('!'i J-- "r'l
1 ,.Jl). ,I ,,\.j.f / I
P r i() 1- L/ib,t
ZONING (ofli" ",.J I
LEGA.LDE~CRIPT10N (oflie, ""only)
LOT
BLOCK
ADDITION
PID
OWNER f\. ..... . .., I ,',-IXi ,'" .
(Name) I )f'f'.1 01D(; iCi:"~ I ;i:..n<,1Yi;i.(\"hc {\~c..,
(Addr~S)IO~))LIO \1\ (A.n c: "Dr-. >)\X,j+f: ,~ i hS)
(Phone) ')''. L X z,q
~'(L.cj-i p{?,'! (,f/.-/
17//
'v1 ~, t
. ,h:
APPLICAl>lT
(N .me)'-:J:t \') '('(',
(Address) 1 'oj c:; Cf)
2: 'S'r .Nt?c
r'.;'.P;'1 ~L
), 1,?1 I
i-l~
1'/ ,
1('
1'-
iV1C,.
(Phone)! L(:J) iJ.l<, -z.'Z.!.o I
PI U [(\ [) (Ii th I\A (\ i::;-"') c_1 "'! '--I
, (CilY) . (Zip Code)
. (Phone) 7 (ti3 ..L!T~ z?[f')
QATE .7) -;;;Z D .' 0 .2
\'
I..)
_ , , ',_ _,,~~~9~e~5)
\. j:.--f) ,'r """1" r ,'. 'I' V-,
(Contact Person) ,-". t'i :!~; If, ;; Lv' ,> f.-/,
-, '~,',:,"
i APPLICANT SIGNATURE C;:/bl,/;Y) iAl4,'J/!j!/YJ
APnICtiNTPLEASE COMPLETE BELOW
\,ZINE\\'f9M~W~VS:TION . .DREPLA("f~NT 0 ALTERATIONS
FURNACE MAKE AND MODELf.1VYLf L-tlvr.:J 10 Q c;:g.j~ '. ...... " ..... FUEL /liLf tia);
FLUE SIZe; ,),' RH1JRN OPENJNGS INPUT i GO/ODD OUTPUT 61.9.()iJri
TYPE OF s ~ ;)1",~' REA TING OR. POWER PLANT
~warm Ai, Pl:lI\~ 05te<un
OGravity 0 Hot Watt'
Q.Mech.nical: 0 Radiation
'.~AirCOrl~i,[i.gIi.jng,: O,Sp=cial,Devic\"~
OVcnt.. ~>;(S;~,~::,;},..:', o Other Oe~iccs
I F1REPLACEMAi<.EA~:@~~'ki;,ctct/.t(g + nVl'!O .2s..tr
rLEASE .NOTE:
Air Conditioner Units .
Cannot Encroach into
Required Side Yard
Setbacks
Industrial. Commercial & Mutti-p'arnily
FEE SCHEDULE
1 % of job cost Rcsi?ent;;u, Gas Fireplace
$39.50 minimum
$99,50 Residential.,Addioons &. Alterations
$64.50 ltesideOlial, AC Onl)'
$39.50
Re::;iaemiaL, Heating & NC (Ncw: S;9'n~~r'llc~ion)
Rc:;idcntial. Heating Only (New Con~tru~tion)
$39.50
$39.~O
Estimated Cost $
Building Permit #
(Qffic:cll"'cOnly)
PAID
SUILO/N WItH
G PEF1Mlt
TJ,i, Application Becomes Your Bu;ld:ng Permit When Approved )I ~ ,rrw ,.[1 1ieceipt No,
D." ".- _,~, 'l 5 ?nn:J-IDy
24 hour notice flJr all in~pe({il.lDS (952) 447.9 :;. . fax (952) 4474245
162UU Ei\i::1c Cr~ck Avenue, ~)rior I..: ~ MN :~~_~2~__
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$_..,_~.~9
$
---"'~
Building OWC'il:l1
(j-'
od W~5P:50 E000 00 '~~W
S9S8ELPo,9 : 'ON 31.0Hd
J/~ pu~ 6ul+~aH d3e~5 WOd~
03.'31/03 10:03 FAX 6123150702
AUTOMATIC GARAGE FRIDLEY
I4J 002
"
CITY OF PRIOR LAKE
HEA TINGI AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
JPleas< tvu. orDrint 3Jld ,jm atboanm)
ADDRESS
3f) 1/ J5rsP Chi n /IJ uJ
l ~ ~!~ I.PERMIT NO. 3 - ( 0 (
'- Ytllow Applied 0
ZONING (offic,us,)
LEGAL DESCRIPTION (om,. we only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
O~~/!mKE- 6.;<.1,...,...
\
(phone) C,97--'C?9 - /71;
(Address) !b2t./o 1I:rj:.~G 1JIt, , <J:r. 10:;:- S{;&tJ I.<;i-~$G-, #'1/V 5331./4
APPLI~T , .
(Name1) .u.1:rrm.rd,;" A- _(" .......~n_,.,_l)n ,~ ^ -t ~ (Phone) rll ,,3-.315- 7500
(Address)::AI() U(~Om~(Y'l~ ffJre_O) ~.\.,r'Y' \=t../lJt (nn Sse/tic:::;
, '. (j\ddn",) 0 (City) (Zip Code)
(Contact Person) t<' ':i"-., U. (phone) '7G:,3-315-7S/G:>
AFPUCANTSIGNATURE :;f;,1~li./h./>Vun~ nATF 3f"St/63
APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTIl.UCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL fuEL
. I
FLUE SIZE RETIJRN OPENINGS INPUT ' OUTPUT
TYPE OF SYSTEM
OWann Air Plants
OGrav;ty
o Meth,,"ica'
OAir Conditioning
OVen!. System
HEATING OR POWER PLANT 1
o Sleam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL /t7 v"I-:J'ES-'7'C
f) V3(,o /.AI
Industrial, Commercial &. Multi-Family
FEE SCHEDULE
1 % of job cost Residential. G83 Firt."P1ace
539.50 minimum
$99.50
$64.50
$39.50
Residential. Heating & NC (New ConslTuction)
Residential, Heating Only (New Construction)
Estimated Cost S
/05-e, (TO
Building Penn it #
Residential. Additions &. Alteretions $39.50
Residential, AC Only ~U,o..q, $39.~O
II{O ~ IA~
~G ."/~
,o~
~~)"
3'1,50
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
'-10.170
(Orric:t UlIC: Only)
This Application Becomes Your Building Permit When Approved
Duildlng omdal
~' ) ~-, __ _ Receipt No,
D Is (/:.; I;; r1 rJJ Pj-
'I bate ~ j By a
' MAR 3 I 788j l 11()
24 hour notic.e {or oH in'pections (952) 44 '.98.50, fn: (952) 447-4245
~-
Doh:
FEB-25-2003 10'44
CITY OF PRIOR LAKE
9524474245 P.01,01
uatc 1'1..'" u
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
t :. ~i; I PERMIT NO. :3 -I J',J
J. Qg!d. ....p1..-m /
i'Ptl!!UC1 tvDC tll tn':im and lIhm a.t boalDm~
I ADDR.liSS
30 II 11>6-- oJ: ~viJ
I ZONING (.ma:....l I
LEGAl DI!SCIUPnON (.ilk<: ... O1Ily)
LOT SLOCK
ADDITION
1'1D
, OWNER
(Name"
--"-
,JofY'l.s, &-\cWot-+
51 0 Q0 C'lL\-I:S A-Jf N
(A_l
(Phone)
f']( t'rr*i riA
feiw)
l\o?rtWlg., l(o~?
M ~ Ss?::6'l
(Zi~ coo.)
(A<ldulSS)
APl'LICANT~' c\_
(N~lllI'"' JIm on::.w-o< -\- (phone) 11o~- tjq 1(, lla& ~
(A<l<Iresr) J:?i{){)(n ClL\-t:\J A\lt'" N (-)rten-EldJ tJ\N go,?,r;7
(Add"..) :;t; (Clll') (Zip Code)
(COntaetPerion) 1IiVV\ ~k . IC:hOOC) l(03-L{qgr-7~,{('"
, APPLICANT SIONATUlUf ~ ./4/JUMr _ ::x DATE F:; -/ {,.,- D 3
APPLICANT PLEASE COMPLETE BELOW
Size of watl!ll' service inches,
Location of IIIIY couplin&S from nructure
Type of sewer pipe, 0 ABC 0 PVC
Estimated lenath of sewer line feet.
Clean out (ifrcquired) located at _ feet from structure,
'.
feet,
o Cast Iron
Residen!ial .e",or an<l ",otor line conne.lion/'S3,.50
Se",o, conneorion only $11,'0
Estimated CO$I $ 3!:J-. SD
FEE SCHEDULE
In<lUflrial, Com'J &: Multi.fomily
Will., connection only
I ~ of job coot ",jlh . S39.50 minimum
SI7.50
~ ~P\ODlu-
Suilding Permit N
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
S ~
$ .:d<'::\', ~,...,
I~' ,0'1 6\dJ:.."~
I DOl. ~ :~ I ~03 ay( fi-/
J - j
14 b.ur noti.. ror aUln,pll<:ti..s (95:1) 447-9150, r.. (95Z) 4A,....Z4S
0...
.
(Onl" VIe Only)
Tbl. Appli.ation lleeom.. Your Bulldlal parmlt Whon Approved
8uUdln.Omclal
TOTAL P.lal
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~ ~ t'Tj,
NATUREOFWORK ~W
USE OF BUILDING ~ .
PERMIT NO. ....D.?J-?5/~r DAT~ISSUED. .
CONTRACTOR 1)..e.e1-' ~ ( ~HON~ I~- 3 ,.# Sl()~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
VI/t' I
I FOUNDATION (Prior to Backfill) I fJb - s - ~ ,0:}
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I Pt>
p'f( ,
/~ r-;
I FOOTING
SEWER I WATER I SEPTIC
FRAMING t.,L, wP
INSULATION
ELECTRICAL
PLUMBING /" /.,. yvy?
HEATING (if required) L-,/", fI17
FIREPLACE
GAS LINE AIR TEST
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
J/~I
- S'" - 0" - "? <;'-
l../-(p
I
1
I
14'
1l{-7
I It~
I
I ~ <;I -0"
I rg
I V$-
1FT ~B
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~~ / t:UJ.TIlIt6lJ S'7J,\J8f 714- I r?l t~/C2..<.
, FINALS 1 \ (\
GRADING (Prior to Sodding) _ . I fJ D
Q,,~ ..l.o aq "-.0 [-'l/L;
BUILDINGr:'tD
ELECTRICAL
PLUMBING
HEATING
DO NOT
JD - J-C?
/
to -) ~r......~
LVc .1 PI} S-:7/
I Yf;
UNTIL ABOVE HAS
NOTICE
OCCUpy
I
I (rif
I
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.
FOR ALL INSPECTIONS (952) 447-9850