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HomeMy WebLinkAboutBuilding Permit 03-0028 CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS ~~fD OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION OA TE TIME SCHEDULED ~/2-i/D.3 ~~ CONTR. PERMIT NO. o PLUMBING RI o MECH RI bWATER HOOKUP qSEWER HOOKUP /5 PLUMBING FINAL o MECH FINAL COMMENTS: ~:;..t.. ( II L I I ~j \/; ~ s-o~ o EXlGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o I (>.AA /' +-- ~ORK 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! INSNOTI to?/OJ '0?f?,o ~It'~ CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION f]/ FINAL '0 SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL f' MECH FINAL CA TE TIME ~ ~ Oz.~ o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI .s' FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: . - 0 I. ~~ ~c;\IY..~...q-/_/J.J..Q-~ 't'V\tS~C{/.ev\1 _ J'~44L'vw> (j(Z-, VV\~ ':pC~r\~, /'J. 3 "0i / ~ ~1N~-, ~iS\2 Ul-- ' \,i tv) VSIIA (.I1~at-, -1-, . ~ ..t- .~1to<: , *,,<1;.9 ~~~~~L.gl lfl~~ &~JJL \NwAs~. <:"<.)eL.~ Q/CJ ,: v f", ~o. (-?~e_v1'~ (J,QA/\,ir"v?< ~ ~ '---,.{" I 1C.." I ' ~. ... w. /' 17 t ~ \7 AA ~~ t tMe, J.M <-v. -\ ~..~V'~. o WORK SATISFACTORY, PROCEED o 90RRECT ACTION AND PROCEED VCORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. lNSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS ~~~o OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION DATE TIME SCHEDULED '1A 7 to 3 '5\~f,,\ CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL OS'D~ o EXIGRADIFILUNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: ~;- V~5 ~ {)L( {/~ J//f.:::jc:'1l&v\ ~ I ('OJV::>.P _,,",.-.r- ;?:,'(Lo --.:: "--- I?< ~ ~ORK 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 & SAFETYI """"n DATE TIME CITY OF PRIOR LAKE / I. r jxz. INSPECTION NOTICE SCHEDULED ~ ADDRESS 1_S'8.o %l...)E..uv:.s"T .pA\'H OWNER CONTR. PHONE NO. PERMIT NO. () .'2... - no 1J!J... o FOOTING o FOUNDATION o FRAMING ~NSULATION ~INAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o E,{~ILLlNG OC~T o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: _~~-ov.... J...ouJ u... GuA:6 'f->(!))< ~WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WOR~ CA .L FOR REINSPECT ION BEFORE COVERING ,nspector:rt~f'A~V Owner/Contr: I - CALL 44 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETYI INSNOTI CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIME (H~-6~ ADDRESS '2. ~"15() S-r()()U~EST f'kTH OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~FINAL r 0 'sITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: CI~ 0'--((01Z- o EXIQIFILLlNG o CO~NT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o /2<WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORREC~RK' C LL EOR REINSPECTION BEFORE COVERING Inspector. 'L. Owner/Contr: ~~ ",- u.~; L.= .",,_ u .....".."'''~ IN_'" CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <I SAFETY! ---.. ._",._..._-_.~-_....,--_..~._~ '. -_.__.._----...~.,---_._--_._- ...---......-.. - -----_.- ~~rfifirab (If ~rrupanrl! CITY OF PRIOR LAKE ~tpa:dmtuf of P.uil~iug Jlusptdiou 'd Final Permitted 0 Conditional e.O. Expires . ~iS 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: Use Classification SINGLE FAMILY Bldg. PermitNn 03-0028 R3 Occupancy Type Type Construction VN Fire Zone Zoning District R2 Legal Description LOT 53, BLOCK 1, MEADOW VI EW Contractor's Name & Address CENTEX HOMES, Site Address 2380 STONECREST PATH 12400 WHITEWATER DR, #120, MINNETONKA 55343 . City Planne< DON RYE ~ Owner of Building ROBERT D HUTCHINS c: H BUildi1 or,i~3 <./ Date: Date: , CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d I. White File 2 Pink City J. Yellow Applicant /2-/f--OY ~ I PERMIT NO. - (Please ~e or print and sign at bottom) ADDRESS ti? 5JO ,.--.- ..5 jOnPcrt'5:T po-lh J<l, CJ. ZONING (office use) ~~ I LEGAL DESCRIPTION (office use only) LOT53BLOCK I ADDITION In ~ cbt/;tt:'/ 053 PIJ:b?S~..3if4-~ .0 OWNER /'7 ........... / J (Name) L "'17 /,t:J 'I /101tJ.aS (Address)/dY't717 tOh'~r ,k)tR. F/;;;b /JJ1J.n~.kCi I (Phone) Cj'Sc) -d33 -0)5t;'3' mil -. .... " 9'~ BUILDER (Name) SOIlJ r' (Contact Name) /~d/ ~_Sk fl:>7a-<I (Address) .::'Sci1/J t? (Phone) (Phone) c <;'(;/71 fl:J 9-9-d33~</5 TYPE OF WORK ~ew Construction DLower Level Finish ODeck OPorch DRe.Roofing ORe-Siding o Fireplace OAddition DAlteration DUtility Connection o Misc. PROJECT COST IV ALUE (excluding land) $ I '73. qQ?, OC . I 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 fOf 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 a ware that the building offi.c" I can reyoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may ~teruponthep to~rrn~. ns. #dm7t/737 /~?~b' ---- Signature Contractor's License No. . D41:e I Permit Valuation "l7.t/.OOO.(J() I I Park Support Fee # $ I Permit Fee $ I~ oS: IS"' I I SAC # $ /~,IJO - I Plan Check Fee $ ~I f). 34 I I Water Meter Siz(U8:'; 1"; $ dZ50.(!)'" I State Surcharge $ Y7,oo I I Pressure Reducer $ ~5".aa I Penalty $ - I City SAC and WAC # $ /2-0tJ.OO I Plumbing Permit Fee $ 100. Co I Water Tower Fee # $ 700. EJd \ Mechanical Permit Fee $ 100, <00 I Builder's Deposit $ /S-OO/~O I I Sewer & Water Permit Fee $ 35.S" I Other $ I I Gas Fireplace Permit Fee $ '/d,Od I TOTAL DUE $ '7. w55. qet I This Application Becomes Your Building Permit When Approved Paid '7. (,!'is. 9.5 I RectNoc .t/;.5'~",)o/ I ~ ::kj~ /.;1/ ~ ~ L- Date J-tf-n7? Bv . I U Building Official I Date 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 issued. ,&. .~ -:(~ A9h~~ 2- Planning Director ~ a..d ~,;.-: -,-tv' ) Date Special CoIJ.i:litions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 ~~ White - Building CanarY - En!J!!leering CJ51nk - Plannln'l..,;.J -"1 Tl1f1' Cfnll'r of lhf L.kf ('ounlry aUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT. APPLICATION RECEIVFn I / e- .'< --- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: " ,,~ I Accepted Accepted With Corrections v/ Denied Reviewed By: ~~, -<!.,. , -:j", jJ~ Date: 1';>-P-4 ,/0 ~ Comments: A~, /1. . ;"J ~ .,...... ~ ~ =- ",',/ll"--P 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." &~~ ~hite - Building::> Canary - Engineering Pink - Planning Thr(-rnfrrnfthrl,lbCoUnll) BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED (l PlJ {J ~ YJ-cn1U2-o I d. - / f-eJ d-.. The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: dOf?O- $~ /J~ Accepted Accepted With Corrections /' Denied Reviewed By: ~ /Jd ,.. ~ Date: du;~z- /U./ ~~ ~~ 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 - Building Canary - Engineering Pink - Planning Th..C"..n'''Tof IhO' L_",Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED , -.../.. / j/:"-/f . - /:' J ~:I ;./_., -'d A...;.?" "\.i-~!- .,.., ~~_..-:" -' ..:.' ".., /'c, crr,..~._.H..-..-.;/ /- /(':1" .-;2 _. !5 -7:'/ C"~ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: .:-~ "'::l. (-.).;-~ .,..., .. J- 1.,,-..' '')--. /r-.:.... < . .1/ " ,.j.. -. '-.'/--' " //,.1 "'r': V-, J' " -'-, ..-> " '"-- ',-' " -.~ . Accepted x , Accepted With Corrections Denied Reviewed By: 1J;?9b Date: /2-27-02 Comments: See Reverse Side for Arlrlition;:!1 Infr.....,,,tiDr" See Attachments: n GfaoitigPlan, 2) Et6sioflr.ontrol Me;l~l1r~~ "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 HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd (Please type or print and shoo at bottom) ADDRESS ; ;;;,:" ~::y I PERMIT NO. 03 -007 Q I J. Yellow Applicant e-TJ 2380 STONECREST PATH NW LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) CENTEX HOMES (Phone) (Address) APPLICANT (Name) AT.T .TFD FTRESTDE DRA FTRRSTDR HEARTH & HOME (Phone) 651-633-2561 (Address) ?700 NORTH FAIRVIEW AVENUE (Address) ll.OSEVTT T F (City) (Phone) _651-633-2561 55113_ (Zip Code) (Contact Person) BRENDA HUSTON APPLICANT SIGNATURE BRENDA HUSTON DATE ZONING (office use) PID 2/6/03 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT D Steam D Hot Water o Radiation D Special Devices o Other Devices DWarm Air Plants DGravity D Mechanical OAir Conditioning DVent. System FIREPLACE MAKE AND MODEL HEAT N GLO SL-550TR Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC On i,' Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks $39.50 $39.50 $3:.30 Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Permit # $ $ $ PAID WITH .50BUllDING .p.bRMIT (Office lIse Only) This Application Becomes Your Building Permit When Approved I Paid I Date I=I=R - h Building Official Date 24 hour nntice for all inspections (952) 447-9850, fax (952) 447-4245 Receipt No. /} By / --) U 10 . d ltJ10l ,.~'~.,.'.~,.) . . ~ , --. .~' ',..:.:~~,.,. ern G;:- ?RlOE L~r-:.E PLt'~r3;~G PER.."\IIT rJ~~= ~;I.:~'I~ Jl... PER.\GT ;'.f) 3;jJ;?-- -- :,,'" .~," ,.,1'1'. \~,.",;~~, ". ;I~ -,i,'~ ,;~ ,::-;:~ I::,: 1= \('"jr",r.-r.r':" _ jjfo.~._ -cf;1lw('e! 4+ Po' -I) f .'I' - :--- ".:...: --.- ~.;:...:.:: :;~.,>':::"':2'7':'':';; .ji,';":=.l>; )~<..) -- :..~,C(-~.::: ::::' ....-:.;c~~~ ? ~T I ;.....!)( ~ ;"1' " .' I,';", I .' t" .'~ ;';, .: :- ':~:' ,,, ;': i --. , I ?~>;,-.~! i -(.......: ! , ) I' !.' . , /k ;' / ij) id /-."'L) /! u . 17;1 ...'.<J ..,' " -'" ,: J .r, /).~;{lJj>71 .i / (/ {/. I' .c.c"';; '....::.;r.::: /7/' <, d. ,:J', f4,~J ot. .. 'I '-7 v.. J. I:"~ ./.:,:.'.. ,J:JyJ/l It. rC~:.,'j (?:<~ / '~J ~:"-) :~Y. ~I'~..'~,~ ' i _.: ._:~;';:' I. .~ .:"; :":l.:) ,~::~f11 ..1../ ,/l.( ( /':'/1"</1 I l I . /, /1 )./Vl..1c> -~. :_:..:..:..:-,-;- .:;'.:>.I,-:-._:::~'::: I)U~l:lr: r. ,J. I ! I , , " ~ .-_! c.~-:-~ "PPUC\:';T PLE."SE CO'\II'LETE 8ELf)\V T.vp~~ of Fi:-:!ur~ I Q1J:J.ntlCV j I3J.::l rub ""'\tit l)r W!t:1QL.:.~ ~jhiJ~"~:'" J ...(. I [j13r.\\.''J;~~1!;;r ! T.vp~,.,r Fi:t:.lr:: l:,\~\)r Jr'J.lr: [,.~",1r(Tf i 8arhir:\i!'n :)lr.!-.:) f....:lur1iJr:. ir'J.:; { i '.)r _ "':l;i7~L:;.:.(":'r.o.=-:lC ..:iin;\. Snov..e:- SC:J.ll Sinks e~r Sink ',:i~c", Clo,~: lTolkl R...JU';.!r\-ln;:; Yv ",;c c-:~:t[oc \V.1r.~:" ,')ut:rl~:- Scirid P:r.oo: I ''''\':l:i:lln~ ~r.l'~~11:;:,:1 ~~'."":.J.~~ EJ..::.::~)r 8~ckrlow A;iS~:nbl:' 8ackrlow Asse:nbly T ost I Lawn Sprinkle" I Othe~ , ---I i i J ! , --'---.~ FEE SCEiEDLLt: Il,du~:::-:::.l. Ccr.:;:;t:::':::.I1 &. .\tulu..r":.r:id; ('!,,) of jl.1fl ':'J:.:t 'Nit~ J. S39.50 minimum {(h':ic: t;~~ Onl:-) R=sidC::1ci::1l. (-Jew One &. Two-F'::.n'ul)' Sr.9'::O R=:dd:::::w:l.l. AJcit:ons &. .~::::::~t;on::i ~~'t.~G E':i::r.'I:.lc~~ (0$~ :s eL.:ik~(:::; P:::7:1it ,:;. PLliMBfl'iG PER.\UT FEE $ STATE SURCHARGE :s TOTAL PER...rIT FEE s .50 .c', " ',~ "0' i ---; I - T~ll.:) Applic:H~un Bc:com.:,:) Your Buildin~ l'ermit When Approved ,,)/'0' d BuihHm, O'-[j~i~j ~ ~i~ ~ ~, \J! ~ rfj Roc:;pt No. ''''''"'"'" ,., :,:'~'"'".. ,"" ~ ~;~ ,,:: ~'~:J,II" ~h-, IN I JJ[]I'~ I El,JnldA3llCi(, BZ:~0 Z00c-~0-El3~ FAX NO. :7634283682 Feb. 26 2003 10:21AM Pl <. CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd ;~, ~:~ I PERMIT NO. 3~ c:::l-6"-J. ~. Yello... ^Pph~l , (.../ CPleoue t"(p;: or ~rln[ and sim1 at bottom) I ADDRESS ;;<376 5.fD/1~ <r-c.s+- ;:::.. I--L- I ZONING (om,,",,) LEG..u. DESCRIPTION (olllce u,. Only) LOT BLOCK ADDlTION OWN1:R (Name) Ce I'! f{ :.<' )(e:;,,,,,,,,<:, " . (Phone) (Address) APPLICANT (Name) #""".,c...~<> , ~ (10" /. '" 9 PID (Phone) -;/< - / '"\ ~ ~ 7 "-, '+-,-,(..7 -;7......... (Address) j ?S-:,a 1" '" ~T1I-'1' t?_~/ g/ (.Addr~~.s) ,/>--;'~/:./~ (::, fr-,,.o (City) (Comact Person) - /.,,,.!.-'- Go~fc-- ~~~, Il/r-:rt::.. DATE (Phone) &'/2... - ? I.:; . S-5~7 APPLICANT SIGNATUR~ - ",;!(,~ (Zi~ Code) 2-2~-O.l APPLICANT PLEASE COMPLETE BELOW , IQNEW CONSTRUCT10N 0 REPLACEMENT 0 At TERA TIONS FURNACE MAKE AND MODEL is ," <> 1'1-1- ~.;o '+ 7,~ .70 FUEL G05 FLUE SIZE Pl/C RETIJR..'10PENINGS g' INPUT? 0, ,,-'1<'") OUTPU:r 7 '-f. on,? TYPE OF SYSTEM HEATING OR POWER PLANT lDWarm Air PIJnt: 0 Steam OGravity 0 Mot IVa!" o MeohMieal 0 Radi"ion iaAir Conditioning 0 Special Devices [gVent. System 0 Othc~ De'ti.::,,~ FIREPLACE MAKE AND MODEL Industriol. Commercial & Multi-Family FEE SCHEDULE 1% of job cost Resjd~nti:ll. OJ!: Fireplace S39.50 minimum $99.$0 R~sidenti:ll, Additions & Alt~rations 564.50 R.,idontial, AC Only Rcsidentisl. Heating & NC (New Construction) Residential. Heating Only (New Construction) Estimated Cost $ Building Permit # HEATINGPERNnTFEE $ STATE SURCHARGE mD-~--=" ~-:;tj)- .1"9-.. f TOTAL PERMIT FEE ~ l"J u; I r (om!::!! Ute Only) , 7, This Application Become. Your Bui1dln~ Permit When Appro .~~ F~, lUUj ::r_ __ I~D_.!'1te I Building Orncll\l DlIrc ~__ ""-- 24 hour nollo. for allln'pectlons (952) 447-9850, fax (952) 447-4245 PLEASE :-iOTE: Air Conditioner Units Cannot Encroach into Reguircd Side Yard Setbacks $,9.50 $39.50 539 50 PAID WITH BY'LO'NG PERMIT Receipt No. ~ ':'J.f'-II~' -' .,~ II . .. , -- --- --- ,.. ,_.. -.. --.... .-.-......--- *Per~# "Job Add,... '; ?f?D <~u'l.~l- "HeolingConuoctorHEATING & r.OOLING TWO "Testers/Signature M.c.M- &..,~ "Gas Une Pressurized Inspected .Percent C~ "Percent O2 Final Inspection Q!!! !.!!!!! PERFORMANCE TEST . n7 'j, . 08''''' "Percent CO "Stack Temp. Pounds Pressure r;6/tJ lJ1?' Date \.. 5/13/2003 14:50 3524612166 DA5EN CONTRACTING FEB-13-201il3 09:06 CITY OF PRIOR LAKE PAGE 01 9524474245 P.01/01 Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT (!'leu: t'(p<; or orlnt IIlld .1.. It bollllm 1 I ADDRESS ~ ,~8'D ':Slorre f rJ4[/ LEGAL DESCRIPTION (olllee use only) LOT I BLOCx53ADDmOl'l rYlDr. (a.fit d ):.J..J~ , ~ .. -~ "" ..- ~ ~ ~~ rCn)-U>A() ~ ~p~, (Addms) 1d-46b' !~ ~ $120 (AiIdrc<.1 APPUCANT ~ l'D,,~ r ~ (Namel .\ ....L-\~r) .\!.)jJl.W....J..I ~ (Adclms)OU.;~J~>~ \\~~7 ~>.Q.., C "./'~\(Addms (Conta",Penon) ~ \ APPLICANT SIONA~ ~ v t ~.:.. ~ I PERMIT NO. --I. - -::l.. i? I ). 0IId AfP:li~ J C/"' I ZONING loma"") I PID (phon~) q7ftJ -7 X .~~. ~j;n(Lp(l~nta.. f;75~L6- (Oir' (VI> Code) (phone) ./j~/-dl6D . ( ~ rJ'o;11 e. 5~t.j, COty) in I Q..."" () (Zip Cod.:) (phone) lW d- - c.,I--M-C::fSL{1J DATE ~/ /3---OA~ . APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Loeation of any couplings from structure Type of sewer pipe. 0 ABC 0 PVC Estimated length of sewer line feet. Clean out (if required) located at _ feet from structure. feet. o CtlSt Iron FEE SCHEDULE Rasld=tial .e....cr ancI wner line connection $35.50 Industtld. Com'\ Oi Multi-Comily \ '10 of Job cost wilh . $3 9.~O minimWll Sewer conn.ction anI)' $I'.~O W.,er conncedon oo!)' SI7,~O Estimated Cost $ Building Permit /I SEWER AND WATER PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE (OUL" tJ.lr. Onty) $ S S PAID WITH =tllLDING PERMIT nil Application Becomu Your Building Permit Wben Approved I P(I~ [1; (D rr; ~, ~~ TItW'" NO,. / Bulldlnroa;d,' Dol' I D\~ ~~ wt:l Z 1 zaJ;~\ J 14 hour ~otlt, tor IlIln'p.ctlo", (951) 04'.9IlS0..~'51) <14'04145 I By - TOTRL P,01 PRIOR LAKE INSPECTION RECORD SITE ADDRESS Z~O srON~~ .N.uj. NATURE OF WORK NEW ~~;ON USE OF BUILDING $.1': '1::). '. PERMIT NO. 03 - 0020 DATE ISSUED ~ Ir CONTRACTOR ce NTeJ Mo....' PHO'NESWD'.~I NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF BUILDING AND INSPECTION INSPECTOR DATE , FOOTING ~ I FOUNDATION (Prior to Backfill) I ~ I L/2-1 !e~ PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS : ~~ I ~ I ' I ~U- I L7;Lt1- I~ I - l / I ~/1):3 SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if reqUired) FIREPLACE GAS LINE AIR TEST l /? "i I$)3 i . {//l !.e'L ~ //1. / oz.. 7 It{ /lJ3 ~ f 2 {B3 'h {7 ((;)~ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I~TN6- I I j FINALS . GRADING (Prior to Sodding) !1Je ?J .(~.o] BUILDING 1-t..,(J JIl H \ 'lf~l {f) I ~ ELECTRICAL \ H/II...-.. .\)PLUMBING -?e.'w-t.-r-- ~ L.~ .::? ~ 1./ /t'ik3:5 ~ HEATING \f\,~~~ J/I/r'? ,5=/4- cf1 DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED NOTICE 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