HomeMy WebLinkAboutBuilding Permit 03-0414
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CITY OF PRIOR LAKE
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IXFinal 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 afissuance this structure was in compliance with the various ordinances afthe City a/Prior
Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAl'1ILY
Bldg. Permit No.
03-0414
Occupancy Type R3
Type Construction VN
Fire Zone
NIA
Zoning District
Rl
Legal Description _ L2 J B2, REGAL CREST
Owner of Buildin"
Contractor's Name & AddreMiENSMA!\'N
Site Address
3917 REGAL PASS N.W.
ROBERT D. HUTCHINS
C' ~- Building Official
j-?"-r)2,
/
HQM.I\$.
r'vrt)
V ,r
1895 PLAZA DRIVE. SUITE 200, EAGAN, MN 55122
DON RYE
City Planner
Date:
Date:
.......,--
~~.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
37 I 7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
4'J}2;>r-'''-bJ f'''-
CONTR.
PERMIT NO.
7- C//'-(
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: /}
I, h'",tvf t:,.~...P ~ ,. ~ (~'
l'k' ~
. ~'
/"t-=-1 ~-""(l
'-'
o WORK SATISFACTORY. PROCEED
'~ORRECT ACTION AND PROCEED
o CORRE RK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: . (\. Owner/Contr:
CODE R UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'''''"'''
OATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ce:.~ri.-o3 - ~30
ADDRESS ~ O~
OWNER CONTR.
PHONE NO.
PERMIT NO.
-:( - q (l).
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
"WLUMBING FINAL
kJ MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COM}'IENTS: ~ 1 .
I.~ IK.,. LoADll..
- I - l n
"? T\A<::\-,.DJv ~^'1/? \K ~
-& ~ILrI\r-- \I
-f-o
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c...; ~_,/J t;....~
"
L/. r;(j)~ C~-l~~_
o WORK SATISFACTORY. PROCEED
~ORRECT ION AND PROCEED
o CORRE W . CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
Owner/Contr:
CAL _ 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~EQU/REMENTS ARE FOR YOUR PERSONAL HEALTH .t SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
3. Yellow
(Please tv'\?e or Print and sign at bottom)
ADDRESS
37/7 If :y,.:/ I'Gfrr
Nt..J
LEGAL DESCRIPTION (office use only)
LOT hBLOCK ;J.... ADDITION If t'9~ /
-V
OWNER
(Name)
(Address)
File
City
Applicant
I PERMIT NO. 03 - 04-/4-+
(' rf'S T
Date Rec'd
<<f-f--tt3
I zor;e~ (offic,use)
PID .;J.:F- ]P6 .. 0,;1..0 - 0
(Phone)
BUILDER , I
(Name) tJC>Nf/7?tTAdv 1--10/7"1 f>J'
(Contact Name) Ga r-....
,
(Address) Ip, ~ jJ/It2..&'" br-/~/ S(-t I'T/' ",l04
TYPE OF WORK
~ Construction
OLower Level Finish
o Misc.
(Phone) ?F/- "lot.. 'YYd /J
(Phone) t,/:J.-367'- 7~J2.
C~ '1/'/\/ /17# 3__5).:2;J..
V
ODeck
DPorch
ORe-Roofing
DAlteration
o Fireplace
OAddition
ORe-Siding
DUtility Connection
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 ~property tozerform .:Z::
X LJ a~ / YS-O"
,/' 0ignature Contfactor's License No. Date
I Permit Valuation
I Permit Fee
1 Plan Check Fee
I State Surcharge
1 Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
"11./1. oeo. DO
$ ).ja.~. 35
$ '7'~/R
t-;Ii ~ D
1 $
1 $
1 $
1 $
1 $
1 $
-
lOt) . fJ f)
/OO,f){)
.~5'. 5;'{)
'10. tuJ
~
This Application Becomes Your Building Permit When Approved
~
~
Building Official
+I~~~
Date
P
1$
1$
1 $
1 $
1 $
1 $
1 $
1 $5; f!)34-. 53
-g~f-I ,e-'l - ,..., f'/
I Paid .Q 0 U '7 . v .....J I Receipt No.t.l1!HJ / 0
I Date [f-- ;::;)<-(- ~ Bv ~
1 Park Support Fee
1 SAC
I WaterMeter(,iSize5IV; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
1 TOTAL DUE
# -.
#
#
#
--
/2.75'. 0 0
z,.Sc. 0 ()
~-:::;.OO
, 2,..OD . O"tl
700.0 ()
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This documer::
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must br
~ ?~ .y~r/t;:J ~
. Planning Director
~
~
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
White - Building
Canary - Enqineering
<:'1'ink - Pla~
Thr Crnl" of lh~ L.kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT.
APPLICATION RECEIVED.
i; ICC..7 '/'/./ I/'/l /
/. l/ {__, (, / 'v'"
L /)
G.f .-' ./' {j .~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
'-oJ"} / 7 /::// (jl / (' /-/) J=S
Accepted
Accepted With Corrections
/
Denied
Reviewed By:
~
~
917.~p
Date: 0 r?!o '$
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."
~~
~__R.lilrli~
Canary . Engineering
Pink . Planning
Tht'(-..nlt'fnfthfl.abCoUnll)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T
NAME OF APPLICANT
w e:;v J /l1 /7 /l/~
4---9-03
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3CJ /7 /2664 L ~,q55
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~
~
:;Z ~ f) J'-I
Date:
~1/JY/03
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."
_._...,~".-,-",~.....~,~:~..,..~..'..,(t..J" ,.,..;;......"'f.~.. .
'-~'~ ,.,.... ........'. ....
-V"""'lt'~'" '......i-'~...,,~--'}"-''''.'.'r'''.,'~~."'''''~ .".._+~".,.,~.,W ,,"',
\:
\
I White - Building
c: .......H..oIn. u a'I~;lliI;o!....,~-;;:j>
, Pink - fliiriiifiig
Th'('lfnl.rnflhlf I._beounlry
mm..DING PERMIT APPLICATION DEPARTMENT CHeCKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
We:JV .J/V; /1 N/l/'
4---9-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3tf 17 /2156;::1 c ;//755
Accepted
x
Accepted With Corrections
Denied
Reviewed By: /J'J4 f3
Comments: See:. /J1e, I 'n r,' It'
Date: ~- ;;{ I-oj
"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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CITY OF PRIOR LAKE
S'E:\f::R 1>1ID WATER ?~?MIT
NO. '3 -Ljllj
NOTE:
Sewer and Water
contractors must.
be re~is~ered
;;it.h the City,
APPLICANT: ~\ ~~
ADOR:::SS: 3<jl~b/~e\~~c::. f'\l.W. OAT::::
S ::~'\~':":: . u'Ifd~-..:-=~...~:~___~n.~.:.=._:r;.
,,--
PHONE :6SJ-'j:9-~J S6:~
'1/~.3J f) 3
-:~':I',lf7""'" :!:
~ ---.--
~=LL IN TEE BL~~~S
Size of wate~ se~vice
of ~at.er serlice
/
'30
fe'2t'.
1.
2.
Es~i~2~2d lenq~h
4.
~ype 0: se~er pipe.
A3S
ii"lc:.(es), ~
from st.=~ct.ure ~/V\
PVC 'K. Cast Iron
1 ine 3D
fest.
J .
Lccation of any coup1inss
6.
C::!..e2n
cut
(if
requirec.) ,
loca":.~d
fee~ ~ fa
a.t ~feet
f::-o,"
~5~i~a~ad leng~h
of
sell'f'e~
s':.=....:.C'~tl.=-e .
============~=============:=~=====================================
'T'\-':""
_.._..:l
applicat.ion
becomes ~ou= per>r\:' t ....;~en 2p~'!:'oVec._
BY
DATE:
=~~~~~~=====~~==========:=~====================;~=================
F~:=:S:
s
s
S
J5.00
.50
35.50
Sewer and wa~e" line connec~ion pe"mit.
Surcharge
TOT.>.L
* :S8 f~= ei~~e~ se~e~ c= wate~ i~civid~a:ly ~s $20.00 plus
S .50 s'..l~c~ar:;e.
*
S~~e= and w2te= pe~its issuec for new c~ns~r~ction must be
recorded on t~e bu~ldii"lS pe~i~ card a~ the t~~ ~issua~ce
-:.::> i:-\~u"e t:-,a-:. no c.u;ol~cate se'.er and ....at@.(l~ t;;.: are
l.ssuec.. ~1\tG' ~~1Jf
a;..:-::: ??:!J .'.'10vN'r ?'.:::O .o~~
-~ ~;i!i:[~ ~tl'''-''
ill APR 2 8 Z003 ~
:;1.. '.:.-._~~:r
By_
?,~:::==:?'!' :!
\ r ~ .
.,.,./K:-,...
. 0f}~' .-
I ,. .~::
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9 d vELES0098vON.WEl'lS/OSEl EO HI' iG3,\\)
L9EO-GSv-lS9 'JNIlV3H ~ 'JN18WfI1d 13ZN3,\\ WOH.l
10/24/01 WED 11:22 FAX 6124474245
CITY OF PRIOR LAKE
Il!I
Date Ree'
CITY OF PRIOR LAKE PLUMBING PERMIT
111_ 'ii,
J. Cold c~
J ytlll;Jrw ....Pf'laPIl
I PERMIT NO'3 - U/4
f?lcuc ~ orDrVit ILDdsim ,11 bottom)
ADDRESS ...., \) .\ ~ t-..\\ '\
3'11 ( \o<.~Q..\. ~~ \'lYV.
ZONING (oftl"...)
LEGAL DESCRIPTION Colli", .It only) ~ !:\--
LOT ~BLOCK R ADDITION ~ CJc:e..b
~~~R t~\etf\Sm~\'\ ~t)me.9:> (phone) ~)-'iDb-WDO
(Address) 12>~S-"f>[o,:L~~. ~\~~t) ~Y\ .\Mf\, ~~J;;Z~
- ,
. ~;;~~ANT LJ~el ~\'D~ ~ W\~~~. (Phone) rlSl-fs)~/SbS
(Addz....) 17/D 'A~b.~~ '<--d. ~""-~, $"/:2/
(A~) --- (City) (Zip Codc:)
(Contact Person) \T~ \-\.~?A~ ~ - (phone) t~/~-15bS:-
AfPLlCANTSIGNATUKE ~. DATE 1-P-3/C3
~LICANT PLEASE COMPLETE BELOW
Type Df Fixtllre Quantity
Bath Tub with or wjthoU1 5how~
DishwlI5her
Floor DnIio
Lavatory (Bathroom Sink)
Laundry Tray (I or 2 compllltlllent sInk
Shower Stllll
Sink,
Bar Sink
W&lc;r ClosCt (Toilet)
Qusatity
,;L.
J
I
~
,
I
I
I
~
Pro
Type afFlxtan
I
RouRh-ins
Water Heater
Water Softner
Stand Pipe (Washing Mlchine)
I S~ap Ejector
I BlI(;kf!ow A,sell\bly
Blcldlow Assembly Test
Lewn Sprinkler
Other
I
FEE SCHOIULE
Indu"".!. Commercl.1 ct. Multi-fillTlIly I'f. of job co:lt with. SJ9.S0 minimum Residenllal. New One 8< Two-FHrnily $99.50
RMoidenlinl, Addition.. Ii. AlteAtlonr;, S3~.SO
(omct U" Only)
Estimated Cost S
Buildillj; Permit ,.
eu,~+() "'--
.sO ~GA:'1f
. ~-9~1}-
PLUMBING PERMIT FEE S
STATE SURCHARGE S
TOTAL PERMIT FEE S
ThiJ Applicarion BecDmes Yout Buildinc Permit Wholl Appro~od _~ Receipt No.
1~[E ~ u w ~ ~ By fA
B.lld1nc Offi,ial I).., J~ I (J1'
-4h "' II" I" /1ln". _~!~9~lIlLonl I V
. OU," "otICe III' a In.pee .... ,'-I .., . .... \ n ...~~.5
S d !7ELES0098!70N/WEllS/OSEl EO H!7 IQ3AI) 1~~HSHS9 0NIIV3H:' 9N18Nfl1d 13ZN3M NOBd
CONTINUE FROM PREVIOUS PRGE 001 s"\ If) 3 -[I (4-
APPLICANT: ~~ & ti-~_ PHONE: ~~-Pl?'(-<lI01
. .
ADDRESS: 'I. <;j~DATE: ~-S-~d3
SIGNATURE:~ Q..... ~~ .BLOG. PERMIT t
SITE ADDRE~ 39/ 7 ~P~(J_PID'
FILL IN THE BLANKS
1. Estimated length of water service l~ feet.
N .
2. Size of water service
/
inch(es).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ASS PVC K Cast Iron
5. Estimated length of sewer line 0-" feet.
6. Clean out (if required), located at
structure.
feet
from
==~====~=__=:I:I::a-======::.____~._.______________,====_____________====
This application becomes your permit when approved.
BY
DATE:
===-l:I:,_=======r=====___~________~_____"~--=================:============
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
., Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge. --
.,
RECEIPT # . ",~'___
Sewer and water pax-its issued for new construction must be
reCOrd~~'1l ~11'ttt' ~ ag pex-it card. at the time of iSll.uance
~o ins I ~:t ~q\j [gl"j) .icate sewer and water permitt'AI8lWITH
~ssued I BUILDING PERMIT
DATE PAID ~ MAY 1 3 2003 J AMOUNT PAID
/r
VV
REC'D BY
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 I FAX (612) 447-4245
Aft 1:.......1 f\nnnrfllft.tv R""n1",,~r
MAY-29-2003 07:16 PM STAR PLUMBING & EXC.
952 BB4 746B
P.09
_....
........ . "-1CWf
.... . ern
CI'l'Y OF PRIOR LA.KE
SEWER AND WATER PERMIT
2/,/'
S.W. No. J~ '-;1'1 t./
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: 3~ ~ tr-ta.J_
ADDRESS:.&li~\j.6AJ. ~DATE;
SIGNATURE:~ BLDG.
SITE ADDRE~ :J'j I 7 f2rR P ~,() PID'
FILL IN THE BLANKS
e,,""..n..'E:
5e)~- J1flCf- ~/'V?
.s--s-~q.3
~L....'\&.....T I
1. Estimated length of water service
Ii
,57J
feet.
2. Size of water service
/
lnch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC X Cast Iron_
5. Estimated length of sewer line 00 feet.
6. Clean out (if required), located at
structure.
feet
from
=-=-=--=-~=~~=-====~======------~;====~=========================
This application becomes your permit when approved.
BY
DATE:
======-~======--=====
=_....====='=c==-===. --.- -.-==================
FEES:
$
$
$
35.00
.50
35.50
Sewer and
surcharge
TOTAL
water line connection permit.
individually is $20.olu~"t~
~p~
Sewer and water perwits issued for new construction aust be ~4f".
recorded on the buildi~ perait card at the time of issuance
to insure that no dupl~cate sewer and water permits
DATEi::::. AMOUNT PAID~~""''''\i '::n ~ ~
RECEIPT /I REC'D BY \1I~ ,,'L 1\J1l~
"
Fee for either sewer or water
$ .50 surcharge.
"
\.,~
16200 Eagle Creek Av. S.E., ~or Lake, Minnesota 55372/ Ph. (612) 447-423o-TF~~612) 447-4245~
An t:......1 t'\ro~...ih' 1=<'"'...T...v......
06/21/03 09:16 FAX 6518919955
WE~ZEL HEATING & AC
141003
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITIONINGIFIREPLACE'PERMlT _un - .
I.Pinc
1.. O."..n
'1, Vello...
~:~ I PERMIT NO. L J J L/
Appllw.c J - Vf (
(Pl~e Me or Mint:u1d rim at bottOm 1
I ~DRESS
:- 99'/7 "&-.--1/
I'
LEGAL DESCRIPTION (ollie. use only)
/695
nl.-U
ZONING (office lIS') I
LOT
BLOCK
ADDITION
Pro
OWNER J
(Name) /~ p/\l5./7?-J/l/.4
~~
(phone)
(Address)
APPLICANT /./ /
(Name)_/-4P.r/~ . ~-/7/-/";
(Address) -c::f'/-?/ ?k/ ~b),(/
(Addm.) /
/IN' dj,e
I' ' .
APPLICANT SIGNATURE ~- ./ ~I
AA
(phone) hC::;! ff4~9f?9F
~rV-.f
(Qdy)
.:Zf5JZ-Z-
(Zip Code)
(Phone)
DATE
/--,b!
/
(Contact Person)
APPLICANT PLEASE COMPLETE BELOW
..J3ffEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL~AI.o'/,( A"?') 6\"?70 FUEL Ak;.,t
FLUE SlZE".2- ~:'8!c.... RETURN OPENr.-1GS &, INPUT ~ax:> OUTPUT b;I~
If/e c;';pM;/ TYPE OF SYSTEM HEATING OR POWER PLANT .
I OWarm Air PlantS 0 Stearn PLEASE NOTE:
4>/-/HO OGnovity 0 Hot WllU:' Air Conditioner Units
/M~30 ~M.chanical 0 Radiation Cannot Encroach into
.J<31'ir Conditioning 0 Special Devices Required Side Yard
OVent. SYStem 0 Other Devices Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi -Family
FEE SCHEDULE
1 % of job cost Residential. Gas Fireplace
$39.50 minimum
$99.50 Residenti:ll, Additions & Altr:r:Uions
$64.50 Residential, AC Only
$39.50
Re.sidential, Heating &. Ale (New Construction)
RcsidonriaJ. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
PAID WITH
BUILDING PERMIT
Building Orfici2.1
~~ ~ ~ D'~' ~]\
\ nj 111t-.L2_5.)nnl .
u~pald -'~ Receipt No.
IB~Date 'By r
Date: L r
24 hour notice for.1I i.spections (952) 447-9850. fn.< (952).~7~~~5" . . -.. - " _.- ~ " ...
HEATING PER.M1T FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(ornce U.e Only)
This Application Becomes Your Building Permit When Approved
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~;w E~i~", I PERMIT NO. 3 ---L/ { t..(
(Please tv]1< or print and si"" ar bottom)
ADDRESS
ZONING (office u,,)
3917 REGAL PASS
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name WENSMANN ROMPS
(Phone)
(Address)
APPLICANT
(Name) ALLTED FIRESIDE nijA FIRESIDE HEARTH &. HOME
(Phone)
1\';1-1\33-251\1
(Address)
7.700 NORTH F AIRVlEW AVENUE
(Address)
ROSEVILLE
(City)
';5113_
(Zip Code)
(Contact Person)
BRENDA RUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
R/7/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
lNPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
D Special Devices
o Other Devices
OUTPUT
FLUE SIZE
RETURN OPENlNGS
TYPE OF SYSTEM
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
. FIREPLACE MAKE AND MODEL
HEATN GLO 6000TR-OAK & SL-150TR
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEA TlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID WITH
BUILDING PERMIT
.5Q
(Office Use Only) I -'.-1
Tbis Application Becomes Your Building Permit Wben Approved ',:~ ~ :~i\f' ~~ ~ ~.; l~ i r: 1 ' Receipt No.
'"--, u.~,~~.,"::._....,)!:.~:.:"::. ~ n,
PRIOR LAKE
INSPECTION RECORD
IMSS
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDIN
PERMIT NO. DATE SUED ~. ~ ~
CONTRACTOR PHONE~51~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING U~ pp P P; 8-: 1/
HEATING (if reqUired) JI/Jr'/
FIREPLACE UOQif O"\'-I/LfJW{1' JfV{1'f-lq dJU
-.
GAS LINE AIR TEST '{ M (
COVER NO WORK UNTIL ABovti HAS BEEN SIGNED
I I
FINALS
5-(; -CI)
g-It.f-03
'if - I '1-rF">
~-(q-iJ)
'1s - ('1.-rf>
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
fib
#' >':'-;Q
t'f. ~-Z1J
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
L-J -75-0'2,
-J
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