HomeMy WebLinkAboutBuilding Permit 03-0407
(llrrfifiratr lIf OOrtupanrl!
CITY OF PRIOR LAKE
~rpndmrnf lIf ~uilMug JlnsprtfiIlu
~.Final Permitted 0 Conditional C.O. Expires
This Cert(ficate 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:
Occupancy Type
R3
Type Construction
SINGLE FA:>!ILY
VN
Fire Zone
Bldg. Permit No.
N/A
Zoning District
03-0407
R1
Use Classification
Legal Descciption L3, B2, JEFFERS SOUTH
Contractor's Name & Address
Site Address 15159 JEFFERS PASS
COLLEGE CITY HOMES, 7920 LAKEVILLE BLVD., LAKEVILLE 55044
Owner of BuildiD'.?
ROBERT D. HUTCHINS vii
BujldiolJ_Official "'-11
C './ J
.J
City Planner
DON RYE
Date:
Date:
"j~",...:.........,~
~",,~-'
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS /5'1 54 lJl1 ' -$
OWNER CONTR.
PHONE NO. PERMIT NO.
IJ FOOTING
IJ FOUNDATION
IJ FRAMING
fl, INSULATION
~FINAL
IJ SITE INSPECTION
IJ PLUMBING RI
IJ MECH RI
IJ WATER HOOKUP
IJ SEWER HOOKUP
IJ PLUMBING FINAL
IJ MECH FINAL
COMMENTS:
DATE TIME
cr- 2t, 'C;,
QAJ~
V
3-({o7
IJ EXIGRADIFILLING
o COMPLAINT
IJ FIREPLACE RI
o FIREPLACE FINAL
IJ GAS LINE AIR TST
IJ
I "',
~(>r~l. ~f/-V
~ORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
IJ CORRbE NORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: -10 OWner/Contr:
CAL c..11850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~ .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
"""""
--,-,,-,,--'-~----"'-"'-'---"--- -----~.~,._..__._,._.- -----,,".'.- ,,--... '---"-~""'---'-'--"---"-'--'--- -
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7/iSJO~
PHONE NO.
JS/r;<1 J"mf\ Pc.~
Co//(Cf ,-,-/-t Hf)/'1'1d
PERMIT NO. (') 1 - '-101
j I
~EXI~LLlNG
o CO~NT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
CONTR.
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.4 FINAL
I::lslTE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
G./f., f3c f. <9/L
I~WORK 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/
""'"'"
DATE nME
CITY OF PRIOR LAKE 8-2lJ'~ '/=30
INSPECTION NOTICE SCHEDULED
/
ADDRESS ISlstj ...\J~ tV ~?"'J
OWNER CONTR.
PHONE NO. PERMIT NO. "< -4DI
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE R1
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMEN"{S:
L nl)..vjlJ:~ +'.~J-'~-, l"""f"
.2. <;'- ,1.d- 'T ~
----
;'1--,9
-1-.....
r'
Q::...t - o~
~k l.a..:lc..Q.A.
, .
~..n..l- - ~,{\~~
o WORK SATISFACTORY, PROCEED
o CORRECT N AND PROCEED
~ORRE W\L FOR REINSPECTION BEFORE COVERING
Inspector: I / / Owner/Conlr:
FOil. T\-I", NF-XT IN!;PECTlON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"''''''"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED .9 ' 8 ,c:;n
ADDRESS 15 \ S',
~ 'f'.....r
CONTR.
OWNER
PHONE NO.
PERMIT NO.
? --- 467
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
ji.,PLUMBING FINAL
~MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
I. fL""",,-,- ee,,(Y 0 ~ ,
{'
} _ (\.slJ ~ r'M &...
~. l~ tll-P Mo.; v\. l[\.Q~M
II T-~a.:.
4'{'{ - Z) (0
,.,,}- t- ('rru....r-
d. '--:::{pro N S,~.o ~~
Z;, WI. \J~ Cc..1A......A b ~D, ~ ~ ..-y",
~)f t..~r c::.;/( ('l"lr(C~
I.
o WORK SATISFACTORY, PROCEED
~CORRE?jT TION AND PROCEED
o CORRE W rJ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ;. 1/ Owner/Contr:
I -)
CAL,. 47-950 FdR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~~ENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
U<SNO"
"" . -., ._~._~._------_._--~~----.. "~----'.'----_._"'--~---'-
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
3-;;'1-63
I PERMIT NO. ()3 -0407 I
(Please ~ or print and siJro at bottom)
ADDRESS
\L;;. '6C\ --.J bFFe-as ~SS
ZONING (office use)
121
LEGAL DESCRIPTION (office use only)
LOT .~ BLOCK 2 ADDITION ~eFF-ea-S SOLd' \-4
PID;5/ 5"- 3 '15- 01'7-!)
OWNER
(Name)
(Phone)
(Address)
BUILDER It
(Name):c. 6\\7'"''1.... (':"'i~ +-\om-r<;.
(Contact Name) Edt:::I, ~ q;;:;. VY'"\r>+ -a.
(Address) --r.nW l \
-r'-"I .G V_ I'C'\ I 1'1 I E.. :p., L \) C
L B1L.~lJ) II...
)
(Phone) C152. l/.~()
(Phone) U, 12. lo~s..::s 2-DCI
\\^ (\ ~604L/
TYPE OF WORK
)t.New Construction
DLower Level Finish
ODeck
DPorch
ORe-Roofing
ORe-Siding
o Misc.
o Fireplace DAddition DAlteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ .;2 ~3 J 50Q ---
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
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 aware th~ilding official can revoke this permit for just cause. Fnrthermore. I hereby agree that the city official or a designee may
;teru ro toperfo ( ~_dinSpecti;: . I7-DC1 3/2.9- lIE
Signatur~ ~ Contractor's License No. Date'
f1'2-fpL{,ooo.ob I Park Support Fee # 1 $
I q I ~. I s- -I I SAC # $
---
/7...42.9:0 -I I Water Meter ~ize5/~I"; $
I ~Z. 0 () . 1 I Pressure Reducer $
1 1 City SAC and WAC # $
I I Water Tower Fee # $
I 1 Builder's Deposit $
1 lather $
1 1 TOTAL DUE ~ 4--6-D3 $fLt:;SZ. 55'
. /"/~-a 'l ---- i.-.::;)
I Paid 7P ,1.0 ;7d. _J J I Receipt No. L/qV:J-/
I Date 4 - 10'- ";;\ By r"
--v-----
I Permit Valuation
I Permit Fee
1 Plan Check Fee
I State Surcharge
1 Penalty
Plumbing Permit Fee
Mechanical Permit Fee
$
$
$
$
$
$
$
$
IOa.oo
100.00
35'.50
Lio, (JiJ
127S'.oc
Z 50.0<1
L/~.(J 0
1200.00
7ClO.oo
.sael, 00
,/
This Application Becomes Your Building Permit When Approved
~1-~
Building Official
...1/2/4 7
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
~ =I~~ d/71o:r RaJ tiLl ~.-h-~
Planning Director ----If--L.' Date Special C:nd~n;' if-:;;'~
24 hour notice for all inspections (952) 447-9850. fax (952) 447,4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
..
,.
Job Address /515'0/ ~{f~o
Heating Contractor _k....,., ~
7-1 ~ c /"
'f5'~f--o ~
~,
Name of Tester
Date
Percent 02
Percent CO
Percent C02
70.
tJ?
Stack Temp.
Combustion air is adequately supplied p/
UMC Sec. 606 " /
^'
$:r>
/()~~r .
Input
',<
Thl' ("l'nll'r of thl' I..kl' ('ounlr)'
White - Building
Canary . Engineering
Cl'ink . Planninv
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
J
"7- -j
,. ..
I,
I
! I
NAME OF APPLICANT
APPLICATION RECEIVED
) ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
',. ., 'I
/ '<". '.. .-
/.......... .....-
/.
/
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
fil'
/I,e. ~
,ad~.
.. "
"::/-'.. ,; f-.>
{J~
Date: 5f7./0 ~
~L o,A ,'j}.
Comments:
~ Jd~
() -
"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"nne - tlullding.::>
Canary . I:ngmeering
Pink - Planning
The' ('C'nl... of Ih..I.8kf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(b;/I.eJle. a/fL
. I
3- d-7-3
~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which Yi'roposed at: /2..,
/5/5"9 (ij~ ~
7 -U () .
Accepted
Accepted With Corrections
----
Denied
Reviewed By:
~ -=I~ Date: ~/7/0'3
r(~.1- aU ~ - a-...:1;;. K~
J
~~ ~ ("~n/f
.)~
Comments:
(Jh__._
"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
White - Buildina
~arv - Enqineer~
Pink - Planning
The- Crn,pr of ,.... I..... c.'ounlry
BUilDING PERM.lLAPPUCATION DEPARTMENT CHECKl ~
NAME OF APPLICANT
/!c:?\ /L /, r
\....:~>.~..'~; , "_ '-1 '~
APPLICATION RECEIVED
,
3 .~ -- --.,
\. --d. l -,::)
. J
.iL~IT I,
I
11.,.-,,<;.. ..' /
! '.f C' / r ...... ......--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which i~_proposed at:
/.L- I.~-- q / -' / l ~" /<;",; . ~ --d---
./ _: / ....../ / / ,/;/ A'--/t-"~~- ~:>G.. '---~
~. /. -....
7 ;~/ 'oj
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
1WJ8
Date:
Lj- 3-0 '5
Comments: . See Reverse Side for Additional Information!
~p.p. A ttachments: I) Grading Plan. 2) Erosion Control MeasllTP~
"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."
APril. ~003 iO:~4AM
GEN= RVAN PLUMBING AND HEATING
Na.0138 P;4
~~ PRIO",
€ 2J~<~
:'".. '-. ",
:....".....,.,.".\.."
*W~~~~;~I~~EaO~~
,
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
,
1 "'u, ,'. I PE'RMl'T' NO L' 1
' Y."ow Ci,y. ~. 3 - (0
3 G"JJ ApphQllt
(Please.fY.EC: orpnn[ and S:Uol athouom)
ADDRESS
'01~q ~je.ffeRS Pass
ZONlNG (oiU,,",,)
PID
OWNER r"" In
(Name) ,nq,L
c;9)'-/!L
(ZlP c~).. ..-.
(Address)
~:~~ANTGfJl7~- ,~ (Phone) ItJt)FL/d-3- IfllLf
(Address) fL!7'1z:J S. ~I Tf!l.. I<JJfrefYlCJV7,vlf, rnVl ~{)~g
(Addle,,) ~. (City) (ZiP,er)
(Contact Person) J'(/Ue..C.\ D L..U . (phone) (Pc;;) -L.(';,).-3- / /<fL/
"LICANT SIGN:TURE . r A.A.1..J.11 A -1u R ^--Cl DATE t.j - ( ?--- O~
-.- --.--- -.--...---
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location 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 Cast Iron
FEE SCHEDULE
ReSldentlal sewer and water Ime connectlOn $3550 Industrial, Com'l & Mult1,famlly 1% of job cost wIth a $39.50 mlD)IDum
Sewer connection only $17.50 Water connection only $1750
Estlll1ated Cost $
Building Permit # _
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID WITH
BUILDING PERMIT
(Olli" u... Only)
BUildiDg Oftldal
I Receipt No.
D... Imt~ @ ~ ~ ill lHf?] I'
24 no.' notice for allln.pectlon. (952) 447.9! ~f.:rAfl'R) fI''8''ZZ1J03 W'
Paid
This Application Becomes Your Building Permit When Approved
'..
IBy
APrI7. :003 10:4AI\1
GENZ RVAN PLUMBING AND HEATING
No.OI38 P 34
Date Rec'd
elT"? OF PRlOR LAKE PLUMBING PERl\1IT
; ~:,: ~:~ I PERi\UT NO. -! - / 'O/{ I
J \'el1ow Al'pJl-=:ll J '-7 J
(Pl~lSe tYEe OJ DJinr. itnd. sitm at bottIJm)
I ADDRESS
15791 ( Ifffef;2.i
;LJas s
,
I ZONING (oflk,",e) I
LEGAL DESCRIPTION (office use only) . . r
w3 BLOCE:~ ADDITION (fflffele..\ cJ7J~
OWNE~ r7 1/;; ~'-A
(Name) {I./ { 'A.; ";,(J
(Address) -:;q I Llkl If, td. .'
AF. PLICANT r: ~I 0.. _~t/JI
(Name1 If( JL) vI'- ~I
(Address) Fin)' ,r,; ~,
(Address) r_, I (City) (Zip Code)
(Contact Person) (!f/JI(/S- _ 17/f:1-.Lr (Phone) L~s7- <B'3- /L41!
~!//1
PID
Inc. (phone) q9-L/bc;--bcfOll
~VI//6: I17n~q
(Phone) h9 -t(,93 -I/!C/-
Mff!JJJA.llr In//) SYJhJY
APPLICANT SIGNATURE
DATE _ 4/ 7~
Quantity
;;,I.
I
I
J.-/
i
I
I
';Z,
APPLlCANT PLEASE COMPLETE BELOW
I Type of Fixture I Quantity
I Bath Tub with or without shower 1:3
I Dishwasher I
Floor Drain i:?-I-
I Lavatory (Bathroom Sink) I
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fb:tllre
Rough' ins
Water Heater
Water Softner
I Stand pipe (Wasbing Machine)
I Sewage Ejector
. Backflow Assembly
Backflow Assembly Test
LaW!) Sprinkler
Other
FEE SCRElHJLE
Industrlal, Commerctal & Muin~farrl.lly 1% of Job CO:<it w1th a $39:50 minimum Re$1dennal, New One: & Two-Family $99.50
ReSldentiaJ. Additions & Alterations $39 50
(O!ti.tc Use: Only)
Estunated Cost $
BUJ]dmg Penmt #
PL1J1...fBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PE:RMlT FEE $
PAID WITH
BUILDING PERMIT
50
BuiJdlng Official
I Paid I Receipt No
IP~ illJ ~ U ~ ~ t'1~y
D.te UJ 11
24 hour notice for all in'pections. (952) 447-\ M fI.H!82Jk-M~8'1 !J
This Application Becomes Your Building Permit When Approved
By
A r r . 17.
o~ PIU~
S~~
""')'NNE.~O"'''
2003 I o 25MI
GENZ RVAN PLUMBING AND HEATING
No 0138
P 44.
CITY OF PRIOR LAKE
e
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Ree'd
: ~.,:"", ~~ I PER1YIIT NO. -:z... - / '6 rJ
) Y~I(I"" ApplkAt\( r -/ ~. .
(Please ~ or priot and den at bottom)
I/D~SLl1 Jefff~s, ~S
ZONING (Offi"Ul')
I LEGAL DESCRIPTION (ornce we only)
LOT.~ BLOCKd-, APDlTION"Jeffe12f J?J~
PID
~~R rl-)~) ('jilJ I/!JJJALUJ]C. _ (phone) t?g-l/f#q~f1J1)
(Address) 1Q.JO Lctki-b II Ie, B/!Jcl/ Ui.hA/J./lf7/. Jnj/) $1JL/4
AP.(N;';;.f""'{j/I1'l- ~ . . ~ho~) ft?9-~~ Im-
(Address) /~.tJC; J _._. . 'f2f ,rd. / ~ t22.tJ ~ l'
(Addr"T_ (CIty) (Zip <iOdJl
(Contact Person) (tA1JfJ>..\f; -mj{f A (Phone) f?:-,74d.6-///!Q
APPLICANT SIGNATURE (J!~)~ 701 L/J __ DATE Lf~/7"-/):::<' .
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION 0 REPLACElylENT 0 ALTERATIONS
FURNACEMAKEANPMODEL (PJ/JnlJX Q~~~/L! -Iffn FUEL llfir: 614c.,
FLUE SIZE RETURN OPENINGS X' I INPUT J.i3J4J:JOO OUTPUT qo?/fJIJD.._
TYPE OF SYSTEM HEATING OR POWER PLANT
~ann Air Plants 0 Steam
DOnv;ly 0 Hot Water
o Mechamcal 0 RadIation
..ciIf.ir Conditionmg 0 Special DeVlceS
DVent System 0 Other Devices
PLEASE NOTE:
Air Condllloner Umts
Cannot Encroach into
Required Side Yard
Setbacks
fJREPLACE MAKE AND MODEL
IndustrIal, Commercial & Multi,f8!Tuly
FEE SCHEDULE
1% of Job cost Residential, Gas Firepl.!.ce
$.19 50 mmimum
$99 50 Res1dentlal, Additions & Alterat10ns
$6450 Residential, AC Only
$39 50
Re.::;tdential, Heatmg & NC (New Construction)
Re;jdentiaJ, Heating Only (New Construcrion)
$3950
$39.50
EStlmated Cost $
Buddmg Penni! #
HEATING PERMIT FEE
5T A IE SURCHARGE
TOTAL PERJ.\ollT FEE
$
$
$
.50
PAID WITH
~LJ1LDlNG PERMIT
(Oflic~ U,c Only)
Building Oftil:.ia..1
_ ...Eail' -.: Receipt No
':lrsli0rc:nm~ "I
~ G [; a-~.c B
. I Y
D~tt I 1
At't( i II lOU.l
24 bour nollce for .il i"'pectlon! (9S2) 447. l; ,fax (952) 447-4245 lc!
.is Application Be.omes Your Building Permit When Approved
Bv_
Date Rec'd
CITY OF' PRIOR LAKE
SEWER AND WATER PERMIT
(Plcu. ra! DrDnnl~ aCboaoaI) ",',\,L
I ADDRESS
! lsl~-1 ~ D~
vv
I LEGAL DESCIUY110N (ollle<.1I ...y)
l LOT!J BLOCK:J ADDITlO:'-l ~~ so,~
: OWNEIl
I (Nome)_
I (Addres,)
I
(' ~ c,p C::c., ~
fJ '
tCrU> L~ f3.~u""-
(Ad4n"l
I APPLlCANJ:... ~
I (Nom.\ '~J.~ e- ~/ r-~'-.J:;;:;:...
v
i (Addle>s) _ ~ 3 75> L.0 70+-1-, ~+r~
(Adillw)
(Conta" Pellon) S~d......,. S, rn"r----=:>
~PLlCANTSIONATURE ~-(/. A~
" -
: ~:. ~~ I PERMIT NO'3- L /0/7 I
J~~ ~~ 7< , !
I ZONINO(;""::;;-l
PlD
(PnOlle)
L~-t! w; (/ C
(CI",)
9~)...-Y~9'-<';;9oo
5SVY(/
(Lo C044)
(phon.) 5U7-7Ylf -S-~<)c. S-
L i~(1.$ d c:.J.o ss-o Vb
(CIry) (lip Code)
(phone) So7-7Y~- ~S"'"
D"TP '-7- rs-"'-o.:s
APPLICANT PLEASE COMPLETE BELOW
Size ofWUer service L inches.
Location of any coupling, from strUcture ~ feel,
Type of ~wer pipe:. 0 ABC 01'VC 0 Cut Iron
Estima.ted len~th of ICwcr line ..::s:Qfeet.
Clean out Cifrequired) located at --feel from structure,
I -
Rddentiol lOwer lIld wlt.r lin. cOMeotlon
Se"er conn.crion only
FEE SCHEDULE
SJ~.50 Indulll'ill, Com'l '" Multi.family 10/. of job cost willi, ~J9.l0 mil1lm\lIl1
S11.S0 W.lI:r coooectlon only $17.'0
Building rennit N. ..-'
'~o
1:1/ 1'1 ~~/D
~/.vG 11.11"""
. PSf:/A,f/"1'-
rbll I\ppllcotio" a..o.... Your Build In, Permit wn.n ApproHd I. L I .~e.,.~t No.
. u:" I~'~]r"'"
Z4 ho., notl<o ror 11I1..poclloftl (95Z)'1 '9150prn (915~ Uf-'ll4S .
A R.l Ii 2003
E.timlted CoSt S
SEWER AND WATER PERMIT PEE
ST A TB SURCHARGE
TOTAL PERMtf FEI
tOmetl'"O..I:t)
';
.wllll..om..1
W 3911d
:)X3 d39GIIEl
S
$
S
~
i/
By
.9..vvLLB.
,
.v:ET EBB~/.T/vB
s@:
.'IW'NES01.'"
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(P.t.OJ
(Please .!VPc:. or Drint and si2I1 at bottom)
ADDRESS
; :i,~~" ~:~ I PERMIT NO. 0'3- /JAJJ11
3. Yellow Apphcant ~V
15 i -5 q
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LEGAL DESCRIPTION (office use only)
LOT 3~ BLOCK ;Z ADDITION
OWNER
(Name)
~o lle~e... {l,l'i' ~
J.L (J 1\0\.0 S
, .
(Phone)
(Address)
APPLICANT L:) I
(Name) OVv\e\l\.:')viL\ll ~OIJ'"
12H ~ ~
I ZONING (ollk,",,)
PID
'i,- HfUlf'lrH''''~ (Phone) Q '>'2.- 'X'g~. 1174
W 15lANU\5/Jll\(l
(City)
(Address)
/...l2
(Address)
?tA-IT-e~V\
Ak~
(Contact Person) -----1Jlp-f?/A/I.
APPLICANT SIGNATURE
,l) ~;o, ~'7
(zIp Codf:) .
~ (Phone) :\14W1t;:
U~ DATE
APPLICANT PLEASE COMPLETE BELOW
gJ'NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
FIREPLACE MAKE AND MODEL M~ ,esli c.. ,3tdJ
" --
'3 SIJ~
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 Only
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit # ().3 -0 4V7
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
PAID WITH
8WoING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
~
I D% . h. 03
Building Official
Date
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
--
I~
IBY ~
U
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS _ PA.5~
NATURE OF WORK fitek.) ""M~ ~,:rlb~
USE OF BUILDING ''S.F: 1). , .
PERMIT NO. ()5'-04-fJ..1 DATE ISSUED ~ W 3
CONTRACTOR PH6NEgl-falS' · 3'ZC,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMI:NT OF
BUILDING AND INSPECTION
FOOTING . L _~
I FOUNDATION (Prior to Backfill) I.n. I 0~~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I 1M
I iYb
I f$ '-/0
I
I
I
I
I tPLJ
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING l/\~d LJ. G - ~ -5113
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
DATE
S;&,~
G '-'0
tYlS
CPI5
I
G--5</'
I~~~
I
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~UO/ /'././lrllltF/LS1'lJN6 I
., FINALS
I AIif 7../5: b3
{If
GRADING (Prior to Sodding)
BUILDING ~ h. .f I-l-~
ELECTRICAL . ./
PLUMBING
HEATING
DO NOT OCCUpy
Cl-~
~ v:'6
I Y
UNTIL ABOVE HAS
NOTICE
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