HomeMy WebLinkAboutBuilding Permit 03-0147
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS ~~;('7
R.os~
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIllE
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIRE~~CE FINAL
o G~Z:rAIR TST
P\;
/
40RK SATISFACTORY, PROCEED
/~ ~ORRECT ACTION AND PROCEED
o CORR0~CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ...L- Owner/Contr:
CALL 447 8 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD}JJUJREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I_on
.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~9
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.;a"'fINAL
o SITE INSPECTION
SCHEDULED
DATE TillE
1-1/-0,
~~~ ~ I
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
[] PLUMBING FINAL
~ECH FINAL
COMMENTS:
\. ~ A- 'T~cs.
-2. Ft~ V>-~- ~~
;, f>4!(l ~~ .Jvf. ~rc'
.s -1c.J7
I
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/'
1~
~v
-
~
,
'''~ fD-v ;
o WORK SATISFACTORY, PROCEED
....t:CORRECT A ON AND PROCEED
/ ~RRE WO LL FOR REINSPECTION BEFORE COVERING
Inspecto
Owner/Contr:
- 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI
I
DATE TIllE
CITY OF PRIOR LAKE ,"1.03
INSPECTION NOTICE SCHEDULED ']:O(j
ADDRESS J B'J C, RuV'. ~)l"T e.,~
OWNER CONTR.
PHONE NO. PERMIT NO. S - Illf"J
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL XPLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENT~
\, ~ ~~U}..l c; (] ___
~_. ~-~ ~~ ~
7. (l ~ '~r J,L{ Tl )
o ~K SATISFACTORY, PROCEED
~ ~~~~EC C ION AND PROCEED
[] CORR .CT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector
Owner/Contr:
50 FQR THE "'~XT ~~~~'S<!nON 24 HOURS IN ADVANCE.
UIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
.
1)/1 'tV r; L e.-
CITY OF PRIOR LAKE BUILDING PERMIT, /' I CL /. Date R~'d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
I. White File
2. Pink City
3 . Yellow Applicant
l~ s-fi3
PERMIT NO. 03.-0/4-7
(Please type or print and sign at bottom)
ADDRESS
3g~~
Ro..:::. be('-('')
R~clot"
j
~
t-.h.J
ZONING (office use)
Rl
LEGAL DESCRIPTION (office use only)
LOT \0 BLOCK ;2.. ADDITION S-e~('S
~th
PID ~5 - 39.5 -0.;24-Q
OWNER
(Name) WQ~~
~~~ J :J rtl' .
(Phone) i.s J) 'loG ,... "'lOG
(Address)
19-. q.c:;
pl~
Dl':'"
.5:u...' -Ie.
c=2ao
~cu"
{V\\J
--:>-5 I .;:L.:<
BUILDER
(Name)
(Contact Name)
(Address)
~
~l
c.~ av.l~r
%~
-~--~
(Phone)
(Phone) ~.:2.) 4'10 - 'to ~~ 7
TYPE OF WORK
"'J&New Construction
o Lower Level Finish
o Deck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
OAlteration
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) S
9t1 ~ Q:X)
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 perform needed inspections.
X Wef\~i\ ~~ \ .xV'C.
Signature ~ ~
~q~ d()(),(JO
$ , 9,13, 75 .
$ (P()O,~ .
$ 'Is,o 0
$
$
$
$
$
14se
Contractor's License No.
it 810.3
Date
Permit Valuation
Sewer & Water Permit Fee
/fJ{), 11(:)
/00,00
35. >#
~~, " #
#
$
$
$
$ ~~()O
$ /~O'dO
$ 7dO,/J()
$ /~IJO,OP
$
I U5. (}()
..:lSd,/)O
Park Support Fee
#
Permit Fee
SAC
#
State Surcharge
Water Meter ~e S/8"}";
Pressure Reducer -
Plan Check Fee
Penalty
Plumbing Permit Fee
-
City SAC and WAC
Water Tower Fee
#
Mechanical Permit Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
$6,6/4-. (dq
~_ '1~~
Building Official
/ / ~(JI():J
I Paid
I Date
-
~ !' /4- . U Gf
2//Y-a<
Ii
Receii( No.
By/ L-- '
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,
This Application Becomes Your Building Permit When Approved
?,JYdJ
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
~ Mf- /I~ ~-~-
Planning Director
!/3o/()J
I '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
.
to. _. .. '-:-
Main Fi~e
White - Buildinq
~nary - Enqineermg)
Pink - t-'1..oI.......~
The' C.n.., ol th~ J..ake Coanery
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
(
NAME OF P ICANT i J ... ~ .;/,"/;'''',.~,'/'',_'''''''1,__ -.....,-...~:;~../
A PL !"/:../...f:~",>(_'1';'+~/;' "-1" . ~ ,-.. '_
APPLICATION RECEIVED
; 0 _ -:::2..-
I ~- .....'( '-'
1-'"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is_e~oposed at:
~ ''', ...-~
<~ iC/
1-;
-..:-........--.. ~I""
/:) {<~_ ,:::':~..~''L-'/l..-l-
/
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/
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/Yff'h
Date:
/-J, /--63
..
Comments: See Rp.v...er5.p. ~irlp. for Arlrlition:::ll Information!
~'n h'lL
See Attachments: 1) Grading Plan, 2) Erosion rontrol Measures
"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 I
I
Main Fi~e
(Whit~_ - Buildi.y
Canary - t:ngmeering
Pink - Planning
The Cen... or the Lake ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~~)1.A&0JAa/Jvk ~~
APPLICATION RECEIVED /- R - '"6
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,={'g-:A9 7?()Ap~/j1-e./
Accepted Accepted With Corrections ~
Denied
Reviewed By:
3~
d-tZ
r-
Comments:
?~~ Date: /P~ft3
~aM~~-~1
"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."
I I
I
Main Fi- e
The ('tnlN of the take ('ounlry
White - Building
Canary - ineering
<:pink - Planm
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
-,
/ -~ ~'j- ~)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J
\. ~~...
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
,.
:2f~ ~~
-Jn~. ~
~.C, ~ oft, ~
Date: ~bqft3
~S-/~eR~ ~
J. '
~i!l#u4f~ ~~#
(/
Comments:
tf/o
"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."
I i
Mar .21. 2003 5:36P
~ENZ RVAN PLUMBING AND HEATING
No.7057 P. 5 i5
:!'
Date Rec'd
CITY OF PRIOR LAKE PLUNIBING PERJ."Vnr
1 Blue )i'ilc PEn 1\iITT NO 'I
2, G(lJd Cil1' ).'-1."....... J. .. ":) _ /' /.
1 Y.llow .I.ppli=, V ...,
O'lc:ase: type: oqmnt and Sl/!';ll at bon-onl)
}l..DDRESS (),
?:, 5?'V1 i2fuJ) )QeAe-~ Kld ~ 'tJ; · .
~{~+~ ,~OllG-+h
. ZONING (omr,.~ 11.';C)
LEGAL DESCRIPTION (office: use: only)
LOT n BLOCK L ADDITION
PID
OWNER
(Name) Wensmann Homes
._ (phone) 65 J.-905-3 709
(Address) 1895 Plaza Dr
Eagan, MN 55122
APPLICANT
(}Tame) Genz-Ryan Plum.hing & Heating
(Address)
Q?bone) 651-423-1144
14745 So Robert Trl
Rosemount, MN
55068
(Zip Code)
(CODtact Pe.r:;on)
(Address) ^, (City)
o 11I~L~h .~ ,J (Phon,)
APPLlCANTSIGNATURE 0~ -crolvJ ._~ DATE
651-423-1144
3 ~c9- J -(),~
I
I
,
I
I
I
I
I
./
)
Quantity
\
\-
r
...::J
)
-
.APPLICANT PLEASE COl\tlPLETE BELOW
Type of Fixture
Bath Tub with or without shower
/ Dishwasher
Floor Drain
LavatoT)' (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
, Sinks
, Bar Sink
I Water Closet (Toilet)
I Type of Fixture
Rough-ins
Water :Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector .
I Backflow Assembly
Backflow Assembly Test
La\-VIl Sprinkler
Other
Quantity
,3
1
12. - :c
I
.r.E.E SClIEDlJLE
Industnal, CommercIal & Multl.fan1l1y 1 '% of Job cost wim a $3950 minimum Resldenulll, New One & Two-Farrllly $99 50
ReSidential, Additions & Alterations $39 50,
Estlmated Cost $
BU11dmg Pennit #
PLU1-fBING PERNlIT FEE
STATE Sl.TR.C~GE
TOTAL PERMIT FEE
PAID WI
BUILDING TH
PERMIT
Building Official
Da.re
$
$
$
-G:,. rc; (~ ~ 0 \fl ~ ~'
\ : ~ l.V , Receipt No.
i~aMA1\. G LffilJ .:.1 By a-,
V
50
(OffICI: UK Only)
This Application Becomes Your Building Permit 'When Approved
24 hour notice for aJl inspections (952) 447.1~' UX (9t]) 4&1..1,1l'"
.
2003 5:42PM
GENZ RVAN PLUMBING AND HEATING
No.7057 P. 6 15
l' CITY OF PPJOR LAKE
tt.t:ATING/.AIR CONDITIONING/fil.KEPLACE PEMlIT
Date Rec'd
i ~~ F.C.i;~.. I PER!vDT NO. 3 _II / /'7
J. "(t.l1(lW ~P\lIIO$~( r "7 - ,
I1a SlJ bt,'RvJel/~
-r (
LEGAL DESClUPTION (officI: use only)
LOy"IOBLOCK 7--. ADDITION ~Je+ff~.\ (\DLttJ
. , ,-,.-
(Please tvee OJ: tmnt and si.l?;Il at bctto.ro.)
ADDRESS
j~~U
(t ~a~/ Kd
ZONING (ofiiceU~8) -
PID
OWNER
~ame)~~~~mr~n H~m~~
(phone) r-;<;1-9n"-':QJ,Q
(Address) 1895 Plaza Dr Ste 200
Eagan, MN
55122
APPUCANT
~~~ Genz-Rvan Plumhin~ & Bent;n~
(Address) 14745 So Roben Trl
f"\ .... (Ad~SS)~
(Cont3.ct Person) _l/h\QJ S 11.' j.l S
APPLICANT SIGNATURE 0 A ^ ,{ '.'
(phone) ._6.5 1 -"-.23- 11M
Rose-mount, HN
(City)
55068
(Zip Code)
(Phone) _.-6.3J.dL? ':\ - 1 1_.4LL
~DATE ~/"dJ-()~
APPLICANT PLEASE CO:MPLETE BELOW
DNEW CONSTRUCTION
FURNACE MAKE AND MODEL L.t.Vt n o '/v
FLUE SIZE RE1lJRN OPENINGS
TYPE OF SYSTEM
~wann AIr Plants
OGravitlj
_0 Mechanical
J2SR..ir Conditiorung
OVent. S)istetn
o REPLACElYfENT 0 AI. TERA nONS
L:8LJlAH ~,~lo;q - 7D FUEL rum- ~~_._.._
f) INPU'f 70, 000 OUTPUT .2Jd)f)
BEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special DevIces
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach imo
Required Side Yard
Setbacks
FlREPLACE MAKE AND MODEL
Industrial, Comme:rc.Ja1 & Multi-Family
FE.ESCHEDULE
1 % of Job cost Residential, Gas Fireplace
$3950 minimum
$99 50
$64 50
$3950
ReSidential, Heating & AlC (New Constnlct.lon)
Residential, Heating Only (New Construction)
Reside."Jtial, Addjtton~ &. AlteraIlOnS
Rc;sidelltial, AC Only
$3950
$3950
Estimated Cost $
BUlJding Peumt #
HEA rING PERlvllT FEE
STATE SURCHARGE
TOTAL PERMIT FE:E
.50
PAID WITH
BUILDING PE
RMlr
(~"- . Use Only)
r
Building Official
Date
::C~P' N~
/I
...,s Application Becomes Your Bu.iIding Permit When Approved
. Bv
24 hour notice for aJl inspections (952) 447~;;. f_.. ~~~2) 441-4":4:5
I
~~ PR/~
... r. <'
I- \"7
3fW:
\;;.::;~~;;;i:.r'~NI!!i Q~ to
"'\~'i\'\i~\'\"
Mar.21.2003 5:41PM
~ENZ RVAN PLUMBING AND HEATING
No,7057 P. 515
:l>
Date Rec'd
CITY OF PRIOR LAKE PLUlVIBING PERlVnr
I Bluc File PET> 1\/rTT NO
2, (j(,ld Cil1' .1'\..J.y...... 1 3..... /1 j 1
1. Y.II"", Appli-::>1\1 ....,
O?lc:asc: tvEc: or 'PnIlt and Sll!;1l at bottom)
, pJ)DRESS y] i/1 .I
'65<;tA PM p0eAe-~ Ktdq& KiA.
J{fr~ SOW-h
ZONlNG (Omc.-lUSC)
LEGAL DESCRIPTION (offici: use only)
LOT 1 () BLOCK L ADDITION
PID
OWNER
(Name) We.nsmann Home.s
(phone) 651.-905-3709
(Address) 1895 Plaza Dr
Eagan, MN 55122
APPLICANT
(Name) Genz-Ryan Plumbing & Heating
(phone) 651-423-1144
(Address) 14745 So Robert trJ.
Rosemount, MN
(Ciry)
55068
(Zip Code)
(Contact Person)
0~~{h .~
APPLICANT SIGNATURE 0~
'- j (phone) 651-423-1144
~1vo _ DATE 3 -C)..J-O,~
Quantity
\
\
r
~
'I
I
)
-
.APPLICANT PLEASE COJVlPLETE BELOW
I Type of Fixture I Quantity I Type of Fixture
I Bath Tub with or without shower I ,3 I Rough-ins
I Dishwasher I 1 I WaterFleater
Floor Drain I t2. -:r: I Water Somer
Lavatory (Bathroom Sink) I. 1 Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink' Sewage Ejector
Shower Stall I Backflow Assembly
Sinks I Backflow Assembly Test
Bar Sink / La\Vl1 Sprinkler
I Water Closet (Toilet) I Other .
.l'.E.E SClIEDUT-E
Indusl:rl;il, CommercIal & Muln.fam1iy J '% of Job cost with a $3950 minimum ResldentJaJ, New One & Two-Fal11lly $99 50
ResIdential, AddJtions & Alterations S3950.
EstImated Cost $
BUIldmg Pennit #
PLUMBING PERl\.11T FEE
STATE SURCHARGE
TOTAL PERlVllT FEE
$
$
$
50
PAID
SUILDIN WItH
G PERM,.,.
I
(omu U5e Only)
This Application Becomes Your Building Permit Men Approved
BuildiDg Official
1 ~ ~ ~ ~ 0 ,\n ~ r---
r u) Lb \::..J l!; 'LI L!; ~ ~. eipt No.
r 3:, MAR 2 5 2003 ~r
--'
Dare
If
24 hour notice for all inspections (952) 447-98S~.y:. (952) 447-4245
II
.-
l. Pink
2. Cir<cn
3. y.sl<,"
~~;~ I.PERMITNO.3-/41.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
(Please me or print md siP.I1 at bottom)
ADDRESS
31Sd.q R~ ~ ~~
LEGAL DESCR.J.J:' L LON (office use only)
LOT
BLOCK
ADDITION
Date Rec'd
ZONlNG (olli" UJ')
pm
OWNERW '
(Name) ~/YY1rO~
\
(Address) /~S {J~ iJ-.-. ~
APPLI~ .
(Name),.~..uL.JI"',\fL .~-Y{"\SLO..(~ ~ +- ~(.)Qc,~ (Phone) 'ltc3-3iS-7500
(Address)~IO LJt~CYru:nn CL >-C'~ 0: bv.. {,k.Q.~ ~Jt: (hn 5Slll/S
, ~ ctddrm) 0 (City)
(Contact Person) +< ,-\""JJ. (phone) '7ec3-31 S-75/(P
APPLIGANT SIGNATURE 7f;;.l..~ Jj/lt.n\...L-'Tna.~ DATE
(phone) (pSI - t/OG:. ~l/'t'aJ
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL f;UEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
$
$ .50
$'~~T
! P~R 0 7 2003 l)1 Rec:i~t No.
By {Jr'
Y
TYPE OF sy~! .eN!
.. DWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent System
HEATING OR POWER PLANT
o Sream
o Hot WafJ:.r
o Radiation
o Special Devices .
o Other Devices
FIREPLACE MAKE AND MODEL ~ 39 /3D v/~A.J
..,
Industrial. Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential. Gas Fireplace
S39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential. Heating & AlC (New ConStrUction)
Residential. Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Omel: Use: Only)
This Application Becomes Your Building Permit Wbell Approved
8uilding Official
Dale
Date
8"
14 hour notice for all inspections (952) 441-9850, rllX (951) 447-4245
;:oo~
xa1aI~d a~v~v~ ~IlVWOLnV
PLEASE NOtE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
S39.50
$39.50
$39.50
~I ~ ..0
~~ :1ft>.
~Q~
~-94,/)-
II
;:OLOStC;:t9 IVd OC:;:t CO/tO/to
Jan .16. 2003 11 :28AM
GEN: RVAN PLUMBING AND HEATING
No.0467 p. 217
41'RI0~
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t.;''''''~')'>>''''>'_'
."~II~.:,~ l'-"-'~;\""'" \
~~';.~;~~~;\;~i'::!....Nl\Il! S 0"( to-
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERlVUT
1. Creon Fil. I PER1~,rrT NO if
2. YeUOw ti~. ll'll. () 7 - 0 I 7
3 Guld A>>pllr.ont :....>
(Please tYPe or PTlnt and sil!).1 a.t bocrom)
ADDRESS ffl /)
.3R9PI ' ",C:Obc1:::n/1 f{;/jjJJ~ eel
I ~ } ~
LEGAL DESCRIPTION (office we only)' - '-.1 ()
LOT }()BLOCKA ADDmON 0.e+b~ GnU n
ZONJN G (Mllet: o::c)
PlD
O'Wm:R
(Name) We.osmann Home.s
(Phone) 651-905-3709
(Address) 189.5 Plaza Dr Ste 200
(Address)
Eagan, }lli 55122
(City) (Zip Code)
APPLICANT
(Name) Genz-Rvan Plumbin~ & Heat.j.l1S1;
_ (Phone) 651-423-1144
(Address) 14745 So Robert Trl Ro~emount. '''N 55068
~Address) . (City) (Zip Code)
(ContaaPerson) _ / ~- _.-- 1 . r""\ (phone) 651-423-1144
T~ICANTSIGNATURE_(22(aJfL.aJl1(J;j~Al~DATE I-/~ tJ~
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
Residentlal sewer and water line connecnon
Sewer connection only
FEE SCHEDULE
$3550 Industrial, Com '1 & Mu1n-famlly 1% of job cost with a $39.50 mmunum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STA TE SURCHARGE
TOTAL PERJ."\flT FEE
$
$
$
.50
j/Itt........
I/?!!i (;.' ~..1I1)
" ...' '.h) Ii
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Offici:lJ
Dan:
-
~ U [f O--m-~ .-,'
/' II ~
I _u fteB (J 7 2003 ID 1. By
Receipt No
24 hour nonee for s\l in:5pection$ (952) 4- B;\'830. fax (952) 447-424.5
Un
//
il
PRIOR LAKE
INSPECTION. RECORD
l,
SITE ADDRESS. ' ~ 9 a. 9 l<(--?a _s p be r r V K/ de,) e R c.J
NATURE OF WORK 1(/6? LV I I l~ .
USE OF BUILDING S FA ·
PERMIT NO. (),~ -- (J/4-? DATE ISSUED 'Maln ELe
CONTRACTOR /iJ~/VS/l1aNN !/cJftJc ~ PHONE C/5.J - C/LfO - L(S-e~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
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DEPARTMENT OF I
BUILDING AND INSPECTION
INSPECTOR
DATE
FOOTING ~J< i1J '//// I
FOUNDATION (Prior to Backfill) I ~g <.{ (J ~,' )- ~ ? - J>
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
LL.~:r ROUGH - INS
If; SEWER I WATER I SEPTIC
7_ 2-(..-{ FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE r,\
GAS LINE AIR TEST MCA~~_~/..~'7- h r-.P t" IJ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
111/Y~
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t!h C"- 2?
tY.b ~- "<J
f& <;j~^C;---
P)f ~ ~~
GRADING (Prior to Sodding)
BUILDING T ~ J- 10'"fo .0 ~ f ~
ELECTRICAL
PLUMBING
HEATING
DO NOT
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..
,/C-%
"
PIJ~- J .
I'h /O'-~
,
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
.