HomeMy WebLinkAboutBuilding Permit 03-0523
Qlertifirate of (0rtupanrl!
CITY OF PRIOR LAKE
~tparfUttnf nf ~uil~ing ~nspttfinn
~Final Permitted D Conditional C.O. Expires
This 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 FAHILY
_ Bldg. Permit No. 03-0523
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District _ R 1
Legal Description L 1, B 1, .JEFFERS SOUTH
Owner of Building . Site Address 3960 RASPBERRY RIDGE ROAD NW
""I
tilh
Contractor's Name & Address WENSMANN
1895 PLAZA DRIVE, SUITE 200, EAGAN, MN 55122
ROBERT D. HUTCHINS
Building Official
I "2 -/I - 6 -r:
HOMES,
'I
I .'
II,
V'''''
_ City Planner
DON RYE
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.
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,
Date:
Date:
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS :?1lPtI
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o JNSULA TION
".....er FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED I Z "'{1-07
~~~
CONTR.
PERMIT NO.
Q1
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PlJIMBING FINAL
~ECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ASLlNE AIR T.n.---
o t<-t~
Q.fa ~(
Q \ ~~ +b:Rie
- ~~~~{Aa"J
A' ~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CO~ WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspec or: f Owner/Contr:
C-~ Ll,,-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO'rr/ )JQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_on
...m... "TO '---'"
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ..~ 'T ~O
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED J2-a...o.3 ~.~
~O. ~CX'.
I V
CONTR.
PERMIT NO.
J.5~~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
P-PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
J. 0",- ('"fl"l- ~ i IA ~
() II..
2, ~~ ~F- (/1.1.1/7'
]. ~Jtk IiCC.lJQc..F;.r &~:.. M ~
o WORK SATISFACTORY, PROCEED
~RRE~TION AND PROCEED
o CORREf It ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: 1 / / ./ Owner/Contr:
--c-ACJ;l[9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
Il'iSNOTl
._m__,........._ -...T...."..'-...
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File I. White File
2. Pink City
J. Yellow Applicanl
(Please type or print and silm at bottom)
ADDRESS
39 tv ~ t::r.r.IJ /'"rr V
. , ,
LEGAL DESCRIPTION (office use only)
l,'d"
v
~Ad
.IV".)
LOT I BLOCK I ADDITION
JeF~frJ' ~/A/J...
OWNER
(Name)
(Address)
BUILDER J I
(Name)_ iJ ~ Nf./!14"NA/ H ()I'7'J~,/
(Contact Name) G" ~ /'" Y' ..:fb h Iv J' () /v
,
(Address) / r1.>' /h ~ .6 F' . v (
....--
~ew Construction
TYPE OF WORK
DLower Level Finish
o Misc.
(Phone)
Date Rec' d
6~ J.. -03
PERMIT NO. tJ3-)0\3/
ZONING (office use)
12/
PID ~-- ~~9...s- -0 {) J ... 0
(Phone) t37 - '/Ob-7'YO ~
(Phone) G/;J.- J{, f - 76/.2..
/H N f,5/:J...1..
ODeck
{IX 9 (/ IV
...J
OPorch
ORe-Roofing
o Fireplace
DAlteration
PROJECT COST/VALUE (excluding land) $
DAddition
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
;teruPo/1ro;;::erf07~ IY':;-~ ~"J--'<-63
/ ~~ature Contractor's License No. ~, Date
V
J'5'?/()(Jf)1 DO
$ IStJ/. 7 S-
$ Y<l~, 1'/
$ 77. .5'tJ
$ - -
$
$
$
$
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
/()tJ.dO
jdl}. ()O
.:3 s".. S- t1
9e>> . 0 0
This Application Becomes Your Building Permit When Approved
~ .;2~ S//9/1;~
Building Official
Date
I Park Support Fee
I SAC ... _ ...
I Water Meter (Size 5/81; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid /)9'7u- i,"
I Date I.J? - ( 0 - ~
ORe-Siding
DUtility Connection
#
$
$ la 7SrtJO
$ ~l!).l)O
$ 4S:tJO
$ J,;J.tJtJ. t) 0
$ 7~{]. d (J
$
$
#
#
/
#
$ 5Q7tJ.fJCj I
; 7-
Receipt No. ~ L/5&'J
By (~
U
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
~i~P;.:;:.~c~;;';-md-.=..otio"~ett1VraiiiFIIe~-'~
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
See Main File
(---~ite- -:.- Buildi-;')
Canary - I;:poineering
C!iiik .-:!Ianning:)
The ('enler of the Like ('ounll")'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
..
NAME OF APPLICANT
/ J) /1 /'11 ~,.'')r)
I / .~"/,, It \..~ /1
.:,... ~
" ;.)
/
74 (r.~':~,l_/
APPLICATION RECEIVED
.-"\ .;)
,-;'; -""-A,
..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.~ / e-, () I,.
/
I
,/
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
Comments:
~~
Date:
5/;;9 ~$
"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."
The ("f'nler of Ihf' L.kf' Counlry
See Main File
~9- - Buildi~
Canary - t::.nglneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I/)//JUYM~ ~
~ ~ :;)-t?0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~ch is proposed at: f21;~
C=sq~ C> - f ~tJ4p ~Rd
, , 0 '
Accepted /' Accepted With Corrections
Denied
Reviewed By:
Comments:
~
1~?
Date:
~/;143
,
"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."
~
See Main File
~te . Building
Can@rY . Engineering ')
Ink . Planning
Th~ Crnlrr of Ihl' [.Ike ('ounery
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
I I I \
NAME OF APPLICANT / ~l /jJ/'ll...o-r7J''/cZJt/>I.J
;/;' - . ....
iC"t. ,."r1.,1,/ ..""....;t-~."
.I ~ (~~ Jl'V"'.<_,r '\;:
APPLICATION RECEIVED
t::':"'" ~. ;-::2. ~~) ~~
'0..-' ,,- '-)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity VVrn,ch is proposed at: /'
:/ ,: I .:' j / ..,-'1 /
- ." ., .., I~>"j .r'.i, _::'. I J"
~-.;;.: (-/ (, c. - ;t-;'/-.;) jJ ;f:;;''',/ l''t{/Ij;'? /\-'('1
I /
Accepted
)("
Accepted With Corrections
Denied
Reviewed By:
JY)Cf Is
Set:- /J1~,'n F/tr
Date:
S--I z.-Q3
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."
lO/2J/Ol WED 11:22 FA! 812447~Z45
c;ITY OF PRIOR LAKE \~"\no-."(o..c\/(.\... '-J.JUJU v'w" > ItlOOl
Date Ree'd
CIIT OF PRIOR LAKE PLUMBING PERMIT
I II.... '11,
I. Gold Cil1
I. Y.I_ "",..,..",
PERMIT NO. .3 - 5 d.-""3
(plclX tYPe: or pnnt IIUd lip it b<Jnorn)
ADDRESS 3Cftn ~~~>~~~~~.
ZONING ColBce UI()
LEGAL DESCRlPTION (olfice use cmJy) ~ t\t\ ~ ~ ~~ ""
LOT ~BLOCK' ADDITION ~ ~ ~
PID
~~e~R \k\eJt\SffiC\X\~_ ~ome.s (Phone) 60)-''-ID(;,-11IOO
(Address) } 2,'1 S- 't"b\L~ ~. (;::::>-A~ ~D ~Y\ ,'^' 1'\, ~...,") ~Q..
~:~~~ANT tJemd ~\b~ ~ \\\~~:\:~. (Phone) a-/-Lfs)-ISbS
(Address) 17/D t\~b."cl~ ,<-ct. ~n.. tim, ~/:21
~ (Ad~\) -- (Ciry) (Zip Codc..J-
(Contact Person) n-eA """-~~~~ ,/ (phone) t5"I.-LfD.-15bS
A?PLICANTSIGNATURE ./?~ DATE S-}J,;2./fJ3
~LICANT PLEASE COMPLETE BELOW
Type of Fixture _q.DDtity
Bath Tub with or without ~hower
Dishwllsher
Floor Dmin
---.. Lavatory (Bathroom Sink)
Laundry Tray (1 or 2 compartment sink
I Shower Stall
Sinks
Bar Sink
W~lcr Clo~ (Toilet)
Quantity
I
I
,
q
,
~
I
Type of FUtclA
I
Rough- ins
Water HO:1ter
I Water Softner
I Stand Pipe (Washing Machine)
S6Wage Ejector
Backflow Assembly
Baekf]ow Assembly TCft
Lawn Sprinkler
Other
(
~
FEE SCHEDULE
Indu~trj81. Commercllll 5: Multi-fwlIl)' IV. or job cost with II S39.50 minimum Resideo\illl. New One &: Two-Family $99.S0
Re;,.denli.l. Additions &. AltenlllOnS 139.50
Estimated Cost S
BUlldi~ Permi! II
PLUMBING PERJ.\,flT FEE S
STATE SURCHARGE $
TOT AL P~T FEE $
PAID WITH
BUILDING PERMIT
.50
(Onier tI.e Only)
ThLJ A.pplicarion Becomes Your Buildint Pennit Wh.n Approved
/' ~ l0 fH ~.'.{}. [l: r ,; Reoe;pt No.
l D'MAY J 3 ;'On'i I if. By a
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:4 ho",. uoti\':~ IlIr .n inJpedioll1 (~, "'f~~' (b ~9S1) <4~"""2..$' i
E d SOOES0098~ 'O~/lO:Sl 'lS./lO:Sl EO iGl'S (NOW) L'9W=l5v':'lj9-.DN!J.V.3H-~ DNl8J~fl1d 13ZN3M )~OHj
Bulldl~ Omeit'
Da'~
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......
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n~;u..o"" . "",.\.IC.AMT
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1,,1. , ,11.'110' ".1..
C!~Y OF PRIOR ~_KE
SC:\-T.::R flTD WATEP. ?S?.!~IT
NO.
3-5d3
NOT2:
Sewe:::- and Hat:er
contractors must
be rec;-istered
wit.h the City.
APPLICAN'!: W€J,~e.\ ~~~
ADO?,~SS: 0,l.D ~~r~~\~~~~,
C:::::~~':'T:::::: ~mF/~,
- -7~~~~ - . _.--~~.-:
PHOHE :tJS)...lJ 9~J .r;bS
OAT=:: 'S"-'?:/O>
=~~r'
-- "- ,...' '.":
"::'"::"'":)'A'T/"P\
... ---.- ...
-;--;- f. f
.. _ ._....,1
i: 1'1 T!-:'::'
:; I-::'..N:~S
~O
-
f 0:':: C'.
2.
size of W2~er se:vic~
of W2t:er se~Iic8
/
1 .
Es~i~a~2= leng~~
4.
~!?e a: sewe~ pipe.
1-.3S
inc':: (es) . ~
from s~~~c~ure ~/V\
P'IC b( Cast Iran
.3t)
feet.
J .
Lccatior. of 2ny co~plinS5
5.
~s~i~a~EC leng~h
of
sew'er line
6.
C!.ea~ cut
S:'::":..lC-:'...l:-e.
(if
;:,,~S'Uirec.) ,
loca~~d
>~ fe1jr+-
fe~t
f':"om
=~;=~====~====~~===============================;~=======~;;=:=.~==
T~~s ap91ic~~ion becomes ~ou~ pe~~~ ~~en app~ovec.
E'~
DAT::::
=====~=====;=========~=~=============;==========~~=~~~=~~~~====~~=
F::=:S:
s
s
S
35.00
,50
35.50
Sewer and wa~e~ line connec~ion pe~~it.
Surcharge
TOT.;'L
* :ee :=: e~~he~ se~e~ C~ ~ate~ i~civicl~a~lv ~s $20.00 pl~s
S . 50 s'.l~\:harge.
'"
S~~e~ and ~at~~ pe~~it5 issuec fo~ neV cons~r.lction m~$t be
:~c~~; i[v~r!r;Jl:fc01l~~'rt'&~~-r;~ c pa=:mi-s'- ~~~:~ ~;d i;h~a ~ ;~e ~~~~: ~s-~a~::
';' 4. .l~r~aL!: lJi~ Lr,.-:"J-- '-- '.:,.... - .. ... '- - . -"-- --
;.,ss~e~ "i PAID WITH
.~~~~ 2oo.~_,,:JI .~,~~O(;~~:' ?~.= D B~~~D'NG p_~aM'T
12';.':'~ ? .~.: J
:~~:::: ?'.=
;z
~
R:::C I D 3'f
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1"'- '....:i.
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V d SOOES009817 'ON,/10:S1 'lS/'~D:Sl EO ,~l'S (N01~)
L9EO-~Sv-1S9 DNIlV3H ~ DNI8Wfl1d 13ZN3M WOBd
ft PR~
5/>~ E
~NE~
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Y&.LCM - API'l.ICMT
... - an
CITY OF PRIOR IAKB
.,.r,;w.ra< AND WA:i:l!.-rt k'~
S.W: No. 3 .,- 5;)3
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: S1l1K ~6IA}:,.. ~ ~J0.
ADDRESS:JDL1 ~~d-,~~/fe.'''':, '-ff~E...DATE:
SIGNATURE: <-J'- BLDG.
SITE ADDRESS: 13 W ~ ~~it.prDt
FILL IN THE BLANKS
PHONE: fold - ;}.d J ... 3 f ;;;)0
tJ/~ J '() 3
PERMIT ,
1. Estimated length of water service ~I)
feet.
2. size of water service
/ II
inch(es).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC V Cast Iron
, .
5. Estimated length of sewer line 50 feet.
6. Clean out (if required), located at
structure.
feet
from
===================~=========~---=================================
This application becomes your permit when approved.
BY
DATE:
==================================================================
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.
* Sewer and water penaits issued for new ,-'...ustruction .~st be
recorded on the building permit card at the time of isn;;uance
~ iDSum ~u::.~ :JW. ate sewer and water permi~., are
1ssued. ~; ~ LS L0 Lf: U V I ' PAID '~
DATE PAID _y 7 ZJOj u AMOUNT PAID I3UILDING ~~MI
RECEIPl' * ~ REC'D BY~. r
IBy V
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Pnm.l ()nnnrtnnih' P".,nlnvpr
: . .~
_-M.I!
-..... - -10MB
... -...
"-.1.."'4 OF PRIOR LAD S.W No.
.:u~..~ AND _.ll.~ Atlatl.~
llO!'E: Sever and Water
contractors must
be registered
with the City.
APPLICAN'l': S~ ~6I~):,~F~- JJ:&~,,8E:jJd-ddl-3f;)b
ADaA~SS: ~ ~. ~J!..' ~Il:.. T ff UAfE.. DAu:-7!IY.1 I) 3
ck 'H!h -J BLDG. ~~\&'&.I.'" _
961J~~~itPIDt
FILL IN THE BLANKS
SIGMA.. ..~:
SITE Au......... ,.s:
l.
2.
3.
Estimated lenqth of ":t;r jrvice ... ~()
. N
Size of water service - inch (es) .
Location of any couplings f4U_ structure
feet_
feet.
4. Type of sewer pipe _ ASS PVC V Cast Iron
r .
5. Estimated length of sewer line SO feet.
6. Clean out (if required), located at feet from
structure.
This application becomes your permit when approved.
BY
DATE:
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.
.. Sewer and vat:er pendts issued for 1l8V_.....s:truction lNst be
~-i&~f\=.VT~I',~..~.=n:.= ::.s ~~ =aJ~
~S8Uect .~) ~ LA LI I,'J ~, I i I,
DATE PAID j._1111 1 5 7DD3 l'!i AMOUNT PAID PAID ~(lTH
RECEIPT' J L'jj REC'D BY 8YtlDfNG Pew,T
By -- '~~:"'~'~~i~~;J
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 4474230 I FAX (612) 4474245
An P.....l n
_",tv 1:....",l""PPr
2:El'd
S9toL toSS 2:!;6
"JX3 ~ ~NIgWn'd ~~iS Wd L~:~El ~ElEl2:-tot-'nr
08/26/03 09:13 FAX 6518949955
WENZEL HEATING & AC
l4J 00.1
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGlFlREPLi\CE-PERl\tlll .-.---.-
Date Rec'd
I. PInk File PERMIT NO 1 j
2. G<ea1 Cicy ., _ ~ <"i
3. Yolloor ^wllc.&lll "J t7
<please type or DriDt aDd sim at bOtIOm)
ADDRESS
~. ~~~ .&kr fj
LEGAL DESCRIPTION (office U5e only)
ZONING (office use)
LOT
BLOCK
ADDITION
Pro
~~~R -'~A/g(Jorrf\
~
(phone) ~ '51-4f'h-44-~
. (Address)
APPLICANT V ~./.. /
(Name) ~/'I 7a ~,r..(C;
. /
(Address) 473/ 4d ~/M// ~/YJ
- . (Addrm) /
(Contact Person) --.fu. i\J
APPLICANT SIGNATURE
<phone) h~l-~~~
~x:'J.;./
;.city)
~......122..
(Zip Codc:)
(phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FUR..\JAC'E MAKE AND MODEL .bvN?:lY ~ s-I ~~ '1 '" _ FUEL ~f-
FLUE SIZE s;?_~,1 RETURNOPENlNGS -1~ rNPUT~tf:l::> OUTPUT .b~~
TYPE OF SYSTEM HEATING OR POWER PLANT
~ann Air Plants 0 Steam
o Gravity 0 Hot Water
~ ~cchanical 0 Radiation
~ir Conditioning 0 Special Devices
Ja'Vent. SYStem 0 Other Device!
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrll.l. Commercial &. Multi-Family
FEE S\..nl.!.DULE
1% of job cost Residential, Gas Firc:place
$39.50 minimwn
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residentilll, He3.ting &. NC (New Construction)
ResidentiaL Heating Only (New Construction)
S39.50
$39.50
HEATING PER.J.\1IT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE ~
(Offic~ Use Only) r, ,..: i, VJ
This Application Becomes Your Building Permit When Approve4' \
\
.50
&UI!.. ~"'ID I...
DING rvt'/"/j
))~
1i4tIJ"'
Estimated Cost $
Building Permit #
{~ til
'\ -',:.1~
\:.1 LS ~ \
~I
:~eipt?;t\
. .---.f) - .
Paid
~Ur, ~ 7 2003
Date
..J
Building Official
Date
."". ". - ---- - -
24 hour notice for all inspections (952)44'~"98::l0, lDX (952) 447-4245
AUG.27'2003 06:32 651 633 8884 FIRESIDE CORNER #1999 P.020
ell Y. OF PRIOR LAKE
HEA TING/AJR CONDITI~G/FJREPLACE PERMIT
(PJeasrtypeor)lriJlunlfslll/Jat&qrrom) Ii 'IRESID~:-" 2i~...1 PERMIT NO'3 -5 ~31
I ADDRF.5S HEARTH&HOMEN
3960 RASPBERRY RIDGE RD
Date Rec'd
ZONING (office 1J~)
rJEGAJ~ DESCRJP.TION (officI! use only)
LOT
BLOCK
ADDmON
PID
OWNER
(Name \l\Qlli..$MANN ijOMES
(Address)
(Phone)
APPLICANT
(Name~ 6J::.LlED BEESI)l&DF.lA FT~.QE HF-ARTJi.& HOME
(Phone)
i?5J -633.2561
(Address)
2700 NORTH FAJRVTEW AVENUE.
(Address)
ROSEVILLE
(City)
55lJ.3
(Zip Code)
(Conr4ct Pcr:'lon)
BRENDA HUSTON
(Phone)
651-633.2561
APPLICANT SIGNA TUItE
BRfNDA HUSTON
DATE
8/27/03
APPLICANT PLEASE COMPLETE BELOW
xO NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SrZE RETURN OPENTNGS INPUT OUTPUT
TYP.E OF SYSrnM REA T.ING OR. POWER PIJANT
o Worm Air P10nrs ] Steam
OOrnvity ] Hot Water
o Mecha.nic~1 0 Rlldfntion
OAir Conditioning 0 Special Dcvicc$
DVcnt. S}'lltcm 0 Othc:r Devices
PLEASE NOTE:
Air Conditioner Units
Conno1; Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N Gtp 6000TR-OAK
Industrial, Commercial &. MulT.i.fomily
FEE SCHEDULE
I % of job Cllst ResidenrfllJ. G3S Firepl:lce
$39.50 minimum
$99.50
$64.50
$39.50
Residential. Healing & NC (New CClnst.nJction)
Residential. He3ting Only (New Const,nJction)
Re.~idcntio.l. Addition\: & Alremrions
Residentilll. AC Only
~ 04 $39.50
- ('/C' ....... "D '-39.50
"'.It/v,..... yV/.,.~
.\:;- p~ '7
l:i4frr
- _ ." C"" -',
I ,I '0 . ~ 1'1 \~i i::, '\ \
I ii,'] b L ~ Lbl!
This Applic:atit)n B~omcs Your Building PcrJPit Whcn.ApprQ.yed of. . f>a~~~-- rl~cej"t No.
A HC!tlrtlz & /1(//lfC /(!chm' IJg! ~$!.il'rfI " 7 ~
,/ - H+- "
I 1. U.'t.iJ.d~/1j n Diu : '
II ( , "Nllcllne OIlj'WJb t.1irview Avc)luC North RoRlIJfllc_ MN 5S I J..l. ;hOl ~ _,(.~, ~?! "I~f 1 1:'. )JJ
IIUII./)" I nUll, 3R50 WCSf '-li~~mlr dJi~~J;p~~i 118J~1J;j~H3~2f~.PP-9~~i~;.~,~~ ~)'IJ ~ ,08
1\'W~'.nrelltl.II'.A~I'" 1\01]11 Co""",,crnr I.Itc"lO If. :flIl~?11
Estimated Cost $
HEA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building remit #
$
$
S
.50
(omrc URe O"'y)
DEPARTMENT OF
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 39'0 IfAsP46>>~~ AlXts- AAJJ )J. W.
NATURE OF WORK /VEW c,tJ1J$Trt.t1t:r1 O~
USE OF BUILDING S'.F:^-.
PERMIT NO. m- 6~~ DATE ISSUED tSl"{d"
CONTRACTOR ~S~ ~f:bJt' PHON~-~-7"h,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING I
FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE 2"",. ~
GAS LINE AIR TEST }f) ~
~!Pi /0-7--0
~h /CJ-7' .
f2b
t) ft>
IJgI;
9 -)2 ~
/.?-;;- <:2.3
/lJ- '")
/2 --II
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
J /...
((11/
""
ffD
fV (j I'? -/1
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
[JJc
/2 -//
12 - 2.
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