HomeMy WebLinkAboutBuilding Permit 03-0748
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CITY OF PRIOR LAKE
~tpatfttttnf nf ~uil~ing Jlnspttfinn
,/?J Final 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 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
03-0748
Bldg. Permit No._
Occupancy Type
R3
Fire Zone N / A
Zoning District
Rl
Type Construction VN
Legal Description L6, B3, REGAL CREST
Owner of Building Site Address 15358 JEFFERS PASS
Contractor's Name & Address COLLEGE CI(f'L~ )'IpMES, 7920 LAKEVILLE BLVD., LAKEVILLE 55044
, '{ (
ROBERT D. HUTCHINS \ I/) City Planner DON RYE
Building Official \J V /
Date: ~ L - 0 l/ Date:
,
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED I '2., ~ ~.(')7
/'
ADDRESS 1635 ~
j~p~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
7 -7l/~
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
J5. PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
\. ~L-'
2. ~,t~
~t)'f Ckf~
M \" 'ill') -18?8
o WORK 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED {- '"2..-oy~
J~~~
ADDRESS 15 ~ SB
OWNER
PHONE NO.
CONTR.
PERMIT NO. ""3- 7 '/21
o FOOTING
o FOUNDATION
o FRAMING
o .!fjSULA TION
pFlNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Q ~,~ ()
t~)~~
I ,(\
(' L~ i-I~.'~J\' \0.
./\
I/-, ,/" I II
~~f,W~
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE<ft WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: .,1 Owner/Contr:
CALl\44 '!9JSO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE '}JQU;REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
~Mltin~ITe PERMIT
(Please type or orint and sign at bottom)
ADDRESS
/535 9 Sefks PctSS
LEGAL DESCRIPTION (office use only)
I:, 3 R
LOT BLOCK ADDITION e(laf
OWNER
(Name)
(Address)
(Address) 79;2LJ
I-ICJ /?7. z'-S
BluJ.
TYPE OF WORK
~ew Construction
ODeck
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
~ . 9. ()3
PERMIT NO.ti 3- 7 f"J'i
(lees -t-
(Phone)
ZONING (office use)
~I
PID ZS - 3fN'" lJ5() -D
(Phone) 9:5:2- 9"~7- ~ 70 t)
(Phone) &/..2-~ 3$- 3-Z0 7
L Ct. R e. U I 1/ e.. /rl ;J 52>ZJ t/ '-I
OPorch
ORe-Roofing
ORe-Siding
o Misc.
OLower Level Finish
o Fireplace DAddition o Alteration DUtility Connection
PROJECT COST/VALUE (excluding land) $ .;2 77'/00-
BUILDER , /f
(Name)=.G, II<,~ -c::: L-~f-'1
(Contact Name) Edc1 / c::. -'
i.aRC",;) ,II-e
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 pia . I am ware that building official can revoke this permit for just cause. F. urtherm.ore, I hu,by ."" "re' "re d'Y Offid/,' . do,;"", m.,
~terupo ope;r ne dins~~ Jol07 ~/fe,/t5
, Signature I Conttactor's License No. / Datei'
-
~,
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
$
$
$
$
$
$
$
$
~'7?,C)OO I
19~q,qb'l
I~ tt1, JJ.'I
13~,So'l
I
100.-
I (1? --
3550
If() ,---.
This Application Becomes Your Building Permit When Approved
~~
Building Official
~/g'dft3
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
1 TOTAL DUE
I Paid .~ l (!:J/lCj ,. /1 _
I Date --; -;;.. ';)- -() :J
#
#
#
#
$
$
$
$
$
$
$
$
I
/a~s.- I
Z5V.- I
~-I
/dJ!j(!),- I
- '7&0- I
I
I
I
$ '715"'1, /7
t
Receipt No. i./qFr::,;}
BY~
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
~~~.~c_~/:;;-md_'ro,_wsee"VaillFilemm'~
Planning Director ' Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9g50, fax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
-..
See Main File
White - Building
Canary - Enaineering
..- ""ok - Planninp
The Crntf'r of Ihe Lailt ('oURlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/ ,.//--
,( ! .<.:.:
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APPLICATION RECEIVED /5:~ <; 8-- -
,. / ,.{ ,j " /" -'
':':~:t; ,i I ,.. ,-" ~
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/.r:-:::<< r (JIIJ
I) J) S .x.::.I/ 1,' ,.,1 ./ ;' .:....-1._,.-/
) /
,
Accepted
/'
Accepted With Corrections
~
Denied
Reviewed By:
~
.
7l~~
Date:
~b~3
Comments:
"
, '
.'
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"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."
S M 0 Fel ~ -e.uildi~
ee aID Ie. c~nary - t:ngm~ering
Pink - Planning
Tht' Crnler or Ihr l..kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~~.
/5 3,srl- ()~ jJ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction a;;: ;h; ;;:roPo(f~: J ~ jJ~.
~W
Accepted
/"
Accepted With Corrections
Denied
Reviewed By:
~
. ID_
:;~
Date: ~/~t!!:) /~.3-
, ,
Comments:
liThe 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
White - euildinL '
('""C8narv - Engineeri~
Pinl( - Planning
The' ('rnlt, of Ihe L.kr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,t -/~./
'~~ __....,(' ". t _:1'~ I';" Ai'",,::,
" I
i ..:~:Z:'
,
,
APPLICATION RECEIVED /5 ,35 g.: -
.. -....//
, / ';-11"" /
I o"" _",.'-""-7 \--<::>1 ,,(j,.....-.
l'" //
.:)2... .';:../,l......-./
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propo~ed.,at:
.. \ .-)
;. .t;-. =:? S'" c- i. ; t} I / /1. . .
,-' -..I. .;~, Jt.._-'-;\."..h.JGA.....<. l <;'..<1.--1----, ,.' .
./ I l Ii)
i../ -:: J C
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
~.~ Date: ~
Driveway Must Have A Concrete Approach
Comments:
-liThe 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."
200312:42PM
GEN2 RVAN PLUMBING AND HEATING
No.2763 p. 18 18 -.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERlVllT
~} I
. ,,~~ ,.
..-:((: ~1.
Date Rec'd
.,. - .
r;~..('
t~~I"'~1
.?";~;/ . ',"
(Please type: or "pom and S~~ at bottom)
ADDRESS
1q)3,~ Jef~-eteS {JagS
I !'ink
2. OnIen
3.. Y.llow
, ,~~_. ~ .~ t
.:. --,;"1l
~ ~~t:i:.
or. -to """' {;;!,:Jf.:
rUe I PED~ Nr-\~i;: ,
Cicy . .1.'-1.".1..\:,""'. ~-:.~f. . _ . .
^pp1lCAllt '-'"*,:~'fll? 0 ~
- - . .~.. '~":'
ZONING (o!D~;~e) ,"
.;.~~. ,
LEGAL DESCRJPTION (office use oIlly)
LOT V; BLOCK 3 ADDITION
~ rd. (!!&r;-t'
~=R \JJJ1 fl1{ rlfz1 l-hrYVlJlJ W r '
., J
(Address) 1 q W I t?dL.(;{/ il/ ~ fJ lrId. Law vii Ie .
.c.- .. . 0'
~~~ANT r1frJ l- ~!dil0 /
(Address) )L 7i.5 ~. 'r<JJ Iofm il2J I J
(Contact Person) r If} 'i{~ hCAddr~mJ ( ~
I .
APPLICANT SIGNATURE ( J.(,( J~ --=&j~
PID
(phone) qh~' L/ /ft1---(oQffIJ
fh n fflJl/L/
(phone) (61-4;)-3- IIL/L/
/0) ~h16U0J I m n '?-; ~(jl.#;
. (City) - (Zip Code)
(phone) (pC::; I - 4;;;;-8- /1 Lief
DATE 7--(e- ~
\.:. APPLICA.J.~T PLEASE COMPLETE BELOW
I'::: . ~W CONSTRUC110N . 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL I t2.t1l ne't 6~q 3-? ~ FUELn)'7.r--b;f7~
FLUE STZE REIDRN OPENINGS' R INPUT 75"/ om) OUTPUT ~ tJ)2f)
TYPE OF SYSTEM
~ann AJr Plants
OGraviry
o Mechanical
&ir Conditionmg
OVent. System
HEA Tr:N"G OR POWER PLANT
o Steam
o Hot Water
o Radlstion
o Special Devices
o Othor Dc:vices
I PLEASE NOTE:
Air Conditioner UOltS
Cannot Encroach mto
Required Side Yard
Setbacks
FIREPLACE 1VlAKE AJ.'ID MODEL
Industrial, Commercial & Multi-Fanuly
FEESCflEDULE
1 % of Job coSt Residential, Gas Fireplace
$39.50 mmimum
$99.50 ReSIdential, Additions & Alterarions
$64 50 Residential, AC Only
$39.50
ResIdential, Heating & AlC (New COnstrUctIon)
Residential, Heating Only (New Construction)
$39 50
$39.50
Estimated Cost $ Building Pennit #
REA TING PERJvlIT FEE $
STATE SURCHARGE $ .50
TOTAL r.l!JKMIT FEE $
8lJIL~1~D W'1h
G PIER"",.,
!... .., "e Use Only)
Building Official
D~fe
r~~ ~ ~ J W ITi" Receipt No.
i nl
lJ&atdUL 2 2 l003 ~!BY
I
~
U
.... ..{~ AppUcatio.n Becomes Your Building Permit When Approved
24 hour notice for all in~pectlons (952) 447. /ij~<(2~~) ~~-42.4S_.,..._~
JIJI.i8. ~003 i~:4iPM
GENZ RVAN PLUMBING AND HEATING
No.~763 p, 17 i8
Date Rec'd
CITY OF PlUOR LAKE PLUMBlNG PERJ."VUT _,~~~~.'
, <lL "
_~.. .t!'
.. ~~;,'!-.,,:;:;;j JI'
,-::;tr2il.-::.r
_...",.--~~ '
I PERJ."UI'_~~~.~~;~-''''~'' ^.1'.~:.....
~~i" . ,.. l,.if
" :'.
,,;...r .
i$'f~-/' :'
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(l'lea.~e tYPe or PJ:int IUld ~ a.J: bottom)
ADDRESS
/53SS \_.effe:f2'
~qs. S
LEGAl. DESCRJl>TION (office use only)
LOTtp BLOCK ~ ADDITION fZe.q ttt ~/!&J;-r
,
&~R Cl21kijfJ C{itJ Homlj Lht
(Address) 1 q ')() (fltfJI i J II) 1%1 vel., LalLJ!A/lll-f
,
APPLICANT n_ f /J I .
(Name) cW?:- Y0if111v
(Address) \l-J7Lls ,~. P,t/be:~ T~,
(Address)
(ComactPerson) OV}Je('~ fl' '~J{(
, .' ''''PLICANT SIGNATURE - (),{ ~i) 1r)}J/J
; ,..1,.
Quantity
I
I
I
:J...
I
I
r
a
1 SJuc Fill:
2. Gold City
) Vellow .\.llpn~t
ZONlliG (c.~.~~~.-
.........
PID
Q?hone) q C) 2-..Lf 00 -lct1 bD
V11 n q;[jJ4
(J'hont:) LPi/; /- Lf'1--3~ Ilcli..-f
,f2.v.(,{;yy1D7;trvll m VI L-;'-dJ&S
(City) (Zip Code)
(phone) (rn 1- L/ 2-3-! Jl-/l{
7 -I g -0'1::>
APPLICANT PLEASE COlVIPLETE BELOW
I Type of Fixture I Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
1 Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
I Water Closet (ToiJet)
I
12- "'J:
I
DATE
Type of Fixture
Rough-ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
Bac.kf]ow Assembly
Backflow Assembly Test
Lawn Sprinkler
I Other .
FEESCBEDULE
Indus01aJ, Commc.rc1al &. tvll1Jti-farTllly I % of job cost Wlth a $39,50 minimum Residential, New One & Two-FanuJy $9950
Residential, Additions & A.lter.ltiOt1S $39 50
Est)mated Cost $
Building Permit #
PLUMJ3ING PERNJIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(ornee U5<: Only)
.', ""'ltis Application Becomes Your Building Permit When Approved
.50
8lJIL~~D WrfJ-f
G PERM.
JR . N n-
.... "_ ece1pt 0,
Ii II.i~Y
I il
I ..'.1
!I
I lj
j/
~
~~ r,'l fjJ rJ rl'~
l" J U; I l~/
Date n
24 hour notice for all inspections (952) 447-~k). f!XY~52~ J7lg~
BuildIng Official
(h
1
By
---.--.:..-=~_.~
JIII,18, ~003 1~:41PM
G E N = R V A N P L U M 8 I N G MW HEATING ,....,.
No.~763 P. 16 18
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1 Green FIl. PEn1l6TT NO -....; .~, '"
~. you;".. Cilf. ~,..u. .ds ~O'7 ~.:.. .
l~ ~_. ~u.
. , .' Date Rec'd
"",1,'.0
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APRI~
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.."":"'~' .
CITY OF PRIOR LAKE
SEWER AND WATER PERl\tliT
(Please type or p.ti7)t ~d ~.I~ lit hotrf.lm)
ADDRESS
/'5~c;Fj Jdf-u~ Pa>5
. ZONING (O~~1lSej_",:. .
, '
LEGAL DESCRJPTION (omee USe only)
LOT 1/ BLOCK ,8 ADDrnON~
I!.€a at ClZtf
'-.j
Pro
~=RColleC{0 rJ";tv rtTml\e~ (VlO.
(Address) ,q 2..0 Lake/ Ii l-t. 13J vd. , Lu;liflV) 11~ ,
(Adrlr(>.ss) , (Ot0
(Phone) Qti2.- L/lt4 - I aqW
1IY1n - c:::r;()l/4
(Zip Code)
APPUCANT (l_ _ 1/1 I
(Name) CtrVrL - K1AtU1J
.' 'J
(Address) 1L17LJS- S. t'O)/UJet lid. 1
(AddTess) .
(~ontaC[Person) r.J1 fi\.(h&J1.r
." . "LlCANT SIGNA~ . CiJ.~LLr; l, )
-o.r- - . - "_- -
(phone) J.10/- Lf~-lltJJ
~f).\1YVl{)})Jli VV7V1 ~~
(Zip Code:)
(phone) {~V] f - Lf 2-D -1/4'-1
~ Il,/\ DATE 7-(f'-(L~-
(City)
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure. feet.
Type of sewer pipe. D .ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water hoe connectJon $35.50 Industrial, Com'l & Multi-tiunily 1% of job cost wIth a $39.50 m1DlmUIll
Sewer connection only $17.50 Water connection only $17.50
Estunated Cost $
Building Permit #
omc!: U,e Only)
8111~tD Wrr,.,
. .. ,-\ Gp~~
This Application Becomes Your Building Permit When Approved \i~~~ @ ~ D \D ~J I \\\\\\ReCejpt No.
BlIilding OfficiaJ D,ne \l\JateJ\Jl. 2 2 20031Jrl. Y .-Llr
24 hour notice tor all inspectioJ:l.~ (952) 447-9 f~O> fax (952) 447-4245_ '--{I
tBy. ~.-
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
87/11/2883 09:52 5077445555
"... ,f~.., >I ~ ... .... . _ . ...
BADGER EXC
PAGE 01
Datt Ree'd
CITY Of' PRlOR LAKE
SEWER AND WATER PERMIT
(7\c:uor ~ or OMI W ''&0 ~ ~"""...)
ADDRESS
15'35"8
~Q~
-~ 5-J)
I OWNER r . l. ; L
ICName) ~~ ~ -n,,~
I (Add1~s) 7'iJ.o ,,~ 8 1 uJ
I
I LEGAL DESCR.IP110N (otl\C'C UII! OII\ly)
l LOT ~lOCK 3 ADDn-ION
~. E~.. ~'~_I PERMIT NO.3 -7L/~ j
ZQNING (oll'a uc)
(,r.0~
PLD
(Mdn:u\
I APPLlCAN1' J--
I (Namt) 6c~,.P-'L ex cGt.,)a_~
I (Addms) X' 2> 7. ,) l.A...) -r o~ J+r.e.Q..::{-
- <A6c.rm)
(ContacrPe.uonl ...c~ &'"/ m~
lE?tICANT SIONATUltE ~~ ~~_,~.!~
.." ( . --
_ (Phone) q,r 2. -'7"~f -.<; ?Oo_
~~
_ (Cl~)
(~ Co4l)
(Phone) ~ 7-7<-r' 'r- U~S- ,
~~ 060%
(Clry) . (tip Code)
(Phone) SD7-7YL(- ~ J
DATE '7- L-.-c)3:
APPLICANT PLEASE COMPLETE BELOW
Size of water service -1- inches.
LOC4tiOt'l of lOy coupllngs from nructure - feet.
Type of ,ewer pipe. 0 ABC B"Pvc 0 Cut Iron
Estimated length of sewer line sO feet.
Clean out (if required) located at feet from structure.
Re:idcntiaJ sewer lnd Wiler line cOMcotlon
~""llr c:unllectlOIl only
FEE SCHEDULE
SJ!.50 lndultrill. Com'l & Mvlti.family 1% of job colt with a: $39.jO millimwn
$17.50 Waler conl'\ectlon ol\l~ S 17.50
Es\imated Cost S
BuildIng Permit #. . .
SEWER AND WATER PERMIT FEE
StATE SURCHARGE
TOTAL PERMIT FEE
IOmn tor Ollly)
.
"
Till. I\.pplleltloll Blleoroe. YU\lr Bulldlne Plrm It Whlln Appro".!d
,
I - tWlelle,Om..1
s
S,
S
.1ju PAID WliH
. 'LOING p~,", .
c:~Mli
I""
~.,
.~r
-'
FIRESIDE CORNER
#2745 P.OOI/002
(Please type en prlnt and silt" at Ill'Jttom)
ADDRESS
CITY OF P~R J~AKE
IlEA J lJ."G/Affi CONDITI~ " GIFIREPLACE PERMIT
~IIR~SIDE-:, ~~~ I PERMITNO.3--7tlg
DMe Ref:' d
Ji. J:::: A J<. 'J.' H t.<:t- H. U M b'.
ZONING (offi~ US~)
15358 JEFPERS PASS
LEGAJ~ DESCRfl>TION (office lJ$e only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name COLLEG~ CITY HOM~
(Pllone)
, (Ad d.rcs~)
APPLICANT
(Name) ALJ~JED ~r~SlDE DBA FjJ~r-sJJ2.E HEABIH..&J:l".9..M.E
(Phone) .
651-633- 250 1
(Address)
2700 NORTH F AIRVIEW A VENUE
(Addre&S)
ROSEV1LLE
(Ciry)
5511.3
(Zip Code)
(Cont.'lct Person)
BRENDA HUST,ON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRfNDA HUSTON
APPJ"JCANT. PT"EASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATiONS
FURNACE MAKE AND MODEL FUET~
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEA TlNG OR POWER PLANT
DATE
9/11/03
DWorm Air Plants
:JGrnvity
:J Mechonicnl
:lAir ConditionIng
OVent. Sy~tem
o Steam
o Hor Wllrer
o Radi:1rion
o Special Devices
o Othcr Devices
PLEASE NOTE:
Air Conditioner Unjrs
Cannot Encroach into
Required Side Yard
SetJ'ilcks
FIREPLACE MAKE AND MODEL
HEAT N GLO SL.750TR
Indu$I,rilll, Commcrcj~J & Multi-Family
FEE SCfJEDUU~
I % of job cost Re$Jdentj~I.l, Gas Fircpl~~
$39.50 minimum
$99.50 Residential, Addit;ons & Alterations
$64.50 Rcsidcnti31, AC Only
$39.50
Rcsidcnti31, HC3[jng &. Ale (New Com:rrucr.ion)
Residential. He:lting Only (New Constnlction)
$39.50
$39.50
Estimated Cost $ Building Penn it #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOT AT.. PERMIT FEE _1: "~---~- r;1 Ii
(Office Use Only) "I 0: u \.s ' 11
This Application Becomes Your Building P,qrPJj~WA'{tJ WoIN(!>JP ~) 1"orU~jJJNlRtl\ . Receipt No.
, ) tzp 1 't 7003
t~""~t 8rlilder Dil '. . In Date --' I B
~811i1dineOrm:il(JO Fairvicw Avenue North l{lDlltCll1e. MN ~~I "ho e 651-633-256] FaX~S1t63t8884
IIU!l.n~1l8 1:111",. 3850 West Hrghw::JY 1.:1 liuTI1Svllle, Ml'l ;':>JJ I nc 9.u".K90n.~~ r~-890-540l:l
24hoIJr notice for: nllln~Decfionll_(I)5? I ,IU ~2) 447-4245
w1'lw.l1l"(1.fd(),uuf.e.)tn M N t'"onf'i Ie...' ~ t:t::rl/W 21lo!lffin1
PAID I...
BUILDING ";;['-1
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PRIOR LAKE ~EP~RTMENToSee ~\1ain File
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~~SS.l Je..pre~s 'P4S.S
NATURE OF WORK - N~
USE OF BUILDING ~~A
PERMIT NO. D..!.- ?.,r ~.E ISSUED
CONTRACTOR (!-OI't!UJ~ PHON~. '-~ ~~D'
NOTE: THIS IS NOT A PERMit FOR ANY F THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING
FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING II) /iL-;o
INSULATION p/,L.J' ,/ CJ ~ .../ (/
ELECTRICAL (
,......, ~
PLUMBING U G PI) "'~O# ;0// -1',/8
HEATING (if required) /11; I~vy
FIREPLACE ~l.lb II.J
GAS LINE AIR TEST { ~ I z.,. ~(
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
0J,
.r IV;
J '//
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
I ~z~
-
;#5 /' ....... Q.
f~
OCCUpy UNTIL ABOVE HAS
NOTICE
~2... ,
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