HomeMy WebLinkAboutBuilding Permit #00-0011
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~ertifi(au of ~(mpanry
CITY OF PRIOR LAKE
1Department of jiuilbing 3Jnspection
~ 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
Bldg. Permit No._ 00-0011
Legal Description
R3 Type Construction VN Fire Zone N / A
W 1/2 LOT 3, BLOCK 1, GLYNWATER
Zoning District R2 SD
Occupancy Type
Owner of Building
\lite Address 3485 BAY KNOLLS DRIVE
Contractor's Name & Address.WENSMANN HOMES, 1895 PLAZA DR.. EAGAN, MN 55122
1)~ UTl~C:
uilding O1ficfar-
Date: ..:E. f'.).NttJ IJ. - n - 0 I Date:
\ POST IN A CONSPICUOUS PLACE
City Planner
u;NNT 'T'mu 1)
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1~-1/-O}
ADDRESS 34-85 ~l K~H.s. 1)".
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
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
S~r
~s.u. €- C t(!) .
c.[(9.s~ 1=:-- J e-
;a-<ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . UlLlJt? Owner/Contr:
CALL 447-9850 FOR ~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
12'1-o(
ADDRESS
5if~S- &.,Krn/Is
(
OWNER
CONTR.
D/:
LNel1~
PERMIT NO. ()(? - C2lJ
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
CiQINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
J(,EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(;/'It-t<.--"t::-
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~ -'.f' . --""
InSpector:'/~ ~ _Vwli~,!Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN$NOTI
'\
'~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DA -E TIME
.Iy pd' (0-:'00
ADDRESS 34'03 +-~~ + Ef1 ~
~y KNow -,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0- J 0 I- fl rl1--.. 13
~OING
OUNDATION A
FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
^ 0 MECH RI
~..\ ~ATER HOOKUP
IA .\,0 .:lcJVER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMME~T~:
l-z.,' ~~
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fy ~ 'r-'\j
l
4u (.) rc---
~0
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r-ON
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'WORKSATI A TORY, PROCEED
o CORRECT CTIO ~ROCEED
o CORRECT O. V OR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447 .985C.FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE0jIRFJMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
V INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
t -;u -Or Ot ~~D
OWNER
34-es- ~ ~ll-s
(
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
(!)f!) - eo r I
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
yPLUMBING FINA@
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
v\I\~O'AA"k.r ~ k
tM~ ~eo.~
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR"', CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . t fJ.J.J.,9) Owner/Contr:
CALL 447.985~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
ADDRESS
DATE TIME
SCHEDULED 5 -9-01 :3 ~C5()
(~lig5'- .Rf1jj j(j{)()/I)' .lJr
CONTR. I
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
PERMIT NO.
0-/1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.f:f-o-f!fNAL
. 0 SITE INSPECTION
o PLUMBING RI
- L-I.I RI
o WATER HOOKUP
o SEWER HOOKUP
^-- 0 PLUMBING FINAL
.t'f ,..9'MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIBEPLACE RI
~EPLACE FINAL
o GASLlNE AIR TST
o
COMME~T~:
-.O~ 1uh..clL(eSs.
. +it
cOt
o WORK SATISFACTORY, PROCEED
~RRECT ACTION AND PROCEED
o CORRECT WORKl CALL FOR REINSPECTION BEFORE COVERING
Inspector: <b '- \ CU\f1 Owner/Contr:
CAll 447-9850 FOR 4E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE RECEIVED CITY OF PRIOR LAKE
1/71zovu BUILDING PERMIT,
I ~ TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
File
City
Applicant
~c::c. HIfI,v FiLS OfJ-{)IJID
Permit No, 00 -()() / L
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3f85 LJt:A.y k Pv"I/ r /.) r . v f'
3. LEGAL DESCRIPTION '
LOT t..; J &... lD 7 J BLOCK I
ADDITION
4. OWNER
(Name)
(Address)
5. ARCHITECT
(Address)
(Name)
I. White
2. Pink
3. Yellow
1. DATE
}-7-.200 c:J
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
I<'L-q)
12. NO. OF STORIES
PID~.:r-.J..5u- 003-1
6. BUILDER (Name)
Wt'/Vf htt.1./Iov
/-1om{'J
7. TYPE OF WORK Fireplace 0
New Construction'b-- Alterations 0
Chimney 0 Misc.
(Addr!l~s)
/ i '15" 1'/4 2.,;. j.) r
f ~y a /V /J1N 5-5/22-
S~tiCO
Addition 0
Deck 0
Finish Attic 0
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
~Sl- ~QI. .yy()()
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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 9JIicial can revoke th~permilJ? just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X LJ a.cy V ~ /YS,J- j-,/<l.C/(::Jf}
/ / / Signature License No. Dete
V
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
BUILDING DEPARTMENT VALUATION
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION --l~~O(')(j. c:J~
USE OF BUILDING ...:;;;;p/j
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
l ro7.;l~
f.t>5'/. , ,
IDl.C'Q
Plan Check Fee ............................. $
State Surcharge ............................. $
I~.OO
~. e>c:>
.'<~O
City:
h no,1;
~bD
I
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
Amount Brought Forward .................. $
Park Support Fee ........................... $ Pf=:;C:J . t!) lJ
SAC ......................................... $----'-' 011 . €!)O
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ..%..'.'................ :
Meter Horn ...........0..'................. $
Water Meter .........:tlL................. $
Sewer & Water Connection Fee ........... $
tf~. t) (j
WaterTowerFee ........................... $
u.s. 00
1,?t!JO .~
. /tf'X> , (!;) tL
Water Tap ................................... $
Builder's Deposit ............................ $ - 0 -
Other ......................................... $
Total Due .............................. $ (0/0/ 9- 'I~
Issued Paid fil, f) 1/" ~ G Re~cei~ tJlo :3 G?77 7..-
Date ~.;- (jO By
This is to certify that the request in the above application and accompanying documents IS In accordance with the City Zonin Ordinlnce and may proce ' s requested. This document when
s~:; PI~. er const~utes a temporary CertiJicate of Zoning compliance --"ld allows con ruction to comm nce. Be re occu ancy. a Certifica of OccuPKn~ be issued.
~~ l-IL-f-~') ~~.' ~~
C anner Date
24 hour notice for all inspections 447.9850
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I
The Crnter of the Lakr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-' ,
~...~_..'_ t~// ;~ ,:-:-
//~/
,I
i , / ;' i
/ " V L-- l., .-.-'
{jl-... .
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
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."
00-00/1
Th. C.nl<r of lh. Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
W6NSM/lAlAl
I /7 / (; 0
I I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3L/!35 Bo/ KIV()~ De.
K
Accepted
Accepted With Corrections
Denied
(?f?~. ~Date:
- ~)/
( - (~- 2l::Jod
Reviewed By:
Comments:
s~ . 5' -P -it-
L:tc:...
00 - 66/0
~r- p~~ s~s. S{Jr~
"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 C.nltr of Ih. uk. Counlry
oo-cOII
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,
t . !,- . /,~ f-l " I
p't! C/V~ IL/liN IV
/ /'7 / (] 0
/ I
The Building, Engineering, and Planning Departments have reviewed the building permit
application' for construction activity which is proposed at:
3Lj'J35 /3~V /C/\/Of-L5 012,
/
Accepted
./
Accepted With Corrections
Denied
r""l_..:_~.._.-.I "_.. ., --,.,... .
n~vl~w~u oy: hJr'tIfEfl Ct-fItE!\MI4NN
Daie: tli~/on
Comments: sa: i3.J&U;)/All. PEltMfT 'f:I:. 00- OIQ (3"'~J f.3,qt KAoc..LS .I:>R/l/E)
F'o~ INF;:,(lW'1.4TlDIU
.4-rrAC.t-lMEN'13 I A,.JJ:) t:..OfOotMENTS .
"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."
Job Address 3'1f~ Py I(/.-dJI.I
Heating contract~r~ / p1 ~ /2 'Y~ ,..
IJ] .
A,- (-
1- 't-~/
7
o
<
-./
Name of Tester
,.
Date
Percent 02
Percent CO
Percent C02
Stack T~mp.
/CJo 4
Combustion air is adequately supplied per
UMC Sec. 606
Input
--
. CITY OF PRIOR LAKE' \)
. 16200 Eagle Creek Av. S.E. PermltNo. ()O .. Q () (7
Prfor Lake, UN 55372
Dale
Sle AddrlJ8l
B~ Add.bn
Owner"aName 1.1 Y..n~ n10 ~
Addt.1I l~qC --P~7 ~ W_ 9-~- 2tSo f:i:1~1
HeEding Contrac1Dr f".,~ J") 7 - R..LJIt Jr'\
Addless IU'1U, .So ~ ';;-J- Tt?-L &~l.(')T
Telephone'. ~,;::. I -- U 7. _~- II L/ L/
Furnace Make & Model fi",.If 11 '" lC' TYPE OF SYSTEM
- Warm Air Plants ')(
Model Size t=.. 7 ~~ -- -, C- Gravlty
Machanleat
AlrCond.bnklg\L 2-'f'1 "Tn ~ \
FUll 1\Jwr. Pxl.~Flue SlzeU I' !b,,~ Venl S~em
Supply Openings t c..... HEAllNG OR POWER PLANT
. Steam
~ HoI Waler
() ~ Re.dIa1lon
Output (f} : ' 1I J LJ Spedal Devlcas
'Lot
Conn. Load
RelUm Openings
Inpul tr;,rmTJ
Ed,.
Other Dlvlces
elm.
TYPE OF WORK
)(
Alterations
Reppmem New Cons1ruCllon
Est Comp. Date
RepaIr
Est, Cod $
HEATING PERMIT FEE'
STATE SURCHARGE $
TOTAL PERMIT FEES $
. BuildIng Permit.
fJn - ()()(I
.
.50
PAID WITH
. BUILDING PEi-ii\JlIT
Recelp't tI
TVPE OF STRUCTURE
1,1'1*
2. Ore
), Yell. :
Ria
Oty
CIMllrac:tac
Single Familv .
Commsrdal
~
3:
D
AJ
Multi-FamllV
, Public Other
lWo-Famlly
I nduslrial
.....
.t:.
N
lSl
lSl
lSl
Fee Scbedule
Industrfal, Commerclal & MulU-Famllv
ResldenUaJ, Healing & AC
ResldanlJat, Healing Only.
Residential, Gas Aleptace
Reslden1lal, Adrlitlol"lS & Alterations
Reskfenftal, AC Only
1 % of Job cost (139,60 minimum)
$99,60
$84.60
$39.50
$S9.50
$89.60
(j)
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Remember to add the Stale Sureharge on the bottom 0' Ihls appMca~on.
The,piIce 01 your heating permit Includes one rough-In and one flnat Inspection.
AdditIonal inspections will be bIlled I.' '35.00 each,
House Healing Te.s1 Record musl be submitted with r,,~ '!~'11,~,. P'I......it N'~tw' belQf8 build-
mg certiflcale 01 QCCuplll1&y will be lssued.
Ul=aT r.A' r.. II .Tln~AI=IFOIIIRFn with number of supply and return openings IIsled per .
room with CFM'a per opening, New structures or addilions lend Door plan wlh supply
and ralum locatIons shown. HEAT lOSS CAlCULAllONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E, PRIOR LAKE, MN 55312.
City Hall business hours are 8 8.m, ' 4:30 p,m.
All WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HAll
441-4230
I hereby apply for a mechanical syslems permit and I acknowledge thallhe
information above I. comple'e and accurale; Ihal Ihe work will be In conformance
with Ihe ordinances and codes oJ Ihe city and with Ihe state buTldlng/mech.nlcal
code.; tn..I Ihls form does nol become a perm II unlll sIgned by the BUILDING
OFFiCIAL; that 'he work will be In accordance wJth the approved plan in 'he
C.Sj 01 E:.:~rovl8W Bnd approv.lo' pl....
Appllca ,-. -,. , -
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CITY OF PRIOR LAKE Me ! . .
16200 Eagle Creek Av. S,E. Permit No. 0 - 0 i I
Prior Lake, MN 55312
HEATING APPLICATION I PERMIT
Date /J~i''-OD PIIJ. ~~-J ,~,!)D- D 03-
SltllAd~QS$' Jq~.'i' L .J(J/r f1,~~ - ()o"" II
tNll ~-\ I ,.. /'
Lot ~ ~ Addition l...O(UIlJ UMe,r t [;~
Owner's Name I JIJAI__.A",_ ~..J I
~
Address
HeatingConlractDr ALLIED FIRESIDE dba FIIESIDE CORNER
Address 2700 N, FAIRVIEW. ROSEVILLE, MN 55113
Tefephone,651-633-2561
ptREPLACK I
lMnIaP Make & Model ""lid JJ ~ Co
1 '
ModelSizll ~ 1S1JW_
Conn. Load
Fuel f/-.A.i
SUJlPly Open! ngs
Relurn Openings
TYPE OF SYSTEM
Warm Air Plants
Gravily
Mechanical .
Air Conditioning
Vent.Systsm
HEATING OR POWER PLANT
Sleam
Hot Water
Radlalion
Spectat Oevlces
Flue Siu
lnpuI
OUlput ;l.l CAD
Edr.
Other Oevlces
elm.
lYPE OF WORK
x
Alteralions
R9placement New Conslruclion
Repair
E$t. Comp. Da1e
/ j.~l'l... a:>
Esl. Cosl.S
//00. en
8u~ding Permit It-
HEArING P ERMJT FEE $
STATE SURCHARGE $
TOTAL PERMrT FEES $
.50
PAID WITH
BUILDING PERMIT
Recelpl ,
TYPE OF STRUCTURE
] Pi".
1. Gn,n
1_ Ydr-
en
ro
- Rk :J
air r-t
CD....' OJ
'<
Single Family
Commercial
"
H
::Il
m
en
H
a
m
n
o
::Il
z
m
1 % of ~ cost ($39,50 minimum) ::Il
$9,9.50
$64.50
$39.50
139,50
S39,5O
Two-Famtly
Industrial
Multi-Family
Public Olher
Fee Schedule
Indul.!lrial, Commercial 8. Multi. Farrnly
Residenlial, HealIng & AC
ResidentiaL Healing Only
Residenlial, Gas Fwepiace
Residential, Additions & Alterations
Residential, AC Only
Remember 10 add the State Sureharqe on Ihe bottom or lhis appication.
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....
The price of your heating permil Includes one rough-in and one Onal Inspection.
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W
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Additional Inspections will be biDed at $35.00 each.
OJ
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House Healing lesl Recora must be submitted \\;th Iluiidina ~M~W'~ DIIDbII: before bull ~
inq cer1flicale of oocuparlCY win be issued.
HEAT CALCULATIONS R~n, m:u::n with number of auppty Ind retum openinp I6ted
room with CFM'& per opening. New structures Dr addftlons lend ftoof plan wiltIlupply
and return locations shown, HEAT LOSS CALCULATIONS, PJ\YMENT AND
APPLICATIONS MAV BE MAILED TO THE CITY OF PRIOR (ME, 18200 EAGLE
CREEK AVE. s,e. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. ..4:30 p.m.
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ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL em HALL
441-4230
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1 hereby apply lor a mechanical systems permit and I acknowledge thai the ~
inlormalfDn above is complele and accurate; Ihat Ihe work wtll be in conformanc
willi the ordinances and code. of Ihe cily and with lhe slate buUdinglmeehanlc
codes; that this form does not become.. permit until signed by the BUILOINI
OFFICIAL; lhat the work will be in accordance with the approved plan In the
case of all work which requires review and approval of plans.
~~fJ, IL~
Applicanl's SignatlNe
CJF~
8Ui~ OffiCiI's Signature
I1ljk
/ Dale
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MAR. 14.2000 1:48PM
GENZ RYAN 6513226147
NO. 766
P.4/5
1.
2.
3.
l~') 4.
-- 5.
6.
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........./
.... - ....
ftU.OW . AI'IU:AIrI'
lIOLD . CITY
CITY OF PRIOR LAICE NO. 00 -() 0 II
SEWER AND WAJ..u\. PElUfIT
NOTE: Sewer and Water
. contractors must
be registered
wi 1:h the Ci ty .
APPLICANT: & ,frZ_-~
ADDRESS: {~~\tC\ St-- ~ ~ TlZ..L- fL<!.vYl'r
SIGNATURE:.j ~ (JL- ~
SITE ADDRESS: r ~R, I ~ De
. '_I,.
PHONE: .ltt2L=Y'Z.:~ -11~lJ,
DATE: tlL, l5D
BLDG. PERMIT # .../1/) -~Q{) I /
PID# 25- 3S()- OQ~ -I
FILL IN THE BLANKS
LfnJ
Estimated length ot water service
J "
Size of water service inch(es).
feet.
Location of any couplinqs
from st:ructure
PV~ ~ Cast Iron
4()' .feet.
feet.
Type of sewer pipe- ASS,
Estimated length of sewer lin,
Clean out (it required), located at
structure.
feet
from
....---__R...-
iiiiiiiZE===-iiiiii:
..
,
...
This
your permit ,wnen approved.. ;;
O~TE: 3./i 4-; iJ ()
BY
-,---------------...--
FEES:
$
S
$
Sewer and water line connection permit.
Surcharge
TOTAL
35.00
.50
35.50
* Fee for either se~er or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
to insure that no dupllcate sewer and water permits are
issued.
DATE PAID
RECEIPT *'
<,,' :"C 'N\1"~'l'\\\
/ V',\~G ~
~ts~\\.o .
AMOUNT PAID
REC'D BY
. 4629 Dakota St. SE, Prior Lake. MiMssota 55372' I Ph. (612) 4474230 I Fax (612) 4474245
Ni EQUAL OppOR11JNIT'f ~Pl!MR . n_ , . - .
MAR. 14.2000 4:31PM
GENZ RYAN 6513226147
NO,775
P. 14/21
11M Cftt", ., 1M .. c.u..,
1. al. FIle
~ (lqkl Oty
3. YeIIlIw AppliQllt
# 00 -()() / /
Appllcant:--"!:v' ,Cl'/ - ~ Phone: 611 5'1- L/"Z~-tf L/ U
Address: I Ll1 L.l, ~ _ _n::J -r(g..J.... ~~ lJf ~
Signature: Uf"'\ ~ >
Legal Description: iol ) Block .Sub
Site Address:~ ~ ~y ~I t ~ 'l)t'2-
Building Permit 1# . --LJ () - 0 () U PID, z5- 361) - () (r~- I
Nv I t:: This permit ~II not be processed Without complete information.
FIA I ~RE UNITS
CII V OF PRIOR LAKE
. PLUMBING PERMIT
Quantity Type of Fixture Quantity Type of FIXture
l Bath Tub with or without shower .3 Rough-ins
l Dishwasher I Water Heater
r Roor Drain R-I, Water Softner
3 Lavatory (bathroom sink) J Stand Pipe (washing machine)
, Laundry Tray (1 or 2 compartment sink) Sewage Ejector,
l Shower StaJl Baclctlow Assembly (RPZ, Double Check, PVB)
, Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
, ~r
. .J 1- Water Closet (toilet) Other
rei: SCHEDULE
Industrial. Commercial & Multi-Family
(1 % of job cost. $39.50 minimum)
Residential, New One & Two Famny
Residential, Additions & Alterations
State Surcharge
$99.50
$39,50
$
$
$
$
.50
GRAND TOTAL ~\
{
. "I
-- ..-/
Call far all' speC:tions 24 hours in advance.
16200 Eagle CreekAv. S.E" Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-42~5
AD Equal Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS <t/d5 ~u KIAI"JL{s Dr-
NATURE OF WORK ~.~-
USE OF BUILDING 5FA
PERMIT NO. ~o - 00 It DATE ISSUED I-/~ - 2000
CONTRACTOR ~.......,"~ "'"~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I (/]) ;~:~:R
FOUNDATION (Prior to Backfill) ih aI-~1 (/J) zJc./(~() I
PLACE NO CONCRETE 1.JNTIL ~OVE HAS BEEN SIGNED
ROUGH/lINS
SEWER I WATER I SEPTIC (41 I'll fir)
FRAMING {/ ~\ll
INSULATION ~ V
ELECTRICAL
-
PLUMBING I ~\i/ tJ / {jj
HEATING (if required) vJ/e- {/ ~.; I 1111 & I tt1J
FIREPLACE . ~ //I/c,k
GAS LINE AIR TEST (j~j:/(/fJ ~f) ,;/,q)Ob
COVER NO WORK UNTIL A" HAS BEEN SIGNED
I~D I I
FINALS
lib
0\\
h.\Jr~
1)~
OCCUpy UNTIL A~O~~\AS
NOTICE
DATE
rc'tNJ )(90
IA.
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
I}() NOT
/?L(/~OJ
5. q,et
Ii .
II ;2"?; . 0 I
.
6 C\ of
v ,
BEEN SIGNED
Thi$ 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850