HomeMy WebLinkAboutBuilding Permit 97-223. �
� �
4 :
9
- 7)
Vk
a
� � ƒ �
� �: �
N
JA
x
Job Address /6510 Q 04k A
Heating Contractor
-
Name of Tester
Date
!7
Percent O
9.5
Percent CO
(o, '-
Percent CO
A60—
Stack Temp. — 11 o r
LA .
Job Address /5510 kul Oktk
Heating Contractor s
Name of Tester
Date /
Percent O 7
Percent CO2 b
Percent CO
Stack Temp.
O
O
lowrn �wvncut l�l5 /0 /?aA � R�
15510 QtGI O&lk �( Job Address
Job Address - Heating Contractor KIS ,
Heating Contractor a Ati.
Name of Tester
Name of Tester .
// 7 Date i
Date Percent (7�
Percent O 8.0 Percent CO
Percent COp 7. 2 Percent CO
Percent CO . �7 LT� Stack Temp. 113
Stack Terra. �3 — S� I -
DATE TIME
CITY OF PMM LAID: CALLED""
No COMPLETED
A t55 U iKel. O&k
owl
CONTR.
TRA PIIONENO. _.
r
�y ❑ FOOTING OPLUMBING a
t LL o MINING NO
y C INSULATION F HOOKUP
q ❑ WALL b. SETTAN ON
y OFNAL HOOKUP
ND 'K O FOUATION INSTALL.
O ONLOL. ❑ SEPTIC MANE.
❑ FIE REV. ❑ PLUMBING FNAL
commu
ONTE INSPECTION
❑ EAV,9RAONURLLKNO
IU.'
0
❑COMP COMPLAINT LOWKESHORIVIVIETLANDS
❑FOLLOWAIP
❑ SEPTIC FINAL
❑ FNBIACE
❑
J
S•
La
❑WORK 8ATMFACTOIIV:PROCEED
WRRECTT WOTSf ATO PROCE�
❑PID1DTAgN
WORK CAI.I FOR IE BI.POIE
COVEIWIO
_NdDB.
❑ CORRECT UNSAFE<OONOITI IN
❑ STOP ORO PaB. CALL
NSPFCTOR WILL REIU:IN.
• INSPECTION PINSPECTION N OIII RE CALL IOAMAIDE ACCESS.
TOMAN
cKdlbrUKSNISKT:' ED n2A- launintlNNw.v.
OwnOFMonlr.
InspW O<
_
447-4230
�CSP�/
AbHi�m
DATE TIME
CITY OF PRIOR LAKE CALLEWH
INSPECTION NOTICE SCHEDULED p-t - 4'7 1 a • r�
PENrIT NO. , 97- 223 COMPLETED
I55IO ?ad C�,k Vic(
TELEPNONENO.
W O PORTING
O FRAMING
y O INSULATION
OPLUNBING RI
O MECHANICAL
- eWATER HOOKUP
OSRE INSPECTION
O ELCAWOPADNLLFIWNG
O LAKESHOREANETLANRS
o WALL W.
2 O FINAL
O METER SETITURN ON
�'BEYA<R HOOKUP
O COMPLAINT
O FOLLOWL►
-K O FOUNDATION
❑ SEPTIC INSTALL.
O SEPTIC FINAL
I O DEMOL.
X O FIRE PREY.
COMMENTS:
O SEPTIC MAW
O PLUMBING FINAL
O FIREPLACE
p
rd
IV T
C
l� - /
W
O PHOTOTAKEN
7 M4rN >'A
DATE TIE
arr OF FNan LAKE C A L LENN
EmPEom � "MAW 11 -12-97 ��:30
FEnENr N0. "" ` � 3 COWLETED
ADDe 15SID
Ad OAA4 2d
A O z.
o
owNEN
ApPECT ON
cowm.
TELEPHOMNO.
OMIISfIC011D.011 IN
O MOVING ONAAMMON RI
��ICCC O FR IANO O MECHAM LLA1
aj O NSIAATION O WATER HOOKUP
Q OWALL SD. 0RIVER AEFRUN ON
Z 0FNAL 0SEWER HOOKUP
O FOUNDATION O SEPTIC NSrALL
DEM 0 SEPTIC
t� 0 "M" SEPTIC W FO
PIEV. ` i0®_ UINNO F . A
OSM INSPECTEIN
O EXC VARADMIMM NG
O MKESIOFWJWEAMQ4
000KVL4W
OOASUNEAUITEST
O SEPTC FOUL
O MECHANICAL
O MECHANICAL FNUL
ye AA vu. -fL,
Vllw..n
O PIIOTOTNEN
7 OdtlECf 011 N
_IIOUIS. AMMECWR WUL RETUN.
A O z.
o
IEEAOCEW
ApPECT ON
plI 10rtl1AIIMR I / h01A ntlw1CA.
OMIISfIC011D.011 IN
Impoetor
417.4290
EED
C CORRECT CORRECT UNSA FE CALL CONDITION WITHIN - N BEFORE FS. INS CO
;] UNSAFE 171NN _IIOURS. INSPECTOR WILL RETURN
call for
I cm, ' Ii
DATE TIME
MY OF PRIOR LAKE CALLEavw
IN$PECTON''� N SCHEDULED l L 3:db
PERART NO. 7 - 22 COMPLETED
AOORM I r 75 10 &1 Oak 9d .
OWNER
TELEPNONENO.
r
i ❑ FOOTING
_
DEPL RI
O FRAMING HANICAL 7
TE INSPECT1t
0 E%CAV SLUNG
❑ INSULATION ❑ WATER RIOOKUP
/GRADIN.
O LAKESHORENYETIANDS
O O WALL SD. ❑ METER $ET/TUR
0 COMPLAINT
z C FINAL ❑ SEWER HOOKUP
❑ FOLLOWLP
t ❑ FOUNDATION ❑ SE TALL.
❑ SEPTIC FINAL
j E O DEMOL. C MAINT.
❑ FIREPLACE
O FIRE PREY.
O
t
a
D m
d
25� 15 SL.aS
Iv,`1)
2
y A^ GFAQ Q�
N..•2 �L,.L>t \
�4 .0
W
Q
W O Y P 7 E
❑ PHOTO TAKEN
CARIE WORK AND
RECT WORK AND PROCCC ID
EED
C CORRECT CORRECT UNSA FE CALL CONDITION WITHIN - N BEFORE FS. INS CO
;] UNSAFE 171NN _IIOURS. INSPECTOR WILL RETURN
call for
I cm, ' Ii
gerttffratt of Orn*=M
CITY OF PRIOR LAKE
Mtpartmmt of 39nabing 3noptctim
Final Permitted ❑ Conditional C.O. Expires
7has Cenific hard Pnrwmo m du re9WMMms of Swum 307 of the Umform BNddang Cade
nrdfymg dmt m the rime of LematlCe dds snuMm u an CmnPlaonCe with the mbar ordammces of the
Cary of Prior late mir"bang building contnactimt or w For the fowl
� n8:
Us aavmrim Sinale Family pemtit No 9
0 - , Pm7TTpn R3 Tyye COmuadim V F tom N/A Zaanef)n _. R
L.Sw Dmwipd 1/2 of Lll S L12. Red Oaks Addition
omv m&iin` Brett Thielen Siu Adams 15510 Red 0 ke Road
Don Rye
Ponnrer _...
am: 1 1-7-q—/ mw:
POST IN A CONSPICUOUS PLACE
DATE TWA
CITY OF PIEOR LAKE CALLED01
ENwECnoN� SCHEDULED
ERm
PT NO. COMPLETED
Aoo9EEE I 5� 0 9. �, (') s L, .
ow►m COMM.
TELEPHom No.
O FOOTING OPLUNOM TV OSRE INSPECTION
O NMLENO ❑ MECNANWU411 O Ell01WARADINGIFlLLE16
O O WATER HOOKUP O LOXESHORENVETLANDS
go.
p ❑ CID. O METER U ON O COMPLAINT
Z O S E W E R IC SMALL OAS LINE L TEST
S
O DEMO FOUN DATION O SEPTIC INSTALL O SEPTIC A
FIRE
i
• FIRE P O SEPTIC FIN O F
❑ PREY. 13 PLUNGING 1BING q PWI1L 11 YECHAECHA MECHANICAL FINAL
M_ _
tlA
W
11yy f oiOv SATNFACTDWPROCEED OPNDIO TAKEN!
9 O CORRECT V ONTNO PNOC®
O OOR T UNIP C
COM THIM _ BMW COM
• COR IIILBNE O CALLNM TEA _JIOIMIR I/BP WILL lEi1RN.
• INSP ECTION FIGURED. J
• INSPECTION CALLTOANW/IEADCEB&
CaN1ErUU i1YpECIWn,IEfi�TE� Mlw
ina.
owfl.r a�E ) -
TnIPID u712ae
YIIr�(1A�/AY r��1A•
* rIMA Y CITY OF PRIOR LAKE
BUILDING PERMIT,
2 1 1991 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
D UTILITY CONNECTION PERMIT
1. IMate File
2. Piok City
J. Yellow ApMeam
PemIt No. - a � 3
DIRECTIONS
1, DATE
SPACES NUM
1
BEFORE PERMIT IS ISSUED (Please Poor or Tylre am agnateonorw
j
IL/o
BUILDING INFORMATION
2. SffE ADDRESS
11. S¢E OF STRUCTURE
S S OA 1
S n
I Z and O�ml
3. LEGAL DESCRIPPON
12. NO OF STORIES
y
, Z �
8
LOT BL
^ -�F7 k�
t3. TYP?OF CONSTRUCTION
ADDITION. _
y
a. ER (PlMrle) IAaaess)
ITO Nw)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT (Name) (AadWS)
fial. NaJ
ST O
SOO
6. WILDER (Nama)
(Tae. No.)
15. NUMBER OF OCCUPANTS OR SEATS
Sao-
P
OCCUPANTS 3
SA•w�sts' 66/0 u/ 89'037(0
SEATS
T. TYPE OF WORK Fireplace O DeckO He- raafilg0 PoMM0
New CorYlWCdwg< AXeretbrls0 Addnlon0 RrgsI AM.0 Re- rding0
Fnlen Basemen(❑
16. P/IOJECT COSTIVALUE
CIInereyO Mi..
ZSO Q2".
S.PROPERTYABEAORACRES 19,
PROPERTY DIMENSIONS
10. CULVERT SIM
t>. COMPLETION DATE
Sir 0 �S
Wmn 5' Depth /,/,5,
Yee
No
.SE',PI - , / ST
I IlaneYY nAIY flew NIIYYIIed Ydomason on tlb apgWaibn wNM is to me Bestof my knowledge two arw Mro 1. lalsoc tyMallam Neownerwaullwwwagemfor
tlw eEmv� mmmm a' E pmpbry xA tlat ap nrWrucnon wY nnlo ell evsling slab and (oral
laws aM vMll procee0 in edvNarwe wXn wominetl vlarw. am aware that me
rewketlMY 1 Inuse Fu OarepY a9rea lltel me cny aXiciel or designee maY enter upm Me DropeM to Peep
/x Elaal�olfYY1
SbM.wn
/ ee�inspecpotw.
Lmnsa rvo. De
FOR ADMINISTRATIVE USE
SETBACKS: Fattened
MATERIAL FlLED WITH APPLICATION
AIWI
SOIL TESTS 0 ENERGYOATA
PIUNGLOSS O PEPCOUTIONTESTS O
F. Back Sqe
SiW
WILDING DEPARTMENT VALUATION i
OFF STREET PARKING
SPACES REO.
PUIIS & SPECY� SETS
OF
a
SPACES ON PUN
SURVEY .0 COPIES
T E—
PERMIT VALUATION as °• CL�O
PLOT PUN O
iYPEOF WNSIRIICIgN: I II III W to
OmyNly DYry A B E F I M® S U CXy
moM
Amt SmugM Fore a d .................. $
/ �H a
D 1 2
Park Suppo t Fee ........................... E O
y>
PBingt Fee ...................... .. ......... - $ L. G 37. a .S
SAC ........... .......................,......E �
PYn Cneck Fea .............................E 1.06 a/
-- ----------- -- e .......................
IA$ 00
Sewer Tap .. ................... ..__........5_
Stale SUafame ........._......... E
penMa/ .......................................
Pressure Reducer .9.....................
yy $
Phan gPemNFee.Pl /�O•nO
Meter lbm..... ... E
.T
Pews Fee I /Q(� Qa
n —
We. Mahn.] . .........................$
7 '"r S P
Server & Wafer Conre:don Fee ...........E D
Server& WeYr PemK V IF(�.7..�
Gvs Flreplxe PemWryIL. {. /..:_°.�WE LIAr OC
Water Tawer Fee ........................... E 0 _
Water Tav ..................... ........... ...E
1p1�A eemlrMasy� rBUgdkg PemevAmABpowp..
Data S -Z9 _4
_
BuNbrs Deposit .. .......................... s�JO
D mer .......... ............................... s
cannlnre w�—
TwW Due .............................. $
Implied
PeM y -�.��. 4( RaDaIpI ND. ,
D. Y
TINYbc Yyi a @ @@ CbtlYaOO. eip&$ onan0asmryenyYMpdoMarbYba [mMkImMEYCXY
>AaaM latdnWCaeMmaY IaVtIMBE. doNrW WYn
J / Yb YSaBrywaYCdNaba la YgmblNmbtlalowameM Wmb dmY Ya Be wean pecy.aCmMrebp mdpa YaY1
4w
9prJw iwy
zelv.minlvaaKOx&YY u >ex3o 10�� 97• a2.3
Building Pormn 11
P.1-D. #
CITY OF PRIOR LAKE
SINGLE FAMILY WORKSHEET
Name of General Contractor. D AFT T ! 41 P- - E/✓
Address of Proposed Project: �,a /Z-E� JAk 12
Sgwro Foot Floor Area:
First Floor
• Second Floor
• Basmienn Finished
• Basement Urdmohed
`y • Garage
• Car Pont
Deck Z 00
_ 3 Season Porch
Sven Poin
•
Number of P.8 Bathrooms 3 1
• Number of Hoff Bathrooms J d4
(Sguare toot pna of e Season Ponch to be included in Fist Floor) S'O C ) J
SWg7't777 Wat «Cunt acto STATE I 44 _ 1 9
,550 T Name Address 1 iSSVF
Working Under. _Z n�t,Fo --
(Nam, of Licensed PWmber) (i same Address Phone#
Number of Masonry Fire Places:
Stacked Fireplace -6xick one Yes O
No ❑
of Gas Fir
M C 177 - /p Number F -3 / '^L
al
UT � J ;7
Instel br. ame �j��LJJiJ/
s�
/0 . 00 Name Address
Phone#
Number of 0 Clearance Wood Burning Fireplaces:
Installer Name
Name Address
Phone#
'l
MC97- / Nam {Z'� H A /Z(oSl
Z6u/t1A26' P32y- 03 7trji
Name re5b
Phon9a
/00.00 Funs.. Check One Yes.ti(
No O
Air Conditioner: Check Ore: Yes $.
No 0
Air ta Ai Exchanger. CMtlr One yes)(
No O
Gas Line Imtager: Nam 12 -' S t'f ea•4'r.
'•i" V(. //i/f
,PL 97-ISJ. Plumbing Contractor. Name L:Aktr :5" ?,E
PLVN1$G -G
i 00 00 Check all items included: Lawn Sprinkler
X
Water SOMer
RPZ or PVB Baddlow Preventor
Water Mier Sire:
` Chek one Sla' Standard
• r
o
_
I 1R G 4 's
Z 13
ATTENTION APPLICANT: '.
Your bekltlleg permit application will exalt Ma"ftdor - Ormwlmd lnromraUon In eonrpletad.
E
PRIOR LAKE B DEPARTMENT OF
UILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3 0
RK �
NATURE OF WO
USE OF BUILDING
PERMIT NO. 1 I DATE ISSUE ll il9l
CONTRACTOR
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
INSPECTOR
DATE
FOUNDATION (Prior to Backfill) U ° , 14111//97 1
PLACE NO CONCRETE UNT ABOVE HAS BEEN SIGNED
ROUGH-INS
SEWER / WATER / SEPTIC
I lu
9/2/97
FRAMING
// /
INSULATION
�f7
ELECTRICAL
PLUMBING
&7147
HEATING (if required)
7 1 1 0 7 9
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
WALLBOARD
FINALS
GRADING (Prior to Sodding)
y� V
BUILDING
// /
ELECTRICAL
PLUMBING
HEATING
DO NOT 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447 -4230
White - Building
Canary - Engineering
Pink - Planning
B UILDING PERMIT APP DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/SS /n Lid On 61 �o-a�
Accepted ✓ Accepted With Corrections
Denied
U
"Thu lSsu a or granting of a permit oir 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.'
Reviewed By: Yz&� Date: V'�J_ ?7
,- - 7 ------__
OF PWOR
U f m
iM Cw,n J,b We CxJry
Whit - Building
Canary - Engineering
Pink - Planning
PIII [A \ _ A \ Ll \
NAME OF APPLICANT
APPLICATION RECEIVED S1-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/SS /n L<el0AJJ
Accepted
Accepted With Corrections X
ReviewedBy: Date: S-77-q?
1. S61 CA o Ja soil Qtaca
ON U
� � l
M W I i 1 F E 111 5 ,
'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.'
OF PR1oR
U m
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED .51 1 - 7.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
155 /CJ LLL� On fI �� n�
Accepted _ Accepted With Corrections
Denied
Reviewed By Date:
Comments: 2 5
.{e4 yjwvo ±a� — 0t
of a permit or
strued to be a De
at of plans, specifications and
or an approval of, any violation of
lance of the jurisdiction. Permits
provisions of this code or other
re va"a.
3 -97 OB_ 29 ... ......... -+....
v - oa
CITY OF PRIOR LAKE
Impervious Surface Calculations
(rn be SubMiaed with auildina Pw it ApplintiM)
For All Properties Located in the Shorcland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
property Address 15-'DO 12eD 0A.05 1;XD
Lot Area
,....:�: .. „.....,. S Feet .: 00/i.......::;:.3Y 7..SO
LENGTH WIDTH SQ. FEET
HOUSE x _ � l
x =
ATTACHED GARAGE
TOTAL PRINCIPLE STRUCTURE ...................... Z y 8
DETACHED BLDOS x
(Grua dsbed) x
TOTAL DETACHED BUILDINGS .......................
DRIVEWAY/PAVED AREAS x =
(@Iwwry-PVed tx W) 2 t / x �
(swnw§WP,tx� Ateas) 3 x /I - 3 3
TOTALPAVEDAREAS ...... .. ..._ ........................... 633_
PATIOS/PORCHES/DECKS
x
(npe� Dab lP'tniw. apN.a bwwtrt
x s
bsrda, wah.�w.:.s..ra. MNw,
rnr(netiNd r to irp..ieus)
x
TOT AL DF. CYS_._._....._....... ...._ ......................__..
OTHER
x =
x
TOTAL OTRBR_........ .. _......_ ..... ....... .
TOTAL IMPERV SURFACE a //
�d By Date 512219
Woodrow A Brown, R.LS NO. 15230
Company Phone
CITY OF PRIOR LAKE
4629 DAKOTA STREETS.E. permit Na y7•
PRIOR LAKE, MN 55972 �(
: f , — I - LEATING APPLICATION / PERMIT
Data A 1
She Address
Lot Block Addition
OwneYS Name
Heating Contractor
Address - -____ - 16151 MAIN MN E.
Telephone s P12) 41549 OW
Furnace Make & Model
Model Size
Conn.: Load
Fuel Flue Size
Suppy.Openings
Return Openings
Input Output_
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Edr.
TYPE OF WORK
Alterations Replacement New Construction
Repair ESL Comp. Date
Coat S Building Permit t
HE 7_
HEATING PERMIT FEES
STATE SURCHARGE $ .50
TOTALPERMITFEES.S Receipt•
1. Pink Re
2. Green - On,
r TXFF OF STRUCTURE 3. YOM - corugaw
All Family Mufti -Fatuity t 1 W
Public Other
2% f pb value, min. $20.00
$1,001 - $10,000 $20.00 fir the first $1,000 plus $1.25 for each additional
$100.00 or fraction thereof to and including $10,000.
$10,001 - $50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
tional $100.00 or fraction thereof, to and including
$50,000.
$50,001 and over $532.50 for the first $50,000 plus $7.50 for each addi-
tional $1,000 or fraction thereof.
The price of your heating permit includes one rough -in and one final inspection.
Additional inspections will be billed at $25.00 each.
House Heating Test Record must be submitted with building permit number before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed
per room with CFM's per opening. New structures or additions send flow plan with sup.
ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 4629 Dakota SL
S.E. Prior Lake, MN. 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH414 AND FINAL) - CALL CITY HALL
447 -4230.
I hereby apply for mechanical systems permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the ordi-
ne rims and codes of the city and with thg5fate buildingnmechanical coder that this form
does ripirb9come a perr#k until signed %V the BUILDING OFFICIAL; at Ow work will be
in ar rite plan the rase of,* work which/quires gfview and
Signature Data
/F PRrO_�N
R7
P
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
�-rye
VKLM .�"
o D -ar.
NO. 7-- 0 7 y
NOTE: Sewer and Water
contractors must
be registered
with
(�y the City,
APPLICANT: y PHONE: y Y y - p 7
ADDRESS: O D _ - DATE: /3 -? ; 7
SIGNATURE: /� /1 BLDG. PERMIT - # ? 74= 3
SITE ADDRE /' < /iq '01 JP1 PTnu
FILL IN THE BLANKS `,
1. Estimated length of water service �s � feet.
�
2. Size of water service / l inch(es).
3. Location of any couplings from structure feet.
a. Type of sewer pipe. ABS_ PVC >�, Cast Iron_
5. Estimated length of sewer line -Yd feet.
6. Clean out (if required), located at feet from
structure.
This application becomes your permit when approved.
°Z DATE:
FEES: $ 35.00 :;ewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
r.
C
r ( y ' t. Ptra - ink
F PRICA TYPE CF STRUCTURE 3. Ye - Cmtracmr
F ., CITY OF PRIOR LAKE
v m 4828 DAKOTA STREET S.E. Permit No. Ala Single Family Two-Family Mufti -Family
PRIOR LAKE, MW 55972
Commercial Industrial Public Other
HEATING APa y PERMIT Dab �� n PDP n a y ` OWL JOB VALUATION FEE
Site Address 1 -4 K�� A. JY' QJ $0411800 2% of job value, min. $20.00
Lot _ Block _ Addition
Owoers Name Zce4
Address
Heating Contractor V e rt k "I PAL a c 6. �, ,1
Address 16151 &L2A Ae �' r Lsakc. 19VA/ b37.Z
Telephone s ��Q SG� S �•.nw.� hr c...�,�i
+cam 45-
Furnace Make 8 Model
ds (Y,�y}:• r rr_ F SYSTEM
Mo Size Gravity 'r Plants;
Conn. Lead Mechar icw
Air Conditioning
Fur __AZ6 Size Vam. System _
Supply Oporrings HEATING OR POWER PLANT
Steam
Return Openings Has Water
oPat Output won _
Special Davicas
Edr.
Other Dawes
CIm.
TYPE OF WORK
Alienations RWbmmwt New Catffiucton
Repair Est. Camp. Date
Eat. C'd $ Building perms a 47.1.��
HEATING PERMIT FEE
X�? q.s d STATE SURCHARGE t 150
TOTAL PERMITFEES ' Receipts
"W, 00
$1.001- $10,000 $20.00 for the first $1,000 plus $1,25 for each additional
$100.00 or fraction thereof o and imiuding $10,000.
$10,001 - $50,000 $132.50 for the first $10,000 plus $1.00 for each addi-
tional $100.00 or fraction thereof, to and including
$50,000.
$50,001 and over $532.50 for the first $50,000 plus 1i.50 for each addi-
tional $1,000 or fraction thereof,
The price of your heating permit includes one rough -in and one final inspection.
Additional inspections will be billed at $25.00 each.
House Fading Test Record must be submitted with burg cermit number before build-
ing cerlificate of occupancy will be issued.
HEAT CALCULATIONS REQUIRED with number of supply and return openings listed
per room with CFM's per opening. Now structures or additions sesd floor plan with sup-
ply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY aF PRIOR LAKE, 4628 Dakota St.
S.E. Prior Lacs, MN. 55372.
City Hall business hours are 8 a.m. -4:30 p.m.
ALL WORK NIUSTBE M PECTED (ROUGMN AND FIIAL)- CALL CRY HALL
447-/270.
I hereby apply for mechanical sydems permit and 1 admowodga this the information
above Is compote and aocorere; that the weak will be in comormaraa with the obi.
mops and codes of the city and with the stria bWWiaghnedrenipl coda; that this form
does net become a perms until signed by toe BUILDING OFFICIAL; dealt to work will be
In accordance with the approved plan in tlw caw of as work which required review and
i
/
a
V m
Dam Ark
PIDS ,lS -09'Z -004 -P
SMAddowa Mtm nett Mn
L J of 1 d all ollmW kd— Q�1—/
Osteh Nama BRETT TRIBI@]
Address 14958 Pixie Point Circle Prior Lake Mn
Hedilg CArtbedt: A R RMATTwa A ATM rasn- TW
Address 12651 Zenith Ave So. Suite 107 Burnesdlle No. 55 337
Telephone It 894 0376
Fu Make 8 p3URD20809501 TTPE OF SYSTEM
Werra Air Plains
Modal SW
Cam. Laid It �.(Ep wen
Fuel Fkw Stu r
Sl *Opndnps AA
Return Openings; s T.. rot
klpd 9Vnt awr OUWA 995 Y M
Edr. _
am 4,000
Y
Gravity
Mecharical
Air Condiionn9 Y
Vero. System T
HEATING OR POWER PLANT
SWm
Hot Wrier
Radiation
Spa" Dwices
Other Devices
TYPE OF WORN
AMrdbnt Repktamed WnCaudrudion ZII
Rapdr - EsL. Carp DW October 1 1997
EsL Ood i 0.50-00 npeuid" Pam'%
HEATING PEFKAIT FEE q9 ti�
ST ATESUROHARGE 8 50
TOTAL PWWFW a ldd ".6� Heeelpl
F VY1.Q � 0 LJ 3. Cream ry
CITY OF PRIOR LAKE t.,.Uw Cmerm
18200 Eagle Creek AV. S.E. Perms No. 4 � -11.5 PTbr Lab, RAN 55572 7 1997
HEATING APPLICATION / PERWr
amity t2R andly MW0 -Family
mamial_ I Pubic Other
Fee Sch Jule
Industrial, Commercial A Mrdfl -Famiy
Resider", Heating 6 AC
ResidentiA Heatlrg Only
Residential. Gs Fireplace
Residential, Additions E Aserasos
Residential, AC Only
1% of job cost (599.50 mean um)
$99.50
$84.50
$39.50
$39.50
539.50
Remember to add the State Surcharge on the bottom of this application.
The price of your hsdng permit includes one rough -in and one final inspection
Addisonal inspecaone will be billed at $35.00 each.
Howe Healing Test Record must be submitted with buitift owtIDO011ml}8[ balms build-
ing cardinals of occupancy will be issued.
HM CALCULATIONS REWIRED wflh number of supply and rebxn openings listed per
roan with CFM's per operft New stmcmws or atl65ons send floor plan whir supply
surd return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 18200 EAGLr
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hags are 8 a.m. - 4:30 pun.
ALL WORK MUST BE INSPECTED (ROUGN4M AND FINAL) - CALL CITY HALL
4474270
1 hereby apply for a mechanical systems permit and 1 acknowledge that the
irdormation above is complete and accurate; t the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case which re juires revs roval of piano.
�'— Appw�durs --
ie-a - 1e of
CITY OF PRIOR LAKE ,
PLUMBNYO PERM/T x 97- / s2
,)uN 2 7 1997
Thb Pw"* wE not be piaeasad w* an awpk to kdomn& n.
RXTURE UWTS
Dunn* Type of Fdlae pyandty
BWh TUb wM w wkhoid shaver
Dbh wwlw
Fbor.Dfidn
lavawY (bWmswnsM)
Lratlry Tray (1 w 2 oa "fbn nt sk"
M. skm
SWs
Bw Sink
y / tKawcbm (W" J
PEE scNEDDLE
lyd=bW. Ca ummW 8 MuN -Faaky
(1%.ofjob cm% SUM alrwam)
R"Wwdd. Mm Orr 6 Two Fai*
RrMwft. Add bm S Aftmd r
$",So
Mse
ORAND TOTAL
Type of Flslure
Rautlh4m
wow N.aw
v4v" Sotbwr
Sbrq pto (Wm ehb Y mwhkr) i
�I�P° ■AwW"(R Do"ChM *Pve) 3,
Baebbw Amy TW
Lawn Sprkddw i
Dft
i
i 99 0
i
S �
• A00 00
7Nt awew h awwu 4M do card wad N aw wW
a maw. am aw - 3 to A rwwtw.Mk ac wai
b Q - n �nrue aYlc &ow.
arcwaaewa actor.
' 'K RB CWs ND: DA7E
G11 :6x dl iw ocdses 24 in m f0 m .
162M FA& Ceeek Ar. S.E., Ftior Lake, sace,.c"a 55372 / Fk. (61.2) 4474230 / FAX (612) 447 -4245
An Egad Oppem I Ewpbyb
'[0'd: SbZbL6b O1
i0'd - dill
CITY OF PRIOR LAKE P �
,U( 2 71997
jpwmAx y7-gaz
TMspm warot a weea..a wehoutoanpkte wonvolon.
Ov.npy
TWO F6Bea
Luray
Typed Fkkm
Brh Tubwah wwNma diesrr
gpph.wp
cishodow
VYrar )ISasw
Flaw Drdn
VVMr Bslbw
1 a W I (hoseore sk"
of
SMnO Plpe pwafdr11 mewr)
Laundry TORY (I or 2 OW"h rm sii6
sh wr sw
awn
Br a"
a 0 Eww
BedaorAawIft (RPZ Daft attic PVB)
Sasldbw Aremaly Tar
loan Spllredw
MOONEDULE
mdw6W, fan.lwaol a eMrwFamiry
(T %stWb COKinsoM MLon) $
a.www.
NOW One & Two Family in=
ReoMWAk1. Additw A AlMrkne =920 i
swe audwo $ _ .BD
GRAND Tarty. s A20. P &
enrol" ar aw
NrCat tID, __
CAN fm ON bapecdons : 209
161110 Fink CM* AV. S.B., prior Lake, d WMMA $3372 / Ph. (612)147.4230 / FAX (611) 447 -4245
An Sjud 600 11 BaMo
TB'd 502bL6b Dl ZB :iT 466S/4Z/`J0 -.
W* ISKUWN \-j SURVEYING. INC.
8078 Cedar Awuw So& Suft 228 WOODROW e BRDWM. R.L.S.
=r W W425
, es4 Sutyey For: �7 22 3
BRETT TH ELEN
ff \\ Scale: 1" =30' 4
jj �s?a ` Monument.
Prior Lake j j , \ 0 Denotes Iron
Jj
Rio 1997. s jj `tt c
ff
f /
rf ° / r ?o yp
j / \ 1, �J
f 4O
f s T / \\
f \ / ' 924.7
fsr rf
_
rf / � 7 2 Q
,,,, v� � P
\ z,
/ `4to\
IMM
\ � 1
h Y ,
Square Footage Above 904 ?: O
contour= 11,425 Sq. Ft. / /
O Opervio2 Sur1ec0= 3,418.11
Proposed Elevations: /
Q
Top of Block = 930.2
Wa wt =920 -99�.5 Denotes Existing El ion.
Lowest Floor= 919.4 Denotes Proposad Elevofion.
NOTE: No Search Was
Made For Any -
PROPERTY DESCRIPTION Easements.
The North 1/2 of Lot 11 and all of Lot 12, "RED OAKS', according to the recorded plot
thereof, Scott County, Minnesota. j
I hereby certify that this survey, pion or report was prepared by me or under
my direct supervision and that 1 am a duly Registered Land Surveyor under the
laws of the State of Minnesota.
W. BROWN LAND SURVEYING. INC.
Raised. November 12. 199
Doted: Mav 22. -1997 -
3,x 00drow A. Brown, R.L.S. "NO. 15230 Revised: May 30,1997