HomeMy WebLinkAboutBuilding Permit#00-0138
6. BUILDER (Name) (Address) ~o.)
~,,~ ~.~ WC/. 1/f~1 I)J (/0. p!?, # VD'-' -- ~~I ~
~rrta I~ &Ji:j)~V( ue lAAjIJ ~ ~
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New constructio~ Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PRO tiE T COSp" ALUE
Chimney 0 Misc. ~
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COMPL iON'OAT':J_
Sq. Ft. "'t6 73~ Width / U 04- Depth 4/fP Yes @ 7h 70.. P(l
I hereby certi~ 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 r 0 this pe . for just c . Furthermore, I hereby agree that the city official or a designee may enter upon the property to perf~~ed inspections.
X _ 64 ~ ~O/7$1~~ --~
ignat ~tl.LK. ~t..(J~ ,LicenseNo. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. $
Park Support Fee ........................... $ 8so . 06'
SAC ......................................... $--1: I tJD . O~
Collective Street Fee ....................... $
Sewer Tap ................................... $
~/8 $
Pressure Reducer .......................... $
pATE RECEIVI;,Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
MAR 7 200iJ
1. DATE
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
I 1't, 1 'b fi.J ~5l~P --rfAt L,.
3. LEGAL DESCRIPTION
LOT It? BLOCK! PID ze;-3(~Z-- QJS"" 0
~ 1Ju J1rl~l:.~ riP ~-)
4. OWNER (Name) (Address)
.~~ UJ';,
5. ARCHITECT (Name)
.~~~ ~ {(J
12./
ADDITION
(Tel. No.)
(Address)
(Tel. No.)
SETBACKS: Required
Actual
Side
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2.40,000. OC>
USE OF BUILDING
SED
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 ................................... $~~~ I '2 ~
Plan Check Fee ............................. $----40 3 L.1J
State Surcharge ............................. $ J 20 · 0 0
City:
Penalty ....................................... $
Plumbing Permit Fee tJ{)~............... $ /0 0 . 0 0
Mechanical Permit Fee 01/-::............. $ 10 0 · 0 ~
Sewer & Water Permit (fl2.-:.............. $ .;3 5. 5~
Gas Fireplace Permit ([1J..-::............. $ 1- o. () ()
This&""rflBeCO~i1ding Permit When Approved.
BY~ Date ..3-13-2~~
Certificate of Occupancy
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00 -O/3PL
BUIL_ INFORMATION
11. SIZE OF STRUCT~.:.;
(Height)!'f I (Width'71 (Depth)l',
12. NO. OF STORIES I
13. TY\V;;;ST~;~
14. FLOOR ARfA APPORT;h. MENT USE
l4J@., "'f
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
4(:;.Q6-
Meter Horn... ..... C:Z.... .... .... .... ....... $
Water Meter ...... :m.... .... ............... $ / ::2. s: , t)/2.
Sewer & Water Connection Fee ........... $ I, L ~ (') . c:> "
'700.0 rJ
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $ II ~- on . C70
Other ......................................... $ . I
Total Due .............................. $~ 3'1. 'f/L
Paid e Ss ~ t.f~ Receipt (1(,' 3{, 99S-
Date 3/Z-l-/0V By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinahce and may proceed requested. This document when
sign by t~ . Planner constitutes a temporary Ce~ficate of Zon~n~ompliance and allOW. ~t~ to ~~mence; ~for~ occup~ a ?rtificate of qc~upancy must be issued.
b~ze~C9U ~ - ~~ ~('~~<;'_I
City Planner Date Special Conditions if any
Issued
24 hour notice for all inspections 447-9850
fiD -D(3i
The ('enler of lhe Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
SONA.//1 HoM65'
3/ / 1t2D
/ /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
./4-2 76 &ut5t5/12O 1~f7IL--
Accepted
Accepted With Corrections L:-.
Denied /)
Reviewed By: VII.~ Date: S-f~
Comments:
I, ~ a~ IM-~
2 ~'-'\.~~ ~~ ~
]. S"..Q. ~ ~ p.r~Y1-
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."
~
l\I) -0 (3 r
White - Building
Canary - Engineering
Pink - Planning
The Center of the L.ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST.
NAME OF APPLICANT
APPLICATION RECEIVED
(Iv rJ-;r7-) I-./~ll.-J 65
3/ / /(~C)
/ /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/' 42 7 C2: /:51..- [/'(5 1.5/ i.J /) '-17<! f-) I ~
- .
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
~~
Date:
3-W-eo
Comments:
2-t1 F'\ Mtvd\.M.UM..~.~ iJ~ M R~
\~{epeA1. _~e -.\ ~v i/J..,{)-tV1o ('Vv~.
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.1I
/'
'/
60 0/3 c{
./
Th~ C~ni~r or th~ L."~ Country
White - Building
Canary' - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
5- (/, lv' /--} -Tl-i )-/0 It) 65
3/7 /(2[)
/ /
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-Z 76
. ,
/3L c/f5 6/~? n -,I R A I f..-,.,
Accepted
../
Accepted With Corrections
Denied
Reviewed By: jJ~tfe;,( EJ.irt~SMA"';,v
n_4_.
Ucllt:.
'7J,^}^"
..:7/'V!V'J
Comments: j).se:. CA,.rnON W~~N
eONSTtl."C:T\O,v Acnv.TY ()~ NCAA..
-Y-~E STottM SEwElL S,-(tvc.:ru(t€S
ON 1t-fe:
S OU"TH f..dT (.) AlE. .
~F"_ WFo~fI\A~ (.ll.J 11t.E. f?c:.\JfRS-E s I~ -
~a: ~TTACHMt,.JfS: J. hM"l- ~L ~c.n'N INFoR.MAi"'tJAJ 2. GRtt~ PtA~
'3. E:~~,J COf-.JTttot- P1FA5v~E:5'
t.J. Eft.OS/AAJ C~AJm.L.. R.~,J
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."
~
Percent CO2
Stack Temp.
Combustion air is adequately supplied per ..
UMC Sec. 606
Input
Job Address 'LJ:31 ~ E} J e b; rd. --Yl
Heating Contractor ALTA, LTD.
~~ I.
1- t~...o(\
. 1.I'Jo
<g~~
J . ~ '1~
-~/~
Name of Tester
Date
.
:' 'p'~rcent O2
t
Percent CO
..'
,'~
'"
MAR-30-2000 15:03
651 438 8683
651 438 8683
P.02
(fi~.
(~~
~~Kr:j;J
.31_
.... ~ .....
lfIlLLOW. aHJUCA.T
001." - CST"
CITY OF PRIOR LAXE
SEWER AND WATER PERMIT
NOTE:
No.flll ~OfS t
.;../
Sewer and Water
contractors must
be re9istered
\lith the City..
. .......~
APP.Llt...n~~-~:f:';:co.\f~\1\\. \ i):, PHONE:~?\ ~ '8.~qJ....
ADDRESS: ~.~~ 1..\\)&1 U~{\~<; :tJ~~DATE:Q~\~~ OO-oa~
1\ '~_/\ ., J I <-; ~ ",-.1: \ \ :'00
SIGNATURE:, ~\\i~\ 1'\L~ BLOC. PEMIT t '~-1 ~~<
SITE ADDRESS; ~~ (E)~nf\fa~\ Plot. QS-...~c;>-oJS-Q
FILL IN TIlE BLANlCS
5'~
Estimat~d length of water service ~
1 .
feet.
2. Size of water service
\
inch(es) .
3. Location of any cOQplings fro~ structure
L.
feet~
.(\ .
5.
Type of sewer pipe. ABS PVC
Estimated length or sewer 11'ne l)\:)
Cast Iron
5c\-\ 'to 1..1 \\ fJ I:'
feet.
6. Cle~n out (if required), located at
struct:ure.
feet:.
from
_~.S~=~~============__===~~_~=~~==~~=~=~~~=_=====~-~~-____~~__a==
This .application becomes your permit when app~oved.
ByJ i~~~_,'17 ~~h~ nATE:~~
=====l1~c~=======~========--================-====-=~-=====-----=
FEES: $ J5..00 Sewer and water line connection permit.
$ .50 Surcharqe
$ 35.50 TOTAL
. Fee for Qither se~er or ~ater individually is S.J.5o plus
$ .50 surchar9'e.
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time gf issuance
to insure that nc duplicate s&wer and water permits are
issued. (' PAID WITH
DATE PAID AMOUNT PAI&UILDING PERrvUT
*
RECEIPT #
REC~D BY
4629 Da~ta St. S.E.. Prior Lake, Minnesota 55372 I Ph. (612) 447-4230./ Fax (612) 447.4245
I\N EQUAl. OPPOrmJNITY F.HP1.CVER
03/28/00 TUE 17:08 FAX 6124474245
CITY OF --flUO.~ T &Ill:' _ .-:~ 1__"
ru[E@[E \TI 5 i
\. APR 3 - 2000 .
L_ ~
!4I001
i1~
~
OIIEE. . "IL~
YILLOw . .IIP\.ICAIIIT
GO\.D . elf 1
By
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. 00 -0/38
NOTE:
Sewer and Water
contraotors must
be registered
with the City.
APPLICANT: ~'Q.....-5x.CCA\f~\~ \~, _ PHONE:1,7\ ~~ '2>~~J-..
ADDRESS: ~'B~ l-\\\&) U~{\C\S ':::r3~~DATE:~ ~~
SIGNATURE: Q~~n,.M\ mC~,,- J BLDG. PERMItT #..f}n-"'t'/38
SITE ADDRESS: \~<{, (\:)\\JQb\rf\7'G\~\ PIO# Z5--3IRZ-OIS-tJ
1 .
2 .
3 .
FILL IN 'rHE BLANKS
. 5~
Estimated length of water service . \)
Size of water service \ inch(es) .
Location of any couplings from structure
feet.
L.
feet.
4. Type of sewer pipe. ABS pVC
5. Estimated length of sewer line l)~
Cast Iron
5c~~C) Y" fVr-/
feet.
6. Clean out (if required), located at
structure.
feet
from
~=~==============~===~~:=~~==~~:===~~~=~===========~=====~--~~~~===
BY
your permit when approv~ed. ;t'
DATE: 4 ~ /df}
/
This
------------
-----------
=============================================~~=~=~===
FEES:
S
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is StJ.5o plus
S .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.
DATE PAID
AMOUNT PAID
RECEIPT #
REC~D BY
'.: ,.'....'t.<,;~~;i'..'"'., ,.;.:;,.,,,,,, .
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 I Ph. (612) 447-4230./ Fax (612) 447-4245
N-4 eQUAl. OPPORTUNITY F.MPl.DYER
;;~PH'I~
~
CITY OF PRIOR LAKE Me
16200 Eag1e Creek Av. S,E. Permit No. 00 - () \ ~ ''is
Prior Lake, MN 55372
HEATJNG APPLlCATION J PERMlT
Dal9 5~;).-o-;:' PlOt d~- ~~~ -O\~- D
s. Adc*ess / V:J 7,f 1]&16.1, J~ fj "fA ~~ J
lot \ 5 Bbck \ ,Addilion ~ l""\ ~ 'or\) \) ~. 't-'h A-b DN
~/}!h- ~, ~1)
Owns"s Nama
AdOress
Heating Contractor ALLI ED FIR ES IDE d 1>a FIRE S I DE CORNEl
Address, Z100 N. FAIRVIElol, ROSEVILl.P', MN 551 13
T slGpron9 ~ 6 51 .. 63 J - 2 5 6 I
FIREPLACE ,11.._ L
P.iuneD Make & Moder ~ JJ h~
Model Size_ _~l.- I ~'b ~
Conn. Load
Fuel ~
SUW~. Openings
Return Openlngs
In put.
Edr. .
crrn.
Alterations
Repair
flue SIz8 ,
Output )..1 (ni)
TYPE OF SYSTEM
Warm Air Plants
GravilV
Mgchank;aI
Air Conditio niog
Vent System .
HEA TINQ OR POWER PLANT
Stum
Hot WalOl
Rad.ation
Special Devices ,
Olher Devicos
Replacemen1
TYPE OF WORK
New Cons1,ruc:ion
x
Est. Comp. 0 ate
. er1 Om
I ,
Building Permit. ()O - a \3)5
Est. Cost S , !/-t-")J11 J)
HEATING PERMIT FEE $,
STATE SURCHARGE S
TOTAL PERMIT FEES S
,50
Receipl ~
en
(I)
J. "lit . AIr ~
1. (m. . at)' OJ
]. Ye1Ietw - C.cNllladDr '<
TYPE OF STRUCTURE
Silgle Fami~
Two&Famlly
IndustrI8J
Mufti-Family
PubCjc, OCher
Comm9fcial
Fee Schedule
Indus'rial, Commercial & Multi-Fami~y
nesidertlal, Healing & AC
R1!siden:ial, Heating On Iy
ResidenUaf, ~.,.eo Fireplace
ResidenCiaJ, Additions & Akerations
ResidentraJ, AC Onlv
1% of ~b-~~{~!l5(}_mi1tmum)
199.50 - i.' _.. - r. ';
$64.50
139.50
S39.50
$39.50
-2_
Remember 10 add Ole Slate Surcharge on the bottom 01 this appir"'~ .J"n.
The price of your heating permU tncludes one rough-in and one linal mspectlon.
'T1
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en
.....
a.
(I)
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(I)
..,
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m
~
~
Addilionallnspections wil be billed al $35.00 each. (I)
(I)
(I)
House Healing Test Record must be submitted wilh "'..",ttq ~m'1' ~,~r belate buld. ..~
ing certificate of occupancy wi be issued.
HEAT CALCUJ..^-JIONS RFf\e IIRf.:n with number 0' $UPPty and return opermgs fisled p8
room with CFMt. p&r opening. New structures or adcfltions send floor plan with suppty
and return focations shown. HEAT lOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED lU THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S. E. PRrOR lAKE, MN 55372.
City Hall bus1ness hours are 8 a.m. . 4:30 p.m.
I
ALL WORK MUST BE INSPECTED lROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
, hereb\' apply for a mechanical syslems permit and I acknowledge thaI the
inlorrroalion above is comptele and accurate; lhat the work wUI be tn c~nf~rman<:e
with Ihe ordrnances am:! codes oJ the city and with the stale btJildmg/mechanical
codes~ that this 10rn1 does not become a permit untH signed by the BUILDING
OFFICIAL: that Itle work will be tn accordance wIth lhe approved plan In the
case o~ work Whlcl1_ requires review and approval 01 plans_
~41'.f2. :n:dLd a..v".,
, Applic8I}rs . n lurf) , / Da1.
U a~ Z~rl...rt.,~ :s-- ~'" /cm
cJ lluiling OIl; SlgnalUnI , ~.
~
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n. CIII'''' 01 ,lie Lake COUftl"
CITY OF PRIOR LAKE
PLUMBING PERMIT PP No,..[f., - () ) ~V
Applicant: Ma~puJ TMnil!./!5 I In(7,. Phone:~S;) .&/~ - ~'1.Bt)
Address: ffU!JO (Jof1rousel ~ .R.4A'6)~. /viIV' S.s-(J'J
Signature: liAr 1-~ .~1~A/1
Legal De~cription. Lot 1'5 - ,-- BlOC; () I Sub ~Y\n \0 H~) 1 L/ffl AfW
Site Address: /J/.~78 ..AJJJ I Ii.} ~A~ ~
Building Permit # 00 - OJ ~~ ~ PIC # ;<~ - ,:<,~ - C}S"- 0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
1. Blue
2. Gold
3. Yc110w
file
Ocy
AppIiCUll
Quantity
Type of Fixture
Quantity
Type of Fixture
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Bacl<tlow Assembly (APZ, Double Check, P'IE'
8ackflow Assembly Test
Lawn Sprinkler
Other
/
I
/
/
/
I
/
Bath Tub with or without shower
Dishwasher
oJ
I
/
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
I
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 ~~ of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$ 99.s()
$
$ .50
J)cY~\ 'f#
'etJ?Y
GRAND TOTAL
=:~~.~~ ~ ~ .
, r .
This pennit is granted upon the express condition that said
contractor, shall comply in all respects with the ordinances
of ~e .~tate Plum~i e and lite "-:,~lS lIteroof.
-/ f. NO. _,-J I::. '(J{) DATE
-LJ.,.- A A- r ·
~^ ~ Al1eST
f} for all ~n.~ctions 24 hours in advance.
16200 Eagle Creek Av. S. ., Prio Lake, Minnesota 55372/ Ph. (612) 447-4230 / F.AJ<: (612) 447-4245
An Equal Opporwnity Employer
MAY
lam
~ CITY OF PRIOR LAKE lie
~ r. '~r 16200 Eagle Creek Av. S,E. Permit No. 01)- O1~Y
.. PrIor uka. UN 55372
~ HEATING APPUCAnON I PERMIT
Date _ . _ f-~~- 0 Z> PID. :J< ~ ~ 1<:'"" (\
SI.Address IlfJ7 Y ~/tAf!/;;rrl '1r .
LIlI j <'Black I Addlion {i."b III I '1'-1 A.t d- h d ~
Owne(sNaml. ..~~ IIrJ~~~
M~..~C;9Cj W (hI'f ~e/~" 6~'II(I~M,J
\ .
He8ling Con1tlCtor /J./ ~ I (, 7l~
Address 19~(.,~ -~~-f-tJw,J N - ~'n{ 11A1=~
TeI.phone' C;~~... y~", ~ ? 75'
i. .."...o~
Furnace Make . Madel (",-"4 ~ ,J ~
Model Size 7C".000
N
o
.
Il.
Conn. Load
Fuel AloJ. W. S Flue Size
If')
5'
5"
Supply Openings
Return Openings
Input ~ <' 1000 OUlpUl
Edr.
Cfm.
TYPE OF SYSTEM
Warm Ail PilWs
Gmity
Mechanical
Atr Conditioning K J _1IA~oIC
Vent System
HEATlNG OR POWER PLANT
Steam
Hot Water
Rad idon
Special Devices
~'3t:)
Other D.vices
p.~;>b:.e",::E OF WORK ~w CcnS:ruc'.ion /
Ar.eta~ions
(
"
Ll)
Repair
Est. Comp. Da1e
BuDding Permh . t5l) -- 0\ :~V
It
aJ
o
o
o
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lD
N
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D.
(
Est. Cost S
HEATING PERMIT FEE S
STATE SURCHARGE $
TOTAL PERMIT fEES 5
.50
Receipt t -
TYPE OF STRUCTURE
1. ftal . File
1. GRa . City
3. Tdlaw . ComnI:I:lr
Singte family
Commercial
Two-Family
Industrial
Multi- Family
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residenlal, Heating & AC
Res!~~~!:a1, Heating Or.~i
Residential, Gas Fnplace
Residential, Additions & Alterations
Residential. At OnJy
"'l:<'~-
..''''''"''''
'. ....".";;.,'':-
~--- '. .... ~":;"''''
,., of job cost ($39.50 minimum,
$99.50
$64.50
S39.50 III 26 3IIl
S39.50
S39.~
-~_ l.._'
Remember 10 Idd 1he State Surcharge on the boIom 01 this application.
Tn. price of your heating permi1 includes one roU~hAi:l anj one final tnspection.
AdditK>nal inspec1ions will be bi8ed al $35.00 each.
House Heating Test Record must be submitted with huitding perntit nU9'f\ber befo!e buId-
ing ceJ1ittcate of occupancy wiR be issued.
HEAr ~..r,1 11 AJ"ln~~ RFnt nRFI1 with number 01 supply and return operings riste~ per
room with CFM's per opening. New structures or additions send 11001 plan with supply
and return locations shown. HEAT LOSS CAlCULATlONS. PAYMENT AND
APPUCATtoNS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
44 7.9850
t hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate: that the wark will be in conformance
with 1he ordinanees and codes of 1he (;;.). and w3th the state buildtng/mecharncal
codes: t~.;\t tms form does not become a permit until s ~ned by the BUILDING
OFFfC!Al: ~~at the work will be in accordance witn the approved ptan in the
cue m y;;;; 7~oval ot~y~~c)
-II A~~nrs S~re ,.. '/. ~
I AA~{V\.~ itJrl~) 1'/~?/(;n
{) Buiiding OIf"""rgnature - / Ooii.
PRlOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS )Lf.Qtt~ 1<:\"f>'o~d ~\"\
NATURE OF WORK ~ ~ ~t-()c{ 1'c.l'v1
USE OF BUILDING S:::F~
PERMIT NO. 00-- (7/373 DATE ISSUED
CONTRACTOR S~~k hv~"
NOTE: THIS IS NOT A PERMIT F6R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCU ENT
SEWER I WATER I SEPTIC
I7RAMING
INSULATION
ELECTRICAL
PLUMBING , 1,5/ZM()
HEATING (if required) . -c:;-k.LtiiJ I f).;Jjo
FIREPLACE tJ/e-- t; . ~/~/#tl.r _ , .
'88 UNE AIR TEST '. '~h kflrtJO
COVER NO WORK UNTIL u;,VE HAS BEEN SIGNED
~e
\ OlTE _
FOOTING ! / . . ~ '},,~ /1b
" , ,,' ./
FOUNDATION (Prior to Backfill) ~\i 41(/ Jm
PLACE NO CONCRETE UNTIL AEkiYBJIAS BEE""" S(GNED
ROUGH - INS
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~\fJJ- /
lff'l 5//z/;t>
4/~ )00
/t/1/t10
, I
I I
FINALS
GRADING (Prior to Soddi~gl , ,\ \Nfl /I,30-tV
BUILDING 'fe~ 7 ~lloo og-\kl.ub 0.0, If ~loo
ELECTRICAL . l l f I
PLUMBING (~)I'I/~jO
HEATING rr- (~J) 1.lo/.(JO
DO NOT OCCUpy UNTIL ABQv!i 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 (612) 447-9850
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. 00-0138
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District R 1
Legal Description
LIS, BI, Knob Hill 4th Addition
Owner of Building
.SiteAddress _ 14278 Bluebird Trail
Contractor'sName&AddressSonata Homes, 2999 W Cty Rd 42,/1136, Burnsville, MN
Robert D. Hutchins
Building Official
. City Planner .
Jenni Tovar
DA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
I L'.. 276
SCHEDULED ; (" 3J)(J) A '.. I
gLUE Bl r21J ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
00 - 0 \3f5)
COMMENTS:
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLrM ING FINAL
o SIT NSPECTION
Soo (~
/
o EXC/GRAD/FILLlNG
o LKSHORE~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
(~<
d 4>{JOS. d
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: <!) - U0.u4 Owner/Contr
,
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
iAZ70
SCHEDULED tL/ ~I 00
~,~
OWNER
CONTR. ~~/~'L1Ll:J aM C S.
PHONE NO.
PERMIT NO.
00 .-O(3~
COMMENTS:
o PLUMBING RI
o MECHANICAL
o WATER HOOKUP
o SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
bN<ge, 'FINkV
.0- EXC/GRAD/FILLlNG
o LKSHORElWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
o FOOTING
o FRAMING
o . INSULA TION
~ FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV.
F:-.J'f'"dtE YACt".c:> I ~
.sODD~
('...ll..S<<:).L I S Au. fcf':1=t'/\t. ~
(I d r....roo ~ () I/.
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: # };ro..dt -.Q..wner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
?jJ;)o
43 ! LLb/ f'e/ . /J71J /
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS JY ~ I ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATlp~ NA
X FINAL 5LUG
/ 0 ~ITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,'\~ 0 LUMBING FINAL
A MECH FINAL A
TIME
3:0(2
G1J - () l3 X'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
U ~ ~'n-eer, n",
~ ~d ~A rek'
0-:-~ow ~ 0lbuf
kJ ~ ~ ~)
~<;;-~rln(j'v) D
( SJ (~ I e ~ y ~ V'l--- I-oa~ S I rt.,o 06
tfe ~~~"S ~
~ ~..I8~'-1O ~'~
\~ ~lA r
() .
Inspector:
CALL
CODE
INSNOTl
Ce"#
~tO~
Cv-~ ~
'^ti'\" <s~dl~
(]~~~ ~~
~ '\\;~~
~ Wt>~ dk-o.t:-
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j I If
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(- ~ I J
~~~
/ '-'
/ /7
/ ~
Jf '~}{.tACT CE~
l CORRECT A :T NO P CE7
EINSPECTION BEFORE COVERING
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~~
l hti\
TIME
3:2J)
ADDRESS
Lla1)'
~lre
"
J1D-0l3~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
1'1 ) /(
~ Ii '
~
OWNER
CONTR.
Inspector: Owner/Contr:
CALL 441-9850 FOR TH/ NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~ ARE FOR YOUR PERSONAL HEALTH.I SAFETY!
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
~~E~RHOOKUP
PLUMBING FINAL
o ECH FINAL
o CORRECT
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
l D1,T TEE /' TIME
~ lO:co
ADDRESS \42/~
~.lrcl Tv
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0- /38
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
v1 0 PLUMBING RI
n fl )IIECH RI
A ~ATERHOOKUP
~EWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTts: !J ~ -
,7/ ~~ 40
po~ -1{ff;~ JL ~
\{/\/C
NIJ
~
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~
/
CORRECT CTI ANC,PROCEED
o CORRECT WO K, CAll, FOR REINSPECTION BEFORE COVERING
Inspector. / Owner/Contr:
CALL 44l.9850 FiR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/NSNOT/