HomeMy WebLinkAboutBuilding Permit 00-0511
: DATEAECEIVED
-,;::::)
.-.,
CITY OF PRIOR LAKE
BUILDING PERMIT,
.1'. TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
. 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
(,? ~~ 7?~T:.~2:.V A-: /d'.
3. LEGAL DESCRIPTION '
2 BLOCK
R'ecl ~A K f
1. DATE
..5" I!: .
S-/:J '110 (J
~,-5j)
LOT
PID 2.5.-# 3W" fJ1l?;>~ 0
Add, -
(Tel. No.)
(C,/J.) ~ ,,- tgo f
(Tel. No.)
I
J.!!;L
4. OW~ (Name) (Address)
I{ tJ~ -t:: ~,. m <: jJ <A L JfJ ~c../
5. ARCHITECT (Name) I (Address)
ADDITION
6. BUILDER
(Name)
(Address)
(Tel. No.)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit NO.~'
BUILDING INFORMA liON
11. SIZE OF STRUCTURE
<He~ CNt;hj <orrb
12. NO. OF ST~S
13. TYPE OF CONSTRUCTION
S,r: p,
14. FL003iEA?~ORhENT USE
15. NUMBER OF OCCUPANTS OR SEATS
~ ~ OCCUPANTS
~;!r )?1"!:..~#~c,, Deck" R~~2 s ~pq:~Kdl> SEATS
New constructio~ Alterations CJ Addition CJ Finish Attic CJ Re-siding CJ Finish Basement CJ 16. PROJECT COSTNALUE
ChimneyLJ Mise.:). 7. ~ 0 00.00
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVE~ 17. COMPLt: IluN'OATE
Sq. Ft. 3 IJ J tiC{, .3 ~ P Width Depth Yes ( No J q tv / 60
I hereby certify that I have fumished'information on this application which is to the best of my knowi9aQe true and correct. I also certnY that f 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
buildi~ic~n revoke this ermit for just cause. Furthermore, I hereby agree that the city official or a designee rn" ..2~er upon the property to perform7ed~ i'1pections.
X H~//1f: f<6YY '3 ~I-IO/
- . Signat License No. . bate '
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~. e:2C)
USE OF BUILDING
~ "F1)
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4 ~ ~
Permit Fee ................................... $--1;J..C.2 · S
Plan Check Fee ............................. $',. f C/f)." "
-tf-'" c:>
State Surcharge ............................. $ t:31... 51 _
MATERIAL FILED WITH APPLICATION
SOIL TESTS LJ ENERGY DATA CJ
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS CJ
SURVEY CJ
PLOT PLAN CJ
SETS
COPIES
City:
Amount Brought Forward ... . .. .. .. .. . ..... $
Park Support Fee ........................... $
SAC ......................................... $
~.(!)O
II /00, ~
,
Collective Street Fee ....................... $
Sewer Tap ................................... $
c:J. .- $
Pressure Reducer .. :1b................. $
Meter Horn ................................... $
Water Meter ................................. $ I ~, <:::Jt::)
Sewer & Water Connection Fee ........... $ I, ~~ ~~
.7
Water Tower Fee ........................... $ ~("J ~(!)
Water Tap ................................... $
Builder's Deposit ............................ $-'1 ~ .~
Other ......................................... $
P~ TC:)I ~;ii(l"7r..~:~;~o$ IJF/ff- 7L
Issued 0 l w
Date ,,/ ::J6/!Jt) By
This is to certify that the request in the above application and accompanying documents is in accclfdance with the City Zoning brdinance and may proceed s equested. This document when
s~.c' ~ner constituIes all3rrCX>f8lY Certificata of Zcnlng CO~Ian~ ~ commanca. Befora 0CCIJIlBIlC'(. ~ of pancy ...... be issued.
.. --- ~ ~2XtJt::) - b~~'''''-' ~ ~ .
City Planner Date Special ConditionS if any
Penalty....................................... $
Plumbing Permit Fee .. . .. .. ... . ... .. .. .. ... $
/tJO.(!) 0
1f2(J.of)
3~. $0
~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Certificate of Occupancy
24 hour notice for all inspections (952) 447-9850
4..~..~
00 -51
The Centef or the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 'RC'\Qif t Tf) (. .\ O_W' t'\U:- i
APPLICATION RECEIVED ~ a L-I-vh ) -::tJIlJL.1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/s...'<. ~ 2re-e.a...y VO)~+- \Locwl ~
Accepted
Denied
Accepted With Corrections :>=z-
Reviewed By:
Date: 6" .. Z-'2ddXa
Comments:
J. ~ a20 (J,~. tf.-c.: ~ -
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."
~--
- ....
Thf ("fnlfr or lhf l.akf Counl".
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAMEOFAPPLlCANT 1\C'>)fA+' f0( \~-OJ'r\U .l~i..
APPLICATION RECEIVED' ~O,Jj (}. L..j ] ;),QjJ1J
,,/
~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ S .:<, ':;( h ~ r e.. ~ \j . ~'-;' (I t- TZ D 0..0 3f
I
Accepted
Accepted With Corrections
.
v'
Denied
Reviewed By: _?w t..A e,Q~-ff
~ k),'({ N-O+
k-l.'~"'L ~ ~ r0o.::f,/\ ~-l (~
. ~ , ~
~~~ ~5~
.~~bfj,ejl ~ ^^ oJ~S Jf::(/~ d ;JiJ!P ~
~O~ ~oho-v> ~
Date:
Comments:
be
c..5~d
e-
"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."
t
1
;.
.~
Th~ C~nl~r of Ih~ Lab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 'RClb.€ r t... 11(. \ C:.-(1~ r (\P ~i
APPLICATION RECEIVED tv'\(1.U' a LI ~ h ;)..07JrJ
'-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IS ,,<, ';(6 ~re.c.:z'l ~~),n} \(e>od ~
Accepted
Accepted With Corrections
~.
. Denied
Reviewed By: ~k- ~
(/
Date:
t .- 2. Lr-f%)
Comments:
~~60~~e-e- Jf-~~ ~k ~vv~J
~~~~ ..31?*~ L V~.
L,f.;v.,cje~ \ FIror l~~ ~'8J1 ~ v-'\ ~ r;~I/
(b-f.- ~f"e4 W~~ .. SSU~ ~
~~. ~~'.c~~~t;l
~
~ ~~.~~ l.s A..~~
~O.~ ~e-O~'~ ~LKLMe-..
liThe issuance or grantiAg 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
--
'<(
Job,,~dress 1.s 3.8 J By~E'a.~
Heating Contractor ~ z' R'In,..1
Nam$ of Tester r;: K
JI3 .1:/ -IJQ
7
p
6
JlJ~
~"-Date
. r-Percent O2
Percent CO
Percent C02
stack Temp.
, Combustion air is adequately supplied per
-;, ,:, UMc ~ec. 606
Input '
~~ ~
(
~_ti
'..1' ,
"
/
,-
0<,
l"
~
OCT. - 30',00 (MON) 13: 43
PROBE ENGINEERING CO
TEL:612 432 3723
P.002
,..
~~. .
.......-:.~~~_...:':
."
.
~
O.M.', No 3,.7-0077
''''';'.1 M.y J'. , "3
ELEVATION CERTIFICATE
FEDER-.L EMERGENCY MANAGEMENT AGENCY
NAnONAL FLOOD INSURANce. PROGRAM
\TTENnON: Use of ltIis cerUflaUe does not proYlde a waiver at the flood insurance purchaM requiremenL TN. form is W18d only ta
,tOVid~ II.vadon information necessary to 1tI1SU1'8 camplanee with applicable community ftaaclplaln management ordInancu, to
determine the proper Insurance premium rale. and/or to support a request for a leiter ot Map Amendmenf or A.\lisian (LOMA or LOMA).
Inslnlctlans far campllltlng this farm ca" be found an the fallowing pages.
SEcnON A PAOPER"TY INFORMATION
BUILDING CWNIA'S NAME n , I
b.J., ~.l tJ M,.,1A..rL... '-G ~T1ru c.."ti b.
STREeT AODR~SS (1nct\lGing ApL. UNto ..... ~ BIdg. Number) OR P.O. ROUTE AND BOX NUMBER
\S~ 8{. &vef.~ P~"I...t r...+~
OfH.~ OUC~~pN (Lac - ~.Nu..,....! .ec..) t ,; I ^ I r -I , I
CITT '-~ 1 J ~ 1 I ~'u.L.Jll"Ddfhm.. I $c.U- <!o~
p~ ~ ~y l;.:~ ~ . '.' . . . t'\. m~I4J1l.
secnoN 8 FLOOD INSUAANC~ RAT! MAP (fiRM> INFOF,lMATlCN
~ . ",'
. ..
Provid~ the ,following from the p~p.r FIRM (See InsU\Jctlans):
1. ....... .NUNI1"r IlIUMI'" . Z. p~ NUMB!A " 3.. IU.......
fro" IflISUAA~! CON......v use
POUCY NUMIER
COMI'ANV NAle ..u".EA
ZIP CODE
: . . lit .
5. ~"M ZONE . .. ~ F1.OCXI !~AnON
(In ..0 %an... ... d.,:Uhl
1.70 tf;'2... . . 000+ , c.. ;, N av ~ \CJ 1"Q1 Af.. '\ . . .,~O'.Cl
7. Indicate the elevation daNlTJ .YS~'" used on ~. 'FIRM lor Base F.1oad .EJ~vatlons (BFE): ~ NGVO '29 :J Other (descn'be an back)
8. For Zones A or V, where no BFE is pravided on the FlAM, and Ihe community has establ~ a BFE for this building site. indIcate .
the community's BFE:.. :.~ feet NGVD (or other FIRM datum-See Sedion B. Item 7).
&. DATE OF 'RAM INDU
SECTION C BUILDING FI IIVA110N INFOAMAnON
1. Using the Elevation Certificate Instructiona. indicate che diagram number trom the diagrama faund on pag.. 5 and 8 that best
describe. the sLlbject building's r.f....nc..I..,.I..3- ,
~(a). FIRM Zones A 1 -A30, Ae. AH, and A (with SF!). The lap of me reference 'evel noor from the sel.cted diagram is at an .Ievatian
or q I 0 ,~".t NGVO (or ather F.1RM datum-see Section B, Irern 7). L. ow., G..... A~: q 1028
(b). FIRM Zones V1 .V30, VE. and V (with SFE). The bottom of the lowest horizontal structUral member of the refererice leveltrom
the s4Ilected diagram. is at an .levation of ii, , I l.~ feet'NGVO (or othe' FIRM daturn-s.. Section S, Item 7).
(c). FIRM Zone A (without BFEj. Th. floor used as Ihe reference level from the selected diagram is :: ,U f~.t above = or
-. - below = (check one) the highest grade adjacent to the buDding.
(d). flAM Zone AO. The floor used as the reference level tram me sefected diagram is' i :.~ f..t abcve 0 or below rr .(check
one) the highest grade adjacent to the buDding. If no flood depth number is availabl8. is the bUilding's lowest noor (reference
level) elevated in accordance with the c:ammunity's noodplain management ordinanc:.1. ~ Yes --; No 0 Unknown
3. Indicate the al,vation datum system used in determining me above r.I.rence I."el elevauons: X NGVO '29 :-! Other (describe
under Comments on Page 2). (NOTE: If the elevation dilrum uslld in measuring the e/fl'4tkJns is difter8nr than that used on
the FIRM [s.. Section 8, /rem 1]. then convert the elevatiofl$ tD the ,*tum 5yslem used on me FIRM and show the canVflrslon
lIqu8r/on under Comments (JfI Page 2.J .
4. Elevation reference mark used appears on FIRM: 0 Ye. ~ No (See Insuuctions on Page 4) .
5. Tl'1e reference level elevation is based an: ~ ac:tual constrUction 0 construction drawings
(NOTE: Us. of amstrucrJofl drawings is ofi;VilIId If the building does nor yet h.". the ,.'.renr:.lllvel flaGr in place. in which
as. this cllrrltfcate will Oflly b" V8I1d far the building during, th. etJlJlSfI of CQn$tructlcn. A p~-canSll'Ut:tIon allvalitJn CanJflCMB
will b. requirwd QfJC. con:rtIUCtiOtl ;. t:t:Impletll.)
8. The elevation of the lowest grade immediately adjacent to the buDding Is: ! 'elfl O.J.~ f.et NGVe (or other FIRM daturn"s8.
Sec:tian B, Item n.
secncN D COMMUNITY INFORMA'T10N
.11 the community official responsibl. ror "arifying building elevations specifies that the ref."ren.:. level indicated in Sec:don C, Item 1
is 110t the Rlowest noor"' tl$ defined in the cammunity"s fIooc:tplain management ordinance, trl. .Ievado" of the building's 'owesn
fIoa.... as defined by the ordl"at1C8 is:; I : i I I.U f..t NGVD (or other FIRM datum..... Sec:tton B. Item 7).
2. Dafe of Ihe start of cansU'Uc1fon or subatar'\tial improvement .
FEM.a Fo,,,, '1-31. M." ,a
REPt.ACES ALL PREVIOUS iOITIONS
seE FUEVlfIISI SIOI FOA CONTI""UATICN
OCT. - 30' 00 (MON) 13: 43
I
PROBE ENGINEERING CO
TEL:612 432 3723
P.003
I.
_.,
~";
SlicnOM! CE1nIPICAnON
This certillcation is to be signed by . land surveyor. engineer. or IrChiwet who fa IU!hariztd by statlt or Iccallaw fa CIIntfy .Ievadon
information wken!he eI."allan infarnwlan far antIS A1-A30. AE. AH. A (with BFE).V1-V3C.VE. IU1d v (with BFE) '- rwqulred.
. CommunitY otftcIaW who ate au1tlarized by lacallaw or ordinance fa pravIde tloac:lplaln l'I'IMagement InfDnnadon. may also sign the
ceniflcation. In Ihe C11!18 of ZeIn.. AO and A (\'Wilhaut . FEMA or community -.u.d BFE). . bu~dlng atrIciaJ. a property owner, or an
awner's rep.....ntatlv. may also sian ttIe certification.
Alference levet aaagrarns 5, 7 and . - Cldngul8hing FeaUIs-Ir the ~rlfffer la unable to centty to braaJcaway/non-b(eakaway wall,
enclasul'llllze, locaUon of s.rvlcing equlpm.nt, ....a use. waD apening., or unfinished ill'8a Fell!lJt8(s)."'en Ist'me F..tLlt8(I) "en
inctuded in the cwdftcadon under Comments belaw. The d~ram number. SectlGn C..ltem 1, must stili btI -'Pered. .
, . . . .'.
I ceffify 'M' th. inlr:JtmtitJan in Sflt:t/rJns B ;urd C on this cenII1eate t8p"'HfI" my bear .ffons ra Tnrrirpret the d_ tlVfliltlble.
IlJnd8t5W1d. thllt any'''' 518,.".,,,,,t may be pun~. QY fine otjTmp. '~'I.nment IJ!IfJ-.n 18 U.S. Code. S-.crI"ir 1001. . . _.
~\JSS~(( p- ~.~lo ~~. I.CfO""
CERTIF1ER'S NAME UCENSe NUMBER Car A.... ..,
_..._ D _lI!"-". ~- "'''41.1 La.!!.l S \lV"c...t 0,," P r'O~. t=dn ; M "f'f'~,..u... Co .
Tm.E I~ · ,.. ~~NAMI! --a -'
~ (!t.6 q. ~40 ~LI"~~"~((.e J M i",~ 5"5331
ACOAisa .A D CITY STAT!! ZIP
L .~~""~ 0' I I 8-I-DCJ. "fl... C{:ll..... lOGo.
SIGNATUAI D. Qa1W PH~...! )
"evIs e,lJ !(J - C', , · -a.... f" D
-
Capl.. should 1:1. made of this Cer,tm-. fDr: 1) community otrIclar. 2) Insurance .CI.ntlc:o~~.ny, .~d 3) building awner.
COMMENTS:
'J!!.
....
,:,
, '
. .
~.
'* WI'M
tioA. .........,.
ON PtU&.
PlmnI. aw c:aLUMNII
A V
ZONU ZC>>t1S
A
ZONIS
I"....~
'. ....... ~-.
( . ,... .
, . ~..
.... 'i'~ .,;..a:
"-DOCI ~
fU'J"'" ~.~J ~
...
PUlIXJ
......101
I
I-~::J l \
~ t
" ~~IM~W~ ~:~
~~~ .\' ~~~i1f(~~~~~ ,tl;~\... '~~"3
~~~ _~f.:'~f:cl'1~~.JR~ MJIICINT~!
,,'~~I J"'","~':",~::J;'"';'~.i\r.',~ lIIIlIGL!:
, . .
The diagrams Ibove illustrate the paints at which the elevations should be measured In A lanes and V Zones.
~. . Elevations for all A Zonas should be measured at the lap af 111. rer.rence leyel flaor.
ElevatlaM for an V Zon.. shculd be measur8d at the boftotn of the lewest horizontal structu~ member.
Pig. 2
09 'l.l 'f.e) THr 1:: oa F.~X 812~.tT.&24S
r -
~~@ [g D'Wcg K\"'''l\
on OF PRIOR 1:-00. If J .aefil n/~
~ J _.~.t)
)J iJ 7 . u"') u,-- ,YIL"O~ · ."L1~T.I'
PJ '1 ~f , 7 ~ 1ICIl8 . ~.. _
~ - p~; ~
'./,
tz I ~._,~ ~
~~H~~ 9
CITY OF PRIOR LA~E
SEWF.R AND WATER PERMIT
S.W.No. Q.-'~!.L
NOTE:
Sf!wer and WaLer
contractar$ mus-t,
be r"c;istered
'tilth the Clty.
~
APPI:" =AN'l': t.lo~Y..I E ~~ Iid'''- 'N"')
ADOlt~ 5JS: fJ.. 0 . S,,-i _ S"J'I f~ ;;'2' t.~'( ~
SIGn.' rtJRE: ~ ~
SITE \DDRESS: IS1';' ~ f";IY
rILL II THE BLANKS
J-D(J
2. !; ~a. of water service L~ _1nch(..) .
'3. 1. )cation ot any coup11nq. from st.ru~tut'g_ iO feet,
4 ~ '1' 'p. ot ..wer pipe. ASS PVC~_ Cast Iron_~,_
,. f: it; mllt.-d longth ef 6~WYWL line Lb 0 teet.
6, C Clatl cut (i f required), located at_ l..a
.. ruet:.ur..
PHONE: 75 ) .. 7 J ~ Jlt.-(./
.r- ...-... ....... -.-....
...DATE: -Ja.::.k? '..tJ1._. ..._
BLDQ. PERMIT M
PlD' J5- -'3l{~::(j)~-"-O
1 ~
11 ;timatod leng'th of wllter service
feet,
feet:
from
-- ::::=:- .c __._-=__c:m__==___*__c::lI:e_1i.';:!:.__Z=S*_S::O:___c.:= ___= =__.;;;,:: _=~. ~_.... co: ::!:e.~::;.
Thi~ " ppllc8~ign bGC,meS yout permit when approved.
BY Q".u~p ~. DA'l'E: it)' JU . t.'O ____..
~._~~_..g_...._.~_....B.__=__.:..~_.___~..______===3__~~__~~____
'fEES:
$ 35.00
$. . ~o
$ 35.50
$.w.~ and water line connection pprmit
SurcharC;8
TOTAL
1"; e for either sewer or water ind.l.vidually is ~..61D plus
s .50 surcharqe.
· g'i~er and water )8rmi~8 i.sued for now construction must ~p.
rl: JQrded on the Juildin9 permit card at the time o~ i..uance
~:,: insure that no dupllcet. ..wer lln~ wa tar! p.6\Jet;-:1 t"'!'
OAT!: J.;: :~:d"-+r> ~ -a {-oJ AMOUNT PAID ~ING PERMIT
RECElI' ~ f - REC'D IW ~
.
16200 !'AlII: Creek AV. 5.8., Prior LakeJ Minnesota ~S312' Ph, (612) 447-4230 I PAX (6121 447-47.4~
3HI ~HI~~^~3X3 aAO" W~ Z~:ll 00-0~-l~O
Z99L+9~L+Z5i:i6
leed
4 '~~ ..ltlor",!~\ arv OF PRIOR LAKE c-fJ'
Sf y-) _~~Av.U_ -.....0- ..J".
\. \ --J ,: Prior Lake. .. :rr~
HEA11NG APPLICAnON I PEIMT
DIM J 0 ~~_~ _0 ~. . _ PtD. . (1,5 ''3lf ~ "CJO?J - 0
u.AlIdI- .__1 ~3'l" ~~t! toitl ~-
10I ~..... '-' AddU>>n_J~__. ~rvi_-
0wnIIfS .... . . . I\l p u.) ~ 1\ ,,",\ s ~~_~..i1 " ~ __
AIIdr- __ __ ___ --- .-----.--.
....ing CcddJ, _. bQ..~. L" fU r ( \A S
~.. _ _ _ .__1i.Q~ ~~tJQ~ ~r
T......' h__ J.c1~-~J.~_~
~. - ...Il........ !J~::N.-:bf 0
. r.. ,-I. (.t.. 1- 000
Uod8I SiLII . ____ _ ~ ___.
P4
(g
.
Q.
V
N
co
IJl
l\-
V
V
N
P4
IJl
1ft
J
Q.
II
C
.J
VI
d
l3
Coon. loacl
F.... AlJ._f5 J:1ue ~..
SufJpIr ap..gs . . -- .
R8tum ap.ings
... ~~.~- -. 0utpu1
fdr.
Ctm. _ .__.__ ____ ____
r.L. S5"37~
nPE Of SYSTEII
Warm Ajr fItInIs
Gfllvily _'__' ._. __ ___
M8chanicat .._ . __ _ _ _.. __ ____ _'___
All CoftdIi)I1~
v.... Syst8m . _ _.__
MEA'" OR fIIMBI A.AIO'
St_1ft ___
Ho1 WaI8f
f'adiaIIion _ __, ._ _ _ ___
Sper.ial Devices
0Ih8r 0eW;es
E
a:
CO
tI')
II
11ft Of WORK
Alerations ____ _.._ Replacement._ _.__.. __ .... CoftsIndDn _.X'
.... __.u ._ _ _ ____ Esa_ CaInp.. Da\tI ___ _. __ . _.
EJI, CaI.I , 3^1fJiO_~ _"" _ Buikhng Permil .
HEAlWG Pl"RMf'f FCF i
P4
P4
(g
(g
I
N
P4
I
I-
U
Q
&1 ATE SUR(.HNlC.t: I
t01 Al. PI.fll.. FfF-S I
.50
r fWD WITH
~___~IT
Rac"9l .
TYPE OF STJ1l1Ct.U8E
I ~ .....
, . _ l...,.
.~.. ' .-.. =-
s.... t-antw -X
C~_
MB-F..,..ey . . .. _.. ,.,....famty
Public
~-
'fDIslri1t
fee SchaUe
.......... Convnafo3l" ~ F:miIy
......... Helling & At:,
ResidentiIl H8IIIIn9 ~
RelidBnIi8I. Gas t-1I1!pIace
ResidInIiaI. AddIIans & AllsallOnS
ResidenIIaI. AI; Only
t"- 01 job coct (S;I9.5CniniYIum)
199.50
1M.!lO
S39.~
1:Il.!JO
1J9.!.O
f\eIneIrtJs to add the Stale SurcNtge on Ihe bottom ullhs ......=*-\.
The pnce of your hYting per.... endudes &Ae rough." and Qne.... IFu,ec-.n.
Ad&MIonal inspedlOft5 ... be bled .. ~ 00 each.
House Ileall1g 1.' J1ecofd must be slbMled .... WtiNjJ """" rQQu belon" ...
IIIIJ certJt~ ot oc.cupancy .... be Is&;ed.
H~~ ~I n' MlfW~ ws-fl' ~.R'--q WIIlt\ ...... 01 ~ and nlkn ..... IisIed pL."
room .-Ih CFM'5 per ~ New ~s or 8dcIihonI ,............ ~
and return IocaIians *"'"_ "AT lOSS CALCUlATIONS. PAVUENl Ate)
APfJLICATtONS MAV DE. MAllt:D TO THE CITY 01. PRIOR !ME. 162CDEAGlr
CREEK AVE. S.E. PRIOR I.AKE. UN 51j372.
City Halllu!ilr-C' hours 31e 8 a.m.' 4:30 p.".
AU WORK MUST BE .SPECTED (ROUGIWN AIID FINAL) -CALL em HAU.
M7-t230
r hereby apply for a medtanic" systems pet..... and I uknawledge- that 1he
.,.fon".'iOft above IS comt*te 'HId accu,..e; "allhe WOfh .. be It COI'fO.IMI1CI
.lIh ..., "inMCtD 8M codes at .. city .... .... the s.... buildilatfnled-nical
codes~ tha11hts form cktes not become a permif un,.t signed by'" BUILDJNG
(WFICIAL. thai tho WOI' wJII be In aC&Mdance with the appwoved pmll in the
caso of all work which r~re$ review and at)prova. of plans.
1~~I!.~r/~' I()-I~-~
Va - ,.... f..pUw~ __ ( t:> - r"~ ....0 C)
V'..~ . l D..we
..
AUG-30-00 11:07 PM
P.01
/9.( ...tllaJi'~
''r.& 'i'
~~;
...\.a............ ........"
"" C .ft'N lIt lh. ......t elf,."",
1, _'\1& File
CITY OF PRIOR LAKE ; ~~D~ ~~jClftt
PLUMBING PERMIT * .___f1.0,:05l../.
Afll'Iir.Rnt:])~ (r\~ho.~: 0;1-( Pt)on.: t..fl.a'?, ("p 9q q
Addrll5S: dt.( /'{9 ~...\"C:~~__~~.~\ l ~uU
Signature: \ ~ '.'iZ' ~.. ~... --pG --., ~ j~
Legal Description: L.ot ~--'7J- Block_J .' Sub -. Cb~iI:----~
SI18 Address: l <~ 9i (.a n(''E'-.e ~~ ~ 0 I Aj-~l2. _._.:... .___.. ... .... ,._
Building Permit # __. ....._.._ ..0,0 ,-.0_5.,/._.,.,- ._._.. ,PIO.dSs':t.8a03....Cr
NOTE: Thia permit will "01 be prDC88led without complete Information.
FIXTURE UNITS
.......-.....,.. ....
auufl~llv ....
Tvpe! u( Fi~lur..
QUit. .mv
Typ. ~f Fixtur.
(~
__---.~, J
I
Y ~._-
I
I
---J
Bath Tub with or without shower
L:J1l.nwasner
Floor Drain
__-_J
I
/
Rough-ins
water Heater
Water Sortner
Stand Pipe (walhlng machine)
...~........~... - .~........."-_.._-,..
Stlwa;e EJIC1Qr
..
Backflow AlHmbty (RPZ. Double Check. PVB)
,
Lavatory.. (bathroom link)
I ...."rtry T~1 (1 or ~ nnrT\fVIrtrMnt "ink)
Shower Stall.
, .- _'0 ..... ...\ . _,_, ... ""t"Y'.'-" ,.
CiMlle
iCloldlow ^DGombly T Qot
lawn Sprlnkl"r
..... -...--.~.'I ...._........._._ ....... . ...._ ___.__. - . ..........._..
Oth.,
Bar Sink
') WalQr CIQoot (toilet)
a...... ..,,~.. .... -. _........ __tl ....
'11 SCHEDULE
Industrial. Commercial & Multi-Family
(1% of Job C08'. $3Q.50 minimum)
Reaidential, New One i. Two Family
R...identla'. Adr.litiO"~ ... Alt.r~Uon.
State 5urc::hi\rge
GRAND TOTAL
$
S
S
S ___. ...-=..50_
PAID WITH
BUILDING PERMIT
$ ---...--
$"9.50
$19.10
can for all i pccdo"" 24 houri In .d"anc~.
)rn@~D'W~
_~ 630.
~'
Thil p.NI'Iil II puud upQft the ...pr... CQftdiLlon t.hal ,:aId
~nlrac:tor. ah,1I tomp y . 11 r ,*tl with the CH'cllngncoa
of '~l; Sl~tc: Plumbin arngrtd"tflCftCl theroof.
. ". S .. C/O P^'c.
A I ,aST
.;;
.
16200 Ba,le Creek Av. S.E.~ Prior Lake, Minnesota SS312/ Ph. (612) 447-4230 I FAX (612) 447-4245
. _. .,,,,,- t. ~_....I...._
i'l~ ~ .
\ ~I :C\o~~t.M"r~.,r~~_mG -S]jmY~~ =~i~: ~:IT
~NES./i\ i a-a. . · NOTE:
_~,
~-'IU
YELLOW - APPLICAIIT
GOLD - CITY
s.w. NoOfY 0 st /
Sewer and Water
contractors must
be registered
with the city.
APPL1CANT:J/oyd ~
ADDRESS: / 53Bl.o 13 ~e L\.1 ~ ~ ~k
SIGNATURE: ~ '
V
SITE ADDRESS: /SJitR
teet
I(;JV
PHONE: 7 3'~ · 7~~ /
DATE: //}-5/,/ -Od
BLDG. PERMIT #m-05/1
PID~~-3 L/~- CkY3-D
1.
FILL N THE BLANKS
Estimated length of water service~()LJ
Size of water service I~ inch(es).
Location of any couplings from structure 10 feet.
Type of sewer pipe. ABS PVC)( Cast Iron
Estimated length of sewer line 1121) feet.
feet.
2 .
3 .
4 .
5.
6. Clean out (if required), located at
structure.
qd feet
from
---------------------------------.---------------------------------
---------------------------------.---------------------------------
This a~~~at~.on becom your permit when approved.
BY ~ . DATE: //1. ?o-etJ
=================- ==========================~====================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
Fee for either sewer or water individually is $J7~ plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
~o insure that no duplicate sewer and water PEf'AYbWIT.are
J.ssued. IUI&.DING PE'"., .
jI_ to -00 "- KJV.. ·
::::1::1: :::~:TB:A1D~~
*
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
~: . CITY OF PRIOR LAKE' ( :'.)
'Ii r...,<t...... . 16200 Eellle Creek Av. S.E. Pell1IltNo. r::Jj -651/. ~
~ J Prior Lake. UN 55372
~ ~ :/. H,EAnNG APPUCAnON I PERMIT :. Single Family
cL Dale. ., . n , 150 PID'. as" - W~ ~ 003 - () CommeIClaI
U) Sle Addfe., 1~?Ji3l CJ f:y~L-?:'-I (Jr fl.../::J Fee Schedule
CD" .
ci lot ..J Block \ Addhfon, .a..W OPr\L 5 2.A>o PrfJO industrial, Commercial & MulG-Famllv
Z awner's Niune ~ Uc. ~ (114\0 _~ Cu ~ ~~. I R&&ldentlal. H&aUng & AC
. Residential, Heating Onty
Address. .PO ~" c~(t) 1-AlUJ1j~I\~ ,~L\ '-I Res~nlla', Gu Fireplace
.n .,.".. I'J A.."'" ... .. . ..... Resldennaf, Adftillons & Alt&ratlons
Heallng Contractor (:"i ~ , ~"~ ~ ResldenUal.. AC Only
AddIS$S, )L/1l/6 ~ tt.eI<<.JIl.:r ~~,_ ~]l.WYLl.flr r~cb8
lP S\ - 4-2:~-l \U~
Telephone II .
Furnace Make & Mode!,' 'P-~'"
Model Size . G2loQ ~ 4 -I crO
Conn. LGad .
[\-
~ Fuel ~Nkr ~ Flue Size ~
U) .
~ SupplV Openings . ,OJ
@ RetlJrn OpeninQl PJ
Z
~ In~ ! "f) ; nrJD . Ou1pol q-) ,lflJ"O
~ Edr..
w
l!) Cfm..
JYPE OF STRUCTURE
I. I'i_
J. OR
3. y.u, }
PPc
C1lJ
CAaIrK_
y
Two-Femly
Industrtal
_ Public
MuIIJ-F8lTl1Iy
Othe r
1 % of Jab cost ($39.60 m InTmum)
$99.50
$64.50
'39.50
'39.50
139.50
JUL Il2fW
i ) ,
v./
V
_.""",.._...,.~----""'''''''''f~~
Remember 10 add the State Surcharge on the bottom of thJs appllca~on.
TYPS OF SYSTEM
Warm Air Planls, "
Gravity , I
MechantcaJ
Air CondftTonlng )t ~~ ro ~
Vant. System.
HEAllNG OR POWER PLANT
Steam
. ~
HoI Wate'
RadralJon .
Special Oevlces
The.plice 0' your heatrng permit Includes one rough-In and one fr.al Inspection.
Additional inspections will be bllled 81 '35.00 each.
Hous.& Healing Test Record must be alDnllt8d with htlirdlno pp,rml' number bafors build-
ing certificate of ... ......lpancy wi. be issued.
~FAT ~.I r,I II .TIO~J~ ~J=(\' U~Fn with numbel 0' supply and rstum openings listed per
room wilh CFMla per openrng. New slructures 0' addil10ns &end floor plan with supplv
and ralum localions shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPUCATIONS MAV BE MAiLED TO THE Cny OF PRIOR lAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR U\KE. MN 55372.
City Hall busTnesa hours are 8 8.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL)- CALL CITY HALL
447-4130
I hereby apply for a mechanical systems permit and I acknowledge that lhe
inform anon above la complete and accu.ate: lhat the work will be In con'olmance
with the ordinances and codes 0' the cUv and with Ihe state bulldlng/mechanlcal
oodes; tha' this 'olm does nol become a permIt until signed by the BUILDING
OFFICIAL; that the wOlk wlll be In a&cordancB with the approved plan In 'he
case of 8 tJwork whtch requIres revIew and approval of plan&.
,/t1/av
7 ;;; I~
I Dalp' ....
Olher Devices
TVPEOFWORK
Replacement
Est. Comp. Date ,
, BuUdll1g Perml' ,
E
<I
If) AltsTations
[\-
Repair.
~ Esl. Cost $
lSI .
N
CD
..-t
HEAllNG PERMIT FEE $
-l STATE SURCHARGE $ ~
~. ~ '
TOTAL PERMIT FEES $
. New Const.uctloll V
00 -<::>$11
PAID WITH
BUILDING PERfvliT
Receipt , ,
PRIOR LAKE. ~DEPARTMENTOF -'f-
.' BUILDING AND INSPECTION
-.t
INSPECTION RECORD
SITE ADDRESS 15.3~lD ~'t-.ef-~ ~4 Ra;v9-
NATURE OF WORK ~ ,
USE OF BUILDING SF\)
PERMIT NO. 00-051 / DATE ISSUED ~-2-2.aoo
CONTRACTOR ~ Mc.N.fIc.J~ ~PHOtJE" :?8G,- 7finfJ _
NOTE: THIS IS NOT A PERMIT FOR JlNY OF THE INSPECTIONS BELOW
E ~ THE ~ERMIT IS B. Y SEPARATE DOCUMENT
~~ ~t)\1 ~ ~ SUNAJ4I'- ~ l=t>U.~C;~PECTOR' DATE
r FOOTING tf=i. ~ , 7/1, / MJ
4 FOUNDATION(PrlortoBackflll)tt'~. 1!Jjj~ iiJ. Q'/4/(J()
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SI~D
ROUG~- INS /J
SEWER I WATER I SEPTIC ~:~J '111.:1./;0 U~ 7 /aJ.:.
FRAMING I~t/ m. ~.~(U1/~ 9/ I?/tm ,. A
INSULATION .- ',~l CfLtoll'JO' ~~~ /1'i//JD
ELECTRICAL '2 - 1 I ,.--
PLUMBING I V ~/lt//~
HEATING (If require 'I it · '11/'11/)1)
, f
FIREPLACE ·
GAS LINE AiR TEST~ ~ Q:r. /6( p.!f1D
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1IIIIIIIIIIIDi '
.-~- f\ltJ~o.~ ~4. ~ II/JI/(Ja
t:J~v. ~~~.'Cc:..~ Rer;. ~I N A L S /
- GRADING (Prior to Sodding) . N~ S'At6&d
BUILOINGf.t-~"1 &1 ~,/D/J4j".,
ELECTRICAL
PLUMBING 7] If /0'" ~~()6
HEATING ' f1r If> 1';2-7 1/J1)
DO NOT OCCUpy UNTIL' ABOVE HAS BEEN I SIGNED
NOTICE
This card must be posted near an electrical servrcE 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
, ,) ::' ~),;
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~-('-ol '1~D()
OWNER
IS 38'. Brtczv II. Rtt/.
(
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
(;)6-6'11
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
~GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
4/1' b &.,;<.. C9 r<
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
4-L. ---- _
Inspector: 'l'~" ~ l>wner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/ 5 3'i~
SCHEDULED ~~/Oo / I :- ()-(J
g/le e ~ V ffi K!cJ.
J
OWNER
CONTR.
PHONE NO.
PERMIT NO.
6 -5/(
o FOOTING 0 PLUMBING RI 0 EXlGRADIFILLING
o FOUNDATI~O 0 MECH RI 0 COMPLAINT
o FRAMING '~/ 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TIO fit \ 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL ro. 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION ~ Ji' MECH FINAL 0 ,-----~
COMMENTS:Q) tJ ~ ~ g"..... ~-
r ~ ~~r[j ~'nA ~ tf D
~ 11 (~ ~, ~~/ "
1JJ ~ PJ-~ ~ ~ t.,.:J;[JtJ.adL
~ ," , fir&., ~ ~~ ~,
J:r~~-.r-/~~
~..<.AAe (lp..J.r;u.:l-, ~ ~ )2-'1 ~Jl.J..
o WORK SATISFACTORY, PROCEED ~ ~
o CORRECT ACTION AND PROCEED
t' CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. f?:r-I OWner/Contr.
CALL 447-9860 FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECnON NOTICE
ADDRESS
/~~ g,
SCHEDULED Io-~-~ lj; aO
br~2-v Pi- ~r/.
/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o-,~II
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKU~'J\
o FINAL ~LUMBING, FIN 1""\
o SITE INSPECTION 0 MECH FINAL ~
COMMENTS: {'~<-,J(J,O s. <~ p~ ~
<2-. ~ /YJ~
rN~ (7M~
~p~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
~ORRECT AC,ONAND PROCEED
o CORRE7IT.. ,.,~K' CALL FOR REINSPECTION BEFORE COVERING
,L../
Inspector: -,.. Jl Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl