HomeMy WebLinkAboutBuilding Permit 99-427
CITY OF PRIOR LAKE
BUILDING PERMIT,
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 tI- /7oS
~J.~
3. LEGAL DESCRIPTION
L/ .3 BLOCK PID tt;?s-o 3 &0 3 R.f:L
ADDITION .A'f <<,..tfJ iz:,.,I} ~I"'k .s Lnr e. ,A eve S 13. TY5~ ~tSTRUCTION
4. OWNE~ (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
~I ck. ;?' A"...vc 5 "7 3 a' 0,A'wv 1.3 se; VR.9'("_ 61.1- 7/J'- Y'.5'?7 4/p'i1'e ~ I /'V"bf? l' ill.
5. ARCHJT CT ~ (N,~e) .. (Address) I V. (Tel. Noj s< ~-er /~ / I,... "? 67 ? ~
" ~ " d~v", ~SJk? /'7S-tf/Mf"~w.1~5. W~ J'tol-3 3'""'.)
6. BUILD R (Name) (Address) (Tel. No.)
.:5e,/~ .Jt+n~ 'iye /361 /A)./lwy /33..v~ 61.2- }f/-~S-,l1
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofing 0 Porch 0
New Construction 0/' Alterations 0 Addition 0 Finish Attic D Re-siding D Finish Basement 0
DATE RECEIVED
APR26 I&)
ry f,./ a. I:. er ~ 'rtt:< I. /
LOT
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. ./: 000
9. PROPERTY DIMENSIONS
Width 7 S .. Depth I t'6 '
10. CULVERT SIZE
Yes (N])
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
c.q, L'~2 7
,
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BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) ,
.<7~
12. NO. OF STORIES
)
/
/
!)!'t 6' "
I
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16.~ROJECT COSTNAlUE
H/(5:~
17. COMP(ETION DATE
/1-30 -97
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above me ioned ope~and t all con ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offi . k is P . for ju use. Fu,rmore, I hereby agree that the city official or a designee may enter upon'the property to perform needed inspections.
X ~. . ~~ 7- 7- Z .7
SignatUre ~ License No. Date (
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
BUILDING DEPARTMENT VALUATION
Side
USE OF BUILDING
l) l--b
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV 6>~
Occupancy Group A B E F HIM (.R' S U
Division 1 2 @ 4 ,--
Permit Fee ................................... $ J 0 I? . G ~
. (O?. 5""0 \\
~5'l. q 7 J)
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
l rJO. C)O
/()() .of)
3t;" , ~o
41? -00
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
~as re I
s I
B
'-'
Beco s Your Building Permit When ApRroved.
Date r_ 7 .:.t7 7
- :::; - 'J .,
ssued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS D
SURVEY 0
SETS
COPIES
I ~~.a:o. <<:> rr>
City:
1A.;~
\f~ ~If
PLOT PLAN
D
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC . .. .. . . .. . .. . .. . . . . . .. . . .. . . .. . . . . . . .. ... $
8S-o. CO
I OS-a ~OQ
Collective Street Fee .. .. .. .. . .. .. .. .. .. . ... $
Sewer Tap ................................... $
~ (, $
Pressure Reducer ..1I~..................... $
Meter Horn ... ~1............................. $
Water Meter . '"fi!J............................ $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap .............................. ..... $
Buiklers DepoM......... .......... ..... $~'1f#:::'
Other ...1r.:................................ $ _ C:O
Total Due.............................. $ I
Paid 79? e . 2.-- "'Z- Receipt No..36(" ~
Date 7/7/49 By
. ,
'is~' 0 rtify that the reqU st in the above application and a ccompanying documents is in accordance with the City Zoning Ordinance and may pr as requested. This document when
n by :he 9'J .P'anner nstitulBs a \empjlrary Cer1ifica~ WOO CO<11lI~ glows ,,:,":Jl'Cti"" to.comB""'''''' Bejore occ_. p Certificate of Occupancy Il1lISt be issued,
r J ~. f.t1 I ~ :IV ,/J'I/Of' .,tnet:Matot ~.~fXL) ,-'t"a-uct4/\ C- L
'-1l .. / / City nn r I a e Special Conditions if any
Ii 24 hour notice for all inspections 447-4230
45,tSrL
/ 2~cC7CL
~ L.Ot:) .~
'1(90 .00
~
Q9-LJ-Z.7
The Cenler or the Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLISI
NAME OF APPLICANT
APPLICATION RECEIVED
Se.VAI-l- I I N~.
4-/~ /qq
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4=2. 30 QUAKER- IRA' L--
L 11{
Accepted
Accepted With Corrections
Denied () I
Reviewed By: v:..p &w.-r-A
Date: t;'- 3-97
Comments:
,~ tiQilA ~\"'- ~1'd\A- )~U
2, ~od) t.r-O"VL~ ~ S~ YoJ--~
3. ~~alt O-~ ~~
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."
qCJ- L/z 7
TM C~nl~r ollh~ Lak~ Co..lry
White .. Building
,~ Canary' .. Engineering
Pink .' Planning
BUILDING PERMIT APPLICATION DEPARTMENTCHECKLIS1:
. NAME OF APPLICANT
APPLICATION RECEIVED
SE:VAH ( i!\j~.
I .
4/z&jqq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-1 2. 30 QUA K.E R- I kA , L--
L/f75
Accepted
./
Accepted With Corrections
Denied
Reviewed By: J}"'L.TE.A-
,-
c:. H RES ""1'4 N AJ
Date:
b/1.%-j"
Comments: R\J,JfJF~ r11,",sr BE l!<:JAJ\JE'f'EO "ro A,tJO ~L.4AlCt DRAIJ>.J,qc.E: ~ vr'C-,TY
f."'A~ EAE' oAJ'T'S
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4m B 1fT'" "Tu ~ SA"oJ ,.r,c:t ft. .,.,
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B~ J....,> -ruE UT"'L' rY €ASEM~jtJr
kJ~u_1! ~~DS~fJ'Je:, ?AClc.~t.- ~.
.r...... s",.o€ST''''C, 2. SCwE.R.. CL.t!.A~~.J'rS
fo4t Vovtt SEil.ul,e: (...,~..u: .E"~ 1""Ptou~H VtJutf.... oNL\" R.~QLlIItW 1""0
f>"" IAl 1.. ~~ 100 I DF ~4!Ru'c~ l..'~~_
5f.f. IAJF'(ltl""ltT'CMJ oN
flE(ff.AS~ SIO€
~ A"YT.qlJ.t"'~.. I. h'"",qL- /.!~ /AJSPEc.7l01\J IIUFoat'1~T'O^-l
2.. , 'i~S E'AJ~#JEE~'J\Jfa.
C.Of/lt1l,.M'C.JJ-r$ ~_ ~ ~D4StON COAolT"It.O&.... J'11EAsulteS
,
~. SA,..JIT14tt't' SEwU. ~
~~ ~~_ B""Lr~ 5 E' It.o~'o^, C oNT"itOl..... Pt. t'tiU
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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."
..........fI"
,f (' I
I' -
~-1
I
The Cenlef or the Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
.>~! t~.,.
f-I /{1\,,(:.
f '. .-
APPLICATION RECEIVED
/ ..~
/ t~
;'
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
/......,".~ &--;.. -- " I L..-
2/,-;', L. .,_.J C.. j (,.~: /,\ K l~-: /,:.._ i K /-\ \ .
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\/
Accepted With Corrections
Denied ~ j
Reviewed By: L tJf .-d(/t()V] _ Date: f;J(tSI/J
Comments: J(Jr t. M ~ kn ~ ,j( c;Ltx..a
~.~~ ~MJiU~
M~ c(~k C(XJ~~
~ lx ~Co::I1(?j ove1 {tI ~.
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 violatiQn 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
- "---'--"-- ,._,_.- -.'.--.-- -'--....- ..~~..". _.. ....-----.-...-~~-.-~~-.--.. -----. -.____..._. __......._..w..__.__...___-- ..._____.;".
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Residential Building Permit Checklist
BY: C <!J~ j~-famil:a:~elli;i ~ ~i~o; R-2
B.uildiOg Pea&&dt # Q1-'1 d-] PIU: . cDs -OJ(p-()3 f -/ Zoning: (2.. --J So .
Site Address 13'10 Qur.4r TrJ ~ <A/I'\d.u {)tel ~
Legal: L '-13 B Subdivision: M~ 1'- /<-- ~~ ?{ou.o
Existing Strucutre: YES ~ Existing NonconformingStrucutre? YES ~
CONFORMS TO ZO~lNG
ORDINANCE
YES
NO
Yard Setbacks: =:~IC@LE
TSCO~
MEET CODE
Requirement
Proposed
. Front Yard
25'
. Side Yard
10'
~~~
I~. y- J
Ji j
d~t r-'
AljA
fi/V-!-
. Side Yard
10'
. Rear Yard
25'
. From 100 year flood elevation of Wetland
30'
. From OHW (prior or Spring Lake)
50'
.-- --
Road Setbacks: l'5OT A PPT .TrABLE ')
MEETS CODE
DOES NOT MEET CODE
. From County Road or Major Collector
Requirement
Proposed
85' from centerline
. FromHWY 13
50' from R-O-W
. From CR 42
150' from centerline
. From CR18
r-- ---
Bluff :~OT APPLICABLF~
MEETS LUDE
DOES NOT MEET CODE
. Setback from Top of Bluff
250' from centerline
Requirement
Proposed
. Bluff Impact Zone
25' minimum of slope less
than 18%
20' From Top of Bluff
. Grading in Bluff or Bluff Impact Zone
L:\TEMPLA TE\BLDGLIST.DOC
Thr Crntrr or thr Lab Country
Quantity
I
/
/
?
I. Blue
2. Gold
3. Yellow
File
City
Applicant
CITY OF PRIOR LAKE
PP No. CJc; -tl z:L
Phone: f9?O""b'/ ~
/)1( I~,
PI,.LJ.lVIBING PERMIT
APPlicant:ffi," fl1!IJUJ6.'~:I .' 4 /l i)
Address:~ ~_ ~ ff, ,'dc~~"
Signature: A iI!i 0
. / /
Legal Description: Lot ,1 lJ3 Block I
Site Address: 1{'-; r UJ /Ll.-/LC1 V,,4_J /
Lrz.-so &. ,
Building Permit # hP <t;21 PID #'25- oJ~' 6"3a. 0
NOTE: This permit will not be processed without complete information.
Sub t\~, ~e..r-Le
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
.50
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
.d)- Water Closet (toilet)
FIXTURE UNITS
Type of Fixture
Quantity
1'......L\
.,\\) \{'\j \ \ r1 -r
Ft'.", '\....['::>~'\i'\'
I \tt\ i.....r\.~G 1"'" \.0-1 .H
CUI'\.-\...-'
This permit is granted upon the express condition that said
contractor, shall compI)' in all respects with the ordinances
of the State Plumb."ng .' a .. .~he ame9dme2ts thereof.
-- R fiiJ. /// ~/cn DATE
1/[1--- Al'lhST
Call for all~ecti:ns - 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
~
_.~?
/
I
I
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
GRAND TOTAL
~~
~NE~
GREEN - FILE
YELLOW . APPLICANT
GOLD - CIT~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. qq- cl27
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT:)9~ .~ ~ ,I r~. #HONE: 9 /"1- / Lft /
ADDRESS: 7/ IV' ~.~tI?-~ATE: /1 - /"~~7'l
SIGNATURE: )/~ ~~ BLDG. PERMIT # c;c;-Ljz
- ~~ F
SITE ADDRESS: tJ.. I // ;;f! ~~~ ~/VPlD#
7
1.
FILL IN THE BLANKS
Estimated length of water service ) j7~
feet.
2. Size of water service
I
inch(es).
3. Location of any couplings from structure
?S- feet.
5.
Type of sewer pipe. ABS PVC )(
Estimated length of sewer line / 7'-
Clean out (if required), located
structure.
Cast Iron
4 .
6.
at
feet.
fo
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
----------- -----------------------------------------------------
----------- ------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $~~.5D 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.
DATE PAID
AMOUNT PAI(;D_ '1'NP\]'J. ~'-~ .,\\
G t"\';"" '"
REC'D BY eU\\..O\N
RECEIPT #
4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPlDYER
CITY OF PRIOR LAKE
16200 Eagle Creek Av. S.E. Permit No.
Prior lake, MN 55372
,~.'P'ijOi~,
i O~'T <"
Ie"/' JI.. " -y \
1... ( 1'-.1
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"''-__'~ HEAl1NG APPLICATION I PERMIT
Dale 1& - tl PI) . 2-5 -0310 - 038 - /
s.. Address __-Y17 ') ~4-t..,,- 'ta>4../ I ,l2/S0
qc;-LIZ 7
10I BIocll Acldkion /-16 / c5 AI\/O /8Oi//!/ 05
0\lIn1ll'S \IIame _En-+- f-r~ ~5-
Address
tleaIing ConlractcK 1t~ltsq>J.;4...k X;~ . -
Address _.9i3 ()~but !:it," JJe ~PlYJl.J" 4>
, --
Telephone #t h.l~ ,.. i' q - ? '1 39
Furnace Make A Model ~J<(M A-~ f' lYPE OF SYsrEM
~ Il- ? ( )term ~r P1an\S
Model Sl;te ~~ ~ ~liJA)O J "O'd"rav\tv '
Com. load 11 0 Medlanical
- A;r Condlioning .
Fool -Ill C4- ~ .Flue Size 0 lJ'L _ vent System.
,
supply Openings 10 _ . ~~1lNG OR POWER PI.NIT
f ",83M
Return Openlngs,~ . Ho4 Water
~O. O^^ J? L 1t0 Radiatlon
input -.0::+ uv.- Ou'puI._~~-- SJMfcial Oe'yaces
Edr.
Cfm..
Other DeviceS
lVPE Of WORK
)
Allera1KJnS
, N- Construction
Est. Cost &
_ Replacement
Est Comp. Date
. Buikllng Permit'
qq- L/-27
Repair ._.-_
HEATtNG PERMIT ..t:t: $
STAlE SURCHARGE $-
TOT AL PEAMrr FEES .
.50 ~", - p~\O wrn-\
e\l\\..O\NG pERMIT
_ Recoipt
1. (ftc(o 0')'
1. Ydlllw CODili,:H.1f
"
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3:
TYPE OF STRUCTUM.
Single Family -X.
.__ Two-Fami'" _~__ _- Mufti-family
Ottley ___ .__0'
Commercial
._.____ 'ndustrial__,. _- Pub6c
Fee Schedu1e
'ndUslrlal, Commerdal & Multi-- Family
Restdent~ls Heating & AC
R~dentialf Heating Doly
ResidenUal, Gas Flrepa800
Resktentia\. Addik>>ns & AlteratIons
ResidentLal, AC Ont)'
1% of j
$99.5C
$64.5C v
$39-~ 1\
$3950
$39.51 ~
Romember lo add the Slate Surchafye on the bottom of this app\lcatiol\-
"
D
X
Z
P
The price of your healin g permit includes one ,ough-4n and one final inRpec1iOO,
AddilionOl inspections win be billed a\ $35.00 each.
Houso Healing TesI Reconl must be s\Almill8d with Il!Illditm ~~ !lIIIIlher lJeIote build-
Ing (:er\ificat8 01 ooc.upan.cy wiU be issued.
UE& CAl.CUlATIONS. Bf.P\JI~ wllh lllINIer 01 supply and I8Wrn oponings tist8d per
room with CAA's per opering. NeW alnlClJMS or addt\OnlI pnd 11001 plan will oUppy
and retloWn tocations $hown. HEAT lOSS CAlCULATIONS, PAYMENT ^ND
APpUCAnONS M^V BE MAILED TO THE ClTV OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIDR lAKE, MN 55372.
Cily Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGtHN AND RNAL) .. CALL CITY HALL
447004230
I hcroby afIplv for a mechanical sySl8ms permil and I acknowledge that 1he W
information above Is completD !IJId accurate; that the _k wID be in OOllf<>rmal1ce of'
wilh the ordinances and oodes of lhe city and with the slate bulldlngfmec:llank:al I\J
codes; lhat Ihlo 101m does not become a permit until signed by tile BUILDING UI
oFFICIAL; Ihat the work will be in accordance with the approved plan in the tD
5>= 7;jJSwes review and approv~ of P7i~ I ~~ ___ ~
Appl~f,~~Jr IDa\eL ~
1/ Z qu 3:
---' . ~ " ------'-.-
~ ~ ~
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. PO,IIl;t No. qq, t.f Z 7
Prior Lake. MN 55372
TYPE OF STRUCTURE,
Z
I, Pin' . file ~
2. Gftlfft . 01 J I
J. Yellow . Con..... N
N
I
\C
\C
o
N
HEATING APPLICATION I PERMIT
Dare // / ),)./~q . PIO" 25 -03~ - 038-CL..
Sire Ad~r~ss ~ QlAc-..b1 ,1'7uJ ~ /-SD
lot Block
Owner's Name
~'I-
,
Addition ft7c~ /lND 60UN~
)f~~~
tJ
Address
Healing Contractor ALL lED FIR F. SID E d b a FIR F. SID E COR N E R
Address 2 7 00 N. F A I R V I EW I R 0 S E V ILL ElM N 5 5 1 1 3
Telephone" 6 5 1.. 6 3 3 - 2 5 61
FIREPLACE .
1Mm. Make & Model !-IG-t I A.} 60_
Model Size.
'7 Do,') i'~
Conn. load
Fuel (0c.. t
Flue Size
Supply Openings
Return Openings
Input. Output ~ 1.o:D
Edr.
C'm.
TYPE OF WORK
Allerations
Replacement
Repair
Est Cost $
Est. Comp. Date
J (Ov,u.)
Building Permit "
HEATING PERMIT FEE $
S1 ATE SURCHARGE $
TOTAL PERMIT FEES $
.50
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mochanical
Air Conditioning
Vent System
HEATING OR POWER PLANT
Stoam
Hal Water
Radiation
Special Devices
O1her Devices
New Conslruction
xX'
upv
qq-t.fz7
,......--PAlD WITH .
l BUILDING PERMIT.
Receipt II
Single Family
y
Multi-Family
Two-Family
Industrial
Commercial
Public
Other
Fee Schedule
U1
W
1J
InduSlrial, Commercial & Mulli-Fam~y
Residential, Healing & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential. Addilions & Alterations
Residenlial, AC Only
1 % of job cost ($39.50 minimum) "T1
$99.50 ,.
$64.50 ID
VI
$39.50 ..
$39.50 i
$39.50 .
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o
"1
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ID
"1
Remember to add the State Surcharge on the botlom 01 this application.
The price 0' your healing permit includes one rough-in and one final inspection.
Additional inspections will be billed 81 $35.00 each.
I louse Healing Test Rccord must be submiUed with Meting R.elmil DU1Dber before bui~
ing cerlificate 0' occupancy will be issued.
HEAT ~l)JATlONS REQUIRED with number 01 supplV and return openings listed J
room with CFM's per opening. New structures or additions send floor plan wilh supply
and relurn locations shown. HEAT lOSS CALCULATIONS, PAYMENT AND '"
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE U1
CREEK AVE. S.E. PRIOR LAKE, MN 55372. ....
Cily Hall business hours are 8 a.m. - 4:30 p.m.
'"
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W
I
ALL WORK MUST BE INSPECTED (ROUGH.IN AND ANAl) . CALL CITY HALL
Q)
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I hereby apply for a mechanical systems permit and I acknowledge that 'he ~
information above is complete and accurate; Ihal Ihe work will be in conformance
with the ordinances and codes 01 the city and with Ihe slate building/mechanica
codes; thatlhis form does not become a permit unlil signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in lhe
case of all work which requires review and approval of plans.
~
- Ap
447-4230
/ / !J;./c;y
I Dale
11/z3Jn
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PRIOR LAKE
INSPECTION RECORD
Lf/75
SITE ADDRESS 1:"''f~ c::J(p.k~r' l ~.A.;\
NATURE OF WOR - /Jel." C'lld.c:kfll.L~_
USE OF BUILDING g F D
PERMIT NO. '1'1 - 4 ~ 'r] DATE ISSUED 5~ ~-cr9
CONTRACTOR ~Q.~ -r:-,^c. ~+J'\\G~ l-J~.QS
NOTE: THIS IS NOT ~ PERMIT FOR ANY OF TffE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
^
FOOTING~/~\ t>-~-1? NO ~.JJ.,~ VdW~t~ t.,.~~. ~r. <:t~\3~1'
.. i I
- FOUNDATION (Prior to Backfil~v'Ir~ -~, g-:5tJ -7)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
_ ~/)) ;;/1/;'1 . I .
if ' j/~ . II r~ /1..
QJ~'i 11/ lloa J
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SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING V'IG . Cd;; // /9/'17
HEATING (if requir~
FIREPLACE
GAS LINE AIR TEST
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
...-1
'f'1/10o)rQ J $; ~?31IktJ
, V ~ /1.t J)'; Jq~1
1)/ ('I. \ . / ii, q1
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
-----
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY
FINALS
G<!. 7. Z 1-~
~o flu
UNTIL ABOVE HA~ BEEN SIGNED
NOTICE
~ '~,Y
1. u,~
This card must be posted near an electrical service cabinet prior to rough-in inspections
. and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPEG~TIONS (612) 447-9850
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~-.............~._'":,.~
*Permit#
*JobAddreas q 17$'-QlA.AIc-l.."", Tf?'.
* Heating ContrllCtor ~ e (\.. ")'(.\I'oJ ,A / Il 1:,.; (. ,
*Testens/Signature~
*Gas Une
Pressurized
Inspected
· Percent CO2
· Percent 02
Final Inspection
Q!!!
Pounds
Pressure
Time
PERFORMANCE TEST
7e ~O'
I, .Percent CO ~,I /~
Y 'll.. qQ 0
_ *Stack Temp. I V
_ Date
.
....
,..
DATE
~OO 3!nv
4/'7~(~-'L- ~ ·
C~N~.
tJ?- 427
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
TIME
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
^ o FIREPLACE FINAL
r ~GASLlNE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~INSULA TIONN '^ A 0 SEWER HOOKUP
i FINAL ,~ ~LUMBING FINAL
o SITE INSPECTION A~ MECH FINAL
~OMMENTS:~~
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(~WORKSATISFACT~.P~ED~ p~ ~ n f~o
~ 70RRECT~CTI PROCEED ~ ~ ak
~ORREC'. .R I CA '=- EINSPECTIO:'..~~~::)'E COVERING
Inspector: l Owner/Contr:
CALL ~7 -gJo FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE R~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
#00
4/7S- CJc/I9~e .'//Z-.
TIME
SCHEDULED
<~:6V
ADDRESS
OWNER
CONTR.
PHONE NO. PERMIT NO. q 9 - c.I L. 7
(
o FOOTING 0 PLUMBING Rl 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TION"-. \ ~ 0 SEWER HOOKUP 0 FIREPLACE FINAL
')( FINAL ( 'I 0 PLUMBING FINAL 0 GASLlNE AIR TST
/[] SITE INSPECTION . 0 MECH FINAL 0 0
/ ~. jJ ,.-:;d-,,,, ~~ '\::L~
~G Cf~;:~S:?0 ~~;;-,..~ d'~, Cs a.JtL...
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q)~~~ ~ ~ ~~
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~. ,,-~.-
COVERING
CALL 7 -9850 FOR/THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE &TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7- ;<()( (
J!.- ......
ADDRESS
lIt 7(
0, \..J (, l<, J.../ \ -( .J
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~
.)):),2/\ () \~
)=I"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECMfU<~ CALL FOR REINSPECTION BEFORE COVERING
I Ii I
,/ I
Inspector: I /1 / Owner/Contr:
, '/
CALL ~t-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
/NSNOTJ
~~_.__~_^...-= ..... . _ _....._....__.,"',...~~.~.__...H.:It;;_";;O!!'_.._"'_..,,_.,,_ ,._.:._..,-.".'....-.~"1..._."__...,_ ~
o FOOTING
o FOUNDATION
=F ING
o LA TION
FINAL
o SITE INSPECTION
~ TIME
cPj,(t:1j~r //'(;(,/
.5p~aA..; TN".
PERMIT NO. 99-~~7
o PLUMBING RI ~GRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
SCHEDULED
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS Lf~~
OWNER
CONTR.
PHONE NO.
COMMENTS:
Grlt~
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.1...JJLI.zPt7X I~
/~ tJK..
~k...
t~(
7'
~
~.
LISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~7' CALL FOR INSPECTION BEFORE COVERING
Inspector: ~h
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl