HomeMy WebLinkAboutBuilding Permit 03-0083
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ADDRESS
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CITY OF PRIOR LAKE BUILDING PERM ,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT/,)BLOCK:;1... ADDITION ki,)~J
OWNER I J
(Name) IA/t:ffNb"'A,J~
(Address) / Jl9<" Pf A:ZA
BUILDER S
(Name) ~.e-
(Contact Name)
(Address)
TYPE OF WORK
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iii New Construction
DLower Level Finish
o Misc.
1. White File
2_ Pink City
3. Yellow Applicant
I PERMIT NO.
(;)_ ~O~
O.3-CX03 I
ZONING (office u,,)
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(..ft II ~
2JJ1)
Plo.:;~~31o- 01 ~ ~o
(Phone) 017~t(tJc:. -q~OCJ
~ <<,:102
&MA.~
(Phone)
(Phone)
ODeck
OPorch
OAddition
ORe-Roofing
OAlteration
ORe-Siding
PROJECT COST IV ALUE (excluding land) $ /0':5/ 73"J'-
Dutility Connection
I 1/'/0'1. DOO, 00
1$/
It) 111).lS:
$ M..O,5'C
$ St.,DO
$ -
$
$
$
$
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IO(),OfJ
"35.~d
L7o, CD
This Application Becomes Your Building Pennit When Approved
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Dare
o Fireplace
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-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 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;teruPo~--:;=dedinspectiOnS I ~ S-l?
/ ./ V tv- Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
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Building Official
I Park Support Fee #. $
I SAC # $
I Water Meter Size 5/8"; I"; $
I Pressure Reducer $
I City SAC and WAC # $
I WaterTowerFee # $
I Builder's Deposit $
lather $
I TOTAL DUE $ (,324, 15
I Paid ;$? 3d.. 4, i~1 Receipt No. ,....;y. / Rl1
I Date ~-II- ~ By U
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This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
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Planning Director
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Date Special Conditions, if any
24 hour notice Cor aU inspections (952) 447-9850, Cax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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Tht'("t'ftlt'fOffht'l.abCountry
Cy.rhite - Buil~
c;anary - I=.nglneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHIiCKLlST
NAME OF APPLICANT --.Lt ~~ ~
APPLICATION RECEIVED l;;l - 8 (Y oa--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
jL/j9? F~~ ~ r2-r
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Accepted
Accepted With Corrections
Denied
Reviewed By:
Comments:
~
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:/~p
Date: _ 1j~3
"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."
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White . Building
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Pink . Pla"n!
BUILDING PERMIT APPLICATION DEPART~NT CHI;.CKLlST
NAME OF APPLICANT
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APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
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/1/1/1
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Accepted
~
Accepted With Corrections
Reviewed By:
Comments:
~
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Date: Jj~/o3
Denied
..
..
"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,"
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White - Building
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IDHJ..DING PERMIT APPLICATION OEPARTMENT CHECKLIST
NAME OF APPLICANT
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APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/il IC?'? f.~;:JU:,{t2 ,t:J('i,j{j~(:) l-/-r
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
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5e,ct11c,fh F,'lr
Date: /-t-03
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
..
Job Address
Heating Contractor
Name of Tester
Date
.
Percent 02
Percent GO
Percent GO,
Stack Temp
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UMG Sec. 606
Combustion air is adequately supplied per
input
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FILE No.174 05/09 '03 06:42 ID:PLYMOUTH PLUMBING
FAX: 7635331121
PAGE 10/ 13
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-=--
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I Ellu. ra, I PERMlT NO
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rf'lr:im lYre or tlrinl JJ'\c1 l11Z0;!1 \"lotl(lm-,
ADDRF.S$
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II LEGAL DESCRlPTION ,,,If,,, us,. onJv'
LOT BLOCK AlX-':TleJN
(\\llNER I "" I ..
(N.mol "'-vV\,:,,1~ ih1t'\ HVV\A..j"-)
(Addres~J I~q() ~r?J77< DC ~.."i',.f..t'
I APPLlCANT d')'
I (Namtl_.. PI 'jlA^-{"L~-t\.\Y IL..LJ\~\I)J~ (Phone) h(c,>I:>~"l~Ll~5(
I Addro,:tl 104(\'1 \^I'_'lv,r~'y;:<o. 410../ L P-,r(,[\kJ,"J,I\jL~ GSLL?J.'K
I ""lore;;,) (Ci,:;0 (Z.Jr (,.de)
I(:OI1l<<CI Personl .f; l\ ~r .~'\ V,$./)(Ji1l1IAf IL1F (l:~I('n.) (71{'~)r:.,7,,?,, U 3&:)]
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APPLICANT SlGNATUfC.2-Ij.v r \ )c/v~//l11A)J~JliA DATE C) q -(J 2.,
APPLlC'ANT PLEASE COMPLETE BELOW
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QU.Dlit)'
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(Phone)
).} 110 ..J.f4C[)
()..t{J Y (ifl ('>..,Uo. IA t<-) SSI}.3.
" ,I "
I Typ,' fir Fixtu..,
I Bath Tub ",lIh elr withOll! shclwer
Dlshw'l~h"r
I Floor Drain
Lovatory (Bathrc,<'f1\ S ",I;)
I Laundry Tray II or: c(ln1panmcnl 51111,
I Shclwer 5\211
Sinks
QuantiI)'
~
I
I
\
Tvp" of Fixtu..,
I
I
I
Rough-ins
Water J-Je"tcr
Water Sonner
Stand 1"1" Cviashlng M"chine)
Sewage Elecwr
I B"cldlow Assemblv
B~ckllow Assembly Tesl
I I.IUI '-'Ill....
I W"lcr CI",'el iTilllt1\
I O~I;~' -e' ..,n'_
FEE SCHEDULE
IncJUUn;ll, (:(ln1mcrcl;.Jl8:. Multl.lumil\ lll:u nf.ln\) ":1l~1 willi iJ. $39,jlllllij)II'l1Ulil
Hc:s,ldcntlal. Ni:v.' OW:. & "w~I.Fatnily S~4,.50
Hc:si<lC:nliiJl.~dchlil\l''l:; & Altcfolitln:; 3:3':\.50
blimUleo Cos, $ ,44'1, c:f)
8uildin~. Pt:m1il.~!
PAID WITH
BUILDING PERMIT
PLUMBING PERMIT fEE $
-
ST.:" TE SURCHARGE ~ .:,0
'<lln" ",,<1'"\'1 TOT....L l'ERMlT FElL .~) ~ ~ it ti ~j u;(0-
I ThiS Applrc~tlO" a,clIn\c> \ ""I' HUlla,"~ PeronI! Wh," Apprll"'" I~ ~AY 1 S 20:113 .~ ! Il.C~lpl ""
I H . DUlL - I B\
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~lease ~ or orint and sim at bottom.)
ADDRESS
/0/"/99 //d~...uA:.
fiL7/-??
;;:. 5,_1 PERMIT NO. -q---<t3 I
/-h/5
ZONING (officeuso)
t?;L
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
-
'OWNER/_ J
(Name) ~~$/H~4.L
(Adt4"ess) /?'lff ~~ :::'4
(phone)
~---
...;; -
APPLICANT A . /. / ~ ~ ~ L.
(Name) /'-?/hfl/Z,d' //~,...A'-~_'-- <. (Phone)............- y~-i'-~77..5.
(Address) , ~~ //~r?.A!:I ~~ ,~_ ~,.~ A SS/J-;'
(Address) (Ci (Zip Code)
(Contact Person) ~~ ~~ A""_ (phone) ~5/-/~a?-.:?7~~-
APPLICANT SIGNATURE -L ~ DATE ~!t9 03 _
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,
APPLICANT PLEASE COMPLETE BELOW
~w CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACEMAKEANDMODEL~ ~<;,~Vr.-zl/.126/J FUELJi.A.-r ;/,"i. 'I
FLUE SIZE '7-11 PI ( RETURN OPENINGS 'S INPUT hn. 000 OUTPUT <;' "\""rlQQ..
I t
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam
OGravity 0 Hot Water
~eChaniCal . 0 Radiation
ir Conditioning 0 -Special Devices
en!. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach intO
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$~'~~
$ .50
$ ~
11~~ I1h....
~G~1t
~4#"..
I
I
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
~-~ ~ ~ n \fJ It rn, ..eipt NO._
- Date . e-,.l~Y 2 1 28DJ ~I ~
24 hour notice for all inspection. (952) 447-98, , x (952) 447-4245 ~
By
Date Ree'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
; =.. ~\~ I PERMIT NO.
,. 00Id ""',.... . 03 - 001 ']
lPlease.!'(pO or orint and sim at botlDm)
ADDRESS
ZONINGloftloellR)
14/q 7
C:::;(}tJ~.I\()",' 1.lJ If c I!.~
.
LEGAL DESCRIPTION (o~ use only)
. ,
LOT I'-BLOCK:J... ADDmON ~UIV't".A-i~ /dill < 'Z-.u1l
OWNER
(Name) v./'eN"-trJIUlAJ H(1Ivl<.A.
(Address) ---1...fi.q~ 7J/.A3A QIL
~)
PID OIS- - YfD -0-1 (, -,:::>
r.tl/....aJ
(City)
(phone) ~t:;"!,t/~" ....tf'1'b
_tt/~
(Zip Code)
APPLICANT ~_
(Name) .:::..Mt.c6-
M
~-?
(Phone)
(Address)
(Address)
(Contact Person) -;E?...." ~~,(~(l:r.-'
c/I,{/J~
APPLICANT SIGNATURE .J;;;
, I
APPLICANT PLEASE COMPLETE BELOW
Size of water service ---L inches.
Location of any couplings from structure 2/J"" feet.
Type of sewer pipe. ~ ABC 0 PVC 0 Cast Iron
Estimated length of sewer line .52SIeet.
Clean out (if required) located at feet from structure.
(City) (Zip Code)
(phone) c;,/7--Z.2-I-/~Z./r;)
DATE
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(Office Use Only)
PAID WITH .
BUILDING PERMIT
This Application Becomes Your Building Permit When Approved _ J Paid
Date ' ~j ~t!1D U; U ill Ig 111 By
24 hour notice ror all Inspections (952) 44 ~952~5 W'
Receipt No.
BuDdl.. OfDdal
T
By
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS ~ fC&tAJrA./~ NlLLS- ~
NATURE OF WORK - NEW ~/tJ 1" IJIIaCTljA
USE OF BUILDING ',)U",' A. .
PERMIT NO, 03 -00 J _ Df.TE.I~SUED ~ 3
CONTRACTOR ~S PHONE.1&J.I/~NJ
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
, FOOTING
, FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER! WATER! SEPTIC
FRAMING
INSULATION
ELECTRICAL ~
PLUMBING "" ll!- ~
HEATING (If required)
FIREPLACE
GAS LINE AIR TEST
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?5-.--1'--0:2
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.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING ~1I'e-/J. 1,')./( W/L ~
ELECTRICAL CS14.....
PLUMBING fA.? I C-
HEATING
DO NOT OCCUpy
~~
~
UNTIL ABOVE HAS
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.
tAJ ~ k6
lL/lPt8]
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447~9850
DATE T1IIE
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
tl!7le~
'Y,tat~ ~I$'~ ~I,l!..
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q-e~3
lJ FOOTING
lJ FOUNDA liON
lJ FRAMING
lJ INSULATION
li'FINAL
ro SITE INSPECTION
lJ PLUMBING RI
lJ MECH RI
lJ WATER HOOKUP
9' SEWER HOOKUP
B PLUMBING ANAL
)f MECH FINAL
lJ EXlGRADlFILUNG
lJ COMPLAINT
lJ AREPLACE RI
~ FIREPLACE ANAL
lJ GASLlNE AIR TST
lJ
Ih
~WO SATISFACTORY, PROCEED
lJ C RECT ACTION AND PROCEED
CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector.
OWner/Contr.
CALL "'7-11850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
-,
QIrrfifitztfr of <IDttupanql
CITY OF PRIOR LAKE
@.rparfmrnf of ~uilMng Jlnsprdion
~ Pinal Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
i
Occupancy Type
R3
Type Construction
VN
Fire Zone
Bldg. Pennit No.
N/A
Zoning District
03-0083
R4
Use Classification
SINGLE FAMILY
Legal Description
LiS, B2, FOUNTAIN HILLS SECOND ADDITION
Site Address 14199 FOUNTAIN HILLS COURT
1895 PLAZA DR., SUITE 200, EAGAN 55122
DON RYE
City Planner
Owner of Buildin,1I
Contractor's Name & Address WENSMANN HOM~j;-
ROBERT D. HUTCHINS I!'J~
G' ( (,B(}tig Official '
Date:
Date:
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