HomeMy WebLinkAboutBuilding Permit 00-0860
5~~
DATE RECEIVED
7- '(;.00
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00 .Q €>G?O
O!~ECTIONS
SrACES NUMBERED 1 THRU 17 MUST BE FillED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
12~~~~E/SS ] /.' ,,-'"
/,..,,..,.., /5l'doI'S;/" A."v'
3. LEGAL DESCRIPTION
LOT J I BLOCK
ADDITlON G'/,-, /i/ AUi 7 t r
>
14. OWNER (Name)
Is, ARCHITECT (Name)
6. BUILDER (Name)
0J(NJI'llIf.N/V
I-J 6m f'..f
7. TYPE OF WORK Fireplace 0
New ConstructionQ--- Alterations LI
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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~that all co truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building,iricial can revoke this it for ju use. Furthermore, I hereby agree that the city official or a designee milt enter upon the property to perform needed inspections.
X /J ~ /7"50 ~-.:u-CrIJ
- / /7c.slQnature UcenseNo. c;p-..ry Date
100 .00 ~ Mete'Hom................................... $
I bO. ()(") Wale' Mete' ................................. $----1 A.5"'-l'X:L.
Sewer & Water Connection Fee ........... $ '1'2~ .rr-.r)
Sewer & WaterPennit ...................... $ ?'. 1"'""0 W t T F $ 1"7 00 ~
tf, .0-' 6'U" aer owe, ee ........................... "/ .'"(../
Gas Fireplace Pennit ..t;.. .. .............:t 0.00 fI?I Water Tap ................................... C(:: _ .
This II II m OU'BUild;ngpemllt,henrf~roved. V\' Builders Deposit ............................ $jj '?~
By Date _ - .!j- 20c:ln Othe, ......................................... $
"'. : ';~:~.;;:,~ ~~::': 40
Th~iS' to certify th. at the request in the above application and accomP.anYing documents is in acc.ordance with the City Zoning O.rdinance. and may proceed as requested. ThiS.document when
sig ._ ""'-' ..----QitviAnnerconst~utes a temporary Certificate of Zonil)9 compliance.Jltd allows c~n to commenCEf Beforepc~~ ~e of ~~ m~s~be issued.
TI-'. ",.- -- --. 4.I'LQ-/~ ~_ ~ (" ~..h,__ " C~ ~
City Planner Date Spec~1 Conditions if any
(("
SETBACKS: Requir'd
Actual
F='
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
SF~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .................. ..................... $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ..................... $
,. DATE 7
~-..2()".J
BUilDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
,.ezSD
12. NO. OF STORIES
/
Jl"c/
PID,;2.F-3" 7- 011- 0
13. TYPE OF CONSTRUCTION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Address)
/tJr5 l'iA2~ I:>r
r~'ttfN, hl/V
~Ptic LJ - Deck CI
Addition 0 Finish Attic 0
(Tel. No.1
t.5l-rfJ~ -'7'Yv"
OCCUPANTS
15. NUMBER OF OCCUPANTS OR SEATS
SEATS
Re-roofing Cl Porch CI
Re-siding 0 Finish Basement Cl
16. PROJECT COSTNAlUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
SOIL TESTS
o
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION "'s:.""'" .(!l('\
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS C"'I
SURVEY 0
SETS
COPIES
PLOT PLAN
o
S U
City:
Amount Brought Forward .................. $
Park Support Fee """"""""""....... $ ~~.&">
SAC ......................................... $-41 /':)('J .00
Collective Street Fee ....................... $
Sewer Tap ................................... $
gr' $
Pressure Reducer .14..................... $
a5'C..C9D
"""SIn. t{O
-
Cf 7 c..-O
,
l./5: o::L-
24 hour notice for all inspections (952) 447-9850
~~
06'0~
Thf ernl.. of Ih" L.a" Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
W6/VSI1ANN
q- PJ.no
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
15::;5/ Beoot::-SID5 LN.
Accepted
Accepted With Corrections X
Denied ~i If) J
ReviewedB\' '.-/LI~
~t I
Date: 9 ~I ~~'Coocs
Comments:
Waoo (2J~ tk-kt-
"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,"
~~~
00 'Og(po
The (~nler of Ih. L.ke Country
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
'\ ~- - ..,..-. -
'I, /_ /\ - /I /1~_1 j\ f\
_ i ~-, --",- i I /. \, { ',-,
//-;'.(.. /' ()
.... ./'--,' (
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ~:,'=::; /
~ ('. I
i. I~ (.,...1-.
..: / F-
~/
,
L /,'
_ I V .
Accepted
Accepted With Corrections
~
Denied ~
RevieWedBY:~~ ~
Comments:
~~ ?6i~~~r) ~~ ~~
~ ~_ c-, U.,IJ. ~ ~~J p~
~ (' ~f LI~ ,3d)J.):dA1k9vl ill
- I
^
{Jr~'>EP~ ~u~)/e___S\?J&> f'l)l~ ~ .
~~Jwr~ ~ ~~~~.
Date:
q /?-.9/.:5C:>
"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."
~
00 .D~00
Thf ("fnlrr or lhf t.k! Count,.,
While - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
iJJ ENS fI1jlAlIV
rJ.8.o(J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/S;S5/ Elf OtJf:5 IDE L tv.
Accepted /
Accepted With Corrections
Denied
Reviewed By: Gra.4 (1rlSo/1
Comments: ~PIar.!1. sdltl!f'e tHdlll!c! ;'/:I
/J/'tllecJ- ONto ill,llan/
f
#.ii.t1.ki? sl&1l/e PCMte.J1.PVJ/y..s-5CJ. e~ /7t'~
/1/ tii't'l'f liI~r h /hI' ~tflitrl1 tuf,h- ('Ldk 5~/J?).
LI7& I.J MfJ L~ dj"f' a I ~/Z/u.l 1:"/,o{/t1h~.:5
lAd,., IH .;lilli/I! 1M !he Or~~ift) f}k/f.
. v../I
5t".p JI'I avtrse. <;iflP ~,- /ldddiollaf irr~M(LfiOtt.
Date:
'/;;;,{;;
0/''' .
Or i//Jj IS
.1&
5f'f alhdrtt1M: / hi/{// C/7JAJ;S'/Jet,j/n1 :Z;;;;Jmdh'H1 0/ ~ #~
LEr/Jt;",(m ckird/ ~(Hf/rf'5 Ljl j;t1>ltff-f ,4~/ /~ _
"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,"
SEP.14.2000 8:32AM
GENZ RYAN 6513226147
NO. 863
P.5/5
.-
2.
3.
-, 4.
5.
6.
_'ru!
..................,...
...... . CI1"
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO. 0- Off00
Sewer and Water
contractors must
be reqistered
with the City.
APPLICANT;.f'--JI'"\~r;tJ' ,.., PluWlb,~ U."""""'lr~ PHONE:jQ!:lI-42.~-II~
ADDRESS: rt41lJE. ~~_~':-..a.r '!>._~_DATE:
SIGNATURE: Lt.. ' ~ BLDG. PERMIT # -
SITE ADD"""'. , """"" 1-<0 PID' f^ 'l- ')(-2-1- 0 fl:: 0
FILL IN THE BLANKS
40'
1.
Estimated length
feet.
of water service
,.
I
Size of water service
inchCes).
Location of any couplings from s~ructure
Type of sewer pipe. ABS PVC X Cast Iron
Estimated length of sewer line~' feet.
Clean out (if required), located at feet from
structure.
feet.
_-===-::; _ _._____=====-=;1;1___...._.. ,_._
--
This application beComes your permit when approved.
BY
D~TE:
I
=~=:======;;;;;;;;~-;;;;::::;::::::-=;;:=--~-====:========~-,-,-,,-_~__,_=_,-,__.,_..____~i:lIIIi:l3I:------_____
FEES:
$
$
S
Sewer and water line connection permit.
Surcharge
TOTAL
35.00
.50
35.50
* Fee for either sewer or water individuallY is $20.00 plus
$ .50 surcharge. --
* Sewer and water permits issued for new construction must be
rec~rded on t~e building' permit card at the timp of issuance
~o lnsure that no. duplicate sewer and water p4IM~ITWre
lssued. M.DING PERMIT
~--
DATE PAID
RECEIPT jf
AMOUNT PAID
REe'D BY ~ (/Z /!./I~
; .
1/
, 4629 Dakota 51. 5..E.. Pmor Lake, MInnesota 55372' I Ph. (612) 4474230 I Fill< (612) 4474245
AN ~~L. ..............1'\1 WNITY EMPt.OV'ER
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Plk
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1_.
J.V....aw
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No. () -xL'::, 0
Prior Lake, MN 55372
HEATING APPLICATION I PERMIT::3 (/1- 0 If -0
1'//"3 "5--- r ".' '-()
11- ;;>-00 PID''''-' . . . 'oj-
.L._
N
-
IYPE OF STRUCTURE
..
'"
'"
(L
Single Family
Commercl8l
Two-FIlI111y
Induslrllll
Mulll.FeniIy
. Oth.r
Public
Dat.
SfteAddlass /5'"5S"1 ,/j},-~"'AI'
Lot lL BIodt I Ad~ion (n! y~,'aa-fe'r ~ ,CL
tJJ4tSJA6A. d....
Fee S<:haclule
::E
<(
'"'
o
Tndustrial, eom"",rcial & M~.FlIIl1Ily
Aesi<lenlia~ Healing & AC
Resid.nli.l. Healing Only
Residenllal, Gas Fireplace
Residential, Additions & Aller.lioo.
Residential, AC Only
1 % 01 job cost ($39,50 minlnunj
$99.50
$64.50
S39.50
S39.50
S39.50
Own.... Nam.
o
o
Address
HeallnqContractor ALLIED FIRESIDE dba FIRESIDE CORNU,
>
o
z
ROSEVILLE. MN 55113
Address 2700 N. FAlRVIEW.
Telephon" 651- 633-2 561
FIREPLACE 11_ .
IlUInMI!r M.ke & Model ~ tJ fPeo
Mod.I Slz. .Q. 1SlJ1>l.
RememD"" 10 add Ihe Slale SurcIlBlge on the bottom 0/ IhIs appIcelion.
TYPE OF SYSTEM
Warm Ail Plants
Gravity
Mech8l1ical
Air Conditklninq
Venl. Systom ,
HEATING OR POWER PLANT
Stoem
Hot Waler
Radiation
Spocial Device.
The price 01 yPUr heating permillnclvdes one rough.1n and ona Anal nspecllon.
IIddiUonallnspeclions win be biled al S35.DO each.
Hous. Healing Tes' Record mus1be stJbmiUed wilh IlIiIllilIlIItIlDll ammm: before buld.
ing certllcale 01 occupancy will be Issued.
I:lf& CALCULATIONS REQUIRED wiIh number of supply end return openings IBIed pt
room with CFM'. per opening. New liruclUre. or eddltiono ..nd Iloor plen with ouppIy
and ",lum 10000U,,"s shown. HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE, IUDO EAGLE
CREEK AVE. 5.E. PRIOR LAKE, MN 55312.
CRy HolI busIn.... houn; are eLm. -4:30 p.m.
...
ClD
ClD
ClD
'"'
'"'
<0
Conn. Load
Fuel-G-.J
Fluo SI10
"'
<0
SuwlY Openings
R.Mn Openings
Output .;l~ a::o
Input
Edr.
,
ALL WORK MUST BE INSPECTED IROUGH-IN AND FINAL) - CALL CITY HALL
441-4230
Other DevlcOJ
elm.
0:
W
Z
0:
o
U
w
o
H
CJl
W
0:
H
LL
TYPE OF WORK
~
N.... Conslrudion
Replacemenl
Menoon"
Est Comp. Dal. _ //-/1'
Rep.;r
IloorP
Building ?errn~ It
Est. Cosl S
HEATING PERMIT FEE $
STATE SURCHARGE S
TOTAL PERMIT FEES $
PAID WITH
BUILDING PERMIT
..
'"'
C!J
...
C
..
CJl
I'\pt.I'lllLiill~. . SignalurB
. 1;rL--
Building Ofl!1"fs S9'1elure
.50
Rocolptlt
If)
..-<
"
IS)
..-<
CITY OF PRIOR LAKE. .
18200 Eagle C1HkAv. 5.E. PermR No. [) -% 6
P,lor Lake, MN 55372
. _ HEAnNG APPLICATION 1 PERMIT
CL Dele ---\.0 \ ,q I 00 PID /I';> S- (2;67- () / (--0
~ SKeAddran I 65€:a \ "Bv-oolf.~1 ~ L~
ci LoI (/ Block (AcIdlllon CO/ L/lv lA./t:J-l-e-r ~ I'd.
z -
Ownef.Nama u.)~""'n. uf", I:Wm~!;
Address I~"\o "P\o..~ 1'),- ~ 2..bo eA~
Haatlng Contraclol"" ~2- fL~
Addl.... ~'I.J.'" \J,~ ,c..c. fDbuL~ TL~ ~ouY)r
Telephone" ~\ - l.\. 2...'& - II '-' ~
TYPE OF SYSTEM
Wlllm AIr Plants.Jl
GravIty
Machanlcal
Air Condllonlng .'11. 2.,1/'1. .,.o~
~TVanl. Syllem
HEAnNQ Oft POWER PLANT
SI.am
HoI Walll
Radlallen
Spacial Oevlcee .
Furnace Make & Modal ~t'\~ 'A
ModalSlle c;"L.~ Q2..h.-.,~
. -
Cenn. Load
l'- .\
~Fl/Ill~"f" 6n.....lueSlze 4
N
liJ Supply Openllllll , \
..-<
1'3 Reluro Oplllllnga 4
z
~ Inpul J~ m1D oUIPUtlc4 n()
~Edr.
w
'"Clm.
OIhel Devas
E
CL
01i AlIersllona
TYPE OF WORK
x
Raplacemenl Now Construc:llon
(T1
Rspalr Ell. Comp. Dale
~ Est Coal $ Building Perml /I
CSl
~ HEATING PERMIT FEE $
..-< ,
,..: STATE SURCHARGE $ .50
u .
o
TOTAL PERMITFEES , Racelpl /I .
PAID WITH
BUILDING PERMIT
TYPE OF STRUCTU~
I. Pi.
2. Ore
1. Vdl.
file
a.,
c..no._
Single Family
Commercial
\(
lWo-Famlly
Induslrlel
Mulli-Famlly
Public Olh.r
,
Fee Schedule
Indusltlal, Commercial & Mulll-Famly
R6lIIdenlial, Haallng & AC
R6lIIdenUaI, Healing Only.
R6lIIdenUaI, Gu Areplece
Residenllal, Adrtlllona & Allerallons
R6lIIdenllal, AC Only
1% 01 lob cool ($39.60 minImum)
$99.50
$64.50
$39.50
$39.5Q
$39.50 OCT ~ \:l 2000
Remember 10 add Il1e Slale Surcharge on Ille bollom 01 Ihls eppUC8Ikln.
The.pllce 01 ~ur healing pelmlllocludes one rough.1n and IlnelinaJ Inspecllon.
Addlllonallnspecllons will be billed al $36.00 saell.
House Healing T.sI Record musl be submlUed wilh I1YII!Iing IIMIIl1II111D11at before build-
Ing <:elllficale 01 occupancv will be Issued
tJm CAI.CULATIONS REQUIRED wllll number of supply and relll1n openings lisled per
room wllll CFM's pe. openlng. New slruelures or addItions send lIoor plan wllh supply
and relurn locallone shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, t6200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall buslnes. hours are D a.m. - 4:30 p.rn.
ALL WORK MUST DE INSPECTED (ROUGH.IN AND FINAl)- CALL CITY HALL
447-4230
I hereby apply ler a mechanical systems parmI! end I acknowledge Inallha
Inlolmallon above Is complele and aecurala; Ihallne work will be In conlormance
wllh Ihe ordinances end codas 01 Ille city Bnd wllh Ille alale bullding/machenlcal
codes; Ihellh.. 10'''' does not baeome a permll unlll signed by Ille BUILDING
OFFICIAL; Ihatlhe work will be In accordenOB wllh the approved plan In Ihe
caee 01 all wOlk whlell requl1ee review and approval 01 plans.
~
ignelure
-.10\ l~J~
/1;?/;3Ll/aT )
/ /'Dale
-
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
ISSS-I
SCHEDULED ~ s-..{J"0
<6 te..6D /C.-~ / Db
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() - Xfon
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o JEWERHOOKUP AO
p"PLUMBING FINAl{!Y
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~,.._"_ ,_ ,$ TST
~...-,. ~.-,
D_''l..:-........~... .
COMMENTS: \
Vl/1 1")1'1. 0 V\/\JO;teA-
(j~
rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO , CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREME+ ARE FOR YOUR PERSONAL HEALTH & SAFETY/
IN$NOTJ
ADDRESS
15GSl
I. D~T7
SCHEDULED I f-M4!2- [
b<CX> ks+Ov\~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
/;30
OWNER
CONTR.
PHONE NO.
PERMIT NO.
M-P-.faO
o FOOTING
o FOUNDATION
o FRAMING
o INSULA~N
~ FINAL
o SITE IN ECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP /i;\
PPLUMBING F~L\lV
J;r" MECH FINAL~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~v&JJr.u) OK ./
I ttUt:\lk~ \ o~,....
<"& ~~lo' . .
lr;./?')tl~lAfj .It- +f'ees. ref'- df'..ueLffM.~A +-
4-eAMf C.o,
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ,V()M.(,J Owner/Contr:
CALL 447-9850 FOR ,LE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/O-2l-d
4"
ADDRESS 1555/- fS-~O Br{J<J(SI'cILLn
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
. 0 ~ITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
/)1/ r?K
WIA(A1&tn1'1
I?I'> ~ >< f/.)
X.EXJ~'ILLlNG
o COMPlAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
SJ-T
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~b;'; ",fi.~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
/NSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I~
TIME
ADDRESS
15551 BROOKSIDE LANE
- PERMIT #00-860
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
D..ANSULA TION
"ti FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
:J:"~W'_ +ew. r C.O.
CIL?&p ..In-!1"~
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W':fK. CALL FOR REINSPECT ION BEFORE COVERING
Inspector: $~~ Owner/Contr:
CALL 447-9850 F&R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
I"'SNOTl
OCT. 19.2000 3:02PM
GENZ RYAN 6513226147
NO.415
P.4/15
T'Iw C'lMrr '" Ik LaR CM"."
I. .... Rio
2. CioN Cloy
1. Yellow "PloD,,",
# _ ()-SW
Aplllieant: t:..-A2.. fl.....J.a " F'hane:~ - U~ - II ~ lJ
Address: ILl"'\U.~ 5c::ftz::"'" ...."t"'" ""'4.-~ (l~'T" I;.'i"~
Signature: ~b ;: e:.L~ . .,J
,.,.0"'"1>''''' '" ~ II ''''' ( ."' (e':.tJUiLrW j ,
Site Address: Il::~. c:..~ ~ _ ~.,....~..,."... _
Building PermiU PIC it;;1.0 ;?:lA-OII-D
NOTE: This permit WJ11 not be precessed without complete information.
FIXTURE UNITS
CITY OF PRIOR LAKE
PLUMBING PERMIT
QUilntity Type of Fixture Quantity Type of Fixture
~ \ Bath Tub with or without shower .3 Rough-ins
\ Dis hwasher I WBter Heater
, Floor Drain e.lt Water SOllner
2- Lavatory (bathroom sink) I Stand Pipe (washing machine)
1 Laundry Tray (1 or 2. compartment sink) Sewage ejector
1 Shower Slall Backflaw Assembly (R Pl. Double Check, PVB)
, Sinks Baekflow ASsembly Test
ear Sink Lawn Sprinkler
2- Water Closet (toilet) Other
FEE SCHEDULE
Industrial, Commerdal & Mul\i.Family
(1% of job cost, $39.50 minimum)
Residential. New One & Two Family
Residential, Additions & Alterations
State SurCharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAL $
r PAID WitH
~ILDING PERMIT
This pormi' is gr>nlOtl upon <he o~p""" candidan <hat ..id
contractor, sboll comply in sll rospo<:t3 with tho ordinances
or tho Stllre Plumbing Code :IIld <he "'J'~lJ'.rns~'fYl
ClffPTNO. /0/.90 a~
fi - '-/' ., A ITEST
Call for al1Upections 24 hours in adv~nce.
OCT J !:J 2000
16200 Eagle Creek Av. S.E., Prior Lakc, Minnesota 553721 Ph, (612) 4474230 1 FA..."'( (612) 44742~5
~. An EqUlll Opportunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ SSSI ~l'a'tksiJ-E:. ~r') ,
NATURE OF WORK ~)
USE OF BUILDING S t-A
PERMIT NO. (JO .0)(&0 DATE ISSUED 7 -I'-/-&x::>o
CONTRACTOR \,A/QWh"'O\{\,^ ~..... ~61- YO~ -'If/oo
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
'fj.ifECTOR DATE
I FOOTING -Vdot:- g..\J l~f I /~/~
, FOUNDATION (Prior to Backfillr~ I ~. 10/'1//JIJ I ffr.y, IO/r,!tro
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH -}t!.$
SEWER I WATER I SEPTIC ..f1r I) '7-2?
FRAMING t...L IOZ) 14100. f '1;-\~ <2)4) c90
INSULATION (wQOP 1~fdlf)tJ 1Z, \\ru,^,,\ j'''1./IOIJO
I="'EC'TRIOAL LO>J~ {~JJ 'rall~tb ." f ___ J \ I
PLUMBING I bl--\ 1111''2,1 ClO
HEATING (if required) .1 ~~ I) I
FIREPLACE I --!<\lo-w/ J ;;2/4 eo I
GAS LINE: AIR TEST I \"b~0 \ !) IN,) t7D
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I~ I I
FINALS
I 1J~
~~{l.WI
l
I -g ~Ia'"
I~\.
OCCUpy UNTIL ABOVE\. HAS
NOTICE
GRADING (Prior to SOddin.l.p~ )
BUILDING '1~~tDI::: 'S1I!EJ1f)
ELECTRICAL
PLUMBING
HEATING
DO NOT
I .
-t$,'
I
.r )"~]DI
,( I tm!J ()1
BEEN 'SIGNED
\
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, !,ard shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850