HomeMy WebLinkAboutBuilding Permit 03-1258
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
B. Ze,OJ
(Please tvD~ or print and sign at bottom)
ADDRESS
Main File
1. While
2. Pink
3. Yellow
File
City
Applicant
I PERMIT NO. 03 -/259J I
)65"ZZ ~J11~EfL U2.5P(
tJ/211l e--
ZONING (office use)
Pt/p
LEGAL DESCRIPTION (office use only)
LOT7.?BLOCK,::( ADDITION -:r;J1IF~ ~,r 4IJrt'o//l
PID 2 s-. 4tJz-. () 94- . 0
OWNER /J ' J
(Name) Yllt..r E-- PIt) M f<;
(Address) ~/5 II!oIZ-THWf'S7-tAil..IJ..LtJ.A.u
. ,
(Phone) ~5/ - #52 - ~200
5IJlrL /i/O / .~ .1!l1v 5SIZ.L
,
BUILDER
(Name\
(Contact Name)
Sknt E:.-
eu i/-1' Z t"f5CHlb)
(Phone)
(Phone)--k/Z- ZZ;/-I./'l~
(Address)
TYPE OF WORK
p{ New Construction
DLower Level Finish
DDeck
DPorch
o Fireplace
DAddition
ORe-Roofing
DAlteration
ORe-Siding
Dutility Connection
DMisc.
PROJECT COST IV ALUE (excluding land) S
?~Of5"
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 willi 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::u.:?to~~ons DC -/37/ ;'VI ,.; 3 Yk~3
, "~:re Contractor's License No. Date r v,,"-
I Permit Valuation #'ej1 oC)a, 00 Park Support Fee # '$
\ Permit Fee $ 'CfZS. 7S SAC # $ /~7S".oo
I Plan Check Fee $ /, 00. "1'1 Water Meter ~~l"; $ ,;t::;-O,OO
I State Surcharge $ L.f~, 00 Pressure Reducer $ Lf~.oo
I Penalty $ City SAC and WAC # $ /;)00, (H I
I Plumbing Permit Fee $ IOa.dO Water Tower Fee # $ 700. DO I
\ Mechanical Permit Fee $ 100. Dr) Builder's Deposit $ 'J SOO,Oo I
I Sewer & Water Permit Fee $ .3'!;'. S-" Other $ I
I Gas Fireplace Permit Fee $ o/tJ, Of) TOTAL DUE :' tP, 8/4-. ~9 I
G:> a I c./. I )
This Application Becomes Y o~ Building Permit When Approved I Paid "'7 I ~~ce~. #~..?7
~ ~ 1~1 ~J' Date C; ..JA/ () '/
(J
Building Official , Date
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 ,.....I-'"......J Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
is''2s~ -:;~ 'J1/lltJJ .dJ a.e/~~
Planning Director I1ate - Special Cond~n~, if any
24 hour notice for all inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White - Buil~in~t
L :'6. ~~~~ - Enqlneerm.D
15inl< - Planning
Tht' Crnl.r or Ill. tab COUllln'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,- I
Pr )/1 --rc J-/'U"!V/' L '''':
l \," _" i t--/ I _ t___J'_;
('i 7 (J I ?
C. f./ ,j . C'...:)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
. ~.---
;',/ ~ c.-' -::c. -, /! j c"i ,""y ;""f,...) /"/'~ <,- )', /".,.
..,. ." V"' '._ -..'" . . . _ '- '" r
/ ,(.-.J ~ L , .I I / I" ('.1':..._ :~/; '?-" /-' / c./,,--,
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
I!I'I4f,)
Date:
'1- /J?-03
Comments: ..see Reverse Side for Additional Information!
See Attachments: 1) GradingYlan. 2) Erosion Control Measures
"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
White - Building
Canary - Engineering
,. r'11'1I( - J:iiannina:>
rht'('rnl..rnr,hrl.lk..Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
ftl IF flC!lj E::=
G, Z' (, (;J
(. ./ Ij . ,.,'-..J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/(/";22. 7/ I' II _/i.l.~ c/,;c ;7- !)/(~ '
Accepted
/
Accepted With Corrections
Denied
Comments:
&-
,
~7~
~
J
Date: 9/1 J /03
_~~_.-,,_~ A,::r-~
v
Reviewed By:
"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."
ii~1
~it.. . Buildi~
Canary . Engineering
Pink . Planning
Thf Cfnlff of thf L.kt ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHF:CKLlST
~
NAME OF APPLICANT
APPLICATION RECEIVED
PUt .TE HoM 65
g. z"B. 03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/&522- I/Nf3EJC c;u::sT DIG.
Accepted
~
Accepted With Corrections
Denied
,.
Reviewed By:
~
~
'?~ . Date: 9//1/03
ad ~~.
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."
Oct 03 03 11:00a
METRO GENERAL SERVICES
763-428-2S68
p.2
J=-- /~,'"" ,I
-~~<ll
Ikc PAID WITH
UlLDING PERMIT
16200 Eagle Creek Av. 8.E., Prior Lake, Minnesota 55372/ Ph. (~5'2) 447-4230 / FAX ('r!i'2) 447-4245
An Equal Opportunity Employer
1.
2.
3.
4.
~, 5.
6.
'--
GRI!EM. filE
YEllOW . "PPLlCA.'"
GOLD - efT"
FH.
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
'15).- 1ft( 7-l/~ 1/-5'
S,w. No.
3 - ( ;).5 g
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT:'y,.,~O ~E.I.JE:R.tV.. ~""J!JCPHONi~-4';~lf-;;.q-.3t?
ADDRESS: s~' 0 tAfWl AVE. AJIf:DATE:
'-/-" Li~ '5T.mlcH"..t.)-mtJ.~!:3"'''
SIGNATURE: '"" I("~ BLDG. PERMI'!' #
SITE ADDRESS: /b5~,('"';z..,d-~ PIO#
FILL IN 1:HE BLANKS
Estimated length of water service ~"
feet.
Size of water service /"
inch (es) .
Location of any couplings from structure (J
Type of sewer pipe. ABS PVC~ cast Iron
Estimated length of sewer line~ feet.
feet.
Clean out
structure.
(if
required), located at
NjA
feet
from
-------------------------------------------------------------------
-------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
============r=================='===================================
puJted {.J,t'4
FEES: f] /e,:! PnlH 11- Sewer and water line connection permit.
~ Surcharqe
No r ee TOTAL
-"--'
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
Sewer and water permits issued for new canst lI~i,liD1,c' , be
recorded on the building permit card at the ~ ~f;~ @~~u~~~
to insure that no duplicate sewer and w I, ,rO-p-erInlt's <'-Ir~
issued. uiJ nO 8 2003 i
DATE PAID AMOUNT PAl
*
RECEIPT #
REC'D BY
OCT-17-2003 ,~:01
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APPLICANT PLEASE COMPLEn: EEL!)"'"
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PLtJ1.CBCNG PERMIT FEE
ST r\ 1'E SURCH..I..RCiE
TOTAL. PER."rrr fiE
.50
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{()tr.c~ C;,.c O,,'~)
"ri1is App/iocon S<'C!ome~ YOtlr BuiIdira:: Pennie Wben Approved
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12-31-03; 1 :13PM;
;952 894 0925
# 1/ 4
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
I, Pink
2. (ir~a1
J, Y~llo"
~:~ I PERMIT NO. r/ _ rv..-Y
ApphQllt ~-;; {O'o Lf
(Please.!V.Ee or Print and sign at bottom)
ADDRESS
Iv 5:2 ~ '1:rv1 ~
eve') .\-
~('.
ZONING (office Ust)
'"
!~
~!,'
::
,
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
~ \A., \ -\z ~1'\ll '\
'i IS NW h.w,,\
~w\( \~D
(phone) 0'51-L/52- 57CO
ylYJ t1t2u1, If'lrl ru '55 I ? I
J
(Address)
APPLICANT
(Name)
P.umsville Heatina & AlC, LLC
12481 Rhode Island Ave. Sa,
l'l"VAgA, MN tl537B-11??
(Address) (City) (Zip Code)
(Contact Person) ,\ '^-^-'\. 'L (Phone) 9 5;.4 - 'b CJ L/ - 0 DO S
APPLICANT SIGNATURE A\~ \.J.. .':A~l.J,t.:lY"'l DATE I~ \:5 l \ \:'l 3
~ APPLlCAN:: PLEASE COMPLETE BELOW
\:E9l%W CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL LM!/loX Gs I ('() P - ;fL./ () - O'lO FUEL rJoJ: qa:::,
FLUE SIZE RE1URN OPENINGS => INPUT '/ (), 00 D OUTPUT ()!4..!:/O 0
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Ai, Plants 0 Sleam
OGravity v'lJ-<'Y 0 Hot Waler
o Mechanical ~iV\, vv (' ,0 Radiation
~ir Conditioning 0 II.. C. c.. 0 ;)... , J 0 Special Devices
OVen!. System I" l 0 Oth<:, Devices
(Phone)
(Address)
PLEASE NOTE:
Air Conditioner Unils
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Commercial & Multi-Family I % of job cost Residential, Gas Fireplace
$39.50 minimum
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alterations
Residential, Heating Only (New Construction) $64.50 Residential. AC Only
Estimated Cost $ .y, OTi71. cJD Building Permit #
$39,50
$39.50
$39.50
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
x
~, PAID WITH
.50 ~~ \ WLDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved I Paid
Dale I Date JAN 0 r: 2003 By
Building Official tI
24 hour notice ror all inspections (952) 447-9850, rax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
Receipt No,
(ttr
V
;i
,~~
:,:i
PRIOR LAKE
INSPECTION RECORD
.
SITE ADDRESS ----&Sl.z, TiM8~ D~/'"
NATURE OF WORK 1J6~ aNST"..,c.r-I~
USE OF BUILDING .s ~ ....
PERMIT NO. o.:s -/2.-::>8 DATE ISSUED ~
CONTRACTOR I'll" r~lIIfo PH~E..JrI" -&&1 -mS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF Main File
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING IJIP IO-lr-C/3
I FOUNDATION (Prior to Backfill) I;/~ / ,I/1/V'/ I IO~v;r 11-'5'li:l
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~-
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
is- t~ <03
t-q-f'lf /
;2-~-CJLI
,
I/VV"/~
V'W'
{- /'3- Ol-(V ,1_ .J'clof.j
}.... - c..(-(Jvj
GRADING (Prior to Sodding)
BUILDING 'It'vtf uvlH ( q 1-Oc(
ELECTRICAL \
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
A/ t? ~. u.. d~
/#VA 9/;Y/;/
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J.-I7"'01.f
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, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
QIrrtifirafr of @rrupanry
CITY OF PRIOR LAKE
~tpZtrfmtnf lIf 1iuilMng JInsptdilIn
/~Final Permitted 0 Conditional C,Q. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time a/issuance this structure was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use. For the following:
Occupancy Type _
R3
Type Construction
VN
Fire Zone
Bldg, Pe,mit No, [).3 . /2.58
N /,~ Zoning District pun
,.
"
Use Classification
SINGLE FA.'l1LY
Legal Description
L28, B3, TIMBER CREST
Owner of Building
Contractor's Name & Address _ PUL TE Ha~ES, ~H 5
ROBERT D. HUTCHIN5~2':C;1
Date y/~/~7mCial
I'
Site Address
16522 7IMBER CREST DRIVE SE
NORTHWEST PKWY., SU1TE 140, EAGAN
DON RYE
55121
City Planner
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/ (.!;J-L
.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
(jj)v t'fA.tc'\v<..
DATE nME
SCHEDULED
5 -'2;-()<./
t7!"",hf-(.~s1
CONTR.
PERMIT NO.
'3 -I J..s.-&'
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
Ilf PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~&;t?c;
o WORK SATISFACTORY, PROCEED
, CORRECT ACTION AND PROCEED
o CORRECT ~o;r' ;,A~R REINSPECTION BEFORE COVERING
Inspector: r 1/ P <)wner/Contr:
, I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH.l SAFETY!
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T,/tJwCnsr D/"o
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63-1).(--1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1(, S 2l...
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
COMMENTS:
R1/-tP (
~
DATE TIME
~LLING
'0 C01liit1JNT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
A.. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor~ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,rNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
BVRNSVILLE
Heating & Air Conditioning, L.L.c.
12481Jlhode Island A~'e S, Savage, MN 55378.952-894-0005
Orstat Test Report for Jobl Ma \
I , ,~g -T". (\ I
Address~ I, mi'" [ ,~rr-", t
Occupant
Dale of Ins13l1
Type of HT. F/A ./' HW Space HT
Other
City..:p, '
L~'; "i\' , f
-
(\
UnitHT
Make
Model
Serial
Input
J",,- i) f)/)r,V
C-.r5' I fY/ p."" I ~;.: - ('':i{) -' (
6''10#1+/41')'-.,_:-
tol" cx::o
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Pilot Type HOT SURFACE IGNITOR
--2 r
Pressure .,;, , ,.:;>
Input CFH I_I ...
S1ackTemp , D5""
Date Teste(! ---' '1~4 , '
Company BURNSVILLE HEATING' & AIR CONDITIONING
Technician ~:'f:ay'
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~~oI TIME
/{;-5:Z.2 r~6erCes/ Jd.-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONlR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,...Ir1'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
c5'J3 - /.2fr
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
(/.-,/
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~
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/-:;;/e
-------
A WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~;,;~OR REINSPECTION BEFORE COVERING
Inspector: /~______ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,'NSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .l SAFETY!
ADDRESS
/ G~)2-
DATE TIME
SCttEDULED ~- :StOC/
1"1 fA1 bt.-C~r
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3 - /L~Y
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)if" FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FIINAL
'r
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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