HomeMy WebLinkAboutBuilding Permit 04-0398
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
If -d "3 '[jLj
See Main File~~i~:' ~:;y
3. Yellow Applicant
I PERMIT NO. Of. 03 '1~ I
q'lease type or print and. sign at bottom)
ADDRESS .
~9Z3
~ uLPF JI,€-/lh75
.-.-
/ /141 '-
ZONING (office u,,)
PL.&D
LEGAL DESCRIPTION (office use only)
LOT/f BLOCK..3 ADDITION hmBM ~ &f2..I<.. ~lhrlOY\.
PID ,J6~ t/OJ,' ()~5-0
OWNER
(Name)
fJULTlZ- )/{)mD
8-5" ~/2:rWCST f/tll.KUA4'f
(Phone)
ts/-~z--.sZ-oO
(Address)
< ~VIT'L I i/o,
1)J-6M1 .
J11n.
S-<S J l..J
BUILDER
(Name)
(Contact Name)
f> 1/1../ L
I!u~ . 'i? I.A5'# J<b
(Phone)
(Phone) t,Jz.-zz./-~9YO
(Address)
TYPE OF WORK
~ Construction
DDeck
DPorch
ORe-Roofing
ORe-Siding
DUtility Connection
DLower Level Finish
o Fireplace
DAddition
DAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
9~t'm
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
;ter~.ponth~;t;r2:ee~~ >8&-/37/ f/z.~t/
..".. Signature Contractor's License No. '/ ~te /
Permit Valuation Cleo, 060. I Park Support Fee # $ -
Permit Fee $ In:1-.1, stb SAC -# 1350. ~o ""("~ J
I Plan Check Fee $ hh1. qx Water Meter ~1'" $ 2.$"0, do
' ,
I State Surcharge $ ~R, 0 Pressure Reducer $ ~S;.OO
I Penalty $ I City SAC and WAC # $ /;)..00.00
I Plumbing Permit Fee $ tOO. 00 I Water Tower Fee # $ fJtJO..O()
I Mechanical Permit Fee $ /(b,QO I I Builder's Deposit $ .-
I Sewer & Water Permit Fee $ SS: 5"0 I I Other $
I Gas Fireplace Permit Fee $ Lf'o,oOI I TOTAL DUE $..5.5 (.,3 . BB
This Application Becomes Your Building Permit When Approved I Paid r.rr.,] -I r I ReceiptAo. 4'r".fd 'J
.~ ~ s,4;1,y Date ~_ 7,0 q-- Bv /L-
0
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
~~::h~: plann'7;;;:......,,-O cero;;t; :7ance and allow, SeeCMa]~" ofOcrup,"~ mu",be
Planning Director Date Special Conditions, if any
24 hour notice for ull inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~
5.{
See Main File
White - Building
Canary - Engineering
<'" "mK - ",annm~
-
rh~ ("I'nl.., of Ihl' (.."1' ('ounlr,'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPUCANT j
APPUCATION RECEIVED
,; ,
!c. / ( I / 'j. .-
L/- c;(:;) -c,::.!
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ./'
1.11). 3 / _ (/~/t:)/ / I (-<.?M/{
I
,
Accepted
./'
Accepted With Corrections
Denied
Reviewed By:
~
.
~
Date: S ~.~ '-/
...
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."
~~
Soo Main File
r-While - Bui~
canary . t:.ngmeering
Pink - Planning
rhe('I'rIl.., of Ih..I.Mh Counl~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
Q~.~
L/- 83--cxj
Accepted
Accepted With Corrections
Denied
'"'
~~
Date: ~~y
Reviewed By:
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."
G~~
See Main File
White - Building
( CHgRrY - t:n~meerma-:>
Pink - Planning
Thr ("..nlrr of Ihflak.. ("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\' ;J .m.!
'.,' I ;' (;J
i, I >1,,/.-'<:./ .r
L/ .'.'--1 xl
.-- ,':,r oJ-(
l_/ ..... ~~
I
'JI<I,"," ',j...,....
r -.. L_,. f;'."'''':''''-''''-''
The Building, Engineering, and Planning Departments have reviewed the building permit
application for con~t~u~tion.activity f'~pi~Jh is pr;os~~ ,!~ '1. -1./\)-/' j,?
LI Gj,.' ,3 , /'~' J:.- /')' /./ '--<:J b. ,.,. /',. . .'-'"1...
j ,...c<...A..//>
- / \ .~
Accepted
x
,
Accepted With Corrections
Denied
Reviewed By:
Comments:
1m/3
SC( !fl':IIA F','(e
Date:
6- '1-0'/
"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."
7-04;12:03PM; ;952 894
HEATING/AIR CONDITIONIN<J/J<l1lliJ:'LACE J:'EKlVllT
0925
# 12/ 17
I. Pink
2. Green
3. Yellow
~:~ .1 PERMITN~ ^mA
Appheull -11II' ...,.... ! ""
ZONING (alii.. =) r
i
,J
~,
(Please!V.Ee or orint and sil1l'\ lilt bottom'
ADDRESS . - -
4G1:;.3 ~\\ la:'
\-\~ \(~
.LOT
BLOCK
ADDITION
PID
[f
H
I
LEGAL DESCRIPTION (nffice use only)
,
~=R~~-Ok~-~rn-r' S--.---
Address) :x... \S hQi-\-Y\ \l 'C:9;\ '\>n. CLi., YO. LI_
b
(Phone) \,oS \ - <-IS? - S 200
8<:. 1\ 1() . r CdX:('dl .g:.121
~"i
(City)
(Zip Code)
!."}
"'1
I
I
:~;1
~
I\.PPUCANT
(Name)
(phone)
QC:;ri -/I;"Cf(j-CYX')S;
- .. ,<> ",...
BurnSVllle neculll~ ~ ,,, ~-. Co::;';"
12481 Rhode Island Ave. So.
savage, MN ~~ilJlw.i1-22
Contact Person) . (phone)
I.PPLICANT SIGNATURE .(~~(LI'Jo..L:J-. DATE
Address)
7-j-OL/
APPLICANT PLEASE COMPLETE BELOW
lSZ!NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
URNACEMAKEANDMODEL [0/1110V" (J=:;il21,o- :Jf..(t"'rOl[, FUEL m..;/-~
WE SIZE RETIJRN OPENINGS c=:, INPUT '-Ie;; ('()1 OUTPUT !i1rJ/XJ
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants 0 Steam .
OGravity 0 Hot WBter
~Mcchanical 0 RadiBtinn
. Air Conditioning 0 Speeial Devices
Vent. System 0 Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
:REPLACE MAKE AND MODEL
<lustrial, Commereial &. Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
,
Residential, Additions & Alterations
ResidCl1tial, AC Only
$39.50
$39.50
$39.50
11
~)l
{ll
f
fSidential. Heating & Ale (New Construction)
.sidentiBl, Heating Only (New Construction)
Estimated Cost S
~~r-.r""I''"'''''J
\I~~~\:'\.n.UL~'
i:'n ["n lir!"(r~ tr~G'(r~ () n<}. ,
.~"rrdQJ .~
T>~
I JIl"II:i ~ U tIJ ~ Ii ,"0"" N.
Ufa1juL 9 2004 ~I By
24 hour notice for all inspections (952) 447. 1850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior [ ily. MN ~<"l
Building Pennit #
HEATING PE FEE
STATE SURCHARG
TOTALPE E
.50
llI.e Use Only)
Fhis Application Becomes Your Building Permit When Approved
Building Official
Dale
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
S. 2-/ ,0 4-
~ ~~ ~:~ I PERMIT NO. 04- ,0:>48 I
} Yellow Applicant ...J I
(Please tvpe or Print and si2l1 at bottom)
ADDRESS
4fZ3 t5IA/pF ff/J' 71L
ZONING (offic<use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
APPLICANT.
(Name) VCZ//-eu. P/~ b I~" '\ J-V1C. (Phone)
. U --J
(Address) A'foo <2>.'-''''k____ /!-",,,,,, 0o,.-d~
(Address) (City)
(ContactPerson)CI..~,'.s Ph",/'.;"'.'''' (Phone) ab",u-.::,
APPLICANT SIGNATURE 4~~~ ~ -i9= DATE 5- Oll- oq,
?/
APPLICANT PLEASE COMPLETE BELOW
I Quantity I Type of Fixture I Quantity
["" I Bath Tub with or without shower Rough-ins
I Dishwasher I Water Heater
I Floor Drain Water Softner
L Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
I Laundry Tray (lor 2 compartment sink Sewage Ejector
I Shower Stall I Backflow Assembly
L Sinks Backflow Assembly Test
[ I Bar Sink Lawn Sprinkler
I Water Closet (Toilet) Other
CfS.P-'T98 -&I,;;l/
..s . <; "3 S'G<.
(Zip Code)
Type of Fixture
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Dllte
$ /
$ .A"o
$ /"
/'
IPai~
I "'Uat~ ..U, 04-
~ff OJ 06f-
6Vll;
()~
Estimated Cost $
Building Pennit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Onty)
This Application Becomes Your Building Permit When Approved
Building Official
24 hour notice for an inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
Apr 20 04 Ol:lOp
METRO GENERAL SERVICES
763-428-2968
p.5
GAU. - filE
VULOW . APPlICaNl
GOlD - Cll'l'
CITY OF PRIOR LAKE
SEWER. AND WATER PERMIT
FAY-- CJS;J.r 'I'I7-'/Z,l/r NOTE:
s.w.No.ai1J;J1s
feet.
'-....-
5. Estinated length of se~er line .t)/J
feet.
6. Clean out (if required), located at feet from
stru:::ture. . /JIA .
=~===~============================================================
This apFlication becomes your permit when approved.
BY
DATE:
I
~,
========?J~/~=~~~======~======================================
FEES: f]ld.. P~~M.'7-. ,Sewer and water line connection permit.
",.-. ., . Surcharge
/lJt) ,-ee... TOTAL
* Fee for either sewer or ~ater individually is $20.00 plus
$ . 'iO surcharge.
* SeW'lr and water permits issued for ne~' cnn<:t-ruction must be
',.., ..~:~E~r;~~1PW4D. \~cr.;mi~e~:~d :~~=MH.~;~
. .OATE;\P,A&P liU MAY 12Z004 J, AMotNT P1Yb . INe
.~ECE;~T .# '. . REC"~"V R.M1T
E:;J -- '~
i_'..::-'~f~j_f~:;;~,{";.' ,
'-', '-,
:r, ,',';,;.....;.,~
'16200Eagle:' :reekAv. S.E., Prior Lake, Minnesota 55372/ Ph. ('l~2) 447-4230 J FAX (91)2) 447-4245
, An EQual Opportunity Employer
---,-~-----
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS "9~ 3 BlMH" ~ '/ r
NATURE OF WORK ~
USE OF BUILDING --.5 Jelf-
PERMIT NO. 04J - - O.3?t3 DATE ISSUED .
CONTRACTOR _.~ ~~~ 'f9f$'"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENTO~pp MI.l1 P.l
BUILDING AND I~JteeT UlD 1 e
I FOOTING
.
I fh.,
INSPECTOR
DATE
Lsii 7~i/
, .
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING /.IJ.1..4 ,
HEATING ~
DO NOT OCCUPY UNTIL ABOVE HAS
/C!JtU~" ~v-d ~,skd....... 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.
- I
. (e.-C ,/ijt"',h j'-//e
.. #4 9/Jc;/4.
9 /r<7~V
'1/ f'/o'-j
'" /;~;J~
. .,
BEEN SIGNED
\
FOR ALL INSPECTIONS (952) 447-9850
QIrrfifirafr of Q1}uupanry
CITY OF PRIOR LAKE
.. ~~p~dm~nf of 'lIiuilMng J1nsp~dion
,cl Final Permitted D Conditional e.O. Expires _
This Certificate issued pursuant to the requirements of Section 307 afthe 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:
Occupancy Type
R3
~NGLE FAMILY
"'
'"fwd Construction VN Fire Zone
r. "-
11) t::M13ER CREST PARK
Bldg. Permit No._09- .0399.
N / A Zoning District PUD
Use Classification
Legal Description
L19,
Owner of Building
Site Address
4923 BLUFF HE[GHTS TRAIL SF.
Contmctor., Name & Addre" . Plll.,TE HOl'lES, 81~. NORTHHEST PK.'Y., SUITE 140, EAGAN 55121
ROBERT D. H~"'CH:r.S J?,y;'!/ DON RYE
"' TN/I'~,,, City Planner
c-, /" Buil~ O\!'<;i>ll
Date:/ / ~ (J / n LX" " Date:
- \',
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
l~A:~
'~9 ;2 S Ahl'~,J/Js 1/1
TIllE
SCHEDULED
ADDRESS
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/*"} L/ . ?~}?'
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
~LUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
/;;-/;;P10~ I"'r';r- -Ie5-/-'
-I
C/ A--
~ /
/-;hc?/
/
rJ/L
~ORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WO~'; c;~7 REINSPECTlON BEFORE COVERING
Inspector: 71J-t!7 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
l-.>n
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
4"7.23
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIMe
SCHEDULED 'W/ Y J"'b f
/fl.-If /-N k/
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
<3 y-'-J9F
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
_/? /
///T:!';?LJ~P ~{'y' r-c:-<.r~
r;~c ff)--' /~~:'-:J
..~ /J/
/
/, /
rl n __
/' r'J
;J::://
/
/
u/
dl'WORK SATISFACTORY, PROCEED
&i:ORRECT ACTION AND PROCEED
o CORRECT WORK; C;;~ ~EINSPECTlON BEFORE COVERING
Inspector: 1/1/ n Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1",,",,1
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
,?g~hy
4'92? /f/ull /A J;:-/
nME
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
e~-J'9P
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,.,g-FfNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ..
f/~CTr" Cc,/ /-;;;'.. / chHe.
7'Ao~./
I
/ ,,-
/---; H<f /
/
C//c..
/ -------- ~
//. ~l:-)
/fc:sf' /~;.e
-~
,/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CA;: ~O;lEINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Conlr:
~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INS1IOTI
...u J' C" rv-o ~,,~..c!YI
BVRNSVILLE
Heating & Air Conditioning, L.L.c.
12481 Rhode Island Ave S. Savage, MN 55378.952-894.0005
Orslat Test Report for JoW q, '13 t(
Mdress~1 /!;t.u.11 1k.:/4/-hS 7tf- Citll /?t.IO,( '-/H..c
Occupant
t Dateoflns1all 1- ZJ3.. oJ
l Type of HT. FlA ;( HW Space HT Unit HT
Other
Make Lti:,.Jt-Jox'
MOdel GIS IMP.. 1,.., t3 .. D,-/S .. 0'
Serial 5'lD4GDIIICs
Input 44,(')00 f3'"fl.<.rl
Pilot Type
Pressure
InllUt CFH
SlackTemp
Date Tested
Company
Technician
HOT SURFACE IGNITOR
~.., I~ C02J.~
'-1'1 02 9.l.!
I \S" CO.. "LI j2f.......
q.. ~- 0'--'
BURNSVILLE HEATING & AIR CONDITIONING
k.o