HomeMy WebLinkAboutBuilding Permit 04-0460
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~ or urint and sian at bottom)
ADDRESS
1"Po/
LEGAL DESCRIPTION (office use only)
Date Rec' d
4- 30-0t/
I PERMIT NO. af, 0411 d I
Filo:
City
Applicant
4omo~
LOT'93BLOCK / ADDITION 'h1Hl?1"~~ ~
See Main Fili~
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Pul#-J/UffI.S
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,
OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
PIQJ.-r ~
ZONING (office use)
PuD
LlO~-()lf3-d
, Sdfff:-/Vq
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(Phone) .k5'/-~.sz-s2co
B
S U
PROJECT COST IV ALUE $
(excluding land)
S5f z.(
(Phone)
(Phone) t,/2 -.1f.AI' - Y'~
TYPE OF WORK ~ew Construction DDeck DPorch ORe-Roofing DRe.Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection D Misc.
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 Of authorized agent for the
above.mentloned perty and that all construction will conform to all existing state and loc:allaws and will proceed in accordance with submitted plans. I am aware that the building
"mci,/ c,n "V ;;'m~ F"~. / h",by ',"e that the city omc'" 0" d"i,"ce m,y ente, upon the P'"petty to perronn necded myclio?
X Z " . -'~ ,8~-/.:?7/ S/~//)Y
/:/' /- Signature Contractor's License No. / /' Dite
F
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
CODE: ~.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
n
F
I
III IV VA
HIM R
2 3 4 5
$
$
$
$
$
$
$
$
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T . s Application Becomes Your Building Pennit When Approved
~~
Building Otlicial
sJ7ftt/
Dlfte
I Park Support Fee
I SAC
I Water Meter (Sizf 5/8'~ ";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
O'~ - ~ :f ' Yi?r
fa - d-"'l-U
I
#
#
#
#
I Paid
I Date
I ReceiPt No.
By
q~_$1J
$
$
$
$
$
$
$
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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
~ity Pl~tempo'~C'rtific"eO;:;;;C;d'l1ow'con'ttuct;'S'ee ~aiirPiIe'n~ mu"~
Plaiming Director ' I Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Th~("nl,r of lh, l...k'Co....lry
See Main File
~ - Building
~arv - En'll(1eirlnD
liink - PJanning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
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:
/--/' ,1/(11." ;I'/iL::A('
Accepted
>\
Accepted With Corrections
Denied
Reviewed By:
~
,
. Date: 5-1]-0'1
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."
See Main File
White ... Ruildina
~ ~anary - Enqineerii'i1r')
Pink . - Planning
Th~ Crnlfr of lhl L.kr ("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L/q(J~ h...~ Aft. ~.
//- 3CJ cJ7V
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construc~ir-r. ctivity which is proposed at:
Yf..-/ II .e1L. ~
,
Accepted
Denied
/
Accepted With Corrections
Reviewed By:
.
Q ,.. -1 /1
~ ~I--
Date: S;/ 7';:e/
,
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."
Thf ('fnlfr of lhf tab Counlry
See M[ain File
White - Building
Canarv - ineering
'--I"lnk - Plann,n
;1.
WILDING PERMIT APPLICATION DEPARTMENT r.HFr.KUSI
NAME OF APPLICANT
APPLICATION RECEIVED
L/e; 0 (I 6-1&", A',/ r( ;:,jz., ~ .
, . . (If)
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,; "I
I~ I (i ,
.. I, ...L
j i
I;
"
Accepted
/
Accepted With Corrections
,
,
Denied
Reviewed By:
~
~
lp,-,Il/-'
Date: .s:/i7~~
.
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."
Jun 2"1 0"1 11:52a
METRO GENERAL SERVICES
763-"128-2568
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d: pa~
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GREEI. fill
YELLOW. .".UCA"Y
GOLD. CITY
Sewer and Water
contractors must
be reqtstered
with the city.
APPLICANT:-fl1etXD ~~11 Ser~ONE:111J,_~-lI2g",;g.~~
AOORESS'_ _~'jr7t;r) (J/.lo.rll. IJv.L 11' DATE: ..
SIGNATURE: l.b h tbi..lu:hl, - BLDG. PERMIT II
SITE ADDFESS: ~~q ~~/f'#4.J1 PIDII
. ..FIIJL.IN THE BLANKS. .
/=)() feet.
CITY OF PRIOR LAKE
SEWER. AND WATER PERMIT
FAy,. '1S;l,- 'I'I7-'1-z.ttr NOTE:
S.W. No. I./-tl (DO
1.
Estir,ated length of water service
. Ij
size of water service I
inch(es) .
2.
4 .
Type of sewer pipe.
ABS
from structure rj
/J't
PVC~ cast Iron
t)() feet.
feet.
3.
Location of any couplings
"--
5.
Estinated length of sewer line
I
6. Cleal out (if required), located at feet from
stru:ture. IJhh
====~==============-=-=-Q-=-------=-=-=~-------=-----=-------=---
This apJlication be:o:e: ~o:~-::::i: :h::-::::::e:~--- ------- ---
BY -I DATE:
I
"",..':,. "",',:''';
==~=T=~====---;=a===--=-~====----=~~;~-------==------=====
Pu.-Jt'e.J w.iij-. ...-- - --- ------ ------
{lldJ p.e,.t>t.7- . ,Sewer and water line connection permit.
.. , .. surcharge
/.fa Pe.e-TO'l'AL
* Fee. for either sewer ~,water individually is $20.00 plus
.. .. $ .ra surcharge. ..'....
.. ................. . ...*.. se.w.!r and water perm.. it. s..~' 55' ed. for . new construc.t~..on. m u.st be
reo ,.rded w"'r" ~U~fP\WJ . it card at the tim~ of ~ssuanoe
., to r-nsure t ~. ri.tJJ l(dtip'J.Ii; sewer and water~~~ts are
.i~:..:;''''.' .. iSS.1E!d. . . . '~1b
s r:"i....;...~:..;)'.'.... . i..' JUN 2 5 2004,.. ~ h~
; .,:~;i/~,,}.",i' .DATE:i;,I;lUP . .. . AMOUNT. PAID ~ '?:,", :}.
...,."n' . ... . .!N!:...ii;y
:..tS~iji} '.RECEln '. . .8'!. REC/DBY . 7J .~
{~;:~\~.~~~j,~~; ;', . ". :':.~:'. . .,~.: ,::.'~...1:
;;';~';!ii:l6200Eagl~.'f!eekAv. S.E.. Prior Lake, Minnesota 55372/ Ph. (,s2) 447-4230 f FAX ('~2) 447-4245
An EQuaI.DpponunilY Employer
-------
-------
FEES:
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMI1' (J.V
~ V4-{)~~
I. .,,, ,". I PERMIT NO.
2. Gold City
3. Yellow Applicant
(Please tvD~ or Print and sim at bottom)
ADDRESS
<-ffo~; '-f9CJt4., Lf90<Ol 0/908' ~It.,./:{) 1/~~'r;L/S J;./~,~/.
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
, OWNER
(Name)
PLl /I.e.
(Phone)
(Address)
APPLICANT I /)/
(Name) Valt~ nu-,,1, ":J
(Address) ?~O (J.l..<4k-G-" AI.I""e-
(Address)
(Contact Person) CL __, ': <: fYlor r , '..S
APPLICANTSIGNATU~~~ .~
V
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture I Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower StalI
Sinks
Bar Sink
Water Closet (Toilet)
~
~c...
~OrdlA-
(phone) %.:r~9.;;J - c; I a J
ft1 N ~SsS"~
(City) (Zip Code)
(phone)
~.b6(......
DATE
"'7- J ~ -00/,
Quantity
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Residential, New One & Two-Family $99.50
Residential, Additions & Alleralions $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
iWDWTfH
eU11.DING ~~HN'lrr
(Office Use Only)
pplicati~n B~r BUildin:;7;;; Approved
Building Official ' Date
I Paid
I Date
Receipt No.
By
24 bour notice for aU inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
;952 S94 0925
# 6/ 9
Date Rec'd
CITY OF PRIOR LAKE
HEATINGIAIR CONDITIONINGfFlREPLACE PERMIT
~. =. ~~ I PERMIT NO.^",- AA...I_^
3. Yellow AppllWlI Lrr. UTlf'CL/
q>>lease tv:l!e or Print and sUm atbottom)
I ADDRESS
4 90-1 ~\LL~c::'
ZONING (office ",e)
-
,.,
~ \(W....Q
o LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PID
I
OWNER
(Name)
~JJ)4t' ~
~\~ rfw-\hlA\C&+ PailwCuj
(phone) (!f5J-L("S2 - SlcXJ
140 I ft{). F- LtfJD/l iVr1 SSI U
,
(Address)
APPLICANT
(Name)
Burnsville Heating & AlC, LLC
12481 Rhode Island Ave. So.
Savage, MN 6ilJIlIrl1122
(Phone) q-=j,.)- \(Cj L/ --ocns-
I
."
",.,
(Address)
(City)
(ZIp Code)
:;,-.
I
(Contact Person)
(phone)
(-!Uu:L, .A))o.JJLYlhlL/J DATE 9-dJ'-O(f
APPLICANT SIGNATURE
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION
FURNACE MAKE AND MODEL I D/J/1.I/X
FLUE SIZE RETURN OPENINGS
TYPE OF SYSTEM
DW8I1Il Air Plants
DGr10vity
o Mechanical
~ir Conditioning
OVen!. System
o REPLACEMENT 0 ALTERATIONS
rT5IMP;;)(-I&'l-I0" FUEL m.:l CtJI L'J
~ INPUT l./5, I.O? OUTPUT t.{ l. (;/)1)
.
HEATING OR POWER PLANT
o Steam
o Hot Water
o Ra4i.tion
o Special Devices
o Other Devices
.v...,
~;"
PLE~~~NOTJ.<:: 0
AirCan<iilia!1erUnits 0
Cannal ~crQa!'l! .i!)ta 0
Required Side yird
Setbacks
FIREPLACE MAKE AND MODEL
.",.
~;::,:
- ~}
Industrial, Commercial & Multi-Famlly
Fi!E SCHEDUl.,i!
I%ofjo~~st ' Rel!I~entia1, ~Fin:place
$39.50 minimum 0 0 0 0 0 00 0 00
$99.50 Residenlial, Additions & Alterations
$64.S0 Residential, AC Only
$39.50
$39.S0
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimaled Cost $
Permit #
:~.:.';:;;::..',::.:.
PAt
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-'::.~..:-y-......_~:.."";'" J ~~~ ~"~l:"" .
24 hour nollce for 011 inspections (951) 44 Waso, fax (952) 447-4245 ~
l~ltagltf~~'0"~;~~~ ~~MN553n 0
;:-';:',".:;Y:
DEPARTMENT ~ee Main File
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
-
'fJ'I BI-.ff tl-1-S I ~
SITE ADDRESS
NATURE OF WORK
USE OF BUILDI~ .
PERMIT NO. OJ - . DATE ISSUEDsl/7 JOlT
CONTRACTOR *' 't-.t' PHO~ ~ ~...,. '-'!i' r
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
/1/%
.. j.
I FOUNDATION (Prior to Backfill) ~""",J,/U19/r ~ I .f~SXJ
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~
~
I FOOTING
INSPECTOR
D~TE '"
7 /~/C31
. ,.
6'/4' /V'7'
/tJ/VJ#/
. /b/2-z-,A-7"
/~1f?/W
/D!7Jftt/
/0/20/"7'
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLU~BING VI (;5. ~ 7/J-,;-'1
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I I
.4w~..' ~"v~//s c./A/,j,/}~d FINALS .
GRADING (Prior to Sodding) --S If> ~ //1." 'lh h /e I
BUILDING. $I /,z//4:"~y
ELECTRICAL I/".c?~/c~
PLUMBING JlVVI JI-~4~
HEATING ft# /.>~()/(}(
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
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.
/H{f
~
FOR ALL INSPECTIONS (952) 447-9850
@nfifitaft of OOttupantl!
CITY OF PRIOR LAKE
~eparf1tnmt of ~uil~iug J'usprtfiou
Jtf Pinal Permitted 0 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:
Use Classification
SINGLE FAMILY
Bldg. Pennit No,
iJ4-. 41;0
Occupancy Type
R3
Type Construction
VN
Fire Zone
N/A
Zoning District
PUD
Legal Description
L43, BI, TIMBER CREST PARK
Owner of Building
Site Address
4904 BLUFF HEIGHTS TRAIL SE
PKWY., SUITE 140, EAGAN 55121
DON RYE
ROBERT D. HUTCHINS
~UildiIJW071c'
/.-7 /' /O/,C~
r .
HOMES, 8I5/NOIlTHWEST
-4'ff
Contractor's Name & Address PUL TE
,
City Planne'^
Date:
Date:
DATE nIlE
q~,dy'
7"9t:Jy b%/}!/ ~ 7//
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
D FOOTING D PLUMBING RI
D FOUNDATION D MECH RI
C FRAIIING C WATER HOOKUP
D INSULATION D SEWER HOOKUP
.IiF1'lRAL D PLUMBING FINAL
D SITE INSPECTION ""p*CH FINAL
CO.MMJ:N't6:. , -"" . /
,PE/;crnC.,/ ~"""" t' ~....~
-
;
N-r'GO
D EX/GRADlFILLING
D COMPLAINT
C FIREPlACE Rl
D FIREPLACE FINAL
D GASUNE AIR TST
D
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0~4 ____)
ARK SATlSF~CTORY. PROCEED
D CORRECT ACTION AND PROCEED
~_~:~.R.E~ FOR REINS::::FORE COVERING
v
CALL ....7.9850 FOR THE NEXT INSPECTION U HOURS IN ADVANCE.
INSNOn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!