HomeMy WebLinkAboutUtility Connection 01-0722
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07/17/01 TOE 10:18 FAX .124474245
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CITY OF PRIOR LAKE
liIao2
CITY OF PRIOR U..KE BVILDING PERMIT.
TEMPOKA.RY CEkulllCATE or ZONING COMPLIANCE
AND UTILITY C."I,.\...cnON PERMIT
DatO Rec'd
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ACDdSS ;
3545. :FOX 'I.AJi , DAtI. 1'l01l.I'IlWESt
t: ~ I PJ;KMlT:NO. 01-077-2.. I,
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LBGA1.DBS~:nONIGlIIcc. .reCllll7l
LOT 1 II . 4........ WENSKANJI ni.iT /lDDlttoK
. A".,..,& I."'''''''''
PID
25-376-031:"0
OWND.
(Name) 'rBDIII ~ ItJ1D lWlDl BO!'l'
(Pbaue) . 441... '"'14'"
: \
(Addrc:u) 3541: FOX TAIL tJlA.IL JlOR'IHWiSr. rUOB. I.AD. MIl 5537Z
BUILDu'
(Name) WHISlIARlI J:10KES. Il'1C. . (Pbclrle)
(Caarm Name) . (PbaIle)
(AcIdze.) Ii, 95 PLAZA Di... SUITE ZOO. EAGAN. KIIIINEsOtA 55101
. . r.. 01' WOJll:
o Mew "-.,.,a1aa ODook 0'..... 0...........
OlA_1..eooIFilliIIl On.pl- 0-- OAllndIlD
~l?:'C:elSTlYAt.UB 1__1ao4'I S
Ole e,,-I..
OUlllioJC, , ..,. ,
~M;,..
I h=b1 CIZli3' tllat J ..... fumillIIII-"_ oa tbII oppIIaIIoa wllIcb If..... _ oCtI\J '" , ,F.... u6 camet. I.......nrr _IUD --..
_...tlllr' ._--~-.', ,'.., lIId_oIl......__wIII___la..nI..._....I8alIa..--~.. ... "'" ......
......... ,lilli, I In ............ NUdiq ollicIlI _ roooIIlIlIIlI pami. tilf Jus. ca_. ,,,,,.,..,,, ,IW, I....., _ lIIII. _.ur dIdtI ... I ....... ..,
:::~ilti;"'"'' . . 'H~
: r __5--.. . . ~.I..._lI'o, l D..~
P....... VoIualiclll I I PUk liuppa" 1'.. "S
l'cnIIill'.... S :lAC .. S
Plan Olcd: F... $ WI" MInar Sbo: 5/1", I"; $
I SlaIOS~ $ .:,.""..W".,... $
I Pt:lllllly S I S.......IW.=C. ",..,aP..," S
I PlllmbiallPcmIilllll S 40.00 I W_T_Pa: ... S
!l""-"_;~I Penn!, 1'... li ....1dIr'1 Pepallt I S
'" SlIWed,W.IUP>t llIitl'= S 35.50 Otlllr 15
I (iUI'In!pIlcz'cr;1itF= S TOTAL DUll IS 3.445.50
1.150.00
250.00
J D.JlP
I.Zo0.o0
700.00
1
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Bull_or dIl
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, 2, 200 1 1 0 : II AM
GENZ RVAN PLUMBING AND HEATING
Date Ree'd
No,7811 P,2/2
CITY OF PRIOR LAKE
SEWER AN]) WATER PERMIT
(hease typo: ""pzmt a..a q,; ""bottom)
ADP:RESS
~~~ frN TPt (L- (t2~A{ f..-.
LEGAL DESCRll"TION (olIi"" UR: 0Jlly)
LOT BL-OCK
ADDmON
OWNER
(Name)
(Address)
W<Z...nS~ UoVV'l (J ~
I~Oi 6 PIA ~Pt Dtrz... Sr-e.. ZDD
(Ad4rc:u)
i.;~. I PERMIT NO'II/r 0 'i'? '7 '/
3. OI:Ild AppllCUlt U ~ ~
ZONING 'oIb_)
PID
(phone)
( ,61-qD~-,r;r..,-r()q
5S-,'Z..?
(Zip Code)
~(,\"""10
(City)
APPIlCANT
(Nam"" 6UIT2-- -12..c..pt./'
(Address) \U1U~ S::~J?()fr.x.fl.:r Wl.
, ~~) ,
(ContaCt~~on) '^.kV''1 ~':;0
. ~IcANr SIGNATURE {^ ~~ o.r--~..
(, . ~
APPLICANT PLEASE COMPLETE BE~OW
Size of water service inches. I
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated lengt\l of sewer line feet.
Clean out (if required) located at fc::ct from structw'c.
(}'hone) I p F-.1-=hl:.? ;z.., -I ( 4 U
t2 of/' .YYYTIJ...Ylr h~ 'i<
(City) (Zip Code)
(phone) I Of-:{ -Uz.~ ~ rJ::jc...j
DAn ..., I (2.-10 ,
FEE SCHEDULE
Residol1tialsewcr and water line connection $35.50 Industrial. Com'l &: Multi-family 1% of job cost with a $39.50 minimum
Sower connoction only $17.50 Water connection only $17.50
Estimated Cost S
Building Pcnnit #
PAID WITH
~ING PERMIT
.so
SEWER AND WATER PERMIT FEE $
STATE SURCEARGE S
TOTAL PERMIT FEE S
(Omer: V.e Only)
I Tbis Application Becomes Your BuOdiDll p_lt Who Approv.cd
L{' llulldlllll O1IIdol
Pot.:
:w hOUT noti... for all inspection, "52) 447.9850, ru (lIS2) 447-414!
I Paid
I Date".
, '
Receipt No.
I'
I
By
3:43PM
GENZ RVAN PLUMBING AND HEATING
No,7861 P, 2/2
Date R.c'd
Lll i OF PRIOR LAKE PLUMBING PERMIT
(,
(' "
! .!W!' ottll'lD1 atlllsno: ubollDml
h..-- .JRESS. . , ,
s6L.fS J6V-.. T A f L- -r~ A ( L-
J. JJ.\IM: 'il~ I PERMIT NO z..t
HI." "'" . 0/. 07,''/ '-
),\".0_ AppIiQlll v
ZONING (oIli<o_)
. LEGAL PESCRu- uvi'i (oflk:<: ",. cllb?
LOT BLOCK
APDmON
PlD
OWNER J I
(Name) 11. Jz.vls.~ H(j~
(Address) /<Qqr::, PIA::eA (}e. S'T7~ ZtsD
_ (phone)
ft;I5(-Qo6-37tPt
e.o.Gaf)
6":::>12- 2-
<r' .
'....tity
I
I
I
I
I
APPLICANT /7 , " /
(Nom<" (rU1 '2- - /C-lJQ./J (Phone) {r/j/ ~u..'0 ~ /Iv.u
(Address) IUl u.~ :b ,&beJz::r ~ ~"l.J....YJf s:,O~
(Address) (City) (Zip Code)
(Contact Rem>n) ----..IA.....do (' '-( ~ (phone) lPS'7 --l.f..'2.-3~ (I 4:c.t
APPLI~ SIGNATURE I A. ft DATE -'7 f 1 '2--/ n (
APPLlCk-iLEASE COMPLETE BELOW
I Type of Finure I Qoutity I
i Bath Tub with Dr without shower Rough-ins
" Dishwasher I I Water Heater
Floor Drain I I w'8kt Softaer
1 Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine) I
I Laundry Tray (lor 2 compartment sink I I Sewage :ejeCtor 'I
I Shower Stall I I Bac1cf1ow Assembly
Sinks I I Ba.eidIow Assembly Test I
I Bar Sink I I Lawn Sprinkler I
I Water Closet <TOilet) I I Other ~,/..-r... -' . a b,-v Y1~1
C(w~
FEE SCHEDULE
Induslriol, CommercIal &. Mulll-filmily 1% cfjcb ecsl oNIlh a $39,,50 minimum Residential. New One /Jr; Twc-Family $99,50
Residential, AddhiOlll /Jr; AJtcraticns $39,50
Type of Ibnlre
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT F.EE
$
$
$
PAID WITH
WlLDING PERMIT
, .,50
(omc. Us. Oolly)
I This ApplicatioJJ Jlecomes Y Ollr Building Permit Whell Appro..ed
P.te
I Paid
jDIIttl' .
R.eeeipt No.
(:
.~U lluijdi.~omd.J
By
1~ bour, aodu for .n iuspectio... (952) 447-9150. fax (951) +f7-4%~5
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
~ WA7ERHOOKUP 0 FIREPLACERI
n 1!" SEWER HOOKUP {)ItoJL.'( 0 FIREPLACE FINAL
o PLUMS'NG FINAL 0 GASUNE AIR TS7
o MECH FINAL 0
~.s:.~"'1 t;.~\DW f~r
(~ dQAV.~\'+-
II
._ VC,Aoof - \ ...
CITY OF PRIOR LAKE
INSPECTION NOTICE
_.
.'
ADDRESS
(57f;'-/S
OWNER
PHONE NO.
o F0071NG
o FOUNOATlON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECT'ON
COMMENTS:
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Hov s..e
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t a:..AtkSe
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SCHEDULED
DATE TIME
7i1't /01 /0: tYiJ
,
v::;.y T14. ( ~ 77e... ,
COHTR.
PERMIT NO.
OI-72...'Z....
.
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nf
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~RK SATlSF*CTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ALL FOR REINSPEC710N BEFORE COVERING
Inspector.
CALL "7._ FOR THE NEXT INSPECTION :u HOURS IN ADVANCE.
Owner/Contr.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH <I SAFETY/
INSNOTI