HomeMy WebLinkAboutBuilding Permit 04-0734
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and silm at bottom)
ADDRESS
10 / de; -OL(
See Main F~le ~:;Ii"", I PERMIT NO. 04-. 0734+
ZONING (office use)
4Bqo
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LEGAL DESCRIPTION (office use only)
LOTito BLOCK I ADDITION
7~M8Ef2.
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PID(;?$' - t1Od.--CFII",-()
OWNER
(Name)
(Address)
~F
CB If;"
Ho Mft<:;
/JOQ..] H WE(T
>J:Te
P~1l1L w,M 1"10
.
(Phone) fo~1 - 4{;Z- 5'200
~At..,4Jl) MiJ S-S' /2/
BUILDER
(Company Name)
(Contact Name)
(Address)
jtfllv.r
CU'ttT /j/N.;~Hi""rI
(Phone)
(Phone)
(,,/2 - 21....1 - 41 9.\'
TYPE OF WORK. ~ew Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish D Fireplace
DAddition DAlteration DUtility Connection 0 Mise.
COD~.R.C. DI.B.c.
Type Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
9~JOfJ()
I hereby certify thaI 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
abovc.mcntlOned perry and that all construction will con~ m to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:,',1 "n e~ fm os Fmth"mm mby ageee th" the C>ty OfficJ32':gn" ;'3e;;pon the pcopert\' to p"roem ne~d?;"i-/ o-f
/ Signature - Contractor's License No. Date
Permit Valuation r!CJtJ IJO().OO I Park Support Fee # $
Permit Fee $ /02...7. C;" I SAC # $ I~SO.t;)D
Plan Check Fee $ ~(,. 7. W'Y WaterMeter0~1"; $ 2~O.DO
State Surcharge $ 'If? 0 0 Pressure Reducer $ '-f~.o 0
Penalty $ Sewer/Water Connection Fee # $ I 2..CHJ . Q ()
Plumbing Permit Fee $ /oo.eo Water Tower Fee # $ 700. co
Mechanical Permit Fee $ /dO dJD Builder's Deposit $
Sewer & Water Permit Fee $ 35'. S;-i> Other $
Gas Fireplace Permit Fee $ lfa.OD TOTAL DUE $ 5-5~3. ~0 I
S.n,J"r / )
This Application Becomes Your Building Permit When Approved Paid Rece~o. rld-?
~~t-J 71t,3/o i Date 7.,.1./.q~ By
U
Buildl1l.g Official
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 SI ned by the City Planner constitutes a temporary Cel11ficate of Zonmg camphance and allows constrUCtlon to commence SefOle occupancy a Certlficate of Occupancy must be
" ~Iannmgl~f-- 7} J J <( .. e
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
See Main File
White_. - Building
r' .....~ ~nan' _ c.rtg.neennq,
Pink - Planning
Thr (-rnlrr of th.,1..kto Country
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 proppsed at:
'.~~'
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
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S (( rJ1",/l Fr 'f (
Date:
/-/f-oLj
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
While - Building
Canary - Engineering
.Eiu.. - r-,aniilrllP
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Thr Crntrr of lhr J.lkr ('oun.".
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/ I
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Accepted
~
Accepted With Corrections
..
Denied
Reviewed By:
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Date:
7f_~v
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Comments:
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"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."
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See Main File
~itl:l ~ RlJildi~
Canary . Engineering
Pink . Planning
Tt!{'("l'nll'rof Ii'll' I..h Counlry
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlRT
fJ-dAd- ~
(0-;;)-5-0<-/
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction aij;q~h is pr~ ~ ~
vv
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
~~~
,
Date:
7/3~y
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."
JLln 24 04 11:50a
Fee for either sewer or water individually is $20.00 plus
$ .'0 surcharge.
sewtr and water permits issued for new construction must be
recJrded on the . 'ng permit card at the time of issuance
i~s ~~~~~ ~ Ii ,~l1cate sewer and water f~~r~~,:~ are
DATE;,..Pll!.C _II_II 29 2004 ~ AMOUNT PAlt0Puq~\.'i\ifl.I~"'repBf."'"
. ~~<r.~,~'n'
RECEI~'I ~ ~ REC'O BY
By_
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METRO GENERAL SERVICES
763-428-2968
p. I
GRI!I:II.fU
YEUOW . APPlICANl
GOlD - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
FAy... CjS~ 'I'/7-'lZ,tlr
q., 0734-
S.W.No.
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: [}1e:tllJ) c 1ieJ1}JVli ,YfVJitbtONE: 7Ip3~Llli--Jq;'z;~'
ADDRESS:_ F..ntln, QIJ4l1L..-I/u-L n~ DATE:
SIGNATURE: lk/p.&:f/JU;/-;/. BLDG. PERMIT #
SITE ADDFESS: 48'9'(J .61.t~ /t..u~5I1PID#
, FILL,.I THE BLANKS. '
r.::
,')0
1.
EstiI.ated length of water service
. Ij
Size of water service I
feet.
2.
inch (es) .
3.
Locar.ion of any couplings
from structure ~)
/J "
PVC"'V Cast Iron
~()
feet.
4 .
5.
Type, of sewer pipe.
ABS
Esti~ated length of sewer line
feet.
6. Clea n out (if required), located at feet from
stru:ture. IlIA .
======~===~=====~==================~=~====================~=====~=
This apFlication becomes your permit when approved.
BY
DATE:
~~~=====~=~~T~=~====~~~~~=======~=============~~=~==~~=~==========
Pwh'e.d w,'H" .
FEES: f) Id.j P<I-!l'<':';- .Sewer and water line connection permit.
,-:'" '.. ..surcharge
Na [-e.e- TOT~L
*
*
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'16200 EaglQ:peek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (~52) 447-4230 I FAX (9$2) 447-4245
An Eaual Opportunity Employer
;952 894 0925
# 6/ 9
Date Rec'd
CITY Uf<'1'KlUJ{ LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
t!Iease!YE.e or Print and si2l1 at bottom)
ADDRESS
Llli{ <10 ?>\ CArr \-H'":"-" \.{~
I
; ::. ~~ 'PERMIT NO.1Wl ^-r2.~ I..~~
J. Yellow Applieanr ...~ I
ZONING (offio: use)
LEGAL DESCRIPTION (olliee use oDly)
LOT . BLOCK
ADDITION
PlD
I
OWNER
(Name)
?l A o::*e.- fu/Y'\--c_s (Phone) ( 0':::>1- LlS2 -r;LC:{)
~(N~\\M.i~-\ Db(;I:H ILIl) CCJJ{d\
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\vii\. SS 12..1
(Address) ~ \ S
APPUCANT
(Name)
Burnsville Heatina & AIr. , I r.
12481 Rhode Island Ave. So.
Savaoe. MN f)fi371l-11??
(Address)
(Phone) Cf"") d - "II: CJ l/ - (Y:,QS
.,'/-
i';~!i"
)~:i
(Address)
(City)
(Zip Code)
(Contact Person) (Phone)
APPLICANT SIGNATURE (~/ /1/1 J K t\ eLJL]o .AC0 DATE
/1- ( 7 -()~
I
APPLICANT PLEASE COMPLETE BELOW
(ZfNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL / Q rl/7CV f:-S/ /t-IIJ- d. L/ /3 - 0</5- FUEL 1'1Cl ;1 C; tJLA j
FLUE SIZE RETuRN OPENINGS ""S INPUT L/5, Oc/O OUTPUT 41. Lj{)()
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants 0 Steam
DGravity 0 ao.t Water
o Mech8llical 0 Radi~tion
~Air Conditioning 0, SpeCial Devices
DVenl System 0 Other Device,
I PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I
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,,,,,.."
Industrial, Commercial & Multi~Family
FEE SCHEDULE
1 % of job cost ReSjd~tjal, GlI.S fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
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FIREPLACE MAKE AND MODEL
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39,50
Estimated Cost $
Building Penn it #
~7P~
...\..\.....i....i.....pJ3I/;;~
(omce Use Only)
Tbis Application Becomes Your BuildiDll PermitWben Approved
.5.0 .
Date
1R.~C~ip; N~,
I By
Building Official
Date
24 hour noUee for all Inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, 1'rior Lake, MI'! e?372
DEPARTMENT OF See Main File
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~89~ :8//'/;-1-. #e-16Hr:r' ~A.i~
NATURE OF WORKJJ&/AJ ~e.uCN',~ .
USE OF BUILDING S. J::-~ .
PERMIT NO. (j4,o7;3'4- DATE ISSUED 711~(I
CONTRACTOR f1,( a-C ~~ PHONE - U/-",S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
, FOOTING I fiY~ I ;p.~1'
, FOUNDATION (Prior to Backfill) f1~JA I'AJ.,;/!, ~. I -rh}~;%
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
pt{7
/~k
I/W/
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
~ .
PLUMBING f/' (;(.' /Iff oP~9'
HEATING (if required)
FIREPLACE .
,GAS LINE AIR TEST~'j LJ7,,/ /'/.,Y ~ ~/1k
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~u It I /U'--4 I /~J/5~
FINALS ~
____\. ee ~;;...k r/e./
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~ /~/j?5-
/~I ~~Vtl~~
W};- :l/2/0 <)
BEEN SIGNED
I'
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/lP/
/4/~
.
7/.-20/0,/
/,2 ~j/d</
j},.-.- 12.ul
/..2 //r /C'/ I
/..2)Ift'-/
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OCCUpy UNTIL ABOVE HAS
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.
FOR ALL INSPECTIONS (952) 447-9850
QItrfifiraft of (IDrrupautl!
CITY OF PRIOR LAKE
@.~parf1U~nf of ~uilMng Jlnsp~dton
~inal Permitted D 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/allowing:
Type Construction
VN
Fire Zone
Bldg. Pennit No.
N/A
04,0134-
PUD
Use Classification
SINGLE FAMILY
Occupancy Type
R3
_ Zoning District
Legal Description
L46, Bl, TIMBER CREST PARK
Owner of Building
Contractor's Name & AddressPUL TE HOMES., .81 j
ROBERT D. HU;CHTNS /$~
? ~ BJ"~Off,c,"1
Date .~c.-<.y / 05-
Site Address
4890 BLUFF HEIGHTS TRAIL SE
NORTHWEST PKINY., SUITE 140, EAGAN
DON RYE
551cl
_ City Planner _
Date:
DATE TIME
CITY OF PRIOR LAKE ., h 1
INSPECTION NOTICE SCHEDULED --1/2-;105 /
-YJ>70 ~#~Yu 7//
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t:).y -Zr
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMI;NTS:/ __
~T!'Cfr'C9( /7h#t/ ~
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)( WORK SATISFACTORY, PROCEED
Ii" O~RRECT ACTION AND PROCEED
o CORRECT W~~~;-;;OR REINSPECTION BEFORE COVERING
Inspector. / tC--7 ~ Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH Ie SAFETY/
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DATE TIME
.;Z/~)
1/190 .klv// //rj. ~ /
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
p-'MECH FINAL
0"7- /'3</"
t'
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE R1
o PREPLACE FINAL
,zr GAS LINE AIR TST
o
COMMENTS:
W' / / J'
/;;~nJl,;-t~ rer T~J r
~,S/'~t'5 ~h;'1
to/c... ~
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res/
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK; C~LtFO~PECTION BEFORE COVERING
Inspector: y.tYt:/q.-. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY/
INSIIOTJ
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BVftN~ .,ILLE
Heating & Air Conditioning, L.L.c.
12481 Rhode Island Ave S, Savage, MN 55378. 95Z-894~0005
Ors1at Test Report for Job# (0 q03
Address 4890 f3Lv.f{ Ik/t:JIII S 1(2 Citv ?RIOt? &"4:=
Occup,.
Date of Install \'2 - ?- L - 04 .......-
Type of HT. F/A v HW Space HT Unit HT
Other
Make
Model
Serial
Input
v.rJuox
,
G'-/7,uc - ?.4P-.- NJ'-.- -- O<.J
Sgo'-lL 64240
'-JejoOO ()fu.l~
Pilot Type
Pressure
Input CFH
Stack Temp
HOT SURFACE IGNITOR
3<; lL0C- C02
L/Y 02
109 CO
to;)
I(J.O
1'-1 j?n/Yl
Date Tested
Company
Technician
2 1-0';-
BURNSVILLE HEATING & AIR CONDITIONING
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