HomeMy WebLinkAboutBuilding Permit 01-0139
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please .type or orint and sign. at bottom)
ADDRESS
/'15 go i~vA- '"
Date Rec'd
2-/3-0/
1. While
2. Pink
). Yellow
I PERMIT~OI39
ZONING (office use)
12/
File
City
Applicant
(;-
Nf,
LEGAL DESCRIPTION (office use only)
LOT 'I BLOCK:5 ADDITION /eN." .11,'1/ .s-:/-". A-oo -;:: r;(/~
PID 25-3(,B'635-0
OWNER 5C,4-,v d I!~"...#,.J ~M pt.! ~5 -Jsj-eO.J r-
(Name) (Phone)
6?Vh€ ,4..( t-J6~/oJj.L-L \
" N
(Address)
BUILDER >G1''''-'.4IJ ( ~.'L:r"",,- /!;^'t / 1.52- 2l(,- J'tJj'
(Name) (Phone)
I ~,~/ i.~ I'lKrjJ:r2
(Address) J 81 r() rlJ c.~ fC".
TYPE OF WORK ~ew Construction
~eck
OPorch
ORe-Roofing
ORe-Siding
B'fireplace
o Misc.
OLower Level Finish
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct J 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 local1aws 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
enter upol} the property to perform needed inspections.
- -----~
X~""'-::'~~ ~~- -
MeTT-tI!~~
1$
1$
$
$
$
$
$
$
1 Permit Fee
1 Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
1 Sewer & Water Permit Fee
1 Gas Fireplace Permit Fee
OAddition
OAlteration
OUtility Connection
PROJECT COST/VALUE (excluding land) $
?()/'t 2rS Y
.,}-/5--<//
Contractor's License No.
Date
/ (p~ ,0 0 0
L~7<{.5'5 1 Park Support Fee
~ 813~~ SAC
p,tj . ~O 1 I Water Meter Si~ I";
I I Pressure Reducer
I I Sewer/Water Connection Fee
I I Water Tower Fee
I 1 Builder's Deposit
I 1 Other
I TOTAL DUE
$
$
$
$
#
BSO.Ol5
I I 5'0 ,af
.
I ~,_cm
45'.00
$ 1_ 20{) .tlt)
$" IfM.OC'
$/ c;M,6l)
$ ,
#
~
lOC'l.DO
#
"~I'\.~
#
~c;' so
4o.(!)1J
$ 8J ,Q7. 5/
. When Approved
2 -J (p, 2o::J(
I Paid 8l jq'1, S'j
I Date 3- "1.0 I
I Receipt }iq. 39()c,e
By /JI/V--
I
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 temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
i0k,i 4-:~ - ~-- 3 t~!t91
, Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~._--
.
White - Building
Canary - Engineering
Pink - Planning
Thr Crnlrr of thr lakr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
v (j r2. v.JA V
I I
2-1'2.,-0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4500 rzA\/E I\J Gi Nf;
Accepted
x
Accepted With Corrections
Denied
Reviewed By: Ii!~/( 13{,'(\.{
Date: Z, Z3 -0 I
Comments: Lorru,+ Sl/tl/~v, fr4,..-f $"_.~..... I'~ ,'^(IJduf 0" b,'fI1 5,..t-.s
I/~, (..,A "(j .. wh." !Jr.,d"ll.~ e,r<J"V\~ Gctk", 1,..,,1,,_
See Reverse Side for Additional Information!
"
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control pl;:Jn Lj) F,',,</ b,...d,'..y I"Vn.:Jioro
"
"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,"
The Cenln of the Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
YOr?-WAy
Z-'~- () I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
14500 EA\/E, N (!..,T N6
Accepted
Accepted With Corrections X
Denied '// f3 _ -k
Reviewed By: C;::f ~ )
c;:2ents~
(~ a1Q ~
Date:
'2 ~ ({p . 2001
~j)~
----
"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."
Th~ Cnlu of Iht Lab Counlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\1 ( k \\ /-\ V
I ~ I
Z-i-()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I LV:JO L f\\,(=_ i\j~l- i\:'(
Accepted
,/
Accepted With Corrections
Denied
Reviewed By: q AA-l::Je.. Z'/~
Date:
512/ot
Comments:
;2'1 1='\ MM~/WM.I. J11}.O'.....~"'-<(1 '^)~ADt. Ar ~i"~
()J~ [;. 'v\-e.. ..t-'TV\v-u V2. l t9 't-J 'iD Uvk\.
"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,"
GREE. - FILE
YEllOW - A....UCA.T
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.w. No. (]/-O/3 c;
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLI CANT: E.J1JL (;1' IlLJ E T:A/C
ADDRESS: 130~, ST, SJ-l~rE ~tV
SIGNATURE: __?Jil.//j/j~I.#&?
SITE ADDRESS: /~".I)[)/) RfJllkAJ rOI.l~-r
FILL IN THE BLANKS
PHONE: '1/il-,;?,]3 -/~ O{)
DATE: 3//5/0/
, ,
BLDG. PERMIT # () /-0/'39
PID# 25,,3(.,S-(j35-0
1. Estimated length of water service
061
feet.
2. Size of water service
I
inch(es) .
3. Location of any couplings from structure
4. Type of sewer pipe. ABS PVC X Cast Iron
5. Estimated length of sewer line (P!J I feet.
feet.
6, Clean out (if required), located at
structure.
JI
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
BY
This
------------- ----------------------------------------------------
------------- ----------------------------------------------------
FEES:
$
$
~
Sewer and water line connection permit,
Surcharge
TOTAL
*
Fee for either sewer or water individually is $~~ plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
AMOUNT PAID
RECEIPT #
REC'O BY
16200 Eagle Creek Av. S,E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponunity Employer
Date Rec'd
"II { OF PRIOR LAKE PLUMBING PERMIT
i::~::' I PERMIT NO, / - /39
3, v".... ."1;foIl1
(1'1I110 ~ or 1IMr...... "_I
ADDlUiSS Z~(ING (0"",''''') 'j
\ 11 'SOQ ~Q,Vfl.11 f)
LEGAL DESCRIPr10N 1_"'OIIIy) Y lD ~
LOT q SLOCK (3 .-\DDmON ~A1J() fi;1J/ C) .
PIO)r;- - 3(",;( - 03;1~)
DWJl/ER 1....1 ""\ J
(NameL 1 0\ ~~. nc\nL'5
(Address)
i ~:;~~ANT ~cre.v-<U" ~\um'o(l"Q (PhOM) q"S'J. -l.\4l-~ 13Lj
(Address) L\'bOO ~ddo."C.\'c.\e.~C::;<f:_ Prl6, L<l.~ Ss 3 72-
I (Addnu) (City) (Zip Code)
(ContaclPerson) 3e:~~ '5c..hexQ,(' (Phone) Col2- 7~ 1- 30& 3
APPLICANTSIQNATtJ1U! ~..~c.;r~~ DATE ?/~Lf/OI
APPLICANT PLEASE COMPLETE BELOW
Type oU'ixture QlIllDtity I Type of Fbtur"
Ball Tub with or without shower . '0{ tlough-ins
Di.hwuhcr i Waler Heater
Floor Drain ~W aler Softner
Lavalory (Bathroom Sink) Stand PiDe (Washing Machine)
Laundry fray (lor 2 ~mpat1ment sink Sewage Ejector
I Sr.ower Stall - -Backflow Assembly
Sinks aackflow Assembly Test .
Bar Sink Lawn Sorinlder
Water Closer (Toilet) Other
Quantity
'r
\
?,
\
\
\
'~
(Phon,,)
"
FtE SCIUDVLE
Industrial. Commercl.l.. Multi-flllllily 1% of job coil wit/!. $]9.50 minimum
S99.,0
$39.'0
Elllmed Coat S
s
s
s
PAID WITH
.50 ,SUILDING PEl::" nr
f"UV.ll
(om.. UI.o.l,1
This Appli..tlon Bec:o.... Your BulldlaC Permit W.... Apprand
a_I.. OtIktoJ
I Paid -' b.,~..::.:;.-~ :J_.
I ~'IeI-j)L{~DruBY ~
, "l'I2) "7-_. fa. (952) "7~2"
h..
U ..., ..el.. fur .U. ,
""" ,." ....,.."'..:............I'~...' i" .. ,. '. ',". j , "., il'
e, .,." ,,1,.,,1,. """'''''' ",.,,"', , ...., . 't..' ,.'..... p~ n"\.. '.. ..1
. . , . . "'T\ ,'.. . "". .
J r ' . ,,,. '~'''''.', .",..' ...., , ",
l_', :,' "1- ';!'-:-I I ~ ,,'.-, -'--::'!, :-./0 ," . l ,~. ..,' . .:' . "..-4
\{iI1i0k,;""'"',;iih II 'i:i~~ Pr~<i( ,['.; ;:~ g~ . ',,,!
i'::;f',n6'2:J.9Et~~!ikRA'~~~~p,il . "I('t'l/_ /\ /~7', 'i;. TVPEOIFSTRUCTURI; '.Yellow C.."=,,, ,,~
".' ; ..!: , ..., : -- .-- .""~-. ! .f. _ -' ." 9rrnt11-I.'&'O.,."/ U. . . a:
,.' . I.. I '-k M~' 5 1" . , , . l-
i.',"" Pr.pr,..... e, ,53[2,: '.'," '. (,0
ij!' ';" ;:i: 1;." rr ';" i ' I. ;', ". Single Family 'ill- Two-Family i'l Mulli-Family 'jil-
. II HEATING Af\PLlC~IO'" IPERp,tIT:. ; .. . 'i , .' I .t.
cD' ; u I kJ":11 ,.1'" i ,'I!: " "; j t. +"':--.:'2 :TeLO' ::2 L -0 Commercial Induslrial" ..' Public Olher ' ,
Lf)' . ~- )f-~O ". -,\,. . I'" 'PIO,I'-'i{':J:-~(9")" - --0';;; _ " _I '
~'~~Ie::;:' i,!::.,~;:;ilIt<i"'",: ;','1, .:,:- (. '1
"",SleAddress '45dn., .I.~", lL"T"'. FeJSchedule : . ,I:
. ~" ~ -4- Block -f:i'!if\ddft~r ~i; '.. '.'..:; ,", tb::IJ~(! ':t9~ . l~d~~lritl, Comm~rciar & Mulli,Family " <:! 1% 01 job cosl($39,50 mlnMnumJ!;:.
I ., . Il: ~ "".oC" ~"'.'" h"".' 1.\,. ."..:. .... c"_'" f!...__,..~I, Heating & AC '.' .' $99,50 1('
Owns,'sName :~'Wll ~kJ' ~~. k,l:.. ~~ ."" '! j" . ."
I' .: '. . "', -S."'I ~". ", ""'1:'i" '.... . '.', ',,' ;' Residelillal, Heating Only i '. " $64.50 ,'J\,'
.... . . -' 'I'\.l,::;.-!.: k'!. I!, . ~l .,:11 !f -. ":J :. I -'". .':_. ,".
. "Add' ra.a 'r . 'II~ ....;,,; b' '. r. Ii .~+, '.,. Residential, Gas Fireplace . ' " . . $39.50 '!
I _. _ "--1 __ . ,__ . ~_ ! .'. I '_~
i.',., . ::Pil~.'I""J\.f~.'.jljyjt'''l~~",~.,.".'~.:(:''i,.i.!~.1:I'::i:. . . ,_,-_ ~. ,~,Addllions&Afterations [j.i $39,50 :f
Heatllg Contraclor ,. 'NI' ~". ' . ....' 'r" ~'. . ,,,,. ,. \.iLO '.JJt..\\LG- R" II I A" 0 Iy , ". '. $3 50 '
-.1' ~l"l~- !':;~'...'. .:l ~':'I''''f' j'.. f",:';' '1"1'; - ,e~~~n:~, ~ n I'.;;. 9. 'I~.
; \'15 ""',^",w,:',", lA'St.",,,, L '.', . 'ji"
Address t:l ,,' '.~ il ":'I':J1l.Hx!: ,.: n::v!. ,'.. "--:. "." ~ .i -,;: ~ .'~_' 'i. ~~~:
. · . n..,\'~.""" \.' i 'I; 'Lh;\l't :;lQ:;." II; ,*,.:1 I 'i1,,:J.,' R. emet\.ber to add lhe State Surcharge' or;'lhebottom oIl1lls applicalion .1]1
tersphone' '--l.'.':>ll~. 'i~.; i-,.-:-:tWJ: 1!...-.,;.,C)"IO.r>;\'J ::, -:j; , -:;~ J!t
'~I' urn8CII Make & .MO~~I.;.I~:.:' " ,:,;j.' l,'-..', :1.; j ,~~iq!.s:ts:.~; ~.. .'I.!. ."; ~l\ Pri~e 01 your heating penTlI includesi li~e; ro;ugh-in and one linal inspection, ';~
~ ..;,.; ':,' i ;~ ;l....~ -!..~, FWarmAlr1lJanfa: 'll . I .~ ;," ;'il
~del Size \:) \! $1t~I:.: ItJ; ~I,I GravitY !. " 1 :,:., ,: Adciltion~1 inspeCllions w\tI be bqred al ~5,OO .~h,ll.
~a: C'onn Load :':. '."- .i:i; HI I> i;'.. ::, ,'AlMla"!janlc:aj. ;:1'; ~e 'H~~ling Tes' Record musl be Subm.~ed ~h buiIrIJog IlI1lDiI DlI!DIm belore bUDd..:!
. " . "~dklo"""" .,. ..' . -.-(,. J ".
([I" J.i .10':1 'I,.j :1.' '!I i:', '!~'I, .. 'm~ ....:ing!:eIi,fiCaleoloccupancywiflbeiSSul!d.:.;,; J'
W Fuel ~J.ut1 FJuiSize . ,.~l ,. ",", '!Ven{sYslem ", .' .,1... ."" .. r', ! ':. 'If;
~ i,.";i' "'1' i." "..,: .: r:I'.' ..i",. .., ~CALCULATIQNSREOUIREDwkhnumb'rof8UpplyandralurnopeningsIJSledpEll'
LL ,~ply Openings .0:.... ., ';. . ;.;. .; .i, '!,'i ; H~)1~q,OR:fO~~~ PLANT . mO(1l with C~ per opening. New stru~/u're~ o'raddkions send floor plan wilhsupply ti
0,: ',:i.,. ,. ,,::, .~, ,il.'::SI~8/!1!.' '" '" "1,: . 8!ldrelurnlocallonsshown, HEATLOSS!C,ALCULATlONS, PAYMENT AND ,
~ F.leIvrn Openings ,"';; I, , . .,,::: JjOll!YaleJ\" ., API'L1CATlONS MAY BE MAilED TO TH~.PITY OF PRIOR LAKE, 16200 EAGLE
~'.'\.' '.; II ~ !~l;:i]'!hl': " ,lijJuijljOfl" .:;1' ',..:;'C~EE.,. K..1AVE.S,E,PRIORLAKE,MN553. ~~':'~' .
::>1~pu1 (fUlPtoll."", ,.1,,' ~S'iaIDevk:es"I"'i'!' ..,j" .' I.);..:..
i". : .-:: ~.. 1;:1 ! '-:i~ :'.,':' -:1; l l ~-r~: ~.: j-:..l~!- ,"1 oil ~.. ~~ ;H"l bus.Jness hours are 8 8.m. - 4:~.~~.:-i:~-' :I'~I
E!F'~! '. ~ !. ':' :. .:;. ';,'~:: ; Jt.~ De;,lt.s~ ':;.: '.' ALi.'WORK MUST BE INSPECTED (ROUGH;IN AND FINAL). CALL CITY HALL~!:
Cfm l;'.!I; ;;',,',1-1\': 'Il Y . i,' '!.;,' , ,j'.:,. ,;.' .I' if
~; , r !,~:;=il; : ijl,.y~~,o~l: ;*1::: :I'r.:, ),:: .'. : . i :h~;~~ apply lor a mechanical Sy~!L:~:rmil and I acknowledge lhallhe :}l'
N " .1 ,1:1.:, ,'i", I:: ,:;" "~f . l' r:.:: Ii, . ! ;i~' " inlo!rmalion above is complete and aCc~ialtiii'lhat lhe work will De in conformanCl8 ;i'
.... ~.k8lations 'j: :~~FIa,:i~l)I~r:~. " ,", ~ew, ~~nsl~~cti?~}i . wll~ .11'ie; ordlnanCles and codes ollhe ;~i1Y; ~':Id ~ith Ih.e s,tate bUJldlng/meChanica~..;
lSl J. I. I;,'" 1." "", I,. .1[1 I '~I!'.' ::1. ~,: ;.:/' codes; Ihat this form does nol Deco"!li a !"ermll unl.1 Signed by the BUiLDINGf :
re repair '" ;; :ESLI,. ~~II:\Y~~J.; ;. i: i .. .. i.:! :" i'. .: ~FFI?IAL; thallhe work will De In a'ICord,~nce with the approved plan In the I{
cb ESI, Cost $ 1:,:..1....' IIJ:I.'.;~~I.iqin~I'p. ;m~ Ii. : " ' '.;.. '}':'" case..~.., all work which requires rev.ler. ra,n~.approval of plans, I.~
...., r ". I ..,.')' "'W "Ii'" 'I, 'I' I'. '. . ..', . '''.:,1 ".. J."
iHEATINGPERMIT~~E~, "i!..J:'!:,i;!i:..I::.!~~',\I.t~.1 . ;::-!P~IPWITH ,dJ~ J<. 0I'reJ,(l~..J)i 4-1 r-()(.(
a: :, . '" ,', .1,' '...."';; i.~....15' '.'0' '; .:.~. :".s '''.' '. BUII,l)ING PERMIT AppJicaMf Signalure l .','1 ,I, . Date I 'f~:'
STATESURCHARG~"$ ,.j,....,.:.!... ," 'ii"."'''' ""... /}, _: >/.. 1.'-0 "
r: ." - '_~ '>r i; '::J' I :.;-:q.. :~; ".i 1: :;( ,l,:J ~~_~:)l Q: .I , .!: I . . I. LfJ./ . : .~; ~.,. I '. t' '-1' ~ .: ;'.
TdTAL PERM!TFE~S "'.,1 :.-.\ ;~ :::, :'t:r'f~ ~ .., BUild\rlg Offical's Signature' . Dale .. ;,
..;. .' ,'''... _
;--,T
....
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permi1 No, 0 (~ 0 139
Prklr Lake. UN 55372
HEATING APPLICATION I PERMIT
n. Date ... _ :l.. - \
N S.eAddrsss . \ ~ l) -b Q A~u,,,,, C-\-.
~ let ~ Block'J., Addltlon 'l, l\AI \0 \--\; \ \ s tl>;..
o
Z Owner's Name ,,( -..r W l< ~ \\ \., 1'l't.5
AddrellS \ ~ \ "10 ((.,' t-\ {\~ Q (' l~_- '-',\u.
H&8Iing ContracIor r\..i".." t't; ~ \" L
Address \ "" ~ Y. (J \..l 'i\.~ (M'-' '4", (
'1 O;~- "'~l- ~\~'-\
PIO.
Pf'I::'~ '-l.ij~
Telephone II .
Furnace MUs & Model c....,-,..~ tv-
Modoll SIze ~ ~ f\ - ~ ~
Conn. Load S S' ) 3 ~
Fuel \'l c.. -\ Flue S i:u f'v t.
TYPE OF SYSTEM
Warm Ail Plants X
GlIIvilV
Mechanical
Air Condilloning .x
Vent SystBfll ~
HEAlING OR POWER PLANT
Sleam
HoI WaI8r
Radiation .
Speda/ Devices
Supply Openings .
t~
.,
. OlApul ""_ ~.. ~
RetUln Openings
l!:i iIlpul ~a\l<:> ~
([ -.
~ Edr,
I- .
~ ctm.. I ~ ';).S
0I1ler D8'llcea
:E
([ .
re Akllt'atlOf1s
~ RepaIr
TYPE OF WORK
Replacement New 90n~lUcIIo~
Est Camp_ Dale
'\ M~ (.)?'
0' - o.L3;t
~ Est. Cost S
'"
~ HEATING PERMIT FEE $
'" STATE SURCHARGE $
([ , ,
:E
TOTAL PERMIT FEES $
Build'1n9 Permi'
,
.50
PAID WITH
BUILDING PERMIT
...
Rec.", ,
I. PIU
2. GmIr:.
J.v.a...
RIo
0tJ
~...
TYPE OF STRI,lCTURE
Single family
c..".. :aJ
Two-Family
Industrial
Fee Sc:Iledule
Induslrial, Commercfal & Multl-Femily
Residential, Heating & AC
RHidenllal. Helling Only
Residential, Gu Fireplace
Residential, Additions & Alleralions
Residential. AC Only
Multi-Family
Pubic Other
1 %.-0/ job cost /$39.50 minimum)
$99.50 PLEASE NOTE:
$&4,50 Air Conditioner Units CI1Il1IC
$39.50 Encroach Into Required Side
$39,50 Yard Setbacl<s.
539.5C
RemerTtler 10 acid 1hB Slale Surcharge on the bottom oIlhis application,
The price 01 your heating permit includes one rough-in and one liNll ",~""..:_n.
Additional inspectiona w~1 be blled aI S3S,110 each,
House HealingTHt Record must be submitted wilh bulldillQ llm!Ilillllll!lll!bofote build-
ing certilicale 01 occupancy will be issued.
!:IW CAlCUlJiTlONS REOUIRED wth number ol supply and relurn openings listed per
lOOII1 wth CFM's per opening, New structures 01' addaions sam! Door plan will supply
and lelUm locations shown. HEAT LOSS CALCULATIONS, PAYMENT ~D
APPlICATIONS MAY BE MAILED TO THE CITY OF PAlOR LAKE, t6200 EAGLE
CREEK AVE, S.E. PAlOR LAKE, lioN 55372. .
City Hal business hours are 8 a,1IL - 4:30 p,m.
ALL WORK MUST BE INSPECTED (ROUGH-IIII AND FINALJ . CALL CITY HALL
~7-9i!iO FA/< ~i. ~,*5"
I hereby apply lor a mechanical systems permit and I acknowledge lhat the
inlormalioB above is complele and accUlale; !hal Ihe wolk will be in con/ormance
wllh lhe ordinances and codes of !he cily and with Ihe alate buncling/mechanical
codes; that this rorm does not become a permit unlll signed by !he BUILOING
OFFlCIAL; lnatthe work wnl be in Bccoreanc. with Ihe approved plan In lhe
case of all work which requires ,eview anel approval or plans.
'-"\\ C~" " I~~.
~) .....1Slg~,'-....l.
.' ~. ,-,I.
i .j'/~"" "i": ""/,- .. *
...---- BwUdr:rg ()f6e I ~~
~~-\
Date
.3-~-{) I
DBte
PRIOR LAKE ,DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS I Y 9)(') ~~ C+-
NATURE OF WORK ....lf~
USE OF BUILDING . Sf' fJ
PERMIT NO, n 1- 0139 DATE ISSUED .;t -It- - 2ClO I
CONTRACTOR y~"..~. PHONE'1S"~ -~(~-Y.t"<:c/
NOTE: THIS IS NOT A PE'RM!T FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
';;~ECTOR
, FOUNDATION (Prior to Backfill) I tJ;r. I ,3 r ?.-1J /0/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN Si'GNED
ROUGH - I~S
SEWER I WATER I SEPTIC tJ:r~/UJ ID I
FRAMING "b N~ ,5' l::;JOI.
INSULATION '1?l,0'4 sf+!cl
ELECTRICAL
PLUMBING 1b .\l/W(/ ~ J ;74101
HEATING (if required) g, C~ ~ h,,\o\ I
FIREPLACE <f:,:J~ ~)4 ill [;.(,.. b.,,'IJ 17'?/O)
GAS LINE AIR TEST ~ ~ L/~5~1 I ! --
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/~
':t.0~
fff:h
l,V
0eck. 1h~.\
DATE
I FOOTING
I 519/N
GRADING (Prior to Sodding)
BUILDlNG1.C'.D. tiJj e I tJOl--
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
~;;~?
7 J ;;z;) &1
t '
0/c;.()/~J
7/;;zc,f(JI
BEEN ISI<3NED
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,
Call between 8:00 ~nd ~:OO A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS j L/S"(t'){)
!<."Vt'^o c.. r
OWNER
CONTR,
PHONE NO,
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
6FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(7 rtt/(!/ - t? /'-
[/JIb gnrf- & t
DATE TIME
If- :13-05
Vl?rwe. II
(?{-)39
,:;i!CExJ~ILLlNG
o COMliEAlNT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,<;7-'1'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
lnSpecto~ --" Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
\
II/sOU
SCHEDULED 7-/7-{)/ a:3o
J!C~'
OWNER
CONTR,
PHONE NO,
PERMIT NO,
1-13 '7
o FOOTING
o FOUNOATION
o FRAMING
A- 0 INSULATION
n ..e-FlNAl
o SITE INSPECTION
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o jlLUMBlNG FINAL
P"MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS liNE AIR TST
o
COMMENTS:
-
o/ak ,,~~rodel b\ CJ~
~~^
"",lll- ~ rr ~elofllL~'
~-\n ~v/
. -.1 I' -
~'~5- ~J 1,": Te..<Mf C.{) r
-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~~CALl FOR REINSPECTION BEFORE COVERING
Inspector:b ~ \lf1..l.t..pL- Owner/Contr:
CAll 447-9850 FOR THJ NEll'T INSPECTION 24 HOURS IN ADVANCE,
,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
ILf '5CJ ()
SCHEDULED hjzztt>!
~CX-;
/1: 00
OWNER
CONTR,
PHONE NO,
PERMIT NO,
or - I "5'1
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH RI
o FRAMING {f)0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL ~PlUMBlNG FINAL
o SITE INSPECTION 0 MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASllNE AIR TST
o
COMMEN~Sr1J (I(),,~ up ~-~ ~
.J:t;:;,. p .
@j /Jb,~ ~ ~ Vt~
'*" r~-~ ~ I '
&)"k,J2 ~ ~~ ~ .~
R~ 2/XJ( O~ ...(\~I
(11) /~ t?...44';- t1~ '
u
*~ ~ ~(};-,,/ Ajp U-o ; ~:".:J
iYl r; r' . I? 'A/i'~ U-( ~,
{~ ~ AeJJ -~, Iii vJ,c.f/-~
o WORK SATISFACTORY. PROCEED
ill1CORRECT ACTION AND PROCEED
(0 CORRECT W~CAll FOR RElNSPECTION BEFORE COVERING
Inspector: t-~. Owner/Contr:
J
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE !3j2.0 /0,
INSPECTION NOTICE SCHEDULED II: {)O
ADDRESS I~StJ(} RAU /:;.,J (I:f--,
OWNER CONTR,
PHONE NO, PERMIT NO, 01- /39
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EX/GRAD/FILLING
~ MECH Rl 0 COMPLAINT
WATER HOOKUP 0 FIREPLACE RI
SEWER HOOKUP 0 FIREPLACE FINAL
PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL " '--.J~ 0
~ n..i-f/' (I~;;;L::'- oJJ
COMMENTS:('ii)
(lwJ~ I
@1~ ~ ~
~ ~ '~J?J-,
~~ -Io~,
(;
.1 II I/'J
\ Tu&1 I'-- ~ - ~ .~ -
"'" O~ vJ/WfI!~~, -~o~
4'( Pilt_ ~f ~~ ~
~ A..A :UJ - ~
o WORK SATISFACTORY, PROCEED
)It CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
~,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI