HomeMy WebLinkAboutBldg Permit 03-1326
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
11. fl.3
1. White
2. Pink
3. Yellow
File
City
Applicant
I PERMIT NO. 03- f3 2& I
I I z;;~5E"use) /
(Please .!VP~ or Drint and sign at bottom)
ADDRESS
/L/ObJ J-I-C.6 r /" k
C'nte.
LEGAL DESCRIPTION (office use only)
LOT q BLOCK I ADDITION ~. iJ5 Nor M
;
.
I
PIDd5 - 'ID L~ Otfl(-t.,
OWNER
(Name)
(Phone)
(Address)
'---------
BUILDER (7
(Namp\ C..,J~;0- . r..rJ.,,1'1 6,^;/ckd
(Contact Name) . /1f:,. W' aldJ",.PJl
V
(Address) Z2B-? 6x...... Ave /"/4"''//~
1
(Phone) 9,Z-l/{,'j - /(;,//
(Phone) (,f 2. - .1 Z?lj Yz.-b
TYPE OF WORK
~ New Construction
OLower Level Finish
DDeck
DPorch
ORe-Roofing
DRe.Siding
o Fireplace
DAddition
DAlteration
Dutility Connection
o Misc.
PROJECTCOST/VALUE (excluding land) $ 32'>;000
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 awar at the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
:.... -Pl~:;rty to ~r~cspections /J b CJ 6' -n -05
.Y'" ~ Y Signature Contractor's License No. Date
I Permit Valuation 3~5\ 000 I Park Support Fee # $
I Permit Fee $ ';;l-a5"3~ 751 SAC # $ /,;r75.-
I Plan Check Fee $ 14/,,4, 94 I Water Meter Size 5/8"V $ 3X>.-
I State Surcharge $ it.;) ,6-0 I I Pressure Reducer $ 7tJ.-
I Penalty $ I I City SAC and WAC # $ j.;lOO.-
I Plumbing Permit Fee $ lIJO, - I I Water Tower Fee # $ ~tJO.-
I Mechanical Permit Fee $ J/J IJ . -- I I Builder's Deposit $ /,5t:J6:-
I Sewer & Water Permit Fee $ . 8Jj,t)D I lather $
I Gas Fireplace Permit Fee $ JI /) .- I I TOTAL DUE ~~v.a1 $ 9'':<01- to 9
This Application Becomes Your Building Permit When Approved I Paid 0/2(11 If, '1 Receipt/})l.,. '1'5/'/5 fj
~ 7~ 9/2.-1'107 I Date /0. ;; . tV Bv AflA-
J
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
when signed by the City Planner constip.ltes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
"~.
? .Il.Jl /J
/Cld tLL-t .~ /rL.
Date " SpeCial Conditi1lf1s, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
9;23hJ>
--~
Planning Director
&~
CJlIhlt" - BuildlnC[:)
Canary - I:rig,""erlng
Pink - Planning
The Ctnler ur lh..l.ak.. ("ounlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
()~l~&~~
q- ;;{ -06
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/l/Ofo/- #&l4 da/tfI- ~
Accepted
Accepted With Corrections
~
Denied
Reviewed By: ~
Comments: /3;d
~~;
::I~ Date: '1h :r~3
ad~~.
~/7~~'
/
"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."
5~1\
White - Building
Canary - Engineering
....-f-rnK - Pla~
lh~ Cfnln of Ihf 1,.lIt Counll1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;
"
/
---'
I-
i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1/ ,/ /_
(,C-,
Accepted Accepted With Corrections
/'
'" .~
Denied
~
Mc..r:
~+
~ 9.v.()~ Date: 9a--J'/d3
, .
R.t2o.d. aD ~(j-1;. _ ~
~~ uJ~ P'12..0,W, 2..t1
~ en..J- tr! ~ --P-
,
'J)~J
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."
~~
'''l:Iite - 8uilding
CCanarv - ~n9ine~..na ./
Pink - Planning
The' ("C'.Utr nf lh" I.-ar ('OURlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
','
.;
l j
':/.[~~' ,.l./i
r .-" _' /,_ ....:...-_
, ,...'
.'
--,
',"':,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ /.
/;/ f~-:".-
.,' '--
I "
-"'.-,,''-'
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
.I)"ll:[)
Date:
/0- I ~(?3
Comments: See Reverse Side for Additionallnfnrm::ltion!
See Attachments' 1) Grllr1ing Pl<m ?) Erosion Control Measures
"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,"
~~(j~(~~~j 13:84
5877445555
~_M'____"
PAGE 01
.-...." '....... ..........,.........
'- . .. "" 4 ," ~ ."..... ...."'1\,"-
"W"...,
Date Ree'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
l1'kUf ~ or DMi md ,lp ie "taocmm)
I ADDRESS
\'-10" ( Hu.os
: :::. ~,~ I PERMIT NO. ::2../-?. -, / I
'.t.l4 A""'18allIl .r JC7""'U::>,
(vJ:e C~
I ZONING [."'" ..,) 1
I LEGAL DESCR.Il"I10N (011I.. uunJy)
I LOr BLOCK ADDITlON
,
PLD
I OWNER
I (Name) Cv.dd..~r~ e-..~-6vn
I (MelIas) d-~\3::3 L...c.:.:;~ Ave
I tAd&...l
G "".' I cL-<.o--
4.~l"(((
(Phone)
VT) N
QS-..2..- '{(.<i-IeJ/
S-n;> 'f yo
(Zlo Co4<)
ICll"l)
I A P PLlCAN;l:..,
I (Nam,\ \~ c cl(f^- P X (" c, U,~
j (Address) X3"7 S- W '7U~ ..s fy-.eo-A-
I (Ad.,...) ,
S Co->- I . .s;:, YY' ,--...-..
(ContAct Pelton) ~ . ,
I ,-
lE'?LICANT SIONATURP A"'<~ A",~
1
(phOllt) '5tJ7-7 'I L(. s.-~<:'.J
L.or..sd4k S' o;vyt:,
(Clly) IZIpCo4e)
(phone)S1Ji- /V~. S"SZ.. l'
DATE 9- '3 Q""'Q$
J
APPLICANT PLEASE COMPLETE BELOW
Siz.c of waltr socvice ...Ii- inches,
Locetion of &DY couplings from ItruCl\Ue - feel.
Type of sewer pipe, 0 ABC [3.fVC 0 CUI Iron
Estimated 1enith of !(Wer line s-O feet
Clean out (if required) located at feet from structure.
-
FEE SCHEDULE
R"identi,1 ..w.r and wlIe, Ilne cOMeollon Sl!.SO Indijltrlll. Com'l '" Mylti.fllllily 1'10 of Job cost with I S39S0 minimwn
$<."er connmion only $ 1 UO WatCl connection only S 17,50
Estimated Cost S
BulldiuJ Pemlt ~,..- .
---_.[~'\
'II
\, \
\,1
oel 082003 u\
:::1 U .,-j
SEWER AND WATER PERMIT PEE $
StATBSURCHARGE $
TOTAL PERMTr FIE $
.SQ'
lulldi_, om..1
OUt
,'1 Paid
,. IDlle
\'.-._'
\
! - .--
\Po L - :::---
,~Celpt No.
tomcrt:.,O"ly)
,.
ThiS Application a,com" YOQr Bulldlnl Plrmll 'W'htn Appro,'cd
II hour nolle. ror alllnlp.ellon. (9!1) .."9150, r.. (981) ..'-414!
I By' ( f"
!
. ,,' . ~
PAID W,
BUILDING 7TH
PERMIT
12/11/2663 13:22
9524461 746
ALTA CLEARWATER
PAGE 61
CITY OF PRIOR LAKE . .
HEATING/AIR C.""," m....,.IJ.l.l:GInREPLACE PERMIT
..t".
DsfIl ~'d
;::::. ~ ,..PERMlTN. O.~...".....-!J..
J.y....."..... "..".~
me-_ttt......._u~
I A." ~/~ ( f) "~.
-IV"" /-J-?::'i"S> L-~ L-/Y .
I .,.........,"'(--
LEGAL.....o.>........ ....hlollke_.,
LOT BLOClit.
A..."i"'.&..I...u.J
PlD
. OWNER
(N1JIle) (''''.A ArL;.~
(AddIm) ? () '8>(j)C
. -
~O'- ._..,
I gt? I..T""'. .", cJ.~
(Pll01le) qt;;;..~t...f{j,"'! -i~1 L
'=~~O ~~::~.~' ~L:r~:.q~::l~'~
~) lea,) , (2ipCl>lltJ
(Contadel1oo;) Sy. ~~.' ~:,...-.. (PhaIIe) ""~7 '1
APPUCANTSlGNATUlW ~4~ DATIl'- /~ /1; /~
APPLICANT PLEASE COMPLETE BELOW
~ CONSTRLI...Ml 0 llEI'LA.CEMENT 0 ALTERATIONS '.,
fURNACEMAlaiANDWODBL lp,.h"" (""'::;-lM~-4'l\'C-IID rom. jJ~
FUlE SIZE ? . PJm)1lN w< oo.,,,,,..s ~ IM'VT 1/ (j. 61ft) OtTll'UT /,'1<4 <1VLJ
TYPE Of' ~"~,,....<<
"sr~
}f<<~:~1 .
~c.,.a-,
~VOftl. s,=a
r~..ACE MADANDJofODEL
HBATJNG Ok" ~. ".:.0. P.LANT
~~.,
tpedaI Dn"*
0lll<I DPIces .
. I'LIASI HOTE: .
Ail- P-l........ Units
. c:-.atiial:lvik:k fII\Q
R. ,", i' 91&: Yard
Sclbacb
-~---'----.----==--_._---::_'-'
FEE S('IlJ'-nVU;
IndvMriIl, Camftl<rclal ot Muld.flllllly 1% of Job CO&! RosIdeMlloI, au Pitcplull.. 539.50
$39,~ miftin>um . .. -_.~
Ilaidcml&l. HcotIll( A Ale (N.'" COIIIIIOI<lion) 199,$0 Jleriolenlill, Addlti.... A A1....rlllllt "9.50
ROJidOftllaJ.HCllliIllOnI1(NewC.....".;m) $64.'0 Jtc:sicIerilll.ACOnly \. $39.$0
&timed. COst S
!llllldllll Permit "
mATING PERMIT FEE
STATE SURCHAllGE .
TOTAL PJ.RMD':rn:
s
$
s
PAID WITH
~LDING PERM/i
(OIIa 1Jto 00IJl
TIlII AppUadioll. :' . . ,
~,.0.
By
I
]
....... 0jlid0I
., YoarBalldllllP_lt_WlleDA"'~ 11'*
_ D8!C 1 5 2003
zc .our ..etIU fo, .11 inspeetle.. (952) ",,,"so, t.. (9S%) ","J,M
~No.
12/11/2003 13:22
3524481740
ALTA CLEARWATER
PAGE 02
~002
~~~~ ur r~lU~ ~
DlteRee'd
CITY OF PRIOR. LAKE PLUl\"""&.L"''' ...~...uT
~= ~ lPERMlTNO.7 ,.,..h..
'-v..,.,..... "~
~~'!!".il.tII..hllla..bG_l
I ADDRESS
/4CtP ( HC'>o>"- L~ CAr.
ZONlNG_.J&l
LOT BLOCl(
LEGAL DESeR.... ,'vli (....... oaf"
Au.....,...,UU.ll
PID
V W"r.A "" d ~. 1'\ _"'-'""'
(Name) (,u.. - J .
(Addn:ss)'P 0 (2.,. t"to<.. I CJ,.p
I;L., .,..~
~~
tpboaI!.) <qg. - '"f(A - I u (J
Al"1"LI
(?'lame) '._ocr- +-l~ 0'h0De) qo.. - '-fL.f7-6"13o
(Addt=) Iq~o rnu.'l.h:.f--tn~ f2...J. 'P"..."'o--~ 0::--::-,..a-
(.A4dres) (City) (Zip Code)
(Coarllct Pa:soD) s....~ ~~-.., :IL (l'b.-) "'19 -<-,t. ~7 -. f""l 30
APPUCANTSIGNATI1PJ:.---1;:1.Ll/y;;...._~~ ~ DATE ~ /~-/I-0-
APPUCANT PLEASE COMPLETE BELOW
QllaRtity
,..
&1
r
~
,
/
I
:4\
1'Jpt or I'iJtare
liIatb TI1b wilh Or ';',ii",.. a..o-r
Pjsllwuher
floor DlaiIl
..... ....
LaY*!y ~"" ...." Sink!
LIuDdIY l'nIy (1 or 2 comlllltlllelll sink
ShoMr S1aII
StGlCS
fl.. SiIIk
\T_ CIGstt (foilet)
QIIutICy
,<..
I
Typeoff,,,..,,, ,
I
~.....
W'*'H_
Waller SoI:lDer
SlmIlll'ip! (WaslliDg MacbiDe)
~~
B-'<flow~
kaci60w Assembiv Tefl;
tawn llllriaklet ..
bdter
FEE S..........."..,E
Ind1lSlri&~ Commen:laJ It M1IIti.llunily. .% .fjob COIl with a $39.50 minimum RefldOlllio1,)lew o.e.t. ToIo-FIIDUy S99,~
JlatdeiltfaJ, Adcllliafta" AlolntioM S39,'0
1Ol!;c. u.. OoIYI
EJrimaud Cost S
B1Iildlnc l'etmic II
PLUMBING PERMIT FEE S
STAiESURCHARGB $
TOTAL l"ERMlT FEE' $
~,,:iO'~AID WITH
.::.;..m;n1NG PFA'll1rr
. Paid
'~No.
"
nls AppIlcMIoII BccolII.. Your BdlIiDclenait WIlllll A"", . I
~c 1 5 llJrn
By
.-.sc-'
Slott
J .
14 .our ..olite for an 1....""1.... ~Z) ""09150, flll. <<,51) "'....24S
---<.----- ----- --~ -~ ----
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
(Please tv'De or orint and sicn at bottoml
ADDRESS
i~~, ~::y I PERMIT NO-'" ".,1l
3.Yellow Applicant ~
140~1 HAAS LAKE CIRCLE
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name CUDDTGAN CUSTOM HOMES
(Phone)
(Address)
APPLICANT
(Name.' ATJJRD FTREsrnF DRA FTRFSTOR HEARTH &. HOME
(Phone)
651-633-25li1
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
1WSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
. APPLICANT SIGNATURE
BRENDA HUSTON
DATE
12/12/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN ST-HV
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Penn it # ~ Ii) \ . .
$ ~ to"",~ 0"'$1'; it",
a'~f,'! -c.
$ .\k~;':P,~ Dr"""'i."/r
~ '.< . >e,""';~,:;"
$
(Office Use Only)
This Application Becomes Y our Building Permit When Approved
Buildine Official
Date
jPaid
I '1fs 2 4 2004
.
o.
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS )4/DI. J 1IA..s l ~~ a.;~,.
NATURE OF WORK ~~, <<M,.C.rID
USE OF BUILDING ~ . ,
PERMIT NO. -.e>~. /37Ap ~::::ED
CONTRACTOR ~u.ddl-1Q^, PHON" Q. V~.. "iI~
NOTE: THIS IS NOT A PER~IT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INsPgCT9R DATE
I FOOTING (1"f7 /?i-? - o",? I
I FOUNDATION (Prior to Backfill) I J !J~ I /d -/~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INj)
SEWER I WATER I SEPTIC ff't7 I(J -F,-
FRAMING ,CL- W!::/---;{/I) /2'-::rz....
INSULATION ?~ ,K- <> ~
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE _
I GAS LINE AIR TEST N..:.- fX.
COYER NO WORK U1TIL ABOVENS BEEN SIGNED
'lATHE' / CULrpfUl) m1JG1 f:ZJ I.
, FINALS' .
GRADING {Prior to Soddin9} N /? ~0.. '7, .;;J 7. dv
, BUILDING "kvl1t/ O(-/_"cl V[1 1-?o
ELECTRICAL
PLUMBING
HEATING
DO NOT
f!~
ill)
j?IJ <'-s--
/I/J/
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.
FOR ALL INSPECTIONS (952) 447.9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
II/exl I-I~c, s LX Cr
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
b/<t~- c9~
CONTR.
PERMIT NO.
o PLUMBING Rt
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
CulL; l~o'<~ of_
DATE TIME
i-71-0)""
03-(7).,;;;'
);( EXlc@lFILLING
. a COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
SiT
")('WORK SATISFACTORY, PROCEED
v 0 ~RRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'nspector:d~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
ImNOfI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
:2 -5-0'1
ADDRESS ~ (la.c:.. LJ.c... \{;.
OWNE;R
CONTR.
PHONE NO.
PERMIT NO.
~ - (32~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATE;R HOOKUP
o S!;WI:R HOOKUP
~LUMBING FINAL
o ME;CH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIRE;PLACE RJ
o FIRE;PLACE FINAL
o GASLINE AIR TST
o
COMMENTS: _ ,; il .
L(iJ.~. ~~"'l
7 r.::~-... ;,,,..3-
~ I fN\T.
~Q~-
~ORK SATISFACTORY, PROCEED '----
o CORRECT ACTION AND PROCEED
o CORRmlE;RK LL FOR REINSPE;CTION BE;FORE COVE;RING
Inspector: Owner/Contr:
CALL' -9 ? FOR THE NEXT INSPE;CTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE '1..20
INSPECTION NOTICE SCHEDULED
,
ADDRESS ;C/O (p (
OWNER CONTR.
PHONE NO. PERMIT NO. 7-/32 (/1
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
P'FINAL o PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
I.
h'~,C;;~ ~
C/
o WORK SATISFACTORY. PROCEED
~ORRECT ACTION AND PROCEED
o CORRE7!lCWO LL FOR REINSPECTION BEFORE COVERING
Inspector: r Owner/Contr:
CALL 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSl<<JT1
.
@tdifiraft of ~rrnpanr1Z
CITY OF PRIOR LAKE
~tJ'arttul'nf of ~uilMng JlnsJ'l'dion
~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 following:
Use Classification
SINGLE FAMILY
Occupancy Type R3 Type Construction VN
Legal Description L9, B1, WILDS NORTH
_ Fire Zone
Bldg. Permit No._ 03-1326
_ Zoning District R 1 3D
Owner of Building
SiteAdmm 14061 HAAS LAKE CIRCLE
BLDRS., 22133 LOGAN AVE., LAKEVILLE 550~4
Contractor's Name & AdmessCUDDI GAN Cl1STpM
ROBERT D. ~UTCHINS () /{
_-; _ Building 9fficial V
/) ()I/
_ City Planner_
DON RYE
Date:
Date:
----"---------------
I'MJ HfrASU:.i(.
Heating Contractor
Name of Tester
Date
Clearwater Plumbing & Heating
.~
2. -'?o- 0 '-f
/j, /,
/},1"
Pe~entC02 t1.~
Stack Temp. 11' ,
Combustion air is adequately supplied per
UMC Sec. 606
Input
Percent O2
Percent CO