HomeMy WebLinkAboutBldg Permit 04-0624
(Please type or print and siltll at bottom)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY C~ECTION PERMIT
~
1 While File
2 Pink City
3 Yellow Applicant
ADDRESSa~34 (\Db~cd-
T\r~\ \
Date Rec' d
ft. 1,.04--'
I PERMIT NO. d 4- _ 0 lit z+-I
NW
L~:;a::::TI\ON ~o::I::~:) Th e. W \ l d s S D~+h
OWNER
(Name)
TIt
~.D.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
~\ \Lb
ZONING (omce use)
R-(
PID25. 3~z....ooz-.O
(Phone) 9 C; ~ ltbl- ?/1~~
\fY\V1 5S () ~
/
~;':~e) l1.Sa. Yhl-3Qg4
----~
(Phone)
St; OaD
TYPE OF WORK. ~ New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
"ITAddition OAlteration OUtilicy Connection 0 Misc.
~JM~+
~()'i
T.e . eJ)V\~+
'- ~V\'^ \.I
.p.D. 61)~ S \
CODE: !ll:D:.a.c. DI.B.c.
Type of c;nst!mction:
Occupancy Group: A B
Division:
I
E
III IV t9 A.<1f)
H I l~ --ae> S U
2t'!'lfP"'5
\'YW)
PROJECT COST IV ALUE S
(excluding land)
/86. 0<:> ,~
~ It}-It (j....f \
J..or-
I hereby certify tha.tl haw ti.tmished informacion on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoflzed agent for the
above-mentIOned !property and that all constructio ~~.~~~rm to all existing slate and local laws and will proceed in accordance with submitted plans_ I am. aware that the building
:"0,1 "0 ,,,uke th" PU---"7"";O Fn" ~"'bY '1<''' thot th, oty offici,1 0" d''''Or t;9"hOO the pmperty tn p"fo,m oeeded 'Z":~ -0 y
Signature Contractor's License No Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace 'Permit Fee
II
F
1
#1)(0 ,OtJQ. Do
$ . 1
15.~_'? So
$ 9.,".791
$ qt). tJo
$
$
$
$
$
/tJO.lJ 0
IOo,oa
3'.5. $"0
LlO,oO
This Application Becomes Your Building Pennit When Approved
~ ,r,;. Q,..
Bllildin~ Otlicial
t/? zh t(
Date
Park Support Fee #
SAC #
-----
Water Meter Size 5/~
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
TOTAL DUE
t~lJ &. z;J .0 4-
$ 8So, 00
$ 13~o. tJ CJ
$ 300.00
$ 70.00
$ 12.00, 00
$ 1 tJtJ, () 0
$ /SO().OO
$
$(3, fj~5.'1fJ
t.i'i<j()~
Paid
Date
./"7___. ./'
ki<t"h~, . l'?r I Receipt No.
//7 - -;:)YJ -rJl{ By /',
';:}
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 constJt temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate llf Occupancy must be
"~
Plannrng Director
/"k 2j~ 4'
; ( Date
~~~
Speci~ondit1ons, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~
~~
~ - Bull"'in!}
c::::Q!!'la"" - ~aineerlna '")
Pink . Planning
Thr (-"nlf'r;lIf lhr 1..11., ('nUlllry
BUlLDIN.G PERMIT APPLICATION DEPARTMENTCHECKLI~
NAME OF APPLICANT
I
-/- (,
,-.
(~'o tJ n-'!L-V {:,::rl U t-_}
APPLICATION RECEIVED
&;.2-.04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Z S 3 4- GuS (!i-f-/"- -/1';'.f-11 1--
Accepted
)(
Accepted With Corrections
Denied
Rewiewed By:
/J/J4lJ
Date:
~-Is~o~
Comments: ,C::;AA RAv..er!':A Skip- fm Additional Informationl
Drivewav Must Have A Concrete Approach
1J1~//rt.,.... el'{)SIO^ ~/,.Irt> I
p\ Ic./'/':'&,I.
v",/,/ Tur!! / S
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
.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."
~~
u.~
White
Can
Pink
. Building
ineering
. Plannin
Th.. C..nl..r:"r lhr I..k... ("ountr1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
N.J!.ME OF APPLICANT
APPLICATION RECEIVED
T-. C.-
Cli IV JT fL.-v'::.:Tl C /---)
&'.2-.04-
.
~
T~e Building, Engineering, and Planning Departments have reviewed the building permit
aRplication for construction activity which is proposed at:
2'234- L,U/)(!hT7 k:.lilL---
A9cepted
D~nied
R~viewed By:
C~mments:
Accepted With Corrections
/
~
~~~
Date:
t,/If /<Jif
I
"l'he 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
p~suming to give authority to violate or cancel the provisions of this code or other
o~dinances of the jurisdiction shall not be valid."
~
o~~
c- While - Buildino
Canary ;: t:ngmeering
Pink - Planning
Th~ C..nlf"r nr Ih.. 1..k.. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
T. c... t.otJJTtzAjc:A1 00
t.o .'2-.04-
T~e Building, Engineering, and Planning Departments have reviewed the building permit
a~plication for construction activity which is proposed at:
2634- BOr5MT ~tL.--
Adcepted
DE!!nied
Reviewed By:
Cci>mments:
Accepted With Corrections /"
~ ~~ Date: G// 1!tJ l-j
~ o.-U ~~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."
FAX NO. :6514637835
Aug. 30 2004 05:33PM Pi
FRm1 : FAR/lItjGTON PI.G & HTG
Dale Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
; ~-:. ~:~ I PERMIT NO.OA.. D{pz.tU
I Y~IIo. AppliCMl -r . ~ I
(Pl.:uc~ arnMt usd sim a.t bottoUl)
ADDRES~
ZONING (0""'...1
~~"1,4
e,06 (' I"->.t
LEGAL Dl!SCRIPTION (olli<< "'" onlYI
LOT BLOCK. AoomON
PID
O~ER \
(Name) To. CoV'\. <;'+ Ir 11.J ,'0""::..--
(Address) ~,c,. ~"l"l 5 {
APPllCANT 1
(Namel . 'f7,.rM "'^U'iaV'\ (phone) &<1.::.'::1.(",- 78:2l.!
(Addn:s$) :;"Ib.-;4 C(;h:~JCl\e Ave. ~"'rYIil1.f1lo" 5.50'J.U
AddrcSfl (CIity) (Zip Code)
(Conuet P~D) J; \'VI I J) (:> ,"- (PhOlle)
APPLICAN)I'SlONATURE'V,....".;,J) l ~) DATE R-30-o4
APPLICANT PLEASE COMPLETE BELOW
Type ofFhture QUlltity
BaJ:!1 Tub with or without shower .3
Dishwasher I
Ploor Draln I
Lavatory (Balhrooni Sink) I
Laundly tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water closet (foilet)
Q..IIUly ,
;;L
I
I
4
I
I
I
3
(Phone)
Type or Fixture
Rough-ins
Water Heater
Wiler Sollner
Stand Pipe (Washing Machine)
Sewage ~Icclor .
Bac:ktlow Assembly
Backtlow Assemblv Test
Lawn Sprinkler
Other
FEE SCHEDULE
lllduarial. ~Ial ... Muld.l'omlly 1% of job COIl willi I S39.$0 IIIInlmum Raldendal. New One & Tw",PlIIIIlIy $99.$0
Raldential. Additions & AltonllOl1l S39.30
E.stlm.t&d Colli $
BuUdIn& PonnJt N
PLUMBING PERMIT FEE
ST^ re SURCHARGE
TOTAL P!RMIT FEE
PAID V\'Il't!
$ .
~ .SO.,B~:o~,',..'I~fi'::,
. ~r ~ ,-<meB. .,. Ii ..,/ft,.,.,
17 00 '11- >, It.: lor ,.; "'.' - . . .
AI", u" t1 ,... .
~l~:': n 10;' ~C,,~d""
(Gm.1Iot 0alJl
nil AppllcatJoa Beeo... Yo., a.Odlac P_lt Wb.a App""'od
.
..a.u.. OIDdal
0...
U ...r ..tlu t.r 11Ila.pedl... <"II "' ,~. In 19S1) "7-4145
5073344811 CANNOt,1 VALLEY MOTORS
CITY OF PRIOR L~E
PAGE 01
9~244?4245 f.01/01
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONINGIFIREPLACE PERMIT
nata Rec'd
fflcaMj'tDI or~tazvl.Pn II boDOm\
i ^+,OR.ESS
:: ~~, I PERMIT NO. /Vi. otZ,ftl
J. .....1.... ,.".-l_r v-r. le' ~- I
2?.J~
gJ~
IY4'JC
I ZONING (011I'..,,) I
LSGAL DESCRImON (ofl,e... 011I)')
r.OT
. oWNER
(N~J
BLOCK ADDITION
PID
Tv en. ,r
(Phone)
(Alldreu)
ABPLICANT / J,~ ''l--.
n-!ame) H, r ~~~,.
(Mdresr) -2,t/71J/ ~ "U-
L (-,ddm'si /J
(C~ntactPeuon) "L7 tl:1vj /1/1.,.)( ~ (Phone)
A~LlCANTSIONATURE _4*,~d 4I1~1..-- DATE q-JtI~AlI
. -~P~ANT PLEASl; COMPLETE BELOW
~wc~cnON o REPLACEMENT DALTEIlATlONS .d
FU~ACE MAKE AND MODEL I..~ FUBL ttlJ.!-
f'tWESIZE .?/'tre...., RNOPENrNOS r INPUT t~AU OUTPUT)>JA.o
TYPE OF SYSTEM KEATING OR POWER PLANT
Phone)
c- -7,r")7.!- '77?
J-t11-
(Zip COlle)
fl......
~.
Ow""" AIt PI."..
~r&Vit.Y
ec.h8l1ial
r Coftdilionin.
Vent. System
OSICllID
o H01 Walef
o Radia.on
o Sp<<JII D.vle"
o Other ~VJ.CCJI
PLItASE NOTE:
Air Cond~ioner Unll'
Cannol Eneroll(:h into
R.equlrod Sid. Ysrd
SetbadJ
F)RfPLACE MAkE AND MODEL
Indu'lri.t, Cammcrc.i.1 &. MlIlti..Farnll)'
RESCHEDULE
1% o!Job CO" lU.ldon,ill. a.. Plrcplaee
Sl9,'0 milllmum
$99 SO Residential. Addition. 01: Alt..-.;o..
S64,0 l\Coid..titJ. AC Only
S'9.$O
$)9.50
$39.50
Rl!.si~entilt. Heating" Ale (N(:\11 Con.ltructlOI\)
RKi4."tral. He..ln. Only (New ConS1ruetion)
HEA TlNO PSRMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEl
s
s
s
.50
~P.\O~~
~\l\
Estimated Coat $
Bulldlnc Pormit N
1011I,. \JI< o.ly)
ThIS Application Becom.. Your Bulldlnl Pornait Whon Approved
J.lldt.. Ol'lel"
Il'iid
I Dale
D.k
U hour ._,.,. .n Ioup""lo.. (m) ",.,.,1( fu <'U) 441~
I R.cocipl No,
lIlY
TOTFl. P.01
PRIOR LAKE
INSPECTION RECORD
SITEiADDRESS Z8:3'/ "'&~,. \R.A.;L N.W,
NATU/RE OF WORK ~E.~ ~'\Ta..""n~
USE OF BUILDING c:;. F: 1:)_
PERMIT NO. tJ ;' .0(" z.4- [),ATE ISSUED lD I , 1/0'1
CONlfRACTOR 1:.C,.. r-1~n~ PHONE~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I FO<!>TING<7'.......... J...<,tz.
I. _
, FO~NDATION (Prior to Backfill) I ~-z; ?~ ~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
r- L::? -:i..
y/tP
SEWER I WATER I SEPTIC
FRAMING
I
INSIJLATION
EL~CTRICAL
.
PLUMBING #fA
HE4TING (if required) ~
FIRl:PLACE
GA$ LINE AIR TEST vvr7 q-L.<J-CA.-/
. CC;>VER NO WORK UNTIL A~ HAS BEEN SIGNED
~(,rlJ"QJ ~ In :/-25 I
FINALS
All> 7.zc.yI
ff)
q - .Jo -rJ1
eJ /y~tf
Cf-kJ-dl/
GRADING (Prior to Sodding)
BUll-DING 'T.-.y i-> 8- f-...~
ELE:CTRICAL
PLUMBING W"c..
HEATING
DO NOT OCCUpy
B. 8- O<b
fr!l:f /J,/a;.l J~ l/
%' / \, II . ~
UNTIL ABOVE HAS BEEN S~GN:D
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
QIrrtifiratr of @uuvanry
CITY OF PRIOR LAKE
~rp(trftUruf of 'lBuilMug Jlusprdiou
~ina1 Permitted C Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section 1]0 of the L Residential I 1--= International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances afthe City of Prior Lake regulating building construction or use. For the following:
SINGLE FAMILY 04-0624
Use Classification
Bldg. Pennit No.
Occupancy Type
Type Construction_
L2, Bl, THE '^,ILDS SOUTH
R3
VN
Zoning District
Rl
Legal Description
Owner of Building
Site Address
2834 BOBCAT TRAIL N.W.
Contractor's Name & Address
T.C. CONSTRUCTION, POST OFFICE BOX 51, ELKO, MN 55020
ROBERT D. HUTCHINS
City Planner_
JANE KANSIER
Date:
Building Official
( /
H[
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE nME
7 -J,ooj
ADDRESS
7.BSY Sob&, f Tr/
CONTR. 7 ~c. Ct1I11~ j'
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MEeH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
bAHt, - ,") /(
Cv/6 }'2,n/.-aK..
1/, '}Ii.
() -t, '
,)!'~ILLING
O'COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
:;JfwoRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: $k~ Owner/Contr:
CALL 447-9850 FOR THO: NO:l(T INl';PECTlON 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
'NV<<>"
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED 8 -8-G?'(
ADDRESS ~ ~3i ~b~CJf'-
OWNER CONTR.
PHONE NO.
PERMIT NO.
LJ-& 2q
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.)UINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~ ~~~TST
COMMENTS:
0lf
I
4~
,
II"')
('(n<p 'j N
c
{
In
'-
V WORK SATISFACTORY, PROCEED
~ CORRECT CTION AND PROCEED
o CORRE K, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
50 FOR. TH.1S "EXT II"RPISCTION 24 HOURS IN ADVANCE"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1N$IWn
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
d-B31 ~~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
:Ji{FINAL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE T1ME
~
i - fR ;).1
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
1..-.E~ Q~ 11Ag,~~W\ 1_\61.6 ScaO
? M"':I~/^ '7'm<~/J\. (~.)
-So ~~IlQ~
~~ d1~~ ~"_
o WORK SATISFACTORY, PROCEED
o CORRECT A ION AND PROCEED
'!\,COR CT 0 K, CALL FOR REINSPECTION BEFORE COVERING
Inspect Owner/Conlr:
CA
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSIWTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1.8 34 ~brt'AJ:
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
'I2l' PLUMBING FINAL
/O"tolECH FINAL
DATE TIME
IPfti
'-1_ 42Y
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
L ~rh~f<;;1~ crn- vr;;fJ-7~/f8
;. D_,,, C':rl"l>'~
<.(. tik u(.J d,..jLdJJ:'''' 9.. -
,"5. C. &.0 ('f Q&-_ ~-
Nt') ~'IA. 8>""'-9 10 tU:l&-
~
o WORK SATISFACTORY, PROCEED
XCORRECT ACTION AND PROCEED
o CORREC K CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
.-....
Job Address ~~.
Heating Contractor
Name 01 Tester
.Date
Percent 0
Percent CO2
Percent CO
Stack Temp.
-