HomeMy WebLinkAboutBldg Permit 04-0247
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
(Please type or print and sign at bottom)
ADDRESS
//137
,6ut?F II ~/t:.h~
LEGAL DESCRi.t'llON (office use only)
LOT/~ BLOCK 3 ADDITION
~
7/mgE~
OWNER
(Name)
PVLT~ )/ot/1C5
(Address) 0-/5 J1/o;27,1//Uzsr Ave
c' -
~J:;
BUILDER
(Name)
(Contact Name)
(Address)
5Aft1 E
dlllr $'USCH/L()
TYPE OF WORK
~New Construction
DLower Level Finish
I. White File
2. Pink City
3 . Yellow Applicant
rllA-/ L.-
4tl:~T ~ .4tJtllrru.
Date Rec' d
$. u.D~
PERMIT NO. 04. oz4 7
ZONING (office use)
P()D
PID zS. +oz. ~ 82 . 11
(Phone) --.ft,5/ - .y'5Z -'S200
fYlVi. 55/2-1
Z4{,4f\.
(Phone)
(Phone) t, / Z- - ?Z,/ - ~r~
ODeck
ORe-Roofing
OPorch
OAddition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
o Fireplace
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 aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~terup~.:/~~?ns. Et -/371 a 1zj}1v
ff~'/ Signature Contractor's License No. '/ .e::.~~,!
/ .,
I Permit Valuation Ii CjJ/ tJ A PI 0
ItA. Vv- 0
I PermitFee $ laa7. So
I Plan Check Fee $ (, f4 7. ~
I State Surcharge $ 1 r: 0 p
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
lOO,OO
tOO. ao
'35".'5""0
'10, 00
This Application Becomes Your Building Permit When Approved
~~~
Building Official
4/rz/o t/
I Date '
I Park Support Fee
I SAC ...- /
I Water Mete<" Size 5/~ I";
I Pressure Reducer
City SAC and WAC
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
. Paid
Date
I ....
rJoft;~. r r
~ 4-.r.$/o~
?0~O
#
#
#
#
"
. Recetf:,t No.
BV~ .
if
ORe-Siding
OUtility Connection
$
$ t"3 5"0. D 0
$ 2-50,O()
$ Ll5.0lJ
$ /2..00.00
$ 7 () () . OD
$ /500. DO
$
$ -; () b3 .~ 8
,
"
#-' ~r
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
iss~ ~~ d1z;& ~ aL( /
- .. -4-( . r . ...-
PlannIng DIrector Date SpeCial CondItions. If any /
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
)1ain File
White - Building
<.,(;anarv - t.nQinee, II 'v
Pink - f5lanning
Th~ Cpnlf'f of thE' Lakf' ('ouRI,.,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APP~ICANT
APPLICATION RECEIVED
. ,'il- j I' , -"' ,.
',' \,. 1 l. ! C 1- [t-. .';
.'-, '? ,'/'
/:..- ~ , ,) i
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(1--:;1 " i_V r- f~ 1-'h=~-1 (-('r :;'T'jc!-/-~' i L-
i
Accepted
x
Accepted With Corrections
.... "-
Denied
Reviewed By:
AlFJD
Date:
'-1- S- -01../
,
Comments: SP.P. Rp.\ffir~A ~ir:lp. for Ar:lr:lition~llnform~nl
rYlc,t''Yl {,' (L
!V1C,,^..,ki"-' Ero(",'o'1 Lot1+fl> I vn-l," 7vl"t is G"0/~/);j4('J
See Attachments: 1) Gradine Plan, 2) ErosioI1 C;ontrol 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."
)!lain File
White - Building
Can::.ry - ~r:laineering
<:::Pink - Planni~
The ('tnler of .he takt Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1_ Tt
j I
J !( I' i L
I
'-
( /,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ e' 7
!
I L i./ I / I t ~ I ! i f r ,Tl I \ ! L-
Accepted
Accepted With Corrections ~
Denied
""",\.-
Reviewed By:
~
~
~ &..iL
J
Date:
.~Z};'1
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."
~ain File
CWhi1e... - BunOlnp
Canary - t:IlYllIeering
Pink - Planning
The ("enlf'r of the t.lkf' Countr)'
BUIL.DING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
Pu L- T6 J-Io M6S
. 4
:3~ ~1 . 04
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
kq:S1
I
15 L-V r::F H€;l ~ tiTS (1V'rt L,./
~
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~~
,e~~
f~,~
aL{l ~
Date:
I/; d-/o t/
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."
Mar 23 04 03:32p
1-
2.
3.
4.
...-..... 5.
,
"-
METRO GENERAL SERVICES
763-428-2968
p.4
GREEN - 'ILE
YELLOW - APPLICANT
GOLD - CIT't
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
FAA 95.2..- Jf tf 7- 'I' z. tf...~
S.W.NO.Y- d.-l{ TJ
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT:
Metro ~eno"?1 C'~ I
-.. .......rvlvC~ I Ie
_5790 Quam Ave. N.E. .
\:)(. MlcnaeJ, MN. 55376
DATE:
PHONE:
ADDRESS:
SIGNATURE:
BLDG. PERMIT #
,f)/u$/I-t/fIlIS/KD#
SITE ADDRESS:
;;q 3 '7
FILL IN THE BLANKS
Estimated length of water service ~
I ,(
size of water service inch(es).
Location of any couplings from structure () feet.
J }II
Type of sewer pipe. ABS PVC~ Cast Iron
Estimated length of sewer 1 ine ;~O feet.
feet.
6. Clean out (if required), located at feet from
structure.
/10--
==~==;==~;===;:====~===============-==================~==~~=======
This application becomes your permit when approved.
BY
DATE:
============,=====================================================
PL~he.d fA> ,-r4
(] lei,j FJe f.-/M I 1-
/oJtJ Fe e_
FEES:
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 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 ins.~'~ethat no duplicate sewer and water ~~.mili_ are
issuedf. L""~ll.J) ~
'" APR 1 5 2004 ~U;lD~~a ~rv~,1
DATE PAID r:: AMOUNT PAID ~-. ~l'l>>.,
r
*
RECEIPT #
REC/D BY
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (tJ52) 447-4230 I FAX ('i~) 447-4245
An Equal Opportunity Employer
APR-19-2004 MON 09:37 AM VALLEY PLUMBING JORDAN
FAX NO, 9524922617
p, 04
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Diu. Fil. PED1u'IT NO J,/ 3dfI
2. Gold Clry "'-I..... . .,
J, y,llo,," ApPU,,"t
,
, ZONING(office\l.Sel
(Please Me: or mint and silm at bonom)
ADDRESS
L\q?Jl ~ OO~ JA
LOT
LEGAL DESCRlPTI0N (officr: U$e only)
BLOCK
ADDITTON
PID
OWNER ....n . . ~ L
(Name) -tV UJl.A:Q..
(Address)
(Phone)
APPLICANT ~ .
(Name)~(\ ~ ~ ~~ ~ lD~JI ~
(Address) ~(On G \ l ~ ~ \Q::
. (Address)
(Contact Person) s..6 ~ (1 "" l,\I('\ X)
APPLICANT SIGNATURE ~A' /]..-10
, I
I
I
I
Quantity
rl.
I
I
~
\
\
\
~
(Phone) q<?fj- L\C\a:a \0. \
~~~rt~~ ~~~S'd
(City) (Zip Code)
(phone) q,:>0.l. L).C\ ~ - r") rtn~
~~ DATE 4.1Q-(J4
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
Sinks
Bar Sink
! Water Closet (Toilet)
Quantity
;>
\
I Type of Fidure
I Rough-ins
Water Heater
I Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
I Backti.ow Assembly
Backflow Assembly Test
Lawn Sprinkler '
lather -
FEE SCHEDULE
Industri::l.I. Commercial &. Multi-family 1 % of job cnst with a $39.50 minimum
Residential, New One &. Two-Family $99.50
Residential, Additions &. Alterations $39,50
Estimated Cost $
Building Penn it # ,
- ,., .::y,
,,', .."." ' c" II,"~
,~,'" UC"I;
.. h ~ IJ",
". ~ 1~ {~t~
, :s ,.-... !/;, v
".." C'
...,.....
'......~0
;"~
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT AL PERMIT FEE $
.50
(Offi~~ Use Only) 1'-;
This Application Bec:omes Your Building Permit When Appro\led rili'~aid - u
i'~: '1:Q>at~ :i. ZGJ4
~ I 1 .
Building Official Date r i u
I
14 bour notice for aU inspections (952) 447-?&$O.--fJlx-C951}A41004Z4S. .
16200 Eagle Creek Ave., S.E., Prior Lake, MN SS37Z-1114
I Jeceipt No.
i :1
, .ly
/i
\
--- !
0925 # 2/ 9
(Please type or print and silm at hnttom)
ADDRESS ~ - - .
LICl31 ~h^~)\)
LBGAL DESCRIPTION (office use only)
I. Pink file
2. Green City
J. ytllow Applicant
PERMIT NOO'f. OZ!/t1
ZONING (oflil% use)
I
I
~
I
,\L. -- U Q
~=:> \ (C^--~/,
;';:,:;
::~.(:
:,:;':
:;".:
t':
PID
i~
~;,
,LOT
BLOCK
ADDITION
~'::~~l.^ 0 ~- +<<'J~Q/)
(Address) '2 \S nC ){~-h lA \tsJ R-l (( ( ~ 'Cu.-I .
. - ~ - \. '
APPUCANT
(Name)
6umsville Heating & Ale, LlC
12481 Rhode Island Ave. tio.
~~. MN 55378-1122
(Address)
(phone) J~(jS(~ US; - ~7 (){)
P clqo.n , )--\n . ~S I L_I
(phone) QSl - ~C-1L(-- (){ yJS
ti~
(City)
(Zip Code)
:#:;.~,
;:::::::~.
;.~t:;.:
:Address)
Contact Person) , (phone)
, (J.' J) /'. L
U'PLICANTSIGNATURE --LJLl1f'L ,"nJ\L)JlLLrl'Oi/'l DATE ,C) ~;;)I -()(j
APPLICANT PLEASE COMPLETE BELOW
, ~W CONSTRUCTION
URNACE MAKE AND M,ODEL (0 n fl. () 'X
LOB SIZE RE1URN OPENINGS
TYPE OF SYSTEM
~.):;
;',::;.,:,
-0 REPLACEMENT 0 ALTERATIONS
FUEL ..tJQ i OJ. ()L)
L/ 0
INPUT '-/..')1 000 OUTPUT ':1.1.. (I{)
HEATINGORPO~RPLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
,PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
dustrial. Commercial & Multi-Family
:sidential, Heating & AlC (New Construction)
:sidcntial. Heating Only (New Construction)
FEE SCHEDULE
1% of job cost Residential. Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
I
I
[~~::j:
H\r::
I
OWarrn Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
:REPLACE MAKE AND MODEL
Building Official
, Datt'
"-
ReSidential, Additions & Alterations $39.50
Residential. AC Only ~ $39.50
Building Pennit ~lT .
$ Y b~dvJ' ~ ,',
$ ,SO '1:)U 0 QD \~C7C
S /\. T t '
J}~ ern 0 ill ~ r ~ReceiPt No.
)aOON 0, 2 2004 III By
Estimated Cost $
lice Use Only)
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.
:'bis Application Becomes Your Building Permit When Approved
24 hour notice for. all inspections (952) 447. ~850, fax (952) 447-4245
16200 Eagle Cri!ekAvenue, Prior] S\Ye. MN Sf~"~ 'u__, .._or.:
PRIOR LAKE
INSPECTION RECOR'D
~5 7 ~ ttE"lC:rtfJ.) -vtA,'~
NATURE OF WORK ~ ~f'tl~ f 1Lw::r,o~
USE OF BUILDING S r:; A.' _ ,
PERMIT NO. h. 04-. oz 4---7 DATE ISSUED .B)J"2.I,1J I(
CONTRACTOR rull:E' ~ PHONE-'.ti-W- C(!8.s
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
Main Fil
SITE ADDRESS
FOOTING 1NSPvwr ~i~ {l-I-d< II
I FOUNDATION (Prior to Backfill) 'I I ~ I 4 - }J'Ul; I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING m f/lY /(/1
INSULATION /#i!f c4o~y
ELECTRICAL
PLUMBINGU.G (</)u\(d~ ~~C" #I~ ~o.l{~.{
HEATING (if required) . ~ IP4if;&~
FIREPLACE " / I I
GAS LINE AIR TEST,&" iJyOr f ~ij /1I/t ?i.Psft(
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to So~ding), /f/l2..a .
BUILDING~I'fI1/ {Ja 9i1s/ov/ ~
ELECTRICAL I .' ,
PLUMBING I'M "
HEATING //t//-
OO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
II). .></.{J
/1. /. b {I' ,
,8' il (/PC{
,f//~/tJi ~
!fI~ 514/
I
BEEN SIGNED
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
_.........-_~'........"~_A.'~'"'".__."-_~,~_""'^_ ,_".....,. _,.,.h ...... ___~_~~....<,.,..."",,,.,__..,-,~..~ ""--""~--"""-
..
QIrrfifirafr of @rtupaury
CITY OF PRIOR LAKE
~~partm~nt nf ~uil~ing JJ nsp~ttinn
~ Final Permitted D Conditional e.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
Fire Zone
Bldg. Permit No,
N / A Zoning District
'?FD
Legal Description
Ll6, B3, TIMBER CREST PARK
Owner of Building _
Site Address
4937 BLUFF HEIGHTS TRAIL SE
Contractor's Name & Address PUT, TE HOME S,~ ! 15 NORTHWE ST PKWY., SUI TE 140, EAGAN
ROBERT D. HUTCHINS J1i!J. City Planner DON RYE
Buj,lding Official /1/ I " /
,_ 'I
Date: / / " f, I Date:
55121
.
~
~;._,i.LJ-,,: ,.:...,:_ 4M..!.l~.
-~-
.... - ~
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I(J"'~~
ADDRESS !/137 Btff 4~, 7)'
OWNER CONTR. P,;/J..t... f/DYH.$
PHONE NO. PERMIT NO. 0" -:J 47
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~rN~LLING
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
G~,8.{
Cu/~ &/-0 IL
'" WORK SATISFACTORY, PROCEED
V~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~-- __ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
~~r-
,~93 7 &/P # ft/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
...JiH'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
.JI1ECH FINAL
COMMENT~ _ ~ _ ~
~C/;r;C~/' /j7;e;-/ d,;e-e
6 ~-.,2j/7
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
A-GASLlNE AIR TST
o
AI' /
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, r /
~ ./
~Chr Fh~ / /
~/tc-~h/ r-~S'-/ CJ ~J /,
~5/~~\ ~"L:..., '~r .~ ~/-L/
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./
_.I-) r:'"J /
; \0/'-V,;Y,/,/K '7 /
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(!-J ~'f:!:C'A J~:/-/ he ~~
j7~/ ~~~~7;?/~v~ /" ,
~ .-..... // /~/I
7-r'p" ~ (~CJ" v~ ~ / ~ //.5/09'
, / ' ,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
CJ/
C//L.
o CORRECT WO~~ ~A~/OR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
V
CALL 447-9850 F<:?R. TH~ NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
~//~o/
~93 /' g~# //'~ k-/
.y/ C/,n,,'" h CONTR.
SCHEDULED
ADDRESS
OWNER
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
, ~LUMBING FINAL
/DMECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
/24
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<--"'( C.
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/~~~ (
o WORK SATISFACTORY, PROCEED
/~ORRECT ACTION AND PROCEED
/' ~ CORRECT WORK, CALL FOR NSPECTION BEFORE COVERING
Inspector:
~
P
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl