HomeMy WebLinkAboutBldg Permit 05-0532
CITY OF PRIOR LAKE BUILDING PERMIT, l;zate ec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT .5~ S-
I. White File I PERMIT NO.t- I
2. Pink City . () 0 _ 0 53 2-
3 Yellow Applicant
(Please tvDe or print and siJtl1 at bottom)
ADDRESS
13<1CiI
\<et1SJ~ ~Y\.
{).ve-
ZONING (office use)
tel
LEGAL DESCRIPTION (office use only)
LOT 5 BLOCK3 ADDITION W,J50 r 65~-k5
PID Z5. 4-/3. 02/. 0
OWNER
(Name)
I\\~-
(Phone)
(Address)
~~~~ Namet[1,.L!1, 6""" (lIto "" 1?...; J M
(Contact Name) ))o.~ e..JJ.f,~
(Address) Z2-1?? Lb'4r\ ;:k~ ~'au,rll;r;' Ptn.
(Phone) q~'l-LJ ''1- /6/ I
(Phone) ~I t. - J 2tf ~ 4P 21::,
.., '> uql/
TYPE OF WORK. IJl New Construction ODeck o Porch ORe-Roofing ORe-Siding
tJAddition DAlteration DUtility Connection 0 Misc.
CODE: .nI.R.C. DI.B.c.
Type ofG'nstruction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
J,l01S, DO 0
I hereby certify that I have furnished in~ ion 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 th~~c$lction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:ciaU~ for ~ . FU~hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mSP~r
/ 1/ Signature Contractor's License No. ~ Date
,
I Permit Valuation ~a-l ~. I Park Support Fee # $ ...
I Permit Fee $ ~ .? $.J~ s-o I SAC # $ /.ySO. -
.-
I Plan Check Fee $ / rS1{ 1'8" I Water Meter Size S/8"Q:.) $ .,500. ~
I State Surcharge $ .1.;1.00, ~ Pressure Reducer $ 75:-
Penalty $ Sewer/Water Connection Fee # $ /.srx::;. ..,p
Plumbing Permit Fee $ /~. ~ Water Tower Fee # $ /CI~. ..u
-
I Mechanical Permit Fee $ .-J Builder's Deposit $ ./ SIX). -
/0::;.
I Sewer & Water Permit Fee $ 3S': SO Other $
I Gas Fireplace Permit Fee $ ~t1. #D I TOTAL DUE c.mwJ ~. 9 .oS $ If, 00 fj- 791
This Application Becomes Your Building Permit When Approved I Paid il c/ () ?), 1-6-' Receipt No. ,,:'3/ 1iJ
~~~ b,1/~s- I Date ~"' <;; ... By ~
Building Otlicial , 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 consuuction to commence. Before occupancy, a Certificate of Occupancy must be
i,&~ ~~ ,17;{;S-
Planning Director 'Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
./
. - BUild'iQ
c-:. - Enqlneeriftii:>
Pin - Plann ng
BUILDING PERMIT APPUCJ\TlON DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(!/(/[){J/ Gri/\/ .
I
5. z tef. (J 2> .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/39' 9 / ,cC:/L/,.J fAI q'IV fJ' /I tiC ,
Accepted
)(
Accepted With Corrections
Denied
Reviewed By: IYJ16 Date: ,- 7-()~
Comments: See Reverse Side for Additional Informationl
'"
See Attachments: 1 ~ Grading Plan~ 2) Erosion Control Measures
liThe 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."
\
\
\
<:....!'~i~~ . Bulldlnj:)
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPART~NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
6 {/OO/6/fA/
,
5, '2-1-. o~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1399 / ~NJI/I.Iq7lJA.J Aile-",
Accepted
Denied
Accepted With Corrections Y
Reviewed By:
Comments:
# 4~U"-
Date:
S' ~~ft:s-
~4/ ~// L~4;{
liThe 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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White - Building
Canary - En9!!!...eering
~ Pink - Plannlflg:)
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BUILDING PERMIT APPLICATION DEfART~NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
(j(/UOIGrI/\/
I
5. 21. u~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/399/ ,t::6/vJIAIQ-tuIJ /1l/6,
A~cepted
Denied
Reviewed By:
...
Comments:
..
Accepted With Corrections
~
~ .:- ~
~ ~ f'J~
.~ '"
',I'? (de.;-
Date:
Air Conditioner and O..her MeclJ8-nical
Units Car.Rot Rncroaph int.o R.P.qnil"P.d
Side Yard Setbacks
liThe 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."
06/09/2005 06:07
5077445565
BADGER EXC
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i CITY OF' PRIOR LAKE
i SEWER AND WATER PERMIT
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PAGE 01
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Date Ree1d
(?~Llt.~ or DMI ~ ~ u '. .... ..}i
^DDRESS
13 9r I
~ =- ~~ , PERMIT NO. c:. ....-r::::3"j
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I :
l Lor BLOCK ADOnnON
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1 APPLICA.N.:L iz:' .'
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I (Add.ms) ~?;;""? S rL.J. '7 ()"'\-1t 0--t\~
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(Contlc:t Penon) S c.,....4 ~ I' mC("\
r : AjlPLICANTSIQNATt}RR .J~.!: ~
PIO
(Phon.)-- 5'0'7- 7<r'Y.... SS~ .~
)..,c/1'~dc..t? SSO Y,b
tell7) (ZIp Cock)
(phone) b 0 )--7W....S'.$6 r
_ OATH ----1, -:, 7~r
AipPLICANT PLEASE COMPLETE BELOW
Size ofv 'l.tor service Y inch.es,
Location! of any ~oupllng. from structure - feet. '.
Type of ,ewer pipe, 0 ABC CJ"PVC 0 Cut Iron
Eatima.tef;\ leneth of &ewer line.1O feet.
ClclUl oU/t (ifrequircd) located a1 _. . feet from'strUcture.
, .
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.
FEE SCHEDULE
Rc,ldcnlJal "'~'r &t\d wat.r IlIIe oOMeotlon $3UO Indultrial. Com'l A. Multi.fAlntly 1 ~ of'Job GOIt with 1 S39JO minimum
~.......r ;un/lttrIO/l only S l7,50 Wlu~r conlllCtlcn 01\1)' '17,$0
tltlm..~ Cost $
Bulldl111 Permit #I.. .,.,,'
s~. WER AND WATER PERMlT FE!
S A TB SURCHARGE
T TAt PERMIT FEE
S
$
S
(omtl t.:,~ Ollly'
v:
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i Till. Appllcatiol\ Becom.. YO\llr BIIlldlnl Ptrmll Whan Approved ..'
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'14 "'\lr II.lIet tor alllll,p.c:tlon. (952) 4~':9.SO, rU (981) 4"".;Q~
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A[)DlTtON
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I. Pink File .. .",.' IT Nm~OS:. O. ~2..
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ZONtNG(oftice .use)
D'.te~QJC' d
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(P1eU!'tVpeot,Print and~~ilm;a:fL",;';;';,.;!,'.
ADDRESS .,
\ 3 q q 1 ~\5~tJ ~ \l~~()oA-~-
LEGAL DES\iIo.rn()N(office~eon1y)
\,. oJ:..€. J Tn T\J
LOT B:L0CK
PIli
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(Addt~$) d. d \ 3 2> e () () (l N ~ \Sf.. .lD. ~e. \!.r t\~,'t'f\ tv5 5 ()4 4
APPLICANT . ,-d. .'" . .-.. J
<::.) ~~,-~~~l~;~~~_W~f, j;~Ot;;q~:j<)1,~0~ d-
(~~$) (City) J (Zip Code")
(Contact Person) --r \'t'() S h') met. .GRhtlfle) L\ q d...' crd1 L:,
APPM~_S~GNATtJ,1W -r\m SbJm~~~,PJ\TE V C11 'Os
""'- .. . 1:......./- . .. .. .. ,..... J
~,~::~TI;~
FURN*CEMAKEANDM()})EtbO()O.71.J~,:0I1)C -..~~O.t ~ (9lo FI1~L bas
FLUE SIZE 'RBtoRNid1f!!tYl~i!~. .JJ>WUT ~tJTPUT
'T"ftJ~.,~F'SYSm:M Im~~lic'~'PoweR PLANT
Em- ~:.r~
OAitCOnajti~~g . ......<.~~i~
EJVelit.~&;st:em '\;})t~tC'~$.
(phone).
4 bq - \ b I (
PLEASE Nu.'1.r.:
Air Conditioner Units
CaJ1t1QtEncroach.into
Reql;iitedBide Yard
S~tbacks
FIREPLACE MAKE A:ND~M~nEL
\~i~~cS~.I:1.1Sj),l;1;LE
J%-otjJ#l(~jt .. ResidentiaJ,GasF4replaoe
$3'9:Sft1ti;;~~";"'J.
$9!MO Residential. Additions & A1terations
$64.-S0 Residential, ACOilly
$39.50
$39.50
$39.50
Industrial,Commerciill& Mutti~F.iini'l1y'
Residehtial,. Heatihg,&AlC (New Gon'Sti1:\pti'(jn)
Residential, Hea:tingOrily(NewCotlsttu~tiOtl!)
EstimatedCost$ ~. q 56 . a 0 BtJildingPem1it# OS: 053 Z-
...... -,'- ,. .". '.....-.-;.'.-..,:....... -,",'
HE~WJNGPER.MIT~EI
;~J#tE.'S~CHAJ{~~
TOTAL,t.'ltL\,MlT>'IIiYlti
$
$
$
:\q . sO PAID WITH
~ .~LDING PERMIT
(omceU.eOiily)
TbiS.,APpU~llfi6n..lJeeome$~qUr;BtiOd.fi1g;~etilllt~,Wllen:A'PPto:v~.d
Bulldhig:Offic:lal
I).tt
24.honrnotite:tQ...8lI;lli${)~etiOns{952)447 .9850"tax (952).447-4245
1~2;OO'Eligle..e~el\"i';4veng.e.Pri()r Lake;MN. 55372
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Rec~
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LOT 'BLLI~ ADDmC>>l
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APPUCAN1'~.rA...u~ -/\ / /' DA~-=zJJllDTI
APPLICANTPLEASECOMPW.... ~.I)W
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....,...... Ad4Idou.. A'tIrIIiaId SJ9.50
EahuredCcla s L-s1tt 73, 1.3 81&Ud1acPcaoit,. .
PU1MBJNO It~FEE S' q~ DO'
STATE. stmaIAllGJ! . S J .50 .
1'01'AL1'IDlMlI' JD' S..../II 1(7(7,~
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-":&1 . OF PRIOR LAICE
BEATING/AIR COND&llONlNG/J'IREPLACE P~.lJ.J.
Baa "'d
~~1lI5at1ll4_al:baaDa'
ADDRESS ,
1~4\ \t-o""'~~~\). ~'~ ~
LEGAL mSClUPTION (ok... oaJ.p)
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a. .. C,
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ZONING (OlIke""
LOT . BLOCl( AD;v.l.uON
Pm
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(Addlas) 2;28~~1 /aitd/l/i:;. '. '.. ,.. :
APPLICANT~ f/:Ic::P; J I ~ '. I ~ / J. I./J' r:a . "',~' . , '
(Name,'" .. " - : ~HePJ ::// //~, ~) '-T~U~".?fJ?171:.'T<: / ::. "
~)jqZ!ff) $IUj~1 itl: M7(-l-/~' ,')1S~,;7~
f) (/oM&fttJJ~ (CtI). ; 1/ ~ (Zip 0*)
, (ContacrPerson) _ ("'!Sa n J~ h~'rz,~ (PhoDe) i../L/()-377Q.
APPLlCANTSlGNA~!r.te-~ _4::?"A["~~ - DATH ~ 7// I LOb'
. ~ APPLICANT PLEASE COMPL.u..L BELOW
~ CONSDUC11ON 0 ~CEMENT .. 0 AL1'EIlA;~tV~'s I:' "
FURNAC2MAK5ANDMODELl F',Ifl(f';:' GbJ~ J:r=-Lt~._ C, -lffi5; . FllilLb.tlk-(')AR
FUJEStzE ~ Ie, .'RE1lJ1lNOPENlNGS ~. INPl1T' [X-)?7. OUTPUT ~ r"SC?
TYPE OF S\ ~I.>>N Bl!A.T.ING O1lPOWml PLANT
, . ~Wlllll Air PlIOII ~ s.a
Oravit, . Hol War
Mec:hBniClll . Wi...
r CoIIcIIdaafas 11*181 D ~....
Vem. 9:YIrlIIl OGIer Oe\Iieec
I PLlASt NOTE: '
A.ir~. Un.
'CaaaGt~ iDto
~SideYed
S...a.ks
FtREn.ACE'MAKE AND MODEL
DE SCIIII:DtJJ..B
1% of Job CIISI &a\deIlIW. Gal r~..
S39.~ IDlah:lMml . -. -.. '
JLcsI~ IIeId1\s ~ AIC ~ Coo.IlrucdoB) 199..50, ,. lWi..... Additlans tk AltlnltCIIU '
Rddenlill, HeIdq Onb' (New CGDItnaclfon) S64.~ , RaidemiaI. ~ Onl, , '. , '
Eatim8RdC4ttS \~ I \'2-\ ,C?O J.1l1tldlDlPembr t .
~ir~PEJl : V]C7f, ~.\: /' .'
1OTAL.PJ,RMlT ID $,:--'..J./v'.C> ~~.\~..,.. ,~:"".~;
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lnduariaL Cclmmtft::iaI " M~_i1Y
$39.50 , ,
,', .
539.50
SJ9.!O
Daft
24 ....,.... ,., .11 i.""It~) -..'7~ t..l"J) 441"'245
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS J~"I ~/N6av AVI': . I. .\
NATUREOFWOR~ ~~ (M 1.1,. ~J
USE OF BUILDING -;ffl!: l,>. - L
PERMIT NO. 05,O-=i32. _ DATE ISSUED GI,
CONTRACTOR t;MtJlI.iJ/,NJ t:I/6nIA ~ONE · -I/IU
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR. , DATJ
I FOOTING ~ ~tt'P(o$'
, FOUNDATION (Prior to Backfill) I ~~ I ~/~-O/,~-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - IN,S ~ , /"
SEWER I WATER I SEPTIC ~ I G / ~ I as-
FRAMING ' >>Pi 7 /:z 5'.4.>"--
INSULATION ~ ///.r~~ ~
ELECTRICAL , 7 ~z.i' /tJs"
PLUMBING ~ 7P'/or ,
HEATING (if required) '~ 7/!~/,t:'Q
FIREPLACE . /"., t("" :7 I/Y~
'GASLlNEAIRTEST~)I};)~/~/f{1 ;LVI 7P'//t>S"~.r
~ I
COVER NO WORK UNTIL ABpVE HAS BEEN SIGNED I I
"~(L~ I~tv nf7/4k 1Ld/,,: /tIf <1ztbf
FINALS
GRADING (Prior to Sodding) ~
BUILDING ,;~~.CCl''-'''~/ 1/~A>'.-~rO/ar .~
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
~
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
. I
1/ /;3110"
?/?/tU-
9h/or
/ /7/ci.r -
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
(!Ltrfifitaft lIf Q1)trnpantll
CITY OF PRIOR LAKE
~tpatbmnf Df ~uil~ing Jlnsp'ttfiDlt
final Pemritted 0 Conditional C.O. Expires ,
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential / 0 International
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordjnances of the City of Prior Lake regulating building construction or use. For the following:
SINGLE FAMILY 05-0532
Use Classification Bldg. Permit No.
D ~. ~
Otcupancy Type
or t
Legal Description
Owner of Building Site Address
CUDD.i[GAN~US'r.O. BLDRS., 22133
Contractor's Name & Address .
ROBERT D. HUTCHINS~ -
_ 'Y~ City Planner
~ ~~. ding Official
Date: ///.-2 ~ Date:
- /' ..,
13991 KENSINGTON AVENUE
LOGAN AVE., LAKEVILLE, 55044
JANE KANSIER
", ,i~,'~~, ~~', ;';~k..:-<::::,~,i' 'i I"I~" '~:'~ ;",':~ii"':;'A~';"';';::-~'~\':li";:' ~(l,'<,i:;~,:t~;i':i'l}~;~~'i~d;~-':i$;..',~~;, ~:ll.~_,1'
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~!:~ '~.'i
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1/-1.J~
ADDRESS
/3CJ1/ Kt't1.I /'1'iI()......
--
PHONE NO.
PERMIT NO.
CuJ,t'cc"
V
C6" -.s.u..
K~LLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
OWNER
CONTR.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
~FINAL
'0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
aN1"'~- /) '-
L fb rJo rrl &<._ () tL--
f;) n-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~._ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSN011
DATE TIllE
CITY OF PRIOR LAKE .1.. ,,/.
INSPECTION NOTICE SCHEDULED.I{ 2f:df--
ADDRESS /.....??9/ k~J;1,9~ ~<...
y
OWNER CONTR.
PHONE NO.
PERMIT NO.
s--S-32-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADJFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
-
~A /'
/~A-~/
t
/'
&/C
~
~/
( .-/
\ C-/e:>..Je- /~ /~ _
~TISF~.....~e[[B
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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'-.- ---
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Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY/
INSII01"I
DATE nue
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.9P~s-
ADDRESS
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~
OWNER
PHONE NO.
CONTR.
PERMIT NO. ~- ~?/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
..a-1'LUMBING FINAL
..JOiiI""MECH FINAL
o EXlGRADlFILLING
o COMPLAINT
.0 FIREPLACE RI
~PLACE FINAL
o GASLlNE AIR TST
o
COMMENT~ .'
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o WORK SATISFACTORY, PROCEED
~RRECT AcnON AND PROCEED
o CORRECT ~~.:. C-"~FOR REINSPECTION BEFORE COVERING
Inspector: ~.--- Owner/Contr:
lIT
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.17/0~-'
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
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