HomeMy WebLinkAboutBldg Permit 03-0145
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
~I
17 ve, /oo/c
- -
LJr
LEGAL DESCRIPTION (office use only)
Date Rec' d
/- 7-6'"6
I PERMIT NO. 03 - {} /45 j
I. White File
2 Pink City
3. Yellow Applicant
SE
LOT4BLOCK / ADDITION ,~~r/ C~r M'<ClAr~
V
OWNER
(Name) < 'Le..P pka. r SS e 6 o,...,~
(Address)
BUILDER
(Name) 7"~
I .
(Contact Name)
(Address) ifV
#",/ ~ C>
/ Ok'
LDB./'
r /J "'" <:' 'rJ
- - - .
ZONING (office use)
~(
PID ~ -.3 7<;-t:b <,1- 0
(Phone) 2S",J- '/V7-'/O')h
. (PhoniJ,_ ~sn1- ~ - ::H19 <;
. (Ph~ -2Q - d:-.9,;2 - L!:LSR
5"')379
t1r
.~Utt-6/ee
TYPE OF WORK
~Construction
OLower Level Finish
o Misc,
o Deck
OPorch
ORe-Roofing
ORe-Siding
PROJECT COST IV ALUE (excluding land) $ 310" t7/YJ
OUtility Connection
I hereby certit)' that I have furnished information on this application which is to the best of my knowledge true and correct. I also certit)' 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
enter upon the property to perform needed inspections.
~~-
Silp1atur~
x
o Fireplace
OAddition
OAlleration
# tt(, 9'1
Contractor's License No.
#
I Permit Valuation 3ro,ooo,OO
Permit Fee $ 2-1 (o~. 7S .
Plan Check Fee 1$ , Y r 0, 3Lf ~
State Surcharge I $ I '55,00,1
1 Penalty I $ I
1 Plumbing Permit Fee 1$ /f)(),OO I
I Mechanical Permit Fee I $ /DO,De
I Sewer & Water Permit Fee I $ 35.So
I Gas Fireplace Permit Fee 1$ ~o, t1d
This Application Becomes Your Building Permit When Approved
~Offi~ ~3
I $
I $ /ZT5:()O
1$ d5"CJ,Oa
1$ 'fS.OO
I $ t z.oO . () 0
1 $ -"1-00, 00
1$ i500,00
I $
l- -J--()J I $ Bj 9 00. ~
. Receip~o. 4a~ t-- I
By/[;_ I
o
Park Support Fee
SAC
#
/-(;-03
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
issued.
~.:1~
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
1 Water Tower Fee
I Builder's Deposit
lather _
I TOTAL DUE ~-
Paid ~ 9g~
Date 2""1-()~
#
#
~~
Planning Director
//27kJ3
, 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
jYhite - ~
CCanary - Engineering.::>
Pink C _ "'tanning
Th~ ("fn.., of "If take Coun.ry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.----- -
NAME OF APPLICANT / /~> l1)
J / /.. ...'.. ..-....., _~-;-
! /1'<' ./ ./"':'.; (:::::: " t~l:Cf )'t.......:.:r. L,,'L__
. f.-' ." J \.~~ ---'
APPLICATION RECEIVED
i --.
I - ...., - *'
" ." _...'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L,,/i,I'_C:-f' _ /7) ..: t. _.'7. '.' t1 Y.".<~J' ./~1 I'/} , ('- r-
~;1 I .~/ j./",-,. ......-t...,c..../,.. ~...--/ Ij/,i/ :;; /=
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
mf13
Date:
I~ - 3-03
Comments: SP.P. Rp\ffir~p Sidp. for Arlciition::ll Infnrm::ltinnl
See Attachments. 1) Grading Plan.. 7) Erosion (;ontr()l Mp.~sllrp~
"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."
~ite - B~
"[~"a," - t:.ngmeering
Pink - Planning
Tht ('tn1rr or Ihe take Counll')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
!7J m No / me Cdnu--cG
1- 7-3
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Ljtf~~l- CfJ {~ !Jy 5 G
Accepted Accepted With Corrections _ /'
Denied
Reviewed By: ~ .:f~i--' Date: 4~ ~
Comments: ~ t1L/.~ ~-~
"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."
_~-.....,"_.~_.."_~.__..~_._.. ",_,._'_'m~,_......"""".~..~,,_~~
White - Building
~ - En5l!neering
c.. Pink - Plann~
Thr Crntr, of Ihr "okr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED /.,)
" (
(
I..~.,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l. ///
.;- J-
,./
, .: ~
/.:-/
to-
..-/ //=
Accepted
Accepted With Corrections
Denied
Reviewed By:
Comments:
~ ~
.~
r
-=1...t.dJ p
Date: ;')';;'~..3
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."
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS ./ / /J
0i2 jjlt d[@!( II/(.. S z:
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
.
~~~R i?J/YJ !t(#lf ~I/~i
(Address)
r I
. ~r;:;,~fANT ?di""rf!th~/ r-[, ~.
(Address) / J-f ~ ~ au j(/~ t"v . (
(Contact Person) '6:7n- //t~~
, I /
APPLICANT SIGNATURE
Quantity
I
I
/
~
<--' I
~
[
,"\
I. Blue File
2. Gold City
J. Yellow Applicant
I PERMIT NO. 03'" () }L/C;-
ZONING (office use)
PID
. (Phone)
;1;;;/#,
(City) /
(Phone)
//11'/1; S-C;]/ I
( Zip Code)
c; s-()... wr-:?/) 19
DATE
(Office Use Only)
Thb APpuca'rlcomes Your Bu;ldiug P;}~q;8)PProVed
.k omd., "",
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or @thout showij>
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray<<Vor 2 compartment sink
Shower Stall -
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
/
!
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99,50
Residential. Additions & Alterations $39.50
Estimat,d Co," $ Building Pennit # 0 7 - 0 /~s: If {
PLUMBING PERMIT FEE $ / {/lIO iJ /
STATE SURCHARGE $$ /'./" .50 1f2/ ,Ofl/
TOTAL PERMIT FEE./ f} L/
/'
p~
Da~/tj,d 3
.'1
R~
BY(;
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
1: 38pr1 r1E~RO AIRCITY OF PRIOR LAKE rlO.016
HEATINGfAIR CONDITIONING/FIREPLACE PERMIT
P.l
Dale Rec'tl
~. ~~" ~:;v l)ERMIT NO. 3._-li/5
J. Vellow "ppll<""'
, (Plt~Ue troc or orint aud sian at bollom)
AQDRESS
'-\ \1 5 \ CJ '" ,.\...\ {) \:) \\ 0 y'"
ZONING (olTict use)
Q~~.. '-~\~
LEGAL DESCRIPTION (office use only)
LOT BLOCK
ADDITION
PlD
OWNER
(N!lmc)
(A\ldress)
T (-) ^' \\ ~ ~ "- ()'("\~\ .
\
~'v\l ~', ~ ~Y' S\\".\\.,6'()'~<I...
(Phone) .'\ ~"J. - d (;, ~- ''\ ~~
I-
Ali,PLICANT '^- \
(l'{amc) \<\<L~0) ~\ r-"' ~- Y'\ ~
(AL,ldress) \ ~ <\ ~ CJ \j ~ \ Lll'~ fnf '-
(Addreu)
(C~nLact Person) ~ (,\ V\ L- \1 S L." '" ~ '- \ \..
AFfLICANT SIGNATURE ~~~~
l - - ,..'
, (Phone) ~ S :~.. ~ '-\ l- ~ \"d-l{
~ r, 0- \.1.,\ l1... ,,~() .S S. ~'I d.
(City) (Zip Code)
(Phone) 9 ~~- \i\~,. ~ \ Q \.\
'-
.
.1 ..
~ .
DATE
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FUr-NACE MAKE AND MODEL <.. "'.,......~ ~- .(")X Os- \,u~ - \ \0 . fUEL~\ (~
FL~E SIZE I(\[ C RETURN OPENINGS \ C) INPUT \~'~. (y~~ OUTPUT ~ 3,. ~""t)\)
TYPE OF SYSTEM HEATING OR POWER PLANT
')~.- " '
, .
.1. ,
, . 'ys;:JWafF? Air I'I:\nts
l]GravlIY
o Mechanical
NAir Conditioning
~tnL. System
o Steam
o Hot Water
o Radil1llon
o Special Devices
o Other Devices
)'LEASE NOTE:
Air Conclitionl:r Units
CMnot Encru<lch into
Rcquired Side Yard
Sctbacks
'.
'I .
FI~PLACE MAKE AND MODEL
.-
Ind\lstrial, Commercial &. Multi.ramily
FEE SCHEDULE
1% of.iob cost Residential, G3S Fireplace
S39.S0 minimum
$99,50 Residential, Addillons & Alterations
~G4.S0 Residential, AC Only
$J9.S0
,
Relljdential, Healing &. AlC (New Construction)
Rellldcntial, Heating Only (New CohstruCtiOIl)
$J9.50
$39.50
\: I
J
ESLimated Cost $ \ \ ~ ~~ ~
Building Permit 1/
PAID WITH
SUIlO'NG PERMIT
Dulldhlg Omclnl
$
$
S
11 ~. ~. ~ n m ~ ~l
~aid - - h ReceipL No.
OJ -:" By l~
D~le - .-/ V\
24 hour nolice for 1111 inspection, (952) 447 ~.\ [ou .;~'1-:1.';':
HEATING PERMIT FEE
STATE SURCHARGE
1'01' AL PERMIT Ii'EE
.50
(O'llel: lln Only)
This AIJllllcallQIl Becomes Your Building rc:nnlt When Appro,'etl
~
~_"__.,~,_"~~~._~.,~"w,"',,~. ___'_"_'>~'~' ..~._._..,...~,_._.,~,"",,".._""m"'_'_""'_'_,_,",'_n"'HM_-"~~._-"-..,~-,,.,."- .--_._--,._"..,,-~.,-~ . . .~-,--,,-_.........,,~~"---_...~---
,~~.,.-. I.'
_ell - l'ILe
nLLOW - APPLICANT
GOLD . CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. 3-(L(5
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: Y in.}~ Gr,A:JATl.Alt6. LQ . ,PHONE: ~ljl-XS-1
ADDRESS: PDlL{p ,--"Pt<.lhr<.. ~ DATE: 1-/- ]5-03
SIGNATURE: ~ K~ BLDG. PERMIT #tJ3-0IVS;-
SITE ADDc~ESS: t/-'/5'J ()~ Ot<.,v'e.. PL PID#
-r;~ ~~~. .,
FILL IN THE BLANKS
7J
1.
2.
3.
4 .
5.
Estimated length of water service 1t)
I"
Size of water service inch(es).
Location of any couplings
feet.
feet.
Type of sewer pipe.
ABS
from structure
PVC)( Cast Iron
tit>
Estimated length of sewer line
feet.
6.
Clean out
structure.
(if
Plk
,
from
required) I
located
at
feet
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
------------------------------------------------------------------
------------------------------------------------------------------
*
$
$
~
Fee for either
$ .50 surchar
is $20.00 plus
FEES:
35.00
.50
35.50
Sewer and water line con 1on~permit.
Surcharge
TOTAL
*
Sewer water permits issued for new construction st be
re Qed on the building permit card at the time of issuance
o insure that no duplicate sewer and water per nits are
issued. ' ;1J I
DATE PAID tf~ /58 AMOUNT PAID Bv1 31C
rv
RECEIPT #
REC'D BY
4629 Dakota 51. 5.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245
AN EQUAL OPPORTUNITY EMPLDYER
.
I
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS J/i/S/lfJllm/'t:JfJI' J)f(.! u.
NATURE OF WORK ~mrlUlcr/d/tJ
USE OF BUILDING SF: D.
PERMIT NO. 03 - 0/ 4-s- DATE ISSUED CI
CONTRACTOR 1bM ~OtJl\T'. PH NE -l!tS8
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
J FOOTING VW, I~:J- e11.43
J FOUNDATION (Prior to Backfill) ~(Jf1 I YJ,If I 'Y-'5- ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING 1/([,( (11(./
INSULATION
ELECTRICAL
PLUMBING ;) .f]> tv{/
I,
HEATING (if required) &1(" fir{}
FIREPLACE
GAS LINE AIR TEST ~AI~ L,\r J. q..J1
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
ISIiI(!(tJILAr~l17J~JJ~NF I
I FINALS
IIiif'
Ll ~ ).~'U!:>
-
JIl/Y /
JA~
~
a.-r-ltl- ~
4 -J-)"-c/3
"/ - Xs~,'~
GRADING (Prior to Soddin~)
BUILDING tf..t '^^f) l}\A '\\\ ~'\-lP
ELECTRICAL
PLUMBING
HEATING
DO NOT
Np
I"d, /7. t1 ~
KIT ;r Wf
tl\
OCCUPY UNTIL ABOVE HAS BEEN
NOTICE
(o'f(d
Gr (~
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
'.Permit"
'JobAddr_ 4~J Ovu Jo,CJA {)II'
.Heating Conlr8ctor Me I nO AIR
O/L~.
/
.r esters/Signeture
.GM Une
Pressurized
Inspected
.Percent c~
.Percent ~
Final Inspection
2!!!
Ii!!!!
Pounds
Pr.......e
PERFORMANCE rEST
L.,8"'?,-.
7. 1")0
.P.,centCO 0'70
.Stac:kTemp. J ;)./0
Date
. . -..-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
fr rC,
ADDRESS
t/ 'f S.r I 6U-(r( nri L /J.J--
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'S-/l.{\
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
iiI PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
f'e~
-
rMf-~
f
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: M G- (G.- ~ Owner/Contr:
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 fE-irr
INSPECTION NOTICE SCHEDULED
ADDRESS 445"1 ~rloo/L D-
OWNER CONTR.
PHONE NO. PERMIT NO. ':? -I tr.r
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
J!l' FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION ""'MECH FINAL 0
Y3
@
COMMENTS:
Cl) (ttOl'1 fu,"r era~rOv\
(':; ') ~l Vl~ 1 VVrl.d~
'--"" /I ' v
""'-- I ".. ..u:" .$
1-J'l~kl( fJ.vIM<Nf~-+ f..-!tMJ<
L~ p q QrtlP}( ~-f/I/I't< <::!dd r
..,
lavtd".,.. is OYl (/{.) t-S 1'~"t"'
Acid - {.b,.,d-IIII Ik ~
C(jVl 1.--J I
a /?(J/{;JI/tl (
~ If- .r:;,.'I/~ 'c
~ ~d
"-
nlMt tx.... ~
.fY'0V'" ~ ,;,.,
"'''./' f
", Q'" II. tl) c::..-
.-.
r !-e~ (?
IJVld1'/
~
g-/-t/3
IJY--.so+ r (v rt./;r d..
o WORK SATISFACTORY, PROCEED
)I' CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: VVY? G- (<'(-01 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
IO.-I7~
OcJ(/'Loa t Dr.
I-{v/tvrt.
-
PERMIT NO. ~-IL/J
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'1472
OWNER
CONTR.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.,Jl[ FINAL
, DSITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
6,&de -t) t:.
DATE TIME
~~L1NG
o COMiifAiNT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
K~ORK SATISFACTORY. PROCEED
o CORRECT 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.
lNSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &I SAFETYI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
z. ZZ. 0"
ADDRESS
1-4-72.. 0 V ~f...,OO~ 1J e.. .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3. 14-5"
o FOOTING
o FOUNDATION
o FRAMING
i11SULA TION
INAL
SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLIN~
!(J .JOD,
COMMENTS:
!:t-oS'G
F'I V6
/'
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~O;KA~OR REINSPECTION BEFORE COVERING
Inspector: J 1/ I' Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INmOTl