HomeMy WebLinkAboutBuilding Permit 06-0091, 06-0090 (demo)
'\.
~ 0 (') 000000 "0 0 >- -0
'" ::I: ~ C z_
"0 0 0 en"z""" 0 c ~~
g CD 0 0 3: ::::jzen~OO z z ::0
0 n ;:0 m mO
)> 0 ;:0 3: ~)>c3:~~ m ;:0 m 0"
:"'! ;:0 " en
t'>l r m m zr>zCz Z CIl ::l"O
r 0 en 9
:ltI )> Z ~ ::!Gl~Gl 0;:0
t ..... z-
t'>l )> ..... -i m 0 - zO
l<::> ~ Cii en o z 0
I 0 -I Z 0::0
S (I) ..... "
Q) (5 )> (5 ::l>
~ UI 0
0 Z -I Z 0"
" )> 0 mm
~ 0 Z ;:0
;:0 0 .-<
~ -I "tI "tI
~ ::I: 0 ;:0 ;:0
~ m ;:0 0 0 000000
z ;:0 0 0
~ m !!! m m 3:"tIen:l:3:"tI
>< m m
-I z 0 0 mr~)>mr
:ltI en OC .....OC
;< C5 z 0 "tI ::1:3: m::l:3: "0 0 en
~ en ~ m ,,~;:o;:o;:o~ m 0 0
c ~ "0 ~ 0 ZZ::I:::I:-Z ;:0 Z ::t
::! CD -I
m ::t )>GlOO G) 3: -I m
"ll 0 0 (5 r!!~~ ~ :::j ?' C
~ -I 0 Z C
0 & lJl zcc Z r
Z m ~"O"O 9 m
~ " C
N 0
,..
~ ::t ::0
m
~ 0 0
c 0 V)
;:0 < 0
en m 000000 f _.
:x! z ;:0 - ~
z Gl""om , ~
)> )>$$O~ -i
Ro 0 Gl ~mm3:Gl ~ m
~ < _"tI"O"OS! 5
)> ifi>>>o
~ z
0 )>oOz=i;
""l !11 _mm....._ -i
~ ;:0";:0 r
.....-_ r i
enZ z m
-I~ G)
5" ~ (') 000000 "0 ~ >- -0
1Il ::I: C z_
~ o ~ 0 en"z""" 0 0 ~~
8 0 n 3: ::::jzen~oo z m ::0 mo
)> 0 ;:0 ;:0 3: ~>-c3:~~ m ;:0 m 0"
~ r ;:0 " zrs:zoz Z en ::l"O
t'>l r m en m 9 CIl
:ltI t o )> Z ~ ::lG)~Gl 0;:0
..... ..... z-
t'>l -i m 0 - zO
~ ~ )> - en o Z 0
. o en 0::0
S (I) -I " -I Z
Q) - )> (5 , ::lS:
~ UI o 0
0 Z ..... z "'J 0"
" )> 0 mm
~ 0 Z .~ ........
;:0 0 """
~ -I "tI "tI
~ ::t ::0 ::0
~ m 0 0 000000
z 0 0 """ ;t\
m m m 3:"Oen~3:"O
~ >< m m mr~>mr -
:ltI -I 0 0 Oc .....oc \ .
~ z ~ ::1:3: m::l:3: "0 0 CIl
C5 en ,,~;:o;:o;:o~ m 0 ;:--.-. 0
~ ~ "tI ~ ZZ::t::t-Z ::0 Z ::t
::! m (1) )>GlOO Gl 3: -I m
::t
~ 0 0 r"OO ;:0 ::::j ?' c
-I 0 -"" - ~ c
0 zcc Z r
~ ~ ~"tI"O 9 m
~ z C
N
,..
~ ::t
~ 0
C -
::0 00000 .......
CIl
:x! z I ~
G)""O '-
>- )>-- ,
Ro en::o;:o ~ m
0 c~~
~ < '"
)> zs:s:
~ Z moo
~ 0 ~mm
!11 ;:0";:0 -i
-1-- r i
enz Z m
.....)> Gl
r
:; 0 ~~ ~'D 0 0 0 "tI 0 > -0
'" ::t ~ C z_
"0 0 C ~~
CD ~-z~C3C3 z
g 0 n o 0 -Izen CO z m ::0 mo
)> ~ ;:0 ;:0 ~>c3:z"", m ::0 m 0"
r ;:0 " ~rsz~z Z en ::l"O
~ r m en 9 CIl
:ltI t o )> "tI _Gl.....Gl 0;:0
..... -I z-
t'>l m 0 - zO
~ ~ )> - o z 0
S cD o en ..... z 0::0
..... "
Q) - )> (5 ::IS:
~ UI o 0
0 z ..... z 0"
" )> 0 mm
~ 0 z ~
;:0 0
~ -I "tI "tI
~ ::t ;:0 ;:0
~ m 0 0 '00000
z 0 0
~ m m m m "tIen~3:"tI
>< m m
-I Z 0 0 mr~>mr
en OC .....OC
;< C5 z ~ "tI ::t3: m::t3: "tI 0 CIl
~ en m ,,~;:o;:o;:o~ m 0 0
~ "tI ~ 0 ZZ::t::t-Z ::0 Z ::t
::! m (1) -I )>GlOO G) 3: -I m
::t (5
~ 0 0 r"OO ;:0 ::::j ?' 0
-I 0 Z -"" - C
~ 0 ~ lJl zcc Z r
Z m (5f "tI "tI 9 m
c N " 0
~ ,.. 0
::t ::0
~ m
~ 0 0
c
;:0 0 ~
en < O~OODD ~~
m l
:x! Z ;:0 ""om
z
Ro )> Gl )>$$O~ V \Z.n:
0 ........ ~mm3:Gl
~ ~ _"tI"tI"tIS! ~
~ Z ~ ifiS:S:S:o
0 \>ooz=i;
~ !11 _mm-l_
'::::;';:0 " ;:0 ~ -i
.....z- - i
.....~ ~ m
5" ~~ () 000000 "tI 0 > -0
z_
'" 0 ::I: ~ C ~~
"0 ~ en"z""" 0 c
CD 3:
8 0 n 0 ::::jzen~OO Z m ::0 mo
> 0 ;:0 3: m>c co m ::0 m 0"
~ " -rs:3:Z..... en
r :"'! m z -0- z CIl ::l."
r en ~ ::I~~~ 9
:ltI t > z 0;:0
z-
t'>l -I -i m 0 - zO
~ ~ Cii en o z 0
S cD " ..... Z 0::0
Q) > (5 ::IS:
~ UI 0
0 -I Z 0"
" 0 mm
~ 0 .~
;:0
~ -I "tI
~ ::I: ;:0
~ m 0 o ~o 0 0 0
Z ;:0 0
~ m m m m 3:"tIen~3:"O
>< z m m mr~>mr
-I 0 0 OC .....OC
lllil en
;< C5 z ~ "tI ::1:3: m::t3: "0 0 CIl
~ en m ,,!!i!::O::O::o!!i! m 0 0
c ~ "0 ~ 0 zZ::t::t-Z ::0 Z ::t
::! m (1) ..... >GlOO Gl 3: -I m
0 ::t (5 r"OO ;:0 :j ?' 0
~ ()
-I 0 Z -"" - C
~ 0 3- lJl zcc Z r
Z :"'! m ~"tI"tI 9 m
~ " 0
N 0
,..
~ ::t ;:0
m
~ 0 0
c 0 C\
::0 < 000000
en m '\
:x! Z ;:0 Gl""O~ ~ \l~
> Z >$$0 ' -i
Ro 0 G'l ~mm3:G'l I m
~ ~ _"O"O"O~ ~
~ z ifiS:S:S:o --.....
0 >OOZ=i; ~i
~ _mm-l_
!11 ;:0"::0 r
.....-_ r
enz Z m
.....~ Gl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/ _ ~.~ O~j
5l\
f~\'e.LA t4 ~12k=~ lR
1. White File I PERMIT NO I
2 Pink City . 0/., _ O. OC/I
3 Yellow Applicant . _ ,,: ~ _ +
~ .=f:- .
ZONING (office use)
t:?/ S D
LEGAL DESCRIPTION (office use only)
LOT't>{PBLOCK
ADDITION ~\UAL-UN ~F S::.
OWNER
(Name)
PID z.5"'_ Os/. 0/ ~. 0
(Phone)
(Address)
BUILDE
(N ame) E:-S
(Contact Name) _'&\\l--
(Address) lloz.\ F6t\ tbl'\-l-r <i<"D.~.
TYPE OF WORK
New Construction
OLower Level Finish
~irePlace
PROJECT COST /V ALUE (excluding land) $
o Misc.
(Phone) CY52~41o-9+2::iO
(Phone) ~E:-
M~. ~6 2-
tfzla~ LA
eck
DPorch
ORe-Roofing
ORe-Siding
OUtility Connection
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 lans. I m 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 up n the e to erform eeded inspections.
x
Signature
Permit Valuation
Permit Fee
.3
$
$
$
$
$
$
$
$
00. 0
00.00
E!:.-rO
0.00
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
es Your Building Permit When Approved
, / (,/()~
I Date
DAddition
OAlteration
11.'2Z-os
Date
#
#
-
--
_\=o~
Contractor's License No.
Pressure Reducer
Sewer/Water Connection Fee #
Water Tower Fee #
Builder's Deposit
Other
c.?TALDUE (//U@;:; 2. ,(/ {I(,
Paid
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.
;2-8- 0" 5e~ C~~ S4.+';';'rG,,~r'
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
CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec'd
/ - -!S~ ()b
I '( I) ~/~ -'il8 -,;; (CfC
k~/'t-^ /-4ke 4!.fO -Cf9tJe;
(Please type or print and sign a~ottom)
I ADsiiS4
I PERMITNO. 00. O(.xlo I
.
ZONING (office use)
~/SD
FA-tz..LAt-uN S~~
--rTL
LEGAL DESCRIPTION (office use only)
LOT 3loBLOCK
ADDITION
~~~
pm Z5. 03 I . (j / ((,
I OWNER
(Name)
(Address)
(phone)
CONTRACTOR ~
(Company Name)~LAt-ID ME:.S
(Contact Name) &, \L . ?l.q.~ )
(Address) IID'Z-1 fi t+ 'YQi-\,
Use of Building:
INTERNATIONAL BUll-DING CODE
Type of Construction: I IT ill IV
Occupancy Group: A B E F H I
Division: 1 2 '0
MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION
tbrnE-
V A B
M d[)s U
4 5
~I ~l..E:- FAM ILy
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 proce accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore,
I here agre a he city official or a designee may enter upon the property to perform needed inspections.
__J2.- 2. L- C>5
. Signature
Date
This Application Becomes Your Demolition
Pe it When Approved
/ ), ~~
I I Date
;t~ c/ c. t 5" /C (! /u <-'/C-
7/
(~-:..L(f"c ~ ..-<::. 7~< <.-L- L
/.S.(,;,.
, ~/;y~
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zomng Ordinance and may proceed as requested.
;L - d->-t7C
Date
Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372
White - Building
Canary - Enaineering
C Pink - Planning-=>
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:
Accepted
)((
Accepted With Corrections
Denied
Comments:
Reviewed By: /~ ~
~b.re de.:,f hlJAJ-r- be.. 6(,1/& ~ ~~II"" 011
><<rvey C/~ Y1h~.
c
.s/~ ..5e.~ A-~ /;" r~r 0:1 ).1f- /es/'o~ ad'
.../
"~ c;",,~~t,'o.1\ , n$ .#~ /;- m~-c- h 1A^~~rd dn'nf 4AL
-./
a.-It-~r ~~J'Jsb-~d:r'p",.
Date:
;2 - ~-CJtS
/Ie un,"r <:::AI'7I't-OC ~c..rOtZd /~-h> ...s-~
"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."
. --- .,-~-, ... -,-.__.,.......:. .~.;'.,"'..".,' .";~'.,._"""_~rr,=~"'."'-"..........-=-""''''~"'..,=,,..,'.~_._'". n.
(White -{Uil~ina?
"Canary - ngmeermg
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
KeYLrlNO He/YeS
/.5_ 00
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(:) 7 / 4- /'::-/-1 / /C L-/} /1/ A/5H G 1G6~- 7/2-r1 / L-
Accepted
Accepted With Corrections ~
Denied ~
Reviewed By:
Comments:
Date: it, /pc.
I
I. t\(l(",- ~o..: ~ 6-~ l\~ ~ t I"tJ l
2. ~~Q a~~ ~~
J. ~ A ~ ,. +,....k cO..~ the&~ ; III W yc.>J ~,
i T~ :::.~~:::::: ;:
-4-lt.ff ~do. ~tl~ ~7- t:t83CJ
"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."
White - Building
~narv-- =nglneer~
Pmk - lannlng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
KeVLr-1Nu HOPi6S
I c- ()/~
. -.-J. 1.0
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
57/4- /::-t4//cLHftlN SHo/2-ES 772/t/L-
Accepted X
Accepted With Corrections
Denied
Reviewed By:
iliff fJ
Date:
2 - z -0b
Comments: ! Se~ Reverse Side for Additional Informatlonl .
~ C,"kd- [,/1 ~f Pr,'"r L.f<, E'rJ;"wi'lj Prfl fir,'" r
10 CtJl1tJ~.lfS' ,/ If) ~rt//lC5 J
~ ~ If SUr/,'qJ
UJr'~r !v lhr?iJ
,
D,,'L/l. jt1(}Jf 0,,,,',,, tJ-.W"f FrDr1 Gr:."'t'o
See Attachments' 1) Graoing Plan, 2) 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."
03:22:08 WED 15:18 FAX 952 890 2753
STOCKER EXCAVATING
[4J 001
Date Rec'd
~PRIO'--
/o~,;;'\
!~ /.; I1r\ '()
Ir-{ \1~7
\U\~- ~ ~
,"'",,--7.?..;::,,- /
" J .........~':.o~.-
'~'c~
CITY OF PRIOR LAKE
SE'NER AND vVATER PERl'vHT
C'':''':l' fit:
'(.::)\':1'" C.;I'/
G.:.,IJ '\i,~.lJ':M'1
I rr<;p,}vlrr NOn(,.. 4.' I
~
(Fi-.;cc [\ope N l?~l ;md ,i r::!:...J [ bO\1om)_
Jo.DDRF.SS
.........-. .-.-_.............. ----
.~
I ZONTI'JG (e.ffi:r. ,I,r.) I
, I
L- .._J
5714 Fairla"m Shores irail
....-.-'-"-
-_.-
-~
-~
I
I
ILEGA.L DESClHPllOrl (offi..~c ~sc onl?)
l LOT 36 BLOCK 1 ADDrrrOH
\ OV/1'lER
(lJ"mc)
I r ~ I~ I:lr,""')'
L " ,- --~
Fairlawn Shore:,.__.._.--
PID
.---.,.-
Keyland Homes
----- ---
(Ph0n~) 952/4/;0-9400
....-...-.,__.__0
Prier Lake, ~m
55372
17021 Fish Point Rd
(i\.rl("rc~:)
(Cily)
(Zi;J Code)
Al'PUCA1'-TT
(J'L:.mtl_ STOCKER r:XCAVATING COMPANY, INC.
__ (f'hon~) ~.52/390-~.241
(Addr':$s) 12336 .Boone AVlO:nue Sav,3ge,_ H}-I 55378
(i"dd'e'~) (CilY)
Cur~ sam8
(Conr,1Cr Person) ') .~ (Phonl::)_,
I APPUCAN':SIGl'T.UURE--.f}y;/j" ~~- DA1C _--3=22=.06
APPLICANT PLEASE COMPLETE BELOvV
(Zip CO':l,;)
i-
I
i
I
I
Siz.e of \}..Iater sGrvice inehes.
Location of any couplings [rom structure _ feeL
Type of sewer pipe. 0 ABC 0 PVC 0 Cast [ron
Estimated length of sewer line _ feet.
Clean out (if_required! located at _.--:- feet from stru~:ture,
--.J
FEE SCHEDULE
tndustri:=.l, Com'l & ;v1ulti-C;,mily 1 % of job cost with;) .;39.50 mir1il11um
Wall::r connection only 1: \7.50
R~s idcnlj;:d sewer ,l[ld water line connection 135.50
S<;wer conn1;crion only $ \ 7.50
[stinnu:d Cost J,
Building Permit #
SEWER AND WATER PERMIT fEE
STATE SURCHARGE
TOTAL PERJvHT FEE
$
'- f1'A-ib WITH
BUIL]JlNO PERMIT
'"
~
>l'
.p
(Oni<.< U~t Only)
Thi,Appli,"ion B'''''''' YO"' B~i1'li"g Pami, Wh'~~~cnvod l
Buildin~ Oflie;al Da\~ __J
Paid
-I R,,,ip' No.-' 1
'2 9 ZO~ 8y -- -
Dare
24 h,'ur norice ror 311 ilHpcction, (957) 447-9S50, i3X (952) J,t-;--1245
METRO AiR 952-447-8126
NO, 480
p, 1
.vllL~ Rec'(}
1,I'ink
2. OI~CII
l v.II."
Pil, [I:)FHl\llT NOt:)' 911
C;IY oJ __
^rpli<.hl
~ L:NI:G(.ffi.~
Cl~JYPC or prinll\Jld sip,n 3t botl\J/1\l.
AI)QRESS
_ _, S'l \ \\ f ~ ~ ~ 1 ~ w~
~\~VQJ \r~~\ \
._~
uiOAL DESCIUPTION (office use onty)
Lo,3 ~BLOCK ADDITION -i==' '-t,.... \ c-'Wl'\
.,
~Wl~ER \) \ \ \.
(N/I~ic)--E-~\p~\\l.' ~~~-
(Av~~s) \ 11.');;>, \. \\,~ ~ e.\" e ~ I ~." \,u, \~_
PID
(Phono) '\ <; ~" '\ 1\ c:, - '1 \( \)<) I
~5S~)"\~ _
AFP~ICANT V\ \ ~.-
(l'{ar.~e) \'\~ '.... '\ r- _L n ~
(A!ld~CSS) \\.1/\'6\) \.j ,\ l(j"'~ f\v '\...
, 1 (Address)
(Cl.Jl1l<ICt PClSon) N (,\ V\ C-\IS l.-'" ~ !l,... \ \..
APPLICANT SIGNATURE ~~~
(Phone) C\ S ;~., \~ \\ -1 - ~j:.), \~L-_
Q n ~,- \.. ~ \ l\. ,,\\j .s S, ~ .2~
(ell)') (Zip Code)
(Phone) "1~' /, - "'\ '-..\ -r ~ \ ~L-
DATE
Al'I)LICANT PLEASE COMPLETE BELOW
,- ,--' )lJ'NEw CONs'fRUCTlON 0 REPLACEMENT 0 ALTERATIONS .'--
FU!\~ACEMAKEANDMODEL~ r'Jt..~_ )"Cl 'Af-1\J o~~- \ ~ FUEL N ~-r-. __
FL\Jr~ SIZE Q\J l. RETURN OPENINGS _:1 lNI'UT ~~) ~ OUTPUT ~ "3 :...51"""00
TYPE OF SYSTEM HEATING OR POWER PLANT
. CiiJ Wnrlll Air I'I~nls
OGravil)'
o Mcchnllicnl
~Air COJllJIlJonlllg
-b;"JVcnL System
o Slcnm
o 1']01 Woler
o Itadintlun
o S[lcclal Devices
o Olllcr Devlce~ __.__._
PLEASE NOTE:
Air Conditioner Units
Cnnnot Encl'u~ch Il1to
Retluircd Silk Yard
Setbacks
Fll~EI'LACE MAKE AND MODEL
FEE. SCHEDULE
1% ofjolJ cosl Resitlcntlllt, O~S Fil'qllacc
$39.10 111 In illllllll
ItcslucJlli<1J, IlcnLing & Ale (New Conmllctloll) ~99.S(}
Rc~idsrlJ;lJ, Healing Ollly (New COl1stl'uclioll) ,$600
Estimated Cost $ ~ 10 Q 0 ~
$39,50
IIIlJ\ISllinf. C0l11l'l1crclal &. MUlLi-l'llillily
Rcsitlcnlial, Atldi\iol1s & AllCr2[iollS
Residential, AC Only
,~J9..)O
$39,50
l'If~ATING PERMIT FEE
SlATE SURCHARGE
TOTAL l)lCRIVlIT IIEE
Duiltling Permit II ~ ~() ~ (J'J ~ I.
PAID WITH
.50BUILDfNG PERMfT
$
$
$
(OlliC~ Use Ollly)
l'hi~ Applkft!loll DecOllles YOllr JJuillHng Permit When ^JlJll'uveu
Receipt No.
-'-'--Uulhllng Offictnl
,.--"..-
OAt~
Pl1ld '
. -
i~
lJlllCf1.PR 2 0 2006
13y
-:-~
H hour notice foJ' nlllnspcctlol1S (952) 447.9850, fAX (952) 4~7.42<15
9528904650
To: 9524474245
P.l/l
Dnte Rec'd
CITY OF PRIo.R :LAKE PLUMBING PERMIT
at bottom
ADDRESS 5, l4 ff\\~u\~ ~\to~s ,~
~ ~1L ~~;IIQlnl I '~ERMIT NO. 0 c:, -9Y
ZON.ING (Ilmcc u~cJ
LEGAL DESCRIPTION (oOke use only)
LOT
BLOCK
ADDITION
PID
I :::: 1~~~N~f:~~7 fJJ f~OI!1A~ (P;; q52~~:LlM
APPLICANT .
(Name)~. hi[ D fYJf.tilfl)JJrYJt.., fYJ
(Address) tJ()2/i tJ 1/uJ!f lOl, ,~[E. f)
(Address)
(Conrtlct Person)
)Au
DATE
APPLICANT SIGNATURE
Qunntlty Type ot' .Fixture Quantity Type 01' Fixture
~ Bath Tub with or WIlhout shower ) ROllgh-ins
/ Dishwasher 7 Wnter Henler
/ Floor Drain Wlllcr Softner
q Lavatory (Bathroom Sink) 7 Stand Pirc (Washing MochineT
7 Lnundry Tray (lor 2 comportmcnt sink Sewagc EJector
1 Shower St:dl 8acknow Assembly
/ Sinks I3aekf10w Asscmbly TCSl
Bar Sink --..r Lawn Sprinkle:r
.~ Wl\tcr Closet (Torlet) Other
APPLICANT l'Ll~ASE COMPLETE BELOW
FEE SCHEDULE
Incluslrial, Cummercial & Mulli-family 1% of.lub coSt with a $39.~O minimum Ri:sldenlial. New One & Two.Pnmily S99JO
Residential. Addlllons & Allerulions $39,50
ESlimotcd Cost $
Building Permit If
au . PAID WITH
.50.. ILDING PERMIT
(omc~ UN' Ollly)
This Application Becomes Your Building Permit When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMJTFEE $
Pal
ReceIpt No.
Ilulhllnll ornCIAI
Ollte
11M 10
By
24 huur notice for lllllo'pectlons (9S:Z) 447-91150, fill (952) 447-4245
05/18/2005 15:01
9524925005
GLOWING HEARTH:/HIGH
PAGE 01/01
;. i&Klt"
J1tEPLA1~f~;ERMftl\'
D:i\t.(\:~R~c' d
I. Pink Fill!
2. Or..n .Qil~i..i"-
], V.II"w A~~1i~~n
~-~
LOT
BLpC':K
81iDDIT10N
.\ _, ' ./.1"
11':~ ;.
'::'l."~~~
';'t"-"":J':
,.,", (,
""~~",
ZOlN1'NO (officc,u~e)
. ~ .,
."' ~----od:..
,\ ""~:';\\.i-~~~;i~r,::'~'.'_:,'. : - .
H.<';lii!itj(.:':~:'~'...'. \ r.. V e.-
""1'" ~r--
\':.1,,' ,.,'
"''':;':r~~~t:,:",.. ...
6rolC".s1 R.'
,., .' . ~.,." l:'I.,..I" .',_. ,.
~ '. '-'" ,.'
LEONI.. O~Sibrol?1:t@*,hll't'ttee~~e'on1y)
..~. '~'i' ",!~" .........,..
I
J
",J
. :....Jl~'; ~',l;.".
.""" .' ~....~.1 " .
~:R. <€\j\ QN9 ~O.rN":"".,j,'''' (Pnon<) JJ.l\O. Cfl:1Ot:l
(Addt~s~)11 oct L ,~t 9 \\'0 \ 0i .. ( - - t!t'q.C, Lot~. r(HJ
. .' . , . ~ ", "" '. .,,'" - ' ../
. .... ... .,.. ..,;""".i;.1..'d,,,,.,,~~,"'i.""'.\"" ' ,,,<.,":t>/.;~:'L"" 'd,," ." """...,d . - . , .
APPLiICAmfl \~ .. ",' (In. . l_toO{~\ :,1iHoMe""". - ..... ... ..... ~\Qd-qClll
(N atn;") l0 ,~u.J\l-:"~"u .;}..d..:, : ,~, . .".,{"::',.,'.........,,..... (Ph'Otlt) -"'-''' ' . , .b
I \:)0 E \ c\ '-{rIA. ""1\('1 h~ . .. <<-J. ,to{", r M .\ . 36:)6&-
(Addres~) ". ,-. ,0 V'v,i)"~\l..!..L.d.p.....",,..., qo.J.,.UO'" _1.\,1,N ..', ... " .
. . {~lH:li'iits~'...' .... . . , . . . (tit)') (Zip {7;ode)
(ContactPtnJon)1\ \':l'\ j h\rof!~, I.Qt.".",._,.~, ,,'" ,," ." '0it1hoflC) Ll q a. C\ a,~0
APPM.g~'W1'S!PNATtt,~"J\~"S~lro.~,~I!.",.,:::" '" ,. .r':.. " .,. ".::." . P~T!, 5 JIB !O~~~~_~~~ '
"", ':::"~I:',""~) :"''';I,'.J'.'.'I~''''';' '. '~\ . ..' J. ~..., (
, ....r!'~:w.. ~iJlt~El:lJ1~~~. ~@~
" . ',t:J1'6i~iic6~~~G~iF .<" ...... N0~~;t "i " ,I I
FURN.J!.(CEMfi:KE.,AN.D:Mt)l:)l3tH-ea-\' ,~tu~l(:).-., ba.()~1.K- (J~ '
FLUE SIZE, _ . ,!R'&TtitRN:I,~~~~~S' ! I ..." ._,~.,....,INPUT
~:Si(1jF."SY$,~$::Mft'EI~~~~:i~~iPOWER PL>A:NT
UJ~~.)ft...'.1.. ,; ~k:eJMrtlltJ..'iSt~.at.li'.
d~~~i;i' " , .., ,;,! ot\Wri~r
Gm~r~~~'afflfilt1 atli'IJi~~,ll(
OAil"G~ffdm~h~(~ '.,&~,~!:;,
IJV'(!nt,SY.i~~l'h .. ~;:~1}# " ..'
......~
PEEJASE NOT.E:
Air Conditioner Units
,CannotEntro;1chJnto
RpqUlted,S ide. Y <rrd
, S~tbncks
FlREPLACEN1AKtiAN:tJ~~<f;rE'r,,~<
--~
....~I
. ",.".
Industrinl,COl11merCili.l.&MultPF:ani'lly'
,irt~)RM'~enED:TJt:jE
!':%'(J~;Jj4:i:l116~i.. .Rt;;'i<t1etttiaI~G9sr;irl:plaoe
$~:t5 ~:rltjl\~llri\IO'l.
$~9,j'O . .. .. ,[kSidCl'ltinl; Additions'& A;!tcratiorts
$G4;50 Re~i/j!:ntial. AC'Oliiy
$39.50
Rcsh:lcntial, F-ftat1l1g&rAJC (NewCdr't:sblitimfrjJI~.
Resldenrilll, Hl:!lting Ol'lly(Ne\vGdMffiJ.::tl~l'I)j
$39.50
$39.50
Estiirl':irei:lCost.,$
,~ ~'
Btlildihg.Perni'it #
.aEi\1:r~,l3;J~J>>!{Mlm.i.'F.J1l&
rSXt:\\!'E:S:tmCPiAItdS .
~Ot'A::I.i\:e,~RMl$,i.lJitE,.
$
$
$
50
I
\\D IC\ ~'-\
'B\J-\\c\C{
. ,
, J: ' /'. . "- " .:" ", .-;'. '."
1b Is,APplltg{'lbn'~ecome'sV>iJ(lrlJ u1.rt1fn&':I!;etrolt\Wh,Ct1,~P'P);d'Vcd
, .
'f'<;1ip
Receipt No,
~
(Offict, mc'Ortly)
."",'", .,
- . BtiiJdin~:orocj!\]
Drite
, , '"
liil:,tc '
",.,',,'", ,l';..":'~~':-~...J
:U,JtdtJi: r\(iUClllor,nlI:,(\1sj;Jl!HI pti!l{.9.S~) 4a1-9850,~tax (952)44 7 ~4245
1!~Z~O 'Eng)e'Crel!k;~j.:~l11Je, Prl otLnk~,}MN',55.372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING .AND INSPECTION
SITE ADDRESS ~I'r LaJ.J '^- S~~ It=:- cg P
NATURE OF WORK tJ~..)
USE OF BUILDING ~
PERMIT NO. Q~, .- () 09/ DATE ISSUED (I c. /t:I (.
CONTRACTOR ~ [~ ~y PHONE J C/)L-l(C{6 _ ?'f6Jc;1
NOTE: THIS IS New-A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
I
FOUNDATION (Prior to Backfill) \ ~/t;.<J; ,,~ L-frr7 U/P
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
f~ .t
yi~~\
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE #v
GAS LINE AIR TEST LJ ')'J.,1{;
COVER::liE!::BK UNTIL ABOVE HAS BEEN SIGNED
I ~oo~ W"'"P --.L__ I I
I FINALS
GRADING (Prior to Sodding) N f3 f>
BUILDING LMh
ELECTRICAL
PLUMBING
HEATING
DO NOT 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.
..5:>r, blj~(/C/
I \ ) ~ ~ (I '7
7--2J-c.
FOR ALL INSPECTIONS (952) 447-9850