HomeMy WebLinkAboutBuilding 02-1167
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
<6/ ~<?- OJ-/
I. White File
2 Pink City
3 . Yellow Applicant
PERMIT NO. 02 - / / (p 7
3./, lP
tJ;id"'orSe.. C',v--c..k f.J.kJ.
ZONING (office use)
R
LEGAL DESCRIPTION (office use only)
LOT 10 BLOCK 5 ADDITION
IHt,. tJ tl..t:>S SOLrT"t-#
PID 2-'5 -"313 z.. -/310 - 0
OWNER
(Name)
SAMe:
(Address)
As ~u I L.J::>E:.R.
(Phone)
BUILDER R.OLi.-i~~Y--k i-IOMES INc... ( 7<:0:::') ~ (
(Name) (Phone) -. D8C::)
,
.
(Contact Name) Sre:vEf--t BRc.-:J<. (Phone)
(Address) 1~18 Wi-l tiEH-ALL Ro. S~~ f1N 55-$,4
, L~
TYPE OF WORK ~ew Construction DDeck OPorch ORe-Roofing ORe-Siding
o Lower Level Finish o Fireplace OAddition DAlteration OUtility Connection
o Misc. PROJECT COST IV ALUE (excluding land) $ 2-40, ODD
<::..............
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
enter upon the prope perform neede ections.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
2D2-9~~3
e -2.6 -oL
Contractor's License No.
Date
Park Support Fee
SAC
Water Meter Size 5/8"
# $
# $
$
$
# $
# $
$
$
., V $ q: /4--g, 7
I ~;ei~, '--I (f 't tl'-J
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ecomes Your Building Permit When Approved
T-/2 -o-Z~
I Paid CfJ Lj~ 71
Date - ,;) - (;l.
Date
Date Special Conditions, ifany
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 ~ ~1w Eu~t
PLUMBING PERMIT PPNo. 02.,/ Jh'1
ApPlicant' h~~ ~. PhoneF\~- ~'-,.-
Address: \500\ _~_ R-J, ~~"- If\_ ~\\~
Signature:~ [fJ 127\dffi
Legal Description: Lot _I CJ Block h Sub\'r--.e W\\.c1:., ~~
Site Address:Cnlo ~\\d, \-\Cl(l:::,-e GN'~\e..-
Building Permit # PID #
NOTE: This permit will not be processed without complete information,
FIXTURE UNITS
TM enlll'r of 1M Llkl' Counlry
Quantity Type of Fixture Quantity Type of Fixture
a. Bath Tub with or without shower ~ Rough-ins d/q L(L b:tr"
) Dishwasher I Water Heater .
I Floor Drain Water Softner
Lf,_ Lavatory (bathroom sink) I Stand Pipe (washing machine)
I Laundry Tray (1 or 2 compartment sink) Sewage Ejector
/ Shower Stall Backflow Assembly (RPZ, Double Check, PVB)
I Sinks . Backflow Assembly Test
Bar Sink Lawn Sprinkler i
I
..3 Water Closet (toilet) ~ Other c:f!:~\\\~C-b 0 ,
I
,
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAl PAID WITH
BUILDING PERMIT
This pennit is granted upon the eltpress condition that said
contractor, shall comply i"n all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
RECEIPT NO, DATE
ATTEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponuniry Employer
OIl!:!:. . I'lL!:
T!:LLOW . A~~LIC.AWT
GOLD. Cln
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NO. D l--II~'7
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT~~<6C:)'\\ ~\'ot ~Ot')f'
ADDRESS~ ~~\~".o&-\L&, ~E:5~\l~
SIGNATuRF.zh;a~ crjJ~
SITE ADDRESS :~\'l\o \ ;J\\d \\a~ Gru\F
~
PHONE F\~-9~~ll'l11
DATE: /0-'7-62
BLDG. PERMIT #
PID;
FILL IN THE BLANKS
1. Estimated length of water service
4$
feet.
2. Size of water service
inch(es) .
3 .
Location of any couPlin~from structure
~%
Type of sewer pipe. ABS . PVC____ Cast Iron
feet.
4.
5. Estimated length of sewer line
4S'
feet.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becones your permit when approved.
BY~a~~rOi/r~" DATE: JO-7-1l Z
-.------------------------------------------------------------------
----------------------------------------------------------------.--
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection perm:t
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
t6 insure that no dupl icate sewp,,- ::> 'I"I,-'l 1.7:::> + 0"- r,o.,..."",; + c: ~ re
issued. .
DATE PAID
PAID WITH
BUILDING PERMIT
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447--1245
An Equa! Opportunity Employer
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~w ~l~icant I PERMIT NO. (~- /1 Iv {
I
ZONING (office use)
3176 WILD HORSE PATH
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) ROLLINGBROCK HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/11/02
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants o Steam PLEASE NOTE:
DGravity D Hot Water Air Conditioner Units
D Mechanical D Radiation Cannot Encroach into
DAir Conditioning D Special Devices Required Side Yard
DVent. System D Other Devices Setbacks
FIREPLACE MAKE AND MODEL HEATN GLO SL-750TRN-C
APPLICANT PLEASE COMPLETE BELOW
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
D lJ (j'?'u ---.,
'''\~,.,_~ii-;j
(Office Use Only)
.., ~--;-,
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Building Official
Date
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
'O-3'~02; 4:26PM;
;952 894 0925
# 1/
.
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
file
Cily
Applicant
I
I. Pink
2. Green
J. Yellow
I PERMIT NO:;< .- / I "1 I
ZONING (office use)
L:l/ i LJ'\
,
f fI,S C.
I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
R 0 LLit'J 6> f.) (loC(L
, ~;l~ LJt\ \ fHt\LL
(Phone)
.7b 1- ~d-I ~ o<&{.~
~q3-l9
(Address)
APPLICANT D () ^II.' } . . .. i \...,-:.- AI. ,
(Name) D~l'L1' o')\, I u.,.~ l:LH'1 I-+-"--
(Address) I ~ ti ~ \ R. \-\ D1\ '7 ::is LA-t'J /::)
(Address)
(Contact Person) ~L,(,L--\ L-
APPLICANT SIGNATURE
DATE
I
APPLICANT PLEASE COMPLETE BELOW
NEW CONSTRUCTION 0 REPLACEMfNT 0 AL TERA TIONS
FURNACE MAKE AND MODEL L e,fJ n ax G ~ fc, lQ.3 L/- I D 0 FUEL IJ d. ~tt S
FLUE SIZE RETURN OPENINGS ~ ~PUT /00 j ODD oUTPuTq~' ,tJo
TYPE OF SYSTEM HEATING OR POWER PLANT
!\J:
OWarm Air Plants
DGravity
o Mechanical
~r Conditioning
OVent. System
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
'.;',';
I
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential. Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential. Heating & AIC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39,50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$ AlIA
{
.50
PAilJ
,-
~J"::~~i. L-,D <'co ('
C H.';;~'-', f.......
'..1./,;..., .
Receipt No. ". ,
lOftier lIse On I}')
This Application Becomes Your Building Permit When Approved
Paid
8uilding Official
Date
NOV - 5 200? By
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
The (t'nfrr or the Llkt COUnll1"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~-=3/7fc, - i//dd ~f d!~
APPLICATION RECEIVED >(- c?L 9--0if-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
R~~ ~)0 ~
Accepted
Accepted With Corrections Y
Denied ~; ~
Reviewed By: & ~ -(. -
Comments:
Date:
1-/2 -cJZ
tZJJi. ~~~~
"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
Canary - Engineering
Pink - Planning
Tht> Ct'nltr or 'he t.kt Counlr1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
,/
Accepted With Corrections '/
Denied
J
Reviewed By:, )'; {;(-
-~"'''
j
Date: / -
\"
Comments:
/
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"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."
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White - Building
Canary - Engineering
Pink - Planning
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BUILDING PEllMIT APPLICATION DEPARTMENT CHECKLIST
.; .
NAME OF APPLICANT ~~ /710 - l//dd.. IJ~ (tiv
APPLICATION RECEIVED R- d- 9-0d-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
f? &t!MI0-. L)/;!r:/G !/c3nU~
'./ (
Accepted
)(
'-
Accepted With Corrections
Denied
Reviewed By:
#lff5
Date:
;-/2 ~e;L
. Comments: See Reverse Side for Arlrlition<3llllforrn~tinnl
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
"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,"
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .3J 1~ LJ; l&Jv,r~ ~'r
NATURE OF WORK JJ.(J.tJ
USE OF BUILDING ~'PO
PERMIT NO. 02--//(,7 DATE ISSUED ~a...1~2-
CONTRACTOR f(~\I''R Et-o~ 1:1......" I;,.c. PHONE ']1..3 - 0lQ}'}-o8cO
NOTE: THIS IS NOT PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING rlsPECToR I TO _Z:~T~~
I FOUNDATION (Prior to Backfill) I {IVt!/ I 10 -/ ( '- oJ-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING o...G _ t.t::)~n
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
We.--
//-J/
/-<.<;,
Ihwet/
./
1-2
/--
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~~ La.~ I ~ I "-/eo
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
/ -07
UJe
~ .>-"'0'
(, - / &
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,
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
GCWlned
w. BROWN LAND SURVEYING, INC.
8030 Cedar Avenue South Suite 228 WOODROW A. BROWN. R.L.S.
Bloomin9ton, MN 55425 Survey For.. President
Phone (612) 854-4055
Fax (612) 854-4268 RollingBrock Homes NORTH
· Denotes Iron
Monument Found
o Denotes Iron
Monument Set
III Denotes Wood
Hub Set
Scale: 1"=30'
Proposed Elevations:
Top of Block= (970.4)
Garage Floor= (970.0)
Basement Floor= (962.4)
,(
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Oa~ ...:.....--...
~
Benchmark: Top Nut Hydrant @
Lots 16 & 17, Block 4.
Elevation=967.98
960.0x Spot Elevation
(960.0 ) Proposed Elevation
PROPERlY DESCRIPTION
NOTE: No Search Was
Made For Any
Easements.
Lot 10, Block 5. WILDS SOUTH, Scott County, Minnesota.
I hereby certify that this survey, plan or report was prepared by me or under
my direct supervision and that I am a duly Registered Land Surveyor under the
laws of the State of Minnesota,
W. BROWN LAND SURVEYING, INC,
-~~-~-)
Woodrow A. Brown, R,L.S NO, 15230
Dated:
August 13, 2002
132-02
76/45
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