HomeMy WebLinkAboutBuilding Permit 99-0253
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QLerlifirs1e of (JDrmpanry
CITY OF PRIOR LAKE
~T jDtpartmtnt of Jiuilbing Inspection
In Permitted o Conditional C, 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 Bldg. Permit No. 99-253
Occupancy Type R3 Type Construction VN Fire Zone N / A Zoning District R 1
Legal Description L24, B2 WOODRIDGE ESTATES 1ST ADDN
Owner of Building _Site Address 17223 WOODVIEW COURL-
Contractor's Name & Address :RS 2849 86TH ST NW MEDFORD MN 55049
- City Planner _
Date:
Date:
------- -. "-- -.-----
Job Address '17~ L.I~ifiJ co/,
Heating Contractor ~ ~e.l' -
Name of Tester _ ~
Date 8 -..:2y. f9
Percent 02
Percent CO
Stack Temp.
Percent CO2
~~3%
0%
,;2....,;2,3 0
- 7.3~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 17223
SCHEDULED
DATE
Y:/}-tt9
TIME
'I:~
wcttJ () jtvJ Gr
OWNER
CONTR.
PHONE NO.
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREVo
COMMENTS:
PERMIT NO.
19- 253
o PLUMBING RI
~ECHANICAL
ATER HOOKUP
SEWER HOOKUP
~~PTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
40 I ~",lJ..( c...e~ P tic. .
rO
-rvv~~~
~r~~~ -ff'-r+ i'-.~ ~\-r,-
t "'-t- 1ft.
t\Jl) t ..h_lL...s
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b Off'/' ~
r ..l...-....c..----\
IA ',La .1
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4WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
T
SCHEDULED
DATE TIME
P/~h J::JO
_rtESS
/722.3 WOODVfGW CT
OWNER
CONTR.
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
;:# 1_ 1
MECH FINAL
QC)'-253
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
01//
L FOR REINSPECTION BEFORE COVERING
Owner/Contr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
------ -- - -,--'----- --.----..- - ---.-.- -------.
~ J:30
/72-2.3 WOOOVIE:W GT
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
XPLUMBING FINAL
~ MECH FINAL
t' Arn.6 ~IL
COMMENTS:
DATE TIME
99- 2 S3
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~c.A.....'S. a L
COVERING
THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
. .-----.~._".""".^-_.._.~_._-..-_...._.._.... , . ..--...--
......._--_.....~,...-."~._..~_.._--_.
DATE RECEIVED
APR I~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
..
OOOV(c,...ioV
3. LEGAL DESCRIPTION
2'-/
LOT
ADDITION
4. OWNER
6. BUILDER
(Name)
7. TYPE OF WORK
New constructioJid
Chimney 0 Misc.
Fireplace 0
Alterations 0
2..
(Address)
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
LiY{- ;)'53
1. DATE
'3
SeptiC 0
Addition 0
Deck 0
Finish Attic 0
760 ~ YZ-I 'L
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPA~
SE~'
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
110 1)00
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. COM LETION DATE
Sq. Ft. I 2 V..l S' Width l' Yes~o ~ - - 1'7
I hereby certify that I have furnished infonnation 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 men' ed property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offi' c rev i it for j cause. F nnore, I hereby agree that the city official or a designee may enter upon the property to perfonn needJd i~~ions.
X ~~ ~C7~
License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
<;;PrD
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F. t:t I M
Division 1 2 0) 4
Pennit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ...................... $
............. $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION II L{,ooo .OC> PLOT PLAN 0
S U
City:
qs'l.zS-
~22. 22-
57. CJO
I 00. 0-0
(00 00
35 .so
~
Thi
By
. ing ~:t,:it wr- i~77
Issued
Amount Brought Forward .................. $
-------
Park Support Fee ........................... $
SAC ......................................... $ I
Collective Street Fee ....................... $
Sewer Tap ................................... $
I $
Pressure Reducer ..~................... $
Meter Horn ................................... $
51. .'
Water Meter... 'If!;......................... $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
a~,05
OSO~OO
t.(6. 06
I 2S"'"C70
1,.2.c9~ .Cl6
( ~ ~c:D
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
sign b he C. PI r constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~(-S-~
City P nner Date v Special Conditions ij any
24 hour notice for all inspections 447-9850
......r......~.~..~.._.
~0
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\\ o\' .
J. Blue File
CITY OF PRIOR LAKE ~. ~:~.. ~~Iicanl
~UMBmGPERWT # 9~z53
....pljganl: Se.nt.\t.,. 9\l\~'o\n _ ,~~~~e:4~~'1I-{O~13L/
Address: 4'00 A.dno.n ~ ?rio, !::ov.~ _ _ _
Signature: ~l.{ 9 j;
Legal De8Crl~Lot z4- Block 2- Sub I1'OODeIDq6 2ND
Site Address: \f"J~'l~ W(Y)d\JiQJ..}~c~L ,Ii!/
BulldlngPermltH 99--253 PIO, 2.5-2-80- 030 - 0
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
TIM- ('f'IIIt'r of II.. I,.", c.......,
Quantity Type of Fixture Quantity Type of Fj)(lure
\ Balh Tub with or without shower ,3 Rough-ins
\ Dishwasher \ Water Heater
\ Floor Drain Water Sortner
~ Lavatory (bathroom sink) \ Stand Pipe (washing machine)
\ Laundry Tray (1 or 2 compartment sink) Sewage Ejector
~ Shower Stall Bar;kftow Assembfy (RPZ, Ool.Jble Check, PVB)
, Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
d- Water Closet (toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi~Famlly
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alteration
State Surcharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAL
''''D W\\H
~ P'1NaPERM\\
\.8 ltD. .
This pennit is grimed upon the: e~prl'SS condition that said
e:onttactor, shall comply in all respa;:t5 with the ordinances
of the SWe Plumbing C d the Imendmh thereof.
1m . ~..6e 9'9 DATE
/ A'ITEST
Call for all in
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
-. --.------- r
Ihd8
TYPE Of WORK
Rep~m.~'
New,c01!stFUCtlon)( .
-, .
. ",- '. - .
. .
'I
[n
wi
co
o
c
a::
H
a:
o
a::
I-
w
E
ctm.
\\,
Other Dlvices
Output S 3
)aoo
HEA~NQORPO~Puun
St&al1l
Hat Water _
Radiation _
Special Dwlces
AU WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CtTY HALL
, ,
447-4230
I::IE& ! REOUIRED with number of supply anet relurn openings IIsled per
room with CFM's pel openlno. New 8InJctu181 or additions send lloor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICJrrIONS MAY BE MAILED 70 THE CITY OF PRIOR LAKE,. 182.00 EAGLE
CREEK AVE. 8.E. PRIOR LAKE, MN 55372.
City HaU tJuslness hours are 8 .a.m. - 4:30 p.m.
TYPE OF SYSTEM
Warm Ail Plintt
Gravlty ----'-
Mechanical ......!.
Air Condhloning
Vent. System
The price of your heating permit Includes
Additional inspections wUI be billed at $35.00 each.
House Heating Teat Record must be 8ubmltled wl\t\ WIldIng IUW!!Il number before build-
ing ce~te of ocoupancy will be issued.
Address
Telephone'
one rough.in and one final mspeclon.
(\j
.-t
If)
o
z
Addrt18S
Healing Conlr
Remember 10 add the Slate Surchlllge on the bottom of Ihis application
Industtlal. Commercial & Multi-Fam ilV
Residentfal, H881lng & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Absralions
Residential, AC Onlv
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
539.50
$39.50
Dale
Site Addr&&s
B
Lo1
.z4
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ll..
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,q
CITY QF PRIOR LAKE
16200 Eaa1e Creek Av. S.E.
Prior Lake, MN 55~7~
l I
HEATING APPLICATION 1. PERM1T
-q~
-030-0
lei
Fee Schedule
Single Family
Commercial
Two-Family
Industrial
Public
Mulli-Family
Other
Pennil No.
Cl9- 263
x
"
Supply Openings q
... -
,
Return ap.nings '^'
lnp~ ,~\
Edr._
~
-~\~
Fumaca Make & Model C ~v., of
Model Siu ~~" ~ <\ ~
Conn. Load 5 \ gl~
Fuel ~ ~ '\ Flue Size '-\.1
l_
1-
3_
Piak
Gre=
Mow
~..
Gty
Coalnl:lvr
~~dS3
Tho ('onl.. of tho Loko Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~VV1 ~ 6(ct(S.
APPLICATION RECEIVED Lj -( -qq
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
II'2Z3 lAlY0Vlt:lV CT.
Accepted
Accepted With Corrections '"Y-
Denied
QQQ:;~
Date:
((-7-Cz (
Reviewed By:
Comments:
ff~~~
-~J cJSL cJkc-leeQ
"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
The- ('rnlrr of the Like Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ ! i j
. , I
f/ ,( (i I ..>.
~.J . ,
j I
t. t'; ;: ~t
! I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, i t
I r 'I
Accepted
~
Accepted With Corrections
Denied
~~~
Lj- ~ ~q
Date:
Reviewed By:
Comments:
~6B9c;e <\t:fes:.c~ ~ ~tv~fd/~~~._
l".-;
~.
"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."
___,~' _'~T._",,___.____...__..,____, _____~____._....~,.-___.--------..--..--..---~-__---_;
9J/n!951 m~ 1J9; 24 FA..'! 61Z.:l4iol~45
CITY of PlUo~ ua:
141001
1aI001
04/13/99 TUE 19:24 FAX 6128621223
JD EXCAVATING, INC.
APR J ~ Wi)
PAID WITH
BUILDING PERMIT ,
...... ...
ft!IL'-. ~
-.-.
CITY OF P.RXO~ LAKE
SBWER AND RATER PERMIT
IIOTE:
S_W: No. qq~ Z2 3
sewer and water
contractors l1\qS~
be re.;is~e:l!'ed
wi 't.b t.~e ci ty .
x APPL!CANT: -:J D EX c f:l \J AT J N (-, J l rJ c.. --,,:Jr' PHONE:: Tb 1- - 4- 3 ~ 2
)t. ADDRESS: I ~4 2. - 13 Z. N ~ ~ E, CCXJN ~I'l-l> J Dr DATE: 3 - 31 - "["I _
"SIGNATlJRE:_ lO~\;... __~_ .~1;;) BLDG. PDHI'l' f qCl-2:=>3
~ SITE ADDRESS = \:1 ~ ')... ~ ~\f'fl i.J. ) d- _ PJ:Dt 25 - 2..BO - Q30 - 0
FILL IN THE BIANlCS
1. Estimated length of uater sarviee
-
feet.
2. Size of wa~er service
inch (8$') -
:3 . LocatioJ"l of 81\y c:ouplin9'S fro1l\ struetur.~
feet:.
4. 'l'ype of sewer pipe. ABS_ pvcL Cast Iron_
S. Esti~a~ed length of ~ew.r line feet.
6. Clean oU~ (if required), located at
structure.
feet
troStl
,=;===,;;;:::;:~=====~-=====~~---~-=-"=~__IllIII:===-_;;;:_-~-----;;;;;;;;:---~"'--~-
This app~ication becomes your permit when approved.
BY
DATr;:
~=~=~====;===_~_===~~"_______===&gW====-- --==~==-~-====--=
FEES:
s
S
$
35.00
.50
35.50
Sewe~ .no vater line connection permit.
Surc:ha rg-e
TOTAL
- Fee for either se~er or wa~er individually is 520.00 plus
$ .50 su:t'ctJ~~~..
* Sewer and water per_its issued tor new eons~ruction must be
recorded on the bujlaing permit ~ard at ~b~ ~l~e o~ issuance
to insure that no duplicate seVer and water peraI~s are
issued.
DATE PAID
RECE:IPT #
AMOUNT PAIO
PAID WITH REC' D By
BUILDING PERMIT
35.50
~
16200 Eagle~.k Av. S_E., Prior Lake. Minncso~ 55372/ Ph. (.612) 447004230 I FAX (612) 447-4245
An Equal CJntonullilJ E'napll1Y""
...-'-.------.--.--1
(""
'-(1- )S.3
TIlt e....' 0,.11<< I.8kt C...lry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L~ t VOl. -fi:1/--Lt.
. I r.r';
L I -, -. t' I
(~iri(S.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
. ffiZ3J LlX'fY{\if('l V crT.
Accepted
./
Accepted With Corrections
Denied
Reviewed By: Wllcf...,-EIl. EH((c:.:S~"'^,N
Date:
&/ JIZ./n
.
Comments: RVNOF~ ~lJs'" &; (!OAJfIE."frO iO A..vL'\ ALOAJu D~""",~e:
A",b t.>T,f..,T'r" EIkE''''fi:.o.)T~
AS M""I-f ,.,s Tn 4<.Ttclft....
seE . INfo~""ATlON ON R~"f'ltsE. 51 t:Je.
SEE A1TAc~",EAlTS ~ ',. h4lAc.. GttAOE' JAJ~fr!E.c:noN /"'F,ftA....AT'<:M.J
2. t: Ill4a'AJ (, RtltN
3. E"1f~~'oAJ COAlTR..Ol- MCASJite s
C/. E~oJ'.A.l (Jo.ur.t.OL- PI-A.A'
"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 I 'J~ l ~\J:-t V r i- -
NATURE OF WORK __)~.&
USE OF BUILDING SFj)
PERMIT NO. qc; ..'253 DATE ISSUED t.{-?-7 ~
CONTRACTOR Q J.-~ \~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
. q,
FOUNDATION (Prior to Backfill) . ~ l.{ " ~ ~ -~...
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~ .~;
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I~ I I
FINALS
1AJE.
OCCUpy U
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 (612) 447-9850