HomeMy WebLinkAboutBuilding Permit 99-0283
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OJ'S HEATING & AIR .......~...ITIONING, INC.
HOUSE HEATING TEST RECORD
Permit No.
owner 'W.I II,,' ",:, n.:> . .J:J ~ V ~I " [> ,,'" ,,-{' ..
Address J '1' I-j:-.. Pk.,. G <i ~,(;r 'Tn <e.n..::l:j h"j
Installed BY.-J). -' .~ .
GAS DESIGNED UNIT
,,;---:z -~ A
Make,,-t;..r...;:.{:::;;;f':;;~::G'7::~~ . Y"t.. A ^ "'-
MOdell.... (" I I-'~ ,., <;
Serial. '1<6" '1, ". .,. ~"
Rated Input. J.1 ~ J C<.::C
TEST
pilot Timinq5 SL.~ Limit
..., / \""i I'
Pressure ~ I ~ ~ ~ , '--' Percent CO2
, . ~.
Input CFH '-I ,:)
Stack Temp:; ~ (.> fIIi
c
Setting. J..~C
;?I
, '<1
"WI
~A:t
Percent O2 ~
,"'-
i'J.. !'.\......
Percent CO~. "."...;; /t-
Heat Anticipator setting
~ <'2;
Date Tested :(3 - .:2 7- <j'Cj
Name of Tester l=) ,:r.:.
'.
j
.1
j
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APR l 7 1999
GREEN - fILE
YELLOW - APPLICANT
GOLD - CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
No.71-~j
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: /0JJI1L. (;J!.Il-/JE I/lJc PHONE: /7?t'O--/5~)
ADDRESS: t70 BDXJD fJ/ioR' i./ll{E /JJ/!/ DATE: ~J~7 J.??
SIGNATURE:~r:fl'//-e~/J1IJ~~ BLDG. ;ERM;T # 71-~JB
SITE ADDRESS:/7JLJ'I jJ#9lSIJAiT f);j3JIJl)u)AIlAJE PID# 25-34-7- OOre,-O
1.
FILL IN THE BLANKS
Estimated length of water service ;'p(J
. . / JI .
Slze of water serVlce lnch(es) .
feet.
2 .
3. Location of any couplings from structure
$
feet.
4 .
Type of sewer pipe. ABS PVC_>C
/..~
Estimated length of sewer line WJ
Cast Iron
5.
feet.
6. Clean out (if required), located at
structure.
-
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This application becomes your permit when approved.
BY
DATE:
------------------------------------------------------------------
------------------------------------------------------------------
..
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
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
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
4-/z-,/qq
~~~t~~~OUNT PAID
~I>-'\ 0. ~
O\~ REC/D BY
~\J\\.:
~
;-
RECEIPT #
16200 Eagle Creek Av. S.B., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
T
..... .~"nor;W-ir~T
. _''''T'' ~..... ~,"" .
, ~
QLtrtificsu at <mcrnpanry
. CITY OF PRIOR LA}(l?
/ 11\tpartmtnt of ~uilbing 3Jn~ptction
r6inal Permitted 0 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
.
Occupancy Type R3 Type Construction VN Fire Zone
Le alDe .. L6, Bl PHEASANT MEADOW PHASE 2
g scnptlon
BI":: PermiIN^ 99-283
N/A
Zoning District
Rl
Owner of Building
...
Contractor's N< '1'. .., ,', ,.....
<:hAddress 17149 PHEASANT MEADOW LN SW
WILLIAMS DEVELOPMENT
.TJ:;'Mf\T:r: "'0lT .^_!' ~
(0' l& .80'-/
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
~ fTE/
SCHEDULED ~~
f'~
TIME
OWNER
Ie. (~
I
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
qq~z.e)
. . r
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
~ SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
CD MECH FINAL , 0
t..ostr Pt d
~ fJ6P~5zr-
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
1 --..-..--..."""--..
. .---.. ,.., '-.-'--'""
ADDRESS
/7/ 4L 9
DATE TIME
SCHEDULED 8~)?~ ~:~
?#D7S//NT /'-16/J.coW
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q9-283
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
\
o PLUMBING RI
o MECH RI
o WATERHOOK~UP "
o SEWER HOOKUP-
~PLUMBING FIN,
o MplNAL
OJ .
(
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
L SATISFACTORY,
o CORRECT ACTI NO
o CORRECT WO LL OR REINSPECTION BEFORE COVERING
Inspector: J Owner/Contr:
CALL 447-9850 FOR~HE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
ADDRESS
/7/49
DATE TIME
SCHEDULED e/2.-"1,I11 3: 30
?/Tt5nS/lN/ n~ J
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
99-2P,~
o FOOTING 0 PLUMBING RI 0 EXlGRADIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSU~ 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ FINAL 'f'J Ar MPLUMBING FI~ 0 GASLlNE AIR TST
o SITE I SP TIO~ r1l-. MEC~ FINAL V 0
COMMENTS: I, ~ W~ of. WItT6iP-- rbP-M if
L.. 5.",1';:>'~ TI28:3>
j. ~/",v:>.. f)f3;fJr . Sf (5N Or F
~,. 6-L6:.... ~,~
4. PL, h~
fi.: WORK SATISFACTORY. PROCEED
~RRECT ACTI~ND PROCEED
o CORRECT nOR . . ASL FOR REINSPECTION BEFORE COVERING
Inspector: lv OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSl'IOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5-3..e;et
1/: So
ADDRESS Ii 11ICf
~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq - 283
o FOOTING
o FRAMING
o INSULATION
A D.):INAL
,ZI FOUNDATION
o DEMOLITION
o FIRE PREVo
o PLUMBING RI
o MECHANICAL
A A WATER HOOKUP
. A 'SEWER HOOKUP
o SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLlNG
o LKSHOREnNETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
Cr;t)E~TS: ~ ~ 40
ll\ T~>L \;L CoYJtPeA
No U ~ 'V
5~ Pr-\Yt..- DU-
~ ~ Uvvlkl(
fVC
-- )jo
~
-
KA-1.St,
,
-it> &ru.d c
~ Lb f/rDN iVtS~1m
~(~ ~ ~ ~nd~
NI) tJ! -h\. ~)
A:wJ,.., i~ ~ o/,<-
/
o ~RK SATIS ACTORY, PROCEED
6 CORRECT A T N AND PROCEED
o CORRECT V 0 A L FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL ~~ ~30 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE R~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
. --. <-< 'T' ,.
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
APR 1 IC,)
IJ . ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-;;)8:3
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
J II cj-q ,:J ikM kIT
3. LEGAL DESCRIPTION
LOT (n
ADDITION !J4,w4 'riT
4. OWNER (Name)
'"\ A ....,-e....
5. ARCHITECT (Name)
6, BUILDER
(Name)
r--teAnov:>
1. DATE
'+/~qq
~/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LA 6.l9!-. c:;.. U-.P...
,
"l:- -3 L/7 ' 60~ -CJ
PID 0(0
a
12. NO. OF STORIES
BLOCK -.L I ')
Mof'~ f' 6LA s.e.
(Address)
(Address)
(Address)
g. PROPERTY DIMENSIONS
Width Depth
13. TYPE OF CONSTRUCTION
Lv II '-I 14Q0.4$ a-f{WJ..,.D(?I-1.~ L ,L ,c.
/
7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0
New Construction 0 Alterations 0 Addition 0 Finish Attic 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
u'/3J q..~ "3 - 7. ~ q.. '+
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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~bo, ~nti . 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
buildi a re~ke this permit for just cau~~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ne ed inspections.
X "'~ ~.J.. U"J I LL-I A-M j Oe.v i.... I.. C ' Ii~nlh J ~ ,~\,L
" Signature License' No. . at
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING .5rn
Front
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I l '31 (!let':).t9f"'1
8ack
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
Plan Check Fee ................. ............ $
State Surcharge ............................. $
Penalty....................................... $
S U
QSQ.2s
~(A . en
5lo.5lJ
100.00
I 00 .en
1,\ ~
Gas Fir ce P~'t ...... ................ $ <.(O . <S>O
Thi A ca 0 me r Building permit~en ~ro"1a.
By Date -/ I
'- I - J
Certificate of Occupancy
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
o ENERGY DATA
Side
PILING LOGS 0
PLANS & SPECS 0
PERCOLATION TESTS 0
SETS
SURVEY 0
COPIES
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
s::\~--o. ~
/~ _C::-O
~~
." l\
~ .f(
~~fd
Sewer Tap ................................... $
5A 'f $
Pressure Reducer ... f>.......... .... ...... $
Meter Horn... ~/' '1'(........................ $
Water Meter .:1.,e........................... $ /26>.0-0
Sewer & Water Connection Fee ........... $----J..raf/!!:Jl!) ..c90
Water Tower Fee ........................... $
4'6' . c50
Water Tap ................................... $
Builder's Deposit ............................ $
I "CO ec>
Other;~;~;.~~~.:::::::::::::::::::::::::::::: :-ior;, /6. /;?~
Paid (, (;73. 2- 'Z-- Receipt No, 3~.s-O
Date 4/te;/qq By ~
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 a~ requested. This document when
sign~he City R ner constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
- , ,^ . ~ -\ 2..0 -en S . led" ,
'--' C Planner ate peela on Itlons" any
Issued
--.
24 hour notice for all inspections 447-985O
~"..,","',_._G,
I
T
1'1
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a:
If)
..-l
~~~~ CITY OF PRIOR LAKE
Gr.", ~ 16200 hUh! Creek Av. S.E. P~';I No. qq - ze.3
.. PrIor Lalcttw MN 55372
... -
HEATING APPLICATION' PERMIT
Dais '-I ~ - '1Q PID. 25 - 34-1""' oo~ -()
511_ Addre.. ./ilt.-/.q ,'YhtJ"'~-\- (Y)u.Am....J L~l" S. J....>,
Lot . (P Block I AchflllonPMEA5ANT' ttFAOOW 2.140 ADDN.
Own"'s Name ,LJ I II i GVl'\ '< Dwe... \ 0 0 1Y\t!' \-. '1 L L
, .
Addre.. I.t)~~ ~a..V~C\fA~ .~o,t' t) Q('\vt....
Heating ~ntractol .'D:S I ~ ~..t; no...f ~ _ c..
Address,~ ~QO)C. ~~c... . ~'h,A \J'\ \ \Q. IY)t\) ~~~ \
T~~phon.' .)../111- ~~ \ ..
Furnace Make & Mod.1 (4~~CA. f:JJ Z lYlIe Of SYSTeM
C; ~ 4 Wllm Air Plants
Model Size . r H_oY -) - 5,000 G,aylly
'".) L" J I } q Mechanical
Conn. Load "") J ./ I Air CondlllDning
Fuel. \\"" \- Flul S1z.e J-/ Vent. Syslem '
Slipply Openings 9 HEAnNG OR POWER PLANT
L f) ~ _ _ Sleam
Return Openlngl I Gn'\~ \ ""' .2 '\"",~ \"\1'0 HoI Wat.r
J JI Oc:::c> '7/ 0 -'_ RadlaUon
Input ~, O~IPUI ~Cr:>. rXJ..J Special Dlvices
0'1
CSl
0'1
0'1
0'1
..-l
CSl
1'1
l-
jl.
a:
If)
0'1
IJ)
N
I"-
0'1
""
N
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IJ)
d
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UJ
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o
:c
n..
Edr.
Cfm.,
Other Devices
TYPE OF WORK
Alleratlons .
R8placenient
Est. Oomp. Olle .
New Construction
x
CJ
Z
.....
f-
a:
UJ
:c
(f)
I-;
Cl
Repair _
Esl. Cost S
HEATlNG PERMIT FEE t.
STATE SURCHARGE S
TOTAL PERMIT FEES .
ReceIpt ,
Bulldlncl Permll' c
crq $2
.50
I ...-0
QJ-
q Cl - z.e?)
PAlD WITH
~BUILDING p~lT ,
E
o
0:::
LL
TYPE OF STRUCTURE
~.,
J. VldIDIf . CGaiIrIcW
Single Farmly
Commercial
lWo-Femlly ,
_ lndullrial
'X
MlAU.Fvnlly
. 0111.,
Public
Fel Schedule
Induslrlal, Commeldal & MuIli.Famlly
Resfdenllal. HeaUng & AC
ResidenUIl~ HeaUng Only
ResidenUal, Gas Fireplace
Resldenllal, Addllions & AII."'llona
A.sldenOal, AC Onl)'
t% of Job COlt ($39.60 minimum)
$89.50
184.50
$39.50
$39.50
$39.50
Remember 10 add Ihe Slaw SuN:t1arve on lh8 bottom of thlt Ippllcatlon.
The price of your heaUng permit Includes one rough-in and one linal In.pecCloll.
Additional inspections will be bRled at $35.00 ellCh.
Hous. Heallng Test Record must be 8ubmiUed with buDd~ J8m1lJYII1\1IJ berore build.
Ing cerllficate of oceupllncy wi! be IlSued.
1-41=111' r.II' r.I II A,..n~.Q. Ifl=(\l IIJ:JF=Il with number or supply Ind relum openlnge llIled per
room wilh CFM's per opening. New I1ruduree or Iddltione "M floor pllll wtIh supply
Ind (elurn localions.hown. ijEAT LOSS CALCULATIONS. PAYMENT AND
APPUCATIONS MAY BEMAIlEDTOTHEClTYOFPRIORLAKE.ll2OO EAGLE
CREEK AVE. S.E. PAIOR lAKE, MN 55312.
CII)' Hall buslnes. hour. Ir. 8 I.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH.fN AND FlNALt. CALL CITY HALL
447-4130
I hereby apply for a mechanical .va'.ml permit and I aeknowledge thllChe
lnlormation above II complel. and Iceurate; Chat the work will be tn eonformlnce
with lhe ordinance. and codel 01 the city and wl1h Ihe "Ile bulidinglmechlnlcll
cod..; Ihat this lorm does not become a permIt untll .Igned by the BUILDING
OFFICIAL; thlt the work wIll be In accordance wllh the approved plln In th,
case of all work which reqlllrll review Ind approval 01 planl.
~ ~ _~ ~ 4-21-99
~~ ~ . 4/3~.Tqq
. Building Offlca'., ~_ I D'''-
~~~
! ~ All a'lIIG APPUCA1ION I PERMIT
en Oat. PID, 2.5- 347- OOf#-O
~ . .
~ Sill Add,... ,,' LID) 1Ih.~<w..rt (Y)et^c\,..v L~f'.l-
a'l '
; lot CQ Block ( . Addllon, PI FASAf\!T" HF.ADrNJ 2. NO ADD N .
1'1 Ownef. Nm.101 )I i WT\ \t\ \)t.1.Je...\O 0 Mtf' \- ~ '1 L (-
1-' "
It Addre.., I J) ~~ ~Q.vo.("'il.l.." ~o ("I',~ \)('\VL.
Heating Cont,1Ctor .'D:S I ~ ~ -\-; ('\o..of ~ \ L.
Add,... ~tD ~C>OX ~~. _ ~\bc,r\u'\ \\,p Mt\\ ~1~ \
lR T.lephon.' ',J..I'f7- ~~ \
~ Furnace Nak.l Mod., ~+ - N ~6)0
I'- -
~ Model Silt .5L- !Se)O '\ R.
N
.-l
\D
CITY OF PRIOR LAKE MC
16_ Eagle Cre.k Av, S,E. PermIt No. qq - Z~3
Prior La1ce, MN 55372
Conn. load.
TYPE OF SYSTEM
Warm Air Plants
G,avhy .
Meehanlcat
Air Conditionin; ,
VenL Sy.em ,
HEAliNG OR POWER PLANT
Sleam
Hot Wal.r .
Radiation
Spedal Divas
. Fuet
o
z
w
z
o
I
a..
Flu. Size
Supply Openings .
Return Openings .
Inpul _
Edr._
elm.,
Output
.
Oth.r Devices
TYPE OF WORK
x
Aller81;ons .
Replacemenl
New Conslroction
~ Repair, Eel. Comp. Dati
....
I-
ffi Ett Cost S . Building Perml J .
~ HEATING PERMIT fEE $ 3q $2-
.....,
o STATE SURCHARGE . .50
TOTAlf'ERMITFEES . 40 ~ R808lpll
q q - 2..a~"3
PAID WITH
BUILDING PERMIT
E
o
D::::
lL.
TYPE OF !;TAUCTIJRE
1. 0.-. . 017
J. Y..... . ~ICIII
Single Family
CommelCill
Two-Familv
Indullrill ,
)(
MulII.Femlly
Ot'hBT
. Public
Fee Schedule
Industrial, Commercial & Mulli.FlmRy
Resldenllll, Helling & At;
ResldenU", Heating Only
RemdenUIl,e..Fbeptace
Residl'tltlal, Additions & Alterations
Residential, AC Only
1 % 01 Job coil (131.50 minimum)
199.50
'84.50
139.50
139.50
$39.60
Remember lo add the Slate SUrcharge on the botklm of thla .~tion.
The pllee 01 your heaU.. J)8.ml1lncludll one rough-In and m. linallnspecUon.
Addltionallntpdonl win b. blled It $35.00 each,
House Healng Test Record mual be submllted wlCh WJIdIDg IIIDDII DYIDbJ[ berore buDd.
ing ce,lificale 01 occupancy wI\ be 'tlued.
l-4FA-r r.lU r" H ATln~~ ~~flT "qr:n, with number of supply end return opan,"gs Il'Ied pe'
room wilh CFM'. plf opening, New Ilfuclur.a Of add1\1ona .enel 11oo, plan w11h tupply
end..lurn locatiON shown, HEAT lOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. '6200 EAGLE
- CREEK AVE, &.E. PRIOR LAKE, MN 55312.
City H.II bualne. hou,. I.e 8 am. . 4:30 p.m.
AU WORK MUST BE INSPECTED (ROUGH~N AND FINAL) . CALL CITY HALL
441...2.10
I h.reby Ipply lor a mechanicallYslema perm" and I acknowled91 thll the
Inform_lion above Is complete and Iccurale; that 'hi work wll be .Il confolmlnce
wllh lne ordlnlncee Ind code. of the clly Ind with the .,.te bulldlngfmtchlnlcal
codes; thlt this fo,m dOli not becoml a permll untlr .tgned by thl BUILDING
OFFICIAL: that the wOlk will be in accordlncl wllh 1I1e approved plan In "'I
ca.e of all work which requlrl' ..view and approval of plane.
~~ ~~ !-J-2-o,-~9
L? 'pJl~SI. ,~ Dill
~~ . ~ 4-/30/QQ
- BUilding OftIeal's 51 na ure · Da1.
1. Blue
2. Gold
3, Yellow
File
City
Applicant
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: ~~ Vf...~/ /I1ec.-t..4.~ll ~i4-~ Phone: P'f?S--Y'b7.J-
Address: 55 / U;/Il-~"o", 2Jr/I/-L" SH;l:/Kopee-
Signature: ~~h~r .
Legal Description: Lot tb Block / Sub~.I9,.vr M(;ItO~ IN Z flit)
Site Address: 17/~9 //~e45't<___f- JJ.1.LJow LQ.~
Building Permit # . 99-- Z~.3 PID # 25 -34-1- OO~-()
NOTE: This permit will not be processed without complete information.
PPNo.
qq- 283
The- Ct'nlrr of tht' Lake Country
JUN-21m
Quantity
/
/
(
2--
I
I
Z-
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
/
/
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
$
$ 9f~
$
$ .50
GRAND TOTAL
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This permit is granted upon the express condition that said
contractor. shall comply in all respects with the ordinances
of the State Plumbing Code and the amendments thereof.
. ~~fP ~/z./9~ DATE
~Z - ATIEST
Call for all inspections 24 hours in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850 I FAX (612) 447-4245
An Equal Opportunity Employer
T
99 -d83
Thr ('rn'tr of thr Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHe..CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
4);11/0&5 Lcvdt1.7~a7
+7~1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ,(
17/V7 ;/hh5.Cl.u-7 Me?ldtJZAi L/V
4-
Accepted With Corrections
Accepted
Denied
Reviewed By: ?l-f L)c
Comments: .
~.a1t~ ~
~ ~~-fr Q1-'282- for Q{~c; . S~S.
l '
Date:
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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
The Ct'nltr or the L.ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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/' ". , /
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: i
( -' , , / -' ..,/;" r, .' .... -' ,"'1; !,.,/ /r-'! / . _ / j~/i
/,/,...-,( !//,I(,.[,{{, ",", "I U ...
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Accepted
v
Accepted With Corrections
Denied
Reviewed By:
c ,) ^
~_..1'A ~~QA.L/--LA.A
Date:
L( - L 2-CJ.A
Comments:
Il(/S-E:D~ ~\Jt~<
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I~/~~~fi
fVh!}y Q fJw4 {5:('~~~
"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."
08/31/1999 05:59 512-440-1524
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FINAL GRADE INC
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PAGE 03
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APR 271m
CITY -OF PRIOR LAl<E NO ~ 'l?- ~3
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
,
APPLICANT: J::;PIIL Gp/j/JE ..ztJc.. 'PHONE: ~~-/S~J
ADDRESS: ,P'O &UtJ i?/tJ()~ ifil;:E #JAlDATE: ;U"fj~?
SIGNATURF,:~.eff~-/.b.A~ BLDG. PERMIT , 7'1...:?d>3
SITE ADDRESS:17:I~ " ~' wr ~A/l,f).EPID'# 250 -~4-7~ (;r;J(~-o
FILL IN THE BLANKS
l.
2.
Estimated length of water service, ~ ()
S. ft. I JI inch (el!l) .
~ze 0 wa er serv~ce ·
feet.
J. Location of any couplin9s from structure
~
feet.
4.
Type of sewer pipe. ADS PVC~
,L..~
Estimated length of sewer line ~
cast Iron
5.
feet.
6. Clean 'out (it required), located at
struc:::ture..
-
feat
from
=~~~~_==~~~:===~_~__=~=~s_==~~~__=====-~~s~-~====~~~~~~=~=-=~=---=
This applipation becomes your permit wh~n approved.
BY
DATE:
'~=~~~=~~~~===~~=~=~~=~=~~__=_;#~~=~=~~s_=~s__~_=~==~~-=-;~~=-=:~;-
"..... . .
". "..FEES,;
$ 35...00
$ .5"0
$:- 35.50
i .
Fee for e1ther sewer or
$ .50 surcharge.
Sewer and wat~r lin~ connection permit.
Surcharqe
TOTAL
*
water
individually
is
$20.00
plus
Sewer and water permits issued for new construction must be
recorded orr.' the building permit card at' the time of issuance
to insure that no duplicate sewer and water permits are
issued. '
DATE PAID 4-/Z-,/ctt:j g~~t~~OUNT PAID
RECEIPT f ' .~~G' RECIO BY
( 'b~\\)
, \
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tJtL-
IF
16200 Eagle Creek Av. S.B., Prior Lake, Minnesota SS372 I Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Op~rtunity Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS IlriJ (j)~o.~ ~ ~ ,. ~
NATURE OF WORK Ne.u, (\JV\.d'hJ.J&rlY'-
USE OF BUILDING St:~
PERMIT NO. cr1 - L~ ~
CONTRACTOR
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING '"fir" I ~~.", ~;TE
I FOUNDATION (Prior to Backfill) I l1 's, ~~3-C;"
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~..s.
DATE ISSUED
SEWER I WATER I SEPTIC ~
FRAMING 15.' - 7At'z/71
INSULATION 'l"a1 ,
ELECTRICAL
PLUMBING W 7/Glj",
I
HEATING (if required) {/ ..:7"S. ,~-7-CJCI
FIREPLACE 1=.QI ~~;.'~ ,~{. (p- ,'S,t:t1
GAS LINE AIR TEST<() ~ eAi t. - ;;9'- ~s-
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I WALLBOARD I I
FINALS
U), ~\
S""- 3-<<1~
GRADING (Prior to Sodding) ~ ,
BUILDING -r.. C.~. /0 " /, ff1
ELECTRICAL 1
PLUMBING clJ; y~ ~.,
HEATING . 1/
DO NOT OCCUpy UNTIL ABOVE
NOTICE
qv()~~9J
! / I
m e;/~!'t?
>~ )-/ S /3 c). At.,
.
HAS BEEN 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.
'.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850