HomeMy WebLinkAboutBuilding Permit #99-0306
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QLertifirate of (JDrtuvunry
CITY OF PRIOR LAKE
~tpartmtnt of ~uilbing Jn~ptction
o Final 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;
\: '.
Occupancy Type
R3
Type Construction
VN
Fire Zone
Bldg. Permit No
B/A
Zoning District
99-306
Rl
Use Classificatiol!
Sinele Familv
Legal Description
L7, Bl, Pheasant Meadow 2nd Addn
Owner of Building
Site Address
17181 Pheasant Meadow Lane
Contractor's Name & AddrC"..Williams Dev., 1535 Bavarian Shores, Chaska, MN
Robert D. Hutchins f2-tJl..J
BUildingJfficial J
I I 10 I~.,
City Planner
Date:
Jenni Tovair
II I,..> h~
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~/zr9!
R1f
ADDRESS 11/ t I H.tE:A.SAJi fJ1~ I' L IV
OWNER CONTR. [AlIlLJAJlof( ~~~V-
PHONE NO. PERMIT NO. <tcr - 'lO{"
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'R FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
)( EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
@flAoE ~ ~l\L.E'..
1+ t':'a.{t(x <'HOVL.b BE: r'1.AOl:: l"l/IJ 7'Jtf.. ~OE-
&AJ'- ""fi.I1! StNrJJ S',IJL oF '1J1t::.sE. VVlr~ REfj;fJj:.
~()rUUh. KlCHT" NeoJ ~ ,~ 8 M,(/Jl~I4L
'fbS,T!.JIIi <(..bP~ - I..Atf4.€ Il!!!!.ItMvT;;:;. oF RIIJAJ cR.
LAIU 0 SCAQI IoJI. ~ ~N(.e "l/ot',s ~^-ADe
Cuaa&x. I~ oP~NA-l.-
,1I1.4tN-ntCN
~c. r Pet.>c.6:- I -'N71.c.... s;.,,~
.x WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~_ ,'] YAel'/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
h:...FINAL h-
o SITE INSPECTION
COMMENTS:
SCHEDU~D ~l T.
U/~ I p~ ~4. 1&
CONTR.
PERMIT NO.
i9. '5CJ '=>
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 GASLlNE AIR TST
o
, C- c-o~ h r..6
~~ lJ94u--
I11I'k '- t!.- p.
I!. WORK SATISFACTORY, PROCEED
o CORRECT ACTI~ AND PROCEED
o CORRECT 1J:. ,:LL FOR REINSPECTION BEFORE COVERING
Inspector: ~~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INIiNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ojz.1t1 }:IS
/7/8/ PI-lt/71S/'ltJT ,frlQ100 W
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
qq -.30(;;
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDATION
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
^' !f:ECHANICAL
~ A TER HOOKUP
EWER HOOKUP
Ot- SEPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRAD/FILLING
o LKSHOREIWETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
C;M,ENTS~ lb p~C-
Lo~~ - No ~
;.~~ ~ 6l.L 0
~~ 1- ~ ~ \,(t{ ~
~ t,.J.J: ~ (-1V'~
I t (
-,No
TJ f{ IL
G..a-s.
Gyq-~
~:>Ls
/
/'
OCEED
CEED
EI PECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-42~O FO~~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIR~TS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'Y-- co
~ 3~o()
1'l1?;/ PHeJ1SrJ-NI n6lWtJv....L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: (. / /....J 5/4 c-L- S(A../ k-
D.~.. DI.sc!'f~
~c-LJS
"
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~ PLUMBING FINAL
rO MECH FINAL
~. I NSt7t ~c..-
MaN~6rtf:Y?-
DATE TIME
97 -3tJro
o WORK SATISFACTORY, PROCEED
~RECT ACTIC-(ND PROCEED
o CORRECTnR~, ~ FOR REINSPECTION BEFORE COVERING
Inspector: d/-, r Owner/Contr:
v '
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS \11 ~l
OWNER
PHONE NO.
o FOOTING
o FOUNDATION~ft
o FRAMING
P ~ULATION
JiYl=INAL
o SITE INSPECTION
SCHEDULED
DATE TIME
11-~..-4Ot
Cl:~
p'~ ~~S'
COrh
-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
qq - 3~Co
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,COMMENTS:
~)K~- ~sk~()\-. (LtLYI'~
(~\1CU\l'\A~ (')('6" OFF Oy. ~r(~
M~ C(~ ~L--~
/'
-, -\~
~V
/
---....
'""
~>I--~
-
o RK SATISFACTORY, PROCEED
CORRECT7mO NDPROCEED
RRECT. ' C'.ILL FOR REINSPECTION BEFORE COVERING
Inspector: / Owner/Contr:
CALL :l47-~; FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE hQUllEMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
--V-- INSNOTI
DATE RECEIVED
APR
~ ,'.I.~-j
~ b~8
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)
1. DATE
tf./~ qq
(Ll
2. SITE ADDRESS
11/ S1/- lr-:Jfj;{ P?J.U~1\6.i. 7 1--l~ A Qo(.() lA~ ~. l.V '
,
3. LEGAL DESCRIPTION _
LOT '7 w-- BLOCK ~ PID&~ -3L/7- 001-0
ADDITION 4ASA...rr MeAoo w t?J..IA.se-:2 14At1..t1'
4. OWNER (Name)
SA-IY e.
5. ARCHITECT (Name) (Address)
1.lt1cU rT~c.r41"\4\.... V\QS J(&..( l.( t1 ~ ~OIV J' fN
6. BUILDER (Name) J (Address)
UJ' tJ-1 4""'.s
(Address)
(Tel. No.)
(Tel. No.)
1-7S.~-71S-- 3/7(0
(Tel. No.)
o..e Ve.t.. Or H QblT', L , l. ..c.
Fireplace 0 Septic 0 Deck 0
Alterations 0 Addition 0 Finish Attic 0
· (b/~4-~~- ~ :2.4-\.fi
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. Cf.q - ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) , (Width) I (Depth),
? <l ~-r "7I.L
12. NO. OF STORIES
I
13. TYPE OF CONSTRUCTION
~ /t A V'1 E...!;)
14. FLOOR AREA APPORTIONMENT USE
I
)~t:;'~ .d
15. NUMBER OF OCCUPANTS OR SEATS
.s I~ l.e.. F' ~ I L"I
OCCUPANTS ,q TrACk CD
SEATS I-k ~"
16. PROJECT COSTNALUE
"'+ qo _ O~..
17. COMPLETION DATE
7. TYPE OF WORK
New constructi~
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS
..., I ,
Sq. Ft. '3 0 ~ '-I- Width ':), Depthg 4- Yes ~ :r l.( l-..J J q q q
I hereby certify that I have fumished information on this application which is to the best of my knowledge true and correct. I also certify that I am \hJ owner or authorized agent for
the above mentioned operty 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
buil~'.2lf9lPcial c v ~ this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter uponthe property to perform eeded inspections.
~,F. -D..-'l. ~ LL, ~ Dt a.J <....L. r. Q1'Jt} 0 J:3 ~~
..... - . Signature - License No.
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
:SPIt
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
10. CULVERT SIZE
FOR ADMINISTRATIVE USE
Back
Side
Side
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION _JJ1; f":Cl') .ct::;)
""'-
TYPE OF CONSTRUCTION: I II III IV ( Y.L...
Occupancy Group A B E F H I M-@ S U
Division 1 2(j 4
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City:
'1~2 .~S--
CJ, Ie .en
S-lo . 50
L 00.00
/ Dr:; . C9Q
~5' 1& ~
lIo .00
~
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SETS
COPIES
SURVEY
PLOT PLAN
o
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
~sn .00
I O~.ca
Collective Street Fee ....................... $
Sewer Tap ................................... $
~" $
Pressure Reducer ... '8..................... $
Meter Hom ....q..ll.............'......... $
Water Meter ...lA........................... $ I ;2. '5. DC)
Sewer & Water Connection Fee ........... $-h ') (:) '" .06
WaterTowerFee ........................... $ /rx'J,c!:r)
q5: 00
WaterTap ................................... $
Builder's Deposit ............................ $ ) , 5fYJ . f)Q
I
Other ......................................... $
,Z-':.i.. ~Ll.,.-
Total DUe .............................. $ I,) I-) r
Paid 7:3 73 . l-- "2,.. Receipt No. 3"i"t> 7 $
Issued I / !!f;:;-,
Date 4!l;)/c,,'i By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordin~nce ~nd may proceed as quested. This document when
SigC'~ nner constitutes a temporary Certiyt~ ZO~Pliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
- City Planner ~ Special Conditions ff any
ecomJ; Your Building Permit When APprov~
~ Date ~/,)-
j/ -
Certificate of Occupancy
...."T""~.-.,--_..,.,
I
24 hour notice for all inspections 447-9850
T
qq-~
The Cenler of the L.kt Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
IAlt {{t'CU115 Oeu.
Lf- q -'if
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I , f ?/ ()~tL5dAJ.i N ttidtJW L-N.
Accepted
Accepted With Corrections X
Denied /)
Reviewed By: W~
Comments:
Date:
Lf -/5. or (
(. ~eoJ. a.H QH~~ ~~
"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."
.----.--- .__...__.._-_._-~._._-_.._-_.._._.~..__.__... ..-.-...-....,-...-.--....-......-.
,^(
, (I :'..1.. ".,
,
Tho Conlor of Iho L.ko Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
! f ; /i,' ii' /',
: 'l ,......
I
i.J'
, -! ~/1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J i i ,I ..A U l It ((r(/rv\./LAJ .
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
c::J ,JAN JJ~
_ - 'v...-
Date:
L(~(,-40
Comments:
NlhOO~ rJ,U:lAw-c ~il -Ocv-/~~
10 ~.~ }fdy-~"'D ~~1~)aM(~~
'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 ordinanc~ 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."
-or' .
t'
qq-~
TIlt e..... 0' .IM Lake CO..'ff
White - Building
Canary - Engineering
Pink - Planning
,BUILDING PERMIT APPLICATION DWRTMENT CHECKUSI
NAME OF APPLICANT
APPLICATION RECEIVED
t. . ~ , .
{lIt 1I/{(j//5
q - q - q1
......
LXu'
The Building,Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: '
, 71 ~ I JJl1Cti 54l.4 . It( cOt! aw LA).
Accepted
Denied
Reviewed By: JJ A I...If4
v
Accepted With Corrections
~
r: 1:iB.ec::.... A^' AJ
Date:
.1 'F- ',-
'f-/ (II 1
I
Comments: BultJoFF ~T'"
1k (Jo~IICy€.D 7i
~Nb ALtt~~~(("'INAtSt:
.iJ.&l) UTl'-.LTV ~H~~~ ~" ""lI~H' t4c:.
mAt.71~' .
~ ttJF'..ltoM"'TI~1 ()"'" RE"'~S~ _"i..Af.
e
S€E A-7'TAC.H}'1e..1r'S: ,. FiAJ;:1c.. ~A6~ '^,SP~T1<JAJ I..., ~.~T/oAl 2. aaAO/,VG.
~ "3. EIl~ CONTft..OL. ~r.A<::'uIl~'"
It &n<IDIo' etJNrR.cl. P'-"'N
..
"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."
:::::
>-
~
---"-"'-~"'--""""-'--"..-
GREEN - FILE
MAY - :3 1999 YELLOW. APPLICANT
GOLD . elT.,
CITY OF PRIOR LAKE NO.7?5?~~
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: FiAJIfL (;/f/JIJE :J:""Alc~
ADDRESS: 10 ~OX /0 fJlfJ/J/2. L.rJh5 ~Al
A/ 'I ..LJ . 1, //. _ ' I
SIGNATURE:~~A7./j1/..qr#'/f!~ BLDG. PERMIT # 99-3tJ0
SITE ADDRESS: /7/2/ fJlfelis4AJr fJJJ!jJ/1:)e,U ~e PID# 2S"'3t./-7- () 07- 0
PHONE: J..j~ -/5,R I
DATE: 573/r9
1.
FILL IN THE BLANKS
Estimated length of water service ~~
feet.
/
2. Size of water service
inch(es) .
3 .
Location of any couplings
ABS
from struct~ ~
PVC ~ Cast Iron
~ feet.
feet.
4 .
Type of sewer pipe.
5.
Estimated length of sewer line
from
6. Clean out (if required) I located at ~o
structure.
feet
==================================================================
This apPlicati~~~es 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 ~;C3~'1
RECEIPT #
~~~ . n-t_
~~O r... ~~~~MOUNT
~ n\~'v
~U\~ REC'O
~ BY
PAID ~
v-
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
~~~
~ ~ HEAnNG APPUCATlON I PERMIT
~Da'. ~ ~. [)t- 9~ PlD. 2.5"'347- 007- 0
IJ) , .'
~SIl.Add". ,1/IB\ ~O\~ (Y).pa..Ao~ ~(\iL 5J W .~/
~Lo\ -, BIoc:k I Addl\loft PlIlyiS/lAIT ,vt6AOOW 2NO MON.
~0Wn1'" Naml,L..). II iG4m'{ "Dt..UL..\oO Mfi'\ \- · '1 LC
E ' '
Addr..., , ~ ~~ ~a.Vo-.C"'itA~-<hO("'~ \)r\VL
Heating Conlrector ,'0':\ I ~ u,.G\ -\-i nc.A..f \\ 1 L.
Addr... ,~f:/:) ~GO')( ~Vt.... ~\b,r\ u~ \ '" Mt\' ~~ 2J:) \
~ .
~ Telephone' ',J.Ri- ~fdo \
!;) Furnace Make" MacIel ~A 80 i::
~ Model StUGc.\ C04~'- 45, ()C;O
..-i '
~ CoM. Lou, ~J)~4Jq
~ FUll Nbt + _Flu. Size ).-( II:.
~ Supply OpIning', ~
tE Return openings. J Cs:<t('~, ....9. ~~.,~~u
Input LI b,(XX:) Outpul ~~ 8cJ::>
CITY OF PRIOR LAKE Me
16200 Eagle en. Av. S.E. Permll No, qq. 3D ~
Prior Leke, MN 55372 '
Ell Cost S _ Bulldlng Perml' ,
HEAT1NG PERMIT FEE' 99 ~
STATE SURCHARGE f .50
~ TOTAl PERMIT FEES' 100 ~ Recelpl" ,
lL.
Edr.
Clm.,
TYPE OFWORK
Allendion.
Rep1aceniI'"
EsL Comp. Dat. .
~ Repair,
~
<I
W
I
lfl
.,
Cl
TYPE OF SYSTEM
W.rm Alr Pllnt,
Gfavlly .
Medtanlcel .
Air CondRioning
Vent. Syaltll'l .
HEAT1NG OR POWER PlANT
Steam' .
Hal Weter
RtdlalloR ,
Spedal1>lvlcel
OIhef Oevlcea
New Construclion
x
qq-.30(P
PAID WITH
, BUILDING PERMIT
TYPE OF STRUCTURE
I., ..... _ Aa N
2. ar- . CIlJ
)..,..... . o.mw
SIngl8 Family
Commercia'
Two-F8miiy
Industrial
"'X
MulU.F8I1I"
PubUc . Other
Fee Schedule
'ndullrlll, CommM:laI .. Muni-FamUy
AesidenUaI, Heating" AC
Rllldenliaf. Heating Only
Residential. Gas Fireplace
Residenll8l. AckJllol'1l & Alterallone
RecldenliBl. AC OnlV
1 % 01 Job 001\ (138,60 mfnImlln)
'BIUG
164.50
139.60
139.50
$aIM
Remlmber 10 add 1he S"I& Surcharge on the boUom ofltil appllcaUon.
The prl~. of your h..Ung permit tndUlln on. rough-In Ind one flnal.lnapecUon.
AddiUonallnlf*lions will be blUed II $35.00 each.
House Healing Test Record musl be IUbmllled wllh &w11JIDlI RIDDI OWDIIII btrlolt bulJd.
Ing c.tllllcele of OCC:Upll1cy will be "sued.
IAF_T r.AI roll' "Tln"'.~ 1=JI=0011RFIl wIth "umber of IU)lfIfy and return openlngt lllled per
room wit" CFM's per openi1g. New IlruCl\fre8 or addnlone aend Roor pi"" wilt auppIy
am.! return locaUon..hewn. HEAT lOSS CALCUlATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR lAKE, 18200 EAGLE
CREEK AVE. s,e. PRIOR LAKE. MN 55372.
Cily Hall bullne.. hoUI'8 are 8 am. . 4:30 p.m. .
AU WORK MUST BE INSPECTED (AOUOH-IN AND FINAL) . CALL CITY HALL
447-4230
I he"by apply for a m-echanloar 1y8leml perm't and 1 acknowledge &hll the
Intormallon above Is complete Ind acx:urale; thlt the work will be in contarmanc&
with 'he eldlnanees Ind cod.. of Ihe 1:11V and wllh Ih. ".t. bulldlng/mechanlcll
cod..; lhallhta form doel not become a permit unlll etgned by thl B\JILDINO
OFFICIAL; lhal the work w\ll be In accordance with the approved plan in &hI
\\\..01.11 work which .oqul... review end .pprovo! of pl-
~"^ , ~ 5- ~/-9G)
, v' 1jPl~'SIgn . 0aiI .
~ :J~' S/Z7/QQ
Bulkling Offic8l'. 8l(lnalure . 06lI
CITY OF PRIOR LAKE Me
18200 _.. CrHkAv. S.E. PermllNo. qtf- 30'
, Prior Lake, MN &5372 .
HEAT1NG APPUCAnON I PERMIT
~ D.",~ - f)./- C)q . pl)..2.5-3'1-'1-oo7"'0
~ Sl.Addr... ,1/18\ ~&.~ iYt~o.dovJ ~~IL S, W ~fl.1
.-i
hi L.ol ., Block I MdkllJn.PflE/iSAfoITM€:"FlOOW 2~AOOrJ..
:il 0wMn HUM LJ I JI i """ ,< \)e.Ut_\O 0 MU" \-. 'IL L
n1 I .. {
E Addma I ~ ~~ ~Q.Vo.c-i,,.,,, ~Oc-t' ~ \)('\VL
Htlllng- ~nlrWctDr .\) -::\ I -) u., ~ ~ ('\C'.;\,...f ~ L
Addr...~~DO')( ~~..,~\h,.c\u.,\\p Mt\\ 51~\
~ Tettphan.' ',J..Iqt- ~~ \ .
~ Furn_ MakllMaCtl ~~t-~N . G 10
~ MocStIs1u5L550-r~
.-i
\D
Conn. Laid ,
d FUll Aue SiD
z
!2! Supply OpInlno. ,
0
I
a.. Rwr n Optnlno1 ,
Input 0ulpU1
Edr.
elm..
nPE OF SYSTEM
Wum Air Plant.
Gmlly .
Mechlnlcal
AIr Cond1llonlnv
Vim. Syllem .
HEAliNG Oft POWER PLANT
Sltam' .
Mol Weler ,
RIdl811an ,
SpecI" o.va. .
Other Devices
TYPE OF WORK
RtpIIctni.nl
AIle,adont ,
New Conalrucdon X
eaL Comp. Dale .
8ulldlng P.rma., CJ9 - 30{e;
::c; 9 ?.9- PAID WITH
l BUILDING PERMIT
~
~ Repair
I-
55 Ell COIU .
I
!f1 HEA 11NO PERMrr ~E .
I-;
Q STAlE SURCHARGE $.
~ TOT At PERMIT FEfS .
n:
LL
LfD
.50.
~ Reel" , ,
1"VP1F OF ~"'RUm11~F
.. .,.. . ....
L 0... . Olr
l."'" . c..tIIIII
SIng18 Fllm1lv
Commerclal
lWo-Family
Induslrial
'X
M..I-Famly
Ofhtr
PublIc
Flit Schedule
Industrial, Commerdal . MuRi-FamUv
R8sld8ntla~ Healing' AC
Ruldsnaal HHfing Only
R.sldentill, Gat FlreplllCl
R.sidenllll, Addillone & AIIlratloos
Resld."UIl, AC Only
'''' of lob C081 (138.50 n*IInuI1)
199.50
$84.50
$38.&0
139.60
I3IUO
Remember to add tile Stale Surcharge on ,he bonom Gllhll appIDUan.
The prlet' of your healing plrf"" Includu 0111 rough-In Ind one final Npecdon.
Additlonallnspec:lions wUl be blllld at $35.00 .ech.
HouSt HeaUng Tesl RecoRl rNI11 be 1U~II.d wl'" IIdIlIDa IIIDIIIlIIIIdJI[ belort IIuIIcJ.
Ing earmat. of occupancy win be lleued.
~~AT r,11 r,l l' u1rw,e, ~l:r"I 'I~~O wllh number ollupply and reJurn opIf".Ingt 11\.III,.
room with CFM'I per opening. New Itrudurea or IddlUonI ..nd IIoor ptln will ~
and ,.,vm localon.shown. HEAT LOSS CALCULAnONS, PAYMENT N4D
APPlICAnONS MAV BE_ MAILED 10 THE CITY OF PRIOR LAKE, '8200 EAGLE
CREEK AVE. S.E. PRlOR tAKE, MN 55372.
City Hall Wlln.. hOURI" 8 I.m.. . 4~ p.m. .
ALL WORK MUST BE INSPECTED (AOUOH-tH AND FINAL) . CALL CITY MALL
447-4UO
I hereby apply for I mtchanlcal .y.'.m. permit and I acknowledge that the
Jnrormalfon above Is comple'. and accur.'.; thl' ,he work wtD HII\ contDnMftCI
wllh lhe ordln.ne.. Ind cod.. o. Ih.. efty end with thl .tate bullclnglmechanical
cod..; lhat 'hll lorm dO'1 no' become .. permll until Ilgned bylhe BUILDING
OFFICIAL; that 'hI work WlCI be In accordance with the .pproved plan In tItI
~\.. 01 .11 work wl.l." ,.qulr.. nvlew .nd oppnMll or pi.....
~~~.~~ 5-~,-q~
t/ 7'~.stg~ · ' . Da&I
~~ 5/2.7ft1Q
BuUcIng Olllcll', Signature ' [7aII
6- 8-99; 9:00AM;ELANDER MECHANICAL
;612 445 7487
# 21 3
ell v OF PRIOR LAKE
I. ....
%. GloW
3. YcIID_
Ala
CIJ
A,I,r"""11
PPNo. qq-$()~
Phone: e/Y5- ~~7.J-
5~ 4Ic.DP,€ ~ PI".)
PLUMBING P~RMIT
Applleant. ,E 14 ,., ~./ JIJ<L eh.t:it. " I C 4' L
Addtess: 5~~~" ~.r.lv,~
Signature: V~
Legal Description: LotI Block I Sub PflEAS MG.I1{XJW 2 NP
Site Address: / 7/ fJ1 / p~ eQ ~t:t '"" -f ,IU~J" fA.) Lot. ^ .e-. /? I
Building Permit # qq - .,3L)(p PID II~ - 347 - 007 - 0
NOTE: This permit will not be processed wlthOU[ complete information.
FIXTURE UNITS
Tat' Ce.....r .f .... ..... c...."
Quantity
I
I
I
"2-
I
I
b
T)'p8 of Fixture
Quantity
Type of Fixture
Bath Tub JVilh or without s"o~r
Dishwasher
Rough-ins
. Water Heater
I '
,:./
Floor Drain
Lavalory (bathroom sinlt)
Laundry Tray (1 or 2 compa~ment sink)
, Shower stall
Sinks
Water Softner
'. . Stand Pipe: (wa~hing machine)
Sewage EJedo~ .
Backftgw Assembly (RPZ. DMie Check, PVB)
Backftow Assernbiy Test
Lawn Sprinkler .
Other
1'1
, , '.
Bar Sink
Water Closet (toilet)
FEE SCHEDULE
~$\\t.\\1
s
9 s-.,;I
s '1-
$
$ .50
Industrial, Commercial & Multi-Family
(1% of job cost. 539.50 minimum)
Residential, New One &. Two Family
Residential, Additions & Alterations
State Surcharge
S99.50
$39.50
GRAND TOTAL
,-t7
S/~-
Thil pennit is gnmu:d upon the exprcu condition mat said
contractor, shall comply in all respects with the ord.inances
or the State Plumbing Code and the amendM thereof.
. (, t?;/qq DA'rn
~ .
AIIc.31
Call for aI inspections 24 houn in advance.
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (61l) 447-4245
An Equal Opportunity Employer
.~._.~.._'- .,.----.-.-----... ,-~...._---'.. "-'-'
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 1'1\~l ~~ ~~
NATURE OF WORK fJ,pw G:h...SJtHr\..I'1"\-r
USE OF BUILDING SFA
PERMIT NO. qq - -Z 0 lot' DATE ISSUED
CONTRACTOR ~ 1 ,'\{ ''r...-.-'" Qo...u.. ,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
t../-/~-7;
INSPECTOR
DATE
J FOOTING I ~.. \\. 15"-~
J FOUNDATION (Prior to Backfill) . (2[) ..s/;;.{, I
PLACE NO CONCRETE U~L ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATERISEPTI~a) 4~/'. (h
FRAMING (/ (d/' YII/ I)
INSULATION Z; 1/ rJ
ELECTRICAL /, II \ .
PLUMBING U~ ldL ~~, ~o' ()b ff-t, 1~~-n
HEATING (if required) ({ d:) 4-1# qC; ~'1 I
FIREPLACE' ,II. l V l' '7"'-'fj
GAS LINE AIR TEST (.J; iI:/') f1. I. I
COVER NO WORtI~NTll ABOVE HAS BEEN SIGNED
~~D I I
FINALS
~ W.~,
RPH
o v: t% -4/1
<t 10 q~
t
GRADING (Prior to Sodding)
BUilDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
C<J -1'3 ~ '11
11/tt>/f1
r
-.
(1) t()/~~/t'/
(]J ~ t.i>/fl
lfNTll ABOVE HAS
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.
BEEN SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850