HomeMy WebLinkAboutBuilding Permit #99-0308
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), CITY OF PKlOR LAKE \[._~
.~i....,' ~. . ~tPartmtnt .~f ~uilbin~ 3Jn~ptttion :....~..'-~.
~ ..:.:~ I Fmal Pemutted . 0 CondItIonal C.O. Explres;A,)
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I ~t) This Cenificate iss~ed pursUant to the requirements of Section 307 of the Uniform Building Code
. ~. -:.11'1' c~rtify ing ~hat at the time of issua~c~ this structu~e was in compliance with t~e various ordinances of the
..:! . City of Pnor LaJce regulating bUlldmg constructIOn or use. For the followmg:
\" . .
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,"( . Use Classification Sing e Family Bldg. Permit No. 99-308
'-:--(
~ 't~. Oc R3 T C . VN F' Z N I A Z' D" R 1
..i' cu~y Type ype onstrucl1on Ire one omng lstnct
~i:.J Legal Description L1 & L. _ Rl,.Dl"lr 1: PhE'."I~;:mr Mp:1nmJ ?n~ Ar1~n
~- ~ Owner of Building "ite Address 17125 Pheasan t Meadow Lane
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Date:
Date:
Robert D. Hutchins
Jiutlding Official
Jtl'Y II - (0 . ~!IJ
City Planner
Jenni Tovar
~
POST IN A CONSPICUOUS PLACE
....1.
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
IO.3/-0tJ
ADDRESS
1112-5 PflEJ75/1I'lT ME/lOovJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1'1 ~3{)~
o FOOTING
o FOUNDATION
o FRAMING
o INSULA~I
FINAL
~ SITE IN CTION
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 GAS LINE AIR TST
o
COMMENTS:
~ORK SATISFACTORY, PROCEED
o CORRECT ACTI~OA DJPROCEED
o CORREC~ ~LL ~R REINSPECTION BEFORE COVERING
Inspector: iI G Owner/Contr:
pALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
Q !:7~
SCHEDULED ~
Ph~~ ~J
TIME
j{):~
ADDRESS III ~5
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tt'1- 3tJi'
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~D CHRI
,...J!C~ATER HOOKUP
WER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: (!j) ~
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o "'ORK SATISFACTORY, PROCEED
, CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: h,
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
CITY OF PRIOR LAKE
BUILDING PERMIT,
.. 9.. TEMPORARY CERTIFICATE OF IJ1l+rA) Flu;, {'if- 3"" }
ZONING COMPLIANCE ('"%;' J
~4ltL1.)'?!O or>. / J AND UTILITY CONNECTION PERMIT Permit No. - If ~ t
~ 1,DATE
4/z.. /qq
, k/
/' J.LeAS A-w7 H /; A.. 'Q(')(l).J LAN.e...- <). Lv ~
MIf.BfCEIVEQ
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
/7 i Z ~ - J I. X'l
3, LEGAL DESCRIPTION
LOT 3 l c..I--
ADDITION /1..kA--5/.l NT
1. While
2, Pink
3, Yellow
File
City
Applicant
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) I (Width)
..:l <J,. ~"7 '
12, NO, OF STORIES
I
(Depth) ,
'7f.L
BLOCK ( I
I--U..A 00 w
") Plrdo~3L/7-CJ03~
/ J..td ~
4, OWNER
SA--M<-
(Name)
(Address)
(Tel. No,)
13, TYPE OF CONSTRUCTION
F/'f{.A M -e..e,O
14, FLOOR AREA APPORTIONMENT USE
I ;'J.5~-:J... d
(Address) (Tel. No,)
ORS ,G/'ol _ /JJ/~f:'.~f~'~ j.75<;.7/5-3/7t.
(Addres~) . ~ / (Tel. No,) ,j.Ad 15, NUMBER OF OCCUPANTS OR SEATS
/535 B/J V/}/!!!-/n/V .sfltJ~J I tyrrl5t::A- S IN"- LG J="A ~; /->oJ
r. s.si31 B OCCUPANTS .L:J...l:+~~ ,
lulL..LI4,^",,~ D~Vfl.LOt?N-ervT, L,I..L. ,-biZ.) ~~~J...?"\-'+ ...L,,'
Fireplace D Septic D Deck D Re-roofing D Porch D SEATS J "" ......
Alterations D Addition D Finish Attic D Re-siding D Finish Basement D 16, PROJECT COSTNALUE
~ 90. ~~.
8, PROPERTY AREA OR ACRES 9, PROPERTY DIMENSIONS 10, CULVERT SIZE \7, COMPLETION DATE
. . ,
Sq, Ft. ~,o;;z. ~ Width Sb Depth Z <t Yes ~ r -L.L...L J () 0
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 the Xnei or auth~z~d 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
buildi~icial ~ rev~ke this perm" it for just cause, Furthermore, I hereby agree that the city official or a designee may enter upon the property to pe7;.1 :;~d inspections,
X r~...-~~,,.:/'A /...u, L-W A-..."" ([ U-elJ L L_ ~ . oono J 3 E'+ !f
Signature License No, Date
5, ARCHITECT (Name)
AlLl"HJ T eG-TUAAi C-
6, BUILDER (Name)
7, TYPE OF WORK
New constructiO?(
Chimney D Misc,
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
FOR ADMINISTRATIVE USE
Side
USE OF BUILDING
C;~
OFF STREET PARKING
SPACES REO,
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
D
D ENERGY DATA
PILING LOGS D PERCOLATION TESTS D
PLANS & SPECS D
SURVEY D
PLOT PLAN D
SETS
COPIES
SPACES ON PLAN
PERMIT VALUATION
crs con . ~
.
IOe,~or.i C,'
WaterTowerFee .u.uu.uuuuuu.u.u $
Water Tap ................................... $
Builder's Deposit .......................u... $.-115'00. c::>t:L
Other u.u..u..u......u.................... $
Total Due .uu..u..u.........u..u.. $ ..., Z- 0,5' ~
Paid "7 d-o s-:~ Receipt No, :3 ~ 0 /1
Date 8/z,o/c;Cj 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 6!equested, This document when
Sig~1\lanner const~utes a temporary Certificate of ~oning complian~nd allows c struction to com"fnce, Itlfore occupan~ a Certificate ~c~ued,
~'1,' ~~ 4..L1,-'"tc; ~- . w1Ak~ ~ ('
/ CitY Planner " Date - - SpecialConditions ff atiy - -
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ......u.........e,s:CO...C-Q $
Plan Check Fee ..........~fi.{,;.~.~9 $
State Surcharge ..............~.~..:.?P$
S U
~1~~
l.s)l~"1 .li
-5'l, ~
Penalty...... ....... ..... u................... $
Plumbing Pennit Fee ....q1.-:..~... $ I (:) ~ , 0 0
Mechanical Permit Fee ..ri1~.2?.~..... $ J nO -00
Sewer & Water Pennit ...r.r..~7?~...... $ '3S" . t:tr"l
Gas Fireplace Penni! ...r.r.--:.'?:!P..... $ 40 l6>6
ThiSflPt" com..hr=..Auilding Permit When Approved,
By ~ --" Date 0":"1 - 't.1
-r V' ....
Certificate of OccuPancy
Issued
City:
1.tI.~
~~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ..uuuu........uu.u......u........ $
Collective Street Fee ....................... $
Sewer Tap ................. u................ $
,. $
Pressure Reducer .~......u........... $
Meter Horn .........,......................... $
Water Meter ..~.......................... $
Sewer & Water Connection Fee ........... $
AC:;j').C)S
IO~ .OS
qb,~6
125.00
I. '2. t!)O . C>G
- , 1'-zoo .0(")
24 hour notice for all inspections 447-9850
"
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DJ'S HEATING" AIR ......"......ITIONING, INC.
HOUSE HEATING TEST RECORD
Permit No.
("-' ' 'T-
Owner \.J,' /.' .... _J.__ YI;!./A{l;V\,.,h
-; / ,,- I'} . t
Address , ,,/ ""'\__ r1.c..:.,~;,;" n rrle:-\ ..J, ./
Installed By ,r] J <. i" H'\. "-
GAS DESIGNED UNIT
Make !- \ (Y\ "'"t. 1'\ .A....
Model (f (~J c(:~ 1.'1 :) G ,>(':SO
Serial CfCf Q ~; I ri...t..J c:, 'J...J1
;-.1 S '-_ t ~i.:,:)
Rated Input 'J
~
i:
\r ,/ c.:.
,.
,
pilot Timinoc;
Pressure 1 - (;
.; 4-Co ,
Input CFH '
3C. ,<.
Stack Temp .::>'"
Heat Anticipator Settina
~,. ""i\ii'I~ PI, " ,
" ";. ~- "., \":, ".':-
Date Tested / ~ I I
! \ I
Name of Tester ,",../ ,J
..~ING " AIR CONDITIONING, INC.
HOUSE HEATING TEST RECORD
Permit No.
,.er WI' J / ,'. ~'i.I"\ "', f) ~', '/l',':"l.; t r(\.;,/ Yi.'T
Address 171 '1c} {)j'l e.~.c(::\ I,:;"(/n*:.-~(H'J
Installed By IJ~r~
GAS DESIGNED UNIT
Make A r"Y"l .~',- Vl "''''--
ModelU-l\.' ()o --10 CA'7"O
Serial '1<10.)?... J.,l <I "'i ~ l
Rated Input '7c'~ .O'~{;~,'lo
TEST
pilot Timina <.; J ..; .r:.';':'
~) f)'
Limi t setting c~. (~(\
c- (),
Percent co. -I .{.
Pressure '"7" . C"...
\,.r ~
~)
Input CFH "7 (',
Stack Temp ""!') C; (')
~.-
Percent O. ,-', ...,
Percent coi') (,I", , '
, -'f
Heat Anticipator Settina -.;;;-
Date Tested /C,- \ - ':~c-1
t-\
Name of Tester ~ )
"1
" ;-~
TEST
\ ~
~" .'
"
Limit Setting J(-"., '- ':.
'I
Percent co.
Percent O.
Percent CO ...,
;.~ }II..
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9-17-99;11 :56AM;ELANDER MECHANICAL
;612 445 7487
# 1/ 2
I. BIIIll
1. 0014
3. Ydlo.-
Ak
of)'
AppliQlll
CITY OF PRIOR LAKE
PLUMSING PERMIT PPNo. qq-3~
Applicant: ~ /a ~ h./ jJ( Let.. <'t....., I & ..4-' c... Phone: ~Y'5'-:::- Vh f' ~
Address: ~ / C( 1'4-,-H""", ~// r/ L. ,)4 4-4(/1'" ~~.. PY"..; S-,j- 1';> '1
Signature:~4/?' fl~~
Legal Description: Lot 3 Block / Sub 'PlleA9lAIr I'1EAI)dW ZA(j';)
Site Address: / 7 / ~ 5' ~A B4 S"~-/ ~~u..I Ler..........c- Ie I -
Building Permit. 99-,308 .PIO' 25-34-1- 003-~
NOTE: This permit will not be processed without complete infonnation.
T~. C,,'.r ... .11. 1... co......,
Quantity
I
I
I
z.
I
/
I
2-
FIXTURE UNITS
Type of Fixture
Quantity
Type of Fixture
Bath Tub with or without shower
Rough-ins
Water Healer
Dishwasher
I
Floor Drain
lavatory (bathroom sink)
Laundry Tray (1 or 2 compa~ment sink)
Shower Stall
Water Sohner
Stand Pipe: (washing rnaCtiine)
Sewage Ej~or:
BacIdlow Assembly (RPZ, Doubie 01eck, P'JB)
BacktlolN Asserhb;y Test
Lawn Sprinkler
Other'
'/,
Sinks
Bar Sink
Water Closat (toilet)
, -
I
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost. $39.50 minimum)
Residential, NeY" One & Two Family
Residential, Additions & Alterations
State Surch~lrge
$
$
$
$
99'~
$99.50
$39.50
.50 ~-
~'l ~OG oe.~~\\
.' ~\N r-
$"" .....-
GRAND TOTAL
This pennit is grantrd upon the ell.pIess condition that said
contractor. sl'lall comply in all respects with th~ ordinance:;
of the Stale Plumbing ~:flj ~7;;9r~:~
_ ~ -- ATI"EST
Call for aI
16200 Eagle Creek Av. S.E. Prior Lake, MN 553721 Ph (612) 447-9850 I FAX (612) 447-4245
An Equal Opportunity EmplQyer
CITY OF PRIOR LAKE Me
16200 Eegle enek Av. S.E. Permit No.
Pllor Like, MN 55312
99--308
1"1
0...
fu ~ HEATING APPLICATION J PERMIT
1"1
~ Date 9 ,~q- g" PIO' 25- 347- 003-0
if: Site Address 1'l12~ 0.v,c:..~~'" M,~~\ow L~.... ,e I
~ J
; Lol 3 Block / Addlllon,n/eASrlNT /'16AOOW 2,",0
(SI Owner's Name lJ I ) I j c.vl'\ \~ DWf-.'O 0 ml.f' \- I '1 L C
Il-' ,I
Jl Addr&&s, J t)~ ~ ~a.vo..c i fA!"'\. ,~o (" l' .S VC\VL
Healing Cilntraclor D:S I ~ ~ i-; ('\0. ~ ~ C-
Address .(j:)fD ~'"'lL))(. ~~.. \\\b"Au', '''' {Y)", ~~.~ \
~ Telephone' ,J-}ql- 'J..rcIo \
~ Furnace Ma1<lI & Model ~+ ~ N . G lo
~ Model Size 5L - 5~o--re..
N
.....
I.D
Conn. load
. Fuel
o
z
w
z
o
I
0...
Flue Size
Supply Openings
Return Openings
lnput _
Edr. ,
Cfm.
OulplJl
TYPE OF SYSTEM
Wann Air Planls
Gflwily
Mechanical
Ai, Condilioning
Venl SYilem
HEA TING OR POWER PlANT
Steam .
Hot Water
Radialion
Special Device!
Other Devices
TVPE OF WORK
Replacement
Esl. Comp. Date ,
Buitdinll P81mll J
~
Alterations
~ Repair,
.....
I-
a:
w
I
(})
I-;
Cl
Est. Cosl $ ,
HEATING PERMIT FEE $, ~o,
STATE SURCHARGE S
.50
40cP
E TOT AL PERMIT FEES S
o
D:::
LL
New Conslroclion
x
Q9-308
~' p~\O \N\1'\-\
ft' ,~~O\NG pE.RWI\\"
Receipt 1Ju
TYPE OF STRUCTURE
1. GrftII
J, Yd'-
ellr
Conlne_
Single Family
Commercial
Two-Family
. Industrial
'j
Multl.Family ,
Other
Public
Fee Schedule
Inlluslrial, CGmmercial & Mulli.Family
Residential. Healing & AC
Residential, Heating Onlv
Residential, Gas fireplace
Residential, Additions At Alleralions
Residential, AC Only
1% of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
t39.50
$39.50
Remember to add the Slate Surcharge an Ihe bottom 01 this eppflcalion.
The plice 01 your healing permillncl\ldltS one roulJh-ln and one final inspeclion.
Additional inspections will be billed at $35.00 each.
House Healing Tesl Record must be 8ubmilled wilh "" ~;I~,'lI',,. "Ill""" "~f" ~~"il'l' berOn! build-
Ing ~'tilicaI8 or occupancy win be issued.
HEAT CALCULATIONS ~ffll IIRFI) wllh number 01 supply and return openings listed per
room with CFM's pe, opening. New slruclures or additions send floor plan wilh 6\lPply
and relum locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 18200 EAGLE
CREEK AVE. S.E. PAIOFlLAKE, MN 55372.
CUy Hall business hours are B a.m. - 4;:!O p.m.
ALL WORK MUST BE INSPECTEO (ROUGH-&N AND FINAL) . CALL CITY HALL
441-4230
I hereby apply fOf a mechanical ayslems pefmllllnd I aclmowledge Ihat the
information above 16 compleie and accurate; that lhe work will be In conformance
wllh 'he ordinances and cod.. of the city .nd wnh the alale bulldlngll'McluII\ical
codes; that this (orm does not become. permit untilllgned by the BUIlD1NG
OFF1~IAl; thaI the work will be In accordance with the approved plan In the
case of all work which requires .evlew and approval of plana.
~,~~ q-9-q9
~s~ ~ q/;/qq
BuIlding Offlcel'. Rl............ / Date
~~~
~ ~ HEATING APPLICATION I PERMtT
~ Oato q - q,. '1c; PIDf, 25-34-7- 003-C)
~ Sile Addre$$ , ill :t tS \7N,c~~ \'f\e~o~ 1.1:,(\(L~ ..e /
..-l
(I) lot ..9 810ck / Addil10n m€'rJS"7NT nG,&/oow 2 ~
IS)' '
li. owoer'sName,LJ I II ic.\m ''{ De..Uf-\o DMe.r'\ \- I '1 LC
i1J ' '
(f) Addr9ss,I.t)~~ ~'-\vo..('"iu...t"'\. _~Orf_S \)c\v<-
Healing ContJ9ctorD ~ I "S ~ -t; r\CA -( ~ l c..
Address (PfD ~a,u1( \\~, _ \\\'ber-\ 0', \ \,p (Y)t\.) ~~ 2p \
. -
_ r
~ Telephone It J-1l1 1- :;(~'=> \
~ Furnace Make" Model ~~CA f1:)'kTYPE Of SYSTEM
~ G L\ / "J I ~ " L: Watm Air Plants
N Model Sin ,~ L..l..r""1 = ): '"1'~. ~ravity .
ill "? c:. I J I q Mechanical
Conn. load ~- '). '-1 A' Co d" .
+- I J I" IF n ItlOmng .
ci Fl/llING. Flue Size '""1 Vent System
~ Supply Openings. '1 HEATlNG OR POWER PLANT
a 1. Steam ,
i[ Return Openings ) {.If\'1.~ \.... 2 ~~f..l''\tv Hot Waler ,
}}/ n"<) -:l / r"') "" Radiation ,
Inpul ~, Output J(,,: Y'){.JD Special Devices
CJTY OF PRIOR LAKE Me
16200 Eagle Creek Av. S.E. Permit No.
Prior Lake, MN 55372
Q'l-308
Edr.
Other Devices
Clm._
TYPE OF WORK
x
Allel ations .
Replacement
New Construction
~ Repair.
.....
I-
<I
W
I
(f)
...,
o
_ Est. Comp, Date
Est Cosl $ .
8uildlnIJ Permit' ,
C1Ot.60
.50
QQ-306
HEATING PERMIT fEE S
/-~~\O \1J\1'\-\
R...~I# 'ell\\.O\\'.\G I'E-Rl>J\li
E
o
IX
IJ...
STATE SURCHARGE $
TOTAL PERMIT FEES $
IDO
0'0
-
TYPE OF STRUCTURE
1.. Green - Ot~
). Vel'- C_ItIOI
Single Family
Commercial
Two-family
Indualrial
y
Multl.FamllV .
Other
Public
Fee Schedule
Imlushial, Commercial & Multi-Family
Residenllal. Heating" AC
Aesidenlial, Healing Only
Residential. Gas Fireplace
Residenlial. AddUions & Alterations
Residential, AC Only
, % of job cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember 10 add the Stale Surcharge on the ooltom 01 this application.
The price of your heating pe1fl1illncludes one rough-in and one Iinal inspeclion.
Additional inspections will be blUed at $35.00 each.
House Heating Tesl Record must be submilted wilh ~r,r~;..,.. "/IIm" ",'"",hA' befont bllDd.
Ing cerlUlcate 01 occupancy wiD be issued.
.HEAT r.AI r.w ATION~ REQUIRED with number of supply and return openings lisled pel
room wilh CFM's per opening, New slructures or addilions send Roor plan with supply
ami relurn localions shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PAIORLAKE, 16200 EAGLE
CREEK AVE. 8.E, PAIOR LAKE, MN 55372.
City Hall business hours are 8 a.m, . 4:30 p.m.
All WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
441-4230
I hereby apply for a mechanical systems permit and I acknowledge 'ha' the
tnlormation above Is comp~8le end accurate; tha' 'he work will be In conformance
with the ordinances and codes 01 the city and wiltl the ,'at8 building/mechanical
codes; thallhis lorm does not become a permit unlit signed by the BUILDING
OFFICIAL; thai the work win be In accordance with the approved plan In the
~~s~ of all work which require. review and app,ovel of plana.
~~~,_~, 9-9-'19
€~ . q/qL99
GREEN . 'K.E
YELLOW. APPLICANT
GOLD . CIT \'
CITY OF PRIOR LAKE NO. qq - ;308
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: HtJlfL (;121f-LJE ..::OJc PHONE:/J~--jl~~-/g/
ADDRESS: ;o.8ox JI) fkIIJJtL.l9J<E jJJA/ DATE: ?/d7!)J99
SIGNATURE~~ BLDG. ~ERMiT #..!l9-308
SITE ADDRESS: /7Jef5' f'fleA5/JAfJ IfJEJ9dJuJ LA-~ PID# 2.5 -3L../-7 - 003-Q
1<../
FILL IN THE BLANKS
1. Estimated length of water service
2..r;-
feet.
2. Size of water service
I
inch(es) .
3. Location of any couplings from structure
CJ
feet.
4. Type of sewer pipe. ABS
PVC X
Cast Iron
5. Estimated length of sewer line ~.~
feet.
6. Clean out (if required), located at
structure.
-
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This apPlic~ti ~~~~ your permit when approved.
BY ~ DATE: PJ/z.s/99
I /
===========-======================================================
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
AMOUNT PA,ID "",1\'0 ,^,\'i~r\~\-r
, ~G \"t;.\ \..--
REC'D BY ~ aU\\"O\
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
"
White - Building
Canary - Engineering
Pink - Planning
Th. ('.nl.r 0' Ih. lib Counlry
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
U \' \ \ I''''--~ ~J.
cB-3-t/
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l'll~e:> C?h~l),~~ ~
Accepted
Accepted With Corrections
~
Denied /J /2 f7
Reviewed s{f:.Y {/ ~Y- ----=-
Comments:
(. W- ~ tL~ uc;;;:Q
Date: B - /2 - 9 ~
"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."
1C;.~306
White - Building
Canary - Engineering
Pink - Planning
The C~n't'r or the Lakco Co..try
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST,
NAME OF APPLICANT
/ j; It.- L I f-] 1-1 S 0E,V/.
6/3/Qc;
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7/;2 5" 7#Erl,S/i,NT /'-JOlL::;o~1/
Accepted
./
Accepted With Corrections
Denied
Reviewed By: lJlf(...1'"Eft.. EtM~~""IW,J
, Date:
I ,
glltlH
. .
Comments: }.Jf1 t!. ..""MEAl'S
s(~
I AIF 0 ft...... fino IV
ON
I?cvELS E:. 5'0("
.5E.F ~:rrAC~: /. F.,u(.JL.. r.;1I.~IiE IN!>~('_-'IDN l.Af~dNtTlD~ 2. b'M01"'~ RAAJ
S. ['ftDSIO^, C.#JTIlDl-M!.4slJttE5
'-1-. E IZOStON r.oJoJTItO t.- 'Pl.-AN
liThe 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." '
IfI/J ..~-~--,<",,,,,,,,,,.,,,"_'" 1f.,;.~ ......~.....
!
.L
~~~.-
;.cW'o-_-"",
,-.,;:'.' "".--
'?,~;- '3 @i;
Th. ConI.. of th. Llk. Country
White - Building
Canary - Engineering
Pink . Planning
_BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT _
APPLICATION RECEIVED
! I 1/ ! :~
,.
i
/1
/'
-'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, .', "'-- , ,r''- , /'--r ' ), /- L ;j
/,'.' ,I ,- , ;I /' , 1\ I ,/" / r-- / i l' of ,I
,.JI' __,..... _ , .' ,," / ~;: " , _ ~,~~~ "'_'_ _
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
J
~(J:.~
?J
Date:
~, ~-q7
Comments: ,
i0()~~ .c~ p~~ ~ Ov- hA'tV-e
~ ~ 0b~ ()~~ ut 0/('). /.(-'1.
~ ~AJ.e..~ L-".rtJ., \, ~~ :L Y -Q.- .o~
&T ltv~ V~~~ [,.,k:-<).
'.f'\
! ,-sm f),wJWP~ fJ~ r:r: ~ b,,_ ~
fV~ CiO ljJev~ t,?;,<6, 9..a-1AL..o .
"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 1'11,)~ .p~~eu..-! t"\e.~ L&.-\..
NATURE OF WORK r-Jew C'alU.'\\'t-VC.~I~
USE OF BUILDING SF."D.
PERMIT NO. ,9 -so ~ - DATE ISSUED 8 - 'f -'1 '1
CONTRACTOR .k,\l\L'c-..A ~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING' I 'NrA70R I ~.~ 't~AT~~
, FOUNDATION (Prior to Backfill)~flLp~ I~. ~-Z~-~ aJ 9~ t
PLACE NO CONCRETE UNTIL ABOVE ~AS BEEN SIGNED
ROUGH - INS
,---stWE~ATE_B.PSEPTI~~ ) +- 'J-S-P'3
FRAMING _ /3-/ // ~~, h...
INSULATION (/ Y 11/~/1 f I /
ELECTRICAL /) v
PLUMBING V/5t//ti.- t/}..f f/zz/YJ'jJ//Z(1~
HEATING (if required) 1/J1~ vY}/ qAfA-"i {))})2/1(} I ,
FIREPLACE . I, ,.ell- I /;/1 {-, /7'1
GAS LINE AIR TEST I I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
l~ I I
FINALS
GRADING (Prior to Sodding)
BUILDING ~ II. it --vJ
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
_w~ere..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