HomeMy WebLinkAboutBuilding Permit 99-1312
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iJ CIIY OF rRIOR LAKE ' 0, ~J
1Il.parlm.nl of lIIniJlling In'pttlion ~
(&.:1' ~ ~Final Permitted 0 Conditional C.O. Expires ;,,~.,
r~ r ::J"~
- :~ This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code '.!(' p
>C", ,. certifying that at the time of issuance this structure was in compliance with the various ordinances of the .1'.;1,
City of Prior Lake regulating building construction or use. For the following:
Use Classificatj"n
Sinele Famil v
:l.ldg. Permit N,.,
R3
Occupancy Type
Type Construction
VN
Fire Zone
N/A
Zoning District
99-1312
Rl
Legal Description
L2, Bl, Knob Hill Third Addition
Owner of Building
~iteAddress 4595 Hnmm-lno-hird Trail
Contractor's Name & Address Tom Ho Ime J 447
fA,
Theis Dr., Shakopee, MN
55379
Dare:
Robert D. Hutchins
1J;n~iC:
I
''"':ity Planner
Jenni Tovar
Date:
POST IN A CONSPICUOUS PLACE
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SclfEDULED
"/ . z-S . 00 fl.T.
ADDRESS
4-5q5 H/JI1I'1I1,J~tS(/<D
OWNER
CONTR.
PHONE NO.
9<7-(3/2-
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
- .-
V WORK SATISFACTORY, PROCEED
/0 CORRECT ACTION AND PROCEED
o CORRECT ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: v f::;7';;r-, Owner/Contr:
i/
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
---' -'---'----r-
-r
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS AS9';
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
DFRA
o ULATION.../ P"-
INAL ,~
SITE INSPECTION
SCHEDULED '7j7;I~
..w.,:f.1JhMl ~
qq-/3/2
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
If 1l!J
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(; ~ f.RJI 5v-o,.11,.,ft?,-~ ~
~ _ U ~ I I
l..?J ~~ .~vv1J, .-fvf~,..J '2- h ('~
P-f'-^ c:A.url Jl., ,,/) ~3 =_ t '\}
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n I f'T"" /0
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-----
o
T"'E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
_ r.A :E} ./ TIME
~ IO:-(b
ADDRESS 4-595 HUW\..v\oo\...'1JL,v-oL ~.
OWNER CONTR.
PHONE NO.
PERMIT NO.
qq- 1312..
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o )NSULA TIOf( I n 0 KUP 0 FIREPLACE FINAL ///
~INAL J '< r PLUMBING FINA 0 GASLlNE AIR T~
o SITE INSPECTION CH FINAL ~ 0 /_/
COMMENTS: ~ A - ~ GK-
tJ n:'-i\11.9 \fP^ ~''v\e.~VOIA~~' _
(;) f'jJ4 - ~. -tv-fY1 ~ ~1A t\ _W\.~
(~fP.I/-!;'TAfJ F/Yld I dV-- /}{; -
(4) ~ lh fru> 1'/.lJ{ -
cJ!illJl c,i i/~I ,~<;
nlr<; at- O~
-L
(;., ,t1,,_,
E COVERING
Inspector:
CALL Jr.9850 FO
THE NEXT INSPECTION 24 HOURS IN ADVANCE.
TS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
-'"--~-_._--'-_.-:---~---~-
DATE TIME
SCHEDULED 1?;/~~
/ /
&/J//#;~C7j,I/""/ 7/:
CONn( ~A? .h{,/A?e
9J1-/3L~
~RAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
.ITV, OF PRIOR LAKE
...SPECTION NOTICE
ADDRESS
1575
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA ON
DFRA
o ULATION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~/,j),,;x
/ '<;
0>~
~K
Gr<:r ct/tO
J
.
/S
/'
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F INSPECTION BEFORE COVERING
Inspeclor:, ~~~- ..,<'lI715Ontr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
l/VS/VOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
----'~-'--"-'-'-,.-----'-'-'--------'- "-.----',---'--~.__r
&'f<=
V~A./?;:r,- r/rJ', (j 1_
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
459 S ~U~/>\
ADDRESS
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(fLUMBING FINAL
o MECH FINAL
~MMEN1f~: _
(I) YJA~~
L\o
(;J thulA- \) C;
Q f" IY. LIJn
,,{
LAJU.olAA y..
fG~
~kl~k
c'S>+ P0L~+ (~V (V
RY. PROCEED
r 1ATE !
,::>leJOu
\
\ ""= B \12-0
TIME
/: 3~
CfCf- (3/2-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
tJ ""-
~r
OK--
OR REINSPECTION BEFORE COVERING
Owner/Contr:
C L 447-9850 F R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~ENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
-~'-'--,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 46'15'
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
~~~L.rA,
CONTR.
PERMIT NO.
o PLUMBING RI
!I 0 MECH RI
~ M-WATER HOOKUP
I ~ ~SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTl\: '\ _ _
u,t ~.UJ 40
~I< I k.- ~<-
- ~ - (' ~~
(J'
'1
(~_~O~'_ r),^-
) OAT'
t~
TIME
t{:"!6
'!'l-<Sf.. J:S1Z,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
- ~J:-
r (L"" /~
vf..Ac;e cL MLvJJ-- ~ A., bob<. fu
i"5V{~~
~
~
/
EINSPECTION BEFORE COVERING
Owner/Contr:
C LL 447-9850 F )R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~ REQUIREJENTS ARE FOR YOUR PERSONAL HEALTH & SAFET;/
~ INSNOTl
~11D
~ ml,.' CITY OF PRIOR LAKE
! I BUILDING PERMIT,
. - 5 IllIXl i fEMPORARY CERTIFICATE OF
~ I ZONING COMPLIANCE
.A.~ UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. ~
Clc?- /3/2-
DIRECTIONS '_
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
<-t('"'7< /lC-..,,-_./t_ h / .~/ ;;.
3. LEGAL DESCRIPTION -"
1. DATE
BLOCK
/
1<./
:z 5- 3t.fc(- 007-- 0
/::/1tJ/5//,/1 >ij/&~/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12, NO, OF STORIES
LOT
;A
PID
13. TYPE OF CONSTRUCTION
ADDITION
14. OWNER
15. ARCHITECT
6. BUILDER
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Tel. No.)
(Tel. No.)
49h" ;JC-''1'' J
h~ !/O/"A.c? 0(,1 '7 T~ '<i! ; <; /J~ )A~;k"J.::;,,,:'P/7
7. TYPE OF WORK Fireplace CJ Septic 0 ' Deck LI Re-roofing L1 Porch LI SEATS
New Construction,s..--- Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE
Chimney Ll Mise, Q!. ,/5-; OO::? 0'
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No ;2..... I - 0 t1'
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 pennit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
~ """7/ /' #- L .
X ~-_..,.....e " C/ 7'7' //-.,-'79-
-..- Signature
(Name)
(Address)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
License No.
Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fron'
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA D
USE OF BUILDING
.!5F"fl
OFF STREET PARKING PILING LOGS Ll PERCOLATION TESTS Ll
SPACES REQ. PLANS & SPECS Ll SETS
SPACES ON PLAN SURVEY Ll COPIES
PERMIT VALUATION 2%~.~.rx-. PLOT PLAN Ll
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I " 111 IV V
Occupancy Group A B E F HIM A S U
Permit Fee ..........~~~~~~...1...~...~..~... $~I ?
City:
Amount Brought Forward .................. q:
Park Support Fee .... ....................... <t
SAC "."""."."".""................... $
Collective Street Fee ............. .......... $
Sewer Tap ................................... q:
Qc' <1'.
Pressure Reducer .':0..................... $
Ac;n. (92,
I ~q) '<90
Plan Check Fee ............................. $
Slate Surcharge ............................. $
Penalty ....................................... $
.2S
'I()lj~ .Of&
177.S0
q,c; .00
I FYI .00
(oc; , DO
Sewer & Water Permit ...................... $' ~C;. t:;n
GaS~i Pla~ en... ..""."""...... $~ - 0 . 00
This . co s Building PermitY'91.J,n/)pprDVP4.C
13y.,.. Date I'''' f::J--r./
ertifica.te of pancy
Paid :8 1/ a 3 2. / Receipt lio" 30'02 0
\ued / .
Date /~~/o/9 By d1tL
is to certify that th.e req, uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed (J. req,uested. T~'S document when
~~~!a/"tr constitutes a temporary Certificate of Zoning comPlian~nd arrows~struction to co mence, Befel:.: occuPS a Certificate of o~cupancy m t be issued.
~JL..<-.,I~..u-v,~ ILc '~-t1A ~ ' .Md'\L:l..~ /"'~ ."'--~__<
clfy Planner Date S~I ~onditionljf any .
Plumbing Permit Fee ....................... $
Meter Horn ......<;;/.T'...................... q:
Water Meter .....Jfil....................... $ I 2c;.t0h
Sewer & Water Connection Fee ........... $#(!)(!') ..~
WaterTowerFee ........................... $ '10(') ,eo
Water Tap ................................... $
Builder's Deposit ............................ $
Mectlanical Permit Fee ..................... $
Other ......................................... $
Total Due .............................. $
I, c; Of') ./0/)
PJt/-932 I
24 hour notice for all inspections 447-9850
\
,
..
.
Job AddteSS 1~.27d~ (I'M,'P
Heating conttact~J:~j~,., r .
Name 01 Tester _ ) ' t .
Date .9 -/0 - nO
~
()
"6
'3:)) ,
, Petcent 02
Percent CO
Percent C02
Stack Temp.
combustion air is adequately supplied per
UMC Sec. 606
Input
-
,
"
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qq-/3(2-
CITY OF PRIOR LAKE
. 16200 Eagl. Cretik Av. S.E. PMlllh No.
Prior l8ke, UN 55372
HEATING APPLlCAnON I PERMIT
PID.. 25-34-9- 002--0
IC/
<<"", '"1 ~
/.ko.r. ^' Co
'r.'V.VY?o III?"-
Address
Telephone' Jn5r- 47_......- 1141.....\
Furnace Mak4 & Model (' OJr"l t (t. T't'PE Of SYSTEM
An /lA, WarmAlrPlanl1 )(
ModIISlz., ," Vff VI ~ - I 20 Gravlty. '
Mechan1ea1
AIr Condllonlng '( 4 'Tl'.l A1
Vent, Syslem
HEATING OR POWER PLANT
Sleam .
1-101 Waler
Radlallan
Spedal Devices
Conn. Load
~ .
" A/.-r' _II A
<0 Fuel IH 1~<:"FlueSlzeS fJ~
~ Supply Openings IOJ
~ Retum OpenllllJl e,
z
~ Input.1 10, {Jl1O OUlpllt 1(<\. troi)
~ Edt.,
W
'"
Clm..
Other Devices
E
CL
r'1
OJ Ahrallons
r'1
Repair
(J) ,
(J) Ell, CosI t
(J)
....
ISi HEATING PERMIT FEE l\'
....
u STATESURCHNWE r
w -
'"
TOTAL PERMIT FEES f'
TYPE OF WORK
Replacomenl
New ConsllUctlon
)(
Ell Comp. Dale
.50
qq- /3/2-
~. "f~\O \fJ\'T\-\
: eU\\.Q\ttG PEf\tJ\\1'
Roceipt. . '
BuildIng Permit.
TYPE OF STRUCTURI;
Single Family
l(
Two.FamIy
Industrial
Pullllc
Cammerol"
Fee Scheelule
Indus1rlal, Cammorclal & Muftl.FamUy
R88ldentiel, Hllaling & AC
RllSklllnllal, Hllatlng Only.
Relklenlial, Gel A,eplace
ResklenUal, Addhlons & Aherallans
Relldenllel. AC Only
I. .... "" PIIt
1. (0'. ) ao,
3.Ydl..._ ~
Multi-Family
O1her
1 % 01 lob cost 1$39,SO m1r1mum)
.99.60
$64.60
$39.60
$39.60
$39.60
Remllmber 10 add the Slale Surchargll on lhe bolIom 01 this eppliclllion.
The.prlca 01 your healing permll Includes one tough-In end one tlnallnapedlon.
AddiUonallnspecllona wll be billed e\ $35.00 each.
House Healing Teal Record musl be submitted wllh "..,~""" lIiIIlIit ~1\~~A',llelore buUd-
Ing certJficelll 01 occupancy will be isall8d.
~"A'I' ~SII'.I" STIO~IR ""OIllR"n w~h number olaupply B/Id 'e\U1n opoolngs Ilsled pet
loom with CRA's per opening. NIlW sttuclul98 or eddillol\& 88ftd IIoor plen with IUpply
end letwn locations ahown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAV BEMAlLEDTOTHECITYOFPRIORLAKE.16200...An. I:
CREEK AVE. S.E. PRIOR LAKE, MN 55:172.
City Hall buslnese houlll ere 8 a.m_ . 4:30 p.m,
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL). CALL CITY HALL
447-4230
'Il'
I herllby apply lor a mechanlcel system.. perm II and I ecknowladge Ihatlhe
Inlormallon above la complele end occurale; Ihe\llIe wotk will be In conlormenee
wIlh Ihe ordlnanclls and codes ollhe city end willi Ihe .tete bulldlngfmschanlce'
codell; lhellhls 10rm does nal become a permll until elgnod by Ihe BUILDING
OFFICIAL; Ihellhe work will be In eccoldance wllh Ihll approved plan In Ihe
CBBO olll1t work whlcJrrequlrell review and epproval o~;~~/ {)C)j
, De"
IZ,ho /99
Dele
Buurrcal'e Slgnalur&
'~~:i:PRIOIi'(
Cl. "Y
'/-. "1-
U t"1
Thf Crnler or lht L.ke Counl"..
Quantity
"J-
I
I
7-
I
/
/
I
rl- I
1. Blue
2. Gold
3. Yellow
File
City
Applicant
CITY OF PRIOR LAKE
# q9-/3/2-
Phone: C/t/tS' ~;) ?C''7
IlUMBINCJ:"PERNJIT
Applicant: IE~'7 ;1~I/},./Cj
Address: _ dL/ ~ $47~ / ~/
Signature: L.?r- '~/?- ~ ,
..... ,
Legal Description: Lot Block , , "J _ ~.w: _ _/
Site Address: <./r<7r~.. .:~.2.:/ /AAUA
Building Permit # /' PID #-
NOTE: This permit will not be processed without complete information.
Type of Fixture
/
Rough-ins
Water Heatet
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
FIXTURE UNITS
Type of Fixture
......~
E ~~~rw~)r without showet
~astier'
Quantity
"3
(
$
$
$
$
.50
Floot Drain
Lavatory (bathroom sink)
Laundry Ttay(jj...6r 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
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
4-"~\~ yrl\';-1
f C~.~\' I
This permit is graniJed u on the express condition that said
contractor, shall com ~ts with the ordinances
of the State Plumbi e r~m,d:n5';ts thereof.
I R2.o/~'j DATE
,...- A TrEST
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Opponunily Employer
GRAND TOTAL
CITY OF PRIOR LAKE MC
16200 Eagle CreekAv. S.E. Perm~NQ. qq-/3/2-
Prior lake, MN 55372
HEATING APPLICATION I PERMIT
Dal. I-/~-OD PID. 2.5-3~- 00z.-0
Sile Address ~,') J!'/A''''''';''h.;P A}AL~ 12../
. . f
lol Z, Block ~ Addmon I< /lOB H Il-t._ 7H / /<..0
awner's Name.--7l3/1,. 'I.kt. Cc-r..;f_
Address.
Healing Conlraclor ALLIED FIRESIDE dba FIRESIDE CORNER
ROSEVILLE, MN 55113
Address 2700 N. FAIRVIEW.
Telephone'. 651-633- 2 561
FIREPLACE
~lII!>M.ke & Model fh4T AJ (;c.
Moder Size
Conn. LoOO
Fool {96S
Supply Openings
Helum Openings
lnpul
Edr.
Clm.
AUeralions
flopai.
Esl. Cosl $
SL. 7.JD '71i',
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air CO<lo"ioning
Vent System
HEATING OR POWER PLANT
Sleam
Hot Waler
Radialion
Speaal Devices
Flue Size
QUlpul d.l ~
OIher Devices
TYPE OF WORK
_ Replacement
New Consltuc~on Xli'
Es!. Comp. Dale
/ !;q/ t7J
/ / ()(jUJ
qq- /3/2-
(jJ~ 13<(
_$,1'
/./
Building Perma.
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Rece il'l .
TYPE OF STRUCTURE
I. PI"
1. .Gren1
:l. ytll....
(J)
..
::J
a<y ...
('.mlIUcluI OJ
'<
F1k
Single Family
T"",.Fomlly
InooslriaJ
WIJ-Femlly
Public OlIIer
"
.....
..,
..
"
.....
c.
..
Commercial
Fee Schedule
n
o
..,
::J
..
..,
Induslrial, ComlMrciat & Multi-Family
Residential. Healiog A. AC
ResHIential, Healif1g Only
Residential, Gas Fireplace
Residential. Additions & Alleratio"s
Residential, AC Only
1 % 01 job 00$1 [S39,50 minimlllll)
$99.50
$64.50
$39.50
$39.50
$39.50
nemember 10 add Ihe Slale SuFdlarge on the bollom ollhis lll'plicalion.
'"
tI1
~
The price of your healing permil includes one rough-in and one rllal inspection.
'"
'"
'"
Mdilional inspections will be billed .t 535.00 e.eIL
CJl
House Heating Tes I Record mllsl be submiUed with buill!iml JlmDil UWDIll:r before bul~ ~
ing cerlilicale 01 -""~''1C}' will be issued. .~
HEAT CALCIJLATIONS RFOlHRFO wilh oomber 01 supply end return opening. lisled I
room wilh CFM's pet opening, New struclures '>r addilions send 1I00r plan w~h supply
and return locations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAilED TO THE CITY Of PRIOR LAKE, 16200 EAGLE
CREEK AVE. S,E, PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p,m.
L
"
::J
,
ALL WORK MUST BE INSPECTED (ROUGlt-IN AND RNAq- CAll CITY HALL
...
o
o
CJl
'"
I hereby apply k)l a mechanical systems permit and I acknowledge thaI the rg
Information above is complete and accurale; lhallh. work will be in conform<<n<.":'
will, Ihe ordinances and codes 01 Ihe cily and wllh Ihe slalo building/mochani,
codes; that this IorIO does not become a permil unlil signed by Ihe BU IlOI N
OFfiCIAL; Ihallhe work wiil be in accordance wjlh Ihe approved plan in the
case of ail work which requires review and approval of plans.
447-4Z30
&~ ?-lJ"'
AWl:
B'
ii/vivo
I ' Dale
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GREEN. .....E
YELLOW . APPLteANT
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S,W. No. qq-/3/ Z-
NOTE:
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: :S--~ ~
ADDRESS: /ofY J1~~~I2.-t...-.
SIGNATURE: ~ ~~ J
SITE ADDRESf{ -ij,Z;yS- ~....i{.::'dJ\f/L",
FILL IN T~ BLANKS
PHONE:
DATE:
;,j'?~/ - Y"/~V
/-,J. 7- "c3
PERMIT # CJ1-j3/2-
25 -3'-14 - 002---0
BLDG.
PID#
l. Estimated length of water service
6?J
feet.
2. Size of water service
III
inch(es) .
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC~ Cast Iron
5. Estimated length of sewer line ~~~ feet.
6. Clean out (if required), located at
structure.
feet
from
BY
s your permit when approve,. /
DATE: 1/ ? 7/ (j 0
/
----------------
---------------
This
------------
------------
==================================================;=
FEES:
$ 1f.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
RECEIPT #
AMOUNT PAID _ "Fn-\
FA\VV ~C.'.l:;',\;clrr
REC'D BY r'. IILOING \
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
~.
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~~
qq~/3/L
Th~ ('~nf~r of lh.. L.kf Counlr)'
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKlJSI
NAME OF APPLICANT
APPLICATION RECEIVED
701'1 !--tCL-Mb--
11/5/qq
I / .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L/.S9!5" HUHMI Nc,BIi<O I k.
I
Accepted
Denied
Accepted With Corrections
c
Reviewed By:
[2~yk
Date: 11- ~~-qq
Comments:
I. ~c.& ,,-l~ C<~ ~~
"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."
~
";
'"'r~''.'.f-~:r;.'''''''
~
QQ-/3/Z-
Tht' ('t'nln of Iht' lib Counlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
lor; HOLM6-
11/5/qq
I / .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1./.595 HUf1MUJ88/!<O TK!.. .
,-
Accepted
,/
Accepted With Corrections
Denied
Reviewed By: ~\...'T"'n F:...""-S......AlA.
Date: II/IS 191
Comments: .:"\1I'r ~";.JJ,e: t"i.J "I"'t-lF" 13~~ n~ .,-..",.. I.o")-r ~JoI...l.JL.o ;;If!. Ef{Ee;~
JC}r- ;-1-4F ~^r..F~ nF=' 1'\1!irl.Jnafo '("'H ,_
_$rF' IAJMfMRT'It"JA' t"lAJ ~F REv(;A.~1!
.s1{}E. .
q'r;:.. A'fT"Au.l~f'N~ ": J. h....AL ~(2Ao.!t" )A1SPlf:.C.T\OI',) JAlF....lf.tC<IA'1'IO:>toJ 2. Ita AO'L<'u" PL....r.J
3, 6zos,."" (",,"'=0.... MIill5oJlt.Es 'I. &"S"'N C""'''f'/J''L rL".J
"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,"
~
-".,----- >--_..._---
.-.....,' -- '-.-""'._'
"__'''L'..'__~' ",':; "'~....._ -il'*;-_ ~__~-."'''':_'-. :-;'""_'.'
~~
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'! /-' ! ,- " /
,_ .- \~_ J j;, ~___
Tht ('tnltrof lht L.kt Counlry
White - Building
Canary - Engineering
Pink - Planning
81111 Olt-.lG PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
"/--- i~;
. ,
-
t'.-I r' ,( I'~--J t;;.,
.1'--- _
, '
f -'
Ii / ,,,- /,i'?
/.// 'I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, I -l'-:i;- I -" '." .' L . -')" -'. '--:--'~K!....---;I
/ / ,l" ~I " I 1: 1-11,,'/1;' I I""J f:"< 'I< /) ,--
"-7"'.-.-/,,-/ ,...( ,I/\......vll-,....'I..~ I _'
I
Accepted
1/
Accepted With Corrections
'-'''''
Denied
Reviewed By: ~l~~~, Date: ILc(<(, '07
Comments: ~~L~D eh~~ Ik/L~
-t/.-~-- - L' J
t~lAI\.V\Ar k'A'\.C-VrY/oC 4 ~o, ~,...~t.9VeA ~tJd2p
ttf~/~s.{jD pr ~ I~ I~ f;
"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 t.l c:; I '-) \-\ 11lM 1M \\Ac" \.n,' r-d \;::"r.... " \
NATURE OF WORK ~I("ll) (tTV1",1-t-ud'l~
USE OF BUILDING --.S F" D
PERMIT NO. '7'7 -(3l7 DATE ISSUED II ~ I~ Ji9
CONTRACTOR 101M. 1I^ I,^^--.(J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DA
FOOTING
/VIp.
11 1." t1
".
, FOUNDATION (Prior to Backfill) Il/ IZ'/'2./T1 I
PLACE NO CONCRETE UNTI ABOVE HAS BEEN SIGNED
ROUGH - IN~ I
SEWER I WATER I SEPTIC elf) t/x; w I jr 1\
FRAMING 1/ L.L U< '(/nvjlv ~
INSULATION (. ..(;1) '1l/(o~ L L (~<0: ~)o
ELECTRICAL 1(/_ i c/' / .
PLUMBING I~.(\. V.b, Ihol~ 11ft>QJ1 /fLt 1/-10-00
HEATING (if required) . I cj:t /?,h..,.Ar .., I
FIREPLACE I ~ J~I/(X) I
GAS LINE AIR TEST "'Apt.' ( r:'./'. I ~ 1/44~ .:p~ I~h~
COVER NO WORK UNTIL ~BOVE HAS BEEN SIGNED
I I
FINALS
Ge. JY"/;:,-.oo .
/~. ~~~
I /J. sided',!
It/' i~/ I
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE V
. --.:..,_.;.'
- ~lliIl-~,
GRADING (Prior to Sodding) .
BUILDING1J.P~ C,!IS/(Jl1 0. ih7ho
ELECTRICAL
PLUMBING
HEATING
DO NOT
'71,?~
.
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