HomeMy WebLinkAboutBuilding Permit 03-0384
<tlrrfifitatr of @trnpanty
CITY OF PRIOR LAKE
. ~rparfnumf of IJiluilMng Jlnsprrfiou
IFinal Permitted D Conditional e.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.
N/A
Zoning District
03-0384
Rl
I
I
I
'i
Use Classification
SINGLE FAMILY
Legal Description
L15, B3, THE WILDS FIFTH ADDITION
Owner of Building
Site Address
3315 WILD HORSE CIRCLE
Contractor's Name & AddressqUDDI GAN CjJSTOM
ROBERT D. HUTCHINS ( I ~
. BUildJ'g Official \\ \\ )
D 'J'
BLURS., 22133 LOGAN AVE., LAKEVILLE 55044
DON RYE
City Planner
Date, \ f\ A , .
V v
Date:
: "f
CITY OFJ'R10R LAKE
INSPECfiON NOTICE
SCHEDULED
ADDRESS.
33/s- W,/J AOrH
OWNER
PHONE NO.
CONTR.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIDN
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMEN~:. /
/ <;p ,
ell/I:; 6"1,(
l'
!f.,/ " -If - I? tL
DATE TIllE
~/.?7/a.3 "Iff'
L/f()~
I',JJ/c,~" Lv~lv", b;;?)
'-'
fl <, ?,x'l
~ILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
Ek.iJ.. \.VI it., 6ft/dr.
!)r ~ J/") t.,u;r:/.
~ 0 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
~~/( -..-;?
lnspectorl" / /' .i'lA'~ Owner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNDn
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE nile
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ttJ~~r
,
ADDRESS :r~ /<:;
l. );[1'1 I~,. JCJ
OWNER
CONTR.
PHONE ND.
PERMIT NO.
~r 3~'f
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlIie.AIR TST
fl ~..I
COMMENTS:
, .....
C \.0".0'
J!. \r<'J
~-J_~'l'~
iWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORREcrr.r' CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ -1- Owner/Contr:
CALL Jr.LslFOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN$NOTI
.-'--." ----- ----.-.-.-.---.-..-.-..-.....-------...-.-----.--.----....-
DATE
tf/~
~~(S- I~(-V~ ~~ ('..112..
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
gf FOUNDATION
I[j FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
iMECH RI
WATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
kkhtJ
J-
L -
I
~~
\
I . ~
v~
TIME
3 -?JS4
v
o EXlGRAO/FILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
\.
/' J fUc L
~L-
.-J
~\
YWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
lJiSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~,~ lC
~ 1".-0 J'J
Lt):lc~ L~~
\
~ - ';J~
CONTR.
SCHEDULED
OWNER
PHONE NO.
PERMIT NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
[J FINAL
[J SITE INSPECTION
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
J! PLUMBING FINAL
[J MECH FINAL
[J EXIGRADlFILLlNG
[J COMPLAINT
[] FIREPLACE RI
[J FIREPLACE FINAL
[J GASLINE AIR TST
[J
COMMENTS:
{, .V~/J L.i'w-~{ ~t 1?t., ,
!_ lL.~!* ~M
~ ~K SATISFACTORY, PROCEED
tytORRECT ACTION AND PROCEED
[J CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector. * Owner/Contr.
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""""
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please .!\'Pe or print and sieJl at bottom)
ADDRESS
55/r
W;/J
1-k'fi'"C
{'7,c ~
LEGAL DESCRIPTION (office use only)
LOT If"BLOCK 5 ADDITION W, I)"
OWNER
(Name)
(Address)
BUILDER /7 '~,.
(Name) G-\I"I 7r.11.
(Contact Name) _ '" ~
(Address) 2211'1'
TYPE OF WORK
o Misc.
0!k~ KtArlM
,,~.J;Q''''^
d
{OCIt:loo1 Aw
I
Date Rec'd
.5-/7-03
I. White
2. Pink
3, Yellow
File
City
Applicant
I PERMIT NO. ()3 - 05' g 4-1
~~
ZONING (office u,,)
1"'-1
PID 25-375- D30-{J .
(Phone)
(Phone) !Jf2.-Ljl,-? -/ '"
(Phone) -,/2- 'j Z}?- <IF 2t.
L..k,,,,(/~ thn.. ~
~ New Construction
DLower Level Finish
ODeck
OPorch
ORe. Roofing
~ Fireplace DAddition DAlteration
PROJECTCOST/VALUE (excluding land) $ l~D, DOC
.-
~~~.o(Jo,ool
$ d'f'-l 9. 75.:1
$ I .5'~ . :s~
$ / Yo,()O
$
$
$
$
$
-
I(,)(,h (:J 0
IO() . co
_~~.!5:'O
.yo,dtl
This Application Becomes Your Building Permit When Approved
,..
~ ~ 5/:z.-tt/O?
t
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-me ioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submltted plans I am aware bUlldlOg offiCIal can revoke thiS permlt for Just cause Furthermore, I hereby agree that the City OffiCIal or a deSIgnee may
;t();:.:to pe ?JZ ~specnons ~ 17' '7 5 -/7 _QJ
y J Slgnature/ Contractor's LIcense No Date
/' ..;..,
j Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
\ Gas Fireplace Permit Fee
Building Official
Date
,
I Park Support Pee
I SAC
I Water Meter Size 5/8~ 1
I Pressure Reducer
Sewer/Water Connection Fee
#
#
#
DRe.Siding
OUtility Connection
$
$
$
$
$
$
$
$
$1<;"<1.00
I Z. 75.0'0
:3 00. (J 0
7o.tJO
I 2..00 . dc
700. D a
ISo 0 .0'0
Water Tower Fee
#
$/0.31z..Sq
I
,
I Paid /d, :!9Z.3 7
I Date 4- 41- -o?
I ~~ce7' "'.3' 7"f /
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
~~l~ne;:~ ~mporMY Cffiifi;;~;/:~li~" ,nd 'll~tion :::;en"~fo; ::~:~~~;:': ofOcrup'n~ must b,
Planning Director 0ate Special Co~itions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue PriOI Lake. MN 55372
Builder's Deposit
Other
I TOTAL DUE
I~ 4--']--03
"-- White_ - Buildinij)
Canary - l:ngmeering
Pink - Planning
ThO' ("..n..., of Ih..I..kf ('ou"lry
BUILDING PERMIT APPLICATION DEPARTMENT CHE.CKLlST
NAME OF APPLICANT C;U DO I 6 A N <!.-;()..5TDM eGD 12-5 .
,
APPLICATION RECEIVED 3 -/7 - 03
The Building, Engineering, and Planning Departments have reviewed the building permit
application tor construction activity which is proposed at:
33/5 WI GO HOIGSt:- ~I Jeu&
Accepted
Accepted With Corrections
~
Denied
~ :4J;J
Comments: ~~ cJ.-f!.f 4~ -.,...;::t:;; ,
R~ ~ /J-rri) ...hOOf) ~.~ (7~-J
V
Reviewed By:
Date:
3P9;!o3
~.
"The issuance or granting ot a permit or approval of plans, specifications and
computations shall not be construed to be a permit tor, 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
C"n"ry - Enai.Deel:!rg
C'Pink - Planninq . )
Tht (-tnll'r of lht t.kt {'ounlry
BUILDING PERMIT APPLICATION OEPARTMENT CHFCI(I l!il
NAME OF APPLICANT
APPLICATION RECEIVED
i i i 'J. 'I " , '
1..../-' v/ c_/r1!\j
,
-,. - - .-,,...--
! Ui' i Lc./iJI:,,~.
\..,'-,
17 - (~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i II L U I I( I. ,.'-'t-- '! 1 'i C-
\ - _,1,_.--/.... \..,.,' '-' \.....-L-
;.. --
{I 1
.' .._.~., t '-"'"
Accepted
Accepted With Corrections
v
Denied
~
1 -
~~
A.c, ~ ~
~~.
Date: 3~h3
~L Ih- ,A':!'-,
Reviewed By:
Comments:
"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."
eI'" - Al.IiIdiJuL
arv . E'~.9!.neeriii!:t)
Ink - Planning
T"~('.III.r of 11I.1....Co...c".
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI$I
NAME OF APPLICANT 60 VD I (1 AN t,.l/ST[)/-j tLAJ 1<:..5 .
I
APPLICATION RECEIVED 3 _. /7 - 0:.3.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33/5 \'i I GO HoesE" C! J((~,U::;
Accepted
)(
Accepted With Corrections
Denied
Reviewed By:
MIJ
Date:
3 - 3/-0.3
Comments: Se~ Reverse Side for Addition::lllnfnrm<>tinr'
See Attachments' 1) Gr"r1i"E Pbn. ?} Frn",inn C:ontrol M"""'l1T"'"
"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."
86/18/2883 13:59
9524481748
AL T A CLEARliJA TER
PAGE m
I~OOl
,.".. - - . ~''''''''.'' .....~u....
CITY OF PRIOR LAKE
HEATING/AIR CONDmONING/FlREPLACE PER.l\fiT
DlItl!R~'d
r!'!<0!l0 Mle '" J!!1!!t mcllliJll ~ bottoll\l
I ADDRESS
z.,~/~ I J.. \dd..~ _
~::.. ~1;. j'PERMITl'lO. 3. - ?-8l/ ,.
.1. Y.-l,,", Appn-z V .......
I ZON.ING C-...., I
LEGAL DESClUPnON (ofli<t "'" ooly)
LOT BLOCK
Auu, uON
PID
g.:R (' h M j-~ (llJ"4a-'H'- -iJ,"ry"y\d \' (Ph"".) U(pq -Ita (!
(Adrlres')~ D&~ (9.0 G~&L r f..J.>-plo
~;::;:;;t;ft:-~-- m'>-~~~:~~
bJ (AJl4:oe$.) CC"Yl (Zip Code)
(Contact PerlO~ _/lU /.(p (Phone) q~ -If'lj)Cr'-S;:;'"Y7
AJ>PtICANTSIGNA"llJl<B _~~~ .'~_ ,!,A'J!. ~I/(') /IJA
APPLICANT PLEASE COMPLETE BELOW
~WCONSTRUCTION O]l.EPLACEMENT OALTmtAnONS
FURNACEMAKEANDMODI!L LenY"lI-...o &~~e.&WC: FUEL _n~cJ--1~
FLUE SIZE ~o RErum OPENlNGS I;:) . - INPUT Jd6IJ7JU OUTPUT 11/, avz )
TYPE OF "j; "..::.1'4 HEATING OR POWEll PLAN!'
, . iwann Ajr PlIll!1
Gravity
ochonJclll
, lr Condltioalng
ont SYS1lllll
FIREPU.ct MAn AND MODEL
~ Steom
Hot W,ter
Ibdilllion
Splcial I).vie..
o Otber D....ie..
I PLEAst NOTE;
Ajr COlldilionor U~jl!
C8xmct EIICl'OllCIl mlO
:R~ired Side Yard
Solbacb
lndustrill. Co...,...lol I;. Multi-Family
FEE scm:VULE
1% o!Job ""lit Rosldm'lIll, Gu FitqllllCO,
!39.S0 mini",ulft .. .- .."' .
S99.5C RCIldeotial, Addiliom It AI.....tlon.
564.$0 ~den'i.l AC Only
(omU u.. Only)
HEATING PERMIT FEE
STArn SURCHAAOE
TOTAL PEllJ'fl'J.' FElt
S
$
S
.50
$39.50
<9~ ,O3!.50
'. ~ ,~~c
4 VL,
~Q -~~
~'Y
'Sl~)-
Rc:<;dentlal.Hcarlng '" Ale eN"" COll.lln1CtiOll)
Rosidcllial, H~ Only (New CO~an)
E<timar:oa Cost $
Bulldlrlg Permit 11
lIullillllr Oll\dol
D.to!
,
r1U) rr 0j [ 0 ~ ~~lo.
I Dat \ III JUN 1 0 Z~OOt ~r
..
Thla Applicllion Becomes YDur BUlldlllg Permit Wh~. Appnwe"
Ie ~ou. ..otltt for.ll i..poet,... <,52) C4?\lUO.lI B~S1) 4474.45
~~
85/18/2883 13:59
9524481748
~~Ll ur rn!v~ LdA~
't'r-I u~'...
VJ.rJ&,I!I,"".c 1....'1:. LJ,.-A.w rn.4. '!?,l~,*'ff':t,.;':l:"
AL T A CLEARI>JA TER
PAGE 82
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'cJ
(:rt!o:ac tvPE Or Dtiot lU1d hlCl. at bol'lOm.~
ADDRE.SS
'3?::'1c:::- I A \i I rl_hA.--<.~
LEGAL DESCRJPTION (olllat,... only)
LOT BLOCK
AJJVJ ..ON
;:r. ~1; " PERMIT NO. ~3 _'2 G LJ I
~,"f't!1fl'll' "".,......~ :J 0
I ZONn,TG ("""" .'", I
Pro
OWNER
(Name) r',.:.l dd-i('~ ('q.!::b"'rr"Y-> H..".--vv>~<; (Phone) C/-I.OC1-/ loll
v '
(Addtes.)yn 'P-.t-..a I Q.p (,-r-t~ ~ '--'r-{.>-IJfr.,
APPUCANJ:. r:-.....
(Narne>-J .te-~ ,,.,,,<>I-r,_ +-'1:+~.f-.I1"lj..
(Add!es",) /q,a !IJV rnliLhhf;~.--1!!d.
(Address)
(Phone) _ qc;:;, -It.U.:7~~
j)ri~
(City) (Zip Code)
(Phone) qL::;3, - ~,,.....f'C).w
DATE ~D/t./?:J-
,
~
s...~
APPLlCANTSlGNATURE A~~~
(ContAl:[ l>er~on)
Quntlty
OJ
/
.<:::.
~
(
I
.~
APPLICANT PLEA-SE COMPLETE BELOW
Type of FiJ:mre
.8at~ Tub with or without s.how.~
Dishwasher
floor Drain
LavatOr:l' ~Bathroom Sink)
I L!lm(\!'Y Tmy (lor 2 compartment sink
I Showe!' Stall
I sinks
I Bar Sink
I Water Close! (Toilet)
Typt! of FI:lI:tnro
QIIIl1l'ti1y
4-
I
Rough-ins
Watltr flo:atet
W8lJ01" Softner
I Stand. Pipt (Wlllhing Machine)
I Sewage ejector
I Backflow All$embly
I 8acidlow A~bly T~t
I uwn Slltinkler
I Other
I
I
FtE SCHEDULE
:nduuri.I, Commmial &. M.lti.fill1l.ily 1% of job ""'I with. $39.50 minlmnm
Eolm.'ll!d Co.t S
PLUMBJNO PER.'>:tlT FEE $
5T ATE SURCRA.RGE. $
TOTALP:tRM1T FEE $
tomu UJot OtI:l.v)
Thit: AppUeadon Recom...! Your BuUcli.Df; PertUit 'WilEn. Approved
B1rildl", Olf....,
DI"
ll...idDn1Jal"New OlIo .It l\uo-Fomlly $99.$0
RO$I~OI\lial. Mdltinn. "Al!el'>tions 139,'0
Building Pmnit *
.so
131.1/1. P-4/D IiItn..
D1tvG :.' l/of
/)~~4,f,.,.
I
I
I P'I'~ ~ G; ~ 0 ~ ~mINO'
,IDt~~J JUN 1 0 ?~~ U,;
I
__i
fA-'
u
1.4 hOb' ..li.. for ,II ;""....:, . (952) 44?-9IS0, fl 8~S2)44?..u4S
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'd
(Please tv1Je or print and siltll at bottom)
ADDRESS
3315 WILD HORSE CIRCLE
; ;;;,~" ~:~ I PERMIT NO. =. 3 py'l
3_ Yellow Applicant ........:) ~ "-/
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) CUDDTGAN CUSTOM HOMES
(Phone)
(Address)
APPLICANT
(Name! AT LIED FT'RF.STHR ORA FIREsrDE HEARTH & HOME
(Phone)
651-633-7561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
RRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/11/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
OWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
OVent Syslem
o Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO ST-TRC
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEATiNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Penn it #
$
$
$
.50
PAID
8UILOIN WITH
G PIEFlMrr
(Office Use Only)
Buildine Official
I r.ru~ [lg ~ 0 ill [~~tiptNO. .
I D I. IlJN, I: }nWl ~:111 ~
!jl /I
24 hour notice for all inspections (952) 447-9850, rax (952) 447-4245 ,
By __'__'__~=._ ---
Date
This Application Becomes Your Building Permit When Approved
84/24/2883 83:88
5877445565
!3i'pGER E~~
~til ur rrtlU~ LA~t
PAGE 81
U,) ~. .,~ t~L ,~.V~ r^~ Olt~~!~~4~
.,..-.---........-
l(j (.IVl
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Ree1d
..!l.1:i..!:!!.cv,o!orDrtat~~a.c~YWl
....OORESS
.:30 \ '5 witd
; ~=. ~~ I PERMIT NO.;z. ~ ":>. 0 J(
), o.w ".....- ......J, -'0 ,
I ZONING -. ...) 1
\+ane C(('d~
I LEOAL OESClUF110N (011I00 u," ...y)
! LOT BLOCK ADDITION
PlD
I OWNER r
. (Name) (""Ar\r!d,.-,Oi", U-.l.S~ ~UI'\dfr-~
,. (Md....s) :;2 ~ \ ~3 I Qua"",. Ave- ~
{Addftu1 } (C'rwl
(Phone) .'3 s ) ~ t..;roq - .t; f.1 '
S-S-O <-!'T
Czo"CodI)
I APPl.!C - --~-.-..._--
i (Namt)~r~.A_. EXLCt()U.~
I (Ad4ms) $(37 S- W 70-'<1, S-t-r~?-
(AddtuI)
Sc",,",cl'-1 So I' ~
,
~c-..L... ), I _
-,
(Cone"", Penon)
(Phonc) .57);-7 '-Iy - s~ s:--.
LC/YI!"d.W SSo'fk
(CI!)') (Zip CocI<)
(phone) ho/-7V'-(- ::'-s(;.,s-"
DATE c....{ - ..1-l..{-O .3
~...,-,..,._....,_.,.
- J
APPLICANT SIONATUR.B
APPLICANT PLEASE COMPLETE BELOW
Si;tC of waler sef'li~ '1' inches.
Location of &I1y co\lplings &om .~twc - feet.
Type of sewer pipe. 0 ABC B1"PVC 0 Cut Iron
Estimated 1eneth of sewer line..fiJd.. feet.
Clean out (ifreq\.lIred) located al -feel from structure.
/
FEE SCHEDULE
R..identi.l..wtr Uld water lin. coMco,lon S3l.S0 Indunrial, Com 'I'" Muhi.famtly 1% of job coil willi a U9.50 minimum
Sow<< connection only S 17.50 W.lcrconnectlon only S 17.50
Estimated Cost S
Bulldiol Pennit Ii......
SEWER. AND W A TEll. PERMIT FEE
STATE SURCHARGE
TOTAL PERMrr FlE
eUll.~D "--
I'vG A~'1f
~J;l-ifl
. tre ,,-:: Q\fj \~;\~~~IPt No. . .,.
I If': Hn '~: ~.. ~. ','1:1 _'" ,
tc 10)'1' <</
DaI. n<'\ n Q OM'l' \l .
I I~ - J d
J~ hour .otl.. for alll.'ptctlOnt ('51) 44"1r '~.~~=~:..-..=.;:.:' f/
S
$
S
:~
tometl'at'OAI)'}
,.
,
! Thb Appllcatio. aetO"''' Your Bulldln. Permit WIle. Approved
.",It'jot om...
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS 331~ \J"IL/) tfctsE C.,~
NATURE OF WORK N!~ ~1I.UC.t",.~
USE OF BUILDING 'S. r': b. .
PERMIT NO. 03 -- tJ.3f34-- DATE J~S~ED ~ tit 16 ~
CONTRACTOR~NI ~M 'B\O&S p~~-~&a"ce"-
NOTE: THIS IS NOT A~ERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DO:~~O~N~!_",~ DATE
I FOOTING I~ ~ ~\y ~1;.~.l-f,ltO Vi> - I .
I FOUNDATION (Prior to Backfill) ,- /~~ I L( { Vbtef3
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I ~
I elf!, ~ ~I
/;$ 6- y,. -I
DEPARTMENT OF
BUILDING AND INSPECTION
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if reqUired)
FIREPLACE
GAS LINE AIR TEST ;::::-YJ. ~ t-I;:t
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'sriI~ I rb' I
FINALS
v/~~
I
/'Z' (., - I't:. I
~15.& ~ -'t f' I
yi5 :
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING 1-0 I c-
HEATING
DO NOT OCCUpy
~~ r IO~c"
I
~ I '7-/lAte?J
I ~ I
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
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
4 /J/-()~
ADDRESS
.33/ } Iv-,' J ~ Ho/' ~ ',.,(,.-1-<
OWNER
CONTR.
PHONE NO.
PERMIT NO.
63.J,"
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
o PLUMBING FINAL
o MECH FINAL
~cmwILLING
o COMfJtAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Curb !3cJ~- ~
.x.. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: 4~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl