HomeMy WebLinkAboutBuilding Permit #00-0334 SFH
- ... - ---- .,.....~. ..---
QAIE RECEIVEQ CITY OF PRIOR LAKE
BUILDING PERMIT,
I,m I 3 tuW TEM:g:.~~YC~~:~~~~~: OF
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
(yJ ~() 334-
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.smt~03' ~ ~
3. LEGAL DESCRIPTION
LOT -4 BLOCK l'
ADDITION ~JX;~ e r# A:t'J.LJ/r/L:JA/'
, ~R AName) .- (,Address) (Tel. No.) 'iJ97 _~I
Y:,~ uc.."f 1<.. ~R:.e:e'" I ~ ~Vll't.{)e 'j 8L41 fl..rAJ" I'HU ~~4:S,
5. ARCHITECT (Name) (Address) ') we..r. r (Tel. No.)
r,,- lc S"l U l.\ '3 '98a ~
(Address) /- (Tel. No.)
IO/Z-~-?~r~ .......
l~?5"~E !~"''''e.. C!-T >~d.qp ,.,l}JA-
Septic 0 Deck 0 RI~-roofing 0 Porch cf
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
1. DATE
4 - 3 -00
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
v5 J :3 5 Lt-- bt14 - r.,
12. NO. OF STORIES
PID ~
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
l . '.'1
C\~OER (Name)
/f1~.;/'tJ..- Ol>,,-~~
1.'I'Vf!e'aP'"WORK
Nf!~/Constructlor)l(
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Fireplace 0
Alterations 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
1 O. CULVERT SIZE
17. COMPLETION DATE
Width
Depth
YElS
No
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 constructi~nform I existing state and local laws and w.. ill proceed in accordance with submitted Plans.. I am aware that the
:ilding official can revo~il tor j use. ~o eby agree that Ihe city offldal or a de~a; enter upon the property 10 per;rh ;.
// /~ ~''''- ~ ~fuk;;N;Z / / :~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
MATERIAL FILED WITH APPLICA nON
SOIL TESTS 0 ENERGY DATA a
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
Back
Side
Side
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
~f=A
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
( 19 'q. COt)
~
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ... %..~................. :
Plumbing Permit Fee ............... ........ $ J fJ 0 . 0 0 Meter Hom ... .... .... ..... .... .... .... ....... $
$ 100.0 ~ Water Meter ................................. $ / 2~~tJ>(7
Mechanical Permit Fee ..................... I _ ") ""
., ) .. 5" C, Sewer & Water Connection Fee ........... $ +f---!:d-t' 0 .. 0 e
Sewer & Water Permit ...................... $ ~ W T F $ '" ()""" ~
ater ower ee ........................... I ~
46..od
rmit ....................... $ Water Tap ................................... $
meJour Building Permit~en ~proved. Builder's Deposit ............................ $1&0I!> ~
By "F Date .:;>- -:t,- Le>O Other................ ......................... $
:::leofOooJpa~ Paid T?e~O>1/.....~:Z~;.. $ ~l!;Zli
Th' . 'fy th th ' h bo I" d . d . , d 'th h c~atze ~LO~d' d BYed ed /'T '
IS IS to certi at e request In tea ve app lcation an accompanYing ocuments IS In aecor ance WI t e Ity omng r Inance an may proce request. hiS document when
s~. . . PI~an~neerr co connstitstituutteess a a temporary Certifi~te of Zoning comPliance. and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
D~~ ~"{,~k~ · . . ~C-:Atc9~,
~ City Planner Date Special ConditicJs ~y
City:
Amount Brought Forward . .. .. .. . .. .. .. .... $
Park Support Fee ........................... $
SAC ......................................... $
eso .(!) (J'
I,(OO.ad
Plan Check Fee ............................. $
't '2f.) 'Z .2~
-Wf.l.{~
8' . 50
State Surcharge ............................. $
""~C21?
Penalty ....................................... $
24 hour notice for all inspections 447-9850
UJ-{)33!~
The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT .V\~( ."f)
APPLICATION RECEIVED A'fX'\ \
()\ ~f)n \iom~s
\/) demD
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-tcubu I' P\QCe.-
Accepted X-
Accepted With Corrections
Denied I/) /1/1 0
Reviewed BYVa.-W~
/
Date: <5--3"'~
Comments:
~~cJ.l a.~~ ~~
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.1I
DO - 0331-.-/
White - Building
Canary - Engineering
Pink - Planning
The Center of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT r~i\ t:... ( \ ',i (}
APPLICATION RECEIVED AF<'\ \
" ' "
()\,~ () t'\ (j YY\~
\ c,p-, '~'1 (......,1 ("\()
\ \ /-;...,,, )
) . ~ ..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~ GD ~ ... t"\ \( 'r)O r' ~ \ C\ C e... NJ~
Accepted
Accepted With Corrections ~
Denied
Reviewed By: ~t4-~
Date: S-/,1) ~'l.9Q
Comments:
Mcp-~ . '.M~~~, I./\J ~CtU c-6 .?-'-! t-\ 'ar-
V2.e<0 $U~ WV)D ~.sU") ~~,
l<e.-~~ ~5 evev- L-f~ t4cJ~ 'W,~
p{J~AN\Let'^ -kl<~~t IZ~.J~ (\V~~ PH~\ ,
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."
.; . .' . "",. :1. '. ":-r' ~.~
(1) i)33f-
Th~ C~nl~r or thr lab Country .
White - Buildin,g
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT >~ t(' \" n
APPLICATION RECEIVED Atr\ \
\
0\ ~C)n nt>me.s
\1 ) ~ono
The Building, Engineering, and Planning Departments have reviewed the building permit
appHcationfor construction activity which is proposed at:
-1 {k..(bOl P\o..c.~
Accepted
./
Accepted With 'Corrections
Denied
Reviewed By: JJI4l:ru ewftE.SMJlAlAI
Date: J./3/00
, 1 .
Comments: S.,....04~ ,N~TEJt.. KJ"1ol0F1=' "'uSI:..-.B~ ~()IoI~'(E)) '-0 AAI/\ ~o^'Gt.-Bt~~
L'~E.5 ~ MoC.1ot ~s ?RAcr'(4~.
S(E J~Fol((t14T10N ON 'THE R..€uen.sE
s,~. t'tA~ - ' OlllilEJlJA-iMltQJio& ~t" "1Jl6, 'Fll.oA}r- Pn._f!f&."''' 1J1ItlE.
IS Ztl FEEt"'.
5E~ ATmC~Me:1oI1"S : I.~"'A&.. bll~Df: IAlSPE c-r,D#J !JJFoAM,(1t/IJ Z. (dfl/.lI>I~r.. A-AN
:3. Eltos,o~ COIo.)T'llo(..ME:~~>
y. Ell-S,ON C1oNT""12.0l.- RAN
, .
"The issuance or granting of a permit or" approval of plans, specifications and .
computations shalL not be construed to be a permittar, 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. II '
, ,.
.
't/.
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor J1IEil.~ ^ ~
Name of Tester -::c:
Date ..2 ~.lI9'(J f
r'
....
Job Address
Heating Contractor
Name of Tester
()'-u, ~) t
~,.,~t)
."..., , () r _
Percent CO2 L)t l.J)-
Stack Temp. I ;..{) ()
Combustion air is adequately sU~d per
UMC Sec. 606 (r
Input f DO I (JI)
v
Date
Percent O2
Percent CO
"
"
IndUSlrial. Commercial & Multi.Family
Residenhl, Heating & N:
Residental, J-iuling On..,
Residential, Gas Fireplace
Hea1i"9 Conlractor ~ ~~ ~ ~t.L~.~~ _.....> ~ ~ ~~ R~denlial. Additions & Atlerations
- ResIdential. AC Only
Address ? I DO 5' L~,.., .." ~c/ '" ';"'~ J ~J_,. ~ '" .
iel.phone t Cf f;7 c:;J- -7/?;1- - 7 ij.y 0 Remefllber to add the Slate SUI'ChafQe on the bonom 01 this application.
Furnace M.ke & Model ~~~ TYPE OF SYSTEM
, ~ j , ~.......... Warm Ai, Plants
/ "1 (J <<' D,"~ Graviry
MechanIcal
Ai, Cond~ioni"g /~_ .3.,1,-
Vent SYS1e"n
N
.
IL
~
00 -033~
CITY OF PRIOR LAKE Me
16200 Elgie Creek Av. S.E. Permit Nc.
Pri or Lake, MN 55372
HEATING APPLICATION J PERMIT
Oat. ;;L - 2.."Z.... - ~ I PlD .
Sit. Address, t,.- 5~ 3 ~.~ _~) r- P ~ ,; ..#
Lot
BIod\
Addition
Own."s Name
~ ,,- 4 C ""'-
l) I-<'~
~~ "-
Address
Model Size
Conn.loaa
Fue' ,
/7~~ - FlLle Size
Supply Openi"lgs
rleturr. Openings
HEATING OR POWER PLA~
Sleam
Hal Wilt.
Radiation
SpecialOevices
Input
OLllpUI
Edr.
Other DeVices
ct .'" ,
TYPE OF WORK
AII.rations
Replac8l'f1sn1
tiew Cons1ruc1fon
Repair
Est Cornp, Date
Buildif1g Pe,mil "
00 - 0334-
lQ
.-t
..
Est Cost S
.-t
.-t
HEATING PERMIT FEE .$
STAT~ SURCHARGE $,
-OlAl PERMIT FEES $,
.50
PAlO W\TH
Aeceip.' ~UILDING peRMIT
ft.
.-t
o
N
N
.D
III
1.1..
TYPE OF STRUCTURE
I. P\~
1 Cin:n
l ytllOtr
FIle
elly
CualnClOf
Single Family
Commercial
L lwo-Famity
tnduSlIial
Public
Multi-Family
Olher
Fee Schedule
1% o' jcb cost (539.50 minimum)
$99. ~O
$64.50
$39.50
$39.50
S39.50
The price o' your healing permit Includes one ,oug"-in and or.e final i"spectiofl.
AddilronaJ inspections will be billed at 535.00 each.
House Healing Test Record musl be submrned with bUlldina, DerrrH\ !lumber belore bu~d.
ing cerftcale of occupancy wii' be Issued.
o
HEAT kA1 CLJ1.ATION~ REQUIRED with number 0' supptv ano retu'n openings listed per "r1
room with CFM's pe' opening. New structures or adC~ions send lloar plan with supply
and retum 10Gations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CIN OF PRIOR LAKE. 16200 EAGLE
CREEK AVE SE. PRIOR LAKE, MN 55372. '
City Hall business houlS are 8 a.m. - 430 p.rn,
ALL WORK MUST BE INSPECTED (ROUGH.IN AND FINAL) . CAll CITY HALL
4&7-98..50
I hereby apply 'or a mechanical s)'stems permit and I acknowledge Iha\ Ihe
inlormation above IS complete and accurate; thai lhe work win tle in contormance
with the ordinances and codes I)' the city and with the slate buildir.g/mechanical
codes; that this torm does F'ol become a permit until signed by lhe BUILDING
OFr:ICIAl; tha' the work will be i" ilccorda"ce with the appro'led plan in the
case of a,1 work wt1ich reqUIres review and approval of plans.
Z-2-Z-C;1
Dale
2-Z(g~Ol
Date
;,
:.
c:
~
"
,I,
,I,
,I,
r.
,I,
CJ
t"':
~
~
."
XI
o
XI
r-
;..
x
IT!
~
o
o
,..
Feb 22 01 11:41a
p. 1
05,.00;99 THl' 11: 01 f.~X 61~Hi~2~5
CJ TY Of PR I OR L:\KE
;"{.. li () :
a.PR/~>
(bfJJ~
~ /J
-----
lit. c ""'" ft' 111I. I..~.. , .....1"
CITY OF PRIOR LAKE
PLUMBING PERMIT
,Blllc F.l:
~ UO'" '~.,: I
.\ T clio- .'\ppll C III:
" JJ6 ~ CL~A-
'7'Y~-~9;-~1/~
.../--- L.,.dA:_~__~~
Applic.:ant ___s.~~ --r-L ~-ze.~--./;d "'L-,- ",..-t ~hone:
Address; z.. (/,~o.5"" L~ ,...,~./:: c:/ ~
Signature: _~A,.4 ....r' ~ ~,..~.-:-<
Legal DescrIption: lot Alack _ SUb_..,
SileAddJess. ~~~3 /-t'.L.-~ ,P~~
Building Permil II fJO - 0.334-- PIU "
NOTE; This permIt will not bo proce5~ed without complete mforrnatiorl,
FIXTURE UNITS
Quantity
Type ot f lJetLJre
OUilm\ily
Type 01 r- ilCture
Dishwasher
I
Rough-ins
Waler Heater
z....
I
I
~
I
"Z-
Bath Tub w\th or without shower
lavatory (bathroom sink)
Laundry Tray (1 Dr~ompartment sink')'
Shower Stall
I
Water Sonner
Stand Pipe (waShing machine)
Sewage Ejector
Backflow Assembly (RPZ. Double Ch~ck, PVA)
Bacldlow Assembly Te!il
Lawn Sprinkler
Olher
Floor DraIn
I
Sinks
Bar Sink
~
Warer Closst (toiler)
FEe SCHEDULE
Industrial, Commercial & Multi,Famlly
p "/0 of job cost. 539.50 minimum)
Residential, New One & Two Family
ReSIdential, Additions & Alterations
Slate Surchalge
$99 t)O
$39,50
$
S
$
$
.50
GHAND TOTAl
, . \Nft\-\ "~-
$ , PA\O uc.~~~,jl\ \
--, eU\\J)\NG ~
~
l"h.~ perm" I~ ~r;lnl~d upon Ihl; e.prelilo t:Ull~llIUII .hl! said
ennlliJClor, ~hlJlI ((llnply in "" rc<pccl\ Wllh .he Clrl.hnilllCC!I
nl .he Srillt: Plumblllg C ;lInt:l1dmcnl< Ihcreol
____. _ ,Z,z,r.".-() I J)Al'E
/
Call fur i1l1lf1slJ "Clam 24 hour~ In advance
^ I 1.;ST
16200 EagJe Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph, (612) 447-41JU I rAX (612) 4,..&7 LllL15
All Equal OrponLJnily Employer
01
.... """1'1""" .. ~ .,
. , '. .' 1"'- :.' "'., ... . 'I' . , . , . ,
H'b,:':,; ':'. ,. " ;;: (\ ",', ;"; 'i', ,', L::' . ': ;' . ) , 0;:
';fj' '" .l\.y ~ ,: ,~?;'j-l,;'i . : 'i'! :i: ;, J', I ~ ~:~, fv ~ ;' . " L P;ok ' Fie .,'
'( I ." c PRIOb . I i It' .. . .,!I. . 1 , , ., f. t 'I. ; 1. . '. 4 - Q ,..............., I I . I'!." . I k 1 GrGcu _ ell)' '! a..
!. : ~ .~. 'T , '. . CITV,I OF PRI D: I'AKE' . ! p; . ;-/ - ',-""":,'. . " ';: J: Vea... ' c..._ '--,
.:~~~ . j.!."I'.:i.",.I!;,.-I.t:., ,;"....'~i'. .....; ! :()O-0-:23/l ,'. JY9€OF'STRUCTURE g
os: . ~ . / . .,! 16~op ~B9'!', c., Jr "v. s.~; P~rmjINo. ,,:/ '1 . . . . " ,., ,0
"'. " . .'. '1'1'1 J,. P'lor lake '. !~5372. [. . :;':' , . ..';' . ,f-
.,..,. , . ,., . , ", · . ", : [ . '. "... . .[: ..': : . .. ; '.. , . '. . I .' . . ,.
IS! ' . 1 ~ /, : Ii' HI! ., ,,; ,;' ,I "" .1" .' "", SIn~la.Fallllly / 'JWo..Famiry, H., MuIN-Famtly . .'!
n. :.': :/ ' ,,:H.~TlN9.r~~Pl;-lc , ;~t' kP.ERMI! ',> . ". -, ,-:: I':' . l'
,i-;: u_ t' -'~ ,f ..!J: ',I ,i .' ...j'l,;i. ' 'ij I,~ ! ii. -.\i k,;- "jQ t;:) 1,/ () ()l/~O ~~~al IndusllJal. '. '.' .... PublIC .. Olller. ~i
'. Dati' , 0,\\., ',. I'" , 1'1' ,...d( :7:: ..!!J d 7' . . ": '.. I. J
iR .[,. . . .~. H..'~ . " ;..r 1,'1I'i '.! ;,:;;.' Lj I Ii' " DI:I ,;' '. :: : :), :;\~ . 'jf
~ 'SiIeAddress . .(0 S.l' J"~':,I J .;Cti'tf ' .:1 BO~vJl.'4AJ t~, ~e';I'Rh~duJe i.it:d,; ';
. .[1,. "'" i [ , IY' '''riJrji,. .,. '.. . ". '... 'i~; '1, J1["';' U-- . ., .' '. ,.1\ . . ,." ',,,1 . '. ,
~ 'k L/. BIoc:k .J' W ~<ii~~~)' . ,;~: .' it : Ii . 'c,v,t0ti1; .!?lndlktiiiiJ. Commen:ial & Multi-Family, 1,,;\' i. 1 % 01 job cost ($39.50 mfnimum) ; :
i . rCt' ~8. , . I J.. ." ~:, 'lJ ". I .tJ"~ :':,{U"" .' I( ~. · ., " . . . . ", . '1
i'I.; ': . '~.: ': I!r!" :. ('L:i1liil . ;i: ";', AS.:: . ; ,. .~.. II.. :.';' . .:..:.......... ^ · -. ':!8\liId9nllal,HeaI1ng & AC . . ',,:. .:; .99.50 "':t'
.'Owner's Nama . ;.. . -"'w ., fXl..; .... f,J', '.' .:!, \JD'r"oJ I . ! ,I. .;, ." ..
"'" ~~- I':,.,. ,....~'I "'1 .~~ 1"'-.' .J: i~ " 1 . L'~, ~. R....ide,. 9 n ..... $64.50 .J;
. ". . .' .' ". ." i '.' ..',.. .'. '" '; '. ,,'.. '" .1 . '.. ", '. " . '" i' 'II
Address ;.~ ;: : '~'r I" '.' i. '. ..,'. , . .. ri;le~.' . Gas FIleplace , 1 :',i. $39.50 ,t~
,.;, . ~: . !.: l ,~~'r :;~). il\ l:;jl'!~ i,"!...! ...! :~~ t ,f" :.i L "<1. ;;~:Y' '.1" r,..,- _ . Ree~(1lja. ons " Allallllions I,! r . I' ':;. $39.50 . {~:
i;Heatfng Contractor '.1: . '':/;!i.\ I~'~.~ ":. ':,\ Ir'! n-'. " . -~. 'l~ R' Id . '0'1 AC 0 I .',:' ,,:1:' $39 50 ;;~..
'I::! (I " . "'.llk.f.II1-...;~ I', ";(}'-'" ;..' .~., 'j ;.'li P .. .8!l t!ll<!ll, ny . ," i,l, ' ,",
..~;. . . '\J:-.... .\ 5" 'r I ; i'1~ .1 .!~. . "."1. . ~ .I,!.. Ir. . ~ . :t.: i. L I ....i . .' ~': . ::~.' . ,.;: ltli
. 'A...Id ,~e ;.. II'. '. ',: 'II' . t i " ..! i f t. 1 ! .. " '..: .' " , "" ., .,'. '. .;, .; . 'J ~
. "'" feu. , '1..' '.' '. ,.. .." ". ., . '. ... , I ,. . . 'r. ,:;., , "
.1 i . . i i :~, ,h ,l(~:r,~ I,: ::. ! t i,',i;l '~:-i-- I,: . (!~ 'fL' "'. .,,' .' ~;;'be, 10 add the Slale Surchalge: oidhlib.~lIom ollhis application. 'j: ,
telephone. " . ',1;1 . ""', '. .,'. . ~ !:.:..J. "r ,,'J) n ~...l .", I.! ; " "'" ,,'
iwn808 Make~ ~,' fL\l\th~i.~~ t~,\~~~OF,SY~a.:}r(: l.h~P;j~~ ~I your heating ""rmitlncJudes,1~e';iLgh-Jn and one fmalln8pecticn']."il.i>
., ' ? rll' '1:) . ~~~:fl( : .: !,01Wallil /lir,r,lantl , '; " , ',I', '.'1 ' '. :', . : "
,~SIzI . oJ fj i~' !L.i\1/ !" ~ ,I: i ~; lii~':"- ~ '.' :~iIdlti~lfrispllClions will be billed al,$35.;QOl!lifh, );
w l~. I.oad '.. ~ 11 ii:i: I ,,;:1:' 1 ~,. ::.;: .:;' ,'~~~ i;,.oj , i: '.: '~o~~~' ~eat~ Test Record musl be ~la~~1h ",.IWOV {lArmh'_"'f baIore buJcf.,t~?'
~ .;' N -.- '. ii II ~!i :it Y {i (';; . '''ll1 '(U~i)lI!f I.' :" '1I)iIQ~ieI,1e of lICeI/pInQy will be 188~j~ '~l, .' r:
--' CJ\ ual tzt). 1 . " ". '. ,. ."" . .I(;.n lIY8lem.." . .., . , . II" . 1...1. .".',. , ,
it ~el -1~i ';i~i';~' T 1::. "j:, Ir. ,:i.l' 'i!. J ' F'", '" L, HF4T t.A1 r.1 " AJ1nN.~ ~Fnt llfil1=n wjl!l ~~Ol Supply and return openings fisled ~l
2:: $uppJ, Or>enln/s.';l . i " H ! 'I::':H '1 '11";1 : ~l1~o,.O~, ~~W~ PUNT . r()o!)l ~h CFM~ per opening. New 81Iyc'~or.additionssend !loor plan wiIh auppIy .! r
lL :' . ". l~ I: '.":~;:!...: .'\ ::"!:SI8~"; '::';.' ,; I.:, iindr'&lyrn locatlons~. HEAT LOSS,.(:AL<;l,.ILATIONS, PAYMENT AND ; U
o Return Opanings It 'i ': /J;l' ii, I,. ; \;i 11101. ~er: ~". . . AP!;'UfATIONS MAY BE MAILED 10 lJ1~c.l* <;JF PRIOR LAKE, 16200 EAGLE.: ~ .
wI 1" " II . .. I' , .', '1,.1. . . .1' J" : 11".1 CREiK Al'E S E PRIOR lAKl:' MN 55370 . .... . ,
'" I:,. .' ,j,..,.' ~. ,',.", 'i;' ,': , . ~y ; ~~Jalionll'! :.,' ......: '. .. . ~v . . . ...., I.~' i '11' ":J~ I
W np ul Oulblii"i . 'i'.. ". ; ,Y, ,., ':" ~ ~iai 0' Yice .; '! i... . '. '.;.' . .r; , . ..y:. " II . . I. !
51 " . 'N lL' V ,-" h ! ,r,":; jj .J}' f !', J:, ! f.. i.', ' . c~ ~~Ibusinees hours ani hm. _ 4:a~~'~f; . . .~' ,
:~r. , i:.:' . -:. 1,1: . ;..; .~ ~;~"'I".' 'I" ..i:: .: ~.' .. ';I'll! ~ QII., 'Q8,iJcel' i' .!. ': : . :. . Au. WPRK MUST BE INSPECTED (R~uGH; ~AND F1NA4 . CALL CITY HALl~1t: .
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'apat ,.. I st n 'lite . h. "', ".., , . . " [... .M if .
~ " : r . '. i: ~I !~i ' "l . ".'ij ',,;!" 'l~ ';', i ;;1 I : F' ,; I,"'; , 9Ft;'!lfl,AL; Ihallhe work will be in p./1,O,''!llllice with the approvad plan in 'hei;~ !
CQ sf f'-..'t $ :f' i': h '''''lli ~ ~U'I~ "p.' ',,;~ ~ "r '..' . , " ;.,," , case .0' aU work which requires rel(l~. ~d approval 01 plans. !W~ ; ':':
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'1' EATING PERMIT fE.E.i h "';f.;: ;,,':I,..'!.i;;/f! I ~ ':!], (:;" ~AIQ, WI~~~ ~r ~; ;ti~, ". .:Y ,I 'ii' . 'f - '1 --V / . j a, :
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crrATESURC~ARQ~":lt ....i...~I:: :.1,:' "~~~~'I)'''' ,.-;.. , 'I,:., 'i:, 'I:.i~~ ; _/1_/11 Jd{'1
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)TAL PERMIT FE ES: { .,::.: r: ';,;; i ';:~;;C;aiPJ" , ;. . . IloiIdlog Olflcars Slgnatu,a :': . :'; :.: . _ . ,~<.. I
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~~
~NE~
GREEI . fl.E
YELLOW - APPLICANT
GOLD - CIT ~
CITY OF PRIOR LAKE
SEWER AND WA.TER PERMIT
s.w. No. [){) -~
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLI CANT ~) ~l kf..- ~L.--
ADDRESS: ~ 1, \ ~,-rp~ V\ ~
SIGNATURE: Y {l-'~1 ~\..;~
SITE ADDRESS: k,S\Ji, i' H- U ""4 '}y'V \
PHONE: f' d.. D -7 f)'1c
DATE: ~//{,IDtJ
I I
BLDG. PERMIT #3:i LJ.-
f
PID#2$ - 3'5"'1 - fJ 04--C>
1.
Estimated length of water service
FILL IN THE BLANKS
/0 6
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure
feet.
5.
Type of sewer pipe. ABS
Estimated length of sewer line
PVC V
~b
Cast Iron
4 .
feet.
6. Clean out (if required), located at
structure.
feet
from
This applicatio
your permit when approved'! I
DATE: & I fa! rru
I
BY
--------------
-------------
----------------------------------------------------
----------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
SurchargE!
TOTAL
* Fee for either sewer or water individually is $J.1..JSO 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
DATEi::~:d. AMOUNT PAID~2;> r5.td /
RECEIPT # REC'D BY . tIJ- ./ Q~
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
...--
i
r
I
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Coo 03 Hc.l"b" ~c...c..p
NATURE OF WORK N~) · ~
USE OF BUILDING 7)PO
PERMIT NO. no -0334-- DATE ISSUED S:J"~~
CONTRACTOR )\-v-~~ Ot~ ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING V~..,\, 15 ~IUII 3, i&.Dl AA.l4 ~ ,1/ f 3/0 (
HEATING (if required) j ~ \~ ~ ~. ~ ,~ o{
FIREPLACE ' ~ _\)~. S' (8f~ \
GAS LINE AIR TEST ~ ~ ~/O.I 1> ~ ~\ ~, I':: 0 (
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~D
INSPECTOR
. ~
FOUNDATION (Prior to Backfill) {v ~ V (P/91e1)
I .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~P# I,/lc,/do
: '6 J~t'
b-
I
DATE
FOOTING
Wtc"
~-I-96'
, J/~/Ol
I r
BUILDING f.c..o. iJllf, /61.-
ELECTRICAL I
PLUMBING
HEATING
DO NOT
FINALS
GRADING (Prior to Sodding) A 1Y8 ~ {I- /3--0 I
h, /I!~l tr-r. 5(';;l~1-
We. fR. ~117/ol ' Pr' 11/;;'/01
tb:r ~ ql (iI tJ)
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
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~ 50s l+/I/eU),L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
'~LUMBING4ti PNv
MECH_ ~L/'
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
)j.n~1 Z;(.'O
ofP- .334-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:@' bj- ~ (~
~ ~ ~~ ~ ~ 61 ~-
~ _ ~. L ~~~ ,,_ _ . I'd n 0
~~vy ~ (~ll.._
~~ ,~~.~f)~,
,~: ~,~, I
'~~. . I~~ ~.
~~-J-~~i~
~ 7 [).:rL ~~~,
. I
Nv~ --~
~r~
~~~
o WORK 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.
INS/fOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
COMMENTS;
~e
~
~ ~09
~~..~~- , ~~
c:T7 ~ f\ '
A
, 1.0 ·
11'_1011 ""-\ ". c.,
~ y.~ ~.~.O.
W 7(iJP. '\,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
II
r
l7
lIlP'
~ Dj / TIME
SCHEDULEj~. /0: '30
~S-03 !Mk.OR- 4-
(...
CONTR.
PERMIT NO.
00 ..-331
o PLUMBING RI 0 EX/GRAD/FILLING
~ECH RI 0 COMPLAINT
WATER HOOKUP 0 FIREPLACE RI
EWER HOOKUP 0 FIREPLACE FINAL
o LUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
sicJ ~/~,
~u~ M~~~.. A-'PPFo\let;;>
Co~ ~c/R.A-TtON
~w~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION A~D PROCEED
o CORRECT w#.1A~~ REINSPECTION BEFORE COVERING
Inspector: K. K Owner/Contr:
, {~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED 5 ell, Y ;4- r
~OG/~
ADDRESS
Lt~03
OWNER
CONTR.
PHONE NO.
f) .--3 3t/
~
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
S'f-r
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR TST
o
..
~~ -
~ ~~. /
." WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~L~ FOR REINSPECTION BEFORE COVERING
Inspector: 1- . Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED / (-d.-I- f O? iDe)
(p5'D2> UMb 0 ~ PL
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
O-BgL.{
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION .Jii1SMeCH RI 0 COMPLAINT
o FRAMING@ ~WATER HOOKUP ~ FIREPLACE RI
o INSULATI . \ ^ . ~ ~EWER HOOKUP O~/O FIREPLACE FINAL
~FINAL \I'T' ~LUMBING FINAL~ 0 GASLlNE AIR TST
o SITE INSP ~ 1....<,11 . A' \ 0
COMMENTS:YJ1 () ~ -J- /) IIJC~
[} ~ rw:T~/~ - to' -r: ~I
~ ~f ~ (\..-0 df <.ft.'
d) ~ ~~ ":"\ ~ ~ j~ ~
~ ~ ~n) ~ ~.,..~.
Jd " - ..... - 7 (I
t.~ .
(3)-~/~ ~ ~ ,~~'
~~~/~I
--:r-'r ~~ 1-r- ~ ok ,
t!!3. ~'~ ~~
~ r J\V&o ~ -c .,' :t-
~~,
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
;a CORRECT WORK, CALL 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 & SAFETY!
INSlVOTI