HomeMy WebLinkAboutBuilding Permit 00-0528
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.~_n..
" 6509 H.-rbo/" t}~,~
3. LEGAL DESCRIPTION
LOT I BLOCK I
AODmoN !1J1i<L10e. B7H
~ (Name)
ft\tdY" o\si^
5: ARCHITECT (Name)
~
DATE RECEIVE~ CITY OF PRIOR LAKE
~ BUILDING PERMIT,
I TEMPORARY CERTIFICATE OF
..:::> /3/ aD ZONING COMPUANCE
AND UTILITY CONNECTION PERMIT
" 'frl']~~
.'1;".
5/31 /00
,e/SD
PID ~?-5-35t1- 001-0
~.'
\A.... t..~
1. White
2. Pink
3. Yellow
cant
Permit No. flO
"\.).,:;:",'
BUILDING INF~TION
11. SIZE OF STRUCTU~E'
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address) (Tel. No.) '11,),,))., .")4- 14. FLOOR AREA APPORTIONMENT USE
~ 7/S Ye~t1f1" br ~ $.6:sLb' sJi71
(Address) 1Tel. No.)
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
~~
17. COMPLETION DATE
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 re e this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X / h.L~ SIJ ~O
I~~ ','"'' License No. ~I'ri\i: ,1:lIMt
FOR ADMINISTRATIVE USE
~~"ER
~
~~~
'CJfWORK
nstructlon lI:
Chimney c::J Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
SETBACKS: Required
Actual
Fireplace c::J
Alterations c::J
Septic c::J
Addition c::J
Re-roofing c::J Porch c::J
Re-siding c::J Finish Basement c::J
Deckc::J
Finish Attic c::J
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yas No
Front
Back
Side
Side
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
5PfJ
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION I~. 00
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Permit Fee................................... $-L 1 ~ .?. ~
Plan Check Fee ............................. $ 73i · Z,(
~cOO
Amount Brought Forward .. .. . .. .. . .. .. .... $
Park Support Fee ........................... $ aso.O Q
SAC ... .. .. .. .. ... .. .. .. .. . ... .. .. .. ... .. .... $ --1,.J 00 · 0 0
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ..~~~................. :
Meter Horn ................................... $
Water Meter ................................. $ I ;;'5- 00
Sewer & Water Connection Fee ........... $~t:)O <'r.2
Water Tower Fee ........................... $ 7o...~ ..&G
City:
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
j.aD .00
/.00.0 C)
'3~.S-D
"0 .OC
Sewer & Water Pennit ...................... $
ce Permit ....................... $
mesltour..Building Permit ~enhe~~Ved. _,
. ~ Date ~"'~
MATERIAL FILED WITH APPLICATION
SOIL TESTS c::J ENERGY DATA c::J
PILING LOGS c::J PERCOLATION TESTS c::J
PLANS & SPECS c::J
SURVEY c::J
SETS
COPIES
PLOT PLAN
c::J
M _
'IS"cO
Water Tap ................................... $
Builder's Deposit ............................ $-1," ,m. ()t'J
Other ..... ............ ................. ....... $
Paid :;I?j LU;.:.~....~:~~o$1,i~
Date t_ "[::l )" /, (f) By I ^ f\J .
request in the above application and accompanying documents is in accordance with the City Zon~d" may proceed ~uested. This document when
~a temporaryCel}ficate 01 Zoning COfI"IlIanaI~~:-~ C 'i'm"""",. P"!2~~~......oo issued.
~-J~~ ~ ,~
City Planner c. Date - Special Conditions if any
Issued
24 hour notice for all inspections (952) 447-9850
o6,~~i
Th~ C~nl~r of Ih~ Lab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
V\if" l!\f\ ()\~
APPLICATION RECEIVED"f\~ 0 \ ~\-) OJ {)t\O
o --
NAME OF APPLICANT
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(p60'\ \\o.x6r ~~{>_.
Accepted
Accepted With Corrections -:><:"
Denied .~/};:? L-
Reviewed By: W~/ -
(/. /'
comm~ja2~
Date: t, - l-c - Zero 0
U 0:::1-.
~
?toJl'C4 H\)~ ~ ~~ ~l-t ~.-- a.pPl'DVcJL \De.~
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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."
~"
Db . 052- r/
The eenler of Ihe Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Y\e..r.~ ()\'\<i11
APPLICATION RECEIVED '~f\~\:-S \ ~\--) Q ()f)C)
o .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~,5 0 q\AT~.x b-i~( 1 r ~ .
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~~ ~
Date:
, ~ ? "GO
IAMI~~ <G;~ ~~~.~ .. .
~"Oj ~\ ~. J4~ ~<n-t ~~,
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 9r cancel the provisions of this code or other
ordinances of the jurisdiction shall-not be valid. II
- ....
OD 'or;~i
Th~ ("fRlff o. Ihf t.k~ Co.nl" , '
White - Building
. Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT Y\er.V\f""\ ()\,\<i'f) .
APPLICATION RECEIVED . ,'\\cllA 0 \ ~\-\ Q()(\(J
o -
The Building, Engineering, and Planning Departments have reviewed the building permit
application fo~ construction activity which is proposed at:"
&50 ~ H-M~ -t1ru (> .
Accepted /
, Accepted With, Corrections
Denied
Reviewed By: (;rJl.II t e.".!so/l, Date: ihJ/1I
, ,
.Comments:See' 1~"'/f1Q t-/~ 4/1 &~ re~erse side..
Seeld+lA.ehl'1~ls; l ~/~ .1A5,.puhHi 1Jtlmufi'D" 02 Crtu./4!J P/R'.
3. ED.sittrJ ~~l\tCo.r Mrt1-;u.~s 'f 'Fr(1~/.~" (j",f,/ &~'
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. Pennits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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...
Job Address '/709 ~~ lie
Heating Contractor ~;!i,ff
Name of T est.r
T
Date I), -/ #'. ~o
-f..1 X
~%
7,&J%
-'3>u
Percent O2
Percent CO
Percent CO,
Stack Tamp.
Combustion air ;s adequater ~pplied per
UMC Sec. 606 f11
Input JI14 ~
"
/
..
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Ronald Joseph Schlink
612-440-8618
p.4
03~06~99 THr 11'01 FAX 6!24~7~2~S
<: ) TY OF PR lOR L..,KE
(lUOJ
-"
,,,.. ( F"'". fI' I'"~ I.... (......."
CITY OF PRIOR LAKE
PLUMBING PERMIT 1#
Applicanl: _,_~",-+L hUc-AoIt -.J.... ~ --..( ,Phone: ~~~ - ~~-O
::::I:~: ;J/~n-::: ~- -E,6c~ J:: ~~~
Legel Descnplion: Lol I Bloc~--.-1 SUb_~ _ __
Site Address: k 50' ~~ "-&e;ry' L...--'L
Building Permit II PIO"~ '~S._LLC;{)I
NOTE: This perm1\ wiUnol be processed without complete information
I lIve f,l.
2 void CII)
~ hilI>:'" l\Pff
, J} ~~~._
~
D
FIXTURE UNITS
Quanhly Type 01 "-,xture Quan\ity
I Ba\h Tub w,'h or wi,houl shower
I Dishwasher /
-",--
/ Floor DraIn
~ Lavatory (bathroom sink) /
I Laundry Tray (1 or 2 compartment sink)
,;;J- Shower Slall
/ Sinks
Bar Sink
3 Water C\oset (Ioilel)
Type of FlJclure
Rough-Ins
Water H~a'8r
Water Sonner
Stand Pipe (washing machine)
Sewage E.jector
8ackflow Assembly (RP1, Double Check, PVB)
Backflow Assembly Tesl
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial & Multi-Family
(1% of job cost. 539.50 minImum)
Residential, New One & Two Family
Residen\ial, Addlhof\s & Alterations
State Surcharge
$99,50
$39.50
$
S
S
$
.50
GRAND TOTAl
s
r PAID WITH
BUILDING PERMIT
\0...-.
~ ~ i~ lli ~"___H_'
-: .::l
Hm pcrmll U Iran\l:d upun Ihe Cllpre"h (UIII,huon thill uid ..,~
conllilClor. .,hall comply in "II rc..pcw. with the: (,rdin:UIt:ClI . I 9 2(XJ)
,,' 'he S,." Plumb"'. Code and Ihe "~'" """.. 'he...r
\ Kc~cIPTNO ./t) ~OnATe
~. ---- A I I.;ST
(;Jfl for all illsVc'lions 24 hour~ In advance:
16200 EagJe Creek Av. S.E.. Prior L3ke. MinnCSOl;l 55372/ Ph. (612) 447.4230 I FAX (612) 447.~245
^n Equal OrrOf1Unily Employer
II,
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~~rf I'R~ ~, : ' diY:OF PRlnR1:.iA'KE . 'j , ':' .':
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u ~, v '. r' i~.:~62~ .~aI18 ~r~k It';': S_~.: . P.~il Nq. /) - h~ .
.. . .'.. . I, I: PriOr: Lake!.UN 55372 ~. .:. .!'
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'; \". :'i'~l;INGAfPLlGAj~ ipEa~~! J l' ': ,
.~Date (brJ-q,~;;~'41::::;..1. ;. '.".~:P,.,..:~.}76~L~f-l~tl;~OLl-'D .1
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:'SfteAdOrMl ~ ~~; ,."~ .." ~:.. ~ l:j.:..... : e_ . I
It.l ,. I f1'. 'Ill. '. ...... ... i ; ,. ; I
. lei \ Block L! "'~!Aadition.; Ufl ~ .. .'.. .... ..': I : "' .
. :,~.! .1 . ' -. . - l' .'1 . , . : : :. I: ! It ; , .
Own.nNam. ~4 :L\~ ..;, .i~' F.d.,\ ~oJ)..:.i,;'i.~I~!.
: r:::~~ ..j;". \ '.: r . ':.t\= .rij .i: . . : i . f: ::{!Il' ' ..
Addrus - \ \-~.... ~~.fi Ji{:s: f7;'"') :.. ,:1,' I.. 5' A\J. ~"-.:.:
'. . i~ \', '~:.!!j ..'! .. "::f;~ rp' ,.~ j. :,I..; '.Li~ . I tl.l q - J .
Heating Contraclor :,." 'V~ii ~ Q C. K. ,:" ~ ,,(.1l.Lr.~~ ~
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Address IbIS." 'i:~. . .i.A-Ve; ,: .. ,'f r ~~
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a-.. l 1 ' '5 6 -..;;..:': !.'. I I
Telephone' ~~ O. ~ ,.i': :: .', .;. ..'.1 ,;:
F_Make..<8;i\ ~iJt.icM-~L\=j~~~~~~~~r
~;':I ".ir. n / ..1.Warh1AilPf.nt$.: ,';
~ISiz.~, .J~ ~..~O \"- W .' :,.'~~aVfty ,.i irt,;, .i~!
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Conn I_...~ !... "I.': .' ,. !~:~caj. . I ..,.
ol..AlG.Y . ',' , .~.".. .. ". .1".
' .j::' :.. ; . ~. AIr Condftbnfrur:~ .: j! i
FueINr..~ ~s~~ "' i, '~\:Ml:Sy,,~~}."IIH:
I 'T ." . ,"...:. ,I . .... "... 1,1" !
sUpply Operings ,ji .),.1:1 ... ... .=:, ~~( ~~~~ pR:r~~~~'LANT
, '! ..:'. .., .."~:St8llh:.' .:.,',.........
Ralurn Opening. ..'....!:-:: "; ~ :;,. > .~~.,'.: HOt ,Wal8r~i ~ ~ {If i: j". r :.:.
: ; :t ., .....: I:.! ;:.:. .;~ ~~n=.,'.l. 'q:'. ,...1.'....
Input Output," ~! ."~ . .. ,': ; . . ... .
. '1. . I - ,. ~ SM~al DevICeS .
.1 " ... ; :!.. 'I'. . \ If-: r. I. ,.'::. .... ,
y . . <, : :. '. :; !~. :lri ..': .,' ! .:. '.:; . :I~! !!'
I' . . ..1 ': .. '.;'.~. ~h.r Devlc~s , '.
;, -:!:, ; ;' . · l !"~ ;! : r: ; ,; I '! ': :
! ;'J. , '. TjlPI; OF 'YPRK ;!'. ,. I:.'.;:....
. ~ :.:.;;.: ~I;:;.~ .1. :!;. !..;.l..-rr~'.
-R~8fHm :. IT.;.:: ~ew ConstructiOn i :
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. E_~ Comp. Date: ;1' '. ; . ~... .;'..
. .: ~ . I.. .. '1',
.. .. ........ .. '....
:sl. Coat $. ;;' . :: 'BU.~~ ~~rmia, ,"'; ';. .. ::!;
.. . I . .1 Ir.: .. ..
d !EATING PERMIT F.EE1. . .~ : :~,.:. ,. :. .~: .' ': .~. . .1. :~. -; , : ...... ....
~. . t '..~' .:..~:.,: :.....".f..~~!..~:. ;. ' ~'.;.'.l.'..
r TATE SURCHARG ~; . ::. .~:. ..~ ~ ~.~\50 I ",;.;r' i:' :::.....; ;-:';':..; PAID WITH
"U . i' " ". .,,:~. ,:. . .SU LD
~1At.PEfWl!F~'" .i':~:-<'_:~~ . . II~GPERMIT
.~ I~ ; :"i .f:"~.': '.';;'.i~~; ., '..
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I , "; . Jt Yellow . ConInctGr ';"
,TYPE OF .STRUCTURE' ~;. 0
...n. .'J.' ;:9
SinuIe Family X lM-FarnJy\ !': Multi-FamIly " ~~ ~
.., . , r I . :' r0
C01p,.,.rcial Induatrial. :.' .' . . Public OUlS r .; ~
-. I 'I.',~ :)~
. :I.~ .!'li .:;:
rea' Schedule i , :,~ I! In
r~ : . I r ,#:.' .;, . '1 ~
;1; :.'. ~I .. '... I ;:. } 'E
.,-~ Commercial & M.,w-Family .,: ." J! ( .1 % of b COIl ($88,50 minimum) ~! ': ~
~~~IiaI. Heat, Ing .. ACil :: ;1:, $9&. f'? p::> &, ' [J ~ .1':~
D_:~ent' I u-.., nnIu I... "H.. LS 0 TiE? fif.'
':'CNIN .i : ra r ~...ng """'1 . :~;!.: r;i. ~. __ LS. .
~~,~~ '"'. Fireplace . .! ~ : I!ii. 139. ~ j,
R~. Addtions & AIemtions:: f': :t $39, a:r 3 O. Ii~u~,. ~ S
R86Jde~r AC Only . 1: ~... .i' $39. , I ..j m
. I l.';u
R--.r ID Bdd the Stale SulchaJge ~ ~e ~ 01 t . . L.:..- ; ,j ~
. . ~ 'J . .,!' 'TI
,'i . p.. _
- : t! . . i. :! ;u
'1lIa'~ III your '-ling permillncludes rre ~ and - inaJ Inspectjon. . i' ~
A~ fnepecIions wil be billed .. S35~ -iCh:;f~ ~
. .. I -; . . .i
H~ ,Heating rest Record must be aub~~ with buitdjn~ RI.DllI numbar before build- .;, '
t~ perll6ca~e 0' occupancy wi be .,.~ .:,.: t. . r ..';.= r
. . .r . . . . j. j' ~ ' : it': I
" f.lFATr.41 rolll mrw,<; "''''I'll ~"''''Il wilhW 01 auppIy and return openings ..led PBfJ
.. . ~ wJth CRA" per opentng: New ItrgCttjr.8 01 addlJons send 1001 plan wfth supply .~i ;1.
ami '1lIlum loc:aIions ahown. HEAT lOSS;pA,lCUlAll0NS, PAYMENT AND r'
'APP.L.ICATJONS MAY BE MAlI "" 10 1lj.6,~lT 01' PRIOR lAKE, 1&200 EAGLE ~ ~
C~EK,AVE. 8.E. PRtOR LAKE. UN ~n. . .!. t :!
· .. . , 1 .. 'I
. '. .: . . . i . . i i
c~ Jla~ ~iness hour. are 8 8.m. . 4:~q;~~~. ri t'.:1
: '.. . I :.1 I ' r, !
AU:. ~ MUST BE INSPECTED (RO~'r AND FINA4 · CALL crrv HALL f~'
.' . '; 4.1-4230 .1.:
. .' p::. . !!" ::1
I'IWtreby applV for a mechanical sy..- p.,mIt and I aclmowledge thallhe ';~ 'lR
information above Is compjete !lnO a""'u.rate:.lhal Ihe work wm be in conrormance;~ l ~
wifh the ordinance. and codes of th~ clty a~d with Ihe s1ate buHdlngJmechanfcat ., Cil
. code.; that thJs form does not beco"le :a permit until signed by the BUrLDING ;:~ ~ ~
. OFFIC.IAl; that the work win be fn a~o.rdance with the approved plan in the ~:;; : (TI
case of all work which requires revieW and approval of plans. j'j;'!. .;.
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,,',~ _.-I- gvrT'~"rM to ' )<1 "~j'':;~
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AppO~nI'S Signature !'~!~.: : i.:~: Date: J-.~ ~ ~
"!; ,.~. 10-:J/ -o() ~::.f:
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BulIdinglOlfk:al"s Signature :; ~:., . .\. Date p~ 1.
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\Iterations
lepajl,
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"'INNEsO't;\I"'i'_'~9 '2tn\ SE~gY ~~
ClllEE. - FILE
YELLOW - APPLICA.'
GOLD - CIT~
PRIOR LAKE
WATER PERMIT
s.w. No. JJ1J -()Sa<6
NOTE:
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: 'j ~vk b":y</
~
SIGNATURE:
SITE AOORESS:~'l
8'~
PHONE: lt14 ?RlI7~
DATE: Ca..j 8. if (/0
BLDG. PERMIT # cJZ)-OS~~
PIO# ~S-- 3S'-l-001-0
ADDRESS:
~b(rr~l~
FILL IN THE BLANKS
1. Estimated length of water service
feet.
2. Size of water service
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
---------------------------------.---------------------------------
---------------------------------.---------------------------------
This 'l~cation omes your, pe~mit when approved.
BY \.J..,A;'~~") DATE: 6jQ9/PO
= ===='==========L==================================:=============
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
*
Fee for either sewer or water individually is $~1.~ 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
/
# /'
/'
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,.l. -<AMOUNT PAID
~p~'"
~Q~~~~ REC'O BY
~ !a~e
~'V'
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
RECEIPT
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(I.InlnClDf
J")*PE OF STRUClURE
In
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~~~~('\ CI1Y OF PRIOR LAKE Me "'lY
i5 \\ 16200 Eagle Creek Av. S. E. Perm" No. fk-.G ~O
) Prior LAke, MN 55372 ~
\:,:/ HEAT1NGAPPllCA110~~M135L/ 001 0 :=y.~
Oall. /e;J - / ., - eo PIO' _(p 5?J '1 I4tv- b oy- L
510 Addro.. ~f O()~ -L....,., < TG-' ~ ~{-;- ) ~ee 5c~edule
lJl4 I BIodI. ( . Adolion. 7 ~ gt:J-- ~ Industrial, Commercial & t.4uli.Farnuy I'll. 01 job cosl ($39.50 .....mum)
LY1 J JI(' / / / - .5 Reside nlal, Heahng & AI; $99.50
Own.fs N.... --47l.,P..u-j ll/f\; V/"o/Jk... f'U'V'J Residonlial Hea~ng Ont{ $64.50
_ ReSIdential. Gas Fireplace $39.50
<:" ~ ~ 'J Residenlial, Additions & Aft.",tions SJl1.5\l. nI"f 1 9 'lnM
~1!2J'L ...;.-, - -.-, c:.. Residenl,a1, PC. Only S39"~D I "" I -
./ ~~ --..., ! \~
Addross .;;J-I 00 5" c..-.:<- ~ ~ 7''' ". , - -:- - I
_ ~Ja ? _ '1..~J ~LO . i=\emember '0 add \~e Stale Surc:hafge on the bonom~l is application,
T.~MO' ~7~ ~77 - -
Furna.. MI.e & r.t>del. f'4--f ~. TYPE Of SYSTEM The price 0' your ~..Iing perm" ,ncludes one loug"in Ind or.e [on", 'nspoc1ion.
',/ r....-J Warm ~r P'a"ts
Model Sill _//" t117" ~r-:- Grauiry. Additional inspections will be biled 11$35.00 ..c~.
8fJ J'I ~OChan'c:al _ - House Heating Tesl Recon! ,",usl be sub""ne. w,.~ bUll.lIl\l oer~ nombe, belore bu'ld-
Air Conditioning, ir:g certificate 01 occupancy Will be i$SLoed,
Venl. Sys1em _
_ lwo-Farn,lv '
Multi- FamllV
Industrial,
:1 ub\lc
Glher
en
.-t
to
en
I
o
~
~
I
N
.-t
to
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HEAT. ~ALCUlJ'liONS B.fOuH~EQ with number of supply anc return oper,l~g5Iisted per ~
roo", with CFM's pel ope:ling. New stnJclures or adCiliOJ"lS sena lloor plan ~llh sIJPply
a~d letum locations shOWI". HEAT LOSS CAlCULATICNS. PAyMENT AND
APPLICATIONS MAY BE MAILEO TO THE CITY OF PRIOR LAKE. \6200 EAGLE
CREEK AVE S,E PRIOR \.AKE. ,,^N 55372. .
/11'6,
. _flue Size
HEAT\NG OR PCWEA PLANT
SIeam
HoI Water
Radiatlc)(\ .
Speclsl o.vices ,
City Hall business hours ale 8 a.m, . 430 P (T'I,
ALL WORK MUST BE INSPECTED (RCUGH-\N AND FINAL) - CALL CITY HALL
U7-9s,SO
FUll
S~ly Op.ni195.
Returr. Openinos
Inpu' _
. OUlput
Edr,
Oth" Devices
Clm
I heleby apply lor a mecnanlcal systems permit and I acknowledge that the
information above 1$ complete and accula'e~ thai lhe work will tie in conlormance
with the ordinances and codes 01 the city ana with the slale tlulldingJmecha"lical
codes; thaI this lorm does not become a permit until signed "JV Ihe BUILDING
OFFICIAL; 'hat the work will be i~ accDrdar:c'e wl,h Ihe approved plan in the
case of all work whichreq,,:res review and approval 01 plans,
TYPE OF WORK
New Con5t1uC1ion
Alteriil~nS
Replilcernerrt ,
Est Camp Oil"
Repair
Est, Cos' $ _
HEATING PERMIT FEE '--
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Buildifl9 Pe,ml" ,
1(/-/9- CO
PAID WITH
_DING PERMIT
~
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BUn9 O""",I"S 5'9""1"'.
Dale
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STATE SURCHARGE $
~OTAl PERMIT fEES $,
.50
Receipl II
I
PRIOR LAKE
~
INSPECTION RECORD
DEPARTMENT OF - '+-
BUILDING AND INSPECTION
SITE ADDRESS iDS-OC) ~ Q. ~JL
NATURE OF WORK tJec-u {\~ '
USE OF BUILDING _ <SFA-
PERMIT NO. t17J - 05Zfj DATE ISSUED G,-/Z- 200'0
CONTRACTOR ~~, ~ PHoNE- q5~:.~(,-. u>~e....
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTION BELOW
THE PERMIT IS BY SEPARATE DOCUMEtt't . ;i
INSPECTOR I, ,V ! D
FOOTING I I ~
FOUNDATION (Prior to Backfill) U'k ~f 7I/~/~1 \ I
, PLACE 'NO CONCRETE UNTIL ABOVE HA'S BEEN SIGNI:D
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING f<1f 10- :Jlf-~
HEATING (If required) ,f( Ii- ,I'('.r ,.2 Lfi-Oo
FIREPLACE · tA- I (/ ~
GAS LINE AI'R TEST 1111- '1b - c;( t./-ocJ
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
WALLBOARD
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W'~ -
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r II Iii I f)'f
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IfJ/a ~
GRADING (Prior to Sodding)
BUILDING ,r(J? Id1~"~ f~V
ELECTRICAL
PLUMBING
HEATING
DO NOT
FINALS
,IV {J
5/dlf--O?..
J. /Z/Iz(~.
fZ. 'j,,!
f2Y- /21~(!D
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OCfUpy 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 INSPECTI(j~S (&12) 447-9850
QLtrtifirau of <<)cmpancy
CITY OF PRIOR LAKE
)j, 1 Department of .uUbing Jn~pettion
,vinal Permitted 0 Conditional C.O. Expires
This Certificate issued PUTSUQllt to the requirements of Section 307 of the Uniform Building Code
certifying t1uJt at the time of issuance this structure was in compliance with the various ordinances. of the
City of Prior LilJce regulating building construction or use. For the following:
Use Classification SINGLE FAMILY Bldg. PennitNo. 00-0528
Occupancy Type . R3 Type Construction VN . Fire Zone N / A Zoning District _ R 1 SD
L1, B1, HARBOR EIGHTH ADDITION
Legal Des... :..~on
Owner of Building
Site Address 6509 HARBOR PLACE
Contractor's Name & Address MERL YN OLSON, 6715 FEATHERSTON DR. , SAVAGE, MN 55378
ROBERT D. HUTCHINS
City Planner
DON RYE
Date:
DATE TIME
CITY OF PRIOR LAKE I.z./ /z/~. -J;3 b
INSPECTION NO)'1CE SCHEDULED
....,
ADDRESS ?r;; ~9 ~ P~..
OWNER CONTR.
PHONE NO. PERMIT NO. OC>-~Z?
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:tO p~ -Q:f-~ ~
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o A TIS FACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOI'K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ 1 fJ>>t( Owner/Contr:
CALL 447-9860 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
1~700 ~730
~5"oq ~r-b(' -;P)ac.e-c_,_'S
~;~ ~
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
00- 5;l$
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION ~ 0 SEWER HOOKU~ 0 FIREPLACE FINAL
.. FINAL (~ l2' PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION )( MECH FINAL 0
~COMMENTS& Ju1-d ~ ~ J1;.J-
fH:! -tu6- .- ~,Cl) ~pe6'&-<'~/~
~ ~/~"~~I '
I1$. W~ ~ ~ (Jill! J
~..@ ~ ~, ~ ok ~~\ I"ri JJ)a- +a p~
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<H. OV"V! 't:": ~, ~.t..-.:. /.w-.-. .~ tIle[ 'I
.~ "A ~/~..~ PoP, ~-"f-s
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
! CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~l Owner/Contr:
.,
t
c',O, vMf.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl
DATE TOlE
CITY OF PRIOR LAKE ~ ...)
INSPECTION NOTICE S~~D /i-dLj'~
0'D'1/Ufr-ayi:Jor ?2.
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
()-5d-8
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
~GRAD1FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
6~
(!)~.
SrPr
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpectO~ Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl