HomeMy WebLinkAboutBuilding Permit 00-0783
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. i; CITY OF PRIOR LAKE
.2 t. <!! I BUILDING PERMIT,
TEMPORARY ~TIFICATE OF ZONING COMPLIANCE
AND TIUTY CONNECTION PERMIT "0 o1fJ.3
Permit No. -L' - V
. DIRECllONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (PJease Print or Type and sign at bottom)
2. SITE ADDRESS H'tw3<- ~<1Clf U<<J:f,/
'3<>v~ II~,,,,,./
3. LEGAL DESCRIPTION ft
Q,i~D
LOT
II
II
bt Me.)
PID
J IJI1I?
~..:JC\-;scD~ o!l{
[Tel. No.)
IH;" qS2- fW'.nr.J~
(), [Tel. No.)
NeVJ r \I'41lAR.. q5~ -8~q ., '7 / (
6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
J 411t(. OCCUPANTS
7. TYPE OF WCRK FireplaceLJ Septiclj Heating(] PlumbingC:J Reroofinglj PorchLJ SEATS
NewConstructioflfl" AlterationsLl Addition!] Finish Atticc:J ResidingLl FinishBasementLl 16. ESTIMATED VALUE
Chimney 0 Misc. ~ :jI :? / 0 ~
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 1'0. CULVERT SIZE 17, COMPLETION DATE
Sq. Fl. I ~.qJ3 WIdth /00 ( Depth J$;~ Yes N;Y( .o-.fN, 1--001
I hereby certifY that I have furnished :. ,..... . on this application which Is to the best of my knowl9dg8 true and correct. I also certify that I am the owner or authorized agent for
the above mentioned .~_~ and that all construction will conform to an existing state and Iocallsws and 'Nfll proceed In aooordance with submitted plans. I am aware that the
buildil19 ~7~ ,Is permit for Just cause. Furthermore. I hereby agree that the city ~ or a designee may enter upon the property to perform needed Inspections.
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BLOCK
/JdI/(fWd41 OUll
ADDITION
4. OWNER (Name)
1),..u!"'",x, t!oldJ~tJ
(Address)
Sllb U>q~
(Address)
5. ARCHITECT
~""<.
(Name)
,
SETBACKS: Required
Actual
1. White
2. Pick
3. Yellow
File
City
Applicant
1. DATE
[-/b-Or)
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(....,., (W"""I
.:h1..... (. ~ .
12. NO. OF STORIES
;) ~ o'..ay
13. TYPE OF cOOSTRUCTION
p,w
14. FLOOR AREA APPORTIONMENT USE
(""",,,I,
Sf-S
FOR ADMINISTRATIVE USE
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 2/0.0tX> .Or-)
Co\lective Street Fee ....................... $
SewerTap ................................... $
UcenseCheckFee .tt.................... $
PressureReducer .:'Z................... $
MeterHorn........~..................... $
Water Meter ......~..................... $ J ;;1,<": CY)
o Sower & Water Cv"".,O"" Fee ........... $_L oj nt") .t')(L
o WaterTowerFee ........................... $ ~')t:)(J. r;ll
WaterTap ................................... $
OIh..-:B....;.LUS..................... $
:..;;~~-l";.)j:~~{ ~~Jt:f
Date 9-/- (j 0 Bv If/U.-
This is to certify that the request in the above appIlcatlon and aooompanying docLments Is In accordance with the CIty Zoning Ordinance and may Dr'OC89d"is requested. This document when
7~~;::'-"'"'YCeIi~i:>com~~ond:':'~...-~comJ::~n~7~be'~
- c;~ PIa""" Date ~ - ~ e:; ~&...tions 'llny -. .
24 Hour noticeb all inspections 447-42309:00 a.m, .10:00 a.m.
F....
IlaOk
""'"
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
Shf'\
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
Division 1 234
City:
Perm~ Fee ................................... $ I. ~ ~~ .2.S-
'1 ~~ . :2 I -
stateSurcha?>............................. $ / ,,-;-.00
- , .........~~......................... $ [ 0tJ .0 (')
Septic System .r;rt..a,.................... $ /flO .t")O
Other ..........S.....!!)..................... $ "3~. So
_[t?fl.;1::'~_'!::.:.O
By ~~~r~ B<m-2v~
Certificate of Occupar/
Plan Checking Fee ......................... $
rH!o
'0' Check n
Deferred
Issued
"..
MATERIAL FILED WITH APPUCATlON
SOIL TESTS LJ ENERGY DATA c:J
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
AmountBrougttForward .................. $
Park Support Fee ........................... $
SAC ......................................... $
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~1
00 '67~3
Th..Oml..roflh..r.Mk..Counlry
White - Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT n EO> .'i' l' tll i -; () Ii:: P .
\ ..-\-~,
APPLICATION RECEIVED \ .=:X)
( c YY'\.::., +-
, "
I' ,r,
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
:iCe' L/q li,\: Ie t i l( AC k ,- C\C~
\ ',-
Accepted
Denied
v-----
Accepted With Corrections
Reviewed By:
Comments:
;)c.{p, ~~~ ~>>~ IJ~n. Nt-~
'(.).r ~"1' I h .J-q-w() ...a.. l /5) .W ~ (' nvh D
/'II III
qfA..1~~
Date:
t:'P,/2 t!:j /&90
./'
''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."
~1
00 ~D1g3
White - Building
Canary - Engineering
Pink - Planning
The CUlfr of Iht Lakt Counlry
WILDING PERMIT APPLICATION DEPARTMENT CI-{fCKLlST
NAME OF APPLICANT 1)p x'J r ~_n} u ~p_ (o~ +-
APPLICATION RECEIVED ~)>A- 6}~,..o./~ ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~~
,-z:.[) Lfq
1-\1\wl Q.-lrl~
Accepted
Accepted With Corrections X
Denied 0'1f? .J-
Reviewed BY;~~ _ ~
Comments: ~ /-
.I. U lill Q11-acW ~ol-~
Date: 8 -:a:; . ~
"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."
00. ()1~3
Thr Ctnlrr of Ih~ L.1tt Counlry
White . Building
. Canary. -Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
APPLICATION RECEIVED
NAMEOFAPPlICANT npx'J rhnTn k~, (O~~+-
n. \ '" '\ ,el, -
~\ J'::-'T C><N l 0l0(Jc)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
eQ)~
.-yJ Y<1
/
1-+n,UJl e~ ('ler-
Accepted
Accepted With Corrections
Denied
Reviewed By:
Crl1nt Ca.rlson
Date ~~m
~r adJ;. , - it1~nHt/ koY!.
Comments:
5pp ./-he rpVff9
SlrlP
Spe a.f./oI'f.1I'11'A1-k f I.
-
F;" tJo 1 af7,fdf' 1iiy>ir' h"ffl 1Ji.{?,rrn",J.';.w, <<, t,'nd.J f/~
~uJP<; Lf.~f?">si<9-vl Conf,ol elf.tA.-\..
3. Ern<,'1"H'I (I~I
"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."
,)
V
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time a/issuance this structure was in compliance with the various ordinances. of the
City of Prior Lake regulating building construction or use. For ,he following:
Use Classification SINGLE FAMILY Bldg. Permit Nr. 00-0783
Occupancy Type R3 Type Construction VN . Fire Zone N/A . Zoning District R1SD
Legal Description Ll1 ~l. NORTHWOOD OA1(~ F~'I'A'I'F~ FT RST ADDITTON
Owner of Building
Cootractor', Name & Address _ DEERBROOKE
ROB~RT D. HUTCHINS
~ite Address
3049 HAWK RIDGE ROAD
CONSTRUCTION
f""ity PlaIUlCr
DON RYE
Dale: _
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
soLler /4w t. R I/--&e M
CONTR. D~cv hrr'/J/::'e
PERMIT NO. rv- 7Q:3
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)(FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
XEXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(~l/rb 150'::- (') II.
brcrdc - " f<
s~-r-
~ORK 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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
j~;;jol
( (
Hav5k: 'R;due 'Rd,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
304Cf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)"!'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
%MECH FINAL A-
TIME
10..00
C90 -07& s
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
Or.. - h'1\1d f1~ <~.9..Ja.\k,
~ ~ eni 0_ A~M(}lV\ Trullk
~ - ~f) OrIJ~A",^ ""'-q 'iflP1'''''~ ~
O\-- 'R f'J:A. cv:c:e 5S ..~..,:')I' + vi- Du. IAA f
re.- Il'\Spec:r- I
b, I ~ If)l ) 0 I
~PA'vIA.'1n .V\,bJAf- "j1'r\It'..uJ~I1.1\J .f..:d@+~JtI\ l::. \
APMS r.?pIUVal r~ q(t1d@ ~l~re sod.
f:' +r~e~ fer (),e<J0"f rM,oAA""'-
"I 6~Ul" / "le..tfl.\D c.o, "-r:;.\l ,1: Dl
~ fl'
~ORK SA TISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
J' ,,",,",-Elf ;ro'~'~'~TIO' ,~~~,,~
Inspector: - Owner/Contr:
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
9'IB'(/) /:'lD
ADDRESS
3D4<1 HAWK.. ~f)fiG
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0-783
o FOOTING ~PLUMBING RI 0 EXIGRADfFILLlNG
o FOUNDATION ;.(\) 0 ECH RI 0 COMPLAINT
o FRAMING 'f". A TER HOOKUP 0 FIREPLACE RI
o INSULATION SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL 0 LUMBING FINAL 0 GAS LINE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
_COMMENTS: p{fti"Y' fiJ. /:;..: ~
(f) ~.~ ~ (~ V;i~~-J-. fW-t:Jl. r-et,,~
1iL.' ~ - (HJe~t}
dPf: ~~ '/tk.~ ~~' r~- ~
',~ IJ~ ~.;
(j'J; {I ..e 01-0._ .d.J.J'V'-G-I-;
~l
~~J<.W~
IX" f"1'." '~~ }
,");3' AeM.-"'''' j~ 4 'I fLJ/~
Jc. ~.j" <It) - S:!>- A,""\'" d.....
f~
( / {I -,-- ,< V I,
9? (!.~ - I "'ff"" J--
Ii - _ Ij I, - ,1-- (J /I ,.,
~) . ~ Ih"t...~ Y'\.oO ..k.~
(;
rr>--€-
o WORK SATISFACTORY, PROCEED
l'-- CORRECT ACTION AND PROCEED
:S:::O~ECT Wft ~ALL FOR REINS:~::/::n::FORE COVERING
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <I SAFETYf
lNSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
~i9
SCHEDULED I/L/IM LI.'3tJ
~ ~ /12,
l;r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() - 71'3
o FOOTING 0 PLUMBING RI 0 EXIGRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL I.iI PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION tJ MECH FINAL ....0
COMMENTS:
('VI /1'-501- ~a.()e.. vi().{...c.eSSil.J N>pJ~ Ci~
y1IIl"l in, (U\d +V~ VI _.\ a.:A.. 7_-z..,
o ,"ORK SATISFACTORY, PROCEED
.)'!" CORRECT ACTION AND PROCEED
o CORRECT WORK~ALL FOR REINSPECTION BEFORE COVERING
Inspector: 'is - W J Owner/Contr:
CALL 447-9850 FOR T~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
..3a If 9
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
llI\FINAL
'D SITE INSPECTION
DATE TIME
SCHEDULED ~ At""
~~~~.
a
CONTR.
PERMIT NO.
610- 773
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
'~LUMBING FINAL
o MECH FINAL
o EXlGRADfFlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: ,JidJ.. (;;) ~~ 9s"l-J.J..'j- 77/1
:"')ci T ,
~
&.\-+e.r--'Zr(jA}IA~"el.
,'~~u..t. (./<U"
e-\I9~P +de
)(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR5CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~.\ Owner/Contr:
CALL 447-9850 FOR T E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Perm~ No. 00, 0763
Prior Lake, MN 55372
Lol _ Black _ Addilion
Owner's Nam;P~~T7rnr..~ ~S-r
Address~o Gi;>INIA .::tND. &.vD.
fDl A ' -
+ie8Iillg onlraelor Au.-toMMV. bA1lAbf: 1::Dco- t FP
Addresl1l- L 0 U)v Du'IN'=. th) J:_ f\Jo -
t::uJ~1 J.I U Pl.. / -
~n8'il 7{t>~ -.~ I c,,- -tc;.OC>
.&:ua Make & Madel ~U- nVrl.(tl)fO TYPE OF SYSTEM
Warm Air Planls
Gravity
Mechanical
Air Condilioning
Vent Syslem
Madel Size
Conn. Load
Fuel
Flue Size
Supply Openings
HEAliNG OR POWER PLANT
Sloam
Hal Waler
Radialion
Special Devices
Return Openings
Inpul Oulpul
Edr.
~D~iC~SJU- ~ pLN:.....
Clm.
TYPE OF WORK
Alterations
Replacement .
Now Construclion
Repair
Est Comp. Date
Building Perm~ #
00-0103
Est Cosl $
HEATING PERMIT FEE $
STATE SURCHARGE $
.50
PAID WITH .
ReceiltVILDING PERMIT
TOTAL PERM,T cEES $
TYPE OF STRUCTURE;
I. Pink
2_ Green
J. Yellow
"'
"'
,
N
"
,
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File
Gly
COllO"'KlDr
Single Family
'f-
Mulli-Family
Olher
Two.Family
Industrial
Commercial
Public
"'
"'
'"
N
Fee Schedule
;:!
...
1% of job!fQS ($;l9.linll)i!liirium) . '"
$9950 "i I 13'.-7.,"",.. ... "'
. J,' ,... -.----, ~
$64.50 '( . ~
$39.50,; .2'. ~
:'., 0
~~~ .. N
"L
$39.50 c W . -----q -.-. ._.. '.'
Industrial, Commercial & Multi-Family
Residenlial, Healing & AC
Residential, Healing Only
CHesloenllal, lias Fireplace
- Residenlial, Additions & Alleralions
Residenllal, AC Only
Remember 10 add Ihe Slale Surcharge on Ihe bellom of Ihis application.
The price 01 your healing permit includes one rough-in and one linal inspection.
Additional inspections will be b~led al $35.00 each.
House Healing Test Record must be submilled with IlWIW!!g I!WI!li! ~ before build-
ing cerlificale 01 occupancy w~1 be issued.
I:!EAI .QAU;ULATIONS REQUIRED wilh number of supply and relum openings lisled per
room wilh CFM's per opening. New struclures or additions send noar 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.
,.
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.,
,.
~
~
..
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City Hall business hours are 8 a.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply IDr a mechanical systems permit and I acknowledge that the
informalion above is complele and accurate; Ihat the work will be in conformance
with the ordinances and codes 01 the city and with the slale building/mechanical
codes; that this form does not become a permil until signed by the BUILDING
OFFICIAL; thai the work will be in accordance with the approved plan in the
caseAili all work whictneqUire~ ~d approval of P.';br~ \
.ure Date
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1 (, 7-.Cf.Oi)
. flale
BUildfn'.Ollical's Signalure
FROM : SRBER Heating and R/C
PHONE NO. : 6124738565
Oct. 31 2000 02:47PM P2
JAH-22-01 12:00 AM STEWART PLUMBING
~l"ZZ..nl lI"'" 11 .
. ~, :3. ,~X D1244?4Z4~
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'k(".." lit I'" Ull.tl:+ ,."
QuantII)'
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6124281733
P.01
IlIcoz
CITf OF PRIOR ~\KE
1.__ File
2, 0014 c:;.,.
1. Va'" AtIM~..
~"ND. JJO - ()7fJ3
Phon.:..2I. ~-I/..7'i"-J t.71;,
AlV. ....-~"7 C/.
CITY OF PRIOR LAKE
PLUMBINO PERM"
Applicant: ~.5dR.~r-+ ~,.... .
Adclrua: ~5-" ~l! I..IJ f.;;jcr~
signature:~. . ~
LlIgal DelCrlptlon: lot 1/ ,.. Plook. .:2 _ Sub.)V, w..J. f'J" Ie. c
Sit. Add",I&:_ ~6 It"', ~If~ f!:' ~!J,J'. ~ -
Bullcllng PemllU ~_._ no - n ""!l'S:;?' ~ICll/_ 7-"; ~ "'IIPO -:- 01 4-~O
NOTE: Tnll perm~ wilt nOI be precelsed wltMoUt cOmplellllnlClIInaUon.
P1XTURI! UNITS
Type ClIl'lxture
i Bath T~b ",~h or WlllloutsMo....r
Dlahwuhtr
I,
i Flog, Drain
~\1atgry (bathroom sink)
Laundry TrtV (1 or 2 compdmenl .Ink)
Shower 91all
links
Bar Sink
Water ClOset (toll.I)
QUlll1lity
TVpe 01 Fixture
I' 5E ICH&:DUUi
Ii ,d~llrlal, Commercial" Mum-Family
! % of iob coal, 138,60 minimum)
I, .Ident;al, New O~p. .. Two Family
,
I' IIldlntial, Additions" "\Wr.liona
:Ial. Surcho'ge
~
I
Rou; ~.1n5
Water l'le8let
Waler Sottner
Stand Pipe (wa.hlng maelllne)
Sawagli EJa~~r
a.:lcI1ow Assemb~ (APZ, Double ChllOlc. PlIO)
Bac:kflow AUambly Tallt
Lawn Sp'lnkle'
O1her
,t
1;;,IiO
"UO
$_-_.
5
$
.
.60
GRANO TOTAL
s .~..-PA'D WITH
lBUILDING PERMIT
"TllI. ponll;, i. "llllld "pon 1M ........ 001\41110. llllt.sld
co_lot, 'hili ..mpl~ I. lilt ",.pec\S with rho or~in",,"1
g! the: Slate P1Ulllblna: C pel n\ll amln.dmcnts ttlr.rl\!of.
. j-7J.~~DA~
ATTIl5T
Call lo, .11 insp lioni 24 hours In .dvan~' ,
162Ct:' Eagle Crack Av, s.t;. Prior Lake. MN .5'3121 Ph (612) 447-911.50 I FAX (612) "'74'.4~
An. EquDI Opp.""nil~ I!nIployer
09'-11'-00 1I0~ 18:12 FAX 81ZH74HS
nn OF PRIOR LEE
~OOl
---........
'l'lluellf - .....1(::....'1
.... . crr~
CI~Y OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
..
S.W.NO.J)/J .()7t3
APpr,:! ~AN~5A5P~S -<-SO~
Sewer and Water
contraotors l1Iust
be reqistered
with the City.
:;:/Jf."
__PHONE: 5 ~2- 6.j'lF->~1 2-
jQ4f. WI+,Te.'.,""c-
~HAc.CA- ,DATE: ~- 1/- 0
~
ADDf:I';S: ~'l .__..1)
SlGNI! rtJRE: C~r1~:., 7
SITE: \DDRESS: 30l{Q 1/;4-1JK.. /'2.,t,?
BLDG. PERMIT .
..PIO'
I~l)
FILL IN THE aLANXS
'-5-
1. Ji ,tim.ted length of water service =>__
f.et.
2.
!; cz:e of W!!Iter service I
J.
r >cation of any eouplinqs
ineh(eSJ.
from structur&~
feet.
4. .' 'pe of sewer pip.. ABS pvc X c..st Iron
5. r ,timated length of sewer 1 inll! 5.>" feet.
6.
C.ean out
f.1 ;ructu:-e..
(if required).
located at /tJ[)
!ee"
from
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FEI;,;S;
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$
$
3
--~==_a___=__~;=_=_~___~____g~=====____~_
~his . 'pplicatio
BY
your permit when ap?roved.
DATE: q..:JS.(;V_
===. 2; ,=:;;:;;;;:r~==__ =lII'---_=.:________z:==_W_"!I:;==_ 0;=: == =':::11I=____.... _iliEoe==_=-=__
Sewer and water line conneetion permit.
surcharge
TOTAL
" f' 'e for either sewer or water individua:.ly is s.tp"..6Il plus
~. .50 sUrcharge.
" ~ 'wer and water permits issued for new eClnstruction must be
I ,cordctd on the l:>uildi"~ permit card ..10 l;he time of i....uance
t , insure that no dupl.l.Cllte sewer and water permits are
i. :sued.
DATE 'AID
RECEl 'T #
AMOUNT !'AID
!~~;.
~\"
REC' 0 B~
16200 Ea8. I Crc:c:k Av. S.E., Prior Lake, Minnesota 55372 I Ph. (612) 447-4230 I FAX (612) 447-4245
An Equ.I Ol>po"unily Employer
PRIOR LAKE
INSPECTION RECORD
R..~ e,-yL
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .3041 ~()I .,\e
NATURE OF WORK N~.....)
USE OF BUILDING S ~ '"
PERMIT NO. 06. 07B3 DATE ISSUEIJ 8.2e- 2oclc:J
CONTRACTOR \)<2"',," 'oM""\n\.z. "tS"2.-84~- lbt{~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
A INSPECTOR DATE
I FOOTING~ ~'Ir '1/ZI/~() J>.r, I l?:f' I '11'1/)f)
, FOUNDATION (Prior to Backfill) I Itrr. I q/..J.t> /~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
iYJ, .
<:R~ \1 r J~r J f)()
/3-;n I !
, ,
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ghl1 r ( 117)00
HEATING (if required) f.J, L 1/ 11/;1 i"
V ,I{IL _~' I/./
FIREPLACE . ~ I ( /";J-9 / c-o
GAS L1N'e AIR TEST ('..0 v1.\.f\ J-e. 'K '~a~ f;! ~ r~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.1 /I/~
~ V r
~.~
~-\Icuk
1. _ \ fn.u.:
OCCUpy UNTIL ABOVE \ HAS
NOTICE
GRADJNG (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
9j;PJdo
1/ /d-t:)~~
. "f
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:bo A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850