HomeMy WebLinkAboutBldg Permit 01-0733
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A,'NNESO"'"
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
b- )-1"D,
(Please type or Pllnt and si2Il at bottom)
ADDRESS
lJ2oC[; ,!,. Lf)(j~ S+
<,f,
P t2. ; ,.,11' I Ci lee>
LEGAL DES CRIPTION (ollice use only)
~""I
LOT BIOCK ADDITION
fc... sA \/-lOO ~
OWNER
(Name)
~ ~ \\ e.
330'6
( DV"\V\\ ~ I;, 'A ~
( il <-1.1 V\ IA)I.L-k ^ Tvl-,\; L
,
(Phone)
{la.;ov LCt lu
(Address)
BUILDER
(Name)-\.,l Jm\>DA--u' Ru\ \~c..
(Contact Nan te) ~'^ -; <....
(Address) ";7,1- lV
TYPE OF W JRK
~ew Construction
OLower Level Finish
Date Rec' d
I PERMIT NO. 01 733 I
r:t;c;;re~
I. White File
2. Pink City
3. Yellow Applicant
PIDd5- }/J- O{Y}-[)
::c:.v c.
OPorch
ORe-Roofing
(Phone) _{~S(-{p?,& - Z-.S.<}<;
(Phone) -.LPn -4* -<; () J<
Ln/...,~~ l) 1-L{2tj~_hm W <'<'L/'L
o
o Fireplace
OAlteration
PROJECT COST IV ALUE (excluding land) $
OAddition
o Misc.
q~2- 44tJ - 7'52..L:;
S <; 3/L
ORe-Siding
OUti1ity Connection
I
I hereby certify llat I have furnished information on this kpplication which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agen1 for the above.mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
subrmtted plans lam aware that the budding fficlal can revoke thiS permit for just cause Furthermore, I hereby agree that the City OffiCIal or a designee may
;terupontheJ.~topetn eded ns ons & _ -ZCr2_ (p d _
VI" V 'SIgnature Contractor's LIcense No ~ ~te
411,/..,-rD'~'7
$;<: ") '3S. '3'5
$ I. '1 77. ~):,
$ e' -
~. 5?")
$
$
$
$ 35. ~"'-6
Gas ~Place :ennit Fee $ '10 . 00
:APP7:-;':72~'
BUd~ ~l Date
,
I Permit Valuatil m
I Permit Fee
I Plan Check Fe, .
I State Surcharg, '
I Penalty
I Plumbing Pern lit Fee
I Mechanical Pe mit Fee
Sewer & Wate: Permit Fee
I f!>(!). C)C)
/00.00
I Park Support Fee #
I SAC #
I Water Meter Size 5/8'<2);
I Pressure Reducer
I Sewer/Water Connection Fee #
I WaterTowerFee #
I Builder's Deposit_
I Other ~"e-L'I~
I TOTAL DUE l'At.Wl'J -1~'4..ol
$
$
$
$
$
$ I
$ I. .<'7l.t?1? . cV I
$....~...a::1
$ '13/1-1 ~ 3-.3 I
aso.co
7rJ.OD
I Paid 7 3/4-3~
I Date '''1. ., " . I'J I
I ~~ce~ 40/5"'/
/
. -
This is to certify th It the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
'~:;ds7':: ~i~lA::~t:::cernfic;~~m;P;-n"mdallom;i::nk:~i:;e~;~~=C::tm:,
~anningnirector Date Special Conditions, ifany _
24 hour notice ror all i.speetio.s (952) 447-9850, rax (952) 447-4245 &~ ~.~
.~. \-R/OIi'
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White . Building
Canary . Engineering
Pink - Planning
Tht (","In of Ih, I.ak, ('ounlry
BUILDING PERMIT APPLlGATION DEPARTMENT CHECKLIST
NI \ME OF APPLICANT
AI lPLlCATION RECEIVED
(J)I)~d~ gQ~
//1- ;)'1-0 I
0-
.
Tile Building, Engineering, and Planning Departments have reviewed the building permit
al )plication for construction activity which is proposed at:
( I) 0 'l ;). I ;) 0 tt-. .5-{--'
Accepted
x
~.
Accepted With Corrections
[ enied
F leviewed By:
~1fJ R
}:
. Date:
/_/2-0/
( :omments:
See Reverse Side' for .Addition::lllnformation!
.
i
.
, ~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
3~ Erosion Coptrol Plan
"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."
t~~
~~
White - Building
Canary - Engineering
Pink - Planning
-
Th~('t'nf.. oflh..t..hCounlr}
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NI \ME OF APPLICANT
APPLICATION RECEIVED
(j)o~~
I/J~ :J,1-0 I
n.e Building, Engineering, and Planning Departments have reviewed the building permit
ap plication for construction activity which is proposed at:
( IJ 0 g>...:2 7 S- 0 f:L.- 5---{--
Accepted
Accepted With Corrections X
Denied ~0 /!P c2-
Reviewed B(/f/ ~r
Cc mments:
Date: 7 - { 2-? od45
1.4J~_~...,,,L. ~~ ~_,
C/
2 f4,~ a.U a.-tto.d...Q_cJ... !-Ic..-.oR. ~
5, M'LI'''''''\-c.u.',^- T"'ClSt'c::Jl...t ~ ulA-til ( fur ,'~ e~-k.\.J\'<;,l&^
"Tile issuance or granting of a permit or approval of plans, specifications and
co nputations shall not be construed to be a permit for, or an approval of, any violation of
an( of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pn !suming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
t~O: 'R~/OIj> \
u '"
,
Th<r('t'nffl'l "rlhe tabCountr}
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
N,l,ME OF APPLICANT
AF PLICATION RECEIVED
i I
.~,e-! -~
! .rl'~
,.
Th e Building, Engineering, and Planning Departments have reviewed the building permit
ap Jlication for construction activity which is proposed at:
<. "
"
(
--..
i ,) C
'+
--
Ac cepted
v
Accepted With Corrections
De nied
Reviewed By: ~~/~A
CC mments: _
.~~ A-'-r...::; I"J~ YeL:w~<
f' <:I' V
\Dl/\M.~4 f)1IlO_ ft.-&:J 4-~
-~~ ~ 9~ I A.<'
_/I7V\ ~r~D~ -:;''-/_
- , ~~&:>
_J~~, ~ ~-Y ~
_jMf)~ . _ y p;v~ .
~~0A_ ~~lJ:J 0.)~
Date:
7/t7/,g l
~~
~~It )
'oaJ~ ~y~
"T 1e issuance or granting of a permit or approval of plans, specifications and
co llputations 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
pn lsuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNG/FIREPLACE PERMIT
(Please,!,VDe or orint and sim at bottom)
ADDRE~ S
lo(')S:;k+ l~()-+h ~+
LEGAL] lESCRIPTION (office use only)
LOT % BLOCK 9 ADDITION
Date Rec
; ~ ~:~ I PERMIT NO. A'I!~ ...., :1 7
). Yellow Apphcanl U I :.u
ZONING (ofliceU>e>
f?/Sn
G~~
PID;5- }1'7-001-o
. OWNER \ ..-.l,.... I
(Namell Ii )("l)Q)(lX \1.. "--^ P .
~\r>\ '( ~
(Phone)
_ (phone) Ilo?-'-Ir:=1l/-L/()OO>
lj\~n flry1b)()r illD Ff5~OG/
(City) (Zip Code)
. (Phone) llo:;zy 7SL/ - U./lnO
APPLICANT SIGNA RE " DATE B J~ )0 I
. - UP~~ PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TlONS
FURNACI MAKE AND MODEL Rhpfm- H{'M-/6P7A,I:S /.t1~M -/~MJSFUEL U~.
FLUE SIZE ;<'11 RETURN OPENINGS ~ INPUT j;JO,dOa/;tJ5.0fXJCJUTPUT LI7J.IJCOJe7,(}CJ(1
. I I
HEATING OR POWER PLANT _
o Steam PLEASE NOTE:
o Hot Water Air Conditioner Units
o Radiation Cannot Encroach into
o Special Devices Required Side Yard
o Other Devices Setbacks
(Address)
~;;~~lNT~\(lrClX (lOY?
(Address) ;;J~Jl CMYWYWi('\cU
\ L (Address)
(Contact I erson) Vln'mQ
TYPE OF SYSTEM
'. OWarm Air Plants
OGravity
o Mechanical
~t}ir Conditioning
~ent. System
FlREPLAC E MAKE AND MODEL
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
~minimum
(""199.51>") Residential, Additions & Alterations
$64.50 Residential, AC Only
Industrial, C )mmercial & Multi-Family
Residential, "eating & NC (New Construction)
Residential, "eating Only (New Construction)
Estimated Cost $ q<Jf.F)(l)
-
$39.50
$39.50
$39.50
Building Pennit #
-
( ~~/t)
~G tti'~
,o<8/Y-
i::.
JJy"
"I'
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ qq.,f=)0
$ .50
$ Jf.nnn
(Omee Use Oily)
This App lication Becomes Your Building Permit When Approved
BI ;ilding Official
Date
f Paid
I Date,? ~7-o I
~~eei"t t Jo.
BY~
U
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I
07/30'01 MON. 09:06 FAX 6124474~.
CITY OF PRIOR LAKE
Iii: 001
. ~~.
~ _ or.mat'('lldC&l:bolm!ll)
ADDIl. .55 '
-6..'Jg~ /~s-o--;--b ,c:;-I ~~,
CITY OF PRIOR LAKE . . ; ) nate Rec'd
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT~\ SEP I 92001
"
:'\1
JL..-
i =.:;, I PERMl'I..NO-AI.-A-?? 21
3.Y.aIcIW APPI.cInt --U -U J~
I ZO~~D")
LEGA ~ DESCR: mON (011I<O use only)
LOT BLOC: ~
ADDmON
PID
) /'//('70~arf};.<!.!.f?.J ':iif/, YP/...5, (PhOllC) G<;/-6S.b-d.3SS--/
s) 7";;?;/ ;;.-u-r:";7--1 ~""", ~c-e. D j'?1?U/ 8v"0A./~ >>J YI/
An CA."lT~ VI' . f' )) ",'1'./7 --- ,// ---/
(Nme) ""I'! f? . /1 ~ C:i 1/"-)--:_ (phOlle) 9's::)~ /'1'6- salOl/'
(Ad411Ss)..L2d-<'/~ /1/.I/&-'/I-,,/AP'-b SO ~/Y1<,-!,/t./ #1rV<?\55/
I (AddIas) (Cttyl (Zip Coile)
(CoIllld;Person: ~/2e5JlJ~~ }CJJ1bc?// (Phone) ~)<J~
APPLICANT $1 ~NATURE / ___ ~./~ nATF,. '7~Yk/
: "~LEASECOMPLETE;Z~;-'-'---- ~- .
3'lBW CONSTR.UCnON LJ ~PLAC~,,-; 0 ALTERAnONS
:hCEMA1SANPMODEL -rftuQJ4I4Wlt7CJ '1t/,0c.e-tM &,/......... FUEL JVif.
# A
FL SIZE _13 Pol/. u RETURN vr"'....iOS INPUT lOt< tKJC/ OUTPUT 9,;:; ClV'C/
'!YPE OF SYS'I1tM HU.TING OR POWllR PLANT
,. ~Wlll'l11 Air Plants CJ SleUI1
Gravity 3 HoP.v_
l\&eohIIlical a Radiation
AIr Condltionini 0 Special Devices
Vent SyClelll 0 Other IloYioes
-
PLEASE NOTE:
Air COll.dft4..... UnilB
Clllllot'EII~~.
Req1I1re4 Side Yud
5elbIcks
FUll :PLACE M.' KE ANI> MODEL
1.4. uill, comml 0111 A Mullt.F..ily
!Wi lenllll, HOlt!' i &: Ale (New Conotru<:Ii<>n)
It..; lenlill. Hoall. g Only (New CODSttUotion)
PEE SCHEDULE
I % of job ooot Restilellnll. (J..l'irop~
sn..so minill1Ufll
S99,W r...idcntw, Addition. 1& AltorIlloDS
$64.~~ Re,idaIllal. AC Only
$39.50
S39.so
$3UI
llstimated Cost $ Buildinc Permi! #- ....~
HBATINOPERM!T FEE $ ~{( -
STATE SURCHARGE $ ...--/ .
TOTAL PERMIT FEE $ ~
(Oil ice VAt Onl)');, ./
1 hit ApPIfl/t./ '~n'1i#~ur Bnlldlnl Permit WIlen Approval
JU/~D q,;q-ol
Build" 1000dal D.1I
.
J
2A hoar aoll.. Cor oJlle.pedio.. (951) 447.9$S0, Cas (951) 447~
I PIlld ______
r-tz}//o/-t?/
.'~
. By /J~f/(.
I _W-
\
1-
,
NOV.D5'2DI1 12:11 651 633 8884
FIRESIDE CORNER
#4332 P.DD1/DD5
CITY OF PRIOR LAKE
HEA TING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
: =. ~~ I PJol.""'-I....T NO. 1,/33
], YoIlw AJ'PIIIl:-r!
(Ple..e !l11.e or '" ill.lllJ:ld. .1,., "' .."",,,,)
ADDRESS
.-
/ e::Or~ &~.Y.
ZONING (offlc<u"l
:8JSD
LEGAL D~~ CRlPTION (om...".. only)
BC1-~l
LOT BlOCK ADDmON [;(}...<Jfwood
PlDc2i)~ 1/1-007-0
OWNER
(Na.me)
u.)tJ/,,1. dLIL. &.dr..
. (Phone)
(Addtoss)
APPLICAN'" '
(Name) A: .LIED FIIlESIDE DBA FIRESIDE CORNER
(Pbone) 1';51-633-2561
(Address) 2'00 N_ FAIRV,[EW~J.m
(Addro..)
BRENDA IIUSTON
(ConnlCJ: Per.! In)
APPLICAW SIGNATURE ni},'~A. d,_-=-
Rn.c:::~'Tr.T.1<; ~
(Cley)
(Phone) 651-633-2561
lC;.~1"J?-
(Zip Code)
DATE
//-S<1/
APPLICANT PLEASE COMPLETE BELOW
~NEW CONSTRUCTION 0 REPJ.ACEMENT 0 AJ.:rEIV\TIONS
FURNACE IV AKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM liEATlNG OR POWER PLANT
OWflmI Air Plants 0 Steam
DOravley 0 Hot Woter
o McehonlcoJ D R.diodon
OAir Condluonlng B Special D"vlce.
DVtTlL Sy.tom OmerDevlces
FIREPLACE IilAKE AND MODEL ~.I JJ cr. /,.o:m"'_
PLEASE NOTE:
Air Conditioner Units
Connot Encr""ch into
Requ.ired Side Y Illd
SOlbacJcs
Industrial, Co", norei.1 &. Muhi~F"",ily
FEE SCHEDULE
r % of job co,~ ResidentloJ, Gas Flrepl_
S39.50 mlnim\ll11
S99,50 Re.idential, Additions &. Alloradons
S64.50 R.e.ldentilll, AC Only
$39.50
Re,lde.tilll, He aing &. NC (No.. ConOl",el;on)
Residential. He ains Only (New ConSllUclion)
$39.50
$39.50
Estimated Cost $
Bu.ilding Penni! #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
D.fe
I Paid
I Dalll
po, p,' 'r'l ,.
!;!I 11/ :~
, '-~''''~o,
.... ~ 1
""
(omee Use Onl, ,
ThIs Appli. diDn BecomOll Your Building Permit When Approved
Ilull.ln. om,;.,
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By 0k.-
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14 ~Dur nD,iee for .Illnapectfun. (951) 447-9850, ro. (951) 447-4145
,
07/17/20e1 14:03
76325'322'3'3
~
SCHULTIES PLUMBING
PAGE 01/01
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date RI!e'd
JUL I 7 2001
" 0.... ~I. I PEDlL<TT r'p
~. '11111111 titr ~"'..u . /_
'.G<sld "'1p1I... ,~.
73>'1
ql~ =ruJiJu:'UdAIII!lJIfDPltom\
I' ADORErs d ..L
b() 5d /5V..z:L>~ ~ r.({,. d.T
LEGAL J lESClUP1l0N (olllG< "'0 .oly)
LOT "'iI ~~OCK AODmOI'l.A ~ ~ otJ-t;;;.lJ a Q
ZO~T-::fi'l I
I
PWd.? //7 -00 7- 0
UM,
. !Vb?
, ,~io'Co<lo)
OWNER, . ~ '".A,-7'( /J - . _../' /J
(Nl.ll1e) ~ ~ (.~ ~ JhOllel
(~leD8;;z. I~ 4JlDd A~.;7/J-:'..
(Addrassl (Citv)
AnLIC; NT ..l t17; /// I'
(Nome) -11:t? ..U Iv r~
(Address) /.5.;;) / ~..#
/7i . (
(Ccnact lenon) ~~
Af'PUCA NT SIONA~
~ (Phone) /h:;'" ~.SOD 7
_~~.:5.-'_... ~~ .:~?
c::~) 7~"~~79t -;;0'7
. PATE 7/!7t;;u)!
APPLICANT PLEASE COMPLETE BELOW
$= of water service ~ inches. .
Location of any couplings from strUC~~ feet.
Type of' sewer pipe. 0 ABC . PVC 0 Cast Iron
Estimated length of sewer 1me GtO' feet.
Clean out <if...cruirec!) located ~t A//Afeet from strUcture.
FEE SCHEDtlLE
Re,i~onlial sewer and waterline eCDIl.ecti"" 535.50 lndustriol. Com'l &; Mwti-family 1% ofjeb cost with. '39.50 mioimwn
SewerecllIection only 511.50 WOlerconneetlononly 117.50
Emrnatcd Cost S
SEWER AND W ATEA PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT:fEE
(omu u. C :lJ~)
This Ap~ ~..t10D Be'OIlle! Your BolldiDll'.rmit Wb... Approved
B' lildl.c Omtgl
!>at.
:4 bour .otl.. ror alll.'p..li.n. (951) 447-91150, flU< (952) 447-4145
;:OOI!l
!DIV'1 llOIlld 110 UI::l
BtUlding Permit #
~
$
$
S
[JIII!.':;:/ D ! .
.50 '/Va'
1-.....
(1"-.//,,
I hid
I Date 7.::D -a
I R.eco;pt !'h
I~
\\'
St.tL,';:19 XVd OS:.l 3n~ 10/Ll/LO
,
07/17/2001 14:04
7532592299
SCHULTIES PLUMBING
PAGE 01/01
-., -. -" -'- -,-
I
, Da.te Rec'cl
CITY OF PRIOR LAKE PLUMBINGPERMlT " JUL I 1 2001
\,a.1u.t P\lo
'" ~lcI ChY
'J.. Yal~ "wIiOIm
I PERlWTNO,'. 1- 733\
-"I
~7!rG5JJ- \
~leue ~ or crilltUl.d.sic atbattDm"
\ ADDRESS ~ ./-
.r ~~ 1:!XJ.4 ~,!A.4/-
UGAL DSS' :RIP1'ION [ollia: lIle only) . /J " I
LOT#tr..,)CK . ADDITION ~~ ~ J Pro .27"-}P7- O()7-f;>
;;'f,,"':,"J$LUc;!) ~.r~// .~ --t .if.'? 1
. (Atldt....) .~';O9'~ /.:~p.., ~7:~
I~ ~~~~AN1~~. :~Y-- :;i::~-~irf?
x (Ad~~).....I/~J qq.~___~1?L II, ~'1~?
(AclcIross) (Ci~) (~i? Codi:)
~(Coo"''''''''''~~- ~_.::zJ.'" ,,~7
Al'PLlCAN'r SIGNA _ ,___ _ DATE ~ --.--
APPtd~ P~ASE COMPLETE BELOW \
Type ofF!lrture QUllqtity Type of Fjxt. .j"e
datn rub "(lIh or without shower Rough.ins
- Di,hwasher / W.wr Hpter
. F.oor ;:irain I W.r Softnet
Lavattlty (B~';~-..." Sink) f Stand Pipe (Washing MiiQi'l~
Launary Tray (1 or 2 compartment sink S"",age Ejector ,
Show..- Stall .BaokfioW Assembly ,
Sinks Backftow Asselll.bly TllSt . :
Bar Sink I Lawn Sl'rinkler
, water Close" Toilet) Other
I
I
\
I
I'
I
QuaDtity
~
(i;.
If
c,.l.
'i
I
~
7
nE SCBEDULE
Industrlal, ' :omm.",j&l &. Multi-l'omily 1% of job coot ..!th . $39.50 minimu!"
..
~dantiQI. New OlIO ok Two-forniI)' \99.50
Rosidon,;&I. Additio...,. ...Jton,tlons;39.50
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIl' FEE
S
$
S
-&H..,o4/.
. -V/l.o,'/v.'0 t, _
"";:., "/
.50 ,.
.....,. .
~'it-;~'r
EstilbBled Cost $
BuHdiltg Pel1l1it II
(om.. VI< O"ly)
This "pp ;catiOIl '8ccom.. Your Buildin; Pormit When ApprDvod
P.id
. '
R,cgClpt No. !
I
III '.diq Ollioial
Dlte
,D-;_g~
By se-cJ.-.
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:4 ~our nod... for on in'po'llo.. ("%) ""7oo!l8S0. fax CIS.) 447-4.45
tOO III
lIlIV'1 801114 dO iUI::l
StZtLttZT9 xva OS:ZT 3llL TOILIILO
I
PRIOR LAKE
INSPECTION RECORD
I so -I-L-- s-\..
DEPARTMENT OF
BuiLDING AND INSPECTION
SITE ADDRESS lj)~
NATU RE OF WORK ..1}g1l '\
USE OF BUILDING SFD
PERfl.IIT NO. (1)/- (f) /3-3 DATE ISSUED 7-/'2--2..001
CONTRACTOR UJ~~&~a... J)ul'l~s; PHONE C,/2-4"fo-SD6-
NOTE:: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
\ INSPECTOR
, FOOrlNG ~~ th, 81[,0(>> ( I ~ ?It/Jlbl I
'FOU~DATION (Prior to Backfill) f~1 (b;r~ ~f'3/bl" I tm (,1'~If))
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SI GNED
ROUGH - INS
SE~ER/WATERISEPTIC ~~.~~ r;r ~ 9//~ftJ/~ ~,~~<lo,
FRAMING ~181D~
INSlLATION .:p. ($", Ii 7/0v
ELEl :TRICAL I ' I
PLUMBING UJ.~ L.LI ~ Oj/~f61 h. 1I/~~1
HEA'rlNG (if required),~ 4- jd/~ ~i~, II~~ z; .
FIREPLACE -..LL, ~l en-.. .(~/I1I/)('r/'lJjNr- ~ ~ /o/J..3{ol
GASLlNEAIRTEST~- r.f, t~~.f ~~'
COVER NO WORK/UNTlt ABOVE HAS BEEN SIGNE~' i1tL.
l..bJi~r~..fClb lit 3/01/ I ~>-"'.~ -&,. ew~I~. .51t,~z- j
f . I .
FINAL.~ /.1-
GRA DING (Prior to Sodding) Wp
BUILJDING
ELE( :TRICAL
PLUf ~BING
HEAl"ING
DO NOT OCCUPY UNT.IL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
I nd maintained until all inspections have been approved. On buildings and additions
, ,here no service cabinet is available, card shall be placed near main entrance.
DATE
(l "-
\J' ~/
//'- 1'1- cY
,- \\J
~b
L/( ()-f/O~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
~ESS
~() 2L I 'YJ JJv-.-.
HOUSE HEATING TEST RECORD
C1Tfl,~ ~~~B
OCCUPANT
HEA T LOSS
SOLO BY .
Electrical Work By
TYPE OF HEA r
APT.____FLOQ~ ..
J OWNER UJuc,.yc::lallf'
OATE HTG. INST. L{lcrL ()
INSTALLED BY I.(\ccor-
_ Gos Line By
GA _ FA -LHW _STEAM _ SPACE HTR. _UNIT HTR. _OTHER
f2~~ qd~AS DESIGN
MAKF~_ .
Mod.1 (( a. (OlzA-:s3
5...101_ . .-j~Ij;;030l.6~
INPUT ~ ~ ;n/)/>) fSI... .
I ( CONTROLS
THERMOS1T",T ~ H.at Plu.
Valve ~ ~
limit II. 1\{;lP['5..J
Limit S.ttln. fOO--F-
Fan Setting \~_A
Pilot Type .. $\1:
Pilot Mak. _ Jv"ll~ ~.-.\
Pilot Model
Pilot Timing
L.W. Cut nu
S 1\-1(
Pressure _ ry l.AJf _ ~
Input CFH (,')C.OorJ
Stack Temp. __/tl.~e<..~
VSeL
_Percent CO2 ~
Percent O2 7
Percent co 1'1
Form 235
CONVERSION
MAKE OF BURNER
_ Model
_ Max. BTU Rating
_ MAKE OF FURNACE
Model
? (,
Vent Size _ U
_ KINO OF LINER SIZE ~ON"
_ Draft Hood ' Regulofor 7?C;t;I!. V Y
_ Filt... S;z.J 1.1C?S-K1-Numb.,
_ Chimney Location - Inside_ V" Outside
_ Chimney Construction f>j (---
\
_ Smoke Bomb
_ Draft
Wiring _
_Test Tag
. Lighting Inst.
- Door Pressure__
ot. Dot. T..t.d S-'I{'-k'~
e
Company T osting lt~~E-r-
I Name of Test.r . ~_
Form # 5
OATE TIME
CITY OF PRIOR LAKE
INSPECTION NonCE SCHEDULED
ADDRESS MP.?.. ISO .u...
OWNER CONTR.
PHONE NO. PERMIT NO. 1- 7<1'
o FOOTING o PLUMBING RI o EXIGRADtFlLLING
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:
C ~.1'1<\ ~
-j-pA 0
V
C lo
!
~RK SATISFACTORY, PROCEED
o CORREC"j N AND PROCEED
o CORREC'. R I, CALL FOR REINSPECTION BEFORE COVERING
Inspector: \ \ g . Owner/Contr:
CALL $9 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
UiSNOTI
DATE TIME
CITY OF_ PRIOR LAKE
iNSPECTION NOTICE
SCHEDULED
5-8-.v2- ,A. y-.
ADDRESS
b ot;z.. 15V7X Jr.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
{J I - 7.53
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 INSULATION,J~ 0 SEWER HOOKUP~ 0 FIREPLACE FINAL
~ FINAL K PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION pi. MECH FINAL 0
o~
COMMENTS: ~ ~/z.-- 4-90 - .5()/~
({il ~ .)U~ <+0 k ~,
~ ~ 1l.{1':'~1{ ".., ~ ~I'
rfj/~~ .;y UlJ.' ~~-o, to tI..'~.~.
Z ALCJ I~ .<2D.=6 A./4. ~
;;I , ~-,,--~..... ,,(j ~~i_ c.
~ ~ ~ . -"lAUd) flit ,z,z, /N.A\J.
~ Na.4l ~ JOel'" ~ ,(Jd~" ~ ~
.L~~WJ. .
~t-'b.."''''~';':' ~ e.;. +-..,.f ~ sJfJ.~.
.,.-.' j . . .
~ Jo-<.A."4L.J~ .~.
~ ~ ..f~ I ~ I7l.- HelM::
-~ cia iK ~.( IJ/F:~~.
(f/)J'~..tYVU4.p .~.~.,... ,,-,/("~ ~ 4.l.;o
-crl ,(. /Ill.,.... !!!'/Rla ~ _ i .
, -r('~o. ti1.O ~rl/,,2.... .
.
o WORK SATISFACTORY, PROCEED
)II CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~.
Inspector:
Owner/Contr:
- I
CALL 447 -9850 FOR THE NEXT INSPECTION 24 Hl)IIRS IN ADW..NCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNOTl
CA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5j8!C!..- tj:OO
ADDRESS
It, (J I? 2..
/S'o~ ~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Dl- 733
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
pia FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP !::1
~PLUMBING FINAL~
~ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLiNE AIR TST
o
COMMENTS: ~/&. .
~ p~U~.~~ ~~.
.:.. ~J~.~4'.e. ~ ~.
~l~i~:~~ ~d~.~,~ ~~~J
< 1I '
. l
--r;:;p ~eJJ .; -11L '~If""f;;-,-,f~'
~ I~U~~O:~'
~~~~~N-u-e
~ ~ ~.-vwr>-sL ~ /lJ ~ itJ ~/- 8"
~~~~,~. .
~~ ~o-eo l>>v2.. ~tit,)-~ (k) -F f~
~.~) ~v.....flM.L~. .
o WORK SATISFACTORY. PROCEED , n
o CORRECT ACTION AND PROCEED ~ ~ ~ ~~
" CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . _ Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY!
fliSliOTJ
DATE TIME
CITY OF PRIOR LAKE JI-N-o.J
INSPECTION NOTICE SCHEDULED
ADDRESS t,'O ~ ). /SrJJ:t--$+-
OWNER CONTR. W~/(. Bldl'S
PHONE NO. PERMIT NO. 61-733
o FOOTING o PLUMBING RI ~~FILLING
o FOUNDATION o MECH RI o CO INT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
ciCf!.NAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
("rt:.IA - r9 K..
L."k Bo-f - ,0/(
:ll(. WORK SATISFACTORY, PROCEED
YO ~RRECT 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 HEAL TH & SAFETYI
fNSNOTJ
--_.__._-_.._~_..__._------~_._-_.. ,----
~
.
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Propert) Address
o f1II?'i.. I So +G 4.t- <t pf2 f O-V LA ILl'
Lot Area 47/0 or (If) Sq. Feet x 30% = .............. I z, 1; ot ,1-, 0
******, ~****************************************************************
HOUSE
LENGTH
1.. Z-. "1
WIDTII
x ,'"
x
=
SQ. FEET
:s z. 9~
=
ATIACfED GARAGE
(,to x'?G.f..s = _I. D'7'1
TOTAL PRINCIPLE STRUCTURE...................... 'I J 9 z...
,
DETAChED BLDGS
Garage/Shed)
x
.?l.f x Z'I J'I,
TOTAL DETACHED BUILDINGS....................... E,l,
DRIVEW A. YIPA VED AREAS
(Driv ,way-paved or not)
(Side' ,alk/Parking Areas)
~,R. ,
"lo. 1 i
x
x
x
IV,
1%',,)
=
5. 08. q
2.'S.1f
=
=
TOTAL P A YED AREAS......................................... s: 3 l{ S
P A TIOSII'ORCHESfDECKS It.... x -?Z- = '5"1Z-
(Open Deck:> !4" min. opening between X =
boards.. wit I a pervious surface below,
are not COI sidered to be impervious)
X =
TOTAL DECKS........................................................ ~I z...
OTHER
x
x
=
=
Compan y
'viii- jiL/'
i;fJ[() Qj/tK. 0 ~() I~ _
~T)/UJ f11~'~m.
Date
It/4
Ln...o l..!
1/1f./~
q/~! /~i .
(t/)/.. ~tJ..1--35S
TOTAL OTHER......................................................
TOTAl- IMPERVIOUS SURFACE
Cillmi;)VER
Preparec' By
Phone #
."-mII" /') I -073':3
.Job_~O$'2 I?"/'J-J-.J; >+
.-.g.. . .. '!;!;i./ Ai yo",~
'T---.,.. '?,$-"'~ -""'-
~ Poundo
~ !l!!!! !l!!!! -
._Uno
P-
PERFORMANCE TEST
*Percent c~
7. <j
7.. 2...
'Porcont co ()
.Stock Tomp. -' I ,d'
Dole '1/ rJIJ;2..
._~
Fln.If.. ."