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COMPLETION DATE I hereby certify that I have fumished 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 buildin offic' I an revo this pe it for just cause. Furthermore. I hereby agree that the city offici lor a designee may enter upon the property to perform needed inspections. X /O-2.1-Cf7 License No. Date FOR ADMINISTRATIVE USE SETBACKS: Required Actual MATERIAL FILED WITH APPLICATION Front Back Side Side SOIL TESTS CJ ENERGY DATA CJ BUILDING DEPARTMENT VALUATION OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION PILING LOGS CJ PERCOLATION TESTS CJ PLANS & SPECS CJ SETS Ulj!:: BUILDING I':;Sl ,~ C;/ SURVEY PLOT PLAN CJ COPIES CJ TYPE OF CONSTRUCTION: I II III IV Occupancy Group A B E F HIM Division 1 2 (j) 4 Permit Fee ................................... $ S U City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ Plan Check Fee ............................. $ State Surcharge............................. $ Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ i1ding ;:tr;itlO~ ~~~tf) Pressure Reducer .......................... $ Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Water Tap ................... .......... ...... $ Builder's Deposit ............................ $ Other ......................................... $ Total Due .............................. $ Sewer & Water Permit ...................... $ Certificate of Occupancy Issued Paid Receipt No. Date By he above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when a temporary ceiJ'~? ~'ring f1(liance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued. Date " Special Conditions ~ any 24 hour notice for all inspections 447-4230 CITY OF PRIOR LAKE PLUMBING PERMIT 1. Blue 2. Gold 3. Yellow File City Applicant PPNo. t; 7-JO{l Thr Crnltr or the L.kt Counlry Applicant: Address: Signature~ Legal Description: ot 2- Block A I Site Address: 2-9 YJ L'./ J~.: (,.~ Building Permit # 9 S- -0) 0 PID # ~s - :10 I-Do 2. -0 NOTE: This permit will not be processed without complete information. J::--,"",,"< Phone: $".. t.J'-(,J.'-Vb 9 ~ _ SubS FIXTURE UNITS Quantity Type of Fixture Quantity Type of Fixture I Bath Tub with or without shower Rough-ins I Dishwasher I Water Heater I Floor Drain Water Softner 3 Lavatory (bathroom sink) Stand Pipe (washing machine) J Laundry Tray (1 or 2 compartment sink) Sewage Ejector I Shower Stall Backflow Assembly (RPZ, Double Check, PVB) J Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 2- Water Closet (toilet) Other FEE SCHEDULE Industrial, Commercial & Multi-Family (1 % of job cost, $39.50 minimum) Residential, New One & Two Family Residential, Additions & Alterations State Surcharge $99.50 $39.50 $ $ ?fS1J $ $ .50 $ /tJ6.00 GRAND TOTAL Call or all inspections 2~ hours in advanc . 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245 An Equal Opportunity Employer ~ en ::J: m JJ )> Q m 5'" JJ en " g> ~ " a;l ~ ::J: ~ i ~ en 0 ~ m !!l- CD ~ 0. 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Yellow File City Applicanl Applicant: Address: Signature: Legal Description: Lot J- Block I Sub: ~ Site Address: aq~) lD III \c\.s Ll1/n.L Building Pennit# ~S -OO~() PID # ,2S--.jD 7 - O()..L-D NOTE: This pennit will not be processed without complete infonnation. FIXTURE UNITS Unit Quantity Type of Fixture Amount Total I Bath Tub 'J:~ er without shower $ 6.00 ~)lOD / Dishwasher $ 6.00 f..o, 00 I Floor Drain $ 6.00 I,., I 0(") .3 Lavatory (bathroom sink) $ 6.00 J g~ 0(\ I Laundry Tray (1 Cl!t-compartment sink) $ 6.00 Cc,.OO I Shower Stall $ 6.00 L~lO{) I Sinks: $ 6.00 1: I oe, Bar Sink $ 6.00 ~ Water Closet (toilet) $ 6.00 Jd l 00 ~ Rough-ins $ 6.00 /8 I 00 J Water Heater $ 6.00 L"l'lV'\ Water Softner $ 6.00 / Stand Pipe (washing machine) $ 6.00 In'll() Sewage Ejector $ 6.00 Backflow Assembly (RPZ, Double Check, PVB) $25.00 Backflow Assembly Test $10.00 Lawn Sprinkler $25.00 Other $ 6.00 Minimum Fee $25.00 SURCHARGE GRAND TOTAL $ .50 9~ ,.07) This permit is granted upon the express condition that said contractor, shall comply in all respects with the ordinances of the State Plumbing Code and the amendments thereof. RECEIPT NO. t/klfs' DATE ArrEST 4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245 AN EQUAL OPPORTUNITY EMPLOYER GREEN - FILE YELLOW - A....UCANT GOLD . CITY CITY OF PRIOR LAKE NO. tfS-.lj SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the city. APPLICANT: C-oQQ lC\) Q \u W)G\ c\J~ PHONE:Y l <)..'1-j \ \0 ADDRESS: <;O~ct ~h0 J'~ \'--Il '\)r M OLt~~ 5S'3&rlATE: 4.-\0 '<1 S SIGNATURE: t} Cc.U..V'\..VnAJ_ ~ BLDG. PERMIT # flS- -0130 SITE ADDRESS: d q"bo Lv ,\ ()~~~ PID#o!.S--j{)7 -00;..-0 FILL IN THE BLANKS 1. Estimated length of water service ~l) 2. Size of water service \\\\~ inch(es). 3. Location of any couplings from structure feet. 4. Type of sewer pipe. ABS PVC l--" Cast Iron feet. 5. Estimated length of sewer line It\) feet. 6. Clean out (if required), located at structure. feet from ------------------------------------------------------------------ ------------------------------------------------------------------ This application becomes your permit when approved. ByJ/7-di4J"I/./, ft'- DATE: 'lIIo/1S'" ====== ==========~=============================================== FEES: $ $ $ 35.00 .50 35.50 Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individually is $20.00 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 1/M/?S- RECEIPT # J... 7J...1c 7 AMOUNT PAID '!f1' SlJ REC'D BY l' a 4629 Dakota 51. 5.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245 AN EQUAL OPPORTUNITY EMPLDYER White - Building Canary - Engineering Pink - Planning Tho Conlor of lho LIb Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ~(\~~~~... ~ -q -IS The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: .'2Q30 lj'L~ ~~ Accepted Accepted With Corrections ~ Denied Reviewed B/{?J2 ~~ Date: 2 -I$"-~ Comments: \.~~ ~,,~ ~c.s.. ~~ (.,~ Y-'\~ ~~ ~ IJ.A:lU -fat+' I~~~ 3.~ ~c9-.~fl_ ~ ~~~ LI.N(!)t~ ~\clw~ ~C4~/ ~ c~~ ~tS' IThe 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." White - Building Canary - Engineering Pink - Planning Th. C.nl.r of Ih. L.k. Cou.lry NAME OF APPLICANT BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST f\ I ,\ 1"- \ \ ..' y' i '. lJ i \): \ ,rJ--'f.o' \_.f'l.""'."...C/...: //........ \. IT ,.~.. I APPLICATION RECEIVED " -" "'''-' , '_..' '~." ~. - f~- /J The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ~"- (,4 '~' ,r" ...... i........;.,. " '.. '-..::., '. .' "'"\./v".L Accepted /' Denied -;: 0 ~ Reviewed By: ~ Date: !}-I(,.C; S- Comments: -f1j fWL .~ flfM.- SJ1Ja-r~ 6h1rd~ Accepted With Corrections "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 yle~of this code or other ordinances of the jurisdiction shall not be valid."- ., (1'1 . .' White - Building Canary - Engineering Pink - Planning Th. C.nl.r or .ho Lab Counlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLlCANT~~ ! ~, APPLICATION RECEIVED 1/ r / ?1 The Building, Engineering, and Planning Departments have reviewed the building permit application for cOl)struction activity which is proposed at: )..930 V~:t ~ Accepted ~,. Accepted With Corrections Denied Reviewed By: 'J c ~:J~~~~~.~ #-"-.u ''ui1iI-Ik~~J 91A liThe issuance or granting of a pe~it 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. II ..Y'-,.'.......~. i'r'" f~/ ;51) Th~ C~"ler of I"~ Lake Coa..lry fflp Wd I'K 1/5'/ I({:> White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT (;"1.'1-1-. (~J -.)~J {f--. ..J2..u . , . APPLICATION RECEIVED ~ /9/15 , ( The Building, Engineering, and Planning Departments have reviewed the building permit application for con~truction activity which is proposed at: ;;'930 1JJtlyet~ ~ Accepted Accepted With Corrections Denied 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." PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS 1130 C>>llds (~__ NATURE OF WORK . USE OF BUILDING S Pb PERMIT NO. _ ~5' 03 v DATE ISSUED /027"7 CONTRACTOR l~e.'JJ~J ('11~JO"Y') ~r~ vL gv.- I ivy. NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT s . ~ S INSPECTOR DATE . SEWER I WATER I SEPTIC FRAMING INSULATIO ELECTRICAL PLUMBING . HEATING (if required) FIREPLACE GAS LINE AIR TEST FOUNDATION (Prior to Backfill) B ~.).' <') PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS ~ (Z\-\ ...0' 1.(..... ......") \. r J' II' .,. I" .,' I' . It,. ~-, COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I WALLBOARD I I FINALS GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING HEATING DO NOT .J 5. 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 447-4230