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HomeMy WebLinkAboutBuilding Permit 11-0268 i .r.. 1'v .:� �tiY Wi �,F v� � ` r �� � M' f \ ���'k�n : . r� ' •!.. / y , �� �� N�� � ���''M r � l�t � a % i rl ,./ � � � . "i��:Y + tI ..; i� � I -.: rYll::: II„ : ,I ':. 1,_. I .. I !: rlolf L 1it :, rlL } r. : ff la�r •� :: � � �I I �.,�VY�II.: IIIV � ��� . � l rl t _ i1 V1e i Y � lV 1 ::}Vill: _ _ I _. �� � S :!4 ill r . 1 � CITY OF PRIOR LAKE Prparftt-truf of utibing cIttsfrrrfion ,, , / 5 ' Final Permitted ❑ Conditional C.O. Expires T his C'rtificate issued pursuant to the requirements of Section 110 of the ❑ Residential l ❑ International Building Code certifying that at the time of issuance this structure was in compliance with the 'various ordinances of the City of Prior Lake regulating building construction or use. For the following: '' Use Classification S /N 61 FR N /Li Bldg. Permit No. / i Z t& > � Occupancy Type �` 'Ty pe Construction V ` V • Zon Distri �.- U K Legal Description L / , E 1.-- - P.7.1/1 - ,S; 6F NC /�- /� /VCGL MEI L)O .`. i;< . Owner of Building Site Address K C ontractor's Name & Address F (��..71 V �/t Ff"// v ' //L y � -0/ / E-- /�e- • x J1/- —/ ' // S _ )ity Planner K = Building Official Date: Date: >/‘ K ill POST IN CONSPICUOUS PLACE ; ! , `, 1 V V Vim DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 7141 ADDRESS MI L S i A t wVr-c._ 01 OWNER CONTR. PHONE NO. PERMIT NO. 1 I - 2 4 `b ❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL itl- FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST ❑ SITE INSPECTION ❑ MECH FINAL ❑ COMMENTS: C(0 %CI P 6 WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED ❑ CORRECT , 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! NSMOTJ DATE TIME CITY PRIOR LAKE IN INSPECC TION NOTICE SCHEDULED ADDRESS OWNER CONTR. !! PHONE NO. PERMIT NO. 1 ❑ FOOTING ❑ PLUMBING RI ❑ EX/GRAD /FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL ❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST ❑ SITE INSPECTION ❑ MECH FINAL ❑ COMMENTS: 4 It; IS CS 61 111195f 2. r Q 3 4A, / 9 a rear „4 ) o 16. %- rt (2,-tays DitrA VI6 ❑ WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED X CORRE K, CALL FOR REINSPECTION BEFORE COVERING Inspector: Owner /Contr. CAL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSWIT DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 1 cif( ADDRESS ! OWNER CONTR. PHONE NO. PERMIT NO. f 2(e,e7 ❑ FOOTING ❑ PLUMBING RI X.E.X/GRAD /FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ INSULATION ❑ SEWER HOOKUP ❑ FIREPLACE FINAL ❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST ❑ SITE INSPECTION ❑ MECH FINAL ❑ COMMENTS: ,,,J br J.i4 s f ❑ WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED )CORREC RK, CALL FOR REINSPECTION BEFORE COVERING Inspector. Owner /Contr. CALL 850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & MINOT! e PR tp CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' d � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4'. g . t 1 AND UTILITY CONNECTION PERMIT f ArNES 0 � 1. Pi File P ERMIT NO. 2 � z Pink city �//7� 3 Yellow Applicant 1 ' L/ (Please type or print and sign at bottom) ADDRESS ZONING (office use) I 31 a 1 'OW A cT• yh i 1.1 SP LEGAL DESCRIPTION (office use only) LOT BLOCK 1 ADDITION if/L �tS of 10Obrr pqol r2l Qgdol✓t PIDZ5, 45/. ogi, 0 OWNER (Name) 0 A 1 w,tis 4 it - a=•J 1L.\ lv.` 5 ►G Is= (Phone) �f (Address) CCU tACT. to Ui)d( e /1- BUILDER ,...- f (Company Name) ef d s iem 6 4 _r,,..1 .� 1 L (Phone) 73 L ' 9- CO (Contact Name) A A' v 1 C. OP- v- y f}.,,.1 (Phone) (Phone) 6 I Z - 7S Z- 787 9 (Address) / 7 6 113-- J LA vtt p Pi T I+ STr• ) 3 .5 t icket/HI /yy/4J s F W q TYPE OF WORK New Construction ❑Deck ['Porch ['Re-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace `_.., ['Addition ['Alteration ['Utility Connection CODE: [.R.C. DI.B.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 2G a/ aU 0 Division: 1 2 3 4 5 ,I (excluding land) I hereby certify that I have . ed 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 p . • . 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 rev. this;,,.. . .■ t ca Furthermore, I h by agree that the city official or a designee may enter upon the property to perform needed inspections. X / ZD6 3 /!6y 41-11-if Signature Contractor's License No. Date Permit Valuation Z G. 0, cpD. - Park Support Fee # $ Permit Fee $ 2 3.5o SAC # $ 2-7..S0 . Plan Check Fee $ l .3 Og . a Water Meter Siz: 5/8 ", 1 "; $ b (D. State Surcharge $ (.!:■ • - Pressure Reducer $ cl Penalty $ . Sewer /Water Connection Fee # . $ t SOO. • . Plumbing Permit Fee $ 154 .S0 Water Tower Fee # $ i Gam. - Mechanical Permit Fee $ 1 54. 50 Builder's Deposit $ l S 40 — Sewer & Water Permit Fee $ 5(0.50 Other $ Gas Fireplace Permit Fee $ 5 4t . TOTAL DUE J $ ry ¢. Z / / This ication Be' . uses our Buiidin¢ Permit When Approved Paid /0 Foy._ b Receipt , " " 1 J / / �� I Date i 41/ J /, By J ∎/ '1. AVM... !Z 1 Building Official Date This is to certify that the req est in above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed ../ . e City '1 ner c i s a temporary Certificate of Zoning comps' ce an allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. / / / i '� 1Z 1k Planning Director Date Special Conditions, if any 24 hour notice for ail inspections (952) 447 -9850, tas (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 t et; sott i oi . Residential Building Permit Checklist New Constru ► ion for Single or Two- family Dwellings in R -1 or R -2 Districts Reviewed by: I C , Date: 12 Building Permit # • I : Zoning: 1 2 • Address: 14.315 -I"-prl +14.0t C.T. Legal: L , B Subdivision: Existing Structure? YES /t9 Existing Nonconforming Structure? YES AV CONFORMS TO ZONING NO ORDINANCE Yard Setbacks: NA 1 FAILS/ C • iIES 1 Standard Proposed • Front Yard. (can be 20' if avg. w /in 150') 25' 2 $. 33 • Side Yards X6'1'' Z, 5 25' if abutting a street 9 .°\ 4 • Sidewall exceeding 60' requires additional side 2" 10' setback + setback for every 1' over 60' in length. Not required 2 71' over 60' if building wall is 10' -0" or greater of being parallel to a side lot line. • Rear Yard 25' �S f • Patio Door: provide for minimum 10' deck or sign 10' side/ statement indicating no deck will be built in the future 25' rear • From 100 year flood elevation of wetland /NURP 30' pond. • Refer in -ground pools to the Planning Department • From OHW (Prior or Spring Lake) 75' or setback average of adjacent structures, but no less than 50' 1 Floor Area Ratio: NA / FAILS / COMUES 1 .30 Maximum 1 . 14 1 Yard Encroachments: NA 1 FAILS /COOLIES Standard 1 Proposed Eaves and Gutters no more than 2 feet in width anikair Conditioner and Othezelllechanica. closer than 5 feet to a lot line (Easements). Units Cannot Encroach into Required NC and other equipment cannot encroach on interior Side Yard Setbacks side yards. Tree Preservation: ip / FAILS / COMPLIES 1 Standard Proposed • Total caliper inc -s • Permit 35% Removal • Caliper Inches Removed • Caliper Inches Preserved • Replacement %:1 L: \TEMPLATE\BLDGLIST.DOC Driveway: NA 1 FAILS / CO S Standard Proposed I • Maximum width at prope y line 24' 2-4 1 • Required setback 5' from side lot line or go 4 . 30' from r -o -w on corner lots • Maximum slope , . 110 % • , • , 1 1 • All parking areas to be paved including R -V or spaces adjacent to the garage • Location to match subdivision grading plan •14(0 Building Height: NA / FAILS / COM , J S 35' Maximum I 7,4) t Shoreland District: NA / FAILS / C IES Standard Proposed Minimum lot area (square feet) ' 7,500 Rip, 7,999 Non -rip Minimum lot width 50' Rip, 57.3' Non -rip Shoreland alterations Imperyious.surface 30% Maximum k S. to Bluff in Shoreland: l FAILS / COMPLIES Standard Proposed I • Setback from t• • of bluff By planning dept. • Bluff impact zone 20' From Top of Bluff • Engineering certification submitted /approved By City Engineer • Grading in bluff or bluff impact zone No importing /exporting Floodplain: I FAILS / COMPLIES Standard I Proposed • 100 year ood elevation 908.9' Prior Lake 914.4' Spring Lake • Lowest floor elevation 909.9' Prior Lake / 915.4' Spring Lake • Proposed lowest floor elevation Must be 1' above flood elevation for new and existing structures. If existing structure was constructed 9/19/90- 11/22/97 then additional foot is not required. • Elevations 15 feet from structure Must be flood elevation or higher • Road access must be no more than 2 feet below .. 907.9' for Prior Lake Regulatory Flood Protection Elevation 913.4' for Spring Lake Accessory Structure: / FAILS / COMPLIES I Standard Proposed • Size 1000 sq.ft. or 30% rear yard • Not located in front yard (Materials) • Side yard and rear yard setbacks 10' • Maximum height 15' • Materials compatible with principle structure L: \TEMPLATE\BLDGLIST.DOC ,. t "'.Fy� .Rr'r"Wr',e" !r'z-`,'f`.dyi ; ,� ° ,g'. , t'�.. - , ". - x,., -- , :c',£#:n•v: , ,.w.s;a,+ =:';' ,..;.,..�ds•!$'i,$ n ay K "' e ABM. Y :x.` ,sa . x;,✓° G ",.... : ��„ 0 PRip. H U t r l White - Building P Canary - Engineering . VNESOc Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT Fie c. 0.S7o'/i& Ffr)f1 a--�; Aic /76 APPLICATION RECEIVED 4-. ei . // / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /6-,3/ 7 i i t) (: r : . Accepted X Accepted With Corrections Denied Reviewed By: f �- Date: AVID a+• "c Comments: See Attachments: 1) Grading Plan, 2) Erosion Control Measires Y See Reverse Side for Additional Information! • "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." ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS • Surface storm water drainage flowing to the perimeter of this lot to and from adjoining properties must be conveyed to the roadway and /or to the rear of the lot in drainage swales within the drainage easement. • All bare soil areas must be protected from eroding into neighboring properties through the properly installed and maintained silt fence or bales. • The silt fence required by the erosion control plan must be installed prior to any earthwork being started. • The builder is responsible for maintaining the erosion control measures until the turf is established. • The rock construction entrance must be installed at the time of backfilling of the foundation. • 6: \Adman \dept info \ ADDITIONAL COMMENTS FOR BOILDINS PERMIT APPLICATIONS,doc (4FRi\\ x U t=i White - Building �� �P Canary - Engineering LANES° Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT F/ELD ‘57NE Pg/ HO//6.5 /� y Hd APPLICATION RECEIVED `f'. S . I / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /(p 31 is 7791-1i1--/i •7 Accepted ✓ Accepted With Corrections Denied / " Reviewed By: � Date: 47(1- (/ Comments: Cawr449c_ L2og � 4tfpv r C ep4-A., Z".Lc�i47^S /dam ALL_ 7 s 6 "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." C RIp � , t.") r1 White - Building ESO�P Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT r E 6. t--` ._ _ / a //c / APPLICATION RECEIVED `f . ( y The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: l & , {edr,r /,.t'f ` . .., i 4 °' Accepted Accepted With Corrections Denied t` - Reviewed By: K e) - 19 / / Date: 4//2-- // Comments: 0 "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." 4 P RIO CITY OF PRIOR LAKE Date Rec'd HEATING /AIR CONDITIONING /FIREPLACE PERMIT � l r kiV E S O 1 Pink File PERMIT NO.1 l 2 Green City .266 3 Yellow Applicant I (Please type or print and sign at bottom) ADDRESS ZONING (office use) 16318 TAHINKA CT LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) FIELDSTONE FAMILY HOMES (Phone) 952- 469 -8800 (Address) APPLICANT (Name) FIRESIDE HEARTH & HOME (Phone) 651- 638 -3318 (Address) 2700 NORTH FAIRVIEW AVE. ROSEVILLE 55113 (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE WENDY SCHROEDER DATE 651.638.3318_ APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ['Gravity ❑ Hot Water into Required Side Yard Setbacks. ❑ Mechanical ❑ Radiation ['Air Conditioning ❑ Special Devices Fireplaces with Box Additions or DVent. System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL HEAT & GLO SL550TR - IPI - E FEE SCHEDULE Industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $149.50 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only $49.50 Estimated Cost $ Building Permit # HEATING PERMIT FEE $ PAID WITH STATE SURCHARGE $ , 5(�UILDING PERMIT TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buildine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 8X.J1 a='R -2E -21 11 1C:19 FROM: A :R MECHANICAL EAaAN B51452E925 TO: 95244 t 4245 P: 2 %2 I f-.. 4: 'ttri,?•, ,, vitr CITY OF PRIOR LAKE Date Recd HEATING/AIR CONDITIONING IREPLA.CE PERMIT 3. i.,„ a � 4,N 01t` �, r.k Pik ao�, c PERMIT NO. i. Yek r Mctxarl . TIMEX tyre pr Print And Sign at bniLOnl? .ADDRESS 4 ZONING int5cc vae) 3j (Il . LEGAL., DESCRIPTION ((Arc asr arty) LOT _ BLOCK ADDITION PID OWNER (Ammo) - 4 i ) - . (Atld�css .. .: k .r . A1Pk''ucANT (S 1f� }(N a r) � �} Cr! ! r Il fl (. . . (Phone) (A ) �1i25 . Q M1P /�,y� f�Ll 4 • C A A �. 1 � ' I , (mama) (City) (Zip Code) (Contact Pra:rotn) ` (Phone) �7S ,APPLICANT SIGNATUiiitt�e.. .,_. ' ! 1 .? DATE d f APPLICANT PLEASE COMPLETE BELOW PNEW CONS:'RUCI'ION 0 REPLACEMENT J ALTERATIONS J • 1fURNACE MAKE AND iv:ODEL )y ei110 3 q0 ' AIL • 1111 At• FUEL ,A),/-4- - FLUE SIZE .0 .. C� RE • OPENINGS _ t TNPLTT -0 Doc) OUTPUT '73, IPOO TYPE OF SYSTEM HEATING OR POWER PLAINT j+s�Wsnos Air Plants ©Stcatn PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach Q OGravity 0 Nat Wetcr into Required Site Yard Setbacks. ❑ Radiation ElAir Conditioning Q Special Devices Fireplaces with Box Additions or Went. 4yetcrn Q Other, Devices Cantilevers to the Outside of Buildings . ' Require a Buildleg Permit. • PIREPLACE MAKE AND MODEL — FEE SCHEDULE Industrial, Cotnmezcia l & Multi-Family I% of jab tout Residential, Gal Firoplaoac . $49.50 549.50 m inamum Ratidential. Heating & A/C (New Conan'nc ticcat) 5144.50 Rcsidesstiei, :Additions & Alterations $49.50 R idcntiai, Heating Only (Navy Construction) $64.50 Residential. AC Only S49.50 Estimated Cost S V) 4_0 c"} - — -- Building Permit # PAID W' , WWI •,,,,-'" Rtes * ,2613.148 HEATING PERMIT FEE $ �' • A a ," h as been changed far one oar cilccti+K STATE SURCHARGE S .54 .iota., 3, 2419. until Jame 3(. 29R I. TOTAL PERMIT IT FEE S Tin talaitmamsurcharpo fora "rood fee" permit mice Ilse OnlY) i+ n beeinnip4 .Illy LIMO This Application Becomes Your Building Permit When Approved Paid T " Receipt No. tlawdise a:; Official etc BY 2.4 hoar notice for all Inspections (952) 447 - 9850, fax (9S2) 447 - 414 4646 Dakota Street �., Prior Lake, Minnesota 55172 • e)x. 11 Ek si ?lt /o4 Date Reed z, CITY OF PRIOR LAKE PLUMBING PERMIT IVES °� L. Blue File x cold cit PERMIT NO. 11 i 3. Yellow Applicant (Tease type or print and alto, at bottom) ,ADDRESS ZONING (ofce,use) 3 ` 4o L ` 6 ^ALI k� CI— LEGAL DESCRIPTION (office use only) V LOT BLOCK ADDITION PM ( �IThd) I I es (?bone) Isa- 10- $� (Address) f 6 Y - c.Mr r / _ S L�_ r_ , ��[ f'� 5 y .APPLICANT (Name) /'''t, d S PIP"( 1 ( . [ (Phone) 6*C 4 t0 -1 t) C (Address) 2 - 7 g 6 /, Dst vc L t S �`► ' /Nf S' (Address) (City) (Zip Code) w (Contact Person) f (Phone) 6 Sl"a`1 S APPLICANT SIGNA,TURS DATE 'V/ APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture 2 Bath Tub with or without shower Rough -ins l Dishwasher / Water Heater 1 Floor Drain Water Softener $ Lavatory (Bathroom Sink) / Stand Pipe (Washing Machine Laun Tray (1 or . 2 compartm s ink Sewage Ejector Shower Stall Backtlow Assembl 1 Sinks Backflow Assembl Test Bar Sink Lawn S •rinkler '1 Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi - family 1% of job cost with a $49.50 minimum Residential, New One & Two- Family $149.50 Residential, Additions & Alterations $49.50 4d Estimated Cost $ 10, `au° Building Permit # PLUMBING PERMIT FEE $ PAID WITH STATE SURCHARGE $ '�)p ru,u(j PERMIT - .�IIT TOTAL PERMIT FEE $ (Office Use On y) This Application Becomes Your Building I'erimit When Approved ' Paid Receipt No. Date By Bnildiog Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 W .11 07/14/2011 09:27 9528816976695295 BOB JECFE PAGE 01 of paro CITY OF PRIOR LAKE Date R�'d ritiIr SEWER AND WATER PERMIT 2. Y01100 C112 Ikiiiiiiiiiiila IWA.1i. 2- Odd Wad alum X COr WIN endsiaasown) ADDRESS ` EOND40 menu* - 1 s LEGAL DescRwriow (olliae use ec14 LOT BLOCK ADDITION PID OWNER (Name) r c d• • . / /t . / e (Phone) (Address) (Add) (O COP OW (Name _ H. -) f , I ` . A3 / ' (Adder) A 3 !b k , , d t.. r >►. 1 , (Address) .; * (P Cads (Contact Person) In b (Pho ,,, f n APPLICANT SIGNATURE DATE • APPLICANT PLEASE COMPLETE BELOW Siva of water service - ( inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ AK [rrPVC 0 Get Iron Estimated length of sewer line 7V fit. Clean out (if required) located at feet from structure. FEE SCHEDULE Residential sewer and water tine connection S35.S0 Indtastriat Com'i & Muhl 1% of job cost with a $3930 minimum Sewer connection only S17.50 Water connection only $17.50 Esdmsted Cost $ Budding Pernik Ti SEWER AND WATER PERMIT PEE $ STATE SURCHARGE $ 54 PAID WITH TOT'S' PERmrT FU $ BUILDING PERMIT Okla the k) t� a TMie Aopffeatioa Becomes Your Bandies Permit Whoa Approved Paid ` !receipt No. Date 1 BY Bolding OIRdM - Date 24 beer aeries he all funds.. 052) 447 -9V Ay fax 052) 447 -4245 IL. -- ,�a�S. IJ PRIOR LAKE BUILDING �A D INSPECTION INSPECTION RECORD SITE ADDRESS f ( Thililvm NATURE OF WORK S 1 1 USE OF BUILDING S - , PERMIT NO. • _ % DATE ISSUED ZO 4 3040 CONTRACTOR . : t', _1 PHONE NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW `�p THE PEgM�IS� RATE DOCUMENT Gam' / W V / O ///.// OR DATE I FOOTING j 2 p � 1 FOUNDATION (Prior to Backfill) 1 Ai/ PLACE NO CONCRETE UNTIL ABOVE / BEEN I NED o ov .r yt/" 7✓1 �Q sT „ vA,00 - x- s ROUGH - N S SEWER / WATER / SEPTIC — ,� FRAMING INSULATION P4 5 // ELECTRICAL PLUMBING )J,, 5 0 / SizS' 'f re) 6 HEATING (if required) t 6 FIREPLACE 2"s) 6�1 GAS LINE AIR TEST 14. "A 6vE W RK UNTIL ABOVE HAS BEEN SIGNED I/ItJOI6frVIZ-tI g7 LA , y/ � /1/ 1 FINALS GR jDING (Prior to Sodding) 74 BUILDING fit [ ELECTRICAL PLUMBING j� c.1297er HEATING pe vsym DO NOT 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. FOR ALL INSPECTIONS (952) 447 -9850