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Expires' 0,:.:::: -: This Certificate issued pursuant to the requirements of Section 110 of the ❑ R es i dential / ❑ In ternational t ally Building Code certifying that at the time of issuance this structure was in compliance with the various ti , ; � fit ' ordinances of the City of Prior Lake regulating building construction or use. For the following: � D 1� ! 7 ( -/ , (�� "" : ' l I IacL�¢G { Bld Permit No. , — • 1 U se Cl , - r g Occupancy Type Type Construction Zoning District 4,0'1.: : L `{ , 1 7 J ,c� �a �o ,717-9 ► Legal Description t T1 rr u1 Owner of Building Site Address > 8 7 ❑%. i?, l PL c e M 1 1 ♦' , { .} Contr t 's Na me & Address c\ 17 (.t 1. (`1 GV`'�. -e�� ..�." kvr • offe-c ( iS (..(0,234- U i ti °( CA Cit Plan Building Official l : Date: f,. ,,. ∎A,n -.RT 12 Date: O POST IN CONSPICUOUS P LACE ., - 7 - - F3 Pv "i r :3 ' 744001047 ,.. � r.' 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" I, 111 S TO 1 4 TYPE OF WORK XNew Construction ['Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ['Addition ❑Alteration ['Utility Connection CODE: I.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F H 6 M R S U PROJECT COST /VALUE $ 1 10/ 0 0 0 Division: 1 2 4 5 (excluding land) 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 -m- - ioned pr..ert 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 , . revoke . i- pe • use. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ins ction X / fC[ (0307 — 7�ii� Signature Contractor's License No. Date Permit Valuation ` ` \t ,} I 1 ©0Q.- _ Park Support Fee # $ Permit Fee $ (2 clq 50 SAC # $ **--Z.- S Plan Check Fee $ e' 44 te Q % Water Meter Size "; 1"; $ i^, 0 , State Surcharge $ 1 0- s, Pressure Reducer $ t z. Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ t.s ■ 0 Water Tower Fee # $ O Mechanical Permit Fee $ J B uilder's Deposit $ lS�. t cal ° Sewer & Water Permit Fee $ 5---(0 y Other $ Gas Fireplace Permit Fee $ 5 , 5© TOTAL DUE $ q 571.6e This ' ,p li io, :' co / s Your Building Permit Wh: Appr ved Pai mu —u �� / .t No. �I i Da te d--- (_ (i ___ Building Official --.41111111111161 D.te This is to .1 ify that t ; equest in the above application and accompanying docume is is in ccordance with the City Zoning Ordinance and may proceed as requested. This document when sig :. by t.e C I 'la ner cons'ittutes a temporary Certificate of Zoning comp ance a allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. ; / r ' y "e v ' 1 cL. '_a L • - .r Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 • •Ab • , of PRZO4 h Builders Deposit U i $o P City of Prior Lake A $1,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 180 days after the date the building permit is issued. If the work is not complete within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $1,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: 1 . /3 - /2- SITE ADDRESS: % i fL _ PERMIT # i � - 74 REFUND TO BE MAILED TO: 'I }C;Pc J of - ' 3 9/' e-) 1 /11 � / Zvi PLEASE REMEMBER 1. KEEP STREETS CLEAN DURING CONSTRUCTION 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPI' OR $500.00 WILL BE FORFEITED AUTHORIZAT e N TO RELEASE SIGNATURE: // 6.4.*Z Lynda S. Building Services 1, 13 Acct. 801.20204 Date J:IFORMStBUILDERS DEPOSIT FORM.DOC 2012 PROJECT VALUATION WORKSHEET ADDRESS: c (7 SINGLE FAMILY ATTACHED: 1 Floor Wood Frame $84.85 X 2 Floor $42.43 X = SINGLE FAMILY DETACHED: 1 Floor Wood Frame $92.94 X = 2 Floor $46.47 X GARAGE: Wood Frame $39.23 X Slab On Grade Garage $20.00 BASEMENT: Completely Finished (New) $25.00 X = Unfinished _ $16.50 X = Crawl Space $16.00 X 3 Season Porch (unheated) $45.00 X = Screen or covered Porch or stoop $30.00 X = Deck $12.00 X = FIREPLACE: Masonry Single $7,000.00 X Stacked Masonry $5,000.00 X = Gas or "0" Clearance E.A. $3,000.00 X = Other X = TOTAL VALUATION ( 4( 36'7 CONTRACTOR'S VALUATION l l UPDATED 6 / 22 / 2012 J:\FORMS\PROJECT VALUATION WORKSHEET 2012.doc 08/08/2012 16:58 6514637835 FARMINTON PLUMING @H PAGE 04/04 1,t ''i n ' il ) Date Ree'd CITY OF PRIOR LAKE PLUMBTISI<; PERMIT a ome n 3. Yellm Vptiesni [..... 4' ' _please Woe or nem aids/pa at bottom) ... .,—...—, . ADDRESS L ZONING come ute) 33(1' Stoci-iov%, V lia ce_. LEGAL DESCRIPTION (Das& ute ttAy) LOT BLOCX ADDITION PID . . — ..___ ...— r iNgit tme ‘ ) _36 (Phone) _II1.a _ (Address) a..11-113:3 6ne..1.6,..3..Act, _A vs....- Lax Vi.... - U. (Name 1' La. APPu ff&...:A0___ _sl (mono (Address) P.N. 1 IS '34 Ce_taiaptns:W:e., A v-..2-,- v., 6a.#_±_ek, 550a 9 (Address) ' ' (City) (Zip Code) (Contact Person) ____ _ (Phone _____(C..La.:1313 L 0 -- APPLICANT SIGNATUR...._____ PATE 1,_,..... \e).,... ,..... APPLICANT PLEASE COMPLETE EI;LOW .. . Quantity .... 11LIvILf Fixture Quantity__ Type of Fixture 1 Bath 'rub with or without shower . .011g4-illS — ---... ,...-- _ ---....... L Dishwasher .. t 'y lathr Heater — 1 Floor Drain '1: Tater Softener 3._ Lavateryffixtbroom Sink) _ _ 1 Stand Pip (Washing Machine) Laundry TLay (1 or 2 compartz sink S ewage Ejector , ..... -- i Shower Stall. •ackflow ASSeillAY - 1 Sinks . ackflow Assembly Test — Bar Sink '. awn. Sprinkler — , "2... Water Closet (Toilet) ,: Ither — , ME SCI1EDULE l odustriai, Commercial & Multi-family 1% ofjob cost with a $49.50 Minh= Resi6 I Mal, New One &Two-.Furnfly S149.50 Rcsic t: ttiat, Additions & Alterations S49.$0 - • - - $ . , st; a &Mina Permit ., The Mimics.= Statutes f 32613.14R "SURCHARGE' has been changed for one yaw effective PUTMFIING PERMIT PEE $ Juty 1. 2010. until June 30, VII i. STATE SURCHARGE $ ..50 ID "Ivvin The mhilsklani surcharge kr a "line Tee" profit TOTAL PERMIT PEE $ NG bin bcgitmieg July 1,2010 P4SRP. ,.,.._ . . . „ .. This Application Becomes Your Building Permit When Approved Paid Receipt No. By • Malta° Official - tlalirt ' 24 hour notice for all inspr4tions (952)44748M tax (!'s t) 447.4245 4646 Dakota Street S.V,., Prior Lake, Minnesota ',' 5372 P RIOR LAKE BUILDING AND DEPARTMENT OF D INSPECTION INSPECTION REC 61 SITE ADDRESS 3 S C 11 ' rArly - L � . U) NATURE OF WORK 'r NI USE OF BUILDING ; , r. FA/0 IL k- --, ;�- PERMIT NO. 12- -` * DATE ISSUED `7 (' 1 z- CONTRACTOR RAT-Lt -mac- f rsc-. PHONE 95 -185 - 4119 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERylIT IS BY SEPARATE DOCUMEN 1, 6 - 5k 0f-3 ''-J TR-�' L.-or L. � �/4 -(N� (� S E OR DATE I FOOTING I FOUNDATION (Prior to Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER /WATER /SEPTIC FRAMING r .. W, Ap (0 / z INSULATION /6 a (e-;- ELECTRICAL PLUMBING HEATING (if required) f� / / FIREPLACE Y 1 0`4[ , AS LINE AI,R TEST dvt` j 6-■ /> (//, pioi, � COV NO WORK UNTIL ABOVE �E HAS BEEN SIG I6 ED X42- I4 FINALS GRADING (Prior to Sodding) G /St BUILDING /22/2 ELECTRICAL PLUMBING ( tee ) 7/c2i1- HEATING 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