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HomeMy WebLinkAboutBuilding Permit 13. 0100 ".' .. F3M --- .`.� ti. -- --- ' .. ' O `... - .I u' ! :. ` . . f r , ;fit: --5 �. r : + r 4 —���' , 4:1 /� 4.. . .r' .. �r..•r.r '4+; •♦ • r 4. .rrf P, 1 r��to;, 'iV't * :7 .4, bb ��r'1WrA o. 'Jr o i - fee ♦ . .. J0,•�e' � ' r'Ar �.pAfJ4A � . ' IS:f <! 0 ' , f rd4yr �rl�.l, ,R,, 1, � e IP b 9 � 0 ,n� ,' 1 peY, r ^ `09'� � w' * NI' r� `1 rn r" � n irrOr .1^1bn•1 * H/r� : Y r :, Ire $rr '' , � rJr, fee , n J1 � NA . r �' , � ; � ( j' I ro��' riy ' 1 /1 , Y , v " ' . r ra . , , 1ttl , :, , ll t ll Vii ; r1 1 . . 11 W P. r 1 f ;. rl ..n t, 1 � lain In ti w nfl 1 tarp � t; i . i I t f 1 i , i' h 1Affiln . r� n ` r ' ,, uL is I 1 u I Eil t s: ttil rt } e tltl t nett s Pit i , 6 , 10 t� t� S i Y.. t t ��+ 'Hit t 1 e r6J66 �1.. ,r6 el e. e. ∎ , r Mi,` r • f r ifii afr of Mcrufrnnci �`� CIT OF PRIOR LAKE :. 3� } ,,,,,...--,, pr of utibing 4 ttsprrfinit ..!„1.,.,51,, io, F Permitted ❑ Conditional C.O. Expires' y This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / El International < -, �� tifi Building Code certifying that at the time of issuance this structure was in compliance with the various ,o _ or of the City of Prior Lake regulating building construction or use. For the following: ') K Use Classification B ld Permit No. n l o n e �) SINGLE FAM�( g' 3— �y PU �. R3 O ccupancy T ype R3 Ty Const ruction Zoning District AN rl = g p L44, .1, JEFFERS WATERFRONT Le al Description 14391 PARKSIDF CO!1RT j I Owner of Building Site Address { i Contractor's Name & Address MATTAMY HOMES ROBERT D , HUTCHINS r # ,. ,. .— City Planner (f 4 / 1 / B Offi e ' , ��e Date: 1' 1 ' Date: PL r; ACE ti PO ST IN CONSPICUOUS r „ y :� 'i ..r' �:� I it ;� t" •: ix,' 'i'� r. ?t ry . t "� ri � 1 iv 1 "sit J ,i�I�N "L1'�tIIIIII'� �1! 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Yellow Applicant (Please type or print and sign at bottom) ADDRESS ■ 4 .- \ PAP Y S l D E 2T ZONING (office use) ,., p /5J LEGAL DESCRIPTION (office use only) t LOT � BLOCK 1 ADDITION L"- ' � x` —1- T' -C-12,9 ra PID 2 -5 / 1 c 4 1'0 OWNER (Name) i'I A T i Ps- NI "t 44 0 NI ES (Phone) (Address) 12- l WASH - 11-1 i U i.-i A v E S S 2-o I t=0 t t\t 4\ H iJ SS 43 9 BUILDER (Company Name) M. YA --i i 4+0 I` 1 E5 (Phone) (Contact Name) S U E g'1 (Phone) (Address) 1Q t t... k S 141; c N vE_ S STh- w t ._o t t.1 Ac [- 1---1 SSA 39 TYPE OF WORK New New Construction SDeck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace ❑Addition ❑Alteration ❑Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑ disc: 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 $ 14 0, 0 00 • OU Division: 1 2 3 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 - 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x----- � =� ESL 2 2- 1 a 5386 t t� i 13 Signature Contractor's License No. Date Permit Valuation - - U Ue. Park Support Fee # $ Permit Fee $ S-c..) SAC # $ 2_47--> Plan Check Fee $ S-11 Id Water Meter Size $r "; 1 "; $ i 8C) State Surcharge $ TS - Pressure Reducer $ • k ` Q Penalty $ Sewer /Water Connection Fee # $ l cc-E.), _ Plumbing Permit Fee $ t c A. v Water Tower Fee # $ y _ Mechanical Permit Fee $ i ,� — Builder's Deposit $ Zr, CO — Sewer & Water Permit Fee $ 5 tom, � � Othe e � t'�-� `� `, �(1. 5 (t , „) $ c 5 - ,to E Gas Fireplace Permit Fee $ 5 4 50 TOTAL DUE $10 1. This App1 on B • c I es Your Building Permit Whe App owed Paid /6', C 7, 7� Re ipt No. Ci, /,� ' t A / Date : L% _ ,:""7. . /3 B /I ' � 3 Building Official _) Date This is to ce - that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signe /F th- Cit• In. •nstitutes a temporary C of Zoning omp ' ce and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. ( ' / Planning Director 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 FRIG 0 4) Builders Deposit ti U , '7 h . 4- ,v.s0 - 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: t l3 r l 1 SITE ADDRESS: t 4 ` "1 9 1 DJ) v S De C_, PERMIT # 1 � I REFUND TO BE MAILED TO: 1-1-k t - 1 A F1Y 4_1-0 1-1 F S "12O I. t Pcc,t4t t J GTO t S SU 1 - 1 ZO I --01.1�111, , 1-11 SSX439 PLEASE REMEMBER 1. KEEP STREETS CLEAN DURING CONSTRUCTION 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED AUTHORIZATION TO RELEASE SIGNATURE: diZ� 500.00 i ynda S. • en, Building Services Amount 3 Acct. 801.20204 Date C: \Documents and Settings \sbare \Local Settings \Temporari Internet Files\Content.Outlook \BD8OXI9A \BUILDERS DEPOSIT FORM.DOC o� rRio? White - Building Canary - Engineering NNES° Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST x, , /4. NAME OF APPLICANT APPLICATION RECEIVED \i/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /1.-Y / � 11 ' leD � 7 1 i /., JP' - ' �7 1 '7 Accepted Accepted With Corrections Denied Reviewed By: Date: 3-s? /3 Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading Plan. 2) Erosion Control Standards "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." O� PRIp� �. , `. U t x White - Building �P Canary - Engineering NNESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT A APPLICATION RECEIVED T The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: gy p- 13-n90 / -I® /. )�> I �� // -- /�> / fiht-i 0 6 " CC( Accepted L.-- Accepted With Corrections Denied X Reviewed By: Date: 3 / 3 Comments: Cid i -OU °�l�N = ��t► �, C ) t?L 5 4r 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." PR' °1 U tx White - Building �� Canary - Engineering NNES ° Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED .! R� /j D The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: i do / C , —f( � a+01 • Accepted Accepted With Corrections Denied Reviewed By: Date: 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." Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractors representative and witnessed by an owners representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: JEFFERS POND DATE 7 I2 /13 PROPERTY ADDRESS: 14393 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS OYES ONO EQUIPMENT USED IS APPROVED 'DYES ONO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS OYES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: OYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS OYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA25 OYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2013 1/2 11 155 SPRINKLERS RELIABLE RES 44HSW 2013 1/2 16 155 RELIABLE F3QR 2013 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR -F DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION* PRESSURE PRESSURE AIR PRESSURE TEST OUTLET` PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/0 Q.O.D. WITH Q.O.D. IF NO, EXPLAIN LOCATION MAKE & SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE & FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) VALVE TEST N/A oo OPERATION: ❑PNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED ❑ YES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES ONO CONTROL STATIONS DELUGE & IS THERE AN ACCESSIBLE, FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES ONO N/A DOES EACI- CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MORE, SU PHUE. InN 1 OSS Al ARM OPFRATF VAl VF RFI FASE OPFRATF F,FI FASE Y.c NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi (13.6 bars) for two hours of 50 psi (3.4 bars) above static pressure in excess of 150 psi (10.2 bars) 'or two hours. Differential dry -pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC: Establish 40 ps (2.7 bers) air pressure and measure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water level am: air pressure and measure air pressure drop, which shall not exceed 1-1/2 psi (0.1 bars) in 24 hours. ALL PIPING HYDROSTATICA_LY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TRSTED DYES NO EQUIPMENT OPERATES PROPERLY OYES ONO N/A DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF E ODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR SIODPIHG LEAKS? (EYES ONO __- DRAIN READING OF GAGE: LC GATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION PSI CONNECTION OPEN WIDE PSI UNDERGROUND MAINS ANC LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THEIJ FORM NO. 85B YES NO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING OYES NO IF POWDER DRIVEN FASTENERS ARE USED IN [OYES NO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ® NO IF YFS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQU RIEMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? YES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE F EQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 EYES ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH. THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE: INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? YES NO CUTOUTS DO YOU CERTIFY THAT YOL HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RE TRIE , ED? YES NO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA ID YES CI NO NAMEPLATE REMARKS DATE LEFT IN SERVICE W IT' i ALL CONTROL VALVES OPEN: [ jig ) i3 NAME 0 SPRINKLER CONTRA: TOR: FIRE SUPPRESSION SERVICES. LLC. TEST WITNESSED BY z� Y O r 91SNEiD) _ TITLE DATE SIGNATURES Y � � j C' _ CS) / 2 �/( 7 FOR SPRIN r.". • .' °ACTOR (SIGNED) TITLE DATE � —t: 7 Z9 i_3 0 1 l ADDITIONAL EXPLANATION AND NOTES Residential Building Permit Checklist New Construction for Single or Two- family Dwellings in R -1 or R -2 Districts Reviewed by: 0 Date: 3� Building Permit # PID: • Zoning: P �.D Address: t 4 1 - i 4 311 17,4d r0 e'CT Legal: L , B Subdivision: Existing Structure? YES he . Existing Nonconforming Structure? YES I NO CONFORMS TO ZONING YO NO ORDINANCE i Yard Setbacks: NAI FAILS/ COjIES Standard ` 1 Proposed • Front Yard (can be 20' if avg. w /in 150') —25' zo Z • Side Yards_ .2&1f abutting a street . Zp 6k.-o c, 1.. g4pb 4 o ± • Sidewall exceeding 60' requires additional, side 2" '10' setback + setback for every 1' over 60' in length. Not required 2 "I1' e6r 60' if building wall is 10' -0" or greater of being parallel to a side lot line. • Rear Yard 25Y k' ' • 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. is • Refer in- ground pools to the Planning Department 4o -- • From OHW (Prior or Spring Lake) 75' or setback average of adjacent structures, but no less than 50' I Floor Area Ratio: NAI FAILS I CO l S I .30 Maximum I p - 17 Yard Encroachments: 121 FAILS /COMPLIES 1 Standard 1 Proposed Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line (Easements). NC and other equipment cannot encroach on interior side yards. 1 Tree Preservation: NA/ FAILS I COMPLIES 1 Standard 1 Proposed • Total caliper inches • Permit 35% Removal • Caliper Inches Rerr?oved • • CalipeIrgches P,r6served • Replacem ntf % :1 L : \TEMELkTE\BLDGLIST.DOC / Driveway: NA 1 FAILS I COM jS Standard Proposed • Maximum width at prope I ine 24' F(- p • Required setback 5' from side lot line or 30' from r -o -w on corner lots • P' P • Maximum slope . 10% 4 s'i . 7 . c • All parking areas to be paved including R -V or spaces adjacent to the garage • Location to match subdivision grading plan Building Height: NA/ FAILS / COIVJES 1 35' Maximum 1 P - > I Shoreland District: NA / FAILS 1 C LIES , Standard Proposed I Minimum lot area (square feet) r� __ 7,500 Rip, 7 999 Non-rip p Minimum lot width 50' Rip, 57.3' Non -rip Shoreland alterations Impervious surface 30% Maximum p see (MP. Ap-6 - Th-c. L E• Bluff in Shoreland 1 FAILS / COMPLIES _ Standard ( Proposed I • Setback from top of bluff By planning dept. • Bluff impact zone 20' From Top of Bluff • Engineering certification submitted /approvec_ By City Engineer • Grading in bluff or bluff impact zone No importing /exporting . Floodplain: / FAILS / COMPLIES Standard Proposed • 100 yea flood 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: (A / FAILS / COMPLIES 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 (:0 Date Rec'd CITY OF PRIOR LAKE 3 2L ./3 ..4,; t,, SEWER AND WATER PERMIT /3 -/Q0 ' i.3 - /0/ 2 Yellow City _ . Green ite 2. PERMIT NO./3 ....../6 Z 3. Gold Applicant r print and sign at bottom) / '� / ADDRES C r LON c� ) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) APPLICANT 6 w4 /'G d7‘/' ye�J /3 ( Name �" �l (Phon j A 0194 (`did - 'me . .45' r/4/ 4S- 5f3 (Address) , J (City) (Zip Code) / ,7 /M ---- ' (Contact Per/ --r//2 ` (Phone) 4/2, 9J9 V o APPLICANT SIGNATURE ' 1" , / ATI --'2Z �' / APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC ❑ PVC ❑ Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial, Com'l & Multi- family 1% of job cost with a $51.50 minimum Sewer connection only $25.50 Water connection only $25.50 Estimated Cost $ Building Permit # SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ .50 PAI , �'�.� TOTAL PERMIT FEE $ BUlLDINn mI T H T (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 P , 4 Rio Date )Etec d a, ? 1 .:Est" CITY OF PRIOR LAKE PLUMBING PERMIT 4 In`NESn* c "st4 rae PERMIT NO. � le cap 3 Yellow Apo! Kant (Please type or print and sign at bottom) ADDRESS ZONING (office tue) 1 361 c ( _i a k)03 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) be _) COl el LX 7 V' L. (Phone) (Address) APPLICANT �' } f� 1 J / QS�^ �} 7 / /� (Name) — GCS / ('L "'` C n l PI U11110, 1 ! i/ (Phone) / � JS (Address) C/ d �-�C 1 L I (ut) 13 3 6/23.6 U) m (Address) (City) (Zip Code) (Contact Person) I Y ->�(C ire 3�.�SY ]��, -i7 /}� f'� (Phone) _ �/ Sd ) 7 -- /Y � / APPLICANT SIGNATURE i--' 1 ' vS DATE ql(/ %/ /3 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture a Bath Tub with or without shower Rough -ins 1 Dishwasher , Heater Floor Drain l d =" Water Softener 3 Lavatory (Bathroom Sink) / Stand Pipe (Washing Machine) PT' Laundry Tray (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly 1 Sinks Backflow Assembly Test _ Bar Sink Lawn Sprinkler ?) 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 the Minnesota Statutes $ 32613.148 ^Est $ Building Permit # "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ .lute 1, 2010. anti) rune 30, 2011. STATE SURCHARGE $ .50 PAID WITH The minimum surcharge fora "axed fee" permit TOTAL PERMIT FEE $ BUILDING PERMIT Is beginning Jul 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date B Building official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 A -1 4 • 4 r /0 CITY OF PRIOR LAKE Date Rec'd ° =- HEATING /AIR CONDITIONING/FIREPLACE PERMIT 41. /NNEso 1 Pink hie PERMIT NO. 2 Often Cii> alfk Yellow Appbeam Please type o r print and sig at bo tto m ) ADDRESS ZONING (office use) I q A Po< A_ c ULU LEGAL DESCRIPTION (otfiiec use only) LOT BLOCK ADDITION PM OWNER Ufa) w (Name) ht d7 O 6 (Phone) (Address) (Name) C P 2 R \ I T l� ) 111 c (1 ( Phone) q J C ) � (C / i SG (Name) (.r � 2 (Address) aaco w �o 3 U'rr11FSU\ke_ 5533 r �� ,,� V ��i�( (Address) (City) (Zip Code) (Contact Person) M (at l � , (P P j hone) L 5 t7 -) - / ) q APPLICANT SIGNATURE , /�`L // I 1�. DATE C 1/(9 0 7//3 APPLICANT PLEASE COMPLETE BELOW ONS UCTION ❑ E ALTERATIONS FURNACE MAKE AND MODEL br Il 't I DS I `1 ( 6� 00 31 FUEL ■CW), C 0, FLUE SIZE RETURN OWENINGS INPUT SAS I COO OUTPUT S3 36' e) I TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Mr Conditioner M Air Plants 17 Steam Units and Fireplaces Cannot Encroach • vity .1lat Water into Required Side Yard Setbacks. �r ?" hanical ❑ Radiation q it Conditioning ireplaces with Box Additions or g ❑ Special Devices Event System ❑ Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE industrial, Commercial & Multi- Family 1% of job cost Residential, Gas Fireplace 549.50 $49.50 minimum Residential, Heating & A/C (New Construction) S149.50 Residential, Additions & Alterations 549.50 Residential, Heating Only (New Construction) S64..5� 50c� Residential, AC Only $49.50 r Estimated Cost $ ' I U (� Building Permit # The Minnesota Statutes § 32611.1411 HEATING PERMIT FEE $ "SL,RCI I,1RGt:" has been changed for one year elTectise STATE SURCHARGE $ .50 Ju■ I, 2011, mil ilJune 311, 2011. TOTAL PERMIT FEE $ The minimum surcharge fora "fired fee" permit (Office Use Only) Is '6, buy in Ili ng.lo1 1.211111 This Application Becomes Your Building Permit When Approved Paid Receipt No. t1 __ Date By Building Official Date = - . al ■ n C 2 14 T 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 -4/ N P [1 T PR 1- / 7c 4 PAIIIMPI , j NNEso CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d TEMPORARY CERTIFICATE OF ZONING COMPLIANCE MAY 1 4 2013 AND UTILITY CONNECTION PERMIT B y : Ptna CI> PERMIT NO. / 0 III , .0.,.. A.,4.c.s. 1 . . (Please or r___rinund sijo_attlotton_si ____ I ADDRESS i ZONLNG koffla uw) 0 14 ' I 1%R451Pc (... N41/4) LEGAL DESCRIPTION wffice use only i LOT BLOCK ADDITION PID _ (Name) I 1 H iii (4 60-AC'S (Phone) 5:0 - 2..1 7 - 21 oc., „ - (Address) 72-01 WASHINiiiii>N A Ur.. 3. CP/ h.lil i Mk( 5 51 litILDEPR 0 i•E cre, g. ,.. (Phone) 7(C - 217 - (Contact Name) " ""'"'? V -. 'g r...1 C.4 (Phone) (A &tress ) 1 I I I 0 0 iTE A 6t. RiVeZ i Mr ' S3 TYPE OF WORK New Construction ODe.. CIPorch Eifte-Rooftng ORe-Sid.ing 7,Lctwei Level Finish 0 FISeplace — 1 Addition C.Alteration OUtiliry Connection CODE: F4.R.C. EI.B.C. ID t.4. _ Type of Construction: I D III IN V A B "? ,-- t: r -- Occupanc, Group: A B E F HI Mj3)5U PROJECT COST/VALUE S 7 --c ''. , --k --' 1 Division: 1 2 6. .) 4 5 (excluding land) __I r abov hereby ceenf that 1 hem furnished intonnaclon on ti appcall,zet Much a to the best at my anemic:le : ana oarrev. 1 is certify [ha: I am the rrWITCT Or autromea arm for the e •,..tet and that aA cmumuction oi,i1 conform re all calory* state 41T14 h3Cal laWS atul Wi2 Muer.; ,t, accordance truh sutentned plans 1 am aware that the htLid,ng offload k c Am pennt C . 1 SI c u Se FLIFthernafr 1 heteM agree Ow *e 4:fry offitmi ot a deilrtt . 1 , d , tree: tmetn the p w r .,, , c , n , needed :r,speoxiu rn 0.44.1k 61.1t41 _____—C.1-1.4___ 5' i3- /3 ,x 1 Supurure ,:ontractc: - .1.,-- , f •. i 1". Permit Valuarion a a CC Pa-k Suppe/ F ..... .,... $ i 1 .. ' .. Permit Fee S SAC ;:: ° s 1 , --. Plan Check Fe $ Water Meer Sze ." 'Y : - s State Surcharge 5 Pressure Reducer $ 1 Penalty S Sewer/WateT Conn:mon Fee 4 5 - -- Plumbing rerr,–, Fee S Water Tower Fee ,.. $ — . Mechanical Permit Fee . 111 Derysr S --. _ Sewer & Water Permit Fee I 5 Other $ l - Gas Firerlace Permit Fee ' $ i 1 TOTAL PIA $ ---. —___ At PAID WITH' Bet cs Your Buildin2 Vern t wit r Approved--; I Parc! Raiirr • — , 1 Date BUILDIft )111.: 1 a 1 lh 3 is w Lerch that the +Nuns in the Abe.? atm. lest .1 and act omparn a' 8 ,loci-meru is in accorelarKe .Ah :ne t ,:, :otani t)tdinar.-ee and may sq,s‘re.: as rc.;ursted ":* s x' -rent when slimed I, the Cr, Kutner commutes a leTTINTIn Certificate of 7ung mmiAtuire and arso.t canstracstm ro commence Before ,r:uparc's a Certificate of 01,11r •-■ TIII.SI he I usuei. ?tanrung Direr ---- Date Spes.,all urtelmons,,f 24 hour notice for ail inspection:1952)44/- faa 052 I 447-4245 4b46 Dakota Swett S.F.., Prior Lake. Minar3ots 5537 2 PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECO F Wain rile SITE ADDRESS 19 3 \ t�N4z.y- I 1-7c-- --.t-. NATURE OF WORK -A.,, J c . X-C- - td - P�2 . o - 'w . L . L . USE OF BUILDING � ►��c...,G F-tt(c -wL..1 .» PERMIT NO. 13- o 0 DATE ISSUE r. CONTRACTOR fitc,. ot S. PHONE 1 1g -6. 1'1?) NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BLOW THE PERMIT IS BY SEPARATE DOCUMENT - > j� ` �-- !MST 1_ . 2-pj t p■, �� Z6,L INSPECTOR DATE I FOOTING yUh1 / I M Y/4/45 1 I I FOUNDATION (Prior to Backfill) 1 I � /i3 I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED :;.a Da- - 62-U ': ROUGH - INS SEWER / WATER / SEPTIC iv u Ili Pk t / / FRAMING b.-H-0 INSULATION , AL! 7; g/Z3 ELECTRICAL PLUMBING u.� . 1 C - ,HEATING (if required) a'. --; _ I FIREPLACE GAS LINE AIR TEST (- AP ° `' 'P°P COV R WORK UNTIL ABVVE HAS BEEN SIGNED ram, (7 pae55 /0te FIN ALS 7 %z9/ GRADING (Prior to Sodding) 1 - BUILDING E ELECTRICAL PLUMBING 6-ig s��_.3- HEATING Pi', $147 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