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CITY OF PRIOR LAKE „,,
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Final Permitted ❑ Conditional C.O. Expires
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This Certificate issued pursuant to t requirements of Section 110 of the ❑ Residential / El International
= Building Code certifying that at the time of issuance this structure was in compliance with the various
Oi: - . 1 ordinances of the City of Prior Lake regulating building construction or use For the following:
4;:10....
Use Classification SINGLE __F A M I L I Bld Permit No. 12-1101 '1;„1101
j `, PUSD
_� Occupancy Type R ” Type Construction v N Zoning District
Legal Description L8, B2, JEFFERS POND THIRD ADDITION
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Owner of Building Sit Address ;;;:.--...11:
Contractor's Name & Address RATZLA F �-IOMES , INC,
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�" "' ROBERT D, HUTCH I NS , City Planner
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�� r1 Building Official 1 /
V D ate: ' ; // -� / Date: '_14P;
? POST IN CONSPICUOUS PLACE
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� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE q r ( �` ( 2_ �' AND UTILITY CONNECTION PERMIT
r4'NESo� . Fi1e See ain 1. White File PERMIT NO .
3 . Pe City ,� HO/
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
39 '01 5 i oN "Ace_ Nw
LEGAL DESCRIPTION (office use only)
LOT i 9 , BLOCK 2— ADDITION A \---) 3 -- PID
OWNER
(Name) - – (Phone) - -
(Address) - -
J
BUILDER p�
(Company Name) I'�TLIAr- 1401`,,aS (NL. (Phone) 952'95S -S959
(Contact Name) J °^l 14 kSi EnIFV -1 Z– (Phone) C i S2 9'6 S – '1 1 7 1
(Address) 2 1 4 t 3 612'/XkD4- 4."E 5L-11 r 12 0 1 LAfcE. vlci –e. S So 1 1
TYPE OF WORK TA.New 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 onstruction: I II III IV V A B
1 Zd oan
Occupancy Group: A B E F H (5) M R S U PROJECT COST /VALUE $
Division: 1 2 `5) 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- ntio ed pro 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 o is ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed spe ns.
x GC 1 $(v 307 9
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
15 3. 000. -
Permit Fee $ ( 31 ` so SAC # $ Z 3 b s . _
Plan Check Fee $ Sq' .4g Water Meter Size V "; 1 "; $ 4 sp. .
State Surcharge $ 1 So Pressure Reduce $ (zD_
Penalty $ Sewer /Water Connection Fee # $ ( Soo -
Plumbing Permit Fee $ 1 S 1' -8c. Water Tower Fee # $ ( o 00. .
Mechanical Permit Fee $ t 5 So Builder's Deposit $ 1500. -
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 5 4 5-0 TOTAL DUE 77Z4F
This ti • n : ecomes'Your Building Permit When Approved
t Paid 7 L- v Re ipt No. 6 73 r
Date v '�. / 4 -- By
il ; ng Official ate
This is to c ify th. t he request'in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig th • ity Planner constitutes a temporary Certificate of Zoning co li e and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
I• 10 3 (Z
' . • • . i _ 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
• " • • .2. •
i
" • * 'w4S,
riuo ,.
Builders Deposit
V
so y 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: /0. 0. /1 SITE ADDRESS: 3 907 $ 77OAof it.. PERMIT # 4 a + • 110
REFUND TO BE MAILED TO: _jeirrelsAileMeS
3 J Ale Sc/1 12
_ w Id A, L. J.
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: it 4500.
ynda S I len, Building Services Amount
8. (g 13 Acct. 801.20204
Date
•
J:IFORMSIBUILDERS DEPOSIT FORM.DOC
( 4iTi\ o CITY OF PRIOR. LAKE .. Date Rec'd
HEATING /AIR CONDI'TIONDIG/F1REPLAC.E PERMIT
I .
d2YZase t. PirJ` Fiyo .
z Cfet Ci PERMIT NO.
3. Ya(]aw mplftana
(Please type or p r i n t a m i g o et bottom) , • •
ADDRESS ZONING (osic'eu3e)
...... 7 i/01 • c.� • •
...
•
LEGAL DESCRIPTION (office use only) ,—
.... LOT BLO ADDITION . A N p D
OWNER - �� S/� / / va n
e
re !�i' ills_ _ one L `T..
(Address) c al B - `e Zakek 1() 4110 53
APPLICANT
(Name) ( 11 - ' ` ' Ak `" 1- 1 . (Phone) _ - `- /q02 -- ga-7C0
(Address) . *7# I 2° GA II i . � ,
(A "• s) (City) Q S-
PLLCA}ffSIGNATtJRB (Zip Cam)
(Contact Person) -_ tt . t1 _ (Phone) ,. ►► . ,. j . . DATE r . _
• • . APP CANT PLEASE COMPLETE BELOW . _ • .. . .
UMW CONSTRUCTION 0 REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL. - FUI L
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
—
TYPE OF SYSTEM HEATING OR POWER PLANT
PLEASE NOTE: Air Conditioner
DWann Air plants Ei•Steasn Units and Fireplaces Cannot Encroach
D+Gr its 0 Hot Water into Required Side Yard Setbacks,
eclranicsl ❑ Radiation Fireplaces with Box Additions or
it Conditioning ❑ Special Devices .
Dieu System ❑Other Devices Cantilevers to the Outside of Buildings
Require a Building Permit.
• FIREPLACE MAKE AND MODEL Dt �Ct- . : . ) • �-` ATE rI
FEE .' ,,;
Industrial, Commercial & Multi - Family 1% of job eb . residential, Gas Fireplace $49.50
S49.50 minimum
Residential, Heating & A,'C (New Construction) S149.50 Residential, Additions & Alterations $49.50
Residential, Heating Only (New Construction) S64.50 Residential, AC Only $49.50
the. Minnesota Statutes §326B.148 . , .ost $ Budding Permit #
'SURCHARGE" has been extended - . / t �
ttnIll rune 30, 2013, .. IEATTNG PERI'bIIT FEE $ �T • • \D"
The minimum surcharge for STATE SURCHARGE $ b r C
"fixed fee" per zt is $5,00 [OTAL PERMIT FEE $ 5'c ,
This Applicati Becomes Your Building Permit When Approved Paid Receipt No.
Date By
Building Official • Date . '
24 hour notice For all tospections (952) 447-9850, fax (952) 447 -4245
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APPLICANT• :P LEASE •COMPLBT B E L OW
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.JiidusMa ` :Coaoneiaial dt Multi- Faitii :'1% o o :...: :. ' - ide titta) GaaF1 lac ►: `: • 549.0 :. • ' x .30 m coat n
• TT' ``� �1
Re s idenb al . 'Heatutg & A%C (NeW •Con ? S 1; � : o _ :. -:. ` + : Rosi d c ptial, Atl :dt Alterations ;. :�. • � , iq�
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; :;:.•.. ' ... .,; ::.. Ju ry 1.2010, untilJ une30,20 1 1 .
•.:. .:'• „T OT11�I,. `.'. ' ° :. The fora fixe fret e • • ..-.:..• • ..':.: •, .. 1s h Inning nningJulyI,2010
1' A ` & Becomes Your Bt Permit•Wlteta A - ro ` Pa Receipt No,
. •Uate .
l�uuaiu OlHelta Dale .
Y... 850, fax (952) 447 -4245 . .
• '� 2d • hour n ot i c e fo r :a lnspecflons (9
4646' Dakota Stre et'S.E. Prlor I ai ke ; '141a. gesoia : 55 37 2 . • '' •
2013 01: 42 8514637335 FARMINTON PLUMING OH PAGE 0
Date Reet
v , r ,?. 0 •
MT OF PRIOR LAKE PLUMBIN( 4 PERMIT
FWC!airr NO. - 0 1
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DDRESS
----------
GAL DESCRIPTION (cam mle toly)
LOT )3LOCK A.Dla:TON__—_ RID
, .
TWNER , ck .,,_
Name) _. I a_.. ' 6“f—.._47P,,JAtIg--- , (Phong) -----, -
Address)
..._ .._
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:Address) r!. I 6 3 Li $ SCA L .1
C1-1,...4_02_,_16.., Cod)
.._
(Address) - 1 (City) (74 o )
:Con.thet Person) ____a3XCr---
APPLICANT SIGNATURE sD.126,4s,e1S0 ' ■ 9ATB Li i. IA . • „
APPIAC,A,NT PLEASE COMPLETE flILOW _______
,
___..- _ TypF4t1ILre
Quantitx T of Fixture II UMW '
, , , --
-----1 13a.th Tub with or witholt shower
i Disbwasher V ,
1 ', !later Heater
-----''—
_Floor Drain i %rater Softener `
--- - . taild
Lavg4 Sink)
—
Laundry Tray (1 at 2 conipartment sink .i.F...ng--ffL
Ti. Sho ___—_
er Stall ilackflow Assert .
_. —,
Sinks
— 13acidlow Assail:1bl Te_yt__
tar Sink — ,aWn Sainkler
„
1 ,2"Tater Clos_._,_41L.___jrailet , , Yber
FEE SCHEDULE
Indmstrial, Commercial, ee Multi-family 1% of job cast witia a S.49.50 xniaimum Rtsint-ntial, New Oat & Two-Faraily S149.50
Res..itkrAia1, AddiXims & Alteratiom $4950
- - ' - Building .PCITOil t ,
Tlic Minnesota Soteteg § 320.14.8 ' ''.
URCHARGS" has been thatipd For one
yar viTectiva PLUMBING PERMIT FEE S PAID WITH
. _ -
Jul I, 2010, nn(il June 30,, 2.011. STATE. SURCHARGE $ - BUiLDING PERMIT
•
aiiltirhurti agreharV icW a "fixed file" amok TOTAL PERMIT FEE $
, .......*
Thin APPlication Becomes Your Building Permit Wien Approved Paid Receipt No-
, _
Dafe
_ . . 1 By .,
Dading Official Doe ! _
_ —
24 Boer notice for oll inspeetiong (952) 447-9850, In , s 152) 447-4245
4646 Dakota Street SX, Prior Loh, 711:ino aJ 5$372
PRIOR LAKE BUILDING AND (INSPECTION
1
' '' :: ' ' '' r ' s ': z IV '4 in File
INSPECTION RECt5i
SITE ADDRESS 3cial �,�-c% t' � N.�
NATURE OF WORK EA.. z N paGw ore Q (24_ L4
at
USE OF BUILDING . 1.vc�Le F t -r /T~� a�64-&
PERMIT NO. 12 1101 DATE ISSUED 1 ° /3 /'z.
CONTRACTOR Imo. z `•.5-1 1 -16ME5 INc-. PHONE 9 S 7 - - `\ SS• 119
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
_ THE PERMIT IS BY SEPARATE DOCUM VT „ --IT, 5 -
1
t crA,..,.. t.'tz0 Ca.,.'rZ -OL. 1 N���k"sirt ".1 GL..6�''4� 1 PE DATE
I FOOTING 1 1 I
I FOUNDATION (Prior to Backfill) I 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
���„a^-1 V-Ti44/z-2‘`n-.� h . OUGH — INS
SEWER / WATER / SEPTIC
FRAMING 1A
INSULATION
ELECTRICAL
PLUMBING ).? V, p 11 :1t7 0 - Izol(9
HEATING (if required)
FIREPLACE t ' '1
GAS LINE AIR TEST
C -for' s 'PIP' COVER )NO WORK UNTIL ABOVE HAS BEEN SIGNED
I 1-1S6 L.AcTN I
FINALS
GRADING (Prior to Sodding).
BUILDING --t, c_.0. 1 - 7/1 ►3 12141_ Lo l v 3 AR / l3
ELECTRICAL
PLUMBING - > /t i /- y
HEATING N (.0 -3_1-3
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