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Expires - This Certificate issued pursuant to the requirements of Sect 110 of the ❑ Resident al l / ❑ International : 1 r 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: SINGLE F AMILY 12 -1103 . Use Classification Bldg. Permit No 11 Occupancy Type R3 Type Construction V Zoning District P U SD � 1 L10, B2, JEFFERS POND THIRD ADDITION - Legal Description c+ I1 Z f1 _ Owner of Building Site Address J `71 1 STATION PLACE N . W . ` I � / 1 it li RATZLAFF HOMFS, T a „, Contractor's Name & Address c ' RORFRT D HUTCHINS / cit Planner wry � Building Official (. , Date: ''? /1.7 i 7 Date: /, POST IN CONSPICUOUS PLACE -� m m 1 n n Im n n an n nn ro n n n ntln+ nrn m m +lull m m 1 r `: _=, mm�:� mnn nom- nmm W r mm� m VNg m n n V nmrr mnn, mm�, n n I m..n n, ilr nm r. m , I n m m µby .__ ,., ,:. 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Pink Applicant W (Please type or print and sign at bottom) ADDRESS ZONING (office use) 39 I k S T A T I afJ pt * /VIA/ LEGAL DESCRIPTION (office use only) LOT tO BLOCK ' - PID OWNER (Name) - - (Phone) - - - (Address) - - I BUILDER (Company 12A1-2-1-AF Hot-% . S INC. 952- 95S— S9S9 (Company Name) (Phone) (Contact Name) Jew u ksi V a . / P R - i Z (Phone) 9Si - cY S — li I 71 (Address) 2 ( 9 t 3 Ga DA- q,✓E 5- -+1TC 120 , LAKE vl - S So 14 TYPE OF WORK IZI.New Construction ['Deck ['Porch ❑Re- Roofing ❑Re Siding E Lower Level Finish ❑ Fireplace ['Addition ❑Alteration ['Utility Connection CODE: I.R.C. ❑I.B.C. El Misc: Type of onstxuction: I 11 III IV V A B Occupancy Group: A B E F 11 � M R S U PROJECT COST /VALUE $ C IS. O 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 a cial o � ntio ed pro • -rty ermit and for j that ust all cause. construction Furthermore will conform I hereby to agree all existing e st ty o anffid cial local or a laws an designee d will may proceed enter upon in accorthe prdaoperty nce with to submitted perform neede plans. I pe am aware ns. that the building ffr ' , that thd ' s X / VC 1 6Co 307 9 A -57z Signature Contractor's License No. Date Permit Valuation t Z G, Goo- - Park Support Fee # $ Permit Fee $ 12_1:::."‘.50 SAC # $ 7-3(.5- - Plan Check Fee $ 1 8(0 -, 8 Water Meter Size 50 " 1 " $ 4 fo. State Surcharge $ 4. Pressure Reducer $ ' ZO, - Penalty $ Sewer /Water Connection Fee # $ t 5 00, Plumbing Permit Fee $ t 54k. C Water Tower Fee # $ (o or), - Mechanical Permit Fee $ (S 50 Builder's Deposit $ k 5- a©, Sewer & Water Permit Fee $ 5 Co . 50 Other $ Gas Fireplace Permit Fee $ ✓- So TOTAL DUE $���j' 48 This A 'ca: ! I. to 1 n t e o 1 s Your Building Permit Wh 3 (� A proved Paid ��' f. 6 R c 1pt NO. (c /JO C} Date lam. / !L B Building Oft : Date This is to certi at the requ:'t th above application and accompanying doc ments is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed b, ■ e Ci , Pl. , -r , .n- *tutes a temporary Certificate of Zoning c' mp ce and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. ,), 4 h. v ° 3 (Z . Planning Di 'or Date Special Conditions, if any notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 ,S*4 4kI± r• Q .J • * • .44 sk try ix 4 1% c,,,t • k OG' . P,Rj9� Builders Deposit V �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: /O• S 1Z SITE ADDRESS: 39/1 470770d /t. PERMIT # a. 1103 REFUND TO BE MAILED TO: AMeS A 1 � I 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 AUTHORIZ TION TO RELEASE SIGNATURE: ;if/ 6500.00 i ynda S. 'tt,I-n, Building Services Amount • 3 Acct. 801.20204 Date J :IFORMSIBUILDERS DEPOSIT FORM.DOC 4 iR .r CITY OF PRIOR LAKE DAte Recd ° _ .:. HEATING /A1R CONDITIONING/FIREPLACE PEE IT 41iNNESd°. i. Pink Yile 2. Green otti PERMIT NO. Z — % / 3. Yekw Appli t (Please type or print and sign at bottom) _ ADDRESS zUN71tr (nHkeuse7 1.4.) .; I 1 \ (71f( i a,c0_,. (NI .. . ..... LEGAL DESCRIPTION (once use only) LOT (BLOC ' ADDITION X'ib ( �7�VIt]E+7t.1(� C.1 t,i ({TY� . - ....�.�._. (Phone) g5-d- 92 . (Address) , II Cr ,�► -._ ► 1 - - - 1 fb .. di - r , .s Y_ , � APPLICANT (Name) - 3 IP ()' -' A `• - AM ! AEA. 0 Phone) q r7 -- 9,1769 (Address) , if . ! 0 ' /.. . 0.. � r f� rn J` V , 2 • ' • (Adds s 4) __gip Cede) , , (Cont 1 Le. . (Phone) t 1 , (U APPLICANT SIGNATURE T , .if .,Fe -- ' _ DATE m- .. _ AP 'CANT PLEASE COMPLETE BELOW �_ .. NEW CONSTRUCTION ❑ REPLACEMENT © ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENNGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT - . Qlyarrs Air Plants PLEASE NOTE: Air Conditioner DGrav 0 H ot V 2ter Units and Fireplaces Caumot Encroach ' hanical into Required Side yard Setbacks, 0 Radiation Fireplaces with Bose Additions or . (DALT Q Special Devices ❑Vent, System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEI. AL!' _ ._.),_. _ =''"' Ole. _,. FEE SCRUM -- '" .. Industrial, Commercial & Multi- Family 1% of job cast esidcntisl, Ga F " .50 $49.50 minimum �,A�® ' 9 Residential, Heating & A/C Kew Construction) $149.50 Residential, Additions & Alteralions ,, fl NC", P .5O Residential, Heating Only (New Construction) $64.50 Residential, AC Only §49.50 The Minnesota Statutes § 3260.148 ''SURCHARGE" has been extended Cost $ Building Permit 4 y until pane 30, `x'.01 / , ' , . i . , , , The minimum surcharge for a HEATING PERMIT FEB $ �I r. Vi y "fixed fee" permit is $5.00 STATE SURCHARGE $ S e C)1.2 ?,(1) 10( J TOTAL PERMIT FEE $ c O (Office Use Only) A''' ........X° NA This Application Becomes Your Building Permit When Approved Paid Receipt No, __ Date By ?8ui4tdinz Officio( Date 24 hour notice for all Inspections (952) 447 fax (952) 447 - 4245 4+646 Dakota Street S.E., Prior Lake, Minnesota 55372 jvd /Zt3 30Vd HJJV3H JNIMO19 9009Z617Z56 8T :60 £T07 /6Ti30 1 /1 U'll 02-13-2013 ...... • ..0 ::::'...:''' 4 . 9:1. .n.iif.:“.%. ...-.,:•::.....:::.::3 ...•-biltee .:..: .. i _.....• -Z-:::: 08:2 42 a.11 „ ,:•-•:::'...........;,.....:: ..:........:...........1......: . ... .. __ _ ..--.., '.-: : -......-.....;,-,i,,:.-Oit LAKE; ' '"': '...,,c'i,' iiivirr.• '..k '- . ::[. %-:'. ... i"':: '•'.: ' • - • '.. '-:' .: '.;:... .....,.'.''' rrroYKANI..'-, ....., - '."".... 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' Date 144,64hionde.f.!).r. . Ail. ( 447 . - - i•,•; •: •-; .:*•' i• .,. '' ....: '• • -* ' ' • • ...... '''' i : : ••' 'a idhiii9mOil - :. ..'•::".;:.: • • ...... : 1 1 •• •:•••.- %'• • iiiiiiipicooks. 05 ii '.'.illinalita .'1537.:::"C . - •: , :.'•.::. :.....7•14 " - : • . '.....'. ..: .. ' : :4.. - • 1 g -.• r i iil'P!7.,!! ':,' .' • :•'-... ' " • - , ....:: ,. • : • ....,.: !: •••• .:. ••• .-. ;-. •-.: ' • *"...:•,*•:: .....•••••*-446.AHkot.u.Stre!, -:."..!:'.: • . •'''' • - % /.,' ...Y. .. — ' ' • . 11/2013 01:42 6514637835 FARMINTON PLUMING @H PAGE 0 Lillt Ail . Date Reed CITY OF PRIOR LAKE PLUMBING PERMIT P IV 3 - 14 Q , 4,2A,N013' i. fibe I t t ipli Nal 1 Z. r 11 0 2. Galli ' 4 7 '.. Yerfriv .).,01kArtt . ..-- , 71=51.11,1 1( ;)E4)___ , MDRESS _. EGAL DESCIUTION (ofErn use only) LOT BLOCK ADDMON ----_... 3WNER I Name) _I r., .3t r.. .'. LA . -------- (Phone) Address) -- —__-.--- ' _. — kPPLICANT Aatess) g' i6:3------C-Int..0-CIALe---.ACLIC-e__24 k lo".- G_Orl (14,664:eSs7 (Cityc)..I (Zip Code) A .. (Contact Person) _g_l_______----- (Phalle; — — 40 APPLICANT . PLEA.SE COMPLETE El IOW . Quantity _ Type of Fixture Quantity _ T e 0 Bath Tub with. or withonishower vater Ilear . ....._..._ Dishwasher I ,.. _ , ,,___ _ — • • Floor Drain . Veer Softener • . ,. P.-- lavatory :al.h.rootrk Sink — '‘t?.n. d. Pipe (Washin$ Ma.chfue) LauttdrzTray (1 or 2 compaitsk Shower Stall 3 ackflow Assembly .. , 1 A - Water Closet (Toilet) . . Bat Sink : ackflo .,awn Sprinkler ,. _... , .! )her FEE SCEIEDULE industrial, Commercial & NIulti-intnity 1% ofjob ockst will% n $49,50 tnitrimuel Resi.? ntiel, Now alc & Tw o:Fa mily $149.5( Besi I 41 eitial, Additions & MS:undone $49,50 .1' $ Building Permit T . Th e Kirladsota Statutes § MBAS • URCHARIV !las been thane for one year effective PLUNIBING PERMIT FEB ____ PAID WITH "_______ Jloy i,20-10, ...to 3rvito 30, 20 1. STATE SURCHARGE $ _ BUILDING P7r; Riff rtaktiolorri sorobargt for a "romi fee Nrntit TOTAL PERMIT FEE $ is g. beginnie,g,he t. 201 0 — ... • ' 1 , /4. ;.,.., p Oka:: on Bemees Your Bonding Permit When AnproveAt Poid Receipt NO. ----- Date ' By Btrilititiit &Walt , — , Date " .• 24 hour notice for an inspeniinns (:52) 447 fax 1 447-4245 4646 Dakota &Yea sx., Prim. Lake, illinnomt.) 5'5372 PRIOR LAKE DEPARTMENT BUILDING AND, INSPECTION e See NI am ti INSPECTION RECORD SITE ADDRESS VP/ ,o� - PAS N. t.kJ. NATURE OF WORK NI d f2> ote 'P> USE OF BUILDING L. 6-- FAt-t Ar - C rAc -k.L�■> PERMIT NO. 1 z- - 1123 DATE ISSUED tali /rz- CONTRACTOR z I--- o►- -tes ( - . PHONE 9S •`\ S •4111 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW _ THE PERMIT IS BY SEPARATE DOCUME VNT,, - - -�, Es N r`AL".. C�T�`jlah! Gem- �TRQI 1/k3`f7tNJ 6e--64 a " INSPEC oR DATE I FOOTING 1 1 I FOUNDATION (Prior to Backfill) 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED f o^- 1 V-11.'"e•P .t5"12- . 17ROUGH - INS SEWER / WATER / SEPTIC FRAMING Z, 22 j( 5 INSULATION ELECTRICAL PLUMBING . T Jl3 HEATING (if required) /91:4 FIREPLACE GAS LINE AIR TEST r~13 ,pars Ip ate � COVi NO WORK UNTIL ABOVE HAS BEEN SIGNED 1-- LA-t-u FINALS GRADING (Prior to Sodding) C `f / BUILDING TL • : ?/, 1 z E3/ l g ELECTRICAL PLUMBING p/ p i0 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