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Expires Will: This Certificate issued rements o ui to the ursuant requirements the ❑ Residential / El International c ` P 4 f Section 110 o f ..ly Building Code certifying that at the time of issuance this structure was in compliance with the various 1 : - 3 ordinances of the City of Prior Lake regulating building construction or use For the following: ( Bld Per mit No. 1 %� — 184 > `!, Use Class S I NriLE FAMILY Bldg. (4 PUD Occupancy Type R3 Type Construction VN Zoning District, 40t3 L8, R� THE COVES OF NnRTHWn ME ADOWS Le Description 1 ,:::::: 2871 KNOLLRIPGE DRIVE NW - ) � / Owner of Building Site Address Contractor's Name & Address I L I ! CONSTRUCTION i �� ROBERT D. HUTCHINS ',- C ity Planner ,� I . 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Y U L.-- 0 • `l , N 01 a O to O Z W F- — -�- 7 Q U U . .4 Z O 4 i N W W J A U 0 Ei Z 0 a 0 r w z _ Y CC o Q p 0 W w W 00 v = i zi 7 LL `�0 0 V U N Oa 0 00 OO 2 v, p ❑ ❑ 0 0 U Z Q 0 a 01:1001;40 CJ ' t� �'" </ k j re ri:c ui = Q § p c.\ \ z z \ _ ■ � �aaa2 D W U m o 0 § �� ES7 § $ z 7 °� q 000000 > Q re § �. o w ° § _ 0 w 0 n D a. z< W .... 0 2 M y 22 m e - k 1 Cr c 2_ §§\\ 'C___4_ 0 \ - £ 0 0 w 2 co i w 2 LT. a j z 2 § D 01- n 0 a 0 o g e e< a 2§ m a 2 w w Q 2 000000 .\ § §) Z q ƒ ƒ E / / o m w 0 < 0 § \ O 0 0 § ) k \ U. § § § rj cl •-.) a.� d 7 � 2 p i z \ \ 0 , § o_ z w m m �� Ct w ft z o o " 0 0 0 / ° / § 0 § 0 U. � u. ?� § D o o a 6- z « o EL OOOOlko 0 0 o / j 1.11 1 VT rl11VA LLi11Pi D1/1LL111l7 rL'llivlll, ijatC net u TEMPORARY CERTIFICATE OF ZONING COMPLIANCE G3 AND UTILITY CONNECTION PERMIT �U _ / Z ',,rNN E S y I. White File ". Pink Ot■ / Z, PERMIT NO . /♦ . //6 /6 3 i- �c 3. Ycl Applicant L (Please type or print and sign at bottom) ADDRESS ZONING (office use) ')41-1 44101 &kC , () V-e N \ l P0-� LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION e C bY.e5 Q{-- ki vv O n A M�()((ADW S PID it- `,Q 0 50 OWNER , C �� . , ��( 1 , , 5 1 — ' 1-A pI (Name) U C 0 `I c u- CO ► tJ Gh 0 (Phone) l 5 '- 1 b (Address) 1k \ GY W w ) c t'I, 20o 1 -P1911 -c, VD,AR1 MN c'i 512' BUILDER ^� �n ' 11 1 (Company Name) S 61A t I C.,(V ik C i s\ Y v f V u V l (Phone) U Ci . Ci R (Contact Name) 2 j /1 CC (A V\ C\110 r ,� r (Phone) U\ 1 cG r 1"∎ 1- p (Address) i t. ‘ 5 l vv6 P'V \ 0\.11 l 6- L() a � �I p\-e Vct�'1 -t , 'ON G� \ TYPE OF WORK it New Construction ❑Deck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace Addition ['Alteration ['Utility Connection CODE: VII.R.C. ❑LB.C. ❑ Misc: Type of • • traction: I II III IV V A B •0 Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ Z. ' dl0O6 Division: 1 2 3 4 5 (excluding land) I hereby certify, : t I have furnished informationcon 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- mentio. . 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 r" oke this permit fo st : us ermore, I herby agreeihat the city official or a designee may enter upon the property to perform needed inspections. x -af ice" _ / G Co 3w 17V l)— `7 - /z. IRIffig Contractor's License No. Date Permit Valuation S ��_ Park Support Fee # $ Permit Fee $ t 03 SAC # $ ; k>,>. Plan Check Fee $ C .)_ fo l el P) Water Meter Size 218 "; 1 "; $ 4b0. State Surcharge $ Pressure Reducer $ ( O (Z'7` Penalty $ Sewer /Water Connection Fee # $ 15 Cx;: Plumbing Permit Fee $ t ,---- Water Tower Fee # $ t ©c:,0_ Mechanical Permit Fee $ ( 5 Builder's Deposit $ C 5c - Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ 5 r it ..70 TOTAL DUE t j1/43) (ob.lit_ ) $ 10033 4 ZS This A t cad. B. me. Your Permit hen pproved Paid /U if i. •21 eceipt No. 6 71,r� /L �.. Date 4„f ? /L-- Y 4.; - td\t tY Building Itrctat Date This is to c I that the request in the abox application and accompanying docu ents ' in accordance with the City Zoning Ordinance and may proceed as requested. This document when sig , .y the i ' annex constitutes a temporary Certificate of Zoning c. plaan. • and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. / // / 1 to anning :...a,. 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 j \ i,\ \1 l.ii 1 yr r1 1'Jrt LLii ii DUii iiii' r r.itivli1. Lint ACC u TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z Z . /3 " �' AND UTILITY CONNECTION PERMIT f '�'NES °Y 1. Pi City t` 2. Pink c PERMIT NO. (a 5 3. Yent Applicant s (Please type or print and sign at bottom) ADDRESS ZONING (office use) LEGAL DESCRIPTION (office use only) 1,, 1 ~� p LOT BLOCK ADDITION f h-t Co'ei (4 (141 AMA M ,(1OW5PID 25L\' U2_00 U O 0 OWNER aC 01A'L C©W'A,ile CON (k 01 t LAG, (Phone) 0 1GJ2-' gsS 13D (Address) 1'l yj \ G CA(9 \1 W k\I f R I"t, Zoo Mlik Si V A ,L1 C4 N N � 24 BUILDER yName) S bvt CG Ir fUly, C ;V CM/10 4 liAC. (Phone) 0 i ' 3s g— Ibt (Contact Name) ¶V U\ � t f. s 0 (Phone) U S V' Z LP I S u> 33 (Address) )'D ) t G el/VC VO \j &ki 1 R, 2-00 ' p -C, V ■, MN 52k ' TYPE OF WORK ❑ New Construction ['Deck ❑Porch ❑Re- Roofing DRe-Siding Lower Level Finish ❑ Fireplace ❑Addition DAlteration DUtility Connection 3 tams. CODE:'I.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V AB ,` r,1�1 Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ LU 10 V(J 0 D Division: 1 2 3 4 5 (excluding land) I hereby certify at 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 - mention•. prope at 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 re •ke th • . '. just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x / ... i / B_-43( g / L/ Signature Contractor's License No. Date Permit Valuation 3 I 0 00 0 0 Park Support Fee # $ Permit Fee $ 7 4 i c SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ / - 7 Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ 54- 6r) Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE bctue, - 0 /, 2 , 2 $ /3 0 '75 This Application Becomes Your Building Permit When Approved Paid /30, 1 ceipt No. to Y/ 07 Date /. 2 ) c e 3 Y Building Official Date r N This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested H ! tg ik 4 t when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Oc.',� ttI 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 Residential Building Permit Checklist New Constr ' ion for Single or Two-family Dwellings in -1 or R -2 Districts 411 • Reviewed by: � Date: !G 'b /2, Building Permit # PID: Zoning: Address: 281 ( 4 t.,.., tz.0 - Dtz 1 v I. Legal: L , B Existing Structure? YES /,/ . Existing Nonconforming Structure? YES 1 NO CONFORMS TO ZONING Y169 NO ORDINANCE Yard Setbacks: NA 1 FAILS/ CO IP S Standard I Proposed • Front Yard (can be 20' if avg.,w /in 150') 25' z S. 3 • Side Yards JO 1 . S 2eif abutting a street 11. . 1.5 '‘.g • Sidewall exceeding 60' requires additional side 2" 10' setback + setback for every 1' over 60' in length. Not required 2"/1' over 60' if building wall is 10' -0" or greater of being parallel to a side lot line. • Rear Yard 25' (S.1 • 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 SV(.t. lo t8 i 1VIES +-. ` I Floor Area Ratio: NA 1 FAIL I C I .30 Maximum 1 • t S I . Yard Encroachments: NA 1 FAILS /C M LIES Standard Proposed Eaves and Gutters no more than 2 fee t width and no 1 • closer than 5 feet to a lot line Easements . . kb 0 th 0fle' an r 1 . , 1 A/C and other equipment cannot encroach on interior F ' annot ;• croa h g , , side yards. 0 q T h. ,.,,- Tree Preservation: /FAILS 1 COMPLIES Standard Proposed I • Total caliper inc s • Permit 35% Removal • Caliper Inches Rerr?oved • Calipilrtches P,r6served • ReplacemeW 1/2:1 L: \TEMPI TE\BLDGLIST.DOC —Th Driveway: NA 1 FAILS / Cy PLI _ Standard Proposed • Maximum width at pro!- • , ine _ 24' 1 Required setback 5' from side lot line or _ 30' from r -o -w on corner lots t 1 • Maximum slope • 10% 4 . Z • All parking areas to be paved including R-V or spaces adjacent to the garage • Location to match subdivision grading plan :N i Building Height: NA FAILS / CO S 1\4 35' Maximum 1 24 ` Shoreland District: NA / FAILS / COII ' ES , 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 — Impervious surface ./ _ 30% Maximum Z S po Bluff in Shoreland: / FAILS / COMPLIES Standard 1 Proposed • Setback from 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: A FAILS / COMPLIES Standard Proposed • 100 ye r ood elevation 908.9' Prior Lake 914.4' Spring Lake • Lowes 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 9/19190- 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 / COMPLI,ES 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 : \'I'EMPLATE\BLD GLIST.D O C ,. PRIpi m White - Building 4'I NVeso� P Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST 1 i ,_.�,� /7// NAME OF APPLICANT ; r >, a ..- t l,/iL�_E__. ( i) w t.. APPLICATION RECEIVED /0 /97/A2-- / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 4''// _ Accepted X Accepted With Corrections Denied Reviewed By: frA Date - : - Pr I L 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." • • 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 rroperly installed and maintained silt fence or bales. • The silt fence requires 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 i;s established. • , The ro k constructIon_ent must be installed at the time of t_... - =ibackf of the foundation. • • 6: \Admin \dept info \ADDITIONAL COMMENTS FOR BUJLI'ING PERMIT APPLICATIONS.doc • C) PRIp� x m White - Building P Canary - Engineering `NNESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ., _,�. , .�� ' AO AL ...d J. _ APPLICATION RECEIVED i v i Y/0-- / The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: G ,g 7/ ..)-v4it,+t- 01) . . Accepted Accepted With Corrections Denied / Reviewed By: A Date: /1J / / 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." +( ,m-, °'. , -- , .. '- "1F +w„- v 1 1 C) ---PRIC :47. x rn White - Building ^�i �P Canary - Engineering �NES° Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted 1,' Accepted With Corrections Denied t 0 4,/ , ,,____ . Reviewed By: Date: /0 14 /7--- Comments: . Air Conditioner and Gther fir ec � r � 'F: Units Cannot Fncroach into Side ' ar-4 Setbarki "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." PRIod' Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT 2. Y ellow C it y PERMIT w . 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZO 1 G (office use) 2871 Knollridge Drive NW LEGAL DESCRIPTION (office use only) LOT 8 BLOCK 1 ADDITION Coves of Northwood Meadows ppj OWNER (Name) Stone Cottage Construction, Inc (Phone) (Address) 14815 Energy Way Apple Valley 55124 (Address) (City) (Zip Code) APPLICANT Bohn Well Drilling Co (Phone) 952 -445 -4809 (Name) (Address) 18190 Dairy Lane, Suite 101 Jordan 55352 (Address) (City) (Zip Code) Charlie Bohn (Contact Person) (Phone) 612- 919 -1542 2 APPLICANT SIGNATURE" Wha t'L'k DATE 02/20/13 APPLICANT PLEASE COMPLETE BELOW Size of water service 1 inches. Location of any couplings from structure - feet. Type of sewer pipe. n ABC E PVC E Cast Iron Estimated length of sewer line 25 feet. Clean out (if required) located at NA 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 PAID WITH TOTAL PERMIT FEE $ BULLING PERMIT (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By 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 Dal ''==:::,',. e CITY OF PRIOR LAKE PLUMBING PERMIT , ._:, , -, B 73, „., d �\ r ti 40-4,„,...0 (: (� 4tl +�.� QSr,.a 1 t s,�,� PERMIT "I' NO. z core car 3. Yellow Apprx •m (Please type or print and sign at bottom) ADDRESS ZONING Zi7 V\� 1c,1 i A v 14.0 . LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER. (Name) (Phone) (Address) APPLICANT V \WV\U LL C one) C15., (4 ! -'� 1 3 t J Ul d ci .S Rc1 5`z C- ∎ `.:G S ' (Address) � (Address) (City) (Zip P Codt c (Contact Person) `' � � ti?x� ( Phone) �1 -�� APPLICANT SIGNATURE ' .. I_" DATE APPLICANT PLEASE COMPLETE BELOW _ Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins j Dishwasher 1 Water Heater a Floor Drain Water Softener 5 Lavatory (Bathroom Sink) 1 Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector I Shower Stall Backflow Assembly 1 Sinks Backflow Assembly Test _ Bar Sink _ Lawn Sprinkler Water Closet (Toilet) _ Other FEE SCHEDULE • Industrial, Commercial & Multi-family 11/4 of job cost with a $44 -50 minimum Ri4idential, New One & Two- Family Residential, bons & Alterations $ -- - - — '1st $ :: I ding Permit # The Minnesota Statutes * 326B.148 "SURCHARGE" has been changed for one PLUMBING P ' FEE year effective July 1, 2010, until June 30.2011. STATE SLiR r - . ' GE $ 5. C' The minimum surcharge for "tfxed fee" permit TOTAL ' I FEE $ is Ki, beginning July 1, 2010 This Application Becomes Your Banditti ' ermit When Approved Pa ti'LDI G p eipt l` Date EIMI Buildiut Official Date 24 boar notice for all inspections (952)447 -9850, fax (952) 447 -4245 ..,..- -.. -_... ca.- ...,ac Ti Dri... T.n1ro. MtnnPenta 55372 ". • , 4 ,, +4. • • i �) r - 1 1, G l ;Z A ;" ‘..-2_ ‘..-2_ i i Vi i ixiv H E` ii L. Date Reed ; = e HEATING /AIR CONDITIONING /FIREPLACE PERMIT Ora i ' i =i3 4 *A s o'te' t. rink n` . 2. Yellow r Cit PERMIT NO '� ( Okra Please � Yeilo�v Applicant • ( type or print and sign at bottom) ADDRESS ZONING (office use) 2;c6 ( I <no l t — tc eve. �e_. LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) - 4Nr ' ' 1- a `�u..<�e a! • _ C (Phone) Q52 3 gR -1301 (Address) (4 I Enejr � SUS- 23 -{ kAkut mV.) SS(Z4- APPLICANT ��, /� _ (Name) LO re in i—k �t [ n9 `d (l' (Phone) "/ 52- -4 I �" �v (Address) : .. •,* - -vl .4 4 .± tLa So�-k. 1 ,�Lt•. _ . I . SS (Address) (City) (Zip Code) (Contact Person) ..t' 1 / V- ) er i i (Phone) Q5Z- 43i — SE - 1 APPLICANT SIGNATURE AP./ , / ALi i_.' !,, . DATE _1(454/2.... APPLICANT PLEASE COMPLETE BELOW KNEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL ri(vir' Sc8i iMc..Bc3 g 3 FUEL 1\bl ' FLUE SIZE 2. ti:O'N WC RETURN OPENINGS 1 INPUT (`") DivOUTP UT 'j? 490031 TYPE OF SYSTEM HEATING OR POWER PLANT ❑Wat�n Air Plants PLEASE NOTE: Air Conditioner ❑ Steam Units and Fireplaces Cannot Encroach ❑Gravity ❑ Hot Water ❑ Mechanical ❑ Radiation into Required Side Yard Setbacks. ❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or DVent. System ❑ Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi- Family I% 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 # The Minnesota Statutes § 32613.148 HEATING PERMIT FEE "SURCHARGE has hen changed for one year eflectke STATE SURCHARGE $ .50 Jul 1, 2010, anti! Jane 30, 2011. TOTAL PERMIT FEE 5 The minimum Surcharge for a "Iixrd fee" permit (Office Use Only) is beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Aii) Willi Date IMF PER qr 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 M 4- 22 -'13 08:37 FROM- T -244 P0001/0001 F. : ',19r. CITY OP PRIOR LAKE D ite Rec'c $ HEATING /AIR CONDYTTONIN /FIREPLA PERMIT aSe 1. P nk T8 j, NO 2. Yretn Cir PERMIT mit 3- Yclrow AppLcare S_SZeD or lint axed s; n at G attont ! t s ZONING (00"ioc use) a r. ... 2 d IAL DESCRIPTION (oilier use only) T BLOCK ADDITION PID �--�- - ne), Ai 1. I' A. ° ;. ■ -t -jPhone) 4 tress) • LICANT teHNaLOUIES T • ale) dba FIRESIDE HEARTH & HOME {Phone} l- l; 667 656 tress) 2700 FAIRVIEW AVEN<!! ---14-Mat. ; MN 55113 (City) (tip Cade) tact Person) C.si�' VLA , _ 651.633.2561 (Phone) _ LICANT SIGNATURE x _U a 4, �: = . DATE 27.— AP1'LZC • ' - PLEASE COMPLETE JEEOW eEW CONSTRUCfl El REPLACEMENT 0 ALTERATIONS 1ACE MAKE AND MODEL PUEL 3 SIZE. RETURN OPENINGS INPUT OUTPUT 8 OF SYSTEM IIEAT"IN'G OR POWER PLANT _ - jWarm Air Plavis Steam PLEASE NOTE: Air Conditioner Units and Fireplaces Cannot Encroach IGravity Ej Hot Water Required into e ui 1 Mechanical D Radiation q 'red Side .Card Setbacks. !Air Conditioning D Special D yiecg Fireplaces with Box Additions or New, System D other DOA= Cantilevers to the Outside of Buildings Require a Building Permit. PLACE MAKE AND MODEL —\.. -- FEE SCITEDULE rial, Commercial & multi- Family t °/a of job cost Residential, Gas Firepta - $49.50 $49 -50 minimum ntial, Heating & AIC (New construction) $149,50 Residential, Additions &Alterations $49.50 intial, Heating Only (New Construction) $64.50 Residential, AC Only $49 -50 Estimated. Cost $ Building permit #� The Minnesota Statutes 4 326E. HBATTt�( "SUItCI.1ARCir" has been changed 1'or to ydxur effective STATE SURCHARGE $ ,54 July 1, 2010. until J ttrlt 30, but L TOTAL PERMIT PEE $ The Milli MOM surds 'g for n "Rxe.0 fro" 1mr Vs °Only) fs s 5 , tetl irn ing July 1.2010 s Application Booms Your Podding Permit When Approved Paid Receipt No. �— Data By j ' - ,' ITF� w Nstatne treiat Da a '� '' RMI 24 ktOnr notice for all inspections (952) 447-9850. fax (952)4474245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 o Builders 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 fora 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 $11,500.00 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 fora period of one year. By signing this I, the undersigned contractor, acknowledge that 1 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 ( - 'SITE ADDRESS: . 2•U ' \ Y4 \1 in-d PERMIT # 2- - ( 1 to REFUND TO BE MAILED TO: 1144 A,. A lit, h t 1/ / J1 i A j r 1 , A k1zt 1 J It L 1 f/ i ' • - - AUTHORIZATION TO RELEASE PLEASE REMEMBER \ / ( 5 _ v ynda S Allen, Building Services Amount i Acct. 801.20204 1. KEEP STREETS CLEAN DURING G�NSTRUCTI ?N Date 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED _, .`_ THIS CHECK IS VOID INITHOUT A COLORED BACKGROUND AND AN ARTIFICIAL. WATERMARK' ON THE BACK - HOLD AT ANGLE TO VIEW . S tone Cottage 7613 ANCHOR BANK Construction, Inc. 14665 GALAXIE AVENUE fi�, - -- -- - -- APPLE VALLEY, MN 55124 ! : ! 14815 ENERGY WAY, SUITE 200 74 1523/960 DATE 10/19/2012 APPLE VALLEY, MN 55124 -5757 PAY TO THE ORDER OF City of Prior Lake $ * *10,733.28 Ten Thousand Seven Hundred Thirty -Three and 28/ 100********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * DOLLARS City of Prior Lake 4646 Dakota Street NE Prior Lake, MN 55372 MEMO : 116 0076 L31 2 1:0960 LS 2321:L00055L72 J :1FORMS\BUILDERS DEPOSIT FORM.DOC Flea I 'a C.q IVI lNb/ 4 : 1 7.107. '01 ' 1;10 PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 2 971 MOLL - DQG DII2.. NATURE OF WORK LO '► ='► USE OF BUILDING 4 1 PERMIT NO. '.' DATE ISSUED 1. 22. CONTRACTOR .'3►7 /t' ann a` COAk,, PHONE .52 308.1301 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE MOM l I I 0111111111111111111111111111116 I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING V INSULATION ELECTRICAL PLUMBING HEATING (if required) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED � I FINALS BUILDING ELECTRICAL PLUMBING 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 P R IO R LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS Z&1 I Kw I t -t. , 17l7(. b(2. .1� NATURE OF WORK -c> rNG L.uQ6s 9 tE�� 70, L. L.. elNttEt z.. ( USE OF BUILDING�ct,(�� 0-1 ;),,o6,-,4,-)� i J PERMIT NO. t Z - Ik 8 4 DATE ISSUED to / 16 f 12 CONTRACTOR . S - r®N16 ec - Corn . PHONE 6,51- 'A NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT t N ' 1-4- e.,-2- 1 0,.,a ('� ot∎iT I- 01..,, d / < 5 � LL- (l 44 E C 1VlA is t-t�4N �` INSPECTOR DATE I FOOTING WC I a ( efir I FOUNDATION (Prior to Backfill) l',/ /d/- I PLACE MO CONCRETE UNTIL ABOVE HAS BEEN SIGNED -2�‘)° R 1164 , ROUGH - I N S SEWER / WATER / SEPTIC " "1 %f FRAMING "Z / S/2 INSULATION Pi / 0 /� ELECTRICAL PLUMBING � � / 2/ /� HEATING (if required) ee FIREPLACE ` 121! ` GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE H S BEEN SIGNED I (1- u9—.., � ,/; ?/ L, 4. 1 l'-'2-) 1 /`7, ° s /4-- T ----,--7 c l e.fe /r/F N A L S % GRADING (Prior to Soddi ) �� BUILDING 4, 'Y43 - ELECTRICAL J ,PLUMBING 3/4 :/. r- �( Z3�7 HEATING ` f DO NOT A O CU Y UNTIL ABOVE AS BEEN SIGNED LL F,(1 , "' `-t 23 )( 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