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Building Permit 13. 0820
a W 0 Z -- ui ` ?� z U U 74. a ° gagg gz > CL W W Z Q w ;Z o EC a aC Z 0 0 0 0 0 0 _ > N ❑0000❑ O ( �� 1 W z o o N O r aa< m O w w J z Y Y z z 0 U 4 i H Fe OO - Q w P N w a o N ti N 0 a m = W 2 a Z c co F oG . W a J W W 112 W W W W '` a 2 3Na2 U U z v ❑ 0 ❑0❑❑ w Cn a a 0 1 o a a o w Z v c s U 0 0 o O : m 0 F N LL. U n o► 0 Z o 0 W H Q a O z O~ 0 a Z N o J W 0 a co Z z ° ?g J z W � � ° a v OW t� 0 w ZO OOLLZ , 0 N . U ? Q 0 a 0 0000 0 J Z Q N w E J Fi LL ce U kl LL Z U U Z u., 3 3g5Z o aa a� a O 2 W W u) z w Z t Ore aQ a ��„ (9Q WULL �_,�, \,,, ❑o ❑❑ ❑❑ M > �' U =O ce 0 C-3 W = +a N w • O »a z o 0 J 0 ci o d 2 0 00LLa F w rz 4 4 a o _ Z z O00 a _IIZ_ a w? m F', y m � CC ocm 8 N Aki a. 2U D 0 o o z ►- o JWQ J W W w X Li Ili a � 3v� a� U U C4 Z (� L. ❑ ❑ ❑ ❑ ❑❑ 1 � o X �J 0 )- Z D ce Y W z O O U O Y CC , P O LL r_ p �7 a U . - O Z O z W E" - F ~ QC Z 0 0i a Z m v v J W a cn z ? 0Z 5 JZ "' • a UJ u Q O U. N f- z� 5 m r �, U U W w O> >4 W 0 O O y V w O a o z o O U U U( o - 3 U ■ °' 6z U ? Q 0 a ❑ ❑ ❑ ❑ ❑ V O PR–fo 0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd F ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE C AND UTILITY CONNECTION PERMIT . J 7. Z / U � a�NNESO�� I. White File PERMIT NO 2. Pink City / < — 0 z _d 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) l Li 1 q o C 1.t,.„, C.,, r .0 P- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) C- t « k ie-- 042— (Phone) 1 4 0 3 - cx) ( 3 (Address) l(4 [ato G r 1 el L-,,- A..) BUILDER n , ' (Company Name) tY�ckr. c Irk. (Phone) (2 ID-- ct Vo - 7 /Cx€y (Contact Name) Oleir_ L C (Phone) 95-a-=' `f�' �5/ 8 _. (Address) 3 S 7 `- a G �,�.�t�c --5 --r-,1 TYPE OF WORK ❑ New Construction gaHeck (eiSrch [Me-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace DAddition ❑Alteration ['Utility Connection CODE: I.R.C. ❑I.B.C. ❑ Misc. Type of Con ruction: I II III IV V A B PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 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 . n revok r h' - rmit f Just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X • • 1 ; 6�C �tS I C -.-a4 t, Signature Contractor's License No. Date Permit Valuation oo©! Park Support Fee # $ Permit Fee $ b Z _ SAC # $ Plan Check Fee $ `�� Water Meter Size 5/8 "; 1 "; $ State Surcharge $ al' - Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL G DUE $ - 1 (. SO This pli • ion B comes Your Building Permit Wh n Ap oved Paid / /. O ceipt No. 7 � 1 Date /� y (� 1 B tiding Official D to This is to certify that the request in the above application and accompanying docu , ents is i' accordance with the City Zoning Ordinance and may proceed as requested. This document when signe y th rity Ph ner constrtutes a temporary Certificate of Zoning co rpliance ...rid allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Pla erector D•t Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 01s1 2.0% :9 N a� 0 0. 0) c a) 0 a U O O 0 O irs U -o x C X (9 N L '' 1 y �1 b f6 N N co II R a t = O a N $ w N 0 o a � j o a m E O ° a w v 0 ? N C N c' N N N .O 0) N 0 O �+ (O u0 ,E li ,CO .o L iw m X N C7 •3 O t.- �M .�yy . a G L ,...., 4 �p,� `� L '. J fib V) Z 032 N c C .E _„) ••••• � W /f - W N i 1- U E J Er Z 0`t w 4L ami cc Z p otl a g+> W o .0 ( _�1 N O: ww V 4 p� N o W m -� W ��+ y -0 0 Li_ IT c Oz _ 8 z o 0 i•• ;r, oo � fa 2 �w ()co o aa. c N W W a W 0 0 o 0 V H- . E '1 f Z ► w - Q Q Z ' i x- ° • Materai Safety Data Sheet U.S. Departm of Labor 4,P nofaf Safety Kest CI Aar:natnoson May ' used m OCorr ""� - Octuoa Mbandstary F*T11) aSKA'$ . 29 CFA 1910.120o. 5cir'Cara mac oat. - Form Aoarovd s .c sot ' OMB No. 1213 -Dori sta are not As "� 1 M era Q far ___ o r no . ' ,T (laid an Lam! A T GOOD NEWS a MAO*. Cs "rust now c floats rig C'� i T ITT [)SF TNTT ATT(1 . 12.F � � 5& n aril 3 E•• �l Taepnoro t u mom FTBER CO. _ (801) 752-0989 ,,oar,r,.,t Sz{..r. Qty. sata aria cow T 1 Humor nr 24 'n°°r `:': 1100 ANVT -L Om peo 4/24/91 HYRUM,UTAH 84321 / Puma . • Ly Et — M rdcus 11fty tritormation Caw Ler= maxsraow Comeon+r+o fia4__ G ++cat ksorloPe Corrrr+or+ Ntarr+ets% 0:504A P. Kral IV/ aacorsrr+rrb.a % ^oaa'sn MILLED NEWSPRINT CAS #65996-61 - 4 PRODUGT/MAZERIAL: CAS # 10043 -35-3 _ FIB RETARDANT: BORIC ACID • • IlmIS RATQIG: - 1 • LATE � _/ • DORIC ACID r b ^Rrr rry i ------- KEACI'IVITY ` __ 0 sonal PR<7IE( fl' 4 "E' . - ACME ZS #5mszArt (respirable) OSHA # 15 '• •• T 9�, RF� ARE �15TTEf� N YISAI3CE ' ST' f ray AND S CU D BE CNTROLLED AS _ INCER SECTION 8 herein. sozden In — PhysiCai/MOrniC ll caarac i h r ' � WI CI am _ S E INS •t I � Pon I�JT APPLICABLE _ 3or 020 • ) NM APPLICABLE t vow Pressure cmre rwa worm Para N(n I 'CABLE TT APPLICABLE Oe vow or nsry .. 1) E+ecaioon Poo IV 9IZI 05.04 ' • n ter in IIQ WATER: I II ,L7ECE, DItPfI Appesrinw aria Coo" FILLY DIVIDED MATERIAL, CLAY COLOR, NO PER=LE =OR. Section N — Fre and Epionion Manna Osa Rain Pan. OM= won) - - - Fantirrson Wass LE. WEL N/A ,-- • • N/A Eaaryw rei; mina � • WAT�2 - _ SOWS Fro Nary Prates uric . 717S7 - Uranus Fri aria Lamm= Mann ' 11117 1 g O @ m 2 2 / 0 q 0 ' • a a ) / E ( ƒ U ±; 0 � � , �� 2 . a�\ �.G ) u) }\ §§ : $2— j � _&_ ` 1 2 — — — — — / . ) I � —. .. \ k / c z § / \ Z f o / co , o \ 2 : ) 8 0 \ 2 U t .q 7 2 4) As 0 7 2 ..4 . ;,,� ' / 0 /.S § / c) - Cti « \ — & / / E » « C Q C = 7 . c / / • 2 / 0 q _ 0 o ( ..0 O. > vs § ■ ueorgia• eaciric MATERIAL SAFETY DATA SHEET GYPT;M ecc- Page ' sr SECT101 1 - PRODIX7 IDE%TiFiCATIOI VAPOR PRESSJRE C. OF MERCURY): Mot Applicable PRODUCT NAME AMD SYNONYMS: Paper Faced Gypsum Bcard (See attached .STIFiC GRAVITY (WATER • 1): Approximately 0.7 list of procUcts covered by this MSOS M0071.) VAPOR DENSITY (AiR a 1 1: Net Applicable CAS NAME AND M0: Mixture PERCENT VOLATILE (BY WEIGHT): Not Applicable CHEMICAL FAMILY: Mixture le: 6.5 • 8.5 CHEMICAL FORMJLA: Not Applicable SOLUBILITY IM WTER: Approximately 0.2% MANUFACTURER'S MAME AND ADDRESS: Georgia- Pacific Corporation 133 Peachtree Street, M.E. EVAPORATION RATE TYL ACETATE • 1): Mot App.icacle -_ Af4intt; tk-- 38303 —__ � SECTION - FIRE AID EXKOSI01I DATA EMERGENCY TELEPHONE MO.: ( 987.5190 or (800) 424-9300 CHEMTREC FLASH POINT: None SECTICE I1 - MAZJIBDCUS iY T)1 FiRE EXTlM Q1ISHIWG MEDIA: Mon- combustible COMPONENT ACOIH TLV OSNk.PEL 1 FLAMMABLE LIMITS (PERCENT BY VOLUME): LOVER UPPER (CAS Registry Mo.) WT, X (TWA) (TWA) N/A N/A Gypsum/Calcium 89.0 10 mg/N 15 mg /M 3(2) Sulfate Dehydrate 5 mq /M 3(3) SPECIAL-,,FiRE FIGHTING PROCEOUVES & EOU1PwENT: More ( T778-18 -9 3 UNUSUAL FiRE AND. XPLOSION HAZARDS: None Par /Cellulose 3.5 - 10.8 10 mg/W 15 mil/w3(2) Fiber ' 5 ms/M3 M The �: prods: are nominally fire resistant and have (9004-34-6) the following surface"btrning characteristics as reported lly recognized 1 stories: Flame Soresd, 0 - 25; Nuisance Particulates 4 - 11 10 mg/M 15 mg/x Smoke D , 0 - 50. including Polyvinyl 5 mg/14 Chloride, Vermiculite, SECT V - IViTT DATA and Clay STABILITY: UNSTABLE STABLE x ( "From ACGUH, value is for total dust containing no asbestos and CONDITIONS TO AVOID: More < 1.OX free crystalline silica. (2) Total dust. iMCCIPATIBiLITY (MATERIALS TO AVOID): None (3) Respirable dust. •• '•- =•-iT • PROD TS: High temperatures could Les SECTION iII - PNTSICAI PBOPEUTIEI t- the formation of vinyl chloride monomer u a deconcesiti pr — t of polyvinyl chloride. PVC is present st less than APPEARANCE AMO OOCR: Paper faced gypsum board. Ho odor. _ in the - oducts Covered by this MSOS. MOLECULAR WEIGHT: Mot Applicable HAZARDOUS POLIIRIZATION: WiLL OCCUR WILL MOT OCCUR _ j ) BOILING POINT (DEGREES FAHRENHEIT): Not Applicable j ODNDIT10WS TO AVO10: None MEL'iNG POINT (DEGREES FAHRENHEIT: Not Applicable e' PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS t 4 \ `l`° � C (P-. NATURE OF WORK USE OF BUILDING /1 �t- PERMIT NO. - 1 / V DATE IS UED CONTRACTOR -__-,q-- 0c,1q- PHONE ( INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE FOOTING LVC ©d' aDrior To Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS AMPRIOMMINP FRAMING %/!_> irinlrainr ELECTRICAL COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED LATH FINALS BUILDING /r e , f696 t ,. / 4 ELECTRICAL 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 4 0