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HomeMy WebLinkAboutBuilding Permit 11. 0568 o §e § a� § _ W. E X 00 Z ( 2 > o §ww� 2 § 1 ES7 ƒA z 2 000000 / & Cr w 2 A \ CI la ci }jk z Lu 03 \ 0 - o E 2 00LE � 0 0 % : P % L.- Q 0 0 w § . 0 0 2 ( 0 j�k2j� ��� > C ). 000000 oo 0 z 1 2 \ \ § 0 % 5 P • z 7/ / 7 2 0 z z o 0.) � � r, / 0 z o 0 m ) 0 0 ■ a Z C � 2 re Z 0. / -i 2 § cc ) - k Q Q / § k 0 §§ 2 B S 0 . o? < 0 2 0000 0 0 0 0 _ W Z • _ Z • J I -J Le Y . gx W Ly, Z W W a 1 0 W W U U ..t W 0 555 3 Z a 41 � �LULUN o 4. O 00000 © W 0 It LT 0 I W z > o W = ol 9� r N 0 CC w O 0- CL , I m c O °C J Z Y Y 0 4 _ U 0 1- c 00�+ J 0 I- E CD 000 1 f' 45 W j 2 Lu w; Z ce Z -2=Z- • 1 0 c N p H CO 0 d 2 W re re m2 i 1 , 0. ? I:4 .% 1 0- 2 co a 2 W W re W ! V 00000 0 , % , 0 0 5 W e VI CI. d LL I W ' 0 Z U O W • a 5U ('') o a 0 0 ~ re Z -- 0 z LU 1— co a W c4 Z (7 Q(7� N Z '- N J U U J W d U) Z Z O oz g z • W Y J A CO u_ 0 } O } W W Z 00 C OZ1 W - .:,�� 4- 0 O O y U O d F_N 0 0 LLLL LLZLLU) O 0 0 w 6 ? a o a ❑❑❑❑ ❑ 0 _; M o IN) F PRip CITY OF PRIOR LAKE BUILDING PERMIT, l O � , TEMPORARY CERTIFICATE OF ZONING COMPLIANC $ . 7 AND UTILITY CONNECTION PERMIT fi JUN 13 2011 4t ilvtvESO"i t. ta, ' z I. white File PERM 147 4 " i? w 3 Yellow w ACpl plicant i ' J 3 elop J (Please type or print and sign at bottom) ADDRESS 143 02 1 17_-1L S t D E C O L..)12-,---t ZONING lattice use) LEGAL DESCRIPTION (office use only) LOT " 1 ADDITION L EP V °c t R t= tzo t-,17 • PID 25 - 4'18 - Go2. - 0 OWNER (Name) In At-TTA, t--i-t' 440 1.--, F (Phone) `x 4 2, 9 S - 21 0 (Address) 2 DO 1..) C"T i 121Th 42_ UR 'dS✓L t W SS . 33 - 1 BUILDER (Company Name) t''t N- TTA 1• --1`1' k4-C> t--t a-S (Phone) 9 G -2- - ZS S - Z.l 6 6 (Contact Name) (Phone) q S - 2 )S2 ,- 61-2 (Address) 21 b p l.til C--1-'11 R-t L(2 la,v 12__K1S v I L.l_g M t.( SS �3-1 TYPE OF WORK "New Construction ti11Deck DPorch ❑Re- Roofing ❑Re- Siding DLower Level Finish ❑ Fireplace (]Addition ❑Alteration ❑Utility Connection CODE: .R.C. DI.B.C. D Misc. Type of onstrttction: I II III IV V AB PRO COST /VALUE $ t 2 .,J Occupancy Grottp: A B E F HI M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify that 1 have furnished information on this application which is to the best of my knowledge tnte and correct. I also certify that 1 am the owner or authorized agent for the above•menuoned property and that all cunstntction 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 c— Z... - FDG2o3 S3`c3,b 410 N Signature Contractor's License No. Date Permit Valuation ( i tam • Park Support Fee # $ Permit Fee $ 1Z 45 SAC # $ Z2- 30 Plan Check Fee $ , C ; ar Water Meter S i z e " ; 1''; $ ' 'l b a - State Surcharge $ &70- Pressure Reducer $ c, s, Penalty $ Sewer /Water Connection Fee # $ l 5 0 a, - Plumbing Permit Fee $ t 54 50 Water Tower Fee # $ (0 Oc.) Mechanical Permit Fee $ ( .S 4-. ca Builder's Deposit $ ISt>©_ Sewer & Water Permit Fee $ 5 Other ( s=- tcs.-1 $ 1 4. 7 Gas Fireplace Permit Fee $ 54. 9 TOTAL DUE $ • This A y ati r B- tes our Building Pernik Whe App - c ued Paid ( ,.. I N Receipt No. {j f `g 7 Date - l - t l By . . 44 - et t3uiidin Utticia Date 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. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued Planning Director Date Special Conditions, if any 24 tour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 o R Date Rec'd / CITY OF PRIOR LAKE PLUMBING PERMIT -,L) _, „, -4-„,v,Es. I. d File 2. Gold City PERMIT NO. I I . 5l9 V 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 1 qa)3 P - i L. -\-- KLO LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) # 1 tAc .1 f 41,0V (Phone) (Address) APPLICANT Qq G1 / ,.1 (Phone) V (Address) I9(7(dLd ' �' 1 �1J lJ' 1b t1V ) Wasiak, 1`.�,� �J " (Addrazls (City) (Zip Code) (Contact Person) C.th at, Q, to (Phone) 6 /5.9119 .- .1P - 0 i .�. , 0 . .il► J. , 4 DATE 0+11411 t APPLICANT SIGNATURE i i%!�i�� �.- APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture a Bath Tub with or without shower Rough -ins Dishwasher Water Heater 1 Floor Drain Water Softener Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector 4;1? Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink 1 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 § 326B.148 Est $ a Building Permit # WITS URCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ 11-19. e„....,5,- BUIL,DI PERMIT July 1, 2010, until June 30, 2011. STATE SURCHARGE $ minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ is 55. beginning July 1, 2010 " 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 o� P RIOT CITY OF PRIOR LAKE Date Reed c HEATING /AIR CONDITIONING /FIREPLACE PERMIT 4 ■ 11000 1. Pink File PERMIT NO . 2. Green City \ -, / a 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) I AL' 2 4:0 V acy_wk, em,A- NW LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID NE ��[� n k � �fl., , �,�,,n (Na R `�1 e,l. - �"ta,'lvw (-two, (Phone) (Address) APPLICANT p, n (Name) �1 i (Phone) 1 li (Address) L''M f 1 16 lik3 - eviensals / n - 5 h..a ddress) J (City) (Zip Code) (Contact Person) 1a Q1AV (Phone) C ` ` nl APPLICANT SIGNAT ' ' Std' • 1>! y∎ � � • • E _Milq..111 L APPLICANT PLEASE COMPLETE BELOW A KEW CO TRUCTION ' ` ❑ ['REPLACEMENT El ALTERAT ONS_� FURNACE MAKE AND MODEL � �' r � ® 11Lc? o O FU �l��vv(( "� FLUE SIZE RETURN OPENINGS INPUT L U U OUTPUT ( V a TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach Gravity ill Hot Water into Required Side Yard Setbacks. Mechanical El Radiation :kir Conditioning El Special Devices Fireplaces with Box Additions or ent. 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 $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 $ %va n / Building Permit # The Minnesota Statutes § 326B.148 _ PAD WITH H 'SURCHARGE" has been changed for one EATING PERMIT FEE $ , 1 1 4C ?I Dte f4'� "�` PERMIT '1� year eve FATE SURCHARGE $ .Ci \..5'6� LD July 1, 2010, until til June 30, 2011. le minimum surcharge for a "fixed fee" permit DTAL PERMIT FEE $ 4 _ 3, 3/ is 55. beginning July I, 2010 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 e 4 CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed "7 s TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 1 2411 • 1 1 TI 0 ' ' RMIT 4' '. FiLs INIKAIN 4(1. 6( F.. . - `'r•% fn. 1 PERMIT NO. 1 cl t , 'Incase 4 or • .t and _ it) - ) AL. .Ale■ ADDRESS LW (7 ilePr" 1 ZONING (office use) '14;ti PA S‘DE. - Z -, k-)R - r ' t LEGAL DESCRIPTION (office use oroy) LOT BLOCK ADDITION Pro OWNER . i . tjt A I-TA k-koi--k. ( Pone) 4 i 5 a - i5q6 - (Name) h (Address) BUn-6-Ert or,' r ,- ----)- -- — (Cornpany Name) 6 „„ t- I - c_ 1;.. c. • %. (Phone) Lob l -1 1'4 -CA I (Contact Name) —111 't)r (..Xics.:1-7ER, (Phone) (06 - - 155 - f (Address) P 2 [ 4 ___LAKE,, j : - . ) e i t i r -tt•feb LJ v E, , ii - - TYPE OF WORK )iil New Construction ODeck OPnrch DRe-Roofmg ORc-Siding 0 Lower Level Finish 0 Fireplace 0Addinon 0Alteration OCralitY Connection CODE: I31.R.C. EJ1.B.C. 0 Nils Type of Construction; 1 11 Ill Pi A a) Occupancy Group: A 13 E F H I Mpt'SU PROJECT COST/VALUE S ---.) Z- - ce I Division: I 2 CS) 4 (excluding land) i hereby certify that : have fumasheet mformarion on thts applic.ation which u fQ :EL be of my kw...edge true and corma i aSso certify that I am the owner or aurtionzed agent for be ahore.merstioned property and that all oonstrucoon sill conform to all cxistuig vim and local laws and ...III proceed in accordance wish submitted planz I am aware tat the budding ofticuo cariciat Eh:1 ?enuli for • t cause Furthermore. i Ilesseby agree Mat the c-ey official or a desi ee ma. enter upon the property to, perform needed .nspections X (-10.4tri ''11-44 c 74 Signature Contractor's License No Permit Valuaricri . LI J oco.P0 I Park Support Fee Fi i $ . 1 . Permit Fee 5 I o3. oo 1 SAC # i a Plan Check Fee 5 449.95 1 Water Meter Size 5/8", I". 1 $ i State Surcharge 5 2 •$1:0 Pressure Reducer $ Penal, $ Sewer, Water Connecnon Fee # i $ Plkunbin g Permit Fee Mechanical Permit Fee SeWGT & Water Permit Fee Gas Fr:mit Fee $ TOTAL DUE L 5 $ S --, Water Tower Fee Builder's Deposl: Other repace Permit # I $ 5 r PAID vviTH 1,0/: I Your Budding Pe 1 1 f en t Approved 4 /. ...... _ Date . Paid Buiyitp PERMI ec a i BY — v iosii,rig i; lord Dr: Thu is to certify that :he request ,n the above appixatxm and ass:company documents is sn accordance with the Cry Zrrung .stdir..ance and MAY proem as requested Thu dc... when %spied by the Cry Plainer constitutes a tesineineveY Cc fat of Zoning compliance ani alicemi conutuctson r cmemence Before occupanzs a Ceraficase of ..)ccuparicii must be anied , I if i dlt. ga 1 10CZtd4 1 L._. Piarlong Director iestc / SptCla: l or411.1013%. if 3.11:. 24 hour notice for all inspections (952i 44 fax (452i 447.424 4t4( Dakota Streit SE.. Prior Lake, Minnesota 55372 • • dr t. 174)s . • - '061.■ eall. • ., • r 14; a?.) i' 40 lel 1 A21 Ali 4..Iii ' .. A 4ii 3. t 6 1/ 1. , PN • ' -- • • 41 ,. . 04 Y R IO,, CITY OF PRIOR LAKE Date Rec'd Et.:A HEATING /AIR CONDITIONING /FIREPLACE PERMIT U lT1 t NN E SO 1. Pink File 2. Green City PERMIT NO . 3. Yellow Applicant • (Please type or print and sign at bottom) ADDRESS ZONING (office use) 14302 PARKSIDE CT. NW LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID • OWNER (Name) MATTAMY HOMES (Phone) 704 -598 -4110 (Address) APPLICANT (Name) FIRESIDE HEARTH & HOME (Phone) 651 -638 -3318 (Address) 2700 NORTH FAIRVIEW AVE. ROSEVILLE 55113 (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE _WENDY SCHROEDER DATE 651.638.3318_ APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ['Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ❑Gravity ❑ Hot Water into Required Side Yard Setbacks. ❑ Mechanical ['Radiation ❑Air Conditioning ❑ Special Devices Fireplaces with Box Additions or ❑Vent. System El Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL HEAT & GLO SL550TR -IPI -E FEE SCHEDULE Industrial, Commercial & Multi - Family 1% 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 # HEATING PERMIT FEE $ PLAID WITH STATE SURCHARGE $ .50 WILDING PERMIT TOTAL PERMIT FEE $ (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 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 owner's representative. All defects shall ge 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 understoo 1 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: U EFrER& V∎fNTU mht\ii DATE g/29 jt PROPERTY ADDRESS: 1430 F'ARKSt (t 1J ACCEPTED BY APPROVING AUTHORITIES: ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS EYES ONO EQUIPMENT USED IS APPROVED El YES ONO IF NO. EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS ®YES 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: EYES ONO 1 . SYSTEM COMPONENTS INSTRUCTIONS EYES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS EYES ONO 3. NFPA 25 ZYES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING IZELa/hY;t_L` 1454-9 2010 1 12 i? 155 SPRINKLERS 2La QLt 12Es 2010 f i 2 155 t LtA (3LE F3t 2.0 10 120 1 ,5> r� Lln V1FR 2010 II / 2 200 PIPE AND Type of Pipe FITTINGS Type of Fitting MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC i I ewv � N �iCpFCGC' 1'0 - V SiZ Q 5G) 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/O 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 OPERATION: ❑PNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE DYES ONO CONTROL STATIONS DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO, EXPLAIN PREACTION FOR TESTING VALVES OYES ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKF Mt713FI Sl IPFRVISIONj CAS Al ARM OPFRATF VAI VF RFI FASF ( FFI FASF YES 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 M excess of 150 psi (10.2 bars) for 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 psi (2.7 bars) air pressure and measure drop. which shall not exceed 1 -112 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop. why shall not exceed 1-1/2 psi (0.1 bars) in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ONO N/A EQUIPMENT OPERATES PROPERLY OYES ONO DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? OYES ONO _ DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION dot ( PSI CONNECTION OPEN WIDE 3o PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING OYES ONO IF POWDER DRIVEN FASTENERS ARE USED IN OYES ONO 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 REQUIRIEMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? OYES ONO WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 YES 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? OYES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? OYES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA OYES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: $tzq 1 t' NAME OF SPRINKLER CONTRACTOR: METRO FIRE PROTECTION TEST WITNESSED BY FOR PRA' O NER ( NED TIITLE DATE SIGNATURES � 2 �/�/ FOR SPRINKLER ONTRACTOR (SIGNED) TIT DATE an ayvlk g 29I ) ADDITIONAL EXPLANATION AND NOTES i*ZG49 ° a i Builders Deposit 44k- : 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. I DATE: SITE ADDRESS: k' -1302 P .�(�1� -SI ORS- Lou P-1 PERMIT* 1/ • 'S REFUND TO BE MAILED TO: M i r3% t-'1--c -44-o 1----1 P S 2t L 0 1>\1 C T`t P-E L4 2 lv1?- INIS�'it- L-E N'1 iN.t SS-63-1 AUTHORIZATION TO RELEASE PLEASE REMEMBER /1 SOb.00 ynda S lien, Building Services Amount 1. KEEP STREETS CLEAN DURING CONSTRUCTION 7. ?O Acct. 801.20204 2. KEEP EROSION CONTROL IN PLACE Date 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED SIGNATURE c J` C:\Documents and Settings\sbare\Local Settings\Temporary Internet Files\ Content .Outlook1BD8OXI9A1BUILDERS DEPOSIT FORM.DOC PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPE REC . ,, 8 , am h e SITE ADDRESS 1 43 02— <4 C,_r NATURE OF WORK Susti FA-M I of A.- rt- Ae- 1467 lac. 17c go Pcc44 e FIN L L , USE OF BUILDING SF,e PERMIT NO. it- 56S . DATE ISSUED te, fr1/u CONTRACTOR Kaerv—� -rl , rt 6, PHONE q.? - 095 6 f 2g NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE P MIT IS BY SEPA TE DO U MN T (�5� -G 6 1 61\7� � /44(An$ i I PE _ T-,-,„,,, DATE I FOOTING i I FOUNDATION (Prior to Backfill) I 1 I PLACE N CONCRETE TIL OVE HA BEEN SIGNED ek,.., �S�" ROUG - SEWER /WATER /SEPTIC FRAMING Pe g fr/ I - INSULATION 66 8r, ELECTRICAL PLUMBING , 'Z. 5/ 1/4 HEATING (if required) e6 o J3 f tl FIREPLACE /J 07 GAS LINE AIR TEST P -14t )°3 'V (P COVER f40 O UNTIL ABOVE Hit BEEN"$IGNED I 0 LA 1 b/I (c I •Piz{N -f, pb kf i I FINALS * I GRADING (Prior to Sodding) ; BUILDING ?/ 7_ ,4)(2 ELECTRICAL PLUMBING /,./650 ntr 4 . 4(r, ._. 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