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't 1 , , - r �' Crrrfifir of (�xtupauc r ❑ � : � C ITY OF PRIOR LAKE \ r r ± i ` _ El Final Permitted ❑ Conditional C.O. Expires :N ■:,,,,,ritii4r,,,, This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ International , 71t 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: Use Classification SINGLE FAMILY Bldg. Permit No. 13-n1 60 // Occupancy Type Type Construction Zoning District - Legal Description L23, D1, JEFFERS ' 4ATERFRONT :- Owner of Building Site Address 14370 PARKSIDE COURT ';''''' Contractor's Name & Address MATTAMY HOMES �,,' - ROBERT D. HUTCH I NS (i; City Planner Building Official .- Datet 1 f/' /�• L/ r ' Date: POST IN CONSPICUOUS PLACE It, ♦ r m i' � i! 'r. �' .r r � vF � Iii (I :� fl °r � ! r. > r r r. I ( s r,k r. 9 1 rn F + r it hf ft ,f „l ' ' u ° tl t f h . 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"T >= M `t' -1-4 0 N-t ES (Phone) 6 6 1 -- ' 9 'b - 21 b d (Address)12C 1 W R S I-1- t h16 i ca +,l A L E S S '7__p ( O t tel \ F1 N S S 4 3 9 BUILDER (Company Name) M M" Y 4- 1 - 0 Fl ES (Phone) 952 - 93 - 612e (Contact Name) S U E ‘R= (Phone) (Address) l'2-c) t 1n. tt S H Ii (, N.,/ p vE S ST-_ 7 0 t -o t NJ is., r 1...._1 SSL-139 TYPE OF WORK 0 New Construction gDeck ['Porch ❑Re- Roofing DRe-Sidin ['Lower Level Finish ❑ Fireplace ['Addition ['Alteration ['Utility Connection CODE: ZI.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F III MR S U PROJECT COST /VALUE $ i f o 60 Division: 1 2 3 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 - 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 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. ( Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ (�`S,O - Permit Fee $ i 3 S3 SAC # $ Z4.3 S — Plan Check Fee $ S)(Aa 2 8 Water Meter Size ' ; 1 "; $ 4 gen.. State Surcharge $ 1 1 9D Pressure Reducer $ l l O. Penalty $ Sewer /Water Connection Fee # $ t S C'p - Plumbing Permit Fee $ SA. So Water Tower Fee # $ ( v 0 Mechanical Permit Fee $ S 4 So Builder's Deposit $ Z 500, Sewer & Water Permit Fee $ 5 5© Other � c? PP F -645 f o,-1 $ o <<i • S Gas Fireplace Permit Fee $ G • d ., . So TOTAL DUE $ `O q 5Q .70 This A /lica ;on i:: o .. e , Your Building Permit . n pproved Paid /0 i / 11 - Date - /O.. i 3 • %_ 3 5 (3 Building Ot Tcial - -, Da e This is to ce ,i' that the request in the above application and accompanying docum is is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signer by th- Ci P : constitutes a temporary Certificate of Zoning com 'anc and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. ligal 3� l3 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 i ! • Residential Building Permit Checklist New Construction for Single or Two- family Dwellings in 1 or -2 Districts Reviewed by: p A___ Date: 3 i 3 Building Permit # PID: Zoning: ?c-) p Address: i i S, p c S\oG C-T-• Legal: L , B Subdivision: Existing Structure? YES 1 t49 . Existing Nonconforming Structure? YES / NO CONFORMS TO ZONING NO ORDINANCE 1 Yard Setbacks: NAI FAILS/ C! e - • S Standard Proposed I • o Yard (can be 20' if av � ' � lin 150') 25' -4 Front ( g t • Side Yards 1 25 a street . 7 - -� - Fes. CO �� -1- • 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 Pc' c • Patio Door; provide for minimum 10' deck or sign 10' side/ statement indicating no deck will be built in the future 25' rear O • 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' I Floor Area Ratio: NA I FAILS I i • �' ' LIES I .30 Maximum 1 I Yard Encroachments:�� I FAILS ICOMPLIES I Standard I Proposed Eaves and Gutters noelre than 2 feet in width and no closer than 5 feet to a lot line (Easements). AIC and other equipment cannot encroach on interior side yards. 1 Tree Preservation: ' FAILS I COMPLIES 1 Standard ' Proposed I • Total caliper Ind s • Permit 35% Removal • Caliper Inches Rerrjoved • • Caliper Inches P,dserved • Rlacementf %:1 L : \T TE\BLDGLIST.DOC / I Driveway: NA / FAILS / CONS _ Standard Proposed • Maximum width at property line _ 24' acs • Required setback 5' from side lot line or _ 30' from r -o -w on corner lots (>,----a. • Maximum slope . 10% YL•6 r ,=‘ 6 • All parking areas to be paved including R -V or spaces adjacent to the garage • Location to match subdivision grading plan r Building Height: NA / FAILS 1 C‘ LIES 1 35' Maximum 1 p p Shoreland District: NA / FAILS 1 d PLIES , 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 p cr o 56 r ow . A-�4 t...6 Bluff in Shoreland: / FAILS / COMPLIES Standard Proposed • Setback from top 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• AILS / COMPLIES Standard Proposed • 100 ye lood elevation 908.9' Prior Lake 914.4' Spring Lake • Lowest 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 9/19/90- 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: ii/ FAILS / COMPLIES 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 :ITEMPLATE\BLDGLIST.DOC (PRI U e I rn White - Building Canary - Engineering ' Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 1 -, t ,? APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: -� -� i" -7 Accepted k Accepted With Corrections Denied SI G Reviewed By: /)44- Date: 3-g / 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." •• .r 7 ' 'WSW. `1•!I''.mfi+ 7'• ""w,.5".!911"r ^ APF , "^IP !rR^r.'A""."! - PRIp 8 .,:,-: kk 1 4 LN - :sC': White - Building Pink r y _Engineering Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT nig/T29 y x'15 APPLICATION RECEIVED 2 ' z`' /3 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /1 - /4376) P/q,eKs /a E e_,ovru Accepted " Accepted With Corrections Denied Reviewed By: 1 Date: 3 4° A Comments: co.Ai rye, S' /c.)e.J 5 ! I414-(A) 04-,.t., Cam,. A- Sra.ci5-7, 4. ,4 7T , mss "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." „ E A*** . •.n,�H,,.w - lN^w rr ^o-,`+�41fiM'+�Iq?iea Arm, +v^Sr r.:, ..va:• :�„�,:•., '�'.F»�M�4' i c IPR/o ie White - Building Canary - Engineering 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 Accepted With Corrections Denied j Reviewed By: Date: 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.” Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be 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 understood 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: JEFFERS POND DATE 0 —Cc 13 PROPERTY ADDRESS: 14370 PARKSIDE COURT "WILLOWBROOK" ACCEPTED BY APPROVING AUTHORITIES: CITY OF PRIOR LAKE ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS EQUIPMENT USED IS APPROVED OYES ONO IF NO, EXPLAIN DEVIATIONS OYES ONO HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE ®YES ONO OF THIS NEW EQUIPMENT? IF NO, EXPLAIN INSTRUCTIONS HAVE COPES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: 1. SYSTEM COMPONENTS INSTRUCTIONS ®YES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 ® YES ONO OYES ONO LOCATION ENTIRE BOLDING MAKE YEAR OF TEMPERATURE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2013 1/2 11 SPRINKLERS 155 RELIABLE RES 44HSW 2013 1/2 15 155 RELIABLE F3QR 2013 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC ALARM DEVICE MAXIMUM TIME TO OPERATE ALARM VALVE OR THROUGH TEST CONNECTION FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR -F DRY VALVE ■ Q.O.D. MAKE MODEL SERIAL NO. MAKE I MODEL SERIAL NO. • DRY PIPE TIME TO TRIP OPERATING TEST THROUGH TEST WATER TIME WATER ALARM TRIP 00 0NNNECTION* PRESSURE PRESSURE AIR PRESSURE TEST OUTLET* PROPER LY 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 & FLOOR MODEL FLOW RATE PRESSURE (FLOWING) REDUCING VALVE TEST INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW (GPM) 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 OYES ❑ NO 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 MAKE MODFI SI1PF(3 ISION I OSS Al ARM OPFRATF VAI VF RFI FASF OPFRATF PFI FASF YE:; 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 in excess of 150 psi (10.2 bars) fo'two hours. Differential dry -pipe valve clappers shall be left open during test to prevent damage. All Aboveground piping leakage shall ae stopped. TEST DESCRIPTION PNEUMATIC: Establish 40 psi (2.7 bars) air pressure and measure drop, which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water lev tI and air pressure and measure air pressure drop, which 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 EQUIPMENT OPERATES PROPERLY YES ONO N/A 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? EYES ONO _ DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION jj % PSI CONNECTION OPEN WIDESS 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 NYES 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 ONO _ IF YES DO YOU CERTIFY AS THE E PRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3? OYES ONO WELDING DO YOU CERTIFY THAT THIE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 OYES ONO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCE DIJRE 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? EYES 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 WITF -I ALL CONTROL VALVES OPEN: 9 _ (-0 - -( ; NAME OF SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES LLC. TEST WITNESSED BY - h RTY O / ►, SIGNED) 0 7E6/(3 TITL SIGNATURES r ER SIGNED) - 1rs TITLE, FO P . CONTRACTOR (SIGNED) TITLE E _ ,,u. 9._ - / ADDITIONAL EXPLANATION AND NOTES 0 � pRlp4 Date Rec'd CITY OF PRIOR LAKE 13 ' 7 -- M SEWER AND WATER PERMIT nNES 1 I. Green File ' 2. Yellow City PERMIT NO p 6 Z 4_5" 3. Gold Applicant % / GG (Please type or print and sign at bottom) ADDRESS ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) APPLICANT � r j/J (Name) L--'��� { t (f (Phone) (Address) (City) (Zip Code) (Address) / /� 1 t�/f% (o ne) 1P_ � Z ,- j � � . ¢. 7 v (Contact Person) Ph � AP • ICANT SIGNATURE I i DATE 7i- ' /3 L APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. n ABC n PVC n Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial, Coln'1 & 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 $ RAID WITH TOTAL PERMIT FEE $ BUILDING 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 ` ?Rio CITY OF PRIOR LAKE , O ,. ~ 4 Date Rec d r HEATING /AIR CONDITIONING/FIREPLACE PERMIT cJ' � : M �nTi ESo " 1 an.' file z. Caee� t,� PERMIT N �� _r��(Dt� ] Yellow Applicant (Please type orprinl and signal bottom) ADDRESS Z ONING office use) tut Pck.g., c PAID -.__ ' LEGAL DESCRIPTION (office use only) BUILDING P LOT BLOCK ADDITION PID OWNER „lam f -- (Name) 't ` v l.JAiN Ac. „, /r l y�� (Phone) (Address) 1u?� PO teke . C 1 1 f � C \(. VG .Q, t P.n 5 I— APPLICANT n 22 f �[ r� { ( q (Name) - 3 ',1), t1 T� ✓ti- t:�(/Un (Phone) `� d - l l�� , 1 S1G 6Y' �1 (Address) (3 L ! 1Ae\ `'7"D I/3 JX•l rt l 1{%1 ( ( \, ` 35� n { ( Address) l (City) l (Zip Code) (Contact Person) � ' t L �� ` _ A _ h kA3 �-l (Phone) 9 S -- • ! - APPLICANT SIGNATURE 9 , t\AC l P I APPLICANT PLEASE COMPLETE BELOW ril NEW CONSTRUCTION � REPLACEMENT ❑ ALTERATIONS FURNACE MAKE A • D MODEL DY1.1t1.,1 Q 1 ) ' � j n tQN ` FUEL I•- ' FLUE SIZE RETURN OPENINGS g INPUT 1 5?) IN OUTPUT 5 0 5 3 TYPE OF SYSTEM HEATING OR POWER PLANT ]War)n Air Plants PLEASE NOTE: Air Conditioner Steam Units and Fireplaces Cannot Encroach ❑ cavity ❑ Hot Water CI echanical ❑ Radiation into Required Side Yard Setbacks. P �� . it Conditioning ❑S Fireplaces with Box Additions or Special Devices ■Vent. 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 0 Estimated Cost $ (0 , J Building Permit $ The hlinuc.nia NtaInle% §32013.1 HEATING PERMIT FEE $ `(1 9_S-0 "SL :KCI IARGL” hm been changed lirr one STATE SURCHARGE 5 , c7'D — 2 10,n until nc July 1, 211111, until n lit, 2(11 1. TOTAL PERMIT FEE $ / , 7j 1 he minimum surcharge for a "fisrti fcc" p ermit (Office Use Only) Is ti5, btginoing.hll) 1.2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date ID WITH Building Official Date DUl NG PERMIT 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 1-111 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 4 vitro Date Rec'd 0 :..:., , 0 ' , - , ,, CITY OF PRIOR LAKE PLUMBING PERMIT �f ?ma I. Sloe Fik 2 ow �r / ` PERMIT NO. /3 —D /' 3. Yellow Apphcme (Please type or print and aim at bottom) ADDRESS ZONING (office usel PAID WITH LEGAL DESCRIPTION (office use only) BUILDING PERMIT LOT BLOCK ADDITION PID OWNER COL-- ( L 4 (Name) h F partsoc `\ (Phone) (Address) 6 �'tbn C ir l W 1 RI Or letft--02_ Mn - 1 - '- (NameCANT I' , �' � U 1 (Phone) oh') t u� `f".-f � l5l) (Address) ). DD 1'ki.i \) t.,3 't ��t ' `1 1 rn - , J 3 L (Addre ) (City) (Zip Code) I�, r', D� (Contact Person) V► j e orhuet�C\' (Phone) V U - .1 APPLICANT SIGNATURE Fl r ' C NDATE /� APPLICANT PLEASE COMPLETE BELOW L✓ Quantity Type of Fixture Quantity Type of Fixture ..,--- Bath Tub with or without shower 3 Rough -ins 1 Dishwasher ( Water Heater ` _ Floor Drain Water Softener -) Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) _ Laundry Tray (1 or 2 compartment sink Sewage Ejector as Shower Stall Backflow Assembly I — Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 3 Water Closet (Toilet) _ Other FEE SCHEDULE Industrial, Commercial & Multi- family 11/4 of job cosi with a $49.50 minimum Residential, New One & Two - Family $ 149.50 Residential, Additions & Alterations $49.50 i The Minnesota Statutes § 32613.148 ^ �St $ ��1 Building Permit # "BURG 11ARGye ar r effective iecliti�e been changed for one PLUMBING PERMIT FEE $ 1 461 S-1-) ye July i, 2010. until June 30, 2011. STATE SURCHARGE $ ()b The minimum surcharge for a 'fixed fee" permit TOTAL PERMIT FEE $ i `. . 5 is 1S, beginning July 1, ?010 This Application Becomes Your Building Permit When Approved Paid PAJWITH Date 1' . ;l t . Building Omclal Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 , . CITY OF PRIOR LAKE BUILDING PERMIT. Date Recd ' A. C 7 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE rz :.... m .AND UTILITY CONNECTION PERMIT 4Silipe<sl ) E PERMIT NO. 15 I ( i (new rape or print and sign at bottom) ADDRESS ZONING _ it i N 14 310 l'g145pc Ca?-, LEGAL DESCRIPTION (office use only) LOT BLOCK ADI)ITION PID ----] OWNER A 1 ,. t 2-1 (Phone) 7 - - 2- - 2T7 - 00 „.. I (Address) - 720( lijilS 14 I ki hT1.) 14 A\ ''› t: )1\J Fl 1 i 6 , 5439 AlcilliDNIt 0- i.' t^4 fi:.i i c.". re: --7 1 -, 7 , ,,--,,, ,- (Company Name) P /iZe uPPIzcs< )1(..bi -)ce ViGE:5 (Phone) IA) - z. i r - - r r (,,( i .... (Lontact Name) 41 Ail V Y.-1.7.P,PC (Phone) (Address) .1 A l.- Al ..) Sciiri /I t z<' e 7 I TYPE OF WORK - New Construction 0Deck DPorch ORe-Rooring ORe-Siding OLower Level Finish 0 Furplact I Addition OA:re-ration OL:nlity C:onnectwon CODE: DI.B.C. DM Type of Construction: 1 II III IV V A B Occupancy Group: A ;, 13 E F H 1 M . S U PROJECT COST /%'ALUE $ 32--q (4% , .,-.' Division: 1 2 (? 4 . (excluding land) 1 hereby certify clic 1 .haVe fUrrlitirti traOTTRAM111 (MI this application which is to the btu of my ancruiedge :rue arcd correct I also certify Mai 1 am the owner or authorize r• for Ite aboveimennorted plypc and that all construesson will conform t at existing stare and Meal taws and ss AI proceed as accordance ssith submared plans I an aware tar dse fultding ' official/1 resonic Mrs perrort : ri st cause urthrmum, 1 (eeds) agree out the cuy t fliiiral or desrgner mar upon rhe property Ir. poloem needed tospecrusers X .4/1400 . IL r — 146" 7— —(5 sisnatwe cm.,,,,, , 1e ti,, Date ......_ Pct Valuation Park Support Fee g 1 $ Per7111! Fee S SAC ,.. • 4 Plan Check Fee S Water Mete r Sae .5 / i+ . 1 ; S State Surcharge S Pressure Reduce(' ' 5 ..... . Penalty S Sewer/Water Connection Fee l Plumbing Penni( Fee $ — 1 Water Tower Fee 74 $ – , Mechanical Permit Fee $ 1 73iidder's Deposit S 1 Sewer tit Wale! Permit Fee S 1 Other $ i I Gas FLrepla4...e Permit per 5 ■ TOTAL DUE i $ , I____ .., PAID Th • t " . Beco , Your Building Perm W ri prrt A.:—.11 _ 4 I Date E -- 3 ,..... 1 :ha: rhc :goes: in the above application and accorapasying docomerus is in accordance with Mc m C Zimung Ordinance and may proceed as requesard Thu document %hen si 1 the Ctrs Planzer consonitei 2, fcmpantry Cer,o6cate <A Zoning 4_ and allow, comaruaten to tolnr.1411,:t before occupancy, a Cern of OCV4ADC'y must he ; istard l .. - --- Planning Ditteloir fdaic Special (ando:ow. 0 ens 4 hoar nonce for all Inspections 052) 4A7-9650. fax rt15 44•4245 4640 Dakota Street S.C., Prior Lake. Nlioneyout .4.5.r.1 : Rip, Date Rec'd i _, L „. CITY OF PRIOR LAKE P. 7.__&- L3 v SEWER AND WATER PERMIT l , (Q I3 / / / Green F PERMIT NO.76 -7 Yellow City /6 ,17 , 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) /4-- 370 ^ 76 2 ' t a s eA, LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) APPLICANT (Name) D3 P// /� , ( (.r / , (Phone) (Address) (Address) (City) (Zip Code) /� (Contact Person) A I G( (Phone) 6 ' I t f'. ¢`; 7 v A - • ICANT SIGNATURE I DATE ' /3 APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC ❑ PVC ❑ Cast Iron Estimated length of sewer line feet. Clean out (if required) located at 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 $ PAID W1TH TOTAL PERMIT FEE $ BUILDING PERMIT (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buiidine Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 n Builders Deposit Ila p City of Prior Lake A $1500.00 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: SITE ADDRESS: 4- YlU PIN-P-e- S i 0 C Co up= PERMIT # 0, 4 REFUND TO BE MAILED TO: M' MY 4-1--o t-1 ES 120 1. 1. --1-1 J(.T ?N t/ S SU 1T Za I ' 1t--11N, / t-1■ SS 439 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 (- %-t_-1 AUTHO' ATION TO RELEASE SIGNATURE: \w` iii/ ZIS60.(,1D Lynda S. Al '-n uildin Services Amount / `/3 Acct. 801.20204 Date „V C:\Documents and SettingslsbarelLocal Settings\Temporary Internet Files\ Content .Outlook\BD8OXI9A1BUILDERS DEPOSIT FORM.DOC PRIOR LAKE BUILDING AND INSPECTION INSPECTION RE COi SITE ADDRESS (z) 31 o PA4 CT NATURE OF WORK C A . Pl✓c t� No k� ePk. FtN USE OF BUILDING t - FA-AA < <- `� .•••mac .c , PERMIT NO. t` tC O DATE ISSUED \ 3/ ;1 CONTRACTOR Vtar A r\ 4 1 K V A - PHONE aSa -81 S> • - ZI ©© NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOQUMEN E1 10A-3 INSPECTOR DATE 1 FOOTING I 4i I- / FOUNDATION (Prior to Backfill) 1 PLACE NO . CONCRETE UNTIL ABOVE HAS BEEN SIGNED 4/ ROUGH - INS SEWER /WATER /SEPTIC rfia1-3 i;16 g9s FRAMING t ��, s� t,,, - P/? ' INSULATION 4__ ELECTRICAL PLUMBING 1,1:v.6,. )411r4iW HEATING (if required) / E FIREPLACE LINE AIR TEST )' COVER VO WORK UNTIL ABOVE HAS BEEN SIGNED I C=1 RE IaN ?6,71,7 j `/i j/- 1 FINALS GRADING (Prior to Sodding) y O ' / BUILDING (..eiN 1,` l3 J ) ELECTRICAL PLUMBING /(7 HEATING ..� zy$41 / 1 % 1.- DO NOT OCCUPY UNTIL A E HAS BEEN I G ED 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