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HomeMy WebLinkAboutBuilding Permit 12. 1022 x � trfifirafi of ®rrn antg [� , CITY OF PRIOR LAKE !iparnt of 7,14uilbing jinspit ±i.an i ; . ❑ Final Permitted ❑ Conditional C.O. Expires K - ' 7 = This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / ❑ Internationals 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: �� r F Bldg. Permi No. i 2 —1 O Use Classification S l N C 1 f F A �'I i I Y ` g' P Z District Occupancy Type Type Construction g Legal Description 1 4f . WI , . wATFpFpONT 14363 PARKSIDE COURT Owner of Building Site Address Contractor's Name & Address MATTAMY �'�O FS ROBERT D D. UTCH I NS I` City Planner —7B' /ding Officia Date: / /9/ l /cling 3 Date: l POST IN CONSPICUOUS PLACE ,: i II i II i i 1 tU al ; ! r r 3 :V rs _ V_ / , J Is, Z Z H _ aEC x 1- 41 . ui t *-. 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Yellow Applicant (Please type or print and sign at bottom) ADDRESS t U 3.6 - R t . , 0 -S I D G CZ v 2—T ZONING (orrice use) PO D LEGAL DESCRIPTION (office use only) LOT 141 BLOCK ( ADDITION -,-J r 1 =� \ " -D.----� P- o'v 1 PID ZS 4 2)0 ( 4 - 1 0 OWNER (Name) ;'1 R T T il. 1'-1 `+c' -14 U I-1 ES (Phone) (Address) l W A S t-i t tJ b t-4 Ave s S 2.p t O t t..1 1-1 N SS t-! 3 9 BUILDER (Company Name) 1 ' 1 Il 1 Y 4 4 - 0 t'' ES (Phone) (Contact Name) S L ' E— 8 i".. 1 (Phone) I (Address) 12.0 l ln. i k 514 t J �-ry t J Pr S' sTh_ 2_O t t-O t N t—t t,1 S SL - 4'-9 TYPE OF WORK New Construction EIDeck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace DAddition DAlteration ❑Utility Connection CODE: QLR.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 1 3 O 0 C' G 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. X� ��P:_ BC- Zc'3 S b — z 9 - t2. Signature Contractor's License No. Date Permit Valuation ( -. - _ Park Support Fee # $ Permit Fee $ 1 .50 SAC # $ '2_ 3G,‘-'51 - Plan Check Fee $ 82-":7. 1 k Water Meter Size t"; 1 "; $ ak 6o_ State Surcharge $ Gg , - Pressure Reducer $ t Zo,, — Penalty $ Sewer /Water Connection Fee # $ lCOO Plumbing Pennit Fee $ ( 5 -STO Water Tower Fee # $ ` Od rJ r Mechanical Pennit Fee $ l5 AV :Sd Builder's Deposit $ ‘ S O O , Sewer & Water Permit Fee $ 5 (o .s-,, Other $ , l f. S Gas Fireplace Permit Fee $ 5-4 , TOTAL DUE ) $ 4 io Z , 18 1 This I. , BecomEs Your Building Permit en pproved Paid 97 o 2 .. t: ipt No. 6, 73 / 0 Date /0 . 2 -- . . iofAL 61 (1 (- ", : ilding • -. ct • Date This is to , tha) requestin • e • • .ve application and accompan ' • . ments is in accordance with the City Zoning Ordinance and may proceed as requested. This document when ' , . ed • the • • er constitutes a temporary Certificate of Zo • g c. • • Hance and allows constructon to commence. Before occupancy, a Certificate of Occupancy must be issued.1 , (Z - ""iItri ■ ,' , g Direc r• 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 From:Genz-Ryan 952 767 1900 10/17/2012 15:38 #657 P.00310g, I yRro, CITY OF PRIOR LAKE Date Rec'd • • O `k,,:.;„ A. ":„-Jr,„. „ } p HEATING/AIR CONDITIONING/FIREPLACE PERMIT -,,E 4'NNes0- �. k Rik PERMIT NO.'. (O Z.2.0 z u«o car (Please type or print and sign at bottom) 3. Wow aRR ADDRESS ZONING (office use) 1 3W 1Qo - de. CA IA U) LEGAL DESCRIPTION (ottue use only) LOT BLOCK ADDITION PID • OWNER . (Name) (Phone) • (Address) . APPLICANTP,,, ( J (Name) V 0A (Phone) • . ,, ?” � �) S`t ,, 3 • ((Address)C7-00 4 �w ( � �� X111 �� C� ��� \t4 -[�� � � r ?� r (Contact Person) \`� ` 0 'l I (Phone) � (zip code) �V� ‘43)G APPLICANT SIGNATURE 1 1 } DATE 1 0) 1 711. • APPLICANT PLEASE COMPLETE BELOW . D ili' EW STRUCTION 0 REPLACEMENT Q AL`fBRAT[ONS • FURNACE MAKE AND MODELS(( TO( *V ° t 1? S. ril itO N FUEL , (j� Cl 04 FLUB SIZE RETURNPENINGS R INPUT 58 1 040 OUTPUT ,(b TYPE OF SYSTEM HEATING OR POWER PLANT - . [Warm Air Plants Steam NOTE: Mr Conditioner Units and Fireplaces Cannot Encroach c. avity 0 Hot Water . apical into Required Side Yard Setbacks. t161t Fireplaces with Box Additions or • - Conditioning 0 Special Devices p e Vent. System Q Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. )1REPLACB MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi Family i% o ?job cost .Residential, Gas Fireplace $49.50 • . ;.�:_ a�?� '�`30t �'.t,''�`;j;'sl�'''�$"x:+.y t�v:••?i��).•u,�;,•, ;:hri.,.�,e» S49.50 n imunt jR9srdeasuttl;'Iie�� stm a�A/c'(1Void oMI 4.i. . $ 49.5P Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) I64,50 - Residential, AC Only $49.50 Estimated Cost $ Building Permit # _ The Minnesota Statutes ¢ 3268.148 HEATING PERMIT FEE $ i L i q . t "St year has been changed for one year e11'oct)vc STATE SURCHARGE $ 50, July 1.2010. until June 30. 2011. TOTAL PERMIT FEE $ % f . C ) The minimum surtharee for n "fixed fee" permit (Office Use Only) is $1, bcelaalae July t.2010 This Application Becomes Your Building Permit When Approved Paid Reoeip - ` . 1 ' ' .: q l - Date , Buitdin[Oitiei 0 Date . 24 hour notice for all inspections (952) 447 fax (952) 447 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 From:Genz -Ryan 952 767 1900 10/17/2012 15:38 #657 P.004 /0. g f 'RIO Date Rec'd .� 1 CITY OF PRIOR LAKE PLUMBING PERMIT V jjj���fff A r ivasd" . t Yell Fila t ' 2. r I PERMIT NO. 1, Yellow hpprKml 1 (Please type orptiat and sign at bottom) ADDRESS ZONING (olnce use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) _ (Address) APPLICANT (Name) (Phone) - RYAN (Phone) (Address) 2200 IGHWAY 13 W , BURNSVILLE, MN 55337 (Address) (City.) (Zip Code) (Contact Person) , �� r' I t (Phone) 9 52 - 76 7 - 1$titi5 APPLICANT SIGNATURE J _ DATE I0 1 I tZi APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity T ype of Fixture 7 Bath Tub with or without shower Rough -ins 1 Dishwasher I Water Heater 1. _ Floor Drain Water Softener L IA,, Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) --' Laundry Tray (1 or 2 compartment sink Sewage Ejector Z Shower Stall Backflow Assembly 1 Sinks Backftow Assembly Test Bar Sink Lawn Sprinkler % Water Closet (Toilet) Other FEE SCHEDULE Commercial &Multi -fhmi[ i : ; ° °•" ;fi „� ��a. -..,, w ; ,...,....'.t;; :� 1 ;.e Industrial, Multi-family % 0£ job co with a 549. minim Reseclti'teal, 1p iii ti' Q `,X? ligiii i 109:50 Residential, Additions & Alterations 549.50 The Minnesota Statutes # 326D.145 tst S Building Permit # - "SURCHARGE" has been changed for ono ye effective PLUMBING PERMIT FEE $ '1 . ar . .itdy 1, 2011), until June :10, 2011. STATE SURCHARGE $ 0 The minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ 1 , t, Is §,,i, beginning July 1, 2010 This Application Becomes Your Building permit When Approved Paid Receipt NJ I -B.l. gg.RNM1T Date By Snildbu Official Data 24 hour notice for an inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street 3.E., Prior Lake, Minnesota 55312 4 p Rto CITY OF PRIOR LAKE Date Rec'd 0, -; ` HEATING /AIR CONDITIONING/FIREPLACE PERMIT : 4 1' 1. , Mn a k Fiie PERMIT NO. 10 721 � '� 2 �ee c;,Y ` 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) / 'i-3 (o3 Pi &.17 iil LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PTO OWNER ��// (Name) . /r 4.- (Phone) C/ 2 g 9 $ - 2 J ap (Address) 71 o / d C S APPLICANT HEARTH & HONrETO EChLOGIL.. (Name) dba FIRESIDE HEARTH & HO t' • od e) • Lic. BCO512060 (Address) 2700 FAIRVIEW AVENUE N (Address) ROSEVILLE, MN 5b116 (City) (Zip Code) 651.633.2561 (Contact Person) ,�1 (Phone) • APPLICANT SIGNATURE / /� Q' Cro DATE 1 /D'"d3 APPLICANT PLEASE COMPLETE BELOW ['NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS • FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Warn, Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ❑Gravity ❑ Hot Water into Required Side Yard Setbacks. ❑ Mechanical ❑ Radiation Fireplaces with Box Additions or ❑Air Conditioning ❑ Special Devices ❑Vent. system ❑ Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL H r a 5L-- MI., 9A Ta 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 $ 1 OW 0 Building Permit # The Minnesota Statutes * 326E3.148 . HEATING PERMIT FEE $ "SURCHARGE" has been changed for one year effective STATE SURCHARGE $ .50 Jai) 1, 2010, until June 30, 2011. TOTAL PERMIT FEE $ The minimum surcharge for a "flied fee" permit (Office Use Only) is IS beginning July 1.2010 This Application Becomes Your Building Permit When Approved Paid pH Date BUILIMINU P 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 . OLSj . . CITY OF PRIOR LAKE Bill DING PERMIT. . ecd TEMPORARY CERTIFICATE OF LONING CONIPIAANCE AND UTILITY CONNEC no\ PERNIIT ---_;=,---- PE111IT NO, __, A DDR.E.SS ,... --PP‘V-.1,4.5t0c._-.-- 1- K■,,..1 1 _______ LEGAL DESCRIPTION (office use entio LOT FLOCK ADDITION PID ____ _ _—_—_----_ _ __----- ONN.NER twky _____—_______-----.--!---1--___ ____——_---_—__. 1101 ki N 1 t,11.3.V0t. Ph,‘,/ - -C. - - '''',' e:V. i 1•3(;:\ j"-At' r .-- 4 t--- (Phone) (Ph ------ _ ---- - - TYPE OF WORK .-----------------------------------------r, ----------..-----------_:;-----r New Constrection 0,0 0 - e6, UPt‘telt. ReF,00t5,rii,; uff..e..-ztt-liag., 0 ■.:Y,Vel L F L. , in Addon 0 Altera:1.; f; L JI,,y CODE: I.R.C. 01.1tC. r Tyr if of Construction: I 13 ID n, V A B 0 rariq Group: A B E F 11 I M at) S U PROTECT COST1VALUE S. - _ -----).-- ,Di victim; !. n 2 4 3 (eNcIuding land) __---____— ._,_----_—_----___ _ —_—_---r-_—_--_------- —.....7 ---____—_--_—,— furnished i infor111e1011 en :his ayt-ftizetittin it ti.:ft r nt tors: of fey i ileis:c.:ter `,:'.:1! sr: .:, ,, cr aWhor:Lt..i 14 --; ' -- e: ;:', Tcr vas! Ihdl ail constrectien wilt :AtAn itt iit: miring ..t: v.'. 1 :3 :lin/: ., ' ';': rmned , 1.3.:1!. .1' . • i - ..: - • ''' -. -- ''' ''.7 tiri..T..- ,..e tl, signatu. ,, No rate , --------------------_--_—___L_ —1_2_...1 :—.----------.----_—_— ----,,-;---. . ..----------r---_—________, r___.--_—_----____...----.„------, P:frnit aluation 1 Ptf,dit uppo --- ----------, 4 5 - ---- ---- 1 — ;- ---------i-------" 5 ,------_—i------_.; 1 Waitti, Nietto: S: .:e 5 5 , 1 5 . _1.---- 5 ----___-_-_---...-__I P!ettrt. Re..:1‘..ictfr $ ---- ---1------ $ L ________— t Sewer Vit:Aft:iit C,.;r:7,f:C.',1:'n Fife .tr --___ 7 "...: rff.'s ir.::: rerrytt Fee I 5 I Water . 1.0Wer r L-----:-- -----------,.--------,-- .•`;',.-.:1...,..:-A:.1": rcrall: Fee 1 $ I Fulkiel $ 1,-.".,!.r.-)511 5 i -- _---__—_ ----____, —_____---_-----_____—___-- stwer & Wa. Ferx.:z Fee S 1 (?rbs:- .47, ? - ---_.--------_-------_. Ga,s Fireptact. Permit Fee I S TOTAL DUE i 5 ---------_-------- L------- —__— _ T ion : comes Your Building Pttn7ir - CI. ---i tin - ort . ! r------ ----- ...--...., - ---- aurint 0 friclal ---------_— Tns 9. l i, „yzItN11)..o elt rcqi.telt sn the 41,0v1: applIcancri zi,,,,kr.tytni ;$ , n 1.,','L'-tar,c11,,t5 tl'.c C ;i it :ttrir.; i1'iiitriance .n . Ma's r:c Z Y. Deq.;t1;5 l'..%i. C;ty Filar,e1 CrratittittX X zerrp.1, Cerneicate of iotehilti, ;:hanix ar,41.1;`,:,,,I.,-r,:,,r,,,..,-:,, ,,, : , , r-,,,,,cr.:., '.. ,c s x-‘11r,er :N. .., 4 .: VIA •,f ),r,, i med ----------- - ----------. _.--,- ._.--- L FixtuungDumtar ---=--------------. 14 hour notict for all imixctiQns (V52i 447-9S54, fa N 0 44' 4.4.4 Mat: ,..■ 4:.rw, et ',..' V Prinr 1 nicis, Mitinesot 1 55312 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 be corrected and system left in service before contractors 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. tt 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 ( td ^ ( a PROPERTY ADDRESS: 14363 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS !OYES ONO EQUIPMENT USED IS APPROVED 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: OYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS YES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 ERNES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 11 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 16 155 RELIABLE F3QR 2011 1/2 1 155 PIPE AND Type of Pipe BLAZEMASTER FITTINGS Type of Fitting CPVC MAXIMUM TIME TO OPERATE ALARM DEVICE THROUGH TEST CONNECTION ALARM VALVE OR FLOW INDICATOR TYPE MAKE MODEL MIN SEC FLOW INDICATOR POTTER VSR - F _/ I 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: ❑ PNEU MAT IC ❑ ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES CI NO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE OYES 0 N 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 MOrWI SI1PFRVISIO 1 ORS Al ARM OPFRATF VAI VF RFI FARE OPFRATF Fl FASE 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 in excess of 150 psi (102 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 -1/2 psi (0.1 bars) in 24 hours. Test pressure tanks at normal water level 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 _p_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? OYES NO DRAIN READING OF GAGE LOCATFF�� AR WATER RESIDUAL PRESSURE WIT VA VE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTIONT5 PSI CONNECTION OPEN WIDE 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 .e YES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN ®YES ONO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED I LOCATIONS I NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ONO IF YFR DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3? ,: YES 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 COMPUANCE 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? BYES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS (DISCS) ARE RETRIEVED? OYES 0 N HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA YES 0 N NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: `? 9, t 3 NAM F SPRINKLER CONTRACTOR: FIRE SUPPRESSION SERVICES, LLC. TEST WITNESSED BY O OWN D) TITLE DATE SIGNATURES / , / "��� _ �� /3 FOR SP IN a ER a . NTRACTOR (S NED) TI LE DA ADDITIONAL EXPLANATION AND NOTES "-to ° 41 t Builders Deposit U ny so 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 'Z SITE ADDRESS: I �3 b'' P rocs < D e PERMIT # /Z • OZ-2" REFUND TO BE MAILED TO: 1-1 1'T �� 4 t-- ES 1.2 a I. w ,& S N- ►1.1 G PO/ S Su vra ZO t 14.k. / 1-1 M SS L3 9 PLEASE REMEMBER 1. KEEP STREETS CLEAN DURING CONSTRUCTION , - . - a — _ 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $50).00 WILL BEF AUTHORIZATION TO RELEASE SIGNATURE: �`-'` — � g' 1 500.00 Lynda S. Allen, Building Services /u•! (. l 3 Acct. 801.20204 Date C:IDocuments and Settings\sbare\Local Settings \Temporary Internet Files\ Content .Outlook1BD80XI9A\BUILDERS DEPOSIT FORM.DOC P R i OR LA" B BUILDING AND INSPE TIgN am File IN R E RD SITE ADDRESS /43`3 Miusva NATURE OF WORK ___StAteg USE OF BUILDING PERMIT NO. • O2 DATE ISSUED CONTRACTOR AkI L1ALD .L! ri .11 , - PHONE ,t'LRfr :-. NOTE: THIS IS NOT A PERMI FOR ANY OF THE INSPECTI • NS BELOW THE PERMIT IS BY SEPARATE DOCUMENT Install erosion control & maintain clean streetsspimall times. DATE I FOOTING J 1 I FOUNDATION (Prior to Backfill) 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Radon system under concrete slain IrrH - INS SEWER /WATER /SEPTIC , FRAMING w f (/�1 ///2c4/ INSULATION ( t jz41' ELECTRICAL PLUMBING HEATING (if required) FIREPLACE ���� GAS LINE AIR TEST frl ./1 7 ladon piping COVER NO WORK UNTIL ABOVE HAS et EN 'SYGNED system, I I Housewrap Fire Sprinkler (" ,(et ( `FINALS '� / �-�' GRADING (Prior to Sodding) BUILDING x. d q t (3 Ole 1077/13 ELECTRICAL PLUMBING HEATING 6b 3(2.2/(1 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