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HomeMy WebLinkAboutBuilding Permit 12. 1171 � �Gy Y.i �' �r i�Y+ur����, °����MV��,: „ m ,? ti rinYv`x��rn '. CI TY OF PRIOR LAKE Prparfluttlf of puitM J n p tt = '''Y Perm f❑ Conditional C.O. Expires'' ylFinal i ssued pursuant to the requirements of Section 110 of the CI Residential / International This Certificate p Building Code certifying that at the time of issuance this structure was in compliance with the various '- ordinances of the City of Prio Lake regulating building construction or use. For the following : ! ° r t m B ldg. Permit No. 1� -117 Use Classification " VN � � � S � R3 Y N! Zoning District Occupancy Type Type Construction Legal Description 17033 KENNETT CURVE S .1' ' .. � S ite Address Owner of Building Contractor's Name I & Address 4 1 ! -p T �� C� ROBERT t1 !4 UTC�3l NS, f C Planner _ Building Official '" 1 d Date: y Date: POST IN CONSPICUOUS PLACE RI 1� r w1 II l i R II I � � i' i :,1 rif�' J1i d" "dliM, �u� � 'p ;,,) ry °1� Yk , � ,i ,r i,w{ + ,,, < :- : ,, , h��U6 �4ti4 r �,� .uMfJ� Ulu „� r u4 C Y � 'r��” k� !"� ' Ga1 "�� �` ,,, � f % r�� 1z � U' J ,_ E i J W ce a Z w 0 2 11J W NI r CO ❑DDDDD O O ui V OZ O N z j W U. L Z �C � m t O W O YYZ � s � � O O V D. kJ �. 0 4 Z 1 . J 0 N d O t 0 OQ < � V O Z z � ===� N 0 a a a. al y \ V 4. =W , \ W W K R rit 0VF- OU `1 W W W Z J W< co .. W U V a�3v�a ,� oc •1 DDD ❑ ❑❑ ■ a a I it Z O w ►� ` %14I \ < \ W .� V Z � W W Z � � ►- � p.. � � .'7 5 U O '� N V OI d' Z O W H 40 V LIJ V .. a. O zpz~ z LL ji, \ L a' Ill c�� V ab N Z ozg O A°0 c a W V W W W Oo "t 2 N O o W . 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V? 0 a a 0000 V V r3 A c DATE TIME CITY OF PRIOR LAKE SCHEDULED iNSPEC TtON NOTICE .)..4.1...3_ -- ADDRESS I r l D 3 � Q Nn..Q"1 • `.. OWNER CONTR. PHONE NO. PERMIT NO. I Z < 0 PLUMBING RI ❑ EX/GRAD /FILLING ❑ FOOTING ❑ MECH RI ❑ COMPLAINT p FOUNDATION DATION ❑ WATER HOOKUP ❑ FIREPLACE RI ❑ FRAM INSULATION 0 SEWER HOOKUP ❑ FIREPLACE FINAL ❑ FIN.. AL 0 PLUMBING FINAL 0 GAASL.INE�AI ❑ SITE INSPECTION R T T ❑ IT ❑ MECH FINAL x=-` C COMMENTS: 0 /( 3 ' - re - z (IS -3 WORK SATISFACTORY, PROCEED ❑ CORR 'T ACTION AND PROCEED ❑ CORR WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector Owner /Contra CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! rxsnan PRI V 0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /0, Z /2. /... „,,,,,, ,„ x• AND UTILITY CONNECTION PERMIT 0 Ti ,.,,..„.... IVI a i 11 lie E $ I Writte Fite 2 p e PERMIT NO /2 / / 7/ 3 Yam Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 171933 KENNETT euellE S1A) LEGAL DESCRIPTION (office use only) LOT2 BLOCK 1 ADDITION Hi GPOry .5 2. ADD pir) OWNER (Name) b. te, 14DA:77)/J, InIC.. (Phone) • (Address) BUILDER (c ompany N D.R.HORTON, INC (Phone) 952-985-7272 Brooke Hareid bmhareid@drhorton.com (Contact Narne) (Phone) 952-985-7806 (Address) 20860 Kenbridge Court, Lakeville, MN 55044 TYPE OF WORIC 91 New Construction °Deck °Porch DRe-Roofing °Re-Siding °Lower Level Finish 0 Fireplace DAddition °Alteration °Utility Connection CODE: c6 01.11.C. 0 Misc. Type of Construction: 1 II III 1V V AB PROJECT COST/VALUE $ 2-lo 1 2.0 1.00 Occupancy Group: A B E F 11 1 M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify that I have furnished information on this application whkh is to the best ot my knowledge true and correct. I also certify that I am the OW114.1 or authorized agent for the above-mentioned property and that all constoietton will conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building official can revoke . is permit faring CAUSC Furthermore. I hereby agree that the city °Bldg or a designee may enter upon the property to perform needed inspections BC605657 x Air it,- z. - , vir Signatur Contractor's License No. Date Permit Valuation 2.... a - - Park Support Fee # $ l 0 0‘) i Permit Fee $ l 7 ( . 5.0 SAC # $ - 2-35 - - Plan Check Fee $ Ill 3 -IF Water Meter Size 5/8“;et $ State Surcharge $ - Pressure Reducer $ 1 CIP' — Penalty $ Sewer/Water Connection Fee # $ I 5 OD. " Plumbing Permit Fee $ I - el . co Water Tower Fee # $ k 0 ec ,. Mechanical Permit Fee $ 1 c A " . r e Builder's Deposit $ k 5 CO, .- "I S Sewer & Water Permit Fee $ 5a, , 5 Oth er t'irs 5, pp (Less ,..,-/ $ t 5 - . 50 . Gas Fireplace Perrnit Fee $ 5 TOTAL DUE $101 4 1 .70 This Appli , on Bet . s Your Building Permit Whe Ap roved Paid iinellriallinErra t No. / \ f / i Date /, I 6 (L. f Z. k ....• .. 11 t ilthtv Official Da Da This is to certif that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as reelltOlCd This document when signed i he • ty ' a' er constituteN temporary Connote of Zoning corn ance nd allows constniction to commence. Before occupancy. a Certificate of Occupancy must be issued i ----_,_ (.4) ( _ fz 'etor .,. Data Special Conditions, if any 24 hour notice for all inspections (952)447-9850, fax (752) 447.4245 4646 Dakota Street Prior Lake, MN 55372 J . _ I i rievi Residential Building Permit Checklist New Construct' • n for Single or Two - family Dwellings in R -1 or R -2 Districts Reviewed by: V___ ,' Date: t o / (7 .... -2, /1 n Building Permit# !'"' Zoning: Pct S Address: 1-, o ;3, 4 (, 4c ( - , -ric -- 6 Legal: L , B Subdivision: Existing Structure? YES 1 NO . Existing Nonconforming Structure? YES I NO CONFORMS TO ZONING NO ORDINANCE Yard Setbacks: NA FAILS! COMS I Standard I Pro po s ed 1 • Front Yard (can be 20' if avg. w /in 150') .2S' .z... ' 2 4 ' 3 1 • Side Yards 101/ 4 25' if abutting a street Z-1' 7o $ mi `'`l a A$ • 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 r•— _ a side lot line. • Rear Yard vakes 46' . • 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. J • 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' Floor Area Ratio: NA / FAILS 1 COMiS I .30 Maximum 1 P051 I . Yard Encroachments: NA! FAILS 1COS I Standard Proposed Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line (Easements). NC and other equipment cannot encroach on interior side yards. - ' Tree Preservation: NA 1 FAILS 1 COMPLIES Standard Proposed • Total caliper inches • Permit 35% Removal • Caliper Inches loved • • Calipdr Igches / P served • Rlacemetti 1/2:1 L :\TgMPkkTE\BLDGLIST.DOC / Driveway: NA / FAILS /COMPLIES • Standard 1 • • Proposed • Maximum width at property line 24' ( 8 • Required setback 5' from side lot line or 30' from r -o -w on comer lots • Maximum slope • 10% 3,.. 4. 4 .g 4 s - - . 5 - • All parking areas to be paved including R -V or spaces adjacent to the garage • • Location to match subdivision grading plan I Building Height: NA / FAILS / COMPLIES 1 35' Maximum Shoreland District: NA / FAILS / COMPLIES 1 , Standard Proposed I Minimum lot area s ' uare feet • 7,500 Rio, 7,999 Non -ri Minimum lot width 50' Rip, 57.3' Non -rip Shoreland alterations Impervious surface j t P n 1 A.b L-6 30% Maximum P JP Bluff in Shoreland: NA / FAILS / COMPLIES Standard Proposed I 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: NA / FAILS / COMPLIES Standard Proposed I • 100 year flood 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: NA / 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 :ITEMPLATEIBLD GLIST.D O C CONTRACTORS MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING PROCEDURE: Upon completion or work, inspection and tests shall be made by the contractor's representative and witnessed by an owners representative. All defects shall be 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. It is understood the owner's representative's signature in no way prejudices any claim for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: Hickory Shores IDATE: 02 -21 -13 PROPERTY ADDRESS: f 033 kenneth Trail ACCEPTED BY APPROVING AUTHORITIES ( NAMES) City of Prior Lake PLANS ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS • YES ❑ NO EQUIPMENT USED IS APPROVED II YES ❑ NO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT • YES ❑ NO IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: • YES ❑ NO 1. SYSTEM COMPONENTS INSTRUCTIONS • YES ❑ NO 2. CARE AND MAINTENANCE INSTRUCTIONS • YES ❑ NO 3. NFPA 25 • YES ❑ NO LOCATION OF SUPPLIES BUILDINGS SYSTEM ENTIRE BUILDING DESCRIPTION MODEL YEAR ORIFICE SIZE TEMPERATURE QUANTITY Reliable F1 44 2012 1/2" 155° 44 Reliable F1 49 2012 1/2" 155° 29 Reliable Dry F3QR 2012 1/2" 155° 3 SPRINKLERS Blazemaster CPVC w/ CPVC Slip Fittings PIPE & FITTINGS 1" Allied XL w/ 3001b Class Threaded Fittings ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST ALARM VALVE CONNECTION OR FLOW TYPE MAKE MODEL MINUTES SECONDS INDICATOR Vane Potter VFS -R O DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. TIME TO TRIP * WATER AIR TRIP POINT TIME WATER REACHED ALARM OPERATED THROUGH TEST CONNECTION PRESSURE PRESSURE AIR PRESSURE TEST OUTLET' PROPERLY MINUTES SECONDS PSI PSI PSI MINUTES SECONDS YES NO DRY PIPE WITHOUT OPERATING Q.O.D. TEST WITH Q.O.D. IF NO, EXPLAIN • MEASURED FROM THE TIME THE INSPECTOR'S TEST CONNECTION IS OPENED. OPERATION ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC PIPING SUPERVISED 0 YES E NO DETECTING MEDIA SUPERVISED I] YES E3 NO DELUGE & PREATION DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS Q YES I] NO VALVES IS THERE AN ACCESSIBLE FACILITY IN EACH CURCUIT FOR TESTING IF NO EXPLAIN 0 YES El NO MAKE MODEL DOES EACH CURCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE SUPERVISION LOSS ALARM OPERATE VALVE RELEASE RELEASE YES NO YES NO MINUTES SECONDS HYDROSTATIC: HYDROSTATIC TEST SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BAR) FOR TWO HOURS OR 50 PSI (3.4 BAR) ABOVE STATIC PRESSURE IN EXCESS OF 150 PSI (10.2 BAR) FOR TWO HOURS. DIFFERENTIAL DRY -PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO TEST PREVENT DAMAGE. All ABOVEGROUND PIPING LEAKAGE SHALL BE STOPPED. DESCRIPTION PNEUMATIC: ESTABLISH 40 PSI (2.7BAR) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BAR) 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 BAR) IN 24 HOURS. 'A ALL PIPING HYDROSTATICALLY TESTED AT � PSI FOR YL-- HRS. IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED 0 YES Q NO EQUIPMENT OPERATES PROPERLY Q YES I] NO TESTS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OR SODIUM SILICATES, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? El YES El NO DRAIN TEST READING OF GAUGE LOCATED NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE STATIC PRESSURE: 7 PSI 7 Q PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFOR CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B I] YES Q NO OTHER EXPLAIN: FLUSHED BY INSTALLATER OF UNDERGROUND El YES El NO SPRINKLER PIPING BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING El YES Q NO IF YES........ DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY 0 YES Q NO WITH THE REQUIREMENTS OF AT LEAST AWS 010.9, LEVEL AR -3 WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED El YES El NO IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A Q YES E1 NO DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS 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. CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS Q YES 0 NO (DISKS) (DISKS) ARE RETRIEVED HYDRAULIC NAMEPLATE PROVIDED - IF NO, EXPLAIN DATA NAMEPLATES El YES 0 NO REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: 5f2/2 0 NAME OF SPRINKLER CONTRACTOR: SUMMIT FIRE PROTECTION SIGNATURES TEST WITNESSED BY ai ' ERTY O WN ( SIG )- TITLE DATE: Z / • _ F IRE PRpTEGT1Oh 7 FOR SPRINK CONTRACTOR ( SIGNED) 77,00e.._ TIT _ DATE: /z /L /3 �� .�/ 04 PRia 4. A c x White - Building Canary - Engineering MrNNESO�P Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT D. k.. / o t: i viLf APPLICATION RECEIVED /0 . 2 ` (2- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: I ©33 176 4-1 j l �7 Q� iU ti£ 7 I (`- P V Accepted Accepted With Corrections X Denied Reviewed By: / 1416 Date: 10- is Comments: See Reverse Side for Additional Information! Aw,:d Q Cove. l d/ 1 444 TT fig+NI *4/ f u 4s ht lute A L A a f 3y fhih t f tta1 17) 14'30144 WJo- '0J1 6tt e "NI, 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." afti 1 , • • • 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 properly installed and maintained Of fence or bales. • •• The'silt fence required 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 is established. • , • • _. The .rock construction entrance must be installed at the time of -iitbackfilling of the foundation. • • • • • • • • • • 4.n 6: \Admin \dept info \ ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS.doc 4 PRi p� h x C.") trf White - Building Canary - Engineering 4-1 INNESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT D APPLICATION RECEIVED /0 ' Z' ( Z The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: / C33 17644 , 17 045 1%���� CA) eA/V Accepted Accepted With Corrections Denied Reviewed By: 1 I i Date: / ° /� �- Comments: / . Cd r t- ,(J s / - ee..• "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." t° 1 Co. PRip� ti Z C.') ny �INNESO) i White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT , + f .' i ::. '' i ;`'' , ' ( f.---/ . APPLICATION RECEIVED f `- • 2, ' i 2 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: t / f J._.. , „;: .d I f / ...! / 1 f� i... ..v.�.. ; �„,,, f . ,.. a ^..I [_, .. / ti. i ` v e .! Accepted .�' Accepted With Corrections Denied Reviewed By: AD f'. Date: /,,, / Z Comments: 1 • "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 RIB Date Rec r CITY OF PRIOR LAKE a - I / �' � i j y I�`` SEWER AND WATER PERMIT 1 f 7 INNESO I 1 1 7/' I)_ -cis l a -11 1. Green File PERMIT NO. i / '7 3- �I77 2. A p p I 1 1 } 3. Gold Applicant / 7 (Please type or print and / at bottom) / i ADDRESS 7 ZONING (office use) X 1 3 3 -/ 70 L -/ I- 1 - i0 ti 5 Goa LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION p OWNER /� (Name) 0- A- 14-01% 1+-01r,,, (Phone) (Address) (Address) (City) (Zip Code) APPLICANT ' (Name) U ...),VI ' . • (Phone) - l $ h L/80- 13 S$ (Address) 9 lG rev, Q.uti►P /44-4-e (Address) (City) (Zip Code) (Contact Person) M 1 kQ /4✓' 1-- (Phone) 6 ix _q i 4 -4 7 1 7 . 4e APPLICANT SIGNATURE DATE / l g— / 2 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 $ .50 r TOTAL PERMIT FEE $ fr°-1 A" (Office Use Only) This t t licatinn Becomes Your Building Permit When Approved Paid Receipt No. I� "l/ ?0,41 0'- 11- 7.1)- Date / Buil 171 Official Date ( — 7 — 1.1_ �� i 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 i Z of P R/04 Date Rec'd E C CITY OF PRIOR LAKE PLUMBING PERMIT d ►INrv> so�� is H ie PERMIT NO, /4_ // 7 I 3 Yellow Applicant Tease type or print and sign at bottom) ADDRESS ZONING onceuae) 1 . ./ • Air .. , LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION LID OWNER (Name) (Phone) - (Address) APPLICANT . (Named )I/ � 1 14.1110I Yl- 4 14.4.4ill (Phone) 1 10 473- 7. (Address) ISSN MAAAAw 4 n ( ) lMtiA In (Zip Code) (Address) (Contact Person) 3 DllikA (Phone) . `1 10 - z. .3 -41g APPLICANT SIGNATURE DATE . i 1 - 15 - I 2. APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture ( Bath Tub with or without shower 1 _ Rough -ins Dishwasher Water Heater I Floor Drain Water Softener Li Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector 2.... Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink 1 Lawn Sprinkler . . Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi- family I% of job cost with a $49.50 minimum Residential, New One & Two-Family S149.50 Residential, Additions & Alterations $49.50 T h e Minnesota Statutes § 326B.148 at s _ 1 . 0 ( o Building Permit # PAID WITH "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ RUIMINP P RAAIT July 1, 2010, until June 30.2011. STATE SURCHARGE $ .50 The minimum surcharge for a "filed fee" permit • TOTAL PERMIT FEE $ is I, beginning July 1, 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buildkut Ov Date - 24 konr notice for W le/pectin= (952) 447 -9850, fax (952) 447.4245 4646 Dakota Street Si., Prior Lake, Minnesota 55372 (I PRi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd e TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT M1�'NF. i. White File PER NO . 2. Pink City / 2 -- 4 Z 3 Yellow Applicant (Please type or print and sir at bottom) r��nia ADDRESS /2- ! /7/ i 17-- —1/ 77 -' / 7 1 - — It 1 3 ZONING (office use) 1 3 .5) r —7a '/l� I I 7DV' / C c., 4V . LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER 0 ,,// / (Name) ii. i L., l/C() 5A.04 e (Phone) (Address) -- BUILDER + (Company Name) Sc.) 4 1 ,4- i 4 ir e_ c 0 t : (Phone) (Contact Name) 6 4- k (Phone) 6 c / - / _ / VT0 (Address) 5 M In ns 1 't 'ta Alit_ l � , s4-, p 4 . , / v'IN s - / 0"5 TYPE OF WORK ❑ New Construction ['Deck ['Porch DRe-Roofing DRe-Siding DLower Level Finish ❑ Fireplace DAddition ['Alteration ['Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. ell- Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 2. Occupancy Group: A B E F H I M ep S U (excluding land) Division: 1 2 3 4 l yy'' 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 rev.. • this permit for just 50 . Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. -.41.001011.e (Q 7 / Z- / 7- / Z x - _. Date Signature Contractor's License No. Permit Valuation Park Support Fee # $ F1,,} Fsa /6Y.5o par U��1� Permit Fee / LS �; �� SAC # $ ) Plan Check Fee lJ $ Water Meter Size 5/8"; 1 "; $ State Surcharge $ Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $NeVt`C Gas Fireplace Permit Fee $ TOTAL DUE o 0 t •s A ' . •c • Be. Imes Your Building Permit When Approved Paid • ti WA, Date �y ,"�� . , , / : , ape. // 1 13 N, f t uildYg Official 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. 'Plus document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of O7cupane -must be issued ,,..-_ ... v Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 /" :4 Y Rxo� ,;;i' CITY OF PRIOR LAKE Date Recd A,, . HEATING/ IR CONDITIONING/FIREPLACE PERMIT H 1 rl.,l;. 0 • 4e 1.r is� P ERMIT N Mat and sign 3. Yell Applicant i1� (Please type or � at bottom) ADDRESS ZONING (office use) \ 1 0 hAA1 at CAM A it c\(11 .Pa-54 LEGAL DESCRIPTION (office use only) LOT i BLOCK / A D D I T I O N / - - f ` /C-,C -1 7 C ' . E e V / 1 ' 4 / 4 4 U PID 7 - 7 i ., ' oR / — d OWNER (Name) (Phone) (Address) APPLIC A.1 1 l (Name) WOk ., r 1 1 � 14 ( —1109)" 4 7 1 - 7-1(61 (Address) Ito J IkkiAL 0 "" t riAI -41 55 (Address) (Citt') (Zip Code) (Contact Person) � , (Phone) ; 1 ti 7 1.5 j ~41 i V APPLICANT SIGNATURE .w° ` .. n.. , , ,L� r • TE 11 - 1 J'2-o) APPLICANT PLEASE COMPLETE BELOW • DNEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT Steam ❑ Wamn Air Plants ❑ PLEASE NOTE: Air Conditioner °Gravity 0 13 Hot Water Units and Fireplaces Cannot Encroach 9 D Mechanical D Radiation Into Required Side Yard Setbacks. oning Special Devices Fireplaces with Box Additions or [(Vent. System 0 Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi- Family I% ofjob cost Residential, Gas Fireplace $49.50 $49.50'minunu n 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 $ ' TOTAL PERMIT FEE $ (onke Use Only) < This Application Becomes Your Building Permit When Approved . Paid Virift No. PAID i Date BUILDING I P Mfl Bundles Orndei Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E,, Prior Lake, Minnesota 55372 I Pit/0 B uliders De•o it 4/11012sdo `it of Prior Lake A $1,500.00 Builders Deposit is included fn the Building Permit fee. `the.. Bulidets 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 gradingf, fended-aping, tree planting, driveways, siding and painting shall be°completed 180" days after the date the building permit is Issued. If the work 18 not cow/plate within the 100 day time period, the pity shall notify 'the applicant-of the viola/Eft and the applicant shall have 10 days to comply or the $1,50000 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 treat are preserved for a period of one year DATE: SITE ADDRESS ' 70.3 3 K-' ,"J''e evfe t/6 PERMIT � / z _ / 1 7 / " REFUND TO Be MAILED TO ; D.R. Horton, Inc Attn: Carolyn Young 20860 Kenbridge Court Suite 100 Lakeville, MN 55044 .., 41 570 .cftt ynda S. len, Building Services Amount IL /7• iY Acct. 801.20204 PLEASE E fr Date 1.. KEEP STREETS OLEAN DURING CONSTRUCTION Lar Poppler, City Engr, 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR X500.00" VIfILL SE FORFEITED. SIGNATURE: , ACCOUNT NO‘ 801-20204 ` BETA INAQE FORFEITURE AMOUNT NO. 32211 AMOUNT: WTHORIZE TO"REI EASE: DATE.' . J t IS Btfl# t .ERS. DEPOSiT FORM.. DEPARTMENT OF P RI R 0 LAKE BUIL11�1 NG AND See SPE T � N�, � � 1 INSPECTION RECORD SITE ADDRESS lo o' e - - , - ,c-A3 . NATURE OF WORK Sc P c I roc. p a ( 2 4 . - + Dac-K tso riN L . L USE OF BUILDING 5, 0 NJ& (-6— F4.44 , , PERMIT NO. '-- ""i Z DATE ISSUED , mAz- 4 2- CONTRACTOR arf• 1- PHONE 2s2-- yes- /8.6 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARA DO �- K"�5 Ls-� �' q eu S CTOR DATE I FOOTING h ,•- Wc__ 1 03 1 4 .7 / l °/ I FOUNDATION (Prior to Backfill) alY ' "'. 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED - INS SEWER/WATER/SEPTIC FRAMING + P•4r2 INSULATION ELECTRICAL PLUMBING / //3% HEATING (if required) FIREPLACE AA15 GAS LINE AIR TEST :K �. Xp.'j V 9 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I CiY - � L,et-IA k ) I /s V C� S� 1 f.„„. S�,�pn. FINALS GRADING (Prior to Sodding) 8 _ y _ ,g E JILDING ELECTRICAL Ft /ZfJI PLUMBING g 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 s ,: .