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Home My WebLink AboutBuilding Permit #12-1172 ��x�� (��r CITY OF PRIOR LAKE „ . � � ��r�z�� ixYI�� x��x�i�a� � . �� . . � � � � . � .. . 1 � � � . . . . . . . � . inal Pernutted ❑ ConditiQ.�a1.C.0. Expires ' r This Certificate issued pursuant to the re uirern��ts of Section 110 of the � Residential / � International Building Code certifying that at the time�f issuance this structure was in compliance with the various ordinances of the City of Prior L�ke regulat� building construction or use. For the following: uSe c�ass��a�on �t NC1 F FAM I L'��<- B�ag. Pe�t rro. 12-117� o��uPan�y TyPe R3 � constru�tion � Y N zoning nistri�t PUSD Lega�vescrip�ion I7R R1 NirKf1RY CEI(1R��,�ECO(Vn--ADj�(� Owner of Building S,teAa�ess 17041 KENNETT CURVE� S'W Contractor's Name & Address �, R-,-.--� Rb-Q-.T�� T-r�r � ROBERT D. HUTCH I NS •-'Ly'v c�ty P�anner ` . rJ Building Official Date: � . 4 . ' N Date: PQST IN CONSPICUOUS PLACE DATE TI6AE CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED � � ADDRESS `'` OWNER CONTR. PHONE NO. PERMIT NO. �� — �r?�G� ❑ FOOTING � PLUMBING RI ❑ EX/GRAD/FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI � SULATION O SEWER HOOKUP ❑ FIREPLACE FINAL INAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST SITE INSPECTION O MECH FINAL ❑ COMMENTS: � G'� � , _ � � , ,� ❑ WORK SATISFACTORY, PROCEED ❑ CORRECT ACTION AND PROCEED Q�,20RRECT WORK, CALL FOR NSPECTION BEFORE COVERING � Inspector: � OwnedContr: -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY! uvsnor, QATE TIME CITY OF PRIOR LAKE p lNSPECTION NOT(CE SCHEDULED J `� ` / � ADDRESS I � C� � � �{�� rZ�" OVYNER CONTR. PHONE NO. PERMIT NO. ��- - l j Z� ❑ FOOTING 0 PLUMBING RI �. EX/GRAD/FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMtNG ❑ WATER HOOKUP � FIREPLACE RI 0 INSULATION O SEWER HOOKUP O FIREPLACE FINAL ❑ FINAL ❑ PLUMBING FINAL ❑ GASLINE AIR TST � SITE INSPECTION O MECH FINAL ❑ COMMENTS: �,u � �`-�� .�=�. ��--�( . n��.z � � �- � � �� ORK SATISFACTORY, PROCEED ❑ CORRECT AC710N AND PROCEED ❑ CORRECT WORK, CALL FOR REINSPECT{ON BEFORE COVERING Inspector. r Y`� OwnedContr. CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH.f SAFETY! lNSHOTI DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 8 � ADDRESS I l � � �.�- OWNER CONTR. PHONE NO. PERMIT NO. f 2"� � ` �" O FOOTING ❑ PLUMBING RI ❑ EX/GRAD/FILLING ❑ FOUNDATION �MECH RI � COMPLAINT O FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI O INSULATION O SEWER HOOKUP ❑ FIREPLACE FINAL �F�NAL O PLUMBING FINAL O GASLINE AIR TST � SITE INSPECTION O MECH FINAI. � COMMENTS: � , t �rc�._ i �n.� z, Se� �- 3, �; ❑ WaRK SATISFACTORY, PROCEED CORRECT CT N AND PROCEED ❑ ORRE T WQ CALL FOR REINSPECTION BEFORE COVERING Inspedor. Owner/Contr. CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY.� �,vsnort OATE TINfE CITY OF PRiOR LAKE INSPECTION NOTICE SCHEDULED 2 ADDRESS I �lO �I ��,-, o � � L9-J'11...2 OWNER CONTR. PHONE NO. PERMIT NO. / Z—I � Z� O F0071NG 0 PLUMBING RI ❑ EXIGRAD/FILLING � FOUNDATtON ❑ MECH RI � COMPIAINT O FRAMING ❑ WATER HOOKUP O FIREPLACE RI ❑ INSULATION ❑ SEVYER HOOKUP ❑ FIREPUICE FlNAL 0 FtNAL O PLUMBING FINAL O GASLIN AIR T T ❑ SITE INSPECTION ❑ MECH FlNAI � � � t'� COMMENTS• �'� .� �� , u2 �, �iM1/ORK SATISFACTORY, PROCEED i ❑ CORREC CTION AND PROCEED Q CORR T ORK, CALL FOR REINSPECTION BEFORE COVERiNG Inspector OwneNContr: CALL 7-9850 FOR TIiE NEXT INSPECTION 24 HOURS iN ADVANCE. CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH dc SAFETY! Lvsnori OATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED � ADDRESS �' 6O"( � �12 [ f�/`�_, OWNER CONTR. PHONE NO. PERMIT NO. f Z-- `( �� FOOTING � PLUMBING RI � FJUGRAD/FILLING ❑ FOUNDATION ❑ MECH RI ❑ COMPLAINT ❑ FRAMING ❑ WATER HOOKUP ❑ FIREPLACE RI O INSULATION SEWER HOOKUP � FIREPLACE FINAL O FINAL �PLUMBING FINAL ❑ GASLINE AIR TS7 ❑ SITE INSPECTION O MECH FINAL p COMMENTS: .L s r �, �_ 2 . (v( 3 � f�.., .�..�,� �, ,�� c'� 5 ❑ WORK SATISFACTORY, PROCEED �CORRECT ACTION AND PROCEED ❑ CORRECT K, CALL FOR REINSPECTION BEFORE COVERING Inspector: OwnedContr. CALt' 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE CODE REQUIREMENTSARE FOR YOUR PERSONAL HEALTH � SAFETY! /NSNOT! ��t�x , CITY �F PRIC3R LAI� BUILDZN� PERI�II'T, I?ate Ree'd ° �y°'` � � TEMP`4RA�tY �I�RT��'ICATE U� �t}1�tIt�iG GCfMFLIANC� � �� y°� /v. Z.C?� � � �; A�r�+ u�r��.,��r� �or��c�rzaN r�c�i� U �� „ , » . -� � �� NESti � � ?4:.. � � �� Whnt ki4e P�RMIT N(J 2 ' . .� .� .:�.r� �. � �;� C�� 7 Z � vti�+�, a�yn�fl� Please or 'nt and s� r� at bottom : � :A1I7T?tt�S� �.'�NTF+�{'.yr E�ec� usc) � E �t/ � Sl,�/ ' LEGAL D��.Itll'T�t7N {ot3icc ��se anty) _ �.Q'T"`28�LC�!CIC � AU1,�ITI�N �1G-�p Z�d ,� PID QVf�I'�R (T�Tame} �, l�, �IZ-TO/�1 ,, �/�1�G �PM��) (Addressl Bi:i�t.ri?EI� : ��,�y�� D.R.HORTON, INC � 952-985-7272 � . �1� � v �� Brooke Hareid bmhareid@drhorton.com ��,�� g52-985-7806 '��,,d,dres�) 20860 Kenbridge Court, �akeville, MN 55044 TXP�;t)F �i�RT£ � Netv et»tstructit�n (��?e�l� (,�P�a'rcfi ,. [�Re•Rr►�fit►g [jIt�-Stding [�I.crwcr �tu�t Finish (� Firepla�e _ �Additian QAltrr.�n �UEiiity Cc►nncetior� ' Ct�L�E: �I.R.!C. �I,B,�. � I+�isc. T�pre vf Constnretton: I It �t�. P�' � A� �?t�tpancy C�m�rp: A I3 E F I� I M I� s u PRtJ�C�' �C�S�"lvALU� $ Zd $��SS .DD Ilivisio�: 1 2 3 �' 3; (ex+�tud�ng land} . I lirrrt+y cirr�iCq �hat t haa� fumishe�i uMformn#Ean c�n this app9ic�t�un whieh is tn the bext of my l:nowic�tgr �nie �n�#:ct>r�'�+�t. l ats� rcetify that t am thr c>wircr �yr authanzrd agrnt: €� ihe abow�-menpwzed �rrc�pert�* and th�[ a!! crsnsteYretibn wi#! �onkum ta alI rxisting state and tarat laws and wili prc:ceed irti accaiAanec wuh submit�rd p�ins. E arn a�va#e that ttu Duitding , �>�l�iat csA revu3�-e fl�u �€rmi �c�ust caasr �cirthe�marc; I h�c�by age�e;yh�t etrct�� afE'�ri�ke�F a des,ig�e� m�y �nE�r upan 4ltetprapetsy cp pertarm t�eedct!'uis�iccttuns. � BC605657 /D - 2 -[ Z Stgnacure C�ntractur`s F�tG�nse �IO: 13ate Permit Vaku�tion Z O D 6.�" Park S�pt�rt Fee #' � Permir P'ee $_ l O ' l 5 '� D �.AC � � Z 3Cos — F1�n Chrck F� � ( D ° e �3 Water Iv�et�r Size 5!�"; , � s C9. _ Stat� Sumharge � � C7 . —c� Pressurre Reducer' : � � �enahy $ Se�uer�l�Vate� �`t�nec#ion Fee # � � . _ . 'Flu�nbrng I�et�trai€ Fee; $ � s- . � �a�er Trn�r �*�e # $ � � _ Mecha��icat Pertt�it Fee $ � 5- —� Builder's l�epasit $ • � �ewer & W��er t��it F�'ee � s(o . o C')the� K t on� � I o. Gas �'ireplac� Permit ��ee � . � `�C7TAL �3UE � . Tl�Is App tia � s o r Bui1dl�[ig Permit Wh�� P �+� I''dtd ' 1�.�C t Ncir� I3�te / � �-'' B t e � /L � t�itr�t � �� t�tii��a � - '�'I�ex �s cu �rrt' �,atrt c Ee 1 i� tt • abo�� p�tic�tcctw ��ct a_rmmpar�yiag dacaments is i� accortfaaceu�i4h ihc-��tp �nclin�f7�rciinanc� and mag��.v! a} crqua��rd. �'bi� d!�'u�ent wlcsxi si�� rc tp F rr tatcktes a cem�arary Crr�i�eate oE Z�ning rnpfi� c and �lt��vs can3EruGliAn Ciz camFnenc�. �etc�re crcc��ras�cy i1 �CftlCiCrll�' qj QE{tIG�1lCY' ftltCi� �C tiSUR'A r� �Z /�L- A�rtni�g rector L)ata 'S Canflitic�ns, if an 24 Iiuiir noiicr far a�lt ii►s�rctians ('3S�) �47-�850, fi� {J�2} 4J?.�2�& 46�16 Dakc�t� St�et Pr�ar La�,.MN 553T2 CONTRACTORS MATERIAL & TEST CERTIFICATE FOR BOVEGROUND PIPING PROCEDURE: Upon completion or work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be 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 for faulty material, poor workmanship, or failure to comply with approving authority's re uirements or local ordinances. PROPERTY NAME: Hicko Shores DATE: 02-21-13 PROPERTY ADDRESS: / p kenneth Trail ACCEPTED BY APPROVING AUTHORITIES ( NAIv1ES) Cit of Prior Lake PLANS ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS YES NO EQUIPMENT USED IS APPROVED � 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, EXPLAW 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 F144 2012 1/2" 755° 44 Reliabie F149 2012 1/2" 155° 29 Reliable D f3QR 2012 1/2" 155° 3 SPRINKLERS Blazemaster CPVC w/ CPVC Slip Fittings PIPE & FITTINGS 7' Allied XL w/ 3001b Ciass Threaded Fittings ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST ALARM VALVE C:UNNECTIUN OR FLOW TYPE MAKE MODEL MINUTES SECONDS INDICA70R Vane Potter VF&R 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, EXPLAW ' MEASURED FROM THE TIME THE INSPECTOR'S TEST CONNECTION IS OPENED. OPERATION � PNEUMATIC � ELECTRIC 0 HYDRAULIC PIPING SUPERVISED 0 YES 0 NO DETECTING MEDIA SUPERVISED � YES � NO DELUGE 8 PREATION DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS Q YES Q NO VALVES IS THERE AN ACCESSIBLE FACILITY IN EACH CURCUIT FOR TESTING IF NO EXPLAIN 0 YES ' Q 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 (2.76AR) 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 (0.7 BAR) IN 24 HOURS. ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR Z- �/ HRS. IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED � YES � NO EQUIPMENT OPERATES PROPERLY � YES � NO TESTS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSNE CHEMICALS, SODIUM SILICATE OR DERNATIVES OR SODIUM SILICATES, BRINE, OR OTHER CORROSIVE CHEMICALS W ERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS7 � YES � NO DRAIN TEST READING OF GAUGE LOCATED NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE STATIC PRESSURE: PSI _� PSI UNUERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FWSHED BEFOR CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. SSB � YES � NO OTHER EXPLAIN: FLUSHED BY INSTALLATER OF UNDERGROUND � YES Q NO SPRINKLER PIPING : BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING 0 YES � NO � IF YES........ . . . . . . . DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT W ELDING PROCEDURES COMPLY Q YES � NO WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3 WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED 0 YES 0 NO IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3 DO YOU CERTIFY THAT W ELDING WAS CARRIED OUT IN COMPLIANCE W ITH A 0 YES � 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 � YES 0 NO (DISKS) (DISKS) ARE RETRIEVED HYDRAULIC NAMEPLATE PROVIDED IF N0, EXPLAIN DATA NAMEPLATES Q YES 0 NO REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: .� Z 20 / NAMEOFSPRINKLERCONTRACTOR: SUMMIT FIRE PROTECTION SIGNATURES S WITNESSED BY �� FOR PROPERTY NE ( ) TITLE D ' �✓.' Z �� N s , SU FIRE PR T6GT10 � FOR PRINKL CONTRACTOR IGNED) TITLE DATE: m', . � � Z. ZO( 1 � � i . � o ,� p�f CITY OF PRiOR LAKE Date Rec'd � �, HEATING/AIIt CONDITI4NING/FIREPLA�E PERMIT ; � � � � ' � i: � cu PERMIT NO. /� —� I 7 ( 3. Ydlo�r ApP%ceol f Icass e or t and si a at botb� ' ADDBESS ZONIIVG (o�ice �e) ' �7 � �'��h �cc �c�e .5 �iV �i�;�la : � LEQAL DESCR]PTTON (otfMe use only) LOT BLOCK ADDYTION PID OWNER (Phone) `1 ° �� / �� (Name) ' ' c��ss> 2U C.[� �C�Yt�° e-f— f l� APl'LICANT �; G n� �C�� ( ��"" C�� — ��/ (Namal � _l__l��f�-e�,�`T� `P {Phone) ,,Q . - cA�s, Z�ZDD ��irt�i� �� A� 1V ��'t�ill� ��J/U 5��r� � tAaaress cctty� cz►� coa�� {Contact Person) l "e�Y ! �- �� ^ j/ (Phane) � ; APPLICANT SIGNATURE DATB / � . ; APPLICANT PLEAS� COMPLETE BELOW � EW CONSTRUC['ION ❑ REFLACEMLNT ❑ ALTERATIQNS ; FUR[�TACE MAKE AND MpDEL FUBL �L' U8 SIZE RE'1 CtRN OPENINGS iNPUT OUTPUT TYPE UF SYSTEM HEATII�TG �R POWER.PLANT � PY.EASE NO'PE: Air Cont]itioner QWarm Air Plan#s ❑ Steem Un9ts and �Ireplaces Cannot Encroacri �]Gravity ❑ Hot Water into Reqnired Side Yard 5etbacks. ❑ ivlachanical ❑ Radiatiom Fireplaces wltb Box Addi�ions or QAir Conditioning ❑ Special DCt+iees ❑Venk Syste�n ❑ pthex Devices Cantilevers to the Outside ot Buildings Require a Buildiag Permjt. . FtREPLACB MAICE AND M4DEL I�E SCHEDULE Induatrial, Commereial & Multi-Family i% of job cosf Residential, Gas Fire�lace •$49.50 ' �d9.50 minimum �,�rD wiTt� 99.54 Itesideniial, Ffeating 8c A/C (I�lew Construction) S 149.50 Residential, Additions & Alter Residendal, Haating Only (New C,:on�iruction) $64,50 Residendal, AC Only Bu ��' ��` F9�� Estimated Cost $ Buildin$ Permit # `flie Minnesotti Stututes � 326[�.148 HEATING PERMIT FBk $ "��RChIARGF° has bcen e4iunged ror ona yenr effe�tive STATE SURCHARGE $ .50 .lniti� I, 201U imtii Jonc 30 2U! 1. TOTA,I., PERM[IT FEE $ Tl�e minlmu�n sorchnr�e for o "tksed fcr" perm�t (OPlice Uee Only) Ls �,,�. bcginieing .hity 1.2111U This Application Becomes Your Bu�ilding Permlt When Approved Paici Receipt No. - Date RY - Bpildtn� Officixl Dato � 24 hour notice for all inapections (952} 447-4850, faz {9S2j q47-42�5 . 4646 Dakota Strcet S.E., Prior Lake, Minacsots 55372 � pRip Date Rec'd a,� � CITY OF PRIOR LAKE PLUMBING PERMIT h � � �� '. B '"` �''` PERMIT NO. 2. GoW Ciry � /�� // 7� 1. Yellow Applipnt lease ar' t and at bottom ADDRESS ZONING (oR'ice use) I �� I �� - C.�.�r�. ��•t LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLIC `� (Name) �(�(�� U � lllh � �IVIh (Phone) � � �J ' 4 `T,� -��'1 (Address) � (Address) (Ci (Zip Code) (Contact Person) (Phone) `�(�� Z53 - �� q � APPLICANT SIGNATURE DATE / / � '' - /7 APPLICANT PLEASE COMPLETE BEL(?W uanti T e of Fizture uanti T e of Fizture Bath Tub with or without shower Rou h-ins Dishwasher Water Heater Floor Drain Water Softener Lavato Bathroom Sink Stand Pi e Washin Machine Laund Tra 1 or 2 com artment sink Sewa e E'ector Shower Stall Backflow Assembl � Sinks Backflow Assembl Test Bar Sink � Lawn S rinkler �, 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 Estimated Cost $ C�q � g.o o Building Permit # PLUMBING PERMIT FEE $ � �� STATE SURCHARGE � ��G PER��lI�` TOTAL PERMIT FEE $ �om� u� ooty� This Application Becomes Yonr Building Permit When Approved Paid Receipt No. Date By Baildin¢ O[ticial Date 24 6our aotice for all inspections (952) 447-9850, fax (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Mianesota 55372 o � r_Rr Date Rec' � � � �,� �. CITY OF PRIOR LAKE � � � I � / � � ��i 1�� SEWER AND WATER PERMIT 1� 7�'� � �� I� 1 I �/` �� l� ��- -1�? r � —7 �: Y� �;�. PERMIT N �/�7 lease e or rint and ' at bottom �� " ' ll !� 3. Gold nPPi�car,� ADDRESS ZONII�TG �ofl�« �� a 3 - t �a �-ll - tZo �S �;� LEGAL DESCRIPTION (ofl�'ice use only) LOT BLOCK ADDITION p� OWNER (� � � (Name) _ t/� �- �� (Phone) (Address) (Address) (City) (Zip Code) APPLICANT (Name) �� S. �_��-t • (Phone) -� F - ySd-- l3 SS (Address) a'"� ��o ��Q.u,d.P � (Address) � (City) � i kQ A — (Zip Code) (Contact Person) /'K' (Phone) � / a- —9 l q - '�i/3'� � APPLICANT SIGNATURE DATE l � �— / 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'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 # f � SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ ,Sp �� TOTAL PERMIT FEE $ ��-' s C,✓ � (Offfce Use Only) - This Becomes Your Building Permit When Approved Paid Receipt No. c,,� . / �,G� s�i� aotrtc�ai � nace '� Date t �.._ r � By /�/'� I -_% . 24 hour notice for all inspections (952) 447-9850, faa (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 o � x�x�t��, r � C�TY OF PRICIR LAKE Date Rec'd � �. HEATIN IAIR Ct�ND�TIUNiNG/F�REPLACE PERMIT /�, �3 ,/ j v f� . � -- ''1''fMv�so"��' i: � c� PERMIT NO. l� � I/ v 7 3. Ydlav AppRiaat -� lease or t anrtai at bottom .A,DDRB$S , _ T,.C►1�IING(offiawe) ' 1' v� � � _� �'v� LBGAL DI3SCRIFTION �oS'ioe use oaty) _ G �� / . : ` LO�D BLOCK � AI7DITIt7N /`° � GK O S�p/2� �!V A PII) - 5�� -�O Z�� . .. ...�.. ,, ,..: � .: . - _ _ �_.._, _..;:�:. ...A.e � �"'�"t+1�SR. �..� __ �. � � v_m.�.�� . �,,e. �:_ � � � _...:_---- ��, �v��. _ ,�. _ n. � .. ..., � ��.__,.u....kmri.�W (Phoae) � _ �.� � . x. jAddress) .�'PLICANT � (Name) '� `�' � _ {Plwne) ,�Q�' '� � •`L2�'� ' (Aaa�) � ' � s�� t�� t � � - � �� (Contact �ersan} (Phan.e) �.�� ` ��' T'� � 1 ' APPLICANT SIGNATURE . DATE �� .f1 I APFLICANT PLEASE CCIMPLETE BEL4W . CINEW GUNSTRUCT�AN ❑ RSPLACBiVSLfi1T ❑ ALTERATTONS , FURNAC� 1VfAK� AND MUDEL _ FUEL _ FLU� SIZE RETtJRN O�'LNINGS INPUT OUTPUT , TYPE OF S'Y'3TEM SBATIl�'l'� OR PUWER PLANT ' — j� Watm ,Au I'leats [� 5taam PLFASE NOTE: Air Conditloner CI��Y ❑�Tot Water Un#ts �nd Ftr�rlaces Cannut Eucroach' ❑ Mechnnical ❑ Radiation �nto Re�uGred Side Yard Setbacks. pAir Conditioning ❑ Speciat Devices Fireplsrcce'cvi#6 Bo= At�dttions or OVoin� Syst�n ❑ Uther Dsvices Cantitevers fa t�e 0�tskle of Buildtngs ' Reqaire a Buitding Pe�rmi#. FIREPLACE MAKE i�l�i3 MC1i�8L _ ' FE�SCAEDULE Industriat, �ommerciat � Mu1ti-Family l°Jo of,iob cast Ro�ident�al, Gas' Rirapl�e 549.50 � 549.50 miinImum Resideatial, Haatiteg �t AlC (l�tew Conskructiun) ; $149.50 Reeidential Additians & A1tt�rations �49.50 Rcsidential, Hea6n� CAa�y (New Constxuction) �:SO Resid�tial, AC OniY ` 549.30 Estimated Cost � � Building Pet�nit # � HEATING PERMIT FBE $ � • �� , �._.W.�_�,, �_ _ .___..�.__. , .,,�-�- - — __�T.�1,�.'E�a�'R.��tiGE_,�—_$". r .�_ ._. m..�. _ ;S�i._..�._: _ �. ��_ TOTAL PERMIT �'EE- S ' {omcc iJ.e i�ary) . _ _ _ _ :,:� � This APPitcatl�►� Becomes Your Batltling Permff'�f'hcn Approwed Paid : �� ¢� � t � ;I)ate _ By , � Bu�Qinq OifficW Dxte 24 6onr nattce far �11 inspeetione (952) �{A7 985b, f� (952) A47-4?AS; • 46�46 Tlakata Street S.E;, Prtor Lake, Minncaota 55372 Q'� `�*��*�' : ��. ; � � � �.�.�.�� : ��' ��` �� '%��` ��'+�. �-��,�SQ(1�� Hyitt�er�s .t3'a�� it��c�tn Axe 8t�4fit� F�� +s�� ;�f�'��1�d�rra [Jepo�i� (� ��e� �,�aur�r t�• �� w�plia�a+a 'f�� a �inal .oacupanay Reimif. (�t' ti� F�c►� ��► ��+tr.�stn# ) .RH �x�set�� r�at+'►s i�c�udta� bt�t �t limit�tl #e�.��ac� s�dir��; �rf�ti��.t�ee P�ara��rg, c�r�re�� iding ��a�(,�Sai�t� �n ��nr�eied t��`a��r #h� �Eat�'t�e.�u}r�li� perrt�i[` t� r�u�� t� f#�°�it�tc �� e�rt�t c�d�a: wlthln #h8 t8tf d�y� ttrne par��i�, t�►e ��Y'�#�all' aci#i�+ the �p�tf�►t �f t1t� +vtt�f�tt�i ar�d t�r� a(��'t��t ahs�tl I�a,ve t6 �"� acr�nplY +� Yhe' $1;6t1�}.4I� k�uit��rss de�sostt c�►tt:� ��f�1�#Ytl,�r�d �+� a�p[�� wtlt b� b�i�a� for c[ean up vr�arr+�lv,�: wo�k, te��tify thersiittat�vee� : 11<S5Q0.0�1 Tre4 Depo�it:may �t�s� be Cet,�latlr.et[�rr�d xtvl�G#�s �fu�tl�tt � s{�sai�te�d't�d� er� p�'��rerve� it±�r �i�p8t'� pf �sn8 �ar., ��: _, . ._ _ '��T`� ,�1E�£�'t�'.�� ?C� �/ �/t/i�-l�� U/z✓Y� P��'' :�:r l Z. l I 7 Z '` � D.R. Horton, Inc Attn: Carolyn Young ��ll[�1#� Tt� �'�1�1.�� `E';��; _ 20860 K e n b ri dge Cou Su 100 Lakev NiN 5504 _ � �� i� �� ` -., `� �� .�G1 C} , C;U . Lynda : Allen, Building Services Amount �� 2 -'«" Acct 801.20204 j .. �� c�'�� .�:��"�� Da1e �. �4�E�'` ��I` �`Q�"��L ��i �l:.�i�' _ _Y._ _ ,..��R :e:c�:�_ .�tX-- x��e r �a. TE��R�fi'� U:G�P��t ��fi ��1�7" I�t' ��P'tR�: C�Ft ��:+�' �!� �E ��RF�i�"�► ��1��"�'�� . . , , .. . �t�k.��'� ��.. ��:��€ R�T�kI�� A��'�;� 1��T I� ;�� 1 �t�1J��t�`; �.U�H?�#�J�'�'��t.�i�� , y E��'��:' ��:�� t�� "�� r D�ARTMENT OF P� I R LA K E BUILDING AN NSPE T �� .� � -�� x� � l�� IN PE TI N RE RD SITE ADDRESS t�o 4� K�NN�=rr C ��vc.� S. �� NATURE OF WORK SF p+ I,��. �. + fiN�� . . �� o Po�t USE OF BUILDING �r��.,.G F�nn�� PERMIT NO. �Z- <« 3 DATE ISSUED �• ,z �� CONTRACTOR p •iz • r�•�-�-a� PHONE_asz - `i�3s- - �8� NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW T E ERMIT IS BY SEPAR T D CUME T �c ' J `�`� � �j" j7A4�.' � � �I�" C" _ • `- C� �� DATE FOOTING FOUNDATION (Prior to Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S1. NED ��Ap9a �- U G H- I N S SEWER / WATER / SEPTIC FRAMING f P�a„�. c�,,,,�� C I2�' i� � � INSULATION y /.? ' ELECTRICAL PLUMBING � �3 HEATING (if required FIREPLACE GAS LINE AIR TEST 1M !� g .r 6� NO WORK UNTIL ABOVE HAS BEEN SIGNED F�n,�- S J(�P�-u�SS(6� F INALS �iADING (Prior to Soddi $ - _ 3 BUILDINC j p 1 �it� . 2- ELECTRICAL PLUMBING � � , HEATING ?j � �/�� DO N,OT OCCUPY UNTIL ABOVE HAS BEEN S GNED J��//'� k�-c�/N,�G N OT I C E�� 5�z/�3 This card must be posted near an electrical service cabinet prior to rough-in inspections and maintained wntil ail lnspections 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