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HomeMy WebLinkAboutBuilding Permit 11. 1038 / AAAAAA AAAAAA. AAAAA AAAAAAAAAAAAAA. K (grrftftxafr trf Orrupatir r X CITY OF PRIOR LAKE ! nzrfnnnf of utUbtng clnsprrft.an '. ❑ Final Permitted ❑ Conditional C.O. Expires K This Certificate issued pursuant to the requirements of Section 110 of the CI Residential/❑International 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 ' . ' k 1', _ , _ ,4/A /,.._-P � �� t Bldg.Permit No. �J ' Occupancy Type Type Construction 'n Zoning District I•(/ ' Legal Description L t ' l � \1_, ) � ) ,1 t i' Owner of Building / / - % '-.1' r` Site Address / �b ! 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Pink File PERMIT NO. ii 3 rink ,, /03 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS 14' 4 1 1')..-12_v-S t 0— c O v ti)-t ZONING(office use) POD LEGAL DESCRIPTION(office use only) LOT S b BLOCK L ADDITION ,-..\ -F--- F t2-', I...r P. 12 "P CZ'o N-r PID ZS t-1 1 $USG O OWNER �S2- - c6 92)- Z t o0 (Name) `1 A T 1\1''t�` -I-1- 0 N1 e-S (Phone) (Address)12e t 1!\_/A S t--1-t t-1 6—t u i--I. A 'E. S STE 2..47_, t GO t 1-.1 4\ M N SS 43 9 BUILDER (Company Name) t'l F i U Fl E S S(Phone) 2— `a 9 t ) - 61 2 (Contact Name) S U (Phone) (Address) l'2-c.) 1-",tk S 14 11,4�`�N pc va S S"1 >_- 7 «I t-O t t.1 1 M I.-1 SSL-139 TYPE OF WORK jg New Construction ElDeck ❑Porch ORe-Roofing ['Re-Siding ❑Lower Level Finish ❑Fireplace ['Addition ['Alteration ❑Utility Connection CODE: I1I.R.C. ❑I.B.C. 0 Misc: Type of Construction: I II III IV V AB (� 0O U G Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ 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 ant 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` t-•..,.__ --,---e_. BL 2C)31 Sag f:::, `) (221`zit t Signature Contractor's License No. Date' Permit ValuationPark Support Fee # $ ((v®tO . Permit Fee $ 14 t3.ee) SAC # $ Z- z Plan Check Fee $ a .- Water Meter Size'; 1"; $ CQ i b State Surcharge $ SO. .- Pressure Reducer $ 10- Penalty $ Sewer/Water Connection Fee # $ i Svp-_ c_ Plumbing Permit Fee $ t S4,So Water Tower Fee # $ . pve_- Mechanical Permit Fee $ t 5-zt0 Builder's Deposit $ (5-00-- Sewer&Water Permit Fee $ Other $ (2,yo ° t, /5-4,66 Gas Fireplace Permit Fee $ 5-4 5-0 TOTAL DUE $ f9/6!70 This • •plicatio, :ec•,, s Your Building Permit When pproved Paid y 9/4- 71 R ipt No. (,1-4 Z Date /C.). S. I/ B • A �1 ' ./LA __ i o 3 /l' Building Office Da e This is to certify that -req A in the above application and accompanying cements is in accordance with the City Zoning Ordinance and may proceed as requested. This document when s•t,'-d by the i P P. •+ constitutes;temporary Certificate of Zonin co fiance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issue. Planning:• - 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 Residential Building Permit Checklist New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts Reviewed by: 4 / Date: /073/0 ‘i 41Lomilla Building Permit# ° I: Zoning: L-)- Address: k34-� , T3, 4 5, 4-/ {7. to 5 tc C Legal: L 53-'1. , B ( Subdivision: ,.6.1i•c. �c� Fyl,wcr-- Existing Structure? YES Ni Existing Nonconforming Structure? YES I kg) CONFORMS TO ZONING la NO ORDINANCE Yard Setbacks: NA 1 FAILS/CO PIIES Standard Proposed • Front Yard(can be 20' if avg.w/in 150') 28'--roc 'ZS_ c:- • • Side Yards la<-tt,t. v V"-t)c. -1-1117.2.10t , 25' if abutting a street _ No 1..-9m C. Att- PAANNt.BA..c td k.©‘ • 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 '2.1Pup � , 6121 • Patio Door: provide for minimum 10'deck or sign 10'side/ statement indicating no deck will be built in the future 25' rear l • From 100 year flood elevation of wetland/NURP 30' —1®- 2-- pond. 3 -- • 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: NAI FAILS/COMP ES I .30 Maximum 1:>u o I Yard Encroachments: NAI FAILS/CtIES I Standard Proposed I Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line(Easements). A/C and other equipment cannot encroach on interior side yards. rat -T' 0 5 Tree Preservation:c /FAILS I COMPLIES Standard I Proposed • Total caliper inches • Permit 35% Removal • Caliper Inches Removed • Caliper Inches Preserved • Replacement '/2:1 L:\TEMPLATE\BLDGLIST.DOC 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 2-27-12. PROPERTY ADDRESS: 14341 PARKSIDE COURT ACCEPTED BY APPROVING AUTHORITIES: CITY OF WOODBURY ADDRESS: PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS EYES ONO EQUIPMENT USED IS APPROVED EYES ONO IF NO,EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS ®YES ONO TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO,EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: EYES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS ®YES ONO 2. CARE AND MAINTENANCE INSTRUCTIONS ®YES ONO 3. NFPA 25 ®YES ONO LOCATION ENTIRE BULDING YEAR OF TEMPERATURE MAKE MODEL MANUFACTURE SIZE QTY. RATING RELIABLE RES 49 2011 1/2 12 155 SPRINKLERS RELIABLE RES 44HSW 2011 1/2 12 155 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 ( 4'k DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE TIME TO TRIP TIME WATER ALARM OPERATING TEST THROUGH TEST WATER AIR TRIP POINT REACHED OPERATED CONNNECTION' PRESSURE PRESSURE AIR PRESSURE TEST OUTLET' PROPERLY MIN SEC PSI PSI PSI MIN SEC YES NO W/O Q.O.D. WITH Q.O.D. IF NO,EXPLAIN LOCATION MAKE& SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE &FLOOR MODEL (FLOWING) PRESSURE REDUCING INLET(PSI) OUTLET(PSI) INLET(PSI) OUTLET(PSI) FLOW(GPM) VALVE TEST N/A OPERATION: ['PNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETACHING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE OYES ONO CONTROL STATIONS DELUGE& IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT IF NO,EXPLAIN PREACTION FOR TESTING VALVES OYES ONO N/A DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MODE! St1PFRVISIO11 I OSS AI ARM OPFRATF VA VF RFI FASF OPFRATF Fl FASF YES NO YES NO MIN SEC HYDROSTATIC: Hydrostatic test shall be made at not less than 200 psi(13 6 bars)for two hours of 50 psi(3.4 bars)above static pressure in excess of 150 psi(10.2 bars)for two hours Differential dry-pipe valve clappers shall be left open during test to prevent damage All Aboveground piping leakage shall be stopped. TEST DESCRIPTION PNEUMATIC Establish 40 psi(2.7 bars)air pressure and measure drop,which shall not exceed 1-1/2 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 2 HRS IF NO,STATE REASON DRY PIPING PNEUMATICALLY TESTED OYES ®NO 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? DYES NO DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION TESTS TEST SUPPLY TEST CONNECTION , PSI CONNECTION OPEN WIDE Y‘..„ 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 ®YES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING ®YES ONO IF POWDER DRIVEN FASTENERS ARE USED IN EYES ONO IF NO,EXPLAIN CONCRETE,HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS 0 WELDED PIPING OYES ®NO IF VFS 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 COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISC ARE RETRIEVED,THAT OPENINGS IN PIPING ARE SMOOTH,THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED,AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? ®YES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS(DISCS)ARE RETRIEVED? ®YES ONO HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN DATA ®YES ONO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: ?-2 7-i 2- NAME OF SPRINKLER CONTRACTOR: METRO FIRE PROTECTION TEST WITNESSED BY 0 '•' R •) NER ISIGNED) _ TITLE �— DATE SIGNATURES �,/!� �SQ� 2/27 1,-2-- 44--- Z .E0R SPF1IN L •tj TRACTOR,(SIGNED) • TITLE DATE / 1 !`�4 . _ 0LovoLi KAT---1,7Z Z7—12 ADDITIONAL EXPLANATION AND NOTES Zu - O PRI3N 8 'Yx U trl White - Building yI �P Canary -Engineering NNESO Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT V1 rsciTIA my APPLICATION RECEIVED q t 7_-3 - ( I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 1434-- 1 PAIK--4 -St D6 . Accepted `/ Accepted With Corrections Denied I Reviewed By: /1-4/4 l'� Date: (0 4 I I Comments: C-0141140 Le-OS let✓ /I1 /i/ c-" et...e-p.i - rA-6 4 _ 4 7T, ic . "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." ( FRJ p4 ti U rn White - Building 44 •c Canary -Engineering "NES°...) Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT t1 /1 My APPLICATION RECEIVED 7 . z,-3 , 1 I 1 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: { 4-34- I FA ---S 0 --e, .--i• . *tic/ude, /1/3113/ 14'31/S 4- 11/3z/7,rksae e Accepted )( Accepted With Corrections Denied // Reviewed By: -.771-C_ Date: /// Comments: See Attachments: 1) Grading Plan, 2) Erosion Coral Wasures See Reverse Side for Additional Information! "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." of PRIp� White -Building MINNESO'tQ' Canary -Engineering Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT V ° �. ' 1 i C APPLICATION RECEIVED f 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: I 0 ill 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." -71 il � PRlp I,I � ',._33 teR 'W .r , CITY OF PRIOR LAKE PLUMBING PERMIT <, Yc-. - � " nI OCT 172011 v r x EJi.J 4 41 NESn�� ' I.aloe Fie I VI)"'`3 - %; 2.Odd Cay , 3 Yellow Applienp �__ n(Plcase type or print and sign at botto) — ADDRESS ZONING(office cl \ in �.)\\ %ac Y.s Nrl._. - Num LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER ' — — -(Name) ' __,,. . -. i. Ill.,$I . (Phone) (Address) ----- - — — -- -- _ APPLICANT ij '� t, ).__ :., . .t A04 _ (Phone) 619.)\,--i-to-, •' W v (Name1 (Address) 091)" liI f t- P ___.-. _ _____ '.-..A1,',')",,'K-•s11\k‘fi1 5532-2) _ (Address) U (City) (Zip Code) (Contact Person) le-,0 at..., Rai f tz t4 (Phone) "[C-R)• l0)- • k `(1-' APPLICANT SIGNATURE e'' �• � 1 r 1 )W.AA . DATE ' D A ( i_-L . APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture --) Bath Tub with_orwithout shower Rough-ins Dishwasher tWater Heater �^ 1 Floor Drain Water Softener ___ Lavatory(Bathroom Sink) _Stand Pipe(Washing Machine) Laundry Tray_(1 or 2 compartment sink Sewage Ejector D Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler L "- Water Closet(Toilet) Other FEE SCHEDULE Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family S 149.50 Residential,Additions&Alterations $49.50 i •The Minnesota Statutes§326B.148 - estITD5Building Permit# 'Sl1RCHARGS"has been changed for oac year effective PLUMBING PERMIT FEE $ l .9) PAID WIT ,i July I,2010.until June 30,2011. STATE SURCHARGE $ S.01.) I ie minimum surcharge ror it"fixed fee"permit TOTAL PERMIT FEE S J"1 , -1) EU HLDf1 .IG PEF IVI r is 5.5,beginning.Illy 1,2014 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 E I�r CITY OF PRIOR LAKE �r� r,nl� r� Y ��i � ���1�e�'tf i_� ' 'I�I %1, ,, HEATING/AIR CONDITIONING/FIREPLACE PERMIT - 1 y`,. .`?'' w I OCT 1 7 2011 i ..,j U 44,7„ p'ir I Pink File FPERivirr S w - _ lVFS 2-Green Cite ."�' i ! ` : �J.Yeibw Apghcnt (Please type or print and sign at bottom) ADDRESS n. I ZONING(office use) LA.T? \ 19(elf lli- lCY., CW+ \I (3-1 —)_.1—\. [... _ c LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID 1 OWNS �j (Name) ' - t" -'`(1/ 4. .L . .rf _A (Phone) (Address) � APPLICANT � pper� - (Name) �' L - (Rhone) 'a, , — (Address) �} —1 1 a ,•� !/ ''Pc -K_. J3 (Addy,.' (City) (Ztp Code) (Contact Person) - - j� �_C A�,` i t — (Phone)1 .)4� •1 ytj . APPLICANT SIGNATURE �y� ' dig 1"� Iii` ���Ut.-EL1.A.----DATE \.0t 1_1 I - ------ APPLICANT PLEASE COMPLETE BELOW iii EW CONS • CTION ❑REPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL / , ili ,010 [i2,- FUEL (1l4 C1;t1) FLUE SIZE RETURN OPENINGS INPUT 11�'0P0�� OUTPUT '�1 --~ TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner [;J 0 Wang Air PlantsSteam Gravt y 0 Hot Water Units and Fireplaces Cannot Encroach icchanical into Required Side Yard Setbacks. ❑Radiation Fireplaces with Box Additions or re Ir Conditioning 0 Special Devices p le Vent System 0 Other Devices __- Cantilevers to the Outside of Buildings -` Require a Building Permit. Pi REPLACE MAKE AND MODEL — FEE SCHEDULE Industrial,Commercial&MuIti-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 $49.50 Estimated Cost$ 51 )L-{� ,'' Building Permit # The Minnesota Statutes(t 3260.148 HEATING PERMIT FEE $ _(I- -4 CI',' t.) y "SURCI IAfifie has heer changed for one year effective STATE SURCHARGE S .(3.(7',-)-:58"-- July I,2010,until June 30.20)1. TOTAL PERMIT FEE S L--51.-i,56 rhe minimum surcharge fura"Ci ed ree"permit (Ocoee Use Only) it Si,beginning.inly I.2010 This Application Becomes Your Building Permit When Approved Paid Receipt Ng,_ .'�v ®p,pTt ---- - -- �A�'►i1.1' 6t 1 tf Building Official Date Date By e1 i1.�r)i1\s P'.� Ail r 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 1 1 r" t 4646 Dakota Street S.E.,Prier Lake,Minnesota 55372 01 PR/04, CITY OF PRIOR LAKE Date Rec'd 4.s.‘ N HEATING/AIR CONDITIONING/FIREPLACE PERMIT NN E SDS PGmkreen FileCity PERMIT NO. 6.3tp 2 3 Yellow Applicant I • (Please type or print and sign at bottom) ADDRESS ZONING(office use) 14341 PARKSIDE COURT NW LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) MATTAMY HOMES (Phone) 952-898-2100 (Address) APPLICANT (Name) FIRESIDE HEARTH&HOME (Phone) 651-638-3318 (Address) 2700 NORTH FAIRVIEW AVE. ROSEVILLE 55113 (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE WENDY SCHROEDER DATE 651.638.3318_ APPLICANT PLEASE COMPLETE BELOW ENEW CONSTRUCTION FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Warm Air Plants ❑ Steam Units and Fireplaces Cannot Encroach ['Gravity ❑Hot Water 0 Mechanical into Required Side Yard Setbacks. ❑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 HEAT&GLO SL550TR-IPI-E FEE SCHEDULE Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace $49.50 $49.50 minimum Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50 Estimated Cost$ Building Permit # HEATING PERMIT FEE $ �at: ` t 1. STATE SURCHARGE $ .50 ��`„ � TOTAL PERMIT FEE $ (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 CITY OF PRIOR LAKE BUILDING PERMIT. Date Rec'd i_s" S•\ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE rtI. i 2- . 1 2. s. nti AND UTILITY CONNECTION PERMIT 4,111111.0":7 •1 N E s 0 ._ _ • ' : '<1 • PERMIT NO. W -TO-Se ,Pleaw M-Mor&at anksign at botton_21_ _ I .-- ADDRESS __ 14 •-•.4-1 ,--) rAtz.i<s)flr ,,_. 1 L. . A/Ij __ .. LEGAL DESCRIPTION toffice use onis 1 , ' LOT BLOCK ADDITION , ' OIN'NER 1 i (Phone) C1 2 41?t3 -Lii3e...." L,---• '''"1re:' -1 4.4j--ii(kS-1111 .Lir_C K. Ave- 'S.. ________ . ,. — ItlettRER C ti..r."-C134..7 toe i:,',.3rnpany Name) 4 Off..7.: 7 ,. i - a 'Phone) _Le5 1-794i-04-17 cConta:::Name)---likaCIJ 1.2"\K•17L-CR- ii-4A; !--4-1z.,,i4 .....__. TYPE OF WORK New ConsTuction Ore;i, Cror:h 0ReRoof:r.c =3Re-SrLowet Level FIrash 0 F:reract 0 Atdd,com C:Ai.;Te+ancr. nt...,It, C on ncin.i n, CODE:XI.R.C. DI.B.C. 0!Av.: I).re of Construction: I n III IV dip A & Occupancy( roup: ARE F HI M & SU PROJECT COST/VALUE S -F:J/Z:c. C'L- Dinsion: - 1 2 c2) 4 5 (excluding land) . ._ .- , I netetn:,,,,*',at.1,-(1‘e-M--Inhoernath,r on'My arriie-athas which a:0 the hest of'71%.klIOWIrhigt!nae and cii7rin I also s-crofy:hal I am the owner(•,-.11;thrm-,eyl zgrer,f .' • 2,17,,,e erre-,Iont.i peceM,an4 that all aorogN(To.T.',III:,..wilmra re all exlmrtg gate and Meal Lass anst yoLl'7mcem,r..r.a,..•••rdamre oath 5.4h.erutted plans :,•••.:aWafe that :an,ri•-•ar lho perms foa at mufti F:arts,c•rtn,y:c 7 neertni arm ti's 7 the We ofrisriai or a olesre pray re '.'r he my7ert.,m perform nee‘leilmpeo:.,s f-4 42- SignatureCar,racio•t L ken•-4 N., Pee —--- —. ------ — , errn:7 VA:Ultl'll Park S-Jpi-cr Fre 4 ' $ -- , ----q.-02a.--°C .--; Vcr:,-;:•Fcc ' S , SAC 103.00 , flan C!-,e,.:,.Fee S 66.c? . 'i , Water Merc: S .5 I:e'• ' , 1 , , j t — , Siaie Slitcharge P:escure Rede: $ I Ferialry $ Sewer.Water Cor.r.eztii,n Fee u t $ -Flui7r..' 1,ing Permit Fee , $ , Water Toe: Fee tt : S --1 ; ler=it.Fee $ ! 13u:Isier' Dcr _,.-.,•;11 ' $ _ ' Sewer S:Water Fernit Fee :.., . ' ()the, PAID NM-I ________, _ .....-tas I'rep:as-e Permit Fee ..,..-i.:— TOTAI.DUE BLILDING PEFiMi[ .. TILL . pp ca om Your Building Permit When Approved rfid ; Reccirt No ,_i_r_ _ — 44,....___ B ____ , --- t•It-.41Ie5t in the Allo,r,AN.',...4.(mr•!IL!'40.-47,7r.r.tr,?-114 U.4,731110:1,,5 in a..-ciirako..'e.,••Ute(,-(r+ :',,n(ng,IrSLe.a.r.e.an, rna‘ nrock.e.1 as re:,-mle.i 7.,:..-:-.. ,-.1.-,• ...he-.(. re.:!-.•:he 1:.-V Planner conoimea a tern,-vira•-, ..e-o- a'a of Z.-,--N1..o.mp((anox an,l a.ir,v1,:o.,m.,..(,.,..•• ,•-.•••senoe :4V-,1n4,,ccupAncy a Cer.166v,.4,4. zo ,,,,,,..,.... _ fet tot,A&Lgiyapk Ner ' atir: ),10i air ---174Z—------ ;;;•c•,:,&I Conditlor3 ,i.ro. :4 hour flOtiCt for all inspections,951)44.-41151).car o 952 44 i "--4:47.'s 4640 Dakota Street S.E...Prior t misc.Minnesota 5'1': 1 o 1,RI Date Rec'd CITY OF PRIOR LAKE U, ¢ / SEWER AND WATER PERMIT j_'NEsdo" • r I Green File PERMIT NO. - or air 2. Yellow City 1 1� 3. Gold Applicant j (Please type or print and sign at bottom) .e A. ADDRESS 'i , i 1 c ! , IL134t - 1H31-1-7 P a LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) APPLICANT (Name) jj -3. ifrA , (Phone) a S '—Y 04-13 57.5 (Address) a-'°t t /41/4- r(Adddress) (City) (Zip Code) (Contact Person) '°, l {� Q ,k Y'", OAA (Phone) C/` A APPLICANT SIGNATURE DATE /0— 5- L! 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 TOTAL PERMIT FEE $ ' ?, y� IJVV (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt 1 o. Date By Building Official Date The Minnesota Statutes§326B.148 "SURCHARGE"has been extended tur notice for all inspections(952)447-9850,fax(952)447-4245 until June 30,2013, 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 The minimum surcharge for a "fixed fee"permit is$5.00 OF PRIR LAKEDEPARTMENT BUILDING AND imactille INSPECTION RECORD SITE ADDRESS tk3`F I Fecka.les 146- CT" NATURE OF WORK stmt c.c - F,a".h t,1 I -w-c, N6. 'Pecte. No Pas24,14©a. F4,1.L.L., USE OF BUILDING 5 I`Ar PERMIT NO. DATE ISSUED to/411r CONTRACTOR Kserrir--c c ©t-te-9 PHONE qsi-9 - 6/Z8 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARAT- P_ ,OOC� A '" 'T M 5 1"r"-- gv-4 Co.&'- -eL C M ' t INSPECT/2i'i TE FOOTING t v'? I FOUNDATION (Prior to Backfill) i9P ro'i s u PLACE NO CON RETE UNTI ABOVE HAS BEE)I S NED 12A-6�" tPcrsc� 'G(s ���' a. A�dj P4.�'�.�/ � /� �x��z���� ,_ ROUG - INS lo0),f9� 112, t-c SEWER /WATER / SEPTIC di uH,15 P' 10/711 (?a,-4-iy FRAMING ?Z i/y/r/ (A)°)1 INSULATION ` R / / /,2_, q 0w"15 ELECTRICAL`zI11PLUMBING at„yi,5 / (Z j,20/, qi /2'/ 2( 617 HEATING (if required) pi /q/i z FIREPLACE GAS LINE AIR TEST wta,,.,k, b3 `'`tpCOVER NO WORK UNTIL ABOVE HAS BEEN SIG ED [ Acvsdr I-0 Qout% t--,4t-t,k-e^ 5P714t-✓ i;i /7 FINALS ',b _) /,- GRADING (Prior to Sod ing) / � j * w BUILDING / C1 p T/i- 1 'ELECTRICAL PLUMBING e ,H, I HEATING & V.7/1� 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