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HomeMy WebLinkAboutBuilding Permit 13. 0603 rrti ttafr of ®x prxtx ;.‹.' CITY OF PRIOR LAKE !tparfxnntf of uit Mxt xtspi tftoxt ( Final Permitted ❑ Conditional C.O. Expires \ This Certificate issued pursuant to the requirements of Section 110 of the❑Residential l El International K Building Code certifying that at the time ofissuance this structure was in compliance with the various ordinances of the City of Prior Lake regulating building construction or use. For the following: Bldg.Permit No. Use Classification R3 SINGLE FANIU Y VN PUSD6O3 ' Occupancy Type Type Construction Zoning District Legal Description , B1 , HICKORY SHORES SECOND ADDITION 3857 TURNER DRIVE' Owner of Building Site Address q ° Contractor's Name&Address D R HO RTON♦ N ROBERT D . 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TEMPORARY CERTIFICATEOF ZONING COMPLIANCE /Z() [. AND UTILITY CONNECTION PERMITT /(.� See Main Fi1e , rtr PERMIT NO. 3 � 1 -� 3 Yotttxv Agpkca l a , (Please type or print and siga.at bottom) _ ADDRESS ZONING ofrice use) ''O 5 7 /vieWaR. 134gw LEGAL DESCRIPTION(once use only) LOT/O BLOCK / ADDITION T/ext? ge > Z! PID OWNER (Name) (Phone) (Address) BUILDER' D.R.HORTON, INC 952-985-7272 (company Name) (phi Brooke Hareid bmhareid@drhorton.com 952-985-7806 (Col ty Name) (photo (Address) 20860 Kenbridge Court, Lakeville, MN 55044 y TYPE OF WORK 0 Ne Constructuon 013e ( Porch QRe=Roof ng [Reding IZILekver Level Finish Q Fireplace DAdditton E]Mltetritio t (futility Connection CODE: 011.0. 0133.C. 0 Mite: Type of Coiistrttctions I II III IV V A B � �' Occupancy'Group: A B E P II I M R S U PROJECT CT(excluding COST/VALUE �'Z 3,} L Division, 1 2 3 4 5 (iexcl�ttttg land) / i hereby certify that I have!u'mishe4 nfontiatiott on tftts:ugpiitutfon which is to the best of my knowledge true and-corral. 'also certify that lam the owner or,authorized agent for the above•menttoned property and thatall co tstrttetlon Will conform to all existing state and local iawt and wilt proceed in accordance with submitted plats, I am aware that the•building alma"can aevoke thistle "ll for just cause "tethctrmore,'hereby agree that the city official or a designee mayeaterupOn aha propeey to pertorni netitotunpeennin. x �'1 BC605657 5/710/3 W` 'a' Contraotefs.License No a Permit C aivat tan49 �i 6 P Supo Fe $ �- Permit Fee $ /1/0/4 74 trD SAC A $ 071/35, f Plan Check ee $ . 38 M Water Meter Size 5/r; ' State Surcharge $ / /, , D ® Pressure Reducer $ /S-6. lrD Penalty . $ Sewer/Water Ci nnecttion Fee It $ Plumbing Permit Fee $ fSq.SG Water Tower Pee # $ (DOo,- .0d Mechanical Permit Fee $ /S-4/4 Builder's Deposit $ 67500. a t Sewer&Water Gas FireplacePermit tFee� $ --C-4,s�p ,,� TOTAL DUE Other t St��r�,si� � /5114 �; This Applie tot et* les Your Building Penult Approved Paid i O t,� ,.3V Ree t Ido. & ' .4- Date 0 By k,..,ofTicim Hatt. This is to certify th the request in the above application and accompanying docume Is is a accordance,with the Cay Zoning Ordinance and may proceed as requested. This document when signed 'the -sty Pinner eonsbttites a temporary Certificate of Zoning co s mac and allows construction to commence. Before occupancy,a Certificate tit Occupancy must be issued r 't- Planning Director II Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(9S2)447-4245 4646 Dakota Street Prior Lake,MN 55372 Builders Deposit .Ma, : • city of Prior Lake A.;$1A0c00 Btolootpueposit to.ittOlatiact in the kitlittitlg.Permit fee. The;EittiWer*Dfitilsit is Issued as,sesyellVioITtsurocomplisoce for a Final Occupancy Permit: a Is not an escrow account)All exterior items including bet-not limited to grading aoddlitch landecaping, tree planting,:.driveways,siding and painting Shall,be completed Mt days after the nate the building permit le issued if the is riot complete within the 180 day time period, the citti-Woll notify the 00100 of the,violation and the applicant shalt have 0 OnYs'.to comply o r the $10.00;00 builders deposit will be forfeited,and the applicant will be billed for clean up or correctivaworktoresiilythoftittistIon. A,800.00 Tree Deposit may also be rettuIreitand will be refunded ifspecified preserved for sported Of One-year.. DATE:.. . ... StrE AIVRESS.t 385-7 Til-A/E7e-- Die4 Pei PERMIT if A. ..4 63 REFUND:TO BE kotteo Tot D.R. Horton, Inc Attn: )f AU 11111/yl A 1 IVA -1 U RELEASE 20860 Kenbric2144 Court Suite 100 JJ itZI5eo'60 Lakeville, MN 56044 Lynda S.Al Muilding Services Amount , : . . , Acct.801.20204. M Date CZ....1.II.1.1.vim,.urs.A J.....11-1 1 4-1,rkkil_LEJ.1-kan PLEASO:MA:MAW El -- ..... ,....- . _ L Poppler, City Engineer 1, KEEP STREETS CLEAN.DLOINC4-CONSTRUOTION 2.. KEEP EROSION CONTROL IN MACE 3, TEM:PORARY OCCUPANCY'PERMIT MUST NOT EXPIEIZOR$15041430,WILL Be mrtmoto sito,001,01e* . . \---AlarAmm.............._ r" II • ACQOUNT NO.801-20204 RgTAINAOR FORFEITLIFI ACCOUNT.NO,32211 AMOUNT': , AUTHOFUE TO PtELEASE; . MOE: JAPORMS‘13.:D.JLDERS DEPOSIT PORVI.DOO 1 l YR/0 CITY OF PRIOR LAKE Date Rec'd a° li ; 4HEATING/AIR CONDITIONING/FTREPLACE PERMIT • 1 ' S°it° I.c,« i PERNRT No./.3 3.Ycnmv Applicant 6 (, 3 (Please type or print and sign at bottom) — ADDRESS ZONING office use) _ 3 57 kt IT M.)C dr SCS • LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION P1]) • (Name) I l Y�� I'�on' (Phone) q5Z" / /G7 • (Address) 2Q (.pO sten bridle a:fa li lake V ii Ie if MN 5s1 ( APPLICANT �/' • (Name) t-/re S( e Ilea lv go the (Phone) (c 5)'' 1p 33 Z Jr'Lo l • (Address) 2:100 Fgv-�e(t) Ave. V 1oS-e Ul f/e, p IMM X5113 k }(Ad dreesss) /� (City),, /1 1 _ (Zip Coder) (Contact Person) Lea LiDae heti 1V (Phone) UJ6I— to3i3— ��1 L • APPLICANT SIGNATURE DATE « .,..-..t..______ , APPLICANT PLEASE COMPLETE BELOW • EW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS • FURNACE AND MODEL _ FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner ❑Wsim Air Plants ❑Steam ❑Crravity ❑Hot Water Units and Fireplaces Cannot Encroach �henical ❑Radiation into Required!Side Yard Setbacks. VAtr Conditioning 0 Special Devices Fireplaces with Box Additions or :Went.System 0 Other Devices Cantilevers to the Outside of Buildings '�� _�� Require a Building Permit. FIREPLACE MAKE AND MODEL f �--` P\'_ FEE SCHEDULE Industrial,Commercial&Multi-Family 1%of job cost Residential,Gas Fireplace •$49.50 $49.50 minimum Residential,Heating&A/C(Now Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50 Estimated Cost$ 131. 0C) Building Permit # The Minnesota Statutes§32611.148 HEATING PERMIT FEE $ "SURCHARGE"has been changed for one year effective STATE SURCHARGE $ .50 Jot),1,2010,until June 30,2011. TOTAL PERMIT FEE $ The minimum surcharge far a"fixed fee"permit (Office Use Only) Is ii,beginning July 1,2010 This Application Becomes Your Building Permit When Approved Paid Recei'•`410 Date ' IittN r�iTH Bodin.Official Date P ' y ' au/IT 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 4 pR/04 Date Rec'd CA CITY OF PRIOR LAKE PLUMBING PERMIT v So° I. Blue File PERMIT NO. 2.Gold City /Z 44,43 3.Yellow Applicant /lJ v (Please type or print and sign at bottom) ADDRESS --- - ZONING ;office use) 3 51 V� nvuJ✓ %/ANtk, LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICAN (Name) '-)600/t, J►t, P A (Phone) 11/5- �'1 - 2:491 ` 8►J� V� (Address) 15536 Qhet., 55,4, ( ddress) itY) (Zip Code) (Contact Person) (Phone) 14/5- 153- LI1 Qt APPLICANT SIGNATURE ,rt,0(, AU.t,i,�,t. t_d DATE ''247-2.0 j APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 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 The Minnesota Statutes§326B.148 �t $ Building Permit# "SURCHARGE"has been extended PAID WITH The minimum surcharge for a PLUMBING PERMIT FEE $ "fixed fee"permit is$5.00 STATE SURCHARGE $ WILDING PERMIT TOTAL PERMIT FEE $ (office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Buildine Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 CTORS 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 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 _ L, Z�ice/ requirements or local ordinances. PROPERTY NAME: Hickory Shore DATE: 12-39 t3' PROPERTY ADDRESS: • S_ 7711 '+l.0- d v - p✓c 1-6ILe� ACCEPTED BY APPROVING AUTHORITIES(NAMES) PLANS ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS • YES ❑ NO EQUIPMENT USED IS APPROVED I. 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: El YES 0 NO 1.SYSTEM COMPONENTS INSTRUCTIONS MI YES [] NO 2.CARE AND MAINTENANCE INSTRUCTIONS • YES [] NO 3.NFPA 25 j, YES [] NO LOCATION OF SUPPLIES BUILDINGS SYSTEM ENTIRE BUILDING DESCRIPTION MODEL YEAR ORIFICE SIZE TEMPERATURE QUANTITY Reliable F1 58 2013 1/2" 155° 13 Reliable Dry F3QR 2013 1/2' 155° 1 SPRINKLERS CPVC with CPVC Slip fittings PIPE&FITTINGS ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST ALARM VALVE CONNECTION OR FLOW TYPE MAKE MODEL MINUTES SECONDS INDICATOR Vane Potter VFS-R at I f DRY VALVE (Q� 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 0 PNEUMATIC it ELECTRIC 0 HYDRAULIC PIPING SUPERVISED 0 YES 0 NO DETECTING MEDIA SUPERVISED 0 YES 0 NC DELUGE &PREATION DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS 0 YES 0 NC VALVES IS THERE AN ACCESSIBLE FACILITY IN EACH CURCUIT FOR TESTING IF NO EXPLAIN 0 YES 0 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. ALL PIPING HYDROSTATICALLY TESTED ATC6 PSI FOR 2- (4^1- HRS. IF NO,STATE REASON DRY PIPING PNEUMATICALLY TESTED 0 YES 0 NO EQUIPMENT OPERATES PROPERLY 0 YES 0 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? 0 YES 0 NO DRAIN TEST READING OF GAUGEOC gATED NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE STATIC PRESSURE: tb PSI J 6 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 0 YES 0 NO OTHER EXPLAIN: FLUSHED BY INSTALLATER OF UNDERGROUND 0 YES 0 NO SPRINKLER PIPING BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING 0 YES 0 NO IF YES........ DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY 0 YES 0 NC , 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 NC 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 0 YES 0 NC 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 0 YES 0 NC (DISKS) (DISKS)ARE RETRIEVED HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN DATA NAMEPLATES 0 YES 0 NO REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: /- Z-Z°`Y NAME OF SPRINKLER CONTRACTOR: SUMMIT FIRE PROTECTION SIGNATURES , TEST WITNESSED BY -✓ EGy. c„? ERTY WNER(SIGNED) TILE DAT 4-0•4-0•510-4/6149C- T7 Z ((c(SUMMIT FIRE FOR SPRINKL NTRACTOR(SIGNED) TITLE DATE: n 7-7j" Z- Z.... r i 1 4 RRto CITY OF PRIOR LAKE Date Rec'd ._ +P HEATING/AIR CONDITIONING/FIREPLACE PERMIT i it;r.' 1 r,,,i, . oqt, 1. Pty PERMIT NO. 13 a Go 01 Mvss z,wreteen eny 3.Yellow Applicant (Please type or print and sign at bottom) - ADDRESS ZONING(office use) 3(e) 1 I urner rive S4 5l l-e-MN '312- LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID • • (Name) 1-1W-1-01n IA GfliP_.S (Phone) 9 52— / Ll J" /.27z : (Address) 2O8 Q YtnbridBe, C-4 .4 H co Laicui(lee,/V\1 '5'oL/1/ APPLICANT Fireside- � Y o- 1-b 051- (co �5�/ (Name) (Phone) • (Address) Z-0 Pa i(view Ave ' J el:ft0i IC i A4 KI 5 /13 Address) (City) 7(Zip Code) (Contact Person) 1J LO ermeiler (Phone) _u C,S1" �3sT��7 2- APPLICANT SIGNATURE (Y�J P 1sj�" ' DATE ) f APPLICANT PLEASE COMPLETE BELOW : ❑NEW CONSTRUCTION ❑REPLACEMENT ❑ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM BEATING OR POWER PLANT . PLEASE NOTE: Mr Conditioner ❑Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach ❑win, 0 Hot Water into Required Side Yard Setbacks. MWechanicai 0 Radiation Fireplaces with Box Additions or ❑Air t.System Conditioning 0 eSpecial Devices Cantilevers to the Outside of Buildings :Went.System 0 Other Delvi�ces,,L (, rym nao'l .Require a Building Permit. FIREPLACE MAKE AND MODEL SL� `T 1�oy1 Yl"g���Q + D47 SIV{)7A 0 Gl�cs, - 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 # The Minnesota,Statutes§32613.148 HEATING PERMIT FEE $ "SURCI TARGE"has been changed for one year effective STATE SURCHARGE $ .50 July I.2010.until June 30.2011. TOTAL PERMIT FEE $ The minimum surcharge for a"fixed fee"permil • (Office Use Only) Is ii.beginning July 1.21110 1 This Application Becomes Your Building Permit When Approved Paid Receipt No. • Date By ,V� DINrPAID Wiry tiufdina Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447.4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 iv" PRt CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd r �, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE U _ AND UTILITY CONNECTION PERMIT *INNE SOAP L White File PERMIT NO. 2. Pink City (3 1, 3 Yellow Applicant S (Please type or print and sign at bottom) -ADDRESS ZONING(office use) 3 5 7 'fur 4 OrtUe– . LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) 1 C.- i '.• (Phone) (Address) . BUILDER / (Company Name) .. (Phone) (o S7 ' i Jc<kO (Contact Name) $v m n4-1; /---,`r e Pre JeC r t ri (Phone) 5"7S i4'1 t^n e 1.4 14 Ave w (Address) ti si. it_v 5 i/vi tt.) 5-57 03 TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Re-Roofing ORe-Siding OLower Level Finish El Fireplace DAddition EAlteration ❑Utility Connection CODE: ❑LR.C. ❑I.B.C. ❑Misc. 2 Type of Construction: I II III IV V B PROJECT COST/VALUE $ 3 DO — Occupancy Group: ABE F HI M $.) SU (excluding land) Division: 1 2 3 4 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 pro. rty 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 •permit for just f use. Furthermor- hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X (0 5 ®d- a7— i 3 ii-/ —Signature Contractor's License No. Date Permit Valuation C] Park Support Fee # $ Permit Fee $ f j 06 SAC # $ Plan Check Fee _ $ e,'0. K Water Meter .Size 5/8"; 1"; $ State Surcharge $ ,2 •OU Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ +' 8141114 This . •plica ' , I es ourBuilding Permit n A.proved Paid � ��p�N � A / �� /O Date 13U1046PEI:" Building tial Da. 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. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. 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 O i ?Rr �� Date Recd CITY OF PRIOR LAKE ut., ,� SEWER AND WATER PERMIT j�NES��P 13- a)I I 1� V i �; lifer ) I. Green File 2. Yellow City PERMIT NO. / O� 3. Gold Applicant l/ C V (Please type or print and sign at bottom) ADDRESS ZONING(office use) 17 J i LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER /^� (Name) LI' � (Phone) (Address) (Address) (City) (Zip Code) APPLICANT ��!! � )) Sif f3 ` (Name) S 6:r6,4 V4174/tP (Phone) / ' "� �A v 5033 (Address) v/��p �^��L�� /�`7"v� /Q���ls � �� ,,,,���� (Address) (City) (Zip Code) (Contact Person) �/// ,- i"' • (Phone) 4'/2" 9/9 Yoqr' APPLICANT SIGNATURE ii _ ALA... DATE / APPLICANT PLEASE COMPLETE BELOW Size of water service 1s inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC jg PVC El 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 Pot r4 TOTAL PERMIT FEE $ (bAjdb/1( (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 DPRIOR LAKE EPARTMENT OF BUIL Al PINSPECTION p * we INSPECTION RECORD SITE ADDRESS 35E7 71'.Lv&.t bA . NATURE OF WORK ed 3/ng4 ..r.,„ - ►v�dL DEEds, LL.Can4-540-Aq4 it Ifjp USE OF BUILDING F PERMIT NO. 3 &O3 DATE ISSUED CONTRACTOR Difforiors PHONE952. • 985' „n 0,,,Z, INSTALL EROSION ONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE FOOTING (1-)a •3 FOUNDATION (Prior To Backfill) J `b ,1- ,1 RADON RETARDER J PLACE NO CONCRETE UNTIL ABOVE HAS BE N SIGNED r.--- __e_ , OUGH - INS /ehk SEWERNVATER/SEP I _ i 0 FRAMING 4/4- �� is/i y INSULATION ..e' /e;."/3 ELECTRICAL PLUMBING u V� �42 `i.le t' g1� 44 , f/21i HEATING //11 d FIREPLACE .205- '1 1 ;;/3 GAS LINE AIR TEST goy �! p / /�,� RADON RETARDER / Ady- COVER NO WORK UNTIL THE ABOVE 1 IAS BEEN SIG E HOUSEWRAP ^ i ry6 LATH (G.' ,z 2343 FINALS t�',.e, 3io01,4 r /2//r GRADING ( PRIOR TO SODDING) 'Nti� i\ v-) lam-`, BUILDING 9191 # ip TDL-Q14' l l Y ELECTRICAL PLUMBING Mfh 4 .,d/r %e7 / /0‘A HEATING c ! 1 / /1 DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGN Ij 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