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HomeMy WebLinkAboutBuilding Permit 14. 0047 CITY c X Etrfiftta t of (1�xrax. t.r OF PRIOR LAKE ,K -, PtpaIrtnittif of `Pnittlittg Ittsiltrtion -,- --;/', ❑ Conditional C.O• Expires________---------final Permitted �r 5ectian 110 of the.❑Residential/'❑International • Nance with the vannas ursuant to the requirements of This ing Codes ierued P that at the time of issuance this sstructure oa in c or�he following: - or inin ces of certifying building � the City of Prior Lake regulating Permit No.���— K' ordinances of Bldg. Use Classification VII Toning District - Type Construction pccupancy TYPe . :, _ -1 16662 MARKLEY LAKE DRIVE Legal Description Site Address Owner of Building Contractor's Name&Address ROBERT I) H 11T C H I N S D-t-c---- city Planner Official Building Date: 't . .—.. , Date: ppgT IN CONSPICUOUS PLACE X u i ILt a 4DDQ000 C.0 Qid w z W W ' cc/Z. ...., , oV W o Z Y Y? 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Pink City PERMIT NO. 1 4.7 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1 14P ip f . i L�14 MaIv, ice/ LEGAL DESCRIPTION(office use only) LOT 9 BLOCK 5 ADDITION -EA( -E Com— . .ST.4-CSS PID a-S. 5-01) 02-2- 0 O _1 l- LIS r z ICI) b J 0' IT. .,V p+ BZWw 31 -,' Z hh1 ° J Jz � o �u, N � 0EW Wy 8 Z < 14 W . . 1 Qlj\1 e a . „ . , J t 1 OlL ...! , Ni o mr z \ Cx'- O VV Ilir.' a" ooJ 111 %t '- ��-- 3 Z IX z _ xxz ?= V d c13 Leg Km = Vq ",� V t— a3O V � t) a2 t. k - 1< L , NI N , OW Z,N ., aWz ~z ku.• 000000 C4 k6 LU v =Iv O W 41 u. Y V z a' g~ 1 a, S "� < O mti ,Ir C., Ocu O N 1- 4. c=4 1 re z O zW zNwaZ IL hC PzILI 8° � s.= l ❑ O c 0 0000 o10 v C/� Sewer&Water Permit Fee 1 $ , �, �r-J Other $ Gas Fireplace Permit Fee I $ 1-r llco TOTAL D�E�Lf, 7752....;,...- 4. 2-3 s/// 650. Q This Appl'/, 'on B: • e, our,:uilding Permit Wh Ap oved Paid ft (�ST, O(./.. R eipt No. —26/IS� ..4, ` r Date 9v _ 3, 41 Building Official J ate This is to certify th, a 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 t ityPlanner onstnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. /—% —/y Planning D' or Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372 o� p�O�A �� Builders Deposit U s � City of Prior Lake A$2,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading,sodding, landscaping,tree planting, driveways,siding and painting shall be complel;ed 480 days after the date the building permit is issued. If the work is not complete within the 180 day time periled, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $2,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors 14---4-7 handout. r •�l DATE: Z—�—)3 SITE ADDRESS: �v X0(02 I' l� .EY? LIC D e. PERMIT# REFUND TO BE MAILED TO: KE?L144141 �S 11 Ozl F 4 1��1-1-r . s 3 F1DZ 1-4c4 14E_ , M�. 37Z MEMBER PLEASE RE 1. KEEP STREETS CLEAN DURING CONSTRUCTION 2. KEEP EROSION CONTROL IN PLACE ,\t fi;�r co 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR$500.00 WILL�B FORFEITED'. SIGNATURE: xoR1ZATlo AsI. f11.#_ 213°° Lynda S.L I n Amount //-IG"1d-- • v�te Acct.801.20204 � d 3 SECURITVFEATURES INCDUDE TRUE WATERMARK PAPER HEAT SENSITIVE ICON AND FOIL HOLOGRAM. ,.o,.,.. - e 4,4 s 3s '€c air 3 a «r,t a3 @ 8z .6 l''''''' ,�. '$4 e iA" �p�. gP'+ 54. ���^x`.ii AT NS wa,.„fly*.tv , § j1 i �, $40, {, '4 g"yyE;Z,,,;,� 0� '&.' � >u+ . .,�.”, 'rte 1- t' ' .�' �°�"`3t. a`" :,',,'''St,'"''/IW '+, `a*' '!t'm 44,14%Z't m,'.,.'y No 444 41 . 33 Ar' + e a .tG`fU,*« o,-c ' . €' 4�"' a U '41I . A � 4" *,"> r`at�3 a. r A , +' I .44401;:',% .,� 1 a ;14'41 xsai 3441444140',"41441:111i1: ' ,,� ++?��R vT k m w '„ as ':��� +.>_ � P:»*s g mar nom' � L s�s s� �T °2�T°°a�' t „1". r. v x;. 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'w,rt( `tc+ '� +�� ?vd.� k ^ , { '. a r �g3r R``+ ,ty t dt«„,L .�+;'� m ;u x'NY+" „.y tw no a st n Y rt rxa,," s R' `3^.�*t, a ,� �. rta'*'.,,rt'� :. �. a''1“::-°°""n14411•4°, "r 'adv r�' �' ,"i 011 4nt14 White -Building Canary -Engineering) ,h'VNESO Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT cyzAz-hio /7-0/4 zZ6�i� ��2-- APPLICATION RECEIVED /6 6 2- 7Vii-x.,/ ,/ /- 7 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /6 6& Z //� e_.. ; e,-,,I b C Accepted Accepted With Corrections w P Denied Al + ____2/4______ Reviewed By: tore. ►—_ Date: Comments: 1'- Ccn10- 64--F-) rte/ x 017=4"r79--(Al .7(-- '''") --11/2-f-CL5-T5 A-- 4_ ovii(f--5 . "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 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." 0YRN) c� White '_-Building Canary ' ldn E �l ,�,INNEe� Pink - ng 7 BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT K ,/C> lUf%ti APPLICATION RECEIVED /C 2" t'/#11tice...-4.2/ /214-- 7- - _ The Building, Engineering, and Planning Departments have reviewed the building pe m��` application for construction activity which is proposed at: / 7Z /l1/Z4.... Accepted i/ Accepted With Corrections Denied 4„ Alr s , j ftk /Af t r Date:A Reviewed By: Comments: x 11-2- "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. 4,0/11000 'p ,T • NAME OF APPLICANT L/j�l-C% ' APPLICATION RECEIV/ED r � ermit ( Departments have reviewed the building p The Building, Engineering, and Planning oosed at: application for construction activity which is p Z,-/1714% �� Accepted Accepted With Corrections Denied Date: it�w 4 Reviewed By: ���'�,� Comments: for approval of plans, specifications tionnd of of a permit or approval of, anc viol "The issuance or granting permita for, or an ofthe pr shall not be this code o be any orother ordinance of the jurisdiction.iorE'Permits computationsprovisions of codeprovisions any the p to violate or cancel the p presuming to give authority ordinances of the jurisdiction shall not be valid." Checklist Residential Building Permit Csin R-'1r R-2 Districts New Construction for Single or Two-family Dwelling ^ 4' Reviewed by: , it, Date: ( I Zoning: S PID: \<7\ �✓ Building Permit# el [44_ttDr„_ Address: k c (6, c m l \'C L., B____--- Subdivision: Legal:L,___—, Structure? YES I NO Existing Nonconforming Structure? YES I _ Existing NO CONFORMS TO ZONING ORDINANCE EIIIIIIIIIIIIII Standard Proposed Yard Setbacks: NA I FAILS!CO� • n 150' � ' Front Yard can be 20'if avg.wli 10I Z 25' if abutting a street • Side Yards setback+ bwall exceoreery1 g 60' requires addi_ tip side 2" 2 10's tbar k0' • setback for every 1' over 60'in length. Not required to if building wall is 10'-0"or greater of being p t11211111111111 a side lot line. 10'side) Rear Yard '� • 25' rear Patio• Door: provide for deck will be built in the signuture ' re statement indicating 5-1, 0' From 100 year flood elevation`o(f w�tl/ r-c.)rv2 6 . • pond. • 75'or setback average of Refer in-ground round �eels to the Plannin• e�artmen but no From OHW(Prior or Spring Lake) adjacent structures, • less than 50' D ,—z 0 Maximum ����F Floor Area Ratio: NA I FAILS I C i', PLIES .30 Yard Encroachments: i r I FAILS(COMPLIES Standard Proposed Eaves and Gutters no rr►: - than 2 feet in width and no closer than 5 feet to a lot line Easements . ent cannot encroach on interior AIC and other equipm side ards. Standard Pro ose;d Tree Preservation: IV!FAILSI COMPLIESam • Total cali ger inc es • Permit 35%Removal • Calder Inches Removed • Calmer Inches Preserved 111111111111111111111111 • Reslacement 1111111111111111111111 L:\TEMPLATE\BLDGLIST.DOC DEC. 30. 2013 5:40PM METRO AIR 952-4471126 NO. 166 P. 1 u''" tCJ YOar,!1:t1,, J L,OiIt:LireAD KL '1cit ei 'r 04, iii;..i.. NC/A. 1 ... ,ctr 4 nDitto!toed 1.Ortie GI cii:Ltomirr..........c.......14;•..... •• Nd�* PyyW1 . . ut t1slu a te.t. ). , ., i1Il . _ ....................... .....aa teen_. .. -- • JVN611 4 4 0 0 \'ITCH )4 n....t.ovoN(4\ tk. ' (A0 k'S r , ---- . .•*•••••••••o • •• , Ct C.+A.l 03 SCitlNI(014tutTh.Cutawayj t�►,,, ..... ._., ._.r.1,')U.....,_._. • ----- I�. tom_ rCk ....... ...� tete .... . tt'l►uIt.o)q��-..«.� \IC)oratisinelti) .i�;���r��{ '� .._._.,._-----=---•-• ..� _----...99t!r511.9_x_ Qatic.:51_9..A...tar.....A.,...uk...01_. n� Com-.�,,,�,�, ».,. .. _..._.._. ., • ,..._. c. _ — . .--- , -t L . cI'bu& ) ....1:. •.- �r ..+..�.. \___ wow) el_:_:___ \.$440 .5. 73 (t:t;'tilns:l 1'Crst)0 ., ... �;• .._•....... , A.t�i'),�tC`•A�i`titt3�1�UIt13 ..\.....t.:" �.-?•�' _w � , � 1�it'.UlY ..,... ...�........_...-._.. ._._...-. 0ruCAN'1.'X'LLMMJ COM , .1: ], .-- -tri�:l�t tyt N�' ,''� ._-_--.�.__. -��1`tl�W CCJ!`lb'1'lil1C'tt N M 1�� ��1 ©�O I�UtiL 1_ - K.11 AND MOMS), .5. 13., 1_;__,,_.•__._.-,... . . . •_ �U,t'I'U'i' - a+U1&NACit MAINNUC ). Jtlt'tJl M tJ1'1SN1Ntiti _____\42......,w -._• °t---«----_tete'""" IEl,t11S SELLS . «_«...-.. 1I13A•1'aiVt3 OIL k'U11Yiiltk>,11.N'i' PL Nta'IR; At Cplttlitioult 'l'YN>r a tf S it Plaine l 3t Units nl+t►trlrWiaccs Cpui tUi t icrOttrk �va�n+Air ktn+tta httu ltequffntt 81du Yi t'd i3Ot1)ttcity. t_thavtty ' 1181:1:40:41.____. ttinto R qui lvltit lSax el ed Both iti tcitttatunl outer : Contiluvors to(Ito 0utrkto orJitilititom Ak L;ugdtttartttty outer! lees ..__._... Acquit%tt littlitttngVonnit. Vett.�tyalont „«.,,.,_.._......,. ......_...._._..,...._ ....(t�i•-*S l M�1K11 AN17 Mt7!)f t` _ - ». .. - VIM SC1UUDUL,1t +;49.50 )%ur'3utt oust 1tv�,IWNinl,Gus Wapiti=u Uulusirial,Cuntt�tr..+.i,it&Multt-Lhrtuity $49.50 mtotttuim $�iy,3t) $149.51) )tcsktontisi,Atklittoos&Alioratlwta X419.50 It oehluuttni,1lnat%Only AIC`oow C:u tHow +ta u 1 a)? $114.50 ttcsidontiei,At;Only itoakiwtitat,!lc.etit+t{ ll'l (p G t t� get tattloct Coal llupdint Vomit (I__ __ , PA IN l�.l.1AT1NG 1.'131 al:Pf- S_ _--_«— tf�j --fid v 111 STATO S WV!AVID Taub xzttm1liEr4 s.-._4.w__.._.,:_.. _� __ t��rtro use unit').__.• tete" Naid~--...,.«.`— -- «llcvoipt p{t►. + 'Ptd A pllautlasti Monies Yank x3nttding 1'at'tuit When A)%WoYtti _,,_—,!_.._._. __. . _...�.._-....._.,«.._ icy Hato • unmet oui.bo � {)eta tete".._.._ r _,._._..._ ..«.. ..,«...—... ' w 2.4hour M n for all Inspections(952)44'198511,rex(952)44'1424 t 4046 IJaketn Simi(I i.,Ma t,nke,Minnesota 55372 i Date R.ec'd ; of r x l'oit ANC � CITY OF PRIOR LAICE SEWER AND WATER PENT 4-.0,..s.-0- • . 1. Gcan Fila PERMIT NO. 2. Yelfow� Cty � I 14-. f 7. Gold Applicant i (Please type or print and sign at bottom) ZONING(otsce use) ADDRESS . LEGAL DESCRIPTION(office use only) CI � ^ PID LOT i BLOCK 3 ADDITION C.0-W 1.2. l re...' k. ft 5 OWNER , '1 (Phone) 96Q—t-1 t-lfl—gi-100 i (Name) ��i.�.�1 ot-1 c��nn F L `l?2�c��. � .— (Address) 1"102-I in SHr Portsr, V.-0 s sre 11)o (City) (Zip Code) (Address) APPLICANT (Phone) 952/890-4241 STOCKER EXCAVATING CO • WA1 , INC. (Name) — (Address) 12336 Boone Avenue Savage, MN55378 (Zip Code) (Address) (City) Curtii (Phone) same (Contact Person) I .� I�!1 � .01:0�' I /10111-1- DATE APPLICANT SIGNATURE _ .✓ Ji .,_ r VP '.' 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 • foe- structure. FEE SCHEDULE Residential sewer and water line connection $35.50 Industrial,Com'l&Multi-family 1%of job cost with a$39.50 minimum Sewer connection only $17.50 Water connection only $17.50 Estimated Cost $ Building Permit# • SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $` '50 PAID wiTH { TOTAL PERMIT FEE SUI .LyEty , P'S- T (Office Usc Only) This Application Becomes Your Building Permit When Approved ReceiptNo.Paid1 • Date By Building Of<cial Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 1 1 i itDate Reed CITY OF PRIOR LAKE PLUMBING PERMIT •. 1 W ,.Pt F ` PERMIT NO. 4...49I x Yell FA I R Yellow Applicant (Please type or print and sign at bottom) ZONING(Dake use) ADDRESS CP (0 &2. liar—k1I 1.1:\ke L LEGAL DESCRIPTION(olibx use only) '• LOT-(�/ BLOCK 3 ADDITION £-A C:.- Ie. r'ee Z; K PID OWNER (Name) 1'1 ) p.,v N (:,r ix u. 5 (Phone) /�2 'a-I U Z b (Address) i~7 0 2.... 1 r ,, L 1 a , ,.)* �Zd , APPLICANT 4 l''C I-)A le' P. t (.c (Phone)% 2 - 15 R - ei (Name) (Address) /t IC jc Ai L4 /V c . ;e Ut 5t,G •71 (Address) (City) (J (Zip Code) (Contact Person) . }t'r lJ t.�► -�4?, k (Phone) ���- ""7 1 APPLICANT SIGNATURE s Aks ,_u = ✓ DATE APPLICANT PLEASE COMPLETE BELOW _ Quantity Type of Fixture Quanti Type of Fixture _ Bath Tub with or without shower Rough-ins 1 Dishwasher / Water Heater _ / Floor Drain / Water Softener _ d2 Lavatory(Bathroom Sink) / Stand Pipe(Washing Machine) _ I Laundry Tray(1 or 2 compartment sink 0 Sewage Ejector _ Shower Stall 0 Backflow Assembly _ / Sinks p Backflow Assembly Test _ U Bar Sink L Lawn Sprinkler Water Closet(Toilet) Other _ _ FEE SCHEDULE Tile Minnesota Statutes§32611.148 rid;cost with a 54930 minimum Residential,New One 8t'No-Fandly $149.50 "SURCHARGE"has been extended' ' Residential,Additions&Alterations x49.50 V The minimum surcharge for a Building Pennit# "fixed fee"permit is$5.00 g 0\,- .PLUMBING PERMIT FEB $ - di 1 '7 STATE SURCHARGE $ k V . .,1'.. 5.00 r TOTAL PERMIT FEE $ (Office Use Only) • This Application Becomes Your Building Permit When Approved Paid Receipt No. Date BypArn INITI1 Dutldtne Official Date D 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 03/25/2014 11:14 9524926006 GLOWING HEARTH PAGE 01/0.4) 04 11`-194. CITY OF PRIOR LAEZ Data ReC'd gc:, ,..,1 lik, HEATING/Amt CONDITION NG/FIREPLACE PEWIT 1.a L . /I• 3. (Pleas*typo or print and sign at bottom) ADDRESSAI ZONING(office use) a' / / . 9 I. L' LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID (Name) • OWNER 1 _ l G . CQ V—� 1Y � - ,- (Phone) . 75 -' ,` � '. Address e-.7r ft* is e 0 t' I e._ , . fM1J f 4 APPmLICAI►iT(Nait , ' ( is, ' 1 4"` \`]Z3I'N (Phone) �', ..-`-i°t'�--'9' !1, (Address) ' . !►:' ! i► _ Aid 1. L 4 � VV (Canted Person) • _}Igitir (Phone) ♦ - '_ + VPs, APPLICANT SIGNATURE P }ATE r Lt 44 . APPLICANT PLEASE COMPLETE BELOW (I$11 i CONSTRUCTION (JREPLACEMENT QALTERA,TIONS FURNACE MAKE AND MODEL FUEL — FLUB SIZE --RETURN OPENINGS _ INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT WPLEASE NOTE:Mr Conditioner . D Warm Air Plants 0 Stearn Units and Fireplaces Cannot Encroach ■;.'ravi Hot Water into Required Side Yard Setbacks. -. a icalRadiation Fireplaces with Box Additions or ❑Air Conditioning 0Special Devices Cantilevers to the Outside of Buildings [Vent.System C1 Other Dev Require a Building Permit. FIREPLACE MAKE AND MODEL kw,Alp :g, ;' • - Ii 1 _ . I --------- FE SCHED $49.50 minimI I __ ` Tru rias,Commercial&Multi Family 1%ofjob cost $49.50 Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Coustnsction) $64.50 Residential,AC Only -.1-, $49.50 Coat$ Building Permit#,- HEATING MOAT!'FEB $ 41 ISO sA, k V • STATE SURCHARGE $ 11 TOTAL PERMIT FEE $ V t This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Huuid1 g Official 24 hour notice for all inspections(952)447-9850 PAID WITH 4646 Dakota Street S.E.,Prior Lake,Minnesota 55313 BUILDING PPRMIT DROF PRIOR LAKE BUILEPADING TMENT AND INSPECTION INSPECTION RECqRD SITE ADDRESS (�&& i `tet lG E OF WORK �, NI() 1�-�2 l- c NATURE ��'� I lip�• -tea USE OF BUILDING __ ,YU`� -i PERMIT NO. 1 _ 4- DATE ISSUED CONTRACTOR P yyc PHONE 4-1-67 — INSTALL EROSION COIVRTOL AN' MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE FOOTING �� (f FOUNDATION (Prior To Backfill) RADON RETARDER PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER/VVATER/SEPTIC p -t_ (172//`f FRAMING c,/,/ -�- Y INSULATION ('(t ELECTRICAL PLUMBING -1-44,67 1 - i/`/rte HEATING &(r� FIREPLACE - %WI GAS LINE AIR TEST RADON RETARDER COVER NO WORKABUNTIL TH OVE1A BEEN SIGNED HOUSEWRAP LATH FINALS GRADING ( PRIOR TO SODDING) • BUILDING 'j�)0 _ .l � �c -S 2/ it, • ELECTRICAL a PLUMBING HEATING 0 - 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 1 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd 0� PRIpR TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 7 . AND UTILITY CONNECTION PERMIT U t� 'yj�xEso'�t' 1, White File 2Pink City PERMIT NO. [4._,4.7 . 3 Yellow Applicant (Please type or print and sign at bottom) ZONING(office use) ADDRESS I Cv(v(pa MA-L i 1_4412, Delv_ LEGAL DESCRIPTION(office use only) 9 LOT BLOCK 3 ADDITION EA(=,L C — �t . PID Z-S. 5- ...0-2,7,_ 0 OWNER (Phone) (Name) (Address) I o BUILDER Name) ( V E LA�1D ``as (Phone) `52-44o - 9.40� (CompI (Contact Name) Zt 4.. rP +4 /Thl3IF 7�2m t7 (Phone) SSG_ 11 OZ l F64 1201i -r Q , Mhl. —3-72 (Address) 5 t��- �- �-� TYPE OF WORK VINew Construction ❑Deck ['Porch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace ❑Addition ['Alteration ['Utility Connection 0 Misc. CODE: gh..R.C. I.B.C. Type of Construction: I II III IV V A B PROJECT COST/VALUE $ I q`.s 2.5U Occupancy Group: ABE F HI M � S U (excluding land) t Division: 2 3 4 5 I` I hereby certify that I have • fished 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-memo,ed proper a . that all construction will conform to all existing state and local laws and will proceed in accordance with submm ned plans. iI am. a are that the building ffi ocial ca. joke t.• .4 m for just t cause Furthermore,I hereby agree that the city official or a designee may enter upon the property per ,i if $4- ep576S2 # 12..-2G- r.5 X Signature Contractor's License No. Date , Permit Valuation 2-`1 tV'��.- -- Park Support Fee # $ 1 Permit Fee $ (7 55 5-z) SAC Plan Check Fee $ ( J 4- i , Og Water Meter Size 5/8"e $ 5747 '- State Surcharge $ (� .SCJ Pressure Reducer $ ( 5 Penalty $ Sewer/Water Connection Fee # $ ( ---e7-;. '-' $ ( s-f s- Water Tower Fee # $ ( ,�v . Plumbing Permit Fee $ Mechanical Permit Fee $ (5-4 ,5 Builder's Deposit ,- ' Other $ Sewer r Water Permit Fee $ 5- ,9J U . 1// (5O 0 Gas Fireplace Permit Fee $ TOTAL DUE /. L� •�-- $ / R eipt No. la� s I This Appl' ion B,. e our,:uilding Permit W ie Ap oved Paid r(` . I �/ I Date r 3-r! Building Official —"init.." •ate This the City oceed as ed. This e u to certify th i e request Tanner in on tttutes a temrpo temporary CertificateCation and of Zoning compliance andpanying documents is in callows co strnce uction tto omme ce. Before and upancy�a Ce ti icate oftOccupancyt must menu when signed by t �� issued � / /0 _� /� 7 Planning D. or Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372