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I"O CITY OF PRBUILDING PERMIT, Date Rec'd F TEMPORARY CERTIFICATE OF ZONING COMPLIANCE I- /10-/Y1 AND UTILITY CONNECTION PERMIT ile o 14-44 f *thNESAS* .White Pink civ FiPERMIT NO. ' —1--10 Yellow APVl,eant (Please type or print and sign at bottom) ADDRESS ZONING(office usel t l LEGAL DESCRIPTION(office use only) LOT t., BLOCK . ADDITION --r. PID t.:i t,-c> t•ti t. OWNER { /-1(7,,,-.:41)- (Mame) > R�� '���,. (Phone) t �..1:r r�-,:;2.,:,,- , (Address) i i , , -1-„. ( BUILDER (Company Name)�J '3 t II ., ,, (Phone)(l i\I `I ? .,v (Contact Name) '.ase ,- , v,,,-.: E. ; ..4. (Phone).f ' ,'i t: h (Address) -y7 TYPE OF WORK'IS.New Construction' ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace ❑Addition Ial9teration ❑Utility Connection CODE: t ti.R.C. ❑LB.C. 0 Misc.. Type of Construction: I lI IIS IV Y A B PROJECT COST/VALUE $ LI.2,-.-_, ,... Occupancy Group: ABE F HI MRSU (excluding land) Division: 1_ 2 3 4 5 1 hereby certify that I c furnished infornr lin on the application which is to the best of my knowledge nue and entree( I also certify that I am the r authorized agent for the alio mentioned erty and that all a trucnpn,t l conform to all exiting state and local laws and will proceed,ceed Sn accordance with ubmitte f plans I em aware that the butidtng oifival can re this permit for ust se Fun moreI hereby agree that the coy official ora designee may entet upon the property toperform needed i sp ct ons „ i trw Signature Contractor's License NoDate Permit Valuation Park Support Fee # $ , __ :J 1' tt�} k}n z i Permit Fee $ • 0._, SAC ? # S Plan Check Fee $ l ci t z } Water Meter Size 5/8" 1", $ '90e 0( [ d / State Surcharge $ r{, Pressure Reducer $ f a' -;409 Penalty $ ........_ Sewer water Connection Fee # $ i IPlumbing Permit Fee $ /1 15-1//'S0 Water Tower Fee Mechanical Permit Fee $ j- Builder's Deposit a.....1,„r„)-00, eJ Sewer&Water Permit Fee S /f, '" ! Other 5 Gas Fireplace Permit Fee S ` TOTAL DUE _t - ' , - This A,,'ca,o,Beec,,es your Building Permit F en A roved i Paid '` ' ,? ReC�Pt No r,'` (�` ry Date j/ (_f By-- �;AAri..r ,/7 14- ,nil ,nil ma UfCoiat 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 peeved as requested This document when signed by the City Planner constitute,a temporary.Certificate of Zon g compltance and allows construction to commence Before c F y, Certificate of Occupancy must be ` . 1'' « � � t / t, d ' f +/_ ' il,_ e4X,'rr a ✓ ffg rl,' ,,,,,d v /,,aa Pr,, 1t - r-a.' r l -,/,,,,,,,,,,-;,-, 3.0'7,,,,,, „ ;• », Planni Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 _ x 4646 Dakota Street Prior Lake,MN 55372 e.. Fltl04, CITY OF PRIOR LAKE Date Rec'd DEMOLITION PERMIT 5,zo . l q 'vNESf3 PERMIT NO11._ % (Please type or print and sign at bottom) ADDRESS ZONING(office use) 11414170 Slack -5-Ca Tyo 4 IE LEGAL DESCRIPTION(office use only) LOT &�,r� ,n � � _ 1 PID 2.SO �(P0 0 co 0 BLOCK ADDITION S(;/A4 15.eat, t OWNER d�" ^ (Name) M(1'GIVIeV -� .�O yi I 1h�'�1� MLA' (Phone) 6752 210 1 LI 2 (Address) l Ll Li '1 .10 hack./ u 0,... 1 �( ( 1 Al 1 l CONTRACTOR I� ` (Company Name) t L LCi€ ��-Inf�.� \y 4.\ 0 (Phone) (Contact Name) /tom�,�,1.8] J Vt (Phone) CO (2 -7-3O & q 2 (Address) s(DO Coaclo is c51-- `±c- nil(7y' L o_ ti 1 i ) c>0 7?- Use of Building: INTERNATIONAL BUILDING CODE ,� ��p Type of Construction: I II III IV V AB �J 1 u�l Occupancy Group: A B E F H I M R S U Division: 1 2 3 4 5 1/1MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION .I ereby 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 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a esignee may enter upon the property to perform needed inspections. Sign. re Date 5 2� / RQ CES SAC ro r This Ap•lication Becomes Your Demoliti n DEE TIO1 � '`i , �� P;rmit When Approved �' /? 14- j24 i2 Soc) . cc' C/ e,-7 Oft ; 5 z Y / - c' '/'/' /J7r' /t4$7Iv`_ Buildi g u. •: _.._...._ Date .� ., This is to certify that the est in the..ov- application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. dor -9 02 9-/f Planning Direc; 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 boi Bo�� , „C� ��� R / wh�9 q/eiC'SS NAME OF APPLICANT pF, T Pp AT • uilding Pink rY;p nginee LICANT A - ianni gang APPLICATION RE I{ 4 1 4 CZE l 1 EN n T CE/VED �l . / r rmit The Building, �� /Y, L,� application r En9�neerin l construction'aCt�;� `J, y wh!ng Depar/ ��' • l&--4c7' ,�� ich rs pr°p So edtathave reviewed Accepted %�`� the building pe Denied Accepted With Reviewed By Corrections CO �1,;/:..4. Comments: ;! �- ��,�vi�� �� � • .� Date: L. 2. ` / A4X6,,, 'o = _ «7� J Sle<Ve' if 0 ©Cid I dinances of tto he a authoritof y code � of to be a permit of jurisdiction to vio/ate any other f°r, or plans, s diction shall be v an ans o pecifi not or ca el ordinance o va/°f cations nc the nce f the jurisdiction. anY viol and valid." provisions lurisdictio ation of ns of this code or other other ,nits r. 041 ntigt /44?eia4/°"Mt) e pin of 17) ./114/S A dors- ss White -Building Canary -Engineering ' asoo Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT?//4,,eiM-e"Ze- ;/)? Zei /1")/146"---1. APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted Accepted With Corrections Denied Reviewed By: Date: Comments: ,.4 .er-IlivuS 5uIZe�N- MAX, 3®Z ,E evovQ w i 'czte. 7Cr AX/1111ea. -41,0441fn- 14i "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." Demo za L Z. O, bt ,° /1")e",4/ Irl r 4-his Adoress White -Building �Nsc��w Canary -Engineering Pink -Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT J /lV G Le- i /4 / /leY APPLICATION RECEIVED - "h'` /�`" • The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted Accepted With Corrections Denied Reviewed By: /Y Date: Comments: See Reverse Side for Additional Information! 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." O1 PRtp4) Builders Deposit U iii 50111- 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 completed 180 days after the date the building permit is issued. If the work is not complete within the 180 day time period,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 handout. DATE: S7(1./if SITE ADDRESS: iYl74 Jhio &(c11;4./ /PERMIT# ,470 y REFUND TO BE MAILED TO: /do 6„,,i,,, .S.r..i SI JIL IAA , /Af ss17) PLEASE REMEMBER 1. KEEP STREETS CLEAN DURING CONSTRUCTION -1J H4 c /�>11' I f - 2. KEEP EROSION CONTROL IN PLACE (For City Office Use Only) 3. TEMPORARY OCCUPANCY PERMIT MUST NOT '7-z /S' II.27 500_00 EXPIRE OR$500.00 ILL BE FO FEITED Date Amount SIGNATURE: .. J / Lar va.ppler 'ynda Allen • City Eei -r- Building Svcs. / • PINNACLE FAMILY HOMES,LLC 2458 3175 LINDEN CIR NW 75-905/519 PRIOR LAKE,MN 55372 r /z/ CjOATE . // -OAT TO THE 1 it p�c....? ? 2/7 0711/ / / / ke...<4 2.4e 1 .4' I,' ."'dir to" ,/,0, Aj Of o•.i•_ (Ja .. i / s / r7ARS; 8ewip e. PRIOR LAKE SPATE BANK Hwy.13&Duluth Ave.P,O.Box 369, Prior Lake,MN 55372(952)447.2101 t:09 i90905;5i: . 1111053 2bill 3111 21458, J:\FORMS\BUILDERS DEPOSIT FORM.DOC U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No.1660-0008 FEDERAL EMERGENCY MANAGEMENT AGENCY Expiration Date:July 31,2015 National Flood insurance Program IMPORTANT:Follow the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name ( Policy Number: A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg�No.)or P0.Route and Box No. Company NAIC Number: syr/ 76 $ ha..cly RPa.c k 1 r-p:?t City State r.,.'ti ZIP Code SS 8 Ir'aBr-- L. ct.K2 A3: Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) )..c,}- ,. SHAVI CSEA.C1-1 NO. Z . SCOOT Ct N.T`c', 011\,1 A4. Building Use(e.g.,Residential,Non ftesideritial,Addition,Accessory,etc.) Fe S,det-t..t "•4-tQ. A5. Latitude/Longitude:Lat.'i 4 LA/ LS Z. Al Long. 93° 2y`O8.7" W Horizontal Datum: 0 NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 113 A8. For a building with a crawlspace or enclosure(s): A9.For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 104-(p. sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b p sq in d) Engineered flood openings? ❑Yes 0 No d) Engineered flood openings? ❑Yes 0 No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 61. NFIP Community Name&Community Number 62.County Name 63.State Ptt.ttoA- c,p,k:S mN '2-7a4-3Z c....10 TT MtNNFSTIIA B4. Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel Effective/ B8.Flood Zone(s) B9.Base Flood Elevation(s)(Zone Revised Date AO,use base flood depth) .2704 00v2.c. 1-Z`[79//il-ig , AE*'"X 9o9 B10.Indicate the sours of the Base Rood Elevation(BFE)data or base flood dept entered in Item 69: ❑RS Profile FIRM ❑Community Determined ❑Other/Source: 611.Indicate elevation datum used for BFE in Item B9: [NGVD 1929 D NAVD 1988 0 Other/Source: 612.Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes o Designation Date: / / 0 CBRS 0 OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: IN Construction Drawings* ❑Building Under Construction* 0 Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2 Elevations-Zones A1-A30,AE,AH,A(with BFE),VE,V1 V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/A0.Complete Items C2.a-h below according to the building diagram specified iq Item A7.In Puerto Rico only,enter meters. BenchmarkUtilized.�i; 1f' Qd^ ev Lt a t} AN;tA. Vertical Datum: Indicate elevation datum used for the elevations in items a)through h)below. NGVD 1929 0 NAVD 1988 0 Other/Source: Datum used for building elevations must be the same as that used for the BFE. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 9 I 0 Lib ®feet 0 meters b) Top of the next higher floor 0 feet 0 meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑feet 0 meters d) Attached garage(top of slab) 910 . ,d_A2 L feet ❑meters e) Lowest elevation of machinery or equipment servicing the building 9 '6 10 . 0 feet 0 meters (Describe type of equipment and location in Comments) 4o Q f) Lowest adjacent(finished)grade next to building(LAG) Il feet 0 meters g) Highest adjacent(finished)grade next to building(HAG) g0 . "7 0 I1 feet 0 meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including RC c1 7 Q I!feet ❑meters structural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.I certify that the information on this Certificate represents my best efforts to interpret the data available. i p ?, I understand that any false statement may be punishable by fine or imprisonment under 18 U.S.Code,Section 1001. 0 Check here if comments are provided on back of form. Were latitude and longitude in ection A provided by a 0 Check here if attachments. licensed land surveyor? Yes 0 No i Ct Certifier's Name License Number TitleNkki Compainy Narpe t S (2.. (._5 i�rokie. L sneer rtt� n"P �► '"",'' }� G ,t .fit Ci tate /►� + ZIP Coe q Addres�060 G. l J � 2.4c tyJLorns i4�e Mrj 3. 7 j�/� , Signature t��� .� /` Date 2..-1 1� Tele q�2-432.- 3 800 ��i ,/11>i�N���� FEMA Form 086-0-33(Revised 7/12) See reverse side for continuation. Replaces all previous editions. ELEVATION CERTIFICATE,page 2 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: k -7bkek.1� t�'e 4 cd. T'-a ( City State ZIP Code r Company NAIC Number: Pro✓ (,4-t INA N .6--. 3 7$ SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,Band C. For Items El-E4,use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters. El.Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters 0 above or 0 below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 feet ❑meters 0 above or 0 below the LAG. E2.For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions), the next higher floor(elevation C2.b in the diagrams)of the building is 0 feet 0 meters 0 above or 0 below the HAG. E3.Attached garage(top of slab)is ❑feet 0 meters 0 above or 0 below the HAG. E4.Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters ❑above or 0 below the HAG. E5.Zone AO only:If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance?❑Yes 0 No 0 Unknown.The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BEE)or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments. SECTION G COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items 08-G10.In Puerto Rico only,enter meters. G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information.(Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. 0 The following information(Items G4-G10)is provided for community floodplain management purposes. G4. Permit Number G5.Date Permit Issued G6.Date Certificate Of Compliance/Occupancy Issued G7. This permit has been issued for: El New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: 0 feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding at the building site: 0 feet ❑meters Datum GbO.Community's design flood elevation: 0 feet 0 meters Datum Local Official's Name. Title Community Name Telephone Signature Date Comments ❑Check here if attachments. FEMA Form 086-0-33(Revised 7/12) Replaces all previous editions. ELEVATION CERTIFICATE,page 3 BUILDING PHOTOGRAPHS See Instructions for Item A6. IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number: City State ZIP Code Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance,affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View."When applicable,photographs must show the foundation with representative examples of the flood openings or vents,as indicated in Section A8.If submitting more photographs than will fit on this page,use the Continuation Page. FEMA Form 086-0-33(Revised 7/12) Replaces all previous editions. 470 CITY OF PRIOR LAKE 0. Impervious Surface Calculations (To be Submitted with Building Permit Application) For All Properties Located in the Shoreland District (SD). The Maximum Impervious Surface Coverage Permitted in 30 Percent. Property Address 14-4-7‘ �// t� em4/ 749/(- Lot Area 14- ��..- --7, 610 ape__ Sq. Feet x 30% = 4-3 ***********1( -ape__* *********************************************************** LENGTH WIDTH SQ. FEET HOUSE x = • x = ATTACHED GARAGE x = TOTAL PRINCIPLE STRUCTURE 2.71c8 DETACHED BLI3GS x (Garage/Shed) x TOTAL DETACHED BUILDINGS N DRIVEWAY AVED AREAS x = (Driveway-paved or not) x = (Sidewalk/Parking Areas) X TOTAL PAVED AREAS /Z 2-c PATIO /PORC S/DECKS x = (Open Decks'/4"mm.opening between X = boards,with a pervious surface below, are not considered to be impervious) X = TOTAL DECKS OW OTHER x = X = TOTAL OTHER TOTAL IMPERVIOUS SURFACE 41 e 3 UNDER/2 VER j 6 Prepared By ---7tr Date _ 3a -/f Company g94,4 (NG 46 . Phone # (9.q .1f2 - 'ew • Date Rec'd C41No* U� CITY OF PRIOR LAKE xSEWER AND WATER PERMIT Z •NESO I. Green FCity iile PERMIT NO. / 7t/ - 2. Yellow 7_ 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) Lien, C.)t y 42)2-CLOnr 1 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER , 1 (Name) r)n (Phone) (Address) 9 0• `€5 A t o5 O (Address) (City) (Zip Code) i-- F APPLICAN (Name) O C.,L°_L e-C o--1/4)l '1 Yl 1 rw (Phone) cl 5 g Q-- (Address) i D Cv "Book-v-- Atx.. vd-ce' (Address) (City) (Zip Code) (Contact Person) Y 9 ,O (Phone) C )-tqD` APPLICANT,SIGNATURE ..ice'_ DA 1'E ur APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC E PVC n 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 $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 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid 114141 � Date 'Y r i Building Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 �o I PRIQ� CITY OF PRIOR LAKE Date Rec' x HEATING/AIR CONDITIONING/FIREPLACE PERMIT 1.Pink File N /PERMIT 1'1 O. ( j- 2.Green City I (Please type or print and sign at bottom) 3.Yellow Applicant ADDRESS ZONING(office ust l ' * ak • I °'a _l r LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) Il CtCiz --e, � fol^ J (Phone) (Address) 5/ 00 ail CP:1 S JC Prf.ciel4x16 c'_yn Il) 7.. r APPLICANT (Name) (`-1 t(;),,05'rQ �n_ k.,k_ tiVc-iI (Phone) °1S' .-t (otra-" (Address)C)0 EV 02 C .X's C 'l 1 ,Q 5 ` `_ (Contact Person) (Phone) ---4-- ' ---q -� APPLICANT SIGNATURE DATE u//1 Vi I/ APPLICA IT PLEASE COMPLETE BELOW ti EW CONSTRUCTION 0 REPLACEMENT C]ALTERATIONS FURN CE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner 0 Warm Air Plants 0 Steam Units and Fireplaces Cannot Encroach gravity ❑Hot Water into Required Side Yard Setbacks. r ecechanical El Radiation Fireplaces with Box Additions or ❑Air Conditioning ❑Special Devices Cantilevers to the Outside of Buildings CI Vent. System El Other Devices i Require a Building Permit. g FIREPLACE MAKE AND MODEL eC --i L (cL 150 —14:31 _.h.---7-- FEE FEE SCHEDULE . - --- --._. Industrial, Commercial&Multi Family 1% of job cost Residential, Gas Fireplac $49.50 $49.50 minimum Residential,Heating&AJC(New Construction) $149„50 Residential,Additions&Alterations $49.50 Racitlpntial. Neatinsr Only(New Construction) The Minnesota Statutes§3268.14 $64.50 Residential,AC Only $49.50 ` "SURCHARGE”has been extended Cost$ Building Permit# The minimum surcharge fora :-MATING PERMIT FEE $ ? eS "fixed fee"permit is• >TATE SURCHARGE $ 5.00 tc- - - 1 `-' COTAL PERMIT FEE $ 5 , , i t 1. This Application Becomes Your Building Permit When Approved Paid Receipt N7 - Date i" Building Official Date rt., ,ni `i 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 OQ?RIO+ • Date Reed ,� CITY OF PRIOR LAKE PLUMBING PERMIT -. Niit • Z3 SDC(Ct. Lslue ria. 2.Gold CityPERMIT NO. i 3.Yellow Appliane • ase • or• ,t and a.••at bottom ADDRESS ZONING(Accuse) LEGAL DESCRIPTION(ot6ce use only) LOT BLOCK ADDITION PID i OWNER f� t (Name) t t ./t�Ps G) �t'ti l y i�C f`\� `S (Phone) (Address) 5)00 en I t $ Sf , S E f l o r i--3, ke1 M yV 372 APPLICANT ` -�" n -' -� (Name) M C. C'yA 1: \ J—N�`_. (Phone) q J 2 l 3 3 0` 3 (Address) 4--t..) (Address) (City) (Zip Code) (Contact Person) U '/) D Se.,c (Phone) 952 -7 i' 3 C g 3 i✓�h (.t. / e .--- 2 ) Ay- APPLICANT SIGNATURE — - DATE �1 gy! T ,s _ APPLICANT PLEASE COMPLETE BELOW Quanta Type of Fixture Quantity Type of Fixture Bath Tub with or without shower D Rough-ins Dishwasher I Water Heater _j` _Floor Drain / Water Softener C Lavatory(Bathroom Sink) / Stand Pipe(Washing Machine) lLaundry Tray(1 or 2 compartment sink 0 Sewage Ejector Shower Stall (Q Backflow Assembly 1 Sim 0 Backflow Assembly Test 0 Bar Sink / Lawn Sprinkler Lf Water Closet(Toilet) Q Other Tile Minnesota Sta.-totes§326B.148 f3 FEE HEDULE ata cost with a 549.50SCminimum Residential,New One&Two-Family $149.50 "SttRCHARGE has Residential,Additions&Alterations $49.50 The minimum surchargebeenextended for a $ Building Permit# "fixed fee"permit is$5.00 .PLUMBING PERMIT FEE $ STATE SURCHARGE $ MI 5.00 TOTAL PERMIT FEE $ (Office Use Only) - This Application Becomes Your Building Permit When Approved Paid t No. 485&:4139'ill°47 Date BuUdine Offictal Date '* 4'� 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 - 43;4-7/7 4646 Dakota Street S.S.,Prior Lake,Minnesota 55372 1'Rto (31 4it 0 0 en 444.4000 MEMORANDUM DATE: Tuesday, September 9, 2014 TO: Janet Ringberg FROM: Lynda Allen RE: Demolition Permit#14-0441 14476 Shady Beach Trail N.E. Please refund the $5000.00 demolition deposit on this permit. The footings for the new home are approved and the demo file is closed. Return to: Pinnacle Family Homes 5100 Condons Street S.E. Prior Lake, Minnesota 55372 Thank you. , Ji ] A i ,dA.M11\ Lynda S. All', L oppler, City Engineer Building Se 'ices Assistant • PRl0R DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS4,1 4 C� rap NIE NATURE OF WOR o 23 ,14 /e e�ji✓G.L, USE OF BUILDING PERMIT NO. (4-,4-7O DATE ISSUED CONTRACTOR PHONE 952. 4'o Cvo9a INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE FOOTING 7,c1 G s'/Y, .;/ FOUNDATION (Prior To Backfill) Val r (re ,J' J RADON RETARDER Wit PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWERNVATER/SEPTIC p6 111 3/'7' FRAMING INSULATION YcS 12,/ VI ' ELECTRICAL PLUMBINGVs UQ' 4'b /4ci 14'7 HEATING FIREPLACE 'y ,. GAS LINE AIR TEST Il �/ /-7 �-- - /" r cT RADO & COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED HOUSEWRAP D L- , elATH 0715 Ofr FINALS GRADING ( PRIOR TO SODDING) 4 _- C��'� l; , BUILDING .rt-IA �/ -� � e ;'' • ELECTRICAL PLUMBING " HEATING 10, imific DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNE 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