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Utility Connection 14. 0195
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M ■ m 00 N r m m ■ m r ■ oz ■ m q q 4 2 $ -1o � Q P z- k t 0 »9. % ► 0 0 z ° z m % 03 C k 0 > \' 0 _ -cif k � n > m m ti 2 F. § 7 1 - \ - —1 - ,, -a % = 2 § § . . 000000 •1 m § 2 m Esc ■ ; � 2 �_ § o o % nc � � C ; m - xmmx_ § m o r Cn § 2 6 0 � Q v k ` > 0 0 � 0 3 -1 V m q / z rm00 m o § z \ § c-, \ 1- � -a P m x m t . z m / n _ 131 2 ! 000000 z E � - - § v £ _ ~ mrnmE© � In > � § gl 0 s_ © © ■ m § a MMW � F 2 m -4i B l SCOTT COUNTY, MINNESOTA 1 „ k`t INDIVIDUAL SEWAGE TREATMENT SYSTEM (IST§)°PUMPING PERMIT 4 1 Owner f E-0 '! / F--,e41 Address ) / 1 g I S-(,),--1 ..3 0-f ,4 U; --- Pumper 4`. �`--I -I' x,,� /its No. of Tanks Pumped ) Total Gallons Pumped SOU Check all that apply: Residential El Commercial ❑Rental eptic ❑ Holding El Pump Chamber El Cesspop.Lbandoned El Other: Condition of Baffles (baffles must be inspected) ❑Acceptable P ❑ Unacceptable E]Replaced Baffles Depth of sludge layer inches \,----' , Disposal Location (be specific) e' Did you observe a surface discharge? ❑ Yes Pumped From: ❑Maintenance Hole ❑Removed Tank Lid(stave, for example)p ) ❑Inspection Pipe(see below) I have been informed about the correct tank cleaning procedures and understand that I risk having my system fail prematurely if the tank is not pumped through the Maintenance Hole/Tank Lid to enable the removal of solids. Signature of Owner/Owner's Agent g Reason for not pumping through the Maintenance Hole/Tank Lid Comments Ho , C)( u1-9 • '\ (,/Y7! , 5 (- Pumper/Inspector Signature ,r le J --- Date 1-7/... 72 -1 V . Only one permit is needed per ISTS.If there .. ore th one ISTS on a property,submit a separate permit for each ISTS. Submit a permit whenever a tank is pumped '• abandonment. Pumping the tank does not constitute a compliance inspection. White-County Canary-Homeowner Pink-Pumper Pr Furor#1120 of PRIp-r CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,; t• TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4, g 14- g ¢ v AND UTILITY CONNECTION PERMIT D 4'�NlyggOt� 1. White File 2 Pink City PERMIT NO. /1.--- / 3 Yellow Applicant I/ (Please type or print and sign at bottom) ` ZONING(office use) ADDRESS /7/6 / s tiA/s� /� /� LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER �� h- /7 F- v/ diqW T 96j (96 6'5- (Address) BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK 0 New Construction ❑Deck ❑Porch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace ['Addition ['Alteration ❑Utility Connection CODE: DI.R.C. DI.B.C. 0 Misc. Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R SU PROJECT COST/VALUE $ (excluding land) Division: 1 2 3 4 5 I hereby certify tha ve furnished infor .tion on t s a,plication 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•mentione. ty and that. 1 .truction ill crnform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revo s permit for rstic it Furthe or I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. I -' P Contractor's License No. Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ 2_4350 Plan Check Fee $ Water Meter Size 5/8"; I"; $ —.590G State Surcharge $ Pressure Reducer $ 15Z. (JD Penalty $ Sewer/Water Connection Fee # $ /...6-60 0 v Plumbing Permit Fee $ 54. Water Tower Fee # $ l UZ>0. V C.J Mechanical Permit Fee $ Builder's Deposit $ rte_ Sewer&Water Permit Fee $ ...5—a, s 37) Other $ Gas Fireplace Permit Fee I $ TOTAL DUE $.3—7 f • 06 GG / This Application Becomes Your Building Permit When Approved Paid ,5 ft:... 6.4) Re ipt No. 7' f z- Date 4-. 6../ Building Official 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 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 4646 Dakota Street Prior Lake,MN 55372 Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT IVES- yGrecticilow aty PERMIT NO. I 3. Gold Applicant �. (Please type or print and sign at bottom) 111 ADDRESS ZONING(office use) 71061 411 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION P1 ) OWNER (Name) (Phone) (Address) (Address) (City) (Zip Code) APPLICANT ,f `A s, �a (Name) /'`► trrss /!�`tS/ 1 i 1 �(P/hone) 9'5"-Z.- � /�c ' (Address) 15-30 tit/i5"/� . g 1 / fe (Addres) (City) (Zip Cod) (Contact Person) ? 1`Q'i,``4 t (Phone) `" 7 4411 APPLICANT SIGNATUREri/ DATE #0 336f APPLICANT PLEASE COMPLETE BELOW Size of water service / inches. Location of any couplings from structure AO feet. Type of sewer pipe. ❑ABC b:' PVC ❑ Cast Iron Estimated length of sewer line ei9 feet. Clean out(if required)located at X/4 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 $ �PAID Wi mice Use only) BUILDING PERMIT 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 Et' "IOP Date Rec'd �1I CITY OF PRIOR LAKE PLUMBING PERMIT JI -.hittoe iss- 4:6 Bold pile PERMIT NOV- 3. I a Gota cry Yellow Applicant 61:5" (Please type or print and sign at bottom) q- ZONING(office use) ADDRESS j --� t S 1 s U N S L / ` 1� LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) / I a - 3 Go/ — -3-3,6�-( APPLICANT: Phone: 952.758.2108 Benny's Plumbing LLC 211 2ns Avenue SE New Prague Contact: Ben Stienessen Phone: 952.292.8101 i t1rr1J1t tuv t »vi�r�i ut�u _______i„....-•o- c- -- .--.___. T___ 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(I 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 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ PAID w, ni STATE SURCHARGE $ .50BU,LDiNG PPP"'"" TOTAL PERMIT FEE $ um1 (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 �r CC 4,r 0. 0 .� • n it"" 4- i 0' 11.1 � a 'N it PRI0 oAr ArtgsSw XXXXXXX, 2013 Leo Alfred 17191 Sunset Avenue Shakopee, Minnesota 55379 Re: SUNSET AVENUE UTILITY IMPROVEMENTS 17181 Sunset Avenue SUBSTANTIAL COMPLETION(Project# 13-011) The Sunset Avenue Utility Improvements are now substantially complete. A number of cleanup items will be completed in the upcoming months and the final layer of asphalt will be completed next summer. The utilities have all been tested and approved. You may now hook up your home to the new sewer and water service stubs. In order to make the connection from the utility stubs to the home, a building permit must be obtained from the Building Department. A"Master Plumber", licensed in the state of Minnesota must sign the plumbing permit. Also, a"Master Plumber"or a sewer and water contractor licensed in the State of Minnesota for pipe laying must sign the sewer and water permit. Building permit and connection fees of$5,786 or$5,636* are due at the time of the building permit issuance. The connection fees are calculated as follows: 1"Meter 5/8"Meter Plumbing Permit $54.50 Sewer and Water Permit $56.50 Sewer Access Charge $2,435 (Fee to increase to $2485 in 2014) Water Meter(1") $740 Sewer/Water Connection $1,500 Water Tower Fee $1,000 $5,786 Plumbing Permit $54.50 Sewer and Water Permit $56.50 Sewer Access Charge $2,435 (Fee to increase to $2485 in 2014) Water Meter(5/8") $590 Sewer/Water Connection $1,500 Water Tower Fee $1,000 $5,636* Page 1 of 2 J:\UTILITY CONNECTIONS\17181 Sunset Avenue Utility Connection Letter.doc The building permit will stipulate requirements for the connection as well as abandonment requirements for the existing septic system. Your existing well can be maintained for outside non-domestic use or can be abandoned and sealed. It should be noted that the sanitary sewer service is required to be located at least 20 feet away from any well or the well will need to be abandoned. The building permit will give further details regarding these items. Sections 704.300 and 705.400 of the Prior Lake City Code requires connection to City water and sewer within one year of availability. Section 4715.0310 of the State of Minnesota Plumbing Code also requires connection to municipal sewer and water systems once they are available. This letter serves as the beginning date for the one year time period. Attached for your convenience are copies of the building,plumbing, and sewer and water permits. If you have any questions or concerns regarding the building permit process, please contact the Building Department at 952-447-9850. Sincerely, Larry Poppler City Engineer/Inspections Director CITY OF PRIOR LAKE CC: Bob Hutchins, Building Official Page 2 of 2 4646 Dakota Street S.E., Prior Lake, Minnesota 55372