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SCOTT COUNTY, MINNESOTA Permit# 34953
INDIVIDUAL SEWAGE TREATMENT SYSTEM (ISTS) PUMPING PERMIT
6 T / -
Owner �l I() l Address J /
6 ! / C- iJ'
Pumper �L` No. of Tanks Pumped Total Gallons Pumped lo-0 �2
Check all that apply: :! Residential ❑ Commercial ❑Rental
0111 Septic ❑ Holding n Pump Chamber ❑ Cesspool ►'l •bandoned ❑ Other:
Condition of Baffles (baffles must be inspected) ❑ Akceptable ❑ Unacceptable 111 Replaced Baffles
Depth of sludge layer `T inches /� ��
Disposal Location(be specific) '7 g-,
Did you observe a surface discharge? ❑ Yes _ No
Pumped From: ❑ Maintenance HoleRemoved Tank Lid(stave, for example) ❑ Inspection Pipe(see below)
I have been informed about the correct t k cleaning predures and understand that I risk having my system fail prematurely
if the tank is not pumped through the Maintenance Hole/1 Tank Lid to enable the removal of solids.
Signature of Owner/Owner's Agent Reason fot pumping through the Maintenance Hole/Tank Lid
Comments • //3 U b TC.) Cf T cy J \
Pumper/Inspector Signature f` . 5(A.-------- Date c-1-11-7/
Only one permit is needed per ISTS.If there is mo an one ISTS on a property,submit a separate permit for each ISTS.
Submit a permit whenever a tank is pumped for a 0 I ndonment. Pumping the tank does not constitute a compliance inspection.
White-County Canary Homeowner Pink-Pumper
Form#1120
of PR/0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
PI AND UTILITY CONNECTION PERMIT
~-HNES011' I. White File
2. Pink City PERMIT NO. /4 ../A30
s Yellow Applicant
(Please type or print and sign at bottom)
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ADDRESS ZONING(office use)
/Z 7/ � /9 /L / "-2 P_ 227AI
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER e ///-7/`t L L-5 r C6 ' "6--(-1(76 ,q i /' Tr(Phone) t /e2 - 7` C l ^c5
(Address) /70 W " % //
BUILDER
(Company Name) Ai/7r S77e4t �/v
(Phone)
(Contact Name) n/e/971/196 6 t..,)/7- (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑De k ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration Utility Connection
CODE: L.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
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-m •tioned property and that allllaaaconstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
ffic
u ./revoke t peEmit for just se � ,�.< l er that the city official or a designee may enter upon the property to perform needed inspections.
l/j/'�O �/ (i//b//5Z
La 07 Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC j� ## $ 24 35
Plan Check Fee $ Water Meter Sizi(.7f ; 1"; $ Q/I -
State Surcharge $ Pressure Reducer $ /10-
Penalty $ Sewer/Water Connection Fee # $ 1 500 '—
Plumbing Permit Fee $ 5—A, O Water Tower Fee # $ t AA')7- 5 'r
echanical Permit Fee $ Builder's Deposit $ 1 `
Sewer&Water Permit Fee $ C, /_- 50 Other $
Gas Fireplace Permit Fee $ ✓ �/ TOTAL DUE $ S/_ w
This Application Becomes Your BuildingPermit When Approved (((//t��/
PP Paid Recero. lo g/ 1--
Date
Date f47 /� By • iii__
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
°C31
PR/0 e+— W,Aa r' Date Recd
CITY OF PRIOR LAKE =PERMIT
�-- 211
z.axefib' naPik PERMIT NO.
(Please or rant and si at bottom a.
Yellow ewnwni
ADDRESS
t-709 t Sly J �i ! f ZONING Office we)
LEGAL DESCRIPTION(offiiceuse only)
LOT BLOCK ADDITION PID
(Ivan m jRCk�Pc-vLu-e: a,a,t 0 (Z ,of�1( G j
(Phone)
(Address)
APPLICANT
(Name) 41 �J (Phone) /� ? 2.1 0 g)
(Address) 1 5-3 0 �,�,_- 2-S O i S f Obvi
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....fit. �.ti� t �-�v� `�700.7
(Address) ( (City) (Zip Code)
{Contact Person} �}k (� �1 �J�1--
DO t (S-8 . 2-(
APPLICANT
(Phone)
APPLICANT SIGNATUR$ DATE -
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity . Type of Fixture
Bath Tub with or without shower Rough-ns
s
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
let/41-€4- /VC
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§32613,148 Building permit#
i �
SURCHARGE has been extended PLUMBING PERMIT FEE
The ntinintulu stn charge for fy
a STATE SURCHARGE $
"fixed fee"permit is$5 GO- TOTAL PERMIT FEE $ ( ' PERMIT
This Application Becomes Your Building Permit When Approved Paid
Receipt No.
Buildlne Official Date Bate By
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
p BRtp$ Date Recd
14
CITY OF PRIOR LAKE PLUMBING PERMIT4.
Z .
dr, sib
LI Fk PERMIT NO. f
3.LI C5ry I l ` ( I�
3.Yellow Applicant (r/
(Please type or print and sign at bottom) '
ADDRESS _
1 o \ ` S O O S t p `V p
ZONING(office use)
LEGAL DESCRIPTION`Mike use only)
LOT BLOCK ADDITION PO
am)R ,J 10Vv_A-Gi e t1�a .. (Phone) LIZ—' -11-6t . J 7
L,
APPLICANT: �
Phone: 952.758.2108
Benny's Plumbing LLC
211 2ns Avenue SE
New Prague
Contact: Ben Stienessen Phone:952.292.8101
I" " " V_ v 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 or2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
---------
Water Closet(Toilet) Other
1 — &✓ote,— ,1e7&
FEE SCHEDULE ,
Industrial,Commercial&Multi-family I%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential.Additions&Alterations $49.50
The Minnesota Statutes§32611.148`t 5 Building Permit#
: uRcHARGE"has been extended PLUMBING PERMIT FEE $
The minimum surcharge for a STATE SURCHARGE $ 'D i �pITH
"fixed fee"permit is$5.00' TOTAL PERMIT FEE $ '13ft•C_ ERNI'
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
As-Built
Project Address Date
Home Builder Work Performed
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Show following items:
• Dimensions to property lines
• Lengths of pipe,offsets in pipe,depth of pipe,size of pipe,type of pipe,offsets from house corners
• Show all termination points of draintile with ties to pipe(from two house corners)
• Septic tanks: length of pipe,height of risers,pump type and model,size of tanks,offsets to house/well/property lines/mound,float settings
• Sewer and water: length of pipe,depth of pipe,offsets in pipe,drop sections,offset between sewer and water,pvc and copper size and type
ties to curb box
• Drain tile:length of pipe,depth of pipe,slope of pipe,any intersections with other utilities,size of pipe,connections at house/garage/etc.
• Mound:size of rockbed/sandbed/downslope/upslope,lateral spacing,lateral size,hole size and spacing,depth of sand,length of force main
Pitjo01 4,
u 1. 7(DI
4stionsoit.
March 14, 2014
Jackie and Charles Elliott
17091 Sunset Avenue S.W.
Shakopee, Minnesota 55379
Re: SUNSET AVENUE UTILITY IMPROVEMENTS
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 this 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 fee amounts are 2013 rates and will apply
for all building permit and connection fees obtained within the calendar year 2014. Fees
for permits obtained after December 31, 2014 will be calculated based on the City's
adopted fee schedule. The connection fees for permits obtained in 2014 are calculated as
follows:
1"Meter
Plumbing Permit $54.50
Sewer and Water Permit $56.50
Sewer Access Charge $2,435
Water Meter(1") $740
Sewer/Water Connection $1,500
Water Tower Fee $1 000
5/8' $5,786
Plumbing Permit $54.50
Sewer and Water Permit $56.50
Sewer Access Charge $2,435
Water Meter(5/8") $590
Sewer/Water Connection $1,500
Water Tower Fee $1 000
$5,636*
J:\UTILITY CONNECTIONS\Sunset Avenue Utility Connection Letter(3).doc
Page 1 of 2
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: Robert D. Hutchins, Building Official
Page 2 of 2
4646 Dakota Street S.E. Prior Lake Minnesota 55372