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TOWN & COUNTRY
SANITARY SEWER SERVICE I N V O I C E
2730 40th Street West
WEBSTER, MINNESOTA 55088
952 / 652-2923 ❖ 1-800 / 417-2718 13177
TO ' 944‘f
/Z,A0 - - DATE
Justin Klepperich
3o3: j r'*'31 31 5(hN*i 4t, OPERATOR
QUANTITY DESCRIPTION PRICE AMOUNT
❑ Pump Septic ❑ Holding Tank ❑ Grease Trap ,)
❑ Lift Station ❑ Excavate Manway
❑ Backflush /Tank Agitation [1100+ Foot Hose Extension
❑ Install Riser
❑ Float Switch Replacement ❑ Pump Repacement
❑ Scott County Permit - Dakota County Log - Rice County Log
❑ Monthly Portable Restroom/s
❑ Fuel Surcharge
❑ Clean Owner's Portable Restroom/s
❑ Regular Portable Restroom/s
❑ Handicap Portable Restroom/s
❑ Handwash Stations
❑ Extra Cleaning Services
!RM': DUE UPON RECEIPT. TOTAL ,
1-1/2°o Finance Charge after 30 days.
REVISED 12/11 750 minimum J'hat2Fur.
ri PRf®,� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
., i , AND UTILITY CONNECTION PERMIT !' '
U
4.**IHNEsogr r. white File PERMIT NO. /9 `�^^�
3 Pell App // / /
Yellow Applicant LLL///CCS///G/
Please 4.eor,rintand si: 17231 Sunset Ave SW
ADDRESS 25-489-006-0 ZONING(office use)
Lindell Revocable T/Carlonna
LEGAL DESCRIPTI
LOT BLOCK ADDITION PID
O(N`ame))ER C Q h l O ti r-,, c< L! h dt l l (Phone) IS,)-d" P'177C 6
(Address) / 7a 3 1 sUptc ef Alit • (, ?si!o t e# 4,4 - -jodo4-141elirbiti)
BUILDER
(Company Name) 4 �Ai 6rl�Wtt. 64 (Phone) 1S2"Ire Z1G(
(Contact Name) 'Fre,HG( er bt7r4 (Phone) q5Z-75t -Z/Ct
(Address) /C3C GVtc 7(OJ4.1 q- blew w f'ri tt.P. /14A) gee'71
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ORe-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
DAddition ❑Alteration ArUtility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: t�, B E F H I M R S U (excluding land)
Division: r! 1 2 3 4 5
I hereby certify that have fur ished information on this app"c ion w rich 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 pr Petty a d that all construction will confor existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke du er it fo;just cause. Furthermore,I her bytgree tha he city official or a designee may enter upon the property to perform needed,nsp. ti ns
X I/ if
tgna Contractor's License No. Date/
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $ 2-4-35, V d
Plan Check Fee $ Water Meter Siz 5/8", I"; $ /10 00
State Surcharge $ Pressure Reducer $ //Q, e d
Penalty $ Sewer/Water Connection Fee # $ /3-0 0 . 00
Plumbing Permit Fee $ 5x/ .CO Water Tower Fee # $ /D U 0 .0O
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ ..5- ,. 57) Other $
Gas Fireplace Permit Fee $ TOTAL DUE $..g-63(p (1 O
This Application Becomes Your Building Permit When Approved Paid rjl 3(' .c121 Rec ' t No. 70 f Y /
Date 4-.. /t,/l_ By `
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 ail inspections(952)447-9850,fax(952)447-4245
• 4646 Dakota Street Prior Lake,MN 55372
AS-BUILT TIES
- lam
L I c :S_ ' DATE:
PROJECT ADDRESS: \ �J
NOTES:
( ilootk ,e1......-
1
b
t1'
I
t
4.-4'..ty„r moi:
Nj
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4,
Show following items:
. Dimension 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 setting
. 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 interesections with other utilities,size of pipe,connections at house/garage/etc.
. Mount:size of rockbed/sandbed/downslope/unslope,lateral spacing,hole size and spacing,depth of sand,length of force main.
o
Date Recd
` �� CITY OF PRIOR LAKE PLUMBING PERMIT
•`iNivEso'c'
I.Blue File pERMITNO.
2.GoldCity
/4...3.Yelllow Appplicant
lease p e or.rint and sien at bottom)
ADDRESS 17231 SunsetAve SW ZONH'G(officeuse)
25-489-006-0
Lindell Revocable T/Carlonna
LEGAL DESCRIP
LOT BLOCK ADDITION PID
OWNER
(Name) Ca Ii to h h qL /h Q "?q7-s7/
' (� l / (Phone) �
� /(� (J
(Address) ? -It U O V t,'(t f Ack - ( frGtkn pit/. S-S C�1s? d1i ,)
APPLICANT: Phone: 92.758.2108
Benny's Plumbing LLC
211 2ns Avenue SE
New Prague
Contact: Ben Stienessen Phone: 952.292.8101
n APPLICANT SIGNATURE "V W&'V V DATE
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) n,l,Pr
PLUMBING FEE OF$54.50 PAID BY –
The Minnesota Statutes§.326B.148. ' FEE SCHEDULE HOMEOWNER—Plumbing Permit must
"SURCHARGE"has been extended Afjob cost with a$49.50 minimum Resid be signed by Plumbing Contractor
The minimum surcharge for a . Resid
"fixed fee"permit is$5.00 $
Building Permit ,
PLUMBING PERMIT FEE Permit Fee $49.50
STATE SURCHARGE State Surcharge 5.00 �r1� �4/
TOTAL PERMIT FEE 'TOTAL $54.50 � f �,e
(Office Use Only) i `"!/1y
This Application Becomes Your Building Permit When Approved rainReceipt No ',,'
g3 j,
Date By
Buildirie Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
VR/0 Date Rec'd
l
g'(''.. .
CITY OF PRIOR LAKE PLUMBING PERMIT 4- a id—
Ail
tivi Es_1„ t.Blue File
2.cold city PERMIT NO. /4_ 7_0
3.Yellow Applicant
'lease j.e or .rint and sign at bottom)
ADDRESS X7231 Sunset Ave SW ZONING(orrice use)
25-489-006-0
Lindell Revocable T/Carlonna
LEGAL DESCRIP
LOT BLOCK ADDITION PID
OWNER
(Name) Ca /
L ( 0 In h q L /h 614 it (Phone) I a17 s7‘O
(Address) as ?y 0 ,D v 4 x-e l Acic . (J"114,1 Pill. SS(a() (ifelifil)
APPLICANT
(Name) (Phone)
(Address)
(Address) (City) (Zip Code)
(Contact Person) (Phone)
n APPLICANT SIGNATURE DATE
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) clui.r
PLUMBING FEE OF$54.50 PAID BY -
TheMinnesota Statutes§326B,148. FEE SCHEDULE HOMEOWNER—Plumbing Permit must
"SURCHARGE"has been extended )fjob cost with a$49.50 minimum Resid be signed by Plumbing Contractor
The minimum surcharge for a . Resid
"fixed fee"permit is$5.00 , $ Building Permit t.
PLUMBING PERMIT FEE Permit Fee $49.50 St' AL
STATE SURCHARGE State Surcharge 5.00 /f/' Wt
TOTAL $54.50
TOTAL PERMIT FEE � ,,���
(Office Use Only) iiy
/3� ,�,
This Application Becomes Your Building Permit When Approved rasa Receipt NY."
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
V Rir°4 Date Rec'd
/1[\ , CITY OF PRIOR LAKE 4-. /f /SEWER AND WATER PERMIT
NNEso
1. Yello File PERMIT NO/
d 6
2. Yellow City
3. Gold Applicant
(Please ty.e or .rint ana-'---.w^,+,,,,.N
ADDRESS 17231 Sunset Ave SW ZONING(office use)
25-489-006-0
Lindell Revocable T/Carlonna
LEGAL DESCRI
LOT BLOCK ADDITION PID
(Name) CQ. k 11, h n ct L 1 ti G(e l (Phone) q(J)— a 97- pa
(Address) ' @4,1 rlI) as rYO bV4A4(-( AYE. D'es-46., (-(cc cs'�
(Address) (City) (Zip Code)
APPLICANT n_ w-tt 6 ?
(Name) 1r /J (Phone) / z 7 -No
(Address) 15-30 (,u
30 ts/ `�T ,,4t if- ,u. BQ�/
(A rens) (City) ✓ (Zip Code)
(Contact Person) art / (Phone) q 2 —75 Z/Gi
lY'APPLICANT SIGNATURE - / /%— DATE 4/6 I/4
APPLICANT PLEASE COMPLETE BELOW
Size of water service / inches.
Location of any couplings from structure eb, feet.
Type of sewer pipe. ❑ ABC ® PVC n Cast Iron
Estimated length of sewer line /S feet.
Clean out(if required) located at ee4,4 feet from structure.
SEWER & WA I ER FERMI I t-EE OF
FEE SCHEDULE $56.50 PAID BY HOMEOWNER.
Residential sewer and water line connection $51.50 Industrial,Com'l&Multi-fami] Sewer& Water Contractor MUST si•n
Sewer connection only $25.50 Water connection only Sewer& Water Permit Form
Estimated Cost $ Building Permit#_ __ —
SEWER AND WATER PERMIT FEE
STATE SURCHARGE Permit Fee $51.50
TOTAL PERMIT FEE State Surcharge 5.00
TOTAL $56.50 —
(Office Use Only)
This Application Becomes Your Building Permit When Approved Paid ''R "7
Date By � 17 `
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
4:0 �
C�RNE
44N
March 14, 2014
Carlonna Lindell
22840 Drexel Avenue
Jordan, Minnesota 55352
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
$5,786
5/8"Meter
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
vRio
e
7x
( ITT
.Sri:%' t-0�1
XXXXXXX, 2013
Carlonna Lindell Revocable Trust
22840 Drexel Avenue
Jordan, Minnesota 55352
Re: SUNSET AVENUE UTILITY IMPROVEMENTS 17231 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
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
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 (5/8") $590
Sewer/Water Connection $1,500
Water Tower Fee $1,000
$5,636*
Page 1 of 2
J:\UTILITY CONNECTIONS\17231 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
PROCESS FOR NEW SEWER & WATER HOOK-UP (Building Department) 10/21/13
sz
1. Have Homeowner sign the Building Permit Application
2. Before any payment, Homeowner needs to know if they will have a 5/8"
Water Meter or a 1" Water Meter (the prices are different---5/8" = $480.00
+ $110.00 for water reducer= total of $590.00 or 1" Meter = $590.00 +
$150.00 = $740.00). Building Permit #, Sewer & Water Permit # & Plumbing
Permit # will all have same PERMIT NUMBER. Assign the # in next sequence
in Building Permit Roster.
3. For 2013* Fees are:
a. SAC Charge $2435.00
b. Sewer & Water Connect Fee $1500.00
c. Water Tower Fee $1000.00
i. Total $4935.00
d. Sewer/Water Permit Fee $ 56.50
e. Plumbing Permit Fee $ 54.50
i. Total $5046.00 $5046.00
f. Water Meter & Reducer
5/8" S 590.00
Total $ 5636.00
OR
$ 740.00
Total $5786.00
4. Complete a receipt for monies paid by Homeowner & give a copy to
Homeowner.
5. Make sure Homeowner understands that the Sewer & Water Contractor &
the Plumbing Contractor MUST sign the respective form even though the
Homeowner is paying the fee. PERMIT# CANNOT BE ASSIGNED UNTIL
HOMEOWNER AND BOTH CONTRACTORS HAVE SIGNED THE RESPECTIVE
FORMS.
*2014 Fees will increase by $50.00 for the SAC Charge. Other potential fee
increases are not yet known.