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fPlii CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2-8:,. AND UTILITY CONNECTION PERMIT
Ir
AryNNESOgP I. White File PERMIT NO. 1/6 5
2. pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
17/a G4it-0 L hl R l
LEGAL,D CRIPTIO (office use oni
,r /
LOT BLOCK APii;ITION PID 4/2-0! 75/
OAR RYAN M STOCKER
(Name) 17101 MAPLE LN SE (Phone)
(Address) PRIOR LAKE MN 55372
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK El New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
['Addition DAlteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. El Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R SU (excluding land)
Division: 1 2 3 4 5
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-mentioned ropeny and that all constructio will conform to all existing state and local laws and w' proceed ino accordance with submitted plans. I am aware that the building
official can re this permit for just cause ore,I hereby agree that the city official or a de gnee ay enter upon the property to perform needed ms ecfions./
5---
e.-- ,-Al
Sign re Contractor's License No. Date
Permit Valuation Park Support Fee # $
95PlaPermit Fee $ SAC # $ 2-.95S—
Plan
n Check Fee $ Water Meter SOP'; 1"; $ 560
State Surcharge $ Pressure Reducer $ / Jr- 0
Penalty $ Sewer/Water Connection Fee # $ /S°4()
Plumbing Permit Fee $
a:?-9., Water Tower Fee # $ /` �J7J�o
Mechanical Permit Fee • $ Builder's Deposit $ c. ��.v
Sewer&Water Permit Fee $ 624 Other $
Gas Fireplace Permit Fee $ TOTAL DUE 6 $ 33 _t, /
I - i CV
..
This Application Becomes Your Building Permit When Approved Paid a - Receipt N1, ./
Date �i s 1 C� 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 all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
I
Date Rec'd
7��n`O { CITY OF PRIOR LAKE 0 -.14.( k
lSEWER AND WATER PERMIT
V �
kin'N ESOP I. Gott^ F°° PERMIT NO. Y✓) 11 lam`"
. .
Z. Yellow Ciiy
3. Gold Applicem
(Please type or print and sign at bottom) ZONING(office use)
i ADDRESS
LEGAL DESCRIPTION (office use only)
PID
LOT BLOCK ADDITION
OWNER !-) r , (Phone)
(Name) ]`\\I an n �UC�'Y" SS' -'1�
1'1141 f ri 0 ,01- 9- - S Fri.or 1a-6--
(Address) (City) (Zip Code)
(Address)
APPLICANT STOCKER EXCAVATING COMPANY, INC. (Phone) 952/890-4241
(Name)
12336 Boone Avenue Savage, MN 55378
(Address) (Address) (City) (Zip Code)
Curtsame
(Contact Person) (Phone)
A
PPLICANT SIGNATURE ��'�Ai� �'' DATE fib'i-t i
'
et 1 ��_I� ,
APPLICANT PLEASE COMPLETE BELOW ���'`'
{
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. U ABC 1 PVC ( ( Cast [ron
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
FEE SCHEDULE
Residential sewer and water line connection 535.50 Industrial,Com'l& Multi-family l% oob cost with a 539.5; mini .um
Sewer connection only 117.50 Water connection only IPEstimated Cost $ Building Permit#
SEWER AND WATER PERMIT FEE $ 50
STATE SURCHARGE $ •
9- '() ))/yjjk-"
TOTAL PERMIT FEE
(Orrice 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)447-9350,fax(952)447.4245
1
04 PRtO�P Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
soo
2.i.sloe AiFilry PERMIT e I NO. 6
Yell ! if
(Please type or print and sign at bottom) 3. Yellow Applicant • I
ADDRESS
ZONING(office use)
/ 7/0/ kbQtf/6 Li !
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER RYAN M STOCKER
(Name) 17101 MAPLE LN SE (Phone)
(Address) PRIOR LAKE MN 55372
APPLICANT p/ b+4 �_'l on ) C _o
t— 3 5-67 3ame)
ddres 17 Da° U-g"1,1a.,..., /`C 4_ r pv-,ate LA- 5-53 ?
(Address) (City) (Zip Code)
onta si ' ..•. $+? c C ---r-- (Phone) gS-01. — 300 — 5-4-73
•vPLICANT SIGNA DATE `0 . /S''
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) 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 $
STATE SURCHARGE $ wittl
okics
(Office Use Only) TOTAL PERMIT FEE $ F-1f
'
This Application Becomes Your BuildingPermit When Approved pproved Paid Receipt No.
Building Official Date By
Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
Mike's Septic Service
16961 Mushtown Road Sales Receipt
Prior Lake,MN 55372
952-440-1800 Date Sale No.
10/16/2015 11860
Sold To
Stocker Ryan
17101 Maple Lane
?tier Laite,MN 5. 72
Check No. Payment Method Project
5384 Check
Description
Qty MEM Amount
Pumping Septic System 2 Tanks Manhole Abandonment
1 230.00 230.00
Metropolitan Waste Dumping Charge
Fee'for Pert sent to"Scott County#38576 1 100.00 100.00
Permit
1 20.00 20.00
PAID IN FULL
Thank you for your business!Mike Rein
Total $350.00