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Fr P ,,,, -..... cr 0 w ft & o Pr Fr D - Ts g.t. vo co o' P , = 0 ,-i. ci, n to 0... 612 U) 0• 2 co E. ..—• ....... 5. (S) A CD CO n S' CO tI7 I* CD 0 (......0 g. 8 7 .‹. i P z of ;;I: CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd �, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Q I AND UTILITY CONNECTION PERMIT /2 /U_�.`3 v 4oiNEso'o• I. White File 2. Pink Cityp I PERMIT NO.i� (465- 3 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS016/ ZONING(office use) PAluA0A-- A-1, LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER ROBERT E & JULIE A (Name) D E U TS C H (Phone) (Address) 17181 PANAMA AVE SE PRIOR LAKE MN 55372 BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK � Construction ['Deck ❑Porch DRe-Roofing ❑Re-Siding ❑Lower Level Finish I=1 Fireplace DAddition DAlteration DUtility Connection CODE: ❑I.R.C. ❑I.B.C. ❑Misc. Type of Construction: I II III IV V A B Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ 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-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 rev ke this permit for just cause. Further re,1 hereby agree that the city official or a designee may enter upon the property to perform needed inspe tions. x Signature Contractor's License No. D to • Permit Valuation Park Support Fee # $ Permit Fee $ SAC ## $ 24 Zz 1a.5Plan Check Fee $ Water Meter Size 5/8"; 1"; $ 5C0 State Surcharge $ Pressure Reducer $ /SO Penalty $ Sewer/Water Connection Fee # $ Jy� Plumbing Permit Fee $ �,�w -56 Water Tower Fee # $ /DOD Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ 52 Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ ,r— 73S al This Application Becomes Your Building Permit When Approved Paid 5; 77f ve) go_Nia6,� eDate '� - (U-L( 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 temporal},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 O� PRIp� Date Rec'd orf fi x`, `,e CITY OF PRIOR LAKE PLUMBING PERMIT /2 - /�. 15- 1fJ4W E S° z:Goa euy PERMIT NO.45 /. 35" 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 17 \ \ Qc.- INCA 11'1 - LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) Don DL)J I"l (Phone) (Address) APPLICANT (Name) Q tst—c)`-lCi P(u44 b...) .- /AL • (Phone) (-IC1 0 '` 3141-Z. (Address) e '"--- II S._1 i-- :. 577 (Address) (City) (Zip Code) (Contact Person) .1,--- (Phone) 6/Z " 2 70 —64cc 7 2._._ APPLICANT SIGNATU' DATE /1 / IS l/-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) I Other 4,cd-c( ,Mcfret /(54,4/Z/xv • 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 $ t43)y [01 .x 959114411" STATE SURCHARGE $ TOTAL PERMIT FEE $ (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 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 p� PRIo� Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT IZ• la IS l*NESANO�� 1. Green File 2. Yellow City PERMIT NO. ' '�e5 (Please type or print and sign at bottom) 3. Gold Applicant ADDRESS ZONING(office use) 17181 Panama Ave, PL LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) Bob Deutch (Phone) (Address) 17181 Panama Ave, PL 55372 (Address) (City) (Zip Code) APPLICANT (Name)_Krueger Ecavating Inc (Phone) _952-447- 8335 (Address) 7577 175thst e Prior Lake 55372 (Address) (City) (Zip Code) (Contact Person) Ttracy (Phone) 952-447-8335 APPLICANT SIGNATURE Tracy Krueger DATE 12-10-15 APPLICANT PLEASE COMPLETE BELOW Size of water service 1 inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC X❑ PVC ❑ Cast Iron Estimated length of sewer line 60_feet. Clean out(if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial,Com'!&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 $ ,;I KIN TOTAL PERMIT FEE $ (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