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HomeMy WebLinkAboutUtility Connection 15. 1484 n 000000 -1 0 a - n � f m > c 0 m § k � / ki § n a p00 m m o0 g m m m zr � § § 7 § $ § -u tri 1- § \ Z § -4 es ` z § 2 $ 0 0 d � \ z z z - ■ 2 ) a % § 0 Z q z 0 7 \ 0 r � m \ m 2 0 0 Okkf00 Z m m m C - cn U Q q zq m ne § � nc 2 ! / z i m % § JJXq § m 0 q m z = = — z ■ z I § \ m § ) S r nO O 0 § -i f m q \ z 2q ) 2 r 0 z • m - 71 -a 0 m o w m i 0 0 § § \ 000000 �� $ c 2 § § § 3 § } m R. > Q 11.7. m -o - ox\ 0 aq § � 0 ® n 55 -n ■ -4F -1 § m § > — z m r § au) k J � � re § E 0 111 Z / )— ) ) jk / > q o ■ wmc ! 0 « § - • ES ƒ u $ V i z 6. OW 12C-1 } 9 > 1.0 / § 0 � § \ Ci LAJ Ci} w L. z col . _ } } z0 0 O ■ E oo � � . \ co \ La k § § � } } § � | Lot'° ` ( Q CL § § / § § j .I ', o0 2 o a � § 2a � ° f r w w ƒ ® E =, OO j \ § j 0 § \ • _ a a I- - , • • . 0 < o § \ Ill Se Lu z k 0 & § \ g n Q _ 0 §_ z § } \ - § « J 2 < o R i 2 / u, 0 0 -I w ag 2k � � � z W \ . )e ƒ & •§ < q Dui n. § z 00W2z /- 2 . ® c . .S ) 0 0 0 cc re t Q § B R § 2 � � � ■ � � s % Q@ « 0 a. 000000 C.) SCOTT COUNTY, MINNESOTA Permit # 39260 INDIVIDUAL SEWAGE TREATMENT SYSTEM (ISTS) PUMPING PERMIT Owner / l --t.1''f— ( ..L'C Orr el-� t A. Address { 7ic Hiik J\c ( ¼.. ILO,. k_-: Pumper f (t No. of Tanks Pumped I Total Gallons Pumped I (ITC) r Check all that apply: ential ❑ Commercial ['Rental 14 Septic ❑ Holding ❑ Pump Chamber ❑ Cesspool ❑ Abandoned ❑ Other: Condition of Baffles (baffles must be inspected) ,Acceptable ❑ Unacceptable ❑ Replaced Baffles Depth of sludge layer \ ( ) inches,—.) Disposal Location(be specific) F..'.)` -- Did you observe a surface discharge? ❑ Yes 17No Pumped From: :[ Maintenance Hole ❑ Removed Tank Lid(stave, for example),,, ❑ 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 pumpedthrough the Maintenance Hole/Tank Lid to enable the removal of solids. Signature of Owner/Owner's Agent , Reason for not pumping through the Maintenance Hole/Tank Lid 1 i ,:j-r: /' ' Comments A f t t /'`a1C111/V)er --; ! Pumper/Inspector Signature 2f` , .) .. .. �." -"N. . Date r I " 1 Only one permit is needed per ISTS. If there is more than one ISTS on a property, submit a separate permit for each ISIS. Submit a permit whenever a tank is pumped for abandonment. Pumping the tank does not constitute a compliance inspection. White-County Canary-Homeowner Pink-Pumper Form#1120 of PR/o. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd fz, ..,,r,?' ,,ii vii 7pmx .,.4.07166 . TEMPORARY CERTIFICATE OF ZONING COMPLIANCE t..) ' lik t• AND UTILITY CONNECTION PERMIT /2 I 4:ES7: I. White File 2. Pink City PERMIT NO. /5 /1746Z 3 Yellow Applicant / (Please type or print and sign at bottom) ADDRESS ,�/ ZONING(office use) /72-9D9D PA-AM111- / � iC LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PIDa5- 9f//'6O-Q OWNER RICHARD L KAUN (Name) 15051 GREEN OAKS TR L SE (Phone) &/? 2-3 7 93/ il (Address) PRIOR LAKE MN 55372 BUILDER /y� D (Company Name) /idrA 5 poG2 f Seev< <e, (Phone) qt./7e(77 (Contact Name) 07;4 h./afye/i 0 (Phone) Y'7 ‘77/ (Address) /9'505 flu.$l4d 4i., ' TYPE OF WORK ❑New Construction ❑Deck ❑Porch ORe-Roofing ORe-Siding ❑Lower Level Finish ❑Fireplace ❑Addition ❑Alteration igttility Connection CODE: ❑I.R.C. ❑I.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 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 re this permit or just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x 04 / /a— 9— /5 Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ e6 Plan Check Fee $ Water Meter Size 5/8"• "; $ , 0 State Surcharge $ Pressure Reducer $ 1 S Penalty $ Sewer/Water Connection Fee # $ / SS Plumbing Permit Fee $ Ea g0 Water Tower Fee # $ /O,, Mechanical Permit Fee $ `•(�' Builder's Deposit $ Sewer&Water Permit Fee $ 52 w e ] Other $ Gas Fireplace Permit Fee $ TOTAL DUE 7-. 9 • This Application Becomes Your Building Permit When Approved Paid ceipt No. - Date — B . Az6irii_ /11 Building Official Date 4 - se's`�_ / f ,j/7',. ' /� c `� f/i' ¢� (moi 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 docum• 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 v04 PRip Date Rec'd �' CITY OF PRIOR LAKE PLUMBING PERMIT /at ?,, r� . Blue PERMIT NO./67/41 2.Gold City �`��''-- ��``'' 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1-7 Zgl) Pk/uw1ft g LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID 5 ci//-05-0 —© OWNER RICHARD L KAUN (Name) 15051 GREEN OAKS TRL SE (Phone) (Address) PRIOR LAKE MN 55372 APPLICANT © J� (Name) / ►-i) ' /� 44.1 (Phone) ('K/.2 3 7 931q (Address) 17?9 0 _d4 2ni a A✓c., ! net, l a lce- 553 22 (/Add��rees/ss) (City) // (Zip Code) (Contact Person) Ri �.LC I\al.�' (Phone) 67 • a37 q3/4 APPLICANT SIGNATURE L` 4-N DATE /02 - 9" /5-. 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 $ n STATE SURCHARGE $g'' _ ' Q: TOTAL PERMIT FEE ,� ' \! r�t' .:��i I (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. ( /,��1A- --e:S5rne..41 Buildine Official Date Dat� �C.. i�J 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 ..-457 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 4 pRip75 Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT / i, 'S Itiji'NEsoi' . Green File PERMIT NO./47 /VI . Yellow City (( � 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 172-TO 1%OAal/4 /4 ' LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID,,?5-- l "-05 - 0 OWNER RICHARD L KAUN (Name) 15051 GREEN OAKS TRL SE (Phone) (Address) PRIOR LAKE MN 55372 (City) (Zip Code) APPLICANT _D i i j% (Name) ntch 2r 7'2[iy) (Phone) 6/,?'.232-93/N (Address) 179 P2ila•na 4 P/'icty taGje 5537.2 (Address) (City) / (Zip Code) ` (Contact Person) . a (Phone) b/sZ 02 37- `7 3/y APPLICANT SIGNATURE (.��� DATE / 9 ' /5-- APPLICANT PLEASE COMPLETE BELOW Size of water service 4.4. inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC (T PVC ❑ Cast Iron Estimated length of sewer line 97 feet. Clean out(if required) located at 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 $ The Minnesota Statutes§32613.148 STATE SURCHARGE "SURCHARGE"has been extended TOTAL PERMIT FEE �� �1�y_,Enmir The minimum surcharg5.e$ for"fixed fee"permit is00a (Office Use Only) 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 .47 'y''! / /4 r 4646 Dakota Street S.E.,Prior Lake,Minnesota 372 • r N 11 i-r p [ C) 0 . cn as 4t a U (Y) . 4-i 'b y U ° F "'` .a ' I o/� cd � I ab ❑ � y WC i°'0 a) - ki rrp - oit ❑ > ° cat a" -o .20 a. �- - U y Ory C/1 ❑ ❑ y c ._ Q.yp - ccs '- s• '7,5- I cC tlo "CS N N n p bp 0 , ,, b C% d sa p c� 0 0 a=i . x `� Z1 b.1 0 0 H o #m ° 9 OP 0 cu UWc ❑ ,C ) 14 cd r; A't .... , 4 1 .A- - k : 1 �• 'Ilk)❑w .' 4 r inw 6 --. _ - . 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LA C0 =V Z V) O a U ° e 7., 1) 'o A � U A A a o- 4) CdF. y r c U at. 0v' buildcounter From: Dale Chard Sent: Wednesday, December 16, 2015 11:17 AM To: buildcounter Subject: Sewer water 17290 Panama Sewer hooked Well ok to keep Pump ticket received Need Ties Hook up water Install meter and reader Sod or seed and cover Install erosion control Keep street clean Sent from my iPhone 1 40 )- n r.4 r4; — .0 tv 5 ri n n ill o ,__Ai* o 0 o 0 0.,;• - 0-. o - ,...• er, o or E 4 r) Cr ....1 • I '< E 15 0.. . 0. iii. .0 0 0 < ,- CO 0 1:1 -' 0 rEt. 9,, eeg 0 0 tV n x, .0 er, od ,..,,, ., 0 lz 5 , CD "I c-P. 0 52 et 0... 0" .61 0 A: 0 r-t• A: .,1 .. en .& ' 0 0 1,-1 cn ,..1.., ,-ee-,• ,..g e.t pi.' r) r. o 0 o - 0 et g 1, 4, c, ,..,, E '1 a cm tli P ••-o• "b. ,-,• ..,. -t. ,-,.. 0 4 4 , 4zo. t,,i g w. ,,, Ig AD .1 • -.. et..-- . ..ti 0 ,.., " 0 0 PI r) • CCD 9 c 18 r. ..9° 00; * '."' omc'• ci)5(1 ,.,_:0 ;* :e9 115;1-11 '10 pa ,-,‘ )1 0) .-, 6•D t c,44 ,—.crt `-; eACD til f ,c.D, 2. o w g •,'t s '-,). %' g ..o .... . -, " .. 0 . . r • _ 0 s...., ,. 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