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Building 14-475, Plmbg 14-627, Mech 14-662
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LEGAL DESCRIPTION� (office ussf sonny) C LOT BLO K DITION PID(?;✓ /q7-0o9—f 1 OWNER (Name) OaI.)zu—y,S>b-7"/GiVS7on,0-4 JNC, (Phone) P'S'7 430 ^8Oy (Address) Viz,7 .�,hFA/C/ / R c cab, t.t, f /ISL$y /'7/-/511/3 7 BUILDER (Company Name) 4&1.//›.1—Y S7.4 7/GAIS7V/7eS //✓/, (Phone) 957-83G'$$IY (Contact Name) ?cit. 7:3., e„`/e (Phone) (Address) TYPE OF WORK 0 New Construction ['Deck ['Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish • 0 Fireplace ' ' ['Addition OrAlteration ['Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑Misc: Type of Construction: I II III IV V AB Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ yam/ O O Division: 1 2 3 4 5 (excluding land) (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 far 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 r yoke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. Signature Contractor's License No. ate Permit Valuation4o Oraf7 �� Park Support Fee # ' $ Permit Fee $ 5-0• 00 SAC # $ Plan Check Fee $ 15. 05 Water Meter Size 5/8"; 1"; $ State Surcharge $ 20 O� Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL D 3 , 4A1 o; rf/I $W . as- This •ppli t'o. ', coin our Building Permit When Approved Paid ,os--- Receipt No. 1-1-1S br Date (o y l BY Sr'�t.) 6---/srJO ' Building 0 i icial to This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 y 4 YRIp Date Recd r�}z x CITY OF PRIOR LAKE PLUMBING PERMIT kINNPsogr .otue File Z ia�a cny PERMIT NO./4.._ 6.z7 7.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(otrce use) e ro Soo CVLVTN Awe. SE LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) t ( C N 0Jk (),__;,(\�..4 (Phone) �i-g 7��t' (Address) c c C9 C>1C i '-4-c ih\t)c-viuN\c 't-crn Y 1 3(-{3 7 APPLICANT (Name) 1M.t - C-11-4 MEc 4ry t C.AA-- (Phone) 76 3. -786. eG I'7 (Address) 5 03 ®AtuEN)P021 sr t'VE 6(r41NE AA", .5'Syq$ (Address) (City) (Zip Code) (Contact Person) n*A.ItvAES 5F12-- (Phone) 7603. —7 Re. .94, 1.7 APPLICANT SIGNATURE DATE 6- le—'4' APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater 'ii Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly I Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other The Minnesota Statutes§32613.14-8- j job cost with a$49.50 min imum mum� Residential,New One&rwo-Family $149.50 "SURCHARGE"has been extendedr Residential,Additions&Alterations $49.50 The nlin}Haiti]surcharge foraj "fixed fee"permit is$5.00 $ 4', 000, 00 Building Permit# 'i �✓ PLUMBING PERMIT FEE $ 41. 5ro �, 1��`t STATE SURCHARGE $ XXX 5.O0 TOTAL PERMIT FEE $ 5-4 (Office Use Only) This Ap 'j� ti, , Be+or 1 � es Your Building Per it hen Approved injilo r R.cAot No. Arti fi 7 Z 14 v , By s-- Building Official —"Numb. Date , 19 ft 24 hour notice for all Inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.B.,Prior Lake,Minnesota 55372 r 4 rRlp CITY OF PRIOR LAKE Date Ree'll ° p,e HEATING/AIR CONDITIONING/FIREPLACE PERMIT ` . /&• if Urrt •AMPS Wi/4" #7.5.1 1.Pink File PERMIT NO. 4/iNNE5011' 2.Green City 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) (Phone) (Address) APPLICA1 .� (Name) ) C3-}G,1 Qtt 010-/-04-0" (Phone) 6SJ • L/� ) 1' -). Y (Address)_ 011-11 S LOeve w a i • . 1 STI 1 (Contact Person) ('Jr (. )eJr (Phone) /Z- 3d $- 331 9 n(� APPLICANT SIGNATURE ( ?.Yh-c _ DATE -1-/CI APPLICANT PLEASE COMPLETE BELOW ❑NEW CONSTRUCTION 14LREPLACEMENT DALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner OWarm Air Plants ❑Steam Units and Fireplaces Cannot Encroach •Gravity DHot Water into Required Side Yard Setbacks. i'!r echanical D Radiation Fireplaces with Box Additions or r Air Conditioning ill special Devices Cantilevers to the Outside of Buildings 0 Vent. System ❑Other Devices Require a Building Permit. I FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial,Commercial &Multi Family 1%of job cost Residential,Gas Fireplace $49.50 $49.50 minimum Residential,Heating&A/C (New Construction) $149.50 Residential,Additions&Alterations $49.50 Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50 Cost$ o.) Building Permit# HEATING PERMIT FEE $ LCI ,50 STATE SURCHARGE $ 5.00 TOTAL PERMIT FEE $ Sy,SO This Applieati .0 6. a Ines Your Building Permi '4'h n Approved Paid S" Receipt No. 7/7/2. ��f � to • �' By Bulb ing 6 to ' 1 _ ate Da 7. . �� /Mama 24 hour notice for all inspections(952)447-9850 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 HOLIDAY STATIONSTORES 4567 American Boulevard West, Minneapolis, MN 55437-1123• 952-830-8700 •www.holidaystationstores.com Holiday City of Prior Lake May 29, 2014 Building and Inspection Department 4646 Dakota Street S.E. Prior Lake,MN 55372 Re: Holiday Stationstore#198 16800 Duluth Ave. S. E. Prior Lake, MN Dear Building and Inspections Department; I have enclosed for your review existing and proposed floor plans as well as a building permit application for the above mentioned location. Holiday Stationstores, Inc. is proposing an interior remodel of the facility to include but not limited to the following: 1. Closed up current entrance door and relocate 3'-4' to the right. 2. Remove current checkout cabinets and replace with new in the same general location. 3. Remove the current food counter wall and 3-4' back into the current storage rooms which will entail relocating the in ceiling furnaces 4. New refrigerator island case. 5. New food service cabinets along wall which will be ADA. 6. Interior wall decor such as paint oak trim,wall tile etc.. 7. Misc. adding food equipment such as the island case, a pop and malt machine. If you should have any questions during your review,please feel free to contact me at 952-830- 8884,via fax at 952-830-1678 or email at:joel.geil@holidaycompanies.com Sincerely, Holiday Stationstores,Inc. Joel D. Geil Construction Supervisor/Project Manager 443 Lafayette Road N. i MINNESOTA DEPARTMENT OF (659)284-5005 9t.Paul, A+linneao 55155 � � i STR "I-$00342-5354 www.dti.rrin.gov i . Division of Construction Codes and Licensing REPORT ON PLANS Plans and specifications on plumbing: Holiday Stationstore No. 198, 16800 Duluth Avenue SE,Prior Lake,Scott County,Minnesota,Plan No.PLB 1 406-00 1 77 OWNERSHIP: Holiday Companies,P.O.Box 1224,Minneapolis,MN 55440 SUBMITTER: Mid City Mechanical Corporation,9103 Davenport Street NE,Blaine,MN 55449 Date Received: June 27,2014,June 20,2014 Date Approved: June 27,2014 SCOPE: This review is limited to the provisions of the Minnesota Plumbing Code,as amended.The review is based upon the supposition that the data on which the design is based are correct. Approval is contingent upon requirements included in this report. A copy of the approved plans,specifications,and this Report on Plans must be retained at the project location for future reference. INSPECTIONS: All plumbing installations must be tested and inspected in accordance with the requirements of the Minnesota Plumbing Code. No plumbing work may be covered prior to completing the required tests and inspections. The contractor/installer must obtain an inspection permit from the Minnesota Department of Labor and Industry when an installation is for a state owned facility,Minnesota Department of Health licensed healthcare facility,or a project in an area where there is no local administrative authority. To schedule inspections,contact the state plumbing standards representative for your region. For your regional inspector's contact information,visit our website at http:/Iwww.dli.mn.gov/COLD/CCLDContactus.asp REQUIREMENT(S): 1. A separate backflow preventer is required at each potable water connection to an individual piece of beverage equipment. The backflow preventers must meet the requirements of Minnesota Rules,part 4715.2100 and part 4715.2110. 2. Floor drain used as receptors for substantial amounts of liquid waste must be individually vented in accordance with Minnesota Rules,part 4715.2620 and part 4715.1300,subpart 4. 3. The relocated island vent must be constructed in accordance with the following(see Minnesota Rules,part 4715.2655): a. The horizontal vent must be pitched at I/4-inch per foot minimum to drain. b. Drainage fittings must be used for all portions of the vent located below the floor. 4. Materials used for water distribution systems must comply with Minnesota Rules,part 4715.0520. Cross- link polyethylene(PEX)tubing must meet Minnesota Rules,part 4715.0520: a. The tubing system must comply with ASTM F877 and F876. b. When installed as a system in accordance with ASTM F877,the tubing and fittings must be of the same manufacturer and be marked as required by the manufacturer. c. When not installed as a system,the fittings must be marked with ASTM Fl 807,F1960,F2080, F2098-01,ox F2159. The tubing must list the fitting and tubing standard. d. Installers must possess a card documenting completion of factory training. This information can be provided to you in alternative formats(Braille,large print or audio). An Equal Opportunity Employer Holiday Stationstore No, 198 Plumbing Plan N .P1.131406-00177 Page 2 June 27,2014 5. Materials used for drain.waste,and vent systems must comply with Minnesota Rules,part 4715.0570 through part 4715.0600. If plastic pipe is used for the drain,waste and vent system: a. ABS plastic pipe shall comply with ASTM 132661 erF628. b. PVC plastic pipe shall comply with ASTM D2665,D2949,or F891. c. PVC solvent weld joints must include a primer of contrasting color to the pipe and cement. 6. The plumbing system shall be tested in accordance with Minnesota Rules,part 4715.2820. 7. The water distribution system shall be disinfected per Minnesota Rules,pan 4715.2250. 8. Complete plans and specifications must be submitted to and approved.by the Minnesota Department of Agriculture. Contact the Dairy,Food,Feed&Meat Inspection Division at 651/201-6027 regarding information necessary for their plan review and licensing requirements. NOTE(S): 1. The scope of this project consists of the remodelling of an existing building. The plumbing installation includes relocating three floor drains and a hand sink. 2. This facility will he served by existing municipal water and sewer services. Authorization for construction in accordance with the approved plans may be withdrawn if the plumbing installation is not undertaken within a period of two years. Plan approval does not necessarily mean that recommendations or requirements for change will not be made at some later time when changed conditions, additional information,or advanced knowledge make improvements necessary. Approved: . Bradley C.Erickson Public Health Engineer Plumbing Plan Review and Inspections Unit 651/284-5880 cc: Mid City Mechanical Coiporation Holiday Companies City of Prior Lake Building Official MDA Food Inspection Division File PRlOR DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 1(°S D V IUB /4e., NATURE OF WORK Attera4-cav► USE OF BUILDING PERMIT NO. / , 447 _DATE ISSUED o/&frJ CONTRACTOR Nol; � PHONE 45a-fl3p, gf3A-'f INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE OINITAWIS I) ' 1 ER PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING —. 111:4 \ INSULATION ELECTRICAL PLUMBING U. ( ik4tt HEATING E GAS LINE AIR TEST COV O WORK UNTIL THE ABOVE HAS BEEN SIGNED aw`wmm moo • FINALS BUILDING tripV%j 7/2 I1 - ELECTRICAL • PLUMBING 11"LA ` HEATING t h3 2--7 iO4 DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough-in inspections and maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447-9850