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HomeMy WebLinkAboutBuilding, Heating, Plumbing & Water Permits 13.293, Building Permit 13.860 'acR, A A A A xa i�') ,.z 1C / a ✓ Crrfffitthh of (Ctrrupattry CITY OF PRIOR LAKE ! rpzrfmrnf of PuUXMMxtg ci1 xtsjrrrf uzz f Fina1 Permitt ❑ Condition C.O. Expires . This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential l ❑ International,;, Building Code certifying that at the time of issuance this structure was in compliance with the various ` ordinances of the City of Prior Lake regulating building construction or use. For the following :` = Use Classification S I NG L F FAMILY Bldg. Permit No: 13-0 `, Occupancy Type R3 Type Construction V Zoning District R3 Legal Description L17 , D4, WENSMANN FOURTH ADDITION � 2576 WATERFALL WAY NW Owner of Building Site Address 1 Contractor's Name &Address „ CENTRAL HOMES ,, , } ROBERT D 1 HUTCHINS City Planner (( Building Official � / � ' ' I Date: �� G (" ' Date: POST IN CONSPICUOUS PLACE s i I i i i u7 i i i � Ilfill.. I I I A w I I lK x ro � '•. �' y � \ � �j:i } �� '�'�+tl1 J �; ✓j� " � 1�k'ii t��/ 4 a � � r R V W 0 z� a a it ILpG W UUa 0 W §3 552 a t,„, r aaa O p cr k055W z Z tv c -� _/ waU.LLO r [. �. (D 0000❑❑ > 1 O ce v ` ;� ro rt _ v U. N O 0 �; J W Z CI IL Cfl a. - z YY Z z Z -ZZZ 0 p r Q: p LL J _ O 000< 1- t W 0 `S, c _ Z d' _ o I w � 0 m�x�ro a 8 Z �. 0 1 ■ n Wl yj =W W W K O �I a23U) W W a W , W / . 000000 ■_ 0 0 0 0 O re W a a LL i- _ >: 0 J cc Z Z Y W " *. z 1- z- LLO to 04 t t 0 o ( 0 w H I a 4 W 1- t- a ° y Z Z J Z w Y ul u - J ' q OW CC W z OOOC E 0 0 0 � y 0 V N 0 0 U. U. U. 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' �m m � © i rn \ z • ri ; ; ; § hi n 1 ��22 1 , ri ��2� ® k r 0 01 N oQ PR /04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd . .- /� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE C Q L___ AND UTILITY CONNECTION PERMIT i 3 ' �' NES , Awn Fi 1. white File O. Yellow City 3: t - ' Z 93 3. YelI low Applicant (Please type or print and sign at bottom) _ ADDRESS ZONING (office use) . 23 762 141,1 NI ty Ai tt - - IQ LEGAL DESCRIPTION (office use only) ADDITION fh rTrO/1 PID 26 . 4, ( Si �(3 . 0 LOT i1 BLOCK ` f Wete6mAn/'t y � OWNER :: &, 7 1� o .63, (Phone) v / c - a\ 7 A - 5 7 4' (Address) ) / 4 /40 R pip , e in Dr. /110/5 /p /j m,V 6 : 5 ' 4 /3 3 BUILDER �/ 4 \ / (Company Name) �e.e) J 1 r- / / U M e s (Phone e /�" 0 " y . S O y l� (Contact Name) a -SDJDr 7On 5O/) (Phone) (Address) f}i')') TYPE OF WORK g New Construction ❑Deck Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace Addition DAlteration ❑Utility Connection CODE: DI.R.C. DI.B.C. ❑ Misc: . dv Type of Construction: I 11 III IV V A B , Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ tI ` �, 7 Division: 1 2 3 4 5 (excluding land) .+= tl5 t of � I hereby certify that I ha mished info.. . - •is 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 erty and tha ./. • : ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revo this permit ' .. e. Furthermore, I hereby agree that the city tcial or a designee may enter upon the property to perform neede i pectin . X / &6 63gg� `-� s is / _ • re Contractors License No. Date Pern iit Valuation IMEIIE !. I' Park Support Fee # $ Permit Fee $ p SAC # $ " 3 s ' 6 • Plan. Check Fee $ d S Water Meter Size s "; 1"; $ 480 00 • State Surcharge $ 543. 5E) Pressure Reducer $ /1 0.00 Penalty $ Sewer /Water Connection Fee # $ /300.0 0 Plurnbing Permit Fee J1 • . Water Tower Fee # $ 'i70 v .0O Mechanical Permit Fee so Builder's Deposit $ Z�d 0 QO Sewer & Water Permit Fee $ 6v Other � J $ ,t • Gas Fireplace Permit Fee $ o• • . 60 TOTAL DUE . /) SZO# C This A • , lic • tion : ec es t B ilding Permit he Approved Paid / U 3 b V ; 57 Receip 1— •� '/1 4 f .7 _ Date ,?723J :5 BY C III 1 / ___- -, Alt / 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 P : - er on 'tutes temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. / '--,,,2?- / ` d A We irector 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 •,74. Z re1/44 . • • 41.„ • 4 • 14. N A 7 .rif • 4.,4 • ti • t• +.0 <64 b 41 ' 16 ' Alo f`e • 4 4 1 nob U trl White - Building Canary - Engineering "'INNES °�P Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT o i' 1 f' ; , vi APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: i r / '' / " 'j f` Y 1 . Accepted Accepted With Corrections Denied Reviewed By: 4446 y Z 2- /3 Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading Plan. 2) Erosion Control Standards The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." PRIO CJ 171 White - Building `NNESO�P Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED 5t The Building, Engineering, and Planning Departments have reviewed the building perhfit° application for construction activity which is proposed at: Accepted ' Accepted With Corrections Denied 4 ' Reviewed By: `" Dat e: 4 /c) 3 Comments: "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." o� VRIp- 9 (1," x erl White - Building yj �P Canary - Engineering NNESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED 4- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 2.57(0 2- 25 mssa W th7/ Accepted Accepted With Corrections Denied Reviewed By: Date: -4- / S d Comments: /• coo L9-49fi 4 c c-e-i&/ "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." O� pRip� 1., Builders Deposit 0 City of Prior Lake A $2,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued a security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 180 days after the date the building permit is issued. If the work is not complete within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $2,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: V/ 5 SIT ADDRESS: Z:5 77 7 r'- WI 1 PERMIT # Z 3 REFUND TO BE MAILED TO: P / ) `` �v' (-{d w, / e.5 / / y6° R ti(s0r1 /Ji' _ _ MI0 /.S iiv /55 PLEASE REMEMBER a -cp ,, ! ,.. r `.,,' 1' t soo co • 1. KEEP STREETS CLEAN DURING CONSTRUCTION iyndas. • Ien, Building Services Amount 2. KEEP EROSION CONTROL IN PLACE / 2 . t Z , ( 3 Acct. 801.202(14 ` 3. TEMPORARY OCCUPA ' ' MIT MU • *.'' RE OR $500.( . < , „te 1 y �` SIGNATURE: � Larry p iler. ity Engineer ____�_ __�__� - _ __ _. _ � _-- _,_______.�____,__r_ _ _______ ___,.�.__ _.,_w Central 23570 CENTFA HOMES, LLC p" 11460 Robertson Dr NW MmMrcer�Ua,bnk twm Mende pab.., MNi55433 . 75.511.919 . a PAY 1 *** ** *42,2 DOLLA AND 32 CENTS DATE . ' AM 2 TO7HE . ORDER OF " 05/21/2013 ** *42,258.32 cit of Prior Lake 4848 Dakota Street SE 1 Prior Lake, MN 55372-1744 11'0 235 ?Ou' 1:09 1,905 & l4': 260000»' 1 13 - PK // 1:) CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d TEMPORARY CERTIFICATE OF ZONING COMPLIANCE • �. 0 g AND UTILITY CONNECTION PERMIT f A'NESO Wit3 • �� / 1. White File 2. Pink City J � p MIT NO . f L 0 601 3. Yellow Applicant i • (Please a or print and sign at bottom) ADDRESS ZONING ffice use) 2576 Waterfall Way Prior Lake, MN 55372 LEGAL DESCRIPTION (office use only) Q LOT 17 BLOCK 4 ADDITION The Approach at the Wilds - PID$. MV. 019.0 OWNER (Name) Centra Homes (Phone) 763- 772 -1000 (Address) 11460 Robinson Dr NW Minneapolis, MN 55433 BUILDER Centra Homes 5 �� ,nn rr (Company Name) h u` f (P 763-772-1000 (Contact Name) Jon Solomonson (Phone) 612 - 242 -5046 (Address) 11460 Robinson Dr NW Minneapolis, MN 55433 TYPE OF WORK ® New Construction ❑Deck ['Porch DRe-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace DAddition DAlteration ❑Utility Connection CODE: ❑I.R.C. ❑LB.C. ❑ Misc: Type of Construction: I II III IV V A B Occupancy Group: - A 13 E F H I M R S U PROJECT COST /VALUE $ Included with origina Division: 1 2 3 4 5 (excluding land) permit application 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 revoke 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. X Signature Contractor's License No. Date Permit Valuation 3 6 0 vv Park Support Fee # $ — Permit Fee $ 14, 1 i SAC # $ Plan Check Fee $ ..---^ Water Meter Size 5/8 "; 1 "; $ State Surcharge • $ / 5 --0 Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ -1 1 S--7) Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE � r icie, l7 $ /3 0 35" This Application Becomes Your Building Permit When Approved Paid Re e' t No. b 1 U l Date 6 , GLc - t' 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, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 •■• 4 • '• • ,„,„,„ • 6 Residential Building Permit Checklist New Construction for Sin I le or Two-family Dwellings in R•1 or R -2 Districts Reviewed by: -, Date: 12_ Building Permit# PID: ' Zoning: - 4 7=- 3 Address: 2 57l0.,'1 £3 3 pi S 2: W/ `- t:: -4- (- c- 3 Legal: L , B Subdivision: Existing Structure? YES / l Existing Nonconforming Structure? YES / , a CONFORMS TO ZONING , ES) NO ORDINANCE _ Yard Setbacks: NA 1 FAILS/ CO P S 1 . . Standard Proposed • Front Yard (can be 20' if avgi lin 150') - v j- • Side Yards 10'I ,261 abutting a street Z 1 4' • Sidewall exceeding 60' requires additional side 2" 10' setback + setback for every 1' over 60' in length. Not required 271' over 60' if building wall is 10' -0" or greater of being parallel to a side lot line. , �5`' • Rear Yard 25' -re, 1;7:‘,._ . C�3-7 D a + • Patio Door; provide for minimum 10' deck or sign 10' side/ statement indicating no deck will be built in the future _ 25' rear • From 100 year flood elevation of wetland /NURP 30' - pond. _ • Refer in- ground pools to the Planning Department • From OHW (Prior or Spring Lake) 75' or setback average of adjacent structures, but no _ less than 50' Floor Area Ratio: NA/ FAILS / CO ES 1 .30 Maximum 1 r.= ' Yard Encroachments: H=AILS /COMPLIES Standard Proposed Eaves and Gutters no re than 2 feet in width and no closer than 5 feet to a lot line Easements . A/C and other equipment cannot encroach on interior side yards. Tree Preservation: / FAILS / COMPLIES Standard Proposed • Total caliper inches • F'ermit 35% Removal — • Caliper Inches Rerrloved � • ' Calip�i1riches Preserved . • Replacement/ 1,4 :1 L: \TEMP kTL\BLDGLIST.DOC • • / 7'1 Driveway: NA 1 FAILS / Cpii0krES Standard Proposed • Maximum width at pr9 rty line 24' u1) • Required setback 5' from side lot line or 30' from r -o -w on corner lots p • Maximum slope • 10% 3 - ' -6,7.- • All parking areas to be paved i ncluding R -V or s. aces ad'acent to the I wale — . • Location to match subdivision grading plan • E- Building Height: NA / FAILS / C • ,a ',LIES 35' Maximum ,',...._ I Shoreland District: NA/ FAILS / C s . ; s , Standard Proposed I Minimum lot area (square feet) 7,500 Rip, 7,999 Non -rip _ • Minimum lot width 50' Rip, 57.3' Non -rip Shoreland alterations Impervious surface 30% Maximum P4 i Bluff in Shoreland: s ir FAILS / COMPLIES Standard Proposed • Setback from tpp of bluff By planning dept. • • Bluff impact zone 20' From Top of Bluff • Engineering certification submitted /approved ' By City Engineer • Grading in bluff or bluff impact zone No importing /exporting Floodplain: "J FAILS 1 COMPLIES Standard Proposed • 100 y r flood elevation 908.9 Prior Lake 914.4' Spring Lake • Lowest floor elevation 909.9' Prior Lake / 915.4' Spring Lake • Proposed lowest floor elevation Must be 1' above flood elevation for new and existing structures. If existing structure was constructed 9/19/90- 11/22/97 then • Elevations 15 feet from structure additional foot is not required. Must be flood elevation or v higher • Road access must be no more than 2 feet below 907.9' for Prior Lake Res ulato Flood Protection Elevation 913.4' for Spring Lake Accessory Structure: )91/ FAILS / COMPLIES I Standard Proposed I • Size 1000 sq.ft. or 30% rear yard • Not located in front yard (Materials) • Side yard and rear yard setbacks 10' • Maximum height 15' • Materials con atible with rind le structure • L :VTEMPLATEVBLD GLIST.D O C CONTRACTORS MATERIA &TEST CERTIFICATE FOR BOVEGROUND PIPING PROCEDURE: Upon completion or work, inspection and tests shall be made by the contractors representative and witnessed by an owners representative. All defects shall be left in service before contractors personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owners representative's signature in no way prejudices any claim for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: Approach at the Wilds IDATE: 9 -30 -13 PROPERTY ADDRESS: 2S 76' 4✓4,+z- 4.10'- r ACCEPTED BY APPROVING AUTHORITIES ( NAMES) City of Prior Lake PLANS ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS • YES ❑ NO EQUIPMENT USED IS APPROVED MI YES ❑ NO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT I YES ❑ NO IF NO, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: • YES ❑ NO 1. SYSTEM COMPONENTS INSTRUCTIONS • YES 0 NO 2. CARE AND MAINTENANCE INSTRUCTIONS • YES 0 NO 3. NFPA 25 IN YES ❑ NO LOCATION OF SUPPLIES BUILDINGS SYSTEM ENTIRE BUILDING DESCRIPTION MODEL YEAR ORIFICE SIZE TEMPERATURE QUANTITY Reliable F1FR 2013 1/2" 155 48 Reliable F3QR (Dry) 2013 1/2" 155 2 SPRINKLERS CPVC with CPVC Slip fittings PIPE & FITTINGS • ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST ALARM VALVE CONNECTION OR FLOW TYPE MAKE MODEL MINUTES SECONDS INDICATOR Vane Potter VFS -R 0 q DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. TIME TO TRIP * WATER AIR TRIP POINT TIME WATER REACHED ALARM OPERATED THROUGH TEST CONNECTION PRESSURE PRESSURE AIR PRESSURE TEST OUTLET * PROPERLY MINUTES SECONDS PSI PSI PSI MINUTES SECONDS YES NO DRY PIPE WITHOUT OPERATING Q.O.D. TEST WITH Q.O.D. IF NO, EXPLAIN * MEASURED FROM THE TIME THE INSPECTOR'S TEST CONNECTION IS OPENED. OPERATION ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC PIPING SUPERVISED 0 YES El NO DETECTING MEDIA SUPERVISED 0 YES 0 NO DELUGE & PREATION DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS El YES El NO VALVES IS THERE AN ACCESSIBLE FACILITY IN EACH CURCUIT FOR TESTING IF NO EXPLAIN 0 YES O NO MAKE MODEL DOES EACH CURCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE SUPERVISION LOSS ALARM OPERATE VALVE RELEASE RELEASE YES NO YES NO MINUTES SECONDS HYDROSTATIC: HYDROSTATIC TEST SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BAR) FOR TWO HOURS OR 50 PSI (3.4 BAR) ABOVE STATIC PRESSURE IN EXCESS OF 150 PSI (10.2 BAR) FOR TWO HOURS. DIFFERENTIAL DRY -PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO TEST PREVENT DAMAGE. All ABOVEGROUND PIPING LEAKAGE SHALL BE STOPPED. DESCRIPTION PNEUMATIC: ESTABLISH 40 PSI (2.7BAR) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BAR) IN 24 HOURS. TEST PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE AND MEASURE AIR PRESSURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BAR) IN 24 HOURS. 4 ALL PIPING HYDROSTATICALLY TESTED AT �" L ') PSI FOR Z HRS. IF N0, STATE REASON DRY PIPING PNEUMATICALLY TESTED 0 YES p NO EQUIPMENT OPERATES PROPERLY O YES 0 NO TESTS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OR SODIUM SILICATES, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? 0 YES 0 NO DRAIN TEST READING OF GAUGE LOCATED NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE STATIC PRESSURE: _2D PSI (9 c PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFOR CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE U FORM NO. 85B 0 YES 0 NO OTHER EXPLAIN: FLUSHED BY INSTALLATER OF UNDERGROUND 0 YES 0 NO SPRINKLER PIPING BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING 0 YES D NO IF YES........ DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY 0 YES 0 NO WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED 0 YES 0 NO IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3 DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A I] YES 0 NO DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED. CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS 0 YES 0 NO (DISKS) (DISKS) ARE RETRIEVED HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN DATA NAMEPLATES I] YES 0 NO REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: f1 - 12 -2 0 NAME OF SPRINKLER CONTRACTOR: SUMMIT FIRE PROTECTION SIGNATURES TEST WITNESSED BY � FOR PROPERTY OWNER ( SIGNED) TITLE DATE: � SUMMIT FIRE PROTECTION FOR SPRINKL CONTRACTOR ( SIGNED) TITLE DATE: 1) - IZ - 20 r3 i� t�� ///',/°//_ c'Q Pltto� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ., TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 5. 3. /3 AND UTILITY CONNECTION PERMIT i /3. 4lj AN E *J� �P . t. White i 2. Pink City �� PERMIT NO. I Yellow Applicant • (PIease type or print and sign at bottom) ..r ADDRESS a '77. 7 1 ''O +. g'2.- 4- 'ales' Qc % weir NfiJ Z e e P ri o r '- Lc ke,. 44A/ ! 3 ' z LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER + /� (Name) _ f 4(f" 11 a. - 4A L 14.1; i L5 (Phone) (Address) BUILDER (Company Name) Ce" il co► (Phone) (Contact Name) '5v.wr+4t 1 -� re ,/tt I- e G r 't a *1 (Phone) ! S` /` Z5'/ l C r 4) ` 5' PI is/ .e� 4441._ £.) ( Address ) TYPE OF WORK fliZiew Construction [Deck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace Addition DAlteration ❑Utility Connection CODE: []I.R.C. ❑LB.C. q9Misc. e re __ W . Type of Construction: 1 II III IV V B tile)" Occupancy Group: A B E F III M ' 9 S U PROJECT COST /VALUE $ /< �� Division: 1 2 <P 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 nstruction 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 revoke t ' permit for just se. Furthermore, 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections. (i X rJ G '3'1 3 Signature Contractor's License No. Date Permit Valuation Park Support Fee # ' $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit . $ Sewer & Water Permit Fee $ Other $ 0 +�A Gas Fireplace Permit Fee $ TOTAL DUE 9ic' Titis : p'lation t ' ome our Building P en Approved Paid ReCei /� _ Date By Buil • ine, icial 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 Data Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 E ., .E . 1. + t? . , ' � 4'4%. t• ti , en C„ y l J 0 4RLp CITY OF PRIOR LAKE Date Ree'd � g ,; � � BEATING/AIR CQNDTTION[NG/FIREPLACCONDITIONING/FIREPLACE, PERMIT I� - HE `f1A7V8SO�� t c PERMIT NO . J _ r ' �l �. Yellin-, ADDl;urq (Please type oft and sign at bottom) ADDRESS ZONING (oficc use) 0 1b _ ',UG UX !1_) , �� u LEGAL DESCRIPTION (office use only) LOT 1 1 BLOCK L ADDITION PIT) OWNER (Name) (Phone) (Address) APPLICANT P t ( (�/� (Name) r 1. 1 ... >{ Vi k_ 1 .` ' (Phone) C S- �}� I WO (Address) ` . f .. - Tjj c id LP !Wu vu SS33 (Addy 4 (City) (zip Code) (Contact Person) (14 1 ( C C ► ‘ ' le r (Phone) I S t∎ -7 (4 - 7 I__6 i APPLICANT SIGNATU ' • " ! LL 1 ' !" DATE ? / is 113 APPLICANT PLEASE COMPLETE BELOW C EI I CONSTRUCTION ❑ REPLA CEMENT 4 ❑ ALT `` FURNACE MAKEANDMODEL Cal n e C i 2�J O SNy FUEL bat D ( .� FLUE SIZE RETURN OPENINGS INPUT (00 OUTPUT 5 i E OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner Air Plants ❑Steam Units and Fireplaces Cannot Encroach ❑Gravity �rt Wat into Required Side Yard Setbacks. - Mechanical ❑ Radiation Fireplaces with Box Additions or Conditioning ❑ Special Devices Cantilevers to the Outside of Buildings t System ❑ Other DEVICES S Require a Building Permit. FIREPLACE MAKE AND MODEL FEE SCHEDULE Industrial, Commercial & Multi Family 11/4 of job cost Residential, Gas Fireplace $49.50 549,50 minimum Residential, Heating & A/C (New Construction) 5149,50 Residential, Additions & Alterations PAID MT 4-I Residential, Heating Only (New Construction) 564.50 Residential, AC Only WO, 3M1T Estimated Cost 5 Si t 1 O Building Permit # The lvlinnccota Statutes § 32613.141 rr ## �� "St 'fin 1.11tUt " has been changed Inr one HEATING PERMIT FEE $ `1 ' `' � / year cflicGrc STATE SURCHARGE $ 5 + DO inh 1, 2019. unlit June 30, 2111 1. TOTAL PERMIT FEE $ 5 St-\ the minimum aur'ehmgc far n "fisetl roe" permit (Office Use Only) Is CC, beginning Jul} 1,20111 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 — 4646 Dakota Street S.E., Prior Lake, Minnesole 55372 i. Date Recd PR , , . d 0 4 . � ,, ip kL � ,. CITY OF PRIOR LAKE PLUMBING PERMIT z...,, .., . is G u Cory PERMIT NO. z 3. Yellow Applicw 45 tease a or tint and s at b ottom ADD RE S r r l { ' `� ` t . ZONING (:excuse) . CC) UVO (�h1 U3O / i'�)Uj LEGAL DESCRIPTION (office use only) LOT 1 r BLOCK `'-t ADDITION pro OWNER (Name) _ _ . (Phone) (Address) (Name) ANTI` / `� �Z U��1b } ) ell�h ` J - 7((;) 1 / UL�.) }'L��" y f ) (Phon d -7 y� � 1 (Address) � 6 � ' L) ( ✓U . - H W \( ,/ UV I 1 le ' 1 V 33 �(� (Address) (City) l (Zip Code) (Contact Person)I i' )( dee S� (J (Phone) Q `1 J � �� I ) / k5_ ! APPLICANT SIGNATURE d 1 ' -, 4V/11/4 DATE c� APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough -ins Dishwasher I Water Heater Floor Drain Water Softener 3 Lavatory (Bathroom Sink) 1 Stand Pipe (Washing Machine) Laundry Try (1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly I , Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler 3 Water Closet (Toilet) Other FEE SCHEDULE Industrial, Commercial & Multi- family 1% of joh cost with a 549.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 The Minnesota Statutes § 326B.148 )st $ I6 4 Building Permit # "SURCHARGE" has been extended PAID until tune 30, 2013, PLUMBING PERMIT FEE $ The minimum surcharge fora STATE SURCHARGE $ .50 BUJ1fl )\Jt 1Pi=RMIT "fixed fee" permit is $5.00 TOTAL PERMIT FEE $ This Application Becomes Your Building Permit When Approved Paid Receipt No. Date B 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 o4 " NESO� P PR� Date Recd CITY OF PRIOR C LAKE \ SEWER AND WATER PERMIT rN Green File PERMIT NO. Yellow Cit . K 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZONING (orrice use) 6 1 4r4J` = /._c. b9 y it 0 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) CE,k ! t O/7j am A LC- 1 (Phone) 7h ° / 7 - J 9/)/ (Address) . / 1 0 P' 'Q 4) U, () U.) C&'I ' i . 1 L2 . 501 (Address) (City) (Zip Code) APPLICANT (Name) 1---� j).4 L �,� 0- 40 .6 _ C (Phone) f — ,/ (Address) 3 1 13 ),W J F i5i1 U ; OR0I44; 53 (Address) (City) (Zip Code) (Contact Person) „-� f9 01 ,Z04.L FJ' (Phone) Z _-_ b 7 ° . -V ry APPLICANT SIGNATURE DATE , APPLICANT PLEASE COMPLETE BELOW Size of water service 1, 5 inches. iOi7i / Location of any couplings from structure feet. Type of sewer pipe. n ABC [K PVC n Cast Iron Estimated length of sewer line 55 feet. Clean out (if required) located at -- feet from structure. FEE SCHEDULE Residential sewer and water line connection $35.50 Industrial, Com'l & Multi - family 1% of job cost with a $39.50 minimum Sewer connection only $17.50 Water connection only $17.50 Estimated Cost $ Building Permit # ER PE - )1�1" —7 / SEWER AND WATER PERMIT FEE $ STATE SURCHARGE $ _ .50 ba j-�` f TOTAL PERMIT FEE $ A Y y ( Offic Ise Only) Tnis Application Becomes Your Building Permit When Approved Paid PAID i t �wNo. s g�L�1 ��T Building Official Date Date U 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 a p # A 4 . ! PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION Man File INSPECTION RECORD SITE ADDRESS 2 5' 74' ,4U... WAY NATURE OF WORK S 'ivc pec.K /1/ fiv. G.L. ez Aaci. USE OF BUILDING PERMIT NO. t3. z 3 DATE ISSUED 4/ , / ' CONTRACTOR PHONE (// • Z, 50 INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DA FOOTING fc 51,aA7 FOUNDATION (Prior Backfill) C. RADON RETARDER C-C Rj PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED y vb ROUGH - I S SEWER/WATER/SEPTIC h3 FRAMING INSULATION �" J , ELECTRICAL PLUMBING ,(11, No, -,o - s3 t� /z j HEATING FIREPLACE GAS LINE AIR TEST You ;-1s / lG� ?� RADON REWeltBER I°. , . COVER NO WORK UNTIL THE AB HAS BEEN SIGNED I HOUSEWRAP LATH 1 FINALS a Z5 �i - # 3 GRADING ( PRIOR TO SODDING) BUILDING rig /2 /,/6" ELECTRICAL PLUMBING 1 /j/2 HEATING /a////r) 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