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asit ''eCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCEAND UTILITY CONNECTION PERMIT
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White ie PERMIJ.'T
2. Pink City ' (,
3.Yellow Applicant
(Please type or print and sign at bottom)
' ADDRESS A/P02ot4 ZONING(office use)
3400 1 7044 Sl: stN,A.1;,K.4�.ke.
LEGAL DESCRIPTION(office use only) pp
LOT BLOCK ADDITION PQ,,,,/4I W;llo�vy 3 t?/`Add;1tmf PID 23..//OD 31Y-D
OR
(Name) (C IA DiAG('.C(r'oulPtCa1•st10) (Phone) 743-852-'466'3
(Address)/1;017 1.44,',4_, live, 5o4.4#4(5t Low's "4,(k JPA' At.,s'y/ 4/o 4Ie 49ita
BUILDER 95,2-93(4 pi I
(Company Name) Za C0 65 (Phone) 6,1.2^2 R6. 0S3/
(Contact Name) Ty J e..e Teo n if G1 (Phone)G/41-296°17(1/
(Address) 7304 iV/c'J1'D ,61/v/. , We 1 0/ 09/5./ 44hi .5-5-V.39
TYPE OF WORK 0 New Construction ['Deck ❑Porch ['Re-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace
❑Addition ['Alteration lUtility Connection
CODE: DI.R.C. I,B.C. ❑Mist: ,CibeA./1! ,,i?e.-T"SAO4i/t ea k..ipteeat,
Type of Construction: I II III IV V AB
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $3,oQ ,1417
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 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 94Y-11.44ki,ay.//rrAi t,tyG, o60 /l/1 G7 eaf.H/
Signature r d/ade Contractor's License No. Date
Permit Valuation k- ?9O , Park Support Fee # $
Permit Fee k (9; , i SAC # $
Plan Check Fee $ e0'/ ga` Water Meter Size 5/8";1"; $
State Surcharge $ YYZ�J .46.
_ 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 DUE $ \7 i .95
This Appl ti i B o. es Y ur :,'ding Permit When Ap ove Paid Receipt No.
IOW Date Q By ,/
_ �Ii S 4 y5— J ei(lfit/f'� 70 Des/ ��V/TF'o7-- J-.6 �.�
Building•1 ei: -, 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
Bob Hutchins
From: Nick Zurbey
Sent: Wednesday, October 14, 2015 7:49 AM
To: Bob Hutchins i,\/\
Cc: sonnymiller@icloud.com ' /�
Subject: RE:T-Mobile building permits
Bob,
This project is done. Issues arose when the work was done without a precon taking place after a lack of communication
with the real estate team managing the project and when it was handed off to the general contractor(they were not
aware a precon needed to take place). We can close this out. It was a fiber bury and the site has been restored. I have
inspected the site and spoken to SEH about it. If you need to, put a note in the file that I signed off on this. Let me know
if this will suffice.
Thanks,
Nick
From: Bob Hutchins
Sent:Tuesday,October 13, 2015 4:50 PM
To: Nick Zurbey<nzurbey@CityofPRIORLAKE.com>; sonnymiller@icloud.com
Subject: RE:T-Mobile building permits
Nick, It does not appear that SEH has signed off on this project. They state that they are needing to conduct a final
inspection. Let's hold off on a building final until SEH has approved the project.
Thanks
Robert D.Hutchins
Building Official
City of Prior Lake
4646 Dakota Street SE
Prior Lake,MN 55372
952.447.9851; Fax: 952.447.4245
Sign up for Email Updates.
From: Nick Zurbey
Sent: Monday, October 12, 2015 7:16 AM
To: Bob Hutchins; sonnymillerOicloud.com
Subject: Re: T-Mobile building permits
Bob,
Here is the letter from SEH for the Willows Park project.
Thanks,
Nick
From:Sonny Miller<sonnymiller@icloud.com>
Sent: Friday, October 9, 2015 3:07 PM
1
/de
SEH
Building a Better World
for All of Us® RESUBMITTED TRANSMITTAL
October 8, 2015
To: Mr. Nick Zurbey Date: Originally Sent July 27, 2015
City of Prior Lake
17073 Adelmann St SE SEH File No.: PRIOR 131639 1.0
Prior Lake 55372
Client No.:
Re: Willows Park Monopole I T-Mobile AAV Al P0201A I Close-out
We are: •
® Enclosing 0 Sending under separate cover 0 Sending as requested
One[1] CD containing the Closeout Documents for the above-referenced project.
® Information/Records 0 Review& Comment 0 Approval
❑ Action 0 Distribution 0 Revision & Resubmittal
The electronic files provided herewith are intended solely for the use by the addressee.These electronic files may be
subject to manipulation and changes beyond the control of SEH.The addressee must verify the accuracy, suitability for
reuse, and completeness of all of the information and detail drawings contained within the electronic files.
SEH provides no warranties,express or implied, including warranties of merchantability and/or fitness for a particular
purpose for the files furnished under this agreement release.
By acceptance of these files,the addressee agrees to indemnify and hold harmless SEH from any and all costs, including
attorney's fees,claims,or causes of action of any sort that result from the use, reuse, or manipulation of these electronic
data files, and to waive all claims for consequential and any other damages of any kind against SEH.
The providing of these files by SEH shall not be construed in any manner to be in derogation of any reserved or
intellectual property rights.
Remarks:
1. T-Mobile completed work on this project without notification to the City. No preconstruction meeting
was held. Tenant provided notification of project completion on July 8, 2015. No daily updates,
photos or Punch lists are available for this site as all work was completed without prior notification.
2. Restoration inspection was completed by City and approved.
3. Final inspection by SEH is scheduled to coincide with other activity in City to reduce cost associated
with extra site visits. Any resulting Punch list items will need to be handled through the City as
Tenant maintenance.
4. Tenant supplied redlines are included in close-out package. Per Tenant, City is not entilited to
electronic as-built drawings. SEH recommends City confirm this claim and request As-built drawings
if allowed under terms of lease.
By: Mike Pease
c: SEH eFiles
•
dmk
s:lpt1p1prior11316391teleoommlwillow parkltmo riberlcloseoutltmo aav at willows park transmittal 072715.docx
Engineers I Architects I Planners I Scientists
Short Elliott Hendrickson Inc.13535 Vadnais Center Drive I Saint Paul,MN 55110-5196
SEH is 100%employee-owned I sehinc.com I 651.490.2600 I 800.325.2055 I 888.908.8166 fax
Ji0,
SEH
Building a Better World
for All of usC TELECOM PUNCHLIST
Owner: City of Prior Lake, Minnesota Date of Current Issue: August 28, 2015
Project: TMO Fiber at Willow Park Mono Pole Date of Original Issue: August 4, 2015
Site No.: Al P0201A Cont Comp Date: Substantial Final X
Contractor: Rockford LandWorks SEH File: PRIOR 131639
Date(s) of Inspection(s): August 4, 2015 &August 28, 2015
Below is a Partial List of Items which must be completed or corrected prior to final acceptance of the subject project
Item Contract Current Accepted
No. Reference Item Description Status By Date
This project is not complete due to the proposed Hand hole not being Closed KL 8/28/15
installed.
2
Please provide 48 hour notice to the Landlord prior to the start of this work to coordinate access. This work should be
completed in accordance with the provisions/notations of the approved drawings and/or as identified in the meeting
minutes. The Landlord reserves the right to conduct a final inspection of the work; therefore, a work schedule should be
provided along with the requested notification.
Remarks: Site restoration has been completed
Thank you.
Issued By: Kyle Linscott
dmk/kl Title: Technician
c: Nick Zurbey—City of Prior Lake, Minnesota
Jake Theisen—City of Prior Lake, Minnesota
Sonny Miller—T-Mobile
Dave Seddon—Rockford LandWorks
Dan Zienty—SEH Saint Paul
Dale Romsos—SEH Saint Paul
Jess Davison—SEH Saint Paul
Steve Johnson—SEH Saint Paul
s:lpt1p\prior11316391telecommlwillow park 1tmo fiber\inspectionlpunchlist\tmo fiber at willow park final final punchlist 082815.docx
Engineers I Architects I Planners I Scientists
Short Elliott Hendrickson Inc.13535 Vadnais Center Drive I Saint Paul,MN 55110-5196
SEH is 100%employee-owned I sehinc.com I 651.490.2000 I 800.325.2055 I 888.908.8166 fax
JI
SEH
Building a Better World
for All of Us'
April 22, 2015 RE: City of Prior Lake, Minnesota
T-Mobile Dark Fiber at Willows Park Monopole
Site No.Al P0201A
SEH No. PRIOR 131639
Mr. Joe Egge
Faulk& Foster
720 Capwood Avenue
Litchfield, MN 55355
Dear Mr. Egge:
In accordance with the request of the City of Prior Lake,we have reviewed the plans submitted by Faulk
& Foster dated April 15, 2015 referencing the construction of the proposed T-Mobile/Zayo Fiber Project at
the Willows Park water tower in the City of Prior Lake, Minnesota.
Based on our review and the above information as provided by Faulk& Foster, it is our opinion that the City
of Prior Lake can proceed with approval of this phase of the project; the remaining comments have been
addressed to the satisfaction of the City. Following approval by the City, a pre-construction meeting must be
scheduled by the tenant to include the City, SEH, the contractor and T-Mobile's representatives prior to
commencement of project construction.
If you have any questions regarding our comments, please contact me directly at 651.765.2971.
Sincerely,
/ ---
John Cvek
Project Manager
jc/dmk
Attachments
c: Nick Zurbey—City of Prior Lake, Minnesota
Dan Zienty—SEH Saint Paul
Dale Romsos—SEH Saint Paul
Andy Roman—SEH Saint Paul
Mike Pease—SEH Saint Paul
s:\pt\p\prior\131639\telecomm\willow park\tmo fiber\correspondenceVetters\t-mobile fiber at willows park monopole to j.egge 042215.docx
Engineers I Architects I Planners I Scientists
Short Elliott Hendrickson Inc.,3535 Vadnais Center Drive,St.Paul,MN 55110-5196
SEH is 100%employee-owned I sehinc.com I 651.490.2000 I 800.325.2055 I 888.908.8166 fax
I ,s~ctsil ow
City of Prior Lake
4646 Dakota St SE
Prior Lake, MN 55362
Attn: Nick Zurbey
February 20, 2015
Enclosed is the Building Permit Applications for the T-Mobile MN project
from Faulk and Foster for site #A1P0201A, at 3600 170th Street.
The check for the application fee, 171.95, is being sent under separate cover
earlier.
If approved,please forward the building permit to me at the address below.
Thank you,
Joe Egge
Faulk&Foster
720 Capwood Avenue
Litchfield,MN 55355
Cell: 612-839-4594
j o e.egge @ faulkan d fo s ter.c om
Fail/ f s st. r'
City of Prior Lake
4646 Dakota St SE
Prior Lake, MN 55362
Attn: Nick Zurbey
February 20, 2015
Please find a check enclosed for$171.95 for the Building Permit Fee for the T-Mobile
MN project from Faulk and Foster for site#Al P0201A, at 3600 1701h Street.
The application is being submitted under separate cover.
Thank you,
Joe Egge
Faulk & Foster
720 Capwood Avenue
Litchfield, MN 55355
Cell: 612-839-4594
joe.ec c e(c�faulkandfoster.corn
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City of Prior Lake
4646 Dakota St SE
Prior Lake, MN 55362
Attn: Nick Zurbey
February 20, 2015
Please find a check enclosed for$171.95 for the Building Permit Fee for the T-Mobile
MN project from Faulk and Foster for site#Al P0201A, at 3600 170th Street.
The application is being submitted under separate cover.
Thank you,
Joe Egge
Faulk & Foster
720 Capwood Avenue
Litchfield, MN 55355
Cell: 612-839-4594
joe.ec e(a�faulkandfoster.com
Bob Hutchins
From: Nick Zurbey
Sent: Monday,April 27, 2015 9:44 AM
To: Bob Hutchins
Cc: Paul Baumgartner
Subject: FW:T-Mobile Fiber at Willows Park Monopole to J.Egge 042215
Attachments: T-Mobile Fiber at Willows Park Monopole to J.Egge 042215.pdf;T-Mobile Willows Park
Building Permit Fee.pdf;T-Mobile Willows Park Building Permit Application.pdf
Bob,
I know you are out of the office so I am not sure if Paulan review this or just wait until Wednesday when you are back.
Attached are the plans for the T-Mobile fiber install at Ilow Please review plans an if they are
satisfactory for City approval. A copy of the building pet application and check are attached for re a ce as well. On
my end, we are good to proceed. No amendments -ere needed since they are placing the fiber line in an exi . utility
easement to the ROW.
Thanks, g
Nick Zurbey ()/\- _�
Public Works Technician A
City of Prior Lake ' frAdNc
952-447-9892 NI\ '�
61.61/4
From: Donna Koontz [mailto:dkoontz • se inc.com] 6()(t'l-/ 1j(CA - aerA,b(A)
Sent:Wednesday,April 22, 2015 3:54 PM
To: ioe.egge@faulkandfoster.com
Cc: Nick Zurbey; Dan Zienty; Dale Romsos; Andy ' an; Mike Pease;JCian_Cvek --
Subject:T-Mobile Fiber at Willows Park Monopole to J. g:- ---
Sent for John Cvek as outgoing email only. Please respond to John at icvek(a�sehinc.com.
Donna Koontz
Senior Administrative Assistant
SEH
3535 Vadnais Center Drive, St. Paul, MN 55110-5196
651.765.2989 direct
888.908.8166 fax
sehinc.com
Building a Better World for All of Us
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