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Home My WebLink AboutBldg Permit 01-1318 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT /1- g - 0 I ~. ~i~~e ~::y I PERMIT NO. 0/- 131 tJ. 3 . Yellow Applicant 1I (Please type or print and si2l1 at bottom) ADDRESS ZONING (office use) 1~~4"'J LV:({) T'u~ (1',~", LEGAL DESCRIPTION (office use only) LOT ~BLOCK /.;1 ADDITION ti-'-L Lv :1:; s. 59 v""',, . OWNER ) /V (Name)~ dJo~~11 l'o~ ...,. . (Address) '1(,c/ /4'rS-rrf or.. f kPPvg- vl'1'VtA;;L1 ~ BUILDER (Name) 1ne.()r:Jn... ..tJ C"" ~?, (Contact Name) ..!iiiiiItJ... S ~ ~j) Cu-A hi> . "'l_ (Address) TYPE OF WORK QtNew Construction (Phone) 5Slz,4- RI PID.;;.t;" - 3rJ.- II o-{) (Phone) c,~ - 4 ~,;.. - ') h 0 ( (Phone) ~ L,S-:J.. - ? (...C) I <2_U c,,~- 701 - gc:'44 o Misc. OLower Level Finish ODeck OPorch ORe-Roofing ORe-Siding ~ireplace OAddition OAlteration .iJUtility Connection PROJECT COST IV ALUE (excluding land) $ JJ. LI b .::s- 0 C) <;> J 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 =ter 6;:l1e P?f.:tt :~::eeded inspections. 000 ~ ~ ") b I ( _ S- _ 0 t rI1'jfi Signature Contractor's License No. Date v V(/ I Permit Valuation I Permit Fee I Plan Check Fee I State Surcharge I Penalty I Plumbing Permit Fee I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Permit Fee $ $ $ $ $ $ $ $ ;l. ~~.ooo .OQ... ',!ti".q~ l J I A I . c ""2-- 12. ~ .e::::-(~ __ -!llQ. ff) () l t2.O .l'fJ?J' '3~-. ~O 40.06 7" ~ "':1! Yo"" Bnildffi. Pmnit Whro Approwl u~Y'.~ II-L'-I-Ot Building 0 cial Date ., I Park Support Fee I SAC ~ I WaterMeter Size5/~ I Pressure Reducer I Sewer/Water Connection Fee I Water Tower Fee I Builder's Deposit I Other I TOTAL DUE f.l(U.ED 11- 2JJ -() J f(11J,. 77 J!.,t?A --rJ / I Paid I Date $ $ $ $ '7n . (1:: $ /. 2ao..~ $ ., _I 7rJ/LOo $ r ~O -(')<2 $ " $~//hJ7 ~ # Rc:rJ. f)(J It I ~..OD . ~SD.c:2J # # # I 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 signe 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. ~ U,LIWA-t. ~~J ~ , Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 White - Building Canary - Engineering Pink - Planning lht Ctntff nf Iht tokt Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ~l tfJ/nlaU ~~ 11-8-01 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is pr9posed at: J~~11 w.ddJ~ u ~ Accepted Accepted With Corrections Denied (~^ Reviewed By\.#' f1 Ue;/ ~ r?:JS~~~ Date: /1- Ic.j-O ( ~cX() V' ~. "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." Th. ('.nl.' of Ih. Llk. Counlry White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT ~n J~7 I ., (7 /F i '- ' APPLICATION RECEIVED 1/- 'c~-ol The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ,/5' 1/"/ / 1<. ~-;f- Accepted (~ Accepted With Corrections Denied ./"'\ I Reviewed By: (~ ~ ~ Date: / IILr:-/ 01 Comments:, ,< ' !-~! 33,U/ b-' fblJu. ~,~ kfkJ I~ I (~O Ii-' ~".l~5 LMlvtll/ltUt<<1 '. wl~~ -~~- ~ y~ ~\~<; . /~4tLi!P V:u,_ {)~~e<j ~~ ~~ ~ L~ ~ ~ ~f1~~, "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." . .<.',...... >'~" >"';'(:'-!r.ir:"",:~l"".\t.,),";l,"~,'oI . " ," ~ '., 1',1." ;""Mj'~'''\'; i.."'", 'oI'f' '1.\ ' ".....,.~ .~,y_:.-t~::;,:\.. "(p'-,l:ilir- "'.t,""-'''':'4'll'' "~r..;"", . . . " " .-,'~ I White - Building Canary - Engineering Pink - Planning Tho Conlor o( Iho "oko Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT /17~ I P{JI7uJt/ ~~ APPLICATION RECEIVED / 1- 8- 0 I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is pr,pposed at: 63'/1 Wdd{j_~ ! x Accepted With Corrections Accepted Denied Reviewed By: It#I3 Date: / /.:../s- -0/ Comments: See Reverse Side for Adrfition::ll Inform::ltion! ~ E o. F . E/"vor/./o'l r!Y'l No br"J.,';., ./ Y) r<..o,r ~ In t. (JO h/Clh e r f1,e,,,, v YCtr,( ~Jt!~T tttl.{.~ ~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures ::\) Fmsion Control PI::ln liThe 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. II . \~t? From JECHEEXC PHONE No. 612 8926396 Dec. 04 2001 7:57AM P01 " Dati RIG'd CITY OF PRIOR LAlCE SEWER AND WATER PERMIT. I'PJtlnll(! t~4: or IIrlat uad 11m at boUDm) ADDRESS -1f- 6~J7_."_wll).. ~".kl Y Cf I. 01_ .11. I P....RMlT NO {!J I J~. Lj'/. ;l, y.u"" CIIY mi . ... } ,. Uold Appll..... ZONING (uIIb_> LRGA 1. OllSCRIPTION (offtClC \lIC only) LOT ~-nI,OCK L/ ADOlTION TL, will J.. ~ .CO PW OWNER (Name) ~ C,nJ-. (Phone) 2$:.< '4 oJ;;z, ~ tJJ (Address) . (AIIIIM.:r.) (C'1l y) . " ," . ." I., " . (Zip CooeL......;_.._._ ArrLlCANl'-r- I L (Name)' .0 e.e, l\,C"J t::..V~ (AddJ'ess) d.31D. J; PII.{." EJ Q ~ e- (Address) (Contac:tPerson) ~ APPLlCANTSIGN~~R~. -F--t~. 'f APPLICANT PLEAS:t COMPLETE BELOW Size of Willer service T _u inohes. .. . . Loc.ation of l:Uly couplings from structure ~ feet. . Typ~ of sewer pipe. . 0 ABC _ e) PVC 0 Cast Iron Estimated length of sewer line J.E- feet. CICW1 out (ifrcquil'ed) located Cit feet from Structure. (Phone) .._.,~I f} ?elf) 74 s-" f.?/ DrH11 i~+~.Y.lJ!tM h,~4,~! ( ny) (Zip Coat) 4U '7~ 0 ?c.jS-~ ... I , I (Phone) DATB rtesidentialllcwl:r und water line COltlleCliulI Sewer connection only FEE SCHEDULE $35.50 Industrial, Com'l &: Multi-family 1% of job cost Wilh. $39.SU minimum $17.50 Water connection ani)' $17.50 Estimatod Cost :II ~ 5'" b Building Permir # 0/-/3/8 . ...---""'0 ~~f\W\~ ~~--/ SEWBR AND WATER PBRMIT FEE $ STATE SO RCHAROE $ TOTAL PERMIT FEE $ (Offid Uk Unly) T~"Applie.tloi DeCCn"'~5VoU." 'ulhU.,,, Permit Wben Approved Paia-. I~'~ lIulldlDc Omtlal ball, Dlltr 5.... 2.-- "'01 24 hour ..otic. lor IIU In.pOClllc'"1l (!)S)) ".7-9850, ra.. (95%) ...7-4145 -....:!:..:!.- ur ~.I'<J.U!( .L."I.lI.~ @OOl CITY OF PRIOR LAKE ~A TINGI AIR CONDI1iONING, J:I.u<.EPLACE PERMIT Date Rec'd I. pink. '11. PERMIT NO 2, Onoel C,,, . -() 1-13/'0- ,. v....... Appl"'""* V (plcll.st: type or erinC 1l1e!. siR!! at Doft'aml ADDRESS -L2l,47 t.:),v,().~ (~, A),Lj, . LEGAL DESCIUPTION (office tl$c ODly) zoNIN'G (ol!lce U5.) .'. LOT. BLOCK AODmON PID OWNER (\ f'\, (Name) ~C~~(f')A.1(']/~ ) (Acidr=ss) A. l/. ~~~~AN~/nJk() .(')JfI (Addrl;ss)d/O?J0 c.D~r0 Ave (A4dress) ~I: (phone) ~r..;:;,:.. 7?;o I (Phone) ~ro - ~ ~I-~, ._~p f o (CI~f) (pho~e) ~ - waa - DATE / - 6 --t1Ql _~c ~ J../ (lip Code) PI-EASE NOTE: Air Conditioner Units Canuot Encroe.cb into R.equired. Side Yard. Setba.cks FIREPLACE MAKE AND MODEL ftESCllEDTJ'LE rn.dU5~ial. Commerch!.l&. M~lti.F$.mHy I'YCI of job l;o4t ~idl:lntiAI. G;ss Fireplace 539.$0 minimum RlUidential. Heating &. AlC (New ConST.nlction) . $99.50 Ruideluial. Additions & Alterations ResidsfttiaJ. Heating Only (Ne.... COl1stnJe!iCln) $64.S0 Residential. AC Onl)' $3~..50 $39.50 S39..50 Estimated Cost $ Building Permit #.._. HEATING PERMIT FEE STAT:ESlJRCHAllGE TOTAL PERMIT FEE S $. 5 ~PA'D WITH B\ilLDING PER~"lT~ t (0ftI0;0: Ua~ Only) This AppliutiaD Becomcs YO&U' Buildbag permit When A.pproved paid ReCleipt NCl. tJate By B"ildllll omeill D.ce , 14 hour Qotica for all iDapadions (95)) 447~98S0t C'alII C'!l2l64'7-4145 100~ HIV G3110H.LNO::> 9L6909tlS9 XVd 6t:91 llHl 6006/CO/l0 CITY OF PRIOR LAKE ~. Ew ~cam PL~G PERMIT PPNo 0/-/3/6 APPlicant:f;ve -S-Ja . U",J;Ao J~\ ,Phone:6-S-1- 1-.1'9- cPA>o Address: '7~r.;~ Q vp..'~~~(~()Ve/J1h ...s-,.r-rJ/6 Signature: 11'1 _ ./. ~ Legal O$scriptlon: Lot '- \ Block-...f.L If . SUb~. [4..souj1. Site Address: I,-~.::r. . e f W u n--r /JLJfL. ._ Building Permit # _0 J> J ~ PIC # NOTE: This permit will not be processed without complete information FIXTURE UNITS _-' . i/~ ~ ",0 COlI... atllw L.... COOl"'''' Quantity Type of Fixture Quantity r\3. Bath Tub with or without shower y / Dishwasher / I Floor Drain If Lavatory (bathroom sink) .I I Laundry Tray (1 or 2 compartment sink) I Shower Stall I Sinks Bar Sink .:~ Water Closet (toilet) ~ : '1"'.. ,,1 '-, .-t , j. ,. ". '). \, ... FEE SCHEDULE ~) , , '.I' Industrial, Commercial & Multi-Family (1% of job cost, $39.50 minimum) Residential, New One & Two Family $99.50 Aesldentlal, Additions & Alterations $39.50 State Surcharge GRANO TOTAL Type ot Fixture Rough-Ins Water Heater Water Sottner Stand Pipe (washing ma.chlne) Sewage Ejector Backflow Assembly (RPZ, Double Chack, PV Backflow Assembly Test Lawn Sprinkler Other .;,',.' $ $ $ $ .50 $F~ This permit is granted up~n the e:\press condition that slid FAID V/;-:: ' contractor, shall comply i re U with the ordinanC~UILD'NG P- , j of the State Plumbing C e mendments thereof. lP I r..... ..... R JAJ.Dl--- DATE ATTEST Call for all i 16200 Eagle Creek Av. S.E., Prior Lake, Minnesota S~3721 Ph. (612) 44744230 I FAX (612) 447-4245 . An Equal Opportl.lnityEmpl"O)'er FIRESIDE CORNER #7660 P.001/002 Date J:(eI:Pd ~:~ E~_l PERMlTNOOI_ /3/6 (Please t'fpl! ur; J)rm~ llJId sian lit 1xlf,1nm.) ADDRESS ZONING (gffjceUIIl) /..53(/7 uJlld -r ~Z1 fY- Ilk.] LEGAL DESCRIPTION (office use only) LOT BLOCK ADomON PIn OWNER (Name) rnt...D~ ~ . (PhODC) (Address) APPLlCANT (Name) AI"LIEO FIRESIDE DBA FIRESIDE CORNEll ,(Phone) 651-633-2561 (Address) 2 700 N. FAIRV1D-AVENU~ (Address) (C ct P ) BRENDA HUSTON onr:a . erson APPLICANT SIONAT~~. ~rT.r.t: ~ (City) 651-633-2561 ~1:;11~ (Zj~ Code) a~ . (phone) DATE I.kJ/01- ~ -r~---- _ APPLICANT PLEASE COMPLETE BEJ..OW ~EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND M.ODEL . FUEL F'l...UE SlZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POweR PLANT OWnrm Air Plan!;S 0 Steam OG/'II.Yi1)' 0 Hot WlIl1:.r o M~h.anical 0 Radllldon OAir Conditioning 0 Special Devices OVent. Syst.em 0 Other Oevices FlREPT,ACE MAKE AND MODEL ikli./ ;J6lA txx:n.1L PLEASE NOTE: Air Cotl.ditioner Units Cannot Enr;rOlleh into Required Side Yard Setbacks Industrial. CommcrdaJ &. Multi-FlIn'Iily Re:sidentil11. Heating &. Ale (New Con9mlGTion} Resid.entlsJ, Heating Only (New Construct;po) FEE SCHEDULE )% of job tOllt Resid"ntial, Gas fireplace $39.50 minimum $99.S0 Resldentilll, Additions & Alterationll $64.50 Residentll!l. AC Only $39"Q S39.50 S39.50 Estimated Cost $ Building Permit # () 1- /3/ f; REA TINO PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .so (omell U,1Il O"ly) This ApplfC:lltion Bec:ome$ Your Building Permit When Approved Paid Blllldi"g Oi1ld,,1 DIle DAtJAN 2 4 2002 I Receipt No. / IBY r- %4 bour nDtice ("r .11 Inspection' (9S~) 447-98SO, fnll (9~) 447-4~4S PRIOR LAKE INSPECTION RECORD (..u',.-k. ~ Co...wr J- (f DEP,1tRTMENT OF aUILDING AND INSPECTION SITE ADDRESS J ~ '17 lA),. ld- . NATURE OF WORK IJ ~ USE OF BUILDING . SFn PERMIT NO. 01- I ~ , ~ DATE ISSUED I J -/'7-a ( CONTRACTOR .,tkt.\M\AcJ.)..._ ~J. PHONE (.,t2- /d/-R~yr NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT I GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING HEATING DO NOT OCCUpy INSPECT~~ DATE , FOOTING I -:-t) V~ I tl~~' FOUNDATION (Prior to Backfill) I ~ ~ ~ 1\ \ ~ 0 \ I b ~ l;L-~ Q( PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS ~::=:~ WATER I SEPTIC ~ \. ~. ckt\ ' ~ ~~ INSULATION ~ ~ lJtfA l /tJ:r II / ~'i/di. ELECTRICAL . I PLUMBING ~f)a,w I !(c,,'O.v HEATING (if required) ~ \-) ~ ' I l ~-a./O ~ FIREPLACE ~ ~o..uJ f ,...:l,o '"'" GAS LINE AIR TEST ~ ,\ rMA, . { . d+ 09.- COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS I dVh I ~~~ //:;;,r d ~ . ~ - 'lb~D'&--- ~ ~~ ~wl4..0~ ~ ~ '2.-~(P-.-OR UNTIL ABOVE HAS EEN SIGNED NOTICE This card must be posted near an electrical, servico\'! 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. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850 DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~ -a., -()~ OWNER /5347 W;I~;TuA'~ CONTR. ADDRESS PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o ~ULATION jrFlNAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o j'LUMBING FINAL IE MECH FINAL o EXIGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: \ bit f8 0\ O~ -GWJ.'wt 1'<-~IlJ b'1. #w. ~ ~f)d a- -r.re.es p-e.r :J - 0''1 Ae.J JO~lM T ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING '",pedoe ::f, ~aMtf OwnerlConte CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSl'iOTI CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /53'17 OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~AL o SITE INSPECTION DATE TIME SCHEDULED 1/- J.5-O"L w;1d TvtK<v LT CONT/ 11/" ChNfIcl C-t;t1S/.. PERMIT NO. (J1-/3/~ o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL \)j(EXI~ILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: Gr4'/'" 19 K Lullo g~;(- ,-9/l:, 11/0 5,rT ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspecto~ _""L- Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: DATE SCHEDULED TIME 2- ~: 70 3-1t.f-OZ- ~ /534-7 Wlf.-O TlJ~ CV I CONTR. PERMIT NO. (-/:$18 o PLUMBING RI o MECH RI o WATER HOOKUP tJ.-O SEWER HOOKUP "f ['it PLUMBING FINAL VD' MECH FINAL o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o vvtdM.O~c9~ '" J1IWORK SATISFACTORY. PROCEED o CORRECT ACTION AND PROCEED o CORRE~OR~\CALL FOR REINSPECTION BEFORE COVERING Inspector: .i?....... \J OJ 1..1.A. Owner/Contr: CALL 447-9850 FOR THE NE\T INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! Il'iSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS I S"34 "l OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION COMMENTS: DATE TIME SCHEDULED ~~{J ~tS7 W:ll TU/b..O CONTR. PERMIT NO. J-~ o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST . ~J..'- ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECIai' LL FOR REINSPECTION BEFORE COVERING Inspector: Owner/Contr: CALL 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI INSNOTI ~ ...;t Itrlifuau of QDrmpanry CITY OF PRIOR LAM ~ 1Bepartment of _uUlIing Jn~pettion final Permitted 0 Conditional C.O. Expires is Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying tlult at the time of issuance this structure was in compliance with the various ordinances. of the City of Prior lAIce regulating building construction or use. For the following: SINGLE FAMILY Occupancy Type Type Construction Fire Zone _ Bldg. Permit No. 01-1318 N/ A z . Di . onmg strict R1 Use Classificatioo R3 VN Legal Description L5, B4, THE WILDS SOUTH Owner of Building SiteAddress . 15347 WILD TURKEY COURT MCDONALD CONSTR., 7601 145TH STREET, APPLE VALLEY 55124 ContractOr's Name &: Address DON RYE