HomeMy WebLinkAboutBuilding Permit 08-0083, Demolition 08-0082
<tItrfifiraft of <IDrrupanrl!
CITY OF PRIOR LAKE
~rparfmrnf of ~uil~ing Jf nsprrfion
,gJ Final Permitted D Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section iiO of the n Residential / [J 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 <; Aib Gt t:f'/I'I/j /L L/ Bldg. Permit No. (: p, 0 Of; "?
\....-.f / _- / / ',__~ .J--'
Occupancy Type K: Type Construction 1,/ N Zoning District Ie / ~~ D
Legal Description
/ r--
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/. 1:1 V [;~..:;
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Owner of Building
Site Address
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;
Contractor's Name & Address /(E V'II'; · I :t,!/ t-1E-L-L..6 S/'/i /\/(:1
IL/,[E/(/I/c,',- jN//~ '/~jt CityPlanner ;
I I ' Building OffiCIal ! '
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
2.. 2 0 . 08
RI.pA~IAN
i =e ~!~y I PERMIT NO. 00..000.3 I
3. Yellow Applicant , u. U'
ZONING (office use)
R/~
'In\ P--d, '::E
y
LEGAL DESCRIPTION (office use only)
LOTS BLOCK
ADDITION
PID
OWNER
(Name)
""eo) l'\ "
(Address)
5~
N\,c'~\'e ~pt:--CS
\.
(PhC)
l1Y'7 ~~~
V)~ bl~'~
BUILDER
(Company Name) ~AU l {l ~ 0\ Or---fv.
(Contact Name) ~
(Address) t..tlT"'l
(Phone)
ew Construction ~eck DPorch ORe-Roofing
OAddition OAlteratlOn OUtility Connection
CODE: ~.R.C. DI.B.c.
Type of &nstruction:
Occupancy Group: A B
Division:
I
E
o Misc:
II
III IV V A
HIM R
2 3 4 5
B
S U
PROJECTCOST/VALUE $
(excluding land)
~cv (CtX:'-
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.
\\
~ \d-t\pb
Date
,Contractor's License No.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
150, co
i5"6. Do
62.,OD
5D,DC
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1 ";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
This Application Becomes Your Building Permit When Approved
~~
Building Official
2/29Ac?
Date'
l-. 7'1
,(;//
...
This is to certify that the request in the above application and accompanying documents is in accor"dance 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.
1-]-0&
Datc
.5e cz. c::; N1H1~~ .:5he~
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
CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec' d
2 20. DB
fZJ~IAN
I PERMIT NO. Of? _ UO B~
(Please
ADDRESS
\ 5 \ '\:; \"~J\ ~
ZONING (office
use) ~I SP
-~B
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2.5. 039. 00 (P. 0
OWNER
(Name)
\~7\
~ l} -\
~ ~ \'r: - ~ ?><OD
f\.\, \' h t \ \ t
S~(l~
'(}-',L:v
(Phone)
(Address)
CONTRACTOR
(Company Name)
~Phone) G\ ~.J.- \..\l\ S q 10m
C\~~ '-\\...\'7 r:JD~o lS)
(Contact Name)
(Address) I ~I'l D
(Phone)
5"2.
Use of Building:
INTERNATIONAL BUILDING CODE
Type of Construction: I II III IV
Occupancy Group: A B E F H I
Division: 0 2 3
V A B
M R S U
4 5
CA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION
R.c. I
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.
3) ~\~
Date
This Application Becomes Your Demolition
Permit When Approved
b~~~
METRO (MCES) SAC UNIT
DETERMINATION
-1-
Building Official
02/~9/t;g'
Date
U~~ "" .lot' , ~/r-
~v-IDi 8~ ~
~/1'~,
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.
3-3-08
Date
Special Conditions. if any
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by:
-:5e/11f1.
Building Permit #
Address:
PID:
Date: ;} --;} r-08
Zoning: ,I( -1 ~
Legal: L
S- B
,
Subdivision: /I;f ..l/e5
/.:st III It,
- I
Existing Structure? @J NO
Existing Nonconforming Structure? @NO
~~)
I CONFORMS TO ZONING
ORDINANCE
NO
Yard Setbacks: NA I FAllSI COMPLIES Standard Proposed
. Front Yard (can be 20' if aVQ. w/in 150') 25' ;J'/
. Side Yards 10'1 II. 3 '
25' if abutting a street 6. 31
. Sidewall exceeding 50' requires additional side 2" ~' ;ea"setback + I ~,J 11.1 '
setback for every l' over 50' in length 2"/1' over 50' 10,15 rerr
. Rear Yard 25' N fi rfJ..skTI! ')
. Patio Door: provide for minimum 10' deck or sign 10' sidel
statement indicatinQ no deck will be built in the future 25' rear /VA
. From 100 year flood elevation ofwetland/NURP 30' NA
pond
. From OHW (Prior or Spring Lake) 75' or setback average of
adjacent structures, but no / (C/~ ./-(.> d~J(
less than 50' fub.tr~C .
_.~~_o+..___
Floor Area Ratio: NA I FAilS
.30 Maximum
Yard Encroachments: NA I FAilS ICOMPLlES Standard Proposed
Eaves and Gutters no more than 2 feet in width and no tr..:t:t.eY$ == I-F~.
closer than 5 feet to a lot line (Easements). C Uw\.rIl 11!.s
AlC and other equipment cannot encroach on interior ,
side yards. /loA
Tree Preservation: NA I FAilS I COMPLIES Standard Proposed
. Total caliper inches
. Permit 25% Removal
. Caliper Inches Removed
. Caliper Inches Preserved
. Replacement %:1
L:\TEMPLA TE\BLDGLIST.DOC
White - Building
O~narv - Engin~g
Ink - Pia"","
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
x
''',,---
Accepted
Accepted With Corrections
Denied
Reviewed By: #' ~ Date: .3- J- O&,
Comments: - /Y!lfHIYJUWl ;L -h-Q"-c:-y~rd &~ neeoleL (!or-.l l:reeJ
/ _\
rr~<"'.t: /~cJ<J 1I1!l5:/C be .7 ~ ""..Iyer M';'/~",,/
- Cree.> mud- ~e ~it1re.~ .on'pr z!::e, cct-fifl"e..iJ.! o.pO<L:~fIto/.
, , /'
- aVdr~n ~r&lS~4 fYJU5r- b <:"MT:/a-d 6v
, I
a Jkrv%r- ;ori,r- to, ';;H-~~vn 1~~~Jt ~~vd
"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."
~-----_._~_.~'"..,_._----_.__._-_.,--_._~-,-_.__.._-_.-------_._.~.__._._--_._-,.--...,-_.,--_.__.
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
c'--- ',_' /, ! _ /'::,._ \ _J ___:' "I ,,-
,. ~-- r \,! ( I) ICCV! 1.1
~. . 2. C . C;::
(~I \ (HELLE:
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ','-- '~-"J -- ",--
" i I I ( t.-- i /-- II 1-,- ( \' I' '. - I 'I'"' i r. " .
I ..............- _ ......... ; j __..' r .. \ '-, .~, I '-. .----' . ~-
! .
Accepted
x
Accepted With Corrections
Denied
Reviewed By: ~ Date: .s -3 -()"
Comments: See Reverse Side for Additional Information I
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
-P~ ~<-
C:Whlte - Bulld~
Canary - t:nglneerlng
Pink - PlannIng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
P "
S ~~~ I K€"\l,~ ~
2-. 2-0' ~ r
,,^,(G l:\ eLL E"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IS I 70 H~(-<..J=bi tJI~, S.f:,
Accepted
Accepted With Corrections
/
Denied
,.
Reviewed By: ~ ~ Date: :t3/3/0tf?
Comments: ~:-;.:..-=tc, ~ ---.J... -t'--- ~
~ f.-.J~~~..J f-- ~ U1HM- d~ 7"";:"
v.
~ ~ ~fh~~/':€P _~tr.~~,
=;~ ~~ ~ --6t ~ ,;:; ~
1;:rri. z, ~ ~-'o/~~
1-<1 -4:l~ f
"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."
Drivewa : NA I FAILS I COMPLIES
. Maximum width at
. Required setback
.
.
Shoreland District: NA I FAILS I COMPLIES
Minimum lot area s uare feet
Minimum lot width
Shoreland alterations
1m ervious surface
.
.
.
.
Flood lain: NA I FAILS I COMPLIES
. 100 year flood elevation
. Lowest floor elevation
. Proposed lowest floor elevation
. Elevations 15 feet from structure
. Road access must be no more than 2 feet below
Re ulato Flood Protection Elevation
.
.
.
.
.
L:\TEMPLA TE\BLDGLlST.DOC
Standard
24'
5' from side lot line or
30' from r-Q-w on comer lots
10%
35' Maximum
30% Maximum
Standard
By planning dept.
20' From Top of Bluff
By City Engineer
No importing/exporting
Standard
~. POQrLa
9T~f.fs rin Lake
c::~Q~.9'pilQrcaker~
915.4' S rin Lake
Must be l' above flood
elevation for new and existing
structures. If existing
structure was constructed
9/19/90-11/22/97 then
additional foot is not re uired.
Must be flood elevation or
hi her
907.9' for Prior Lake
913.4' for Spring Lake
Standard
832 sq.ft. or 25% rear yard
10'
15'
/.~~
Iros
Pro osed
;J.;J If 31
25"
Pro osed
9/~..s3 '
,,/
C <:
~s-:tl: t
CWhite - Buildi~
Canary - EngIneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 5PANCj) \(5\) (N ~ nICA-lSLL6
APPLICATION RECEIVED 2. . 20. () 8
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
15170 F16~ POINT Ro. S.b.
Accepted
Accepted With Corrections
/
Denied
~~
Comments: ~ a...tI ~,
~~~~~~~~
-r~~, ;t'~~J~~~~
, -,tL- - · n #.~ . /] J. /1
~4r~~ ~ ~~...:c.~. '-1t::JCJ.cJ,C/o ~.,. ,~~....... ~
~ 6< ~,-rLJ ~ ~~ ~
7. 'I
~~ ~~~4./' Ale270 ~- 3~ ~~
PtAA/T&J IN ~AJr YAIW 7f" TaTAL ~/2..
T~ ;et:..-PU/ee-xeJr- - SJ:;{) &?JU;~ IN
R!.e;/'-JI YA-1etJ, (~~ --)~ f!d( ~ ~"
h ~~ ~ ~{/-/~.~Jl.a~ d~~P~
~ ~~ h J!)~Je
"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."
Reviewed By:
Date: c2/~9/oP
.
~ ~ a-f(
/
04/29/2888 11:83
9524925885
GLOi.,-)H1G HEARTH: /HlfJH
PA(JE 01 / 01
CITY OF PRIOR LAK.E
HEA TING! AIR CO:\TDTTIONTNG/FIREPLACE PERMIT
Date Rcc'd
I t',,11,:
~ I; t .~ i'; I \
',';:; I PERMIT NO.oe 0- O'}1-:21
^~~,11i.:'1!'1 ...~"!:.._ _.._~~
-----J
I ZONING "."".", I
I. .......,.... "'_'__"_ _._"'__
.1 Y,II.,,,.
~~;;&;~;' nn< M"'i · .""'''.'e- 'i;2 n-
LSJJ-'?_..._..f;~b 0 i(\1__...........L -_~ .
! LEGAL DESCRIPTION (olTice 1I;.~;.'~~\~)._._....._u._.
I
'~__,". PI D _____... __..,,__....___1
I LOT
BLOCK ADDITION
~':,~~€Vl(\ Sr~6- (Phon,)&Jd---3&~-7:55511'
(Add"") LS~S;hjlDi . Di, P(iQ{jp.];'Ji I fli\N 55.312 (!rl~Lo, 1),,- J,
! A.l'PLIC ~- . .........------ ------ .'_00-- . L' u___...___.... '.""."1
I (N,m,) ~.iJJ:u En.~\~:~k.l:LlATI>=:::: (phon,) q9 - 1<; '). :_:J.?-_:1J"L_
, (Addrcss)lo.CL _\_cACtOLQ) h I ,j)cr\)Olv:\ I vY\N .5$35:J-
I ---:- (A<~~~~s~) , (C,ry) (Zip Code)
I (CO""" r",on) ___.J.!...O~ - h:~IJ"'_<:Lh-___._______ (Phon,) j]SJ -- J.!3. de -- 7 dc~'!':.___
. APPUCANT SIGNATURE ;7 '. -~~-_____.-- -- ___g~1E.J://J~/O y.-- .'
APPLICANT PLEASE COMPLETE BELOW
---- ~NE\V CONSTRUCTION 0 R-EPLACEME'lT---'--O ;-\LTl.:RATIONS._..........-
FURN-\Cl:: I\IAKE !\'\lD r"lODEl FUEL
FLUE SIZE
TYPE Of SYSTEM
RETURN OPENfNGS INPUT
HEATING OR PO\VER PLANT
OUTPUT
PLEASE NOTE: Air Conditioner
O\\!nrm Air Pi:lnr.~ 0 Str.am
_ .' Units and Firepl:lc~!'l Cannot Encro;"lch
~llr;)"'IV 0 Hot W:tler .
'1 I' . I DR"dl'a'l'on ..lDrn Req.UiredSid.c Yn.rd Sctbltcl<s.
1\ cc '('nlc~ '" L .1, .. i.' ,
Air C"nd'lIonlng 0 Special DeviC"ell _ , I ':, :.:1<1I'~tt...~~~{~~~'~Ol Additions or .
OVcnr. Sy~tem 0 Other D~vic-ell" . ",:,., ,', :,/,I:.~a~t~(!~c~;~t~;th~ Ottf$lde of BuildlOr.s
, . .... . "RequirtflinuHdlligP~frttlt.
---'~!' ErLAc.~~t^ KE AN D MODEL ,~t:#cGlrf.q(!JJ.iJ_i;)SL:1.5Z:{1f,~{j--=i"/SI S"F-IIV- Ifl/"-j3/e:/i=/1 V~;) /
FEE SCHEDULE.."
1% of job. co~t ~~tia1. ()1lS Fitep~-=:::::',. ~:,r $49.50
$4951) m.lnlmum '-- \.:!.)
R:~ldel1linl, 1'leMlng & AIC (New Conslructlun) $149 50 Re~idcntiuJ. Additiorll: &. AltcrntlMs . $49,50
IZe~idenlinl, HC~lm~ Only (New COl1s\nlcl1on) $64 50 Re,identittl. AC Only $49.50 I
",,1m."" C os! I ",Ild'"g P,nm! #.... BUI~~~~. W'7~~m \'.~
HEi\TING PERMIT fEE $ ~ \, / // (L aE\\}..'
SlAll:: SURCHARGE ~ -~'.~~. j} 0 ~QJ(-\I' /) ~
TOTAL PERMIT FEE " \ (J \}J
1!1t1uSlri!d, C0ll1ll1ercl~1 &:. Multi-Family
Wflitt Use Only)
I Receipt N0. 1
~."...,..- I
i By _
I~_____.u~.__...._._~_j
b-
Dale
This i\pplication Becomes YflU!" Building Permit When Approved
Build in!! ()ffici~1
Dille
24 hflur Ilolie(; 1M nil in~p\!ctiom (951) 447-9850. fllX (952) 447.4245
464(, Oak.ltn Slrct:1 $,(:.. Prior LAke, !\1innc~f1I:1 55372
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
PBtl'HT =ltoe. 00
ELEVATION CERTIFICATE
OMS No. 1660-0008
Exoires Februarv 28. 2009
Important: Read the instructions on pages 1-8.
SECTION A - PROPERTY INFORMATION
For Insurance Company Use:
Policy Number
A 1. Building Owner's Name Kevin & Michelle Spang
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
15170 Fish Point Road
City Prior Lake State MN ZIP Code 55372
Company NAIC Number
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 5, MAVES FIRST LAKE ADDITION, Prior Lake, Scott County, Minnesota
A4. Building Use (e.g., Residential, Non.Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 44 43 46.1 Long. -9324 39.9 Horizontal Datum:
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number Z
A8. For a building with a crawl space or enclosure(s), provide A9. For a building with an attached garage, provide:
a) Square footage of crawl space or enclosure(s) sq ft a) Square footage of attached garage 996 sq ft
b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage
enclosure(s) walls within 1.0 foot above adjacent grade walls within 1.0 foot above adjacent grade 1
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b m sq in
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
Prior Lake, 270432
B2. County Name
Scott
B3. State
MN
B4. Map/Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone
Date Effective/Revised Date Zone(s) AO, use base flood depth)
2704320002 C 11/19/97 11/19/97 X 909.00
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
o FIS Profile ~ FIRM 0 Community Determined 0 Other (Describe) _
B11. Indicate elevation datum used for BFE in Item B9: 0 NGVD 1929 ~ NAVD 1988 0 Other (Describe) _
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? OYes ~No
Designation Date _ 0 CBRS DOPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: 0 Construction Drawings* ~ Building Under Construction* 0 Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, ARlAE, ARlA1-A30, ARlAH, ARlAO. Complete Items C2.a-g
below according to the building diagram specified in Item A7.
Benchmark Utilized MNDOT THUMB Vertical Datum NAVD 88
Conversion/Comments GPS STATIC
a) Top of bottom floor (including basement, crawl space, or enclosure floor).
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member 01 Zones only)
d) Attached garage (top ofslab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG)
g) Highest adjacent (finished) grade (HAG)
Check the measurement used.
913.50 ~ feet 0 meters (Puerto Rico only)
915.60 ~ feet 0 meters (Puerto Rico only)
_ _ 0 feet 0 meters (Puerto Rico only)
913.50 ~ feet 0 meters (Puerto Rico only)
915.75._ ~ feet 0 meters (Puerto Rico only)
912.95
923.90
~ feet 0 meters (Puerto Rico only)
~ feet 0 meters (Puerto Rico only)
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
o Check here if comments are provided on back of form.
Certifier's Name Timothy S. Peterson
Title Land Surveyor
Address 305 Stonebrooke Court
License Number 45332
..........
......~;~~~E;~~.....
...",,~." ',.is'Q''.
.' '. "f; ,
/ .. LICENSED .... '-:
. LAND::
:. SURVEYOR . :
:; \Jl ". No.45332 ":A.."':
.....-;, -..... ......0.....
'..'>-~ ......... <<,C:J...
....'OF MIN'7....
""'lltlt'-
Company Name Stonebrooke Engineering
City Shakopee
State MN ZIP Code 55379
Date 06-09-08
Telephone 952-402-9202
FEMA Form 81-31, February 2006
See reverse side for continuation.
Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding information from Section A. For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
15170 Fish Point Road
City Prior Lake State MN ZIP Code 55372 Company NAIC Number
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments None
~~
Signat
Date
o Check here if attachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zones AO and A (without BFE), complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items E1-E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawl space, or enclosure) is _'_ 0 feet 0 meters 0 above or 0 below the HAG.
b) Top of bottom floor (including basement, crawl space, or enclosure) is _'_ 0 feet 0 meters 0 above or 0 below the LAG.
E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9 (see page 8 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is _'_ 0 feet 0 meters 0 above or 0 below the HAG.
E3. Attached garage (top of slab) is _'_ 0 feet 0 meters 0 above or 0 below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _'_ 0 feet 0 meters 0 above or 0 below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? 0 Yes 0 No 0 Unknown. The local official must certify this information in Section G.
SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address
City
State
ZIP Code
Signature
Date
Telephone
Comments
o Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E),
and G of this Elevation Certificate, Complete the applicable item(s) and sign below. Check the measurement used in Items G8. and G9.
G1. 0 The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. 0 A community official completed Section E for a building located in Zone A (without a FEMA-issued or community-issued BFE) or Zone AO.
G3. 0 The following information (Items G4.-G9.) is provided for community floodplain management purposes.
G4. Permit Number
G5. Date Permit Issued
G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: 0 New Construction 0 Substantial Improvement
G8. Elevation of as-built lowest floor (including basement) of the building: _'_ .0 feet 0 meters (PR) Datum _
G9. BFE or (in Zone AO) depth of flooding at the building site: _'_ 0 feet 0 meters (PR) Datum _
Local Official's Name
Title
Community Name
Telephone
Signature
Date
Comments
FEMA Form 81-31, February 2006
o Check here if attachments
Replaces all previous editions
For Insurance Company Use:
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number
15170 Fish Point Road
City Prior Lake State MN ZI P Code 55372 Company NAlC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right
Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page,
following.
Building Photographs
See Instructions for Item A6.
~. ~ rC~ I~: II ~j ~ ~..~I
AUG 1 9 2008 ! IJ j
I. '
By
MN / DOT Geodetic Database Station # 3032
___,~'_-"'_'e"______'~~'-_\"
"r~ I~ l[~ \'\ WI L~ ~5/24/2008
U _':1 -
AUG 1 9 2008
PDF format County Dump by Map Sheet - English Units
LJ
",[~'~NEI'Ot...
I T- ~
\~ ~'1
O~'fl\"~
STATION NAME: THUMB MNDT
NGS QUAD / S
# 44093134/
COUNTY: SCOTT, MN
MAP SHT / INDEX # 1/63
By
1/4
SE
SEC
35
TWP
115N
RNG
22W
LATITUDE
444307.95
VERT HORZ
LONGITUDE ORDER ORDER USGS OUAD MAP
932508.16 2 C PRIOR LAKE
CONDITION GPSABLE PHOTOS BRDG NO FIPIR
GOOD YES YES FLUSH
DISK TYPE MAGNETIC PROPERTIES
SURVEY DISK STEEL ROD IMBED IN MON
AGENCY
MNDT
YR-SET
1980
YR-REC
2007
MONUMENT TYPE
CONCRETE MONUMENT
DESCRIPTION ( 2007 )
STAMPING: THUMB 1980
AT PRIOR LAKE, 0.15 MILES NORTH ALONG RIDGEMONT AVENUE SOUTIlEAST FROM JUNCTION OF TRUNK HIGHWAY 13
AND RIDGEMONT AVENUE SOUTHEAST/COUNTY ROAD 44/160TH STREET, 106 FEET SOUTH-SOUTHEAST OF POWER
POLE, 63.92 FEET EAST OF REFERENCE MARK 2,35.69 FEET NORTH OF REFERENCE MARK I, 33.5 FEET EAST OF
RIDGEMONT AVENUE SOUTIlEAST, 10.5 FEET EAST OF RAIL, 6.3 FEET WEST OF WITNESS POST
STATION NOTES
MONUMENT IS A CONCRETE POST MISIDENTIFICATION IN L 24611 FIELD WORK CAUSES TIlE 2ND ORDER PUBLISHED
ELEVATIONS TO BE IN ERROR, THUMB REFERENCE MARK 2 IS ACROSS THE ROAD.
ELEVATIONS (ft)
NGVD 29 NA VD 88
980.805
980.805
980.795
ELLIPSOID
HEIGHT
892.354
892.367
ORDER METHOD
GPS - STATIC
ADJUSTMENT
ADJUSTMENT
VERTICAL CONTROL SURVEY
ADJUSTMENT
YEAR REFERENCE
980.585
2
2
2007
1999
1997
1981
HSCOT2
Gl7648
00000231
L24611
Geoid 2003 Separation: -88.46
GEODETIC POSITION NAD83 (1996)
ZONE
STATE PLANE: SOUTH
COUNTY:
UTM: 15
~
2775700.284 ft
473415.361 ft
1531560.625 ft
X
955217.760 ft
190045.827 ft
16246053.506 ft
LATITUDE
444307.94720
ADJUSTMENT
LONGITUDE YEAR REFERENCE
932508.15853
2007
HSCOT2
GEODETIC POSITION NAD83 (1986)
STATE PLANE: SOUTH
COUNTY:
UTM: 15
2775700.516 ft
473415.589 ft
1531560.849 ft
955217.092 ft
190045.155 ft
16246052.835 ft
444307.94058
932508.15538
1991
HI991
Meters = U. S. Survey feet * (1200/3937)
STATION PHOTOS
TYPE
LOCATION:
MONUMENT:
DISK:
FILE NAME
fro:llfro. olmweb. dot state.mn. usl2eodlS tationPhotoslscott!THUMB-PP2632-3E-02N OV2007. i02
fro:I /fro. olmweb. dot state.mn. uS/2eodlS tationPhotos/scott!THUMB- PP2632- 2-02N OV2007. i02
fro:I /fro. olmweb.dot state.mn. usl2eod/S tationPhotos/scott!THUMB- PP2632-1-02NOV2007. i02
DIR DATE
E Noy.2-07
Noy.2-07
Noy-2-07
.. All images can be viewed at: fto://fto.olmweb.dotstate.mn.us/geodlStationPhotos..
Created on OS/24/2008 at 11:21 :52AM
PDF Format County Dump by Map Sheet (Feet)
Page 523 of555
IUG-.6-2....
09:59 AM
P.01
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with BuUdiq Pezmit Application)
Fdr All Properties Located 'in the Shoreland District (SD). , .
The.Maximum Impervious Surface Coverage Pennitted is 30 Percent
'.
Property. Address
/5"/70 Fr-c;~ p~. R~
Lot Area llltt,cs' sq. ft. x 30% = .........~.... to 1'38
. ........ .......... ..*****.............. ....**....11I.......* ............""............ .......* .......... '
tENont WIDni
HOUSB . x
x
ATTACHED GARAGB x
SQ. FBB~
..
=
=
TOTAL PRINCIPAL STRUCl'tJRE...................... 35YO
DBTACHED BUILDINGS
(Garare/Shed)
x
x
l'OTAL DEl'ACHEl> BUlLDINGS.....:..._...._.... .. HI A ..
DRIVBWA YfPA VBD AREAS
(Dr:lvowa.Y-Plv~ or not)
(Sfdewa1klP1I1'kin1 ke..)
x
x'
X
-
=
=
...
,
TOTAL PAVED AREAS...........................................
1 to 'i(.
PATIOS~ORCHESmBCKS PA-ttos X - Lf e1 t- 2QS
(Opm Dccka 'h" lriin. ,oponbl, blltwcm X -
boardl, with I pll'YfOlJj,IIIl'faDO below. PA-d. ~O
&rill Dot co~lderacllo blllmpemoUI)
S~PS X l:lll l~ \
- ~.3~
TOTAL DECKS ................. .....~....... ...............,.,.... ......
OTHER
x
X
1:1
. .
=
TOT AI., OT.BER......Il.. .........,.................... ....... ..... ....
TOTAL IMPERVIOUS SURFACE
~OVER
Prepared By. y; 'wt~1L5t:rYl. Date
S~ hbtJt:..re EhjA~~~ .:t:ht:r
I lt33;2; ./"
f .'~40h '-1
9-9-0$
99 - JftJ2-- 9202-..
PRIOR LAtCE
INSPECTION RECORD
.
SITE ADDRESS 5 Y () F,s Ib i N r A/J S. C.
NATURE OF WORK tJIf~ c:.t.Is't. , _ ",.. U. Fij.J,'S'h
USE OF BUILDING . "';,1), 4"
PERMIT NO. - .~ Wf)_::, DATE ISSUED 2 ~ .
CONTRACTOR Kat#<) 'I. M.'c.tteu.E S'PIuJ~ PHONE -""- 0
.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE P.ERMIT IS BY SEPARATE DOCUMENT
tm.J'fIUJI. i!TaJSOI6,v .u. *=?j~ ,"SPECTOR
FOOTING !,ll-(J ~~ &Jc:..
f EPARTMEi~T OF
BUILDING thND INSPECTION
FOUNDATION (Prior to Backfill) ! J--
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEthTING (if required)
FIREPLACE
GAS LINE AIR TES
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~"'^'~I #fnf.t!"f/tJu$.' ~ : J
, - , FINALS
GRADING (Prior to Sodding)
BUILDING T +0 L( "&-OS
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an eleclrical s.rvlce cabinet prior to rough-in Inspections
and maintained until all inspections have lieen approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
. Jt1 rOY
- -yJ-O'-6
L /:D' () f
S/ )>1"u/
[, ~.
;
FOR All INSPECTIONS (952) 447-9850