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DATE 'i /; /ri t DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (PleasEI Print or Type and sign at bottom) 2. SITE ADDRESS J~9J3 ~E 3. LEGAL DESCRIPTION LOT ADDITION /0:J BLOCK ( M ( "/.1 A ",..P..-? 4. OWNER (Name) ::s e trr-e " Pile (' 5. ARCHITECT (Name) (Name) Ol.(;N!./ 7. TYPE OF WORK 6. BUILDER New Construction D Fireplace D Alterations D Chimney D Misc. B. PROPERTY AREA OR ACRES Sq. Ft. BUILDING INFORMATION 11. SIZE OF STRUCTURE (Her~ (Width), 12. NO. OF STORIES I ZONING c-L f U hd J I PID .:) C' .l/l~? . O/~1. () 13. TYPE OF CONSTRUCTION Tr.JL 14. FLOOR AREA APPORTIONMENT USE (Tel. No.) W '- 33~J (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS SEATS 16. PROJECT COSTNALUE 3C)OD 17. COMPLETION DATE (Address) Septic D Addition D Deckj( Finish Attic D Re.roofing D Porch D Re,siding D Finish Basement D 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No 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 menti ned pro~~~nd that all construction will conform to all existing state and local laws and will proceed in accordance with submitted p.lans. I a.m. aware that the building official n r k~ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to pertorm needed inspections. X .! ~- q/J/1J> Signature License No. Dale WalerTap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Total Due .... ......................... $ Paid 1.1. Receipt No. Date th est in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as nstitutlls a temporary Certifica of Zoni g compliance and allows construction to commence. Before occupancy, a Certificate of Ul-- Q SETBACKS: Required Actual Front BUILDING DEPARTMENT VALUATION USE OF BUILDING TYPE OF CONSTRUCTION: I II III IV Occupancy Group A B E F HIM IiI' S U Division 1 2 (y 4 Permit Fee .................................... $ Plan Checking Fee ......................... $ State Surcharge ............................. $ Penalty ....................................... $ Septic System ............................... $ Other ......................................... $ Subtotal............................... $ FOR ADMINISTRATIVE USE MATERIAL FILED WITH APPLICATION Back Side Side SOIL TESTS D ENERGY DATA D PILING LOGS D PERCOLATION TESTS D PLANS & SPECS ~ SETS SURVEY ~ COPIES OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION PLOT PLAN D ~,oao .c!JG City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collector Street Fee ....................... $ Sewer Tap ................................... $ License Check Fee ......................... $ Pressure Reducer .......................... $ Meter Horn ................ ................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ IJ.. . 14./S- <i B. S4 \ . S'O I J.1f:.f 'f -t!:1!~,.";""" p.m"Wh~Ap~_. By Date L/ 2 18 Certificate of Occupancy Issued Speciai Conditions ~ any 24 hour notice for all inspections 447-4230 '1&'-/5'( White - Building Canary - Engineering Pink - Planning Th. C.n.., of Ih. Lab Counl.,. BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT '- I k:IJI..2? 1'J2..a..-7?- APPLICATION RECEIVED .9 9 / . 91 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: J(~ 9/3 WddMl'l/Y?J Tf~ ~l../ Accepted -:;~ Accepted With Corrections Denied Reviewed By:c?J~", 2. Comments: I, R~ +~ decK ~O-AA.~ ~u ~ Date: tj - 2 - 9f5 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." ..'Plle^ aq lOU lIeLls UO!lOIPs!Jnf aLll JO saoueulpJo JaLllO JO apoo S!L1l JO SUO!s!^oJd aLll laoueo JO alelo!^ Ol ~!JoLllne a^!6 Ol 6u!wnsaJd SllwJad 'uO!lO!!ps!Jnf aLll JO aoueu!pJo JaLllO AUe JO JO apoo S!L1l JO SUO!s!^oJd aLll JO AUe !O UO!leIO!^ AUH '!O le^oJdde ue JO 'JO! l!WJad e aq Ol panJlSUOO aq ~OU lIe4s suo!~e~ndwoo pue SUOneom::>ads 'SUeld JO le^oJdde JO l!WJad e JO 6u!lUeJ6 JO aOuenssl a4l... (JifJ IJj... ~.(. :~~ J:;J . CA??~yW f)J!1/ P T?cup (/:JI/V ~I ~ ~ -f. Jb T'Jh :alBa ~ .7tJ (j ~ :Sluawwo~ :AS paMa!^al:l paluaa / SUOnoaJJO() 4~!M pa~daoo'V pa~daoo'V ,.."""-'i ;~- /' j/ ; l :le pasodoJd S! 40!4M ~!^!~oe UO!lOnJ~SUOo JOJ UO!leo!ldde ~!wJad 6UIPl!nq a4~ paMa!AaJ aAe4 s~uawJ.ledaa 6Uluueld pue '6UIJaau!6u3 '6UIPI!ns a4l )! ,,~ a3^13~3l:1 NOIl.'V~lldd'V IN'V~lldd'v' ::10 3V'J'VN ~ . ,\ . ]]:I1>1~3H~ lN3Wlt:lVd30 NOIlV~l1ddV 11.-.B:Jd DNI(J,~ns 6U!UUeld - lIlU!d 6U!J88U!6U3 - ,(Jelueo 6UIPuna - ell!IIM .(.Ilono:) .~., '~I JO Ja,O':) '~.l '-.~-,-. -~,.....;.. -.... -.-.-- ----._~-, ,.-- ---------..-.. -~-~----..._._-_..."----,'-_..... -..-..,..-.-.-... .,--.-- Residential Building Permit Checklist Single or Two-family Dwellings in R-l or R-2 ~!J1J$1 Date: <{/'hy Building Permit # q ~-I.rf. PID: ~$ -. .3,~'-{)I(P'-D Zoning: Site Address j ~11 3 l{)dt@~ .JLcJ Legal:LiW B J Subdivision: uJdfid-f.MAib .~~ Existing Strucu~or NO Existing Nonconforming Strucutre? YES ~ I CONFORMS TO ZONING ORDINAN.CE I~ I NO Yard Setbacks: ~::~~E Requirement Proposed DOES N' T CODE . Front Yard 25' .{/ -4 Side Yard 10' . . Id 1 . Side Yard 10' i /tI ,~~ . Rear Yard 25' -"-')" I .....-r 5d 7fT .- . From 100 year flood elevation of Wetland 30' ,M 1A . From OHW (Prior or Spring Lake) 50' A/J /I r --.... , Road Setbacks: ~T ~ TF"' .. n~-) Requirement Proposed MEETS CODE DOES NOT MEET CODE . From County Road or Major Collector 85' from centerline . From HWY 13 50' from R-O- W . From CR 42 150' from centerline . From CR18 250' from centerline r --- --....... Bluff~~~ 1"1.1. .~' Requirement Proposed CODE DOES NOT MEET CODE . Setback from Top of Bluff 25' minimum of slope less than 18% . Bluff Impact Zone 20' From Top of Bluff . Grading in Bluff or Bluff Impact Zone L:\TEMPLA TE\BLDGLIST.DOC Flood zoneX:;T APPLICAB~ Requirement Proposed .l:~ ~Ji: DOES NOT MEET CODE . 100 Year Flood Elevation 908.9 Prior Lake 914.4 Spring Lake . Existing Lowest Floor Elevation . Proposed Lowest Must be 1 foot above flood elevation for new and Floor Elevation existing structures. If existing structure was constructed 9/19/90-11/22/97 then additional foot is not required. . Elevations 15 feet from structure I Must be flood elevation or higher Driveway: NO~PLICAB~ Requirement Proposed ~Jih ~ LUlJE DOES NOT MEET CODE . Maximum Width 24' . Required Setback 5' from side lot line 30' from R-O-W on comer lots . Proposed Garage Floor Elevation Must be 18" above Top of Curb elevation . Top of Curb Elevation Building Height: 35' Maximum Shoreland District: NOT APPLICABLE ~TS COD~ DOES NOT MEET CODE Gradin in Shore 1m act Zone 1m ervious Surface Requirement Proposed 30% Maximum -- -- Significant Tree(!' NOT APPLICABLE- ' Requirement Proposed l\IEETS CODE DOES NOT MEET CODE . Total Caliper Inches . Caliper Inches Removed 25% Maximum . Caliper Inches Preserved . Reolacement ~:l Lot Coverage: (Strucutes Only) SFD in R-l exem t: 22% Maximum Accessory Structure" AB MEETS CODE DOES NOT MEET CODE Requirement Proposed . Size · Side Yard Setbacks L:\TEMPLA TE\BLDGLIST.DOC PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDFlESS It '1i~ Z;;j.JJ,~1/J'd~~' NATURE OF WORK ){;~i ~ USE OF BUILDING PERMIT NO. -/!J1 DATE ISSUED 4MI CONTRACTOR NOTE: THIS IS T PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT S BY SEPARATE DOCUMENT INSPECTOR DATE I FOOTING 4J. t/J/!JfY d)2 1#1#,1 I FOUNDATrbN (Prior to Backfill) r I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I WALLBOARD I I FINALS GRADING (Prior to Sodding) BUILDING ELECTRICAL PLUMBING HEATING 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. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS 447-4230 625 Highwoy 10 N.E. Blaine. MN 55434 (612) 763-1880 FAX:78J-1ee3 Cer'tificate of Survey for: BENCHMARK HOMES, INC. f ~ * ... ~ PIDNE&R · enSiJlnesring- -*" i(~** lAND SURvOORS . CIVIL ENGINEER5 I,AND PL"'NNERS. LANDSC"'PE ARCHITi:Cl'S 2422 Er'lterprise Drive Mendota Heights. MN 55120 (612) 681-1914 FAX:681-9488 / 15 I I 16 -7 / 1 () / / / j-- I "I ,,/ >-_ 1--. / I-...'{ :"-:;0_.1 / ~: - ::) c::: I u; ~Q. / '~I-. 0.<' / "{ l>; <~ I -- u; ~C/j I tit: J I ~ "ot C\JU) tri..~ oCt> -0- ~ ,.... C/) X 952.4 953.7 N66'!,<'84. '.~