HomeMy WebLinkAboutBuilding Permit 08-0212 , __ _ �
_Tt� . 4 ' •rr'
C�Q��t��x��� �� (������x�r
CITY OF PRIOR LAKE
����x���rt�xr� .a� �ixY��zz�� �1������Y�rr
��Final Permitted ❑ Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the � Residential /❑ 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�N �(..� /�/ ��L- tf� BIdg. Permit No. V.fl. � Z�Z..
Occupancy Type ` �" Type Construction V� Zoning District f�- �s�
: Legal Descrip6on L..� , � � fJ�/ /V..S /��/�✓OrZ
, f�.3��- rz�rc� E,es sr
Owner of Building Site Address •
}, ,
f ` Contractor's Name & Address �LVO�„�0 �'/fdf %� r1 �i`��I�iG✓ f�/Lfi QrL ,. t�iL-/��
( $S� Z Q
/� (1 / � � � City Planner
$uilding Official ' �"
Date: � Date:
POST IN CONSPICUOUS PLACE
,. ,
w Z Z y
� J �LL� W �"
LLZUU Z G
` 2
N ��Wg ; c� Q �w
W � _ Z
< ` �Utiu.( � Z �
� �' 1 ❑ ❑ O ❑ ❑ 0 > � �
� � � � �
W =
�C �
O N �
� Q� p aaQ m c O oC
J Z YYZ 2 V t wy
� � � ��� J O ` V
S Z a' Z-==Z? W c tA � �
� LL � �
N U a �t W 3�U C C Z F' O
J a�3�"a� t W � W� W �
❑❑�OOO a�G � O W �
a a � � �
� z a o w
o a � � �
Y V Z V O �C
5� ° LL � w �
�z o z w IN— ��—, <
� � � a Z N v v J qc
a � N z� W Y�� o Q q
� � W Z OO�NZI � � O O � V V
F_ � G � S tL LL u. 2� y O � C� C� �
t�? Q O a ❑OOO 0 C) ��
J
W Z Z � �.
� ,'�j � ti � W �"
F- U
= WQ Z R�
�gggJ > �
"���N Z g .�
o (V ����.� W ? �
� ❑000❑❑ > �
� � o �
W =
O - LL N o
aa m = Z
'J Z »= Z o F w
W � � C9 OOt9J O_ _U �Y
< � F- d a p �
U O W ?_xxz? W � � p
m���m� a z �
u� c� a �t � o c z F- O
�Wa �W W r�
a�3 a?e W W � w
DO�OO � � � w �
a a � �
0 J
� � v � �
W {L F- Z p
gF o a��a � �
� J � Z U N ~ � , �
w F- � F,.,
�O O �<�O N Z � W
fA V J
a � Z Z � Z g Z W Y W L � 4
oG � � � a O
� W . W W W O�� N� W � � O O � V V
� n °� o°O�z�,y 0 , 3 � � �.
�? a o a ol�oaaa t� �o o `
J
� J Z ~ �r
� J a' tLL � W h
�yZWWQ z ty
� ��55= > �
C1�W W(A C9 Q �t1
W � � Z Z
< .� �ULLIi� W [�.�
� 00�00❑ > �
� � o �
W =
0.' ,
N
W Z »= 1 z p � W
� YY_ 0 V 0.
� V
0 F_ n: OOLLQ t- y W a �
W Z K Z—==ZZ W � N 0 �
S
m��-'d'm� a � Z �"
N C� G' � W'Q �j � W • J � W W Z X L�
a�3v�a� W "W � W �C
0000❑❑ � o � w .�
n�. a � �
p J
l o a J � �
Y V Z C� Z � �
O < ao �
� Z v � Z W � � W �
a N Z ZoZ Z W Y ��
Qw � W Z O��t�/l� � � 0 O O � V V
�ai c � o u�.��z � � 3 v � �'
t�? � O a ❑000�0 C� � O �� `
J
W Z Z' } �.
� J � LL � W
� ?UU Z G
W
55g� o �
W o� � ����' � z a �
o ` N °�tiC9 W Z �
Q � �00❑❑ > � �
` U Q �
W =
N
W � >>� m O � w .
�� Z YYZ p U F 4
W � � � �9 OO�9J � W �C
= 2 � 2 =S2Z W � N p �
N '� v a �U�3�t , O O z � F- O
w a w r:,
a�3ina� ` � W v� z �
� OOO❑O❑ A � � � W
a a LL � �
�
J
O 4 V � �
go � Z � ` ; \ y�� W �
0 Z *� O Z W �, '�„ � ~ 4 1- � � �
�0 � (7aC7� y Z y U V J W
a N Z Zp?g JZ LLJ Y w O W C J q
O W � W Z ~�� t � u1 � Q O O �j V V
� n °�°$'�� y O S _� � � � a
t�= Q O a ❑�OO ❑ C) � 7��� `
��� j Rt � 9 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�� � TEMPORARY CERTIFICATE OF ZONING COMPLI CE �, 2�, �g
" `�' AND UTILITY CONNECTION PERMIT
" �L.oUO ���� �� ����I'�
'�l �C
r yNES O
. 2. R'n�k ��ty PERMIT NO.
3. Yellow Applicant
Pleaset or rint and si n at bottom
ADDRESS ZONING (orrioeuse>
� � 3 6 � � U r� ✓z -s S' �'yz �� , �.�
LEGAL DESCRIPTION (officeuseonly)
LOT� BLOCK ADDITION PID f�, U��. V
OWNER ��y ��
(N ame) A'1'�;�TY ? eH.� �e Y�- � Y.� �9� (Phone) 6/ z - ? o / - �3 `�S
(A ddress) i Y3 � 2 u TG�✓2 s ST.+e.� ,�
BUILDER
(Company N�ne) �,-Q� vo zs o ni �► t o,eTS� GL � (Phone) 9S z- Z 9 z. -/9��f0
(Contad N ame) �/1,� .9� vo.es o (Phone) 9'f Z- Z g Z �/ 95�0
(A ddress) � � g Z �.9 �.� �,� y . « ,J,e ,��Ko i✓.� w �?.��,�er� �( Sso
TYPE OF WORK �,New Construction ❑Dedc orch ❑Re-Roofing ❑ReSSding ❑Lower Level Finish �Fireplaoe/'
❑Addition ❑Alterffiion ❑Uti nedion `
CODE: I.R.C. ❑I.B.C. ❑ Misc:
Typeof�nstrudion: I II III IV V A B
Occupancy Group: A B E H I M R S U PROJECT COST/ VALUE $ Z Z$ ,o b c.� ,�—
Division: 2 3 4 5 (exduding land)
I hereby certify that I have fumished information on this applicartion which is to the best oi my knowledge true and correct. I also certify that I am the owna or authorized agPnt for the
abovam¢�tioned propaty and th� all con9ruction will oonform to all mcf9ing state and local laws and will proceed in ac�ordance with submitted plans I am aware that the building
oHidal can revokethis permit for'ust cause. Furthermore, I hereby agrcethat the aty ofticial or a designce may enter upon the property to perform need in�ions
x,7����?- L o s y� y8 Y i r o� 8 —
S�gnature Contrador's L icense N o. Dffie
Permit Valuation �y � Q fl Park Support Fee # $ `
c2��r
Permit Fee $ O SAC # $ �I t
.
Plan Chedc Fee $ W ater M eter Size 5/ 8" , 1" ; $ $•, p O
,
StateSurcharge $ 3Z aD PressureReducer $ p� � �
�
Penalty $ Sewer/ Water Connection Fee # $ C ���
Plumbing Permit Fee $��� � O Q Watex Tower Fee # $ G /T
Mechanical Permit Fee $ � O , � Builder'sDepost $/S Q D
.
Sewer & Water Permit Fee $ sZ � d 0 Other $
L�'9' � !ir
GasFireplacePermit Fee $ �� � TOTAL DUE � O � 7D �d
08
ThisApplication BeoomesYour Building Permit When Approved P81d N0.
S �� � �� _ � � Date d B -
�t�'''c- �zG�O�' � � �
Buildin Official Date
Thls is to cetiry that the requesl in the above application and aocompanying doaments is in accordance wiih the City Zoning Ordinance and may proceed as requeffied. Thisdocument
when agned by the City Planner constitutes a temporay Certificate of Zoning compliance and allows construdion to commence. Before ocwpancy, a Cetific�e oi Ocapanq must be
i��.
.� - 0 �7— O� .Sc �mw�G,7G ,��'
PI 'ng Direcror Date � Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fai (952) 447-4245
4646 Dakota Street S.E., Prlor Lake, Minnesota 55372
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by: � Date: � S =��
Building Permit # PID: �_ y 30 _� a Zoning: �a �0
Address � y36 Y ��
Legaf: l , B Subdivision: /U�„ -/�I�te�
Existing Structure?� 1 NO Existing Nonconforming Structure?� 1 NO
CONFORMS TO ZONING NO
ORDINANCE
YaM Setbacks: NA / FAILS/ COMPLIES Standard Pro sed
• FrontYard can be 20' if av . w/in 150' 25' as'
• Side YarcJs 10'/ ��. `� '
25' if abutting a street s o'
• Sidewall exceeding 50' requires additional side 2" 10' setback +
setback for eve 1' over 50' in len th 2"/1' over 50' �°''''y° ��
• Rear Yab 25' NA
• Patio Door. provide for minimum 10' deck or sign 10' side/ N �
statement indicatin no deck will be built in the future 25' rear
• From 100 year flood elevation of wetland/NURP 30' N �
nd
• From OHW (Prior or Spring Lake) 75' or setback average of
adjacent s�uctures, but no 99 �'a'
less than 50'
Floor Area Ratio: NA / FAILS 1 COMPLIES .30 Maximum � l.•�
Yard Encroachments: NA / FAI ICOMPUES Standard PXo osed
Eaves and Gutters no more than 2 ee in Hndth and no
closer than 5 feet to a lot line Easements .
AIC and other equipment cannot encroach on interior
side ards.
Tree Preservation: NA 1 FAILS / COMPLIES Standard Pro sed
• Total cali r inches
�� ..
• Permit 25% Removal 3 7 . s"'
• Cali er Inches Removed O"
• Cali r Inches Preserved �s�''
• Re lacement '/z:1 a "
L:\TEMPLATE�BLDGLIST.DOC
O ,� PRlp�
. � y
ti �
U t�
na - En ineerin
`�'�Sd` Pin ann ng
8tl1L91NC PERMIT APPUC�7ION DEPARTMENT CHECKLIST
NAM� C3F J�PPLICANT . L O ���I O �
APPLICAT�ON RECEIVED `fi"• � . � � :
The `Buitding, Engineering, and Rlanning D�partment� have reviewed the building permit
app�ication for construction activity which is proposed at:
(��-: �" �T12t�- ��
Accepted ` � Accepted WitM C�rrecti+�ns
�enied
R��riewed B�r: „�'� Date: �"�"��
,
Comrnents•;. �i���l�� ���1��� ,����'��
��.`.��ki ,. �s�'v. �n ��o � v n �, �1 � /� � S Gs � dr's ���/.
,. , .
,�
"Th� issuance or granting �f a p�mit flr approval of plans,` specific�tions and
computa#ions sha11 not be construed to be a permit #or, or an approval ofi, any vi�lati�n of
any #he prouisicros of fh#$ code or c�f any other �rdinance c�f the jurisdiction. Perrt�its
` presuming to give authority to viaia#e c�r canCei the provision$ of this code or t�#her
ordinances af the jurisdictic�n shai! no# be valid.°
O � PRIp�
�
N �
U tzf •
- Buildin
,� ,� anary - Engineering
NNESO Pink - Planning
�U{LDING PERMIT APPL{CATION DEPARTMENT CHECKLiST
NAME OF APPLICANT L� �� � O �S
APPLICATION RECEIVED �. �-U � � �
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
� �T V I C I �..�G `
Accepted Accepted With Corrections �
Denied
� .�/L/a�
Reviewed By: ����+^-�-� y�-�'`" Date:
�
Comments: i�� a.� �.0-��6 • �?-r�ii.o� o-�-�
.�..� ��.�. �- � �,� ;.,,..�.� . ��,_�..
A-�— �kr,�.a-4 t,��e�w ' ^ Q�.� � . `�h. e /IYkl��G
-- .
� / .
!J1'.. ' G'�., . ��- � _ _ EJi� :��
t � � �o.�e , �-R'�'"''p ✓1�j2�+-./ l�'�-t7�'+-- �!��- �-v
�4�awu,�.,�.� �.,�.-+.� � .T2.�e-z.�..w ���c,�� �.� a� �cc,��-e'�y
wi�P �c � � i��-;-. �-�-, -�x. . .
U
f
• r i. I` I �
� �
!!'��R!(L�/�!I I
��.�.o�--+ ti✓�cY �o�a...o .
"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 cance{ the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
O � PRIp�
�
ti �
U txf
White - Building
,� ,� ' aa ' ring
NNESO PIISI( - planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
{
_ � � , ;, --- r --
NAME OF APPLICANT �� L. �, ( ; ; '- � � , � . � � - �_.
�
APPUCATION RECEIVED � . �=-'� � �- �'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
� � t.�..�' ( �( �`'� �- + �� �.� � i ..-.,. �L:- �,,. �
Accepted Accepted With Corrections
Denied
Reviewed By: Date: S e?)- 08
Comments Gr�.� Ie�� FF sK�r�u�.,� /S�.t af str��--u.�
IY�ust �e a,t or abav�e 9�f?, 9'P�v�iari '�tve/l.
, .
�� 12-�0 2T 3 c�,e.� TL1M.Pa R..�4R-Y C.c.�Z i Fic �Tc''
t�� C�Cc u p,r�cY � s �s's u�
"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."
b5: 13- 20b8 U6:00 FAY 952�I611552 TC NATURaLLF �����1
�gti6 '°N WdLO � Z 800Z '�! ���. aw �_�--�a�.a
'�
� � � ` � '�' _ i' � '-, i ; I �
i I
� '�� �
�' ��' � �` .� : 1 i� �,
� � � CiTY OF PRIOR LA�� � �� �� �� �IAY �� � 2008 '�
�j � � �xnpervfous Surface C a�culations � �.
(To be Submlaed with Sullctln� Pcrm'c Apnlicatlon)
� For All Pro erties Locafied iz� the Shoreland District (SD). �y
P
TJ�c Maximum Impervious Surface Coverage Penritted is 30 Percent.
Propeny AddressJ
Lot Area ___L�� a sq. ft x 30% _ ......:....... q�'I3ti3 .—
*****�N�N*�k�k**d�d:���M�k�M�h�N�k#�k*�F�k*�k��hd��NN�d��{:�pq��F
LENGTI� WIDTI� SQ- FEE'C
e'c NOUSE 45,0 x_ 4c�?� — �,I�
,
ti
X -
ATTACHED G�C�E ,�p,o x " st.�7
TOTAL PTtTNCXPAI, ST�tUC'I'[3RE-...---......»....... J.��1 ' _
DETACHED BUII.DIl�IGS • X
(Garnge�Shed) x
TOTAY. D�TACk��D BUILDINGS^ ..................... N/,�
DRNEWAY/PAV�D AREAS A e� x �� _ -_ n�a�,_
� (Drivewoypnvod ornal) I ?,gq x � �tZ = �,l
(Sidcwelk/Parking Areas) . x =
'lOTAL PAVCD AREA.S ......................................... 48�1 —
PATIOS/PORCI�S/DECICS �,,q x Z2.33 -- ��3 _
(Open Dack� �G" min. opcain$ betweeu x = ,
boeirds, with a pan�l�ua �in ('uer bciow,
oro no� Conuidcrcd ro be 4tu�ervleuR)
X =
� x'OTAl. DrCICS ........................................................ . �33
OTHER X _ � _
x =
... ................. N q
TOT�L OTHER .................................. .
TOTAL XNCPERVIOUS S'(JR�A,CE � a�
�vEx �
Prepazed By , . Datc S• � Z- of3
Company Phone #_l�� � • 405 • ,(acx�
C:�pnaumrn�a ��.1 cetdnrp�eTwt�Jce�Lee�l3.uln��\Tr�on�ry InlrrnK YIla10(1Ct t]i�W4�EriV10L1S 511W+ACE CALCIJLJ`1'10NS.duc
l�l/ 1�i0 'd ._ 9E Z l(NOW) 800Z-Z l-J�dW
P R 1 C� R LA KE BUp DI�NG� D�INSPECTION
- , .
E TI R �� �►,�
IN R D
SiTE ADDRESS � � � ��_�TC� � ST��?'�'
NA?URE OF WORK ' ' �
. ..
USE OF BUILDING • •
P�RMIT NO. �'- QZ�� [�ATE ISSUED
�ONTRACTOR ,}�t.t�b� �i�I�tl�'�',� Lt�.e. PHONE - -- O
NOTE: TH1S IS NOT A PERMlT FOR ANY OF TME 1NSPECTIONS BELOW
� THE PERMIT IS BY SEPARATE DQCUMENT
�� �► O� v� �O� DATE
FOOTiNG `�'� �'"`p� � . �
FOUN�ATIQN (Prior to Backfili) Y�,t` P o F F�/t � d�f d
�`� PLACE NO CONCRETE UNTIL ABfJ�E HAS BEEN SIGNED
?' o � �I°°r-
�,�(o� � R�UGH - INS
SE�AIER ! WATER / SEPTIC
FRA�IIIN� / � G O �
IAfStJi.ATI�'JN , ' �
EI�C"�lC�L
��.t����� �. c�- �. l3- 7 rs o
HEA1"��+tG ` if i
< �IR�P�..ACE
GAS` �.�Nf A�#� TE�T ' ,
�t�VER NO WC�1RK UHT1� ABt�YE NA BE�N �fC�iHE�
.
t�77�E �'iE" t�l� �
_ �INALS
�RA�1N�i RNor �ddin N`B � u. Z9,
BU1i.O1N#� y
. ����TR�CAL
��U��1�� . � . b �
HEATING /•
DO N�"T OCCUPY U�iT1L ABOYE H S BEEN SIGNEt�
NC�TICE
This e�d mt�t b�► po�! n� ���wl amri� csbin+rt prio� to �n Mspecticns
and mafntain,�d un#11 r�ll in�►psallon� #�ve �en approvsd. On bulldir�t� and additlons
where ru� ssntit�s +cabirt�et i�t �vatt�ble, +�erd st�111�e placed t�ar ma�l �ntr�nce.
.
,
FOR AL.1. INSPE+CTi�NS (95�) 44?-9�50 _
U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency
Expires February 28, 2009
National Flood Insurance Program Important: Read the instructions on pages 1-8.
SECTION A- PROPERTY INFORMATION For tnsurance Company Use:
A1. Building Owner's Name policy Number
Martin R bak
A2. Building Street Address (including Apt., Unit, Suite, and/or Bidg. No.) or P.O. Route and Box No. Company NAfC Number
14364 Rutgers Street Northeast
City Prior Lake State MN ZIP Code 55372
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
P I D: 25-930098-0
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 44-44-33.56 Long. 93-23-24.20 Horizontal Datum: ❑ NAD 1927 � NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Bui�ding Diagram Number 1
A8. For a building with a crawl space or enclosure(s), provide A9. For a buiiding with an attached garage, provide:
a) Square footage of crawl space or enclosure(s} sq ft a) Square footage of attached garage 592 sq ft
b) No. of permanent fiood openings in the crawl space or b) No. of permanent flood openings in the attached garage
enclosure(s) walls within t.0 foot above adjacent grade walls vvithin 1.0 foot above adjacent grade 0
c) Total ne t area of flood openings in AB.b sq in c) Total net area of flood openings in A9.b 0 sq in
SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name & Community Number B2. County Name B3. State
Prior Lake MN 270432 Scott MN
B4. Map/Panei Number B5. Suffix B6. FIRM index 67. FIRM Panel 68. Flood 69. Base Flood Elevation(s) (Zone
Date Effective/Revised Date Zone(s) AO, use base flood depth)
2704320002 C November 19,1997 November 19, 1997 AE 909
B10. Indicate the source of the Base Fiood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile � FIRM ❑ Community Determined ❑ Other (Describe)
B11. Indicate elevation datum used for BFE irt Item B9: � NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑Yes �No
Designation Date ❑ CBRS ❑ OPA
SECTION C BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Buiiding elevations are based on: ❑ Construction Drawings' ❑ Buiiding Under Construction" � 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, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g
below according to the bui4ding diagsam specified in ftem A7.
Benchmark Utilized TNH=909.18 Verticai Datum NGVD-1929
Conversion/Comments
Check the measurement used.
a) Top of bottom floor (including basement, crawl space, or enclosure floor)_ 910.7 � feet ❑ meters (Puerto Rico only)
b) Top of the neM higher floor 921.7 � feet ❑ meters (Puerto Rico only)
c) Bottom of the lowest horizontai structuraf inember (V Zones oniy) N/A.0 � feet ❑ meters (Puerto Rico oniy)
d) Attached garage (top of slab) 910.2 � feet ❑ meters (Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building 910.7 � feet ❑ meters (Puerto Rico oniy)
(Describe type of equipment in Comments)
� Lowest adjacent (finished) grade (LAG) 909.8 � feet ❑ meters (Puerto Rico only)
g) Highest adjacent (finished) grade (HAG) 910.0 � feet ❑ meters (Puerto Rico only)
SECTION D SURVEYOR, ENGINEER, OR ARCHITECT CERTfFfCATiON
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 informa6on on this Cerfificate represents my best efforts to interpret the data avai/able.
I understand that any false sfatementmay be punishab/e by Bne orimpnsonment under 18 U.S. Code, Section 1001. ,Lt��i�+�����°f�t'°`,r f
ti``�4A��' �°= �'�� ` �
��� �• ° �a�` ; �.
❑ Check here if comments are provided on back of form. ,� l� > x `,'�
`�- (�(,o� � :����i..:��: �:.�.��.. ( I'
� �` ���������� �� �
Certifier's Name Jeffrey D. Lindgren License Number 14376 ^�; ���, z :
�``'s� EP�j�YE�F� a � �'
Title VP Company Name Hedlund Engineering Services, Inc. �� a � q
y:. t�� �P �r� f O a��,ti -��.=^�.
Address 2005 Pin Oak Drive City Eagan State MN ZIP Code 55122 �'-. -� ae`n E° �} .;�^
Signatur Q � Date 9/23J08 Telephone 651-203-6615 ,� ti'c� l���'a���
� ��srR � �af.
FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions
� � pR Date Rec'd
� CITY OF PRIOR LAKE PLUMBING PERMIT /�d�
� x �
� �
�
,. B�ue File pERMIT NO.
� 2. Gold City � �. �z /
' 3. Yellow Applicant v v
ease or ' t and si at bottom
ZO1�1lNG (office use)
�l3�� u ��s S-�.
LEGAL DESCRIPTION (oflFice use only)
LOT BLOCK ADDTTION PID
OWNER
(Naxne) (Phone)
(Address)
APPLICANT /
�+rame) 1J�' �.� Z. P�,C� �/2g .�' y • ,(1�ane) ��2 �1y0' � L/.�S'�
� t�s� p� �� X' S R'f� �r ►'o/'�L�� �l,r/ 553�2
(Address) (City) (Zip Code)
� , ._ ) (Phone) �✓ 2 �2�� ` .3 /
�P�,��,���A� �� ��y a�
APPLICANT PLEASE COMPLETE BELOW
Quanti T e of Fizture Quanti T e of Fizture
Bath Tub with or without shower Rou h-ins
( Dishwasher Water Heater
Floor Drain Water Softener
Lavato Bathroom Sink Stand Pi e Washin Machine
Laun Tra 1 or 2 com artment sink Sewa e E�ector
Shower Stall Backflow Assembl
Sinks Backflow Assembl Test
Bar Sink Lawn S rinkler
Water Closet Toilet Other
FEESCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a$49.50 minimum Residential, New One & Two-F $149.50
Residential, Additions & Alter ons $49.50
I
Estimated Cost $ Building Permit # � /� ��
� � VD
PLUMBING PERMIT FEE $ �D , / /
STATE SURCHARGE $ .50 � �1/ �
TOTAL PERMIT FEE $
(OfSce Use Only)
This Application Becomes Your Building Permit When Approved Paid Re ' o
Dat�E � By
Building Ofticial Date �9 �
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
JUL.31'2008 13:01 651 633 8984 FIRESIDE HEARTH AND HOME #7977 P.001/001
o � PR'°,� crT� or P�TOR r�Ar�r ��� R���
� D�, H�AT��iG/AIR CONnT?IQN�NG/FT,�tTPLACE PERMIT
�► jAMR 9 Q �f
� "'°� P;�° �ERMIT NO.
: a�, ci�r
� r�no,. n��rcaM r-� _ --
T?lEasc or xinx and. s' . at botfnxn
�,Dnr.�ss zoz�r,�vG co�� �t�,
3�
LEGAL TJ�SCR�PT[ON (ofhce use on�y)
LOT BLOCK Annz�o�v PtD
OWNF�t � D�, ��,., �,/
{Nam,e) (Pb.on�e) -��� - L7Y�
(Addxess}
APPL�CANI'
�gm�� ALLIED FIRESIDE D6A FIRESIDE CQE�tER (Ph.one) 65 -633-25h1
(Addtess) 2700 N �'A RVIEW AV]�UE R�S�V �,,�° N SS��� —
(Ademsl (City) (Trp Cnde1
(Concact Pers�n) ' ��� 657.-533-2561
APFLICANT SIGNA'�U�tT: AATr ��
APPLxCA�iT ALEASF CON�LTT� BTLO�V
�• A . �Q , f , QNb� CC}NSTRUCTION ❑ LtF�'LACrMT-_'NT �4LTER�4T[ONS
� � �.�,... ..... n/
. iCE AND MODEL _�( � � . ,..�'�� �• • � ��� 1J.t�~
f�U� SI2F � 4 ltE'T'[JRN 0'�NiNGS [N�'UT OUTPUT
TY�F C?F. SYSTEM HEA7'�G OR P�WE�It J'T.ANT
❑W/arm A�r Plants � g�r.�un PLEAS� I�kOTE:
�G�Yi�y Q[�ot water Air Canditi.on.er Units
[] Mechanecset t] [tad(eiion Cannnt F.n.croach. in.to
❑Air Co�ditiani�g ❑ Spais.t Devices Requited Side Yaxd
�Vcnt. Systcr� ❑ Oih.cr t?evices Setbacks
FpREPf ACE B�tAKE ANi� MODFL
�r•. SCHEAVT.E
Industris.t. C�►meccial & Muln-Family t"� ot'job cast Residential, (3»s Pireptace 539,50
$39.Sd minimom
Resic�crstial. Heating 8c A/C (New Conswcti�n) 599.50 Residm.ti8l. Additiorts & Alterstions 53�9.50
Residentiel. Heacing On1y (New Constrnction) $b4.56 Residcntial. AC Unly PA �p W �-�. H a39so
�s[imate� C�s� 5 Buil.ding Pcrm' # �����E��
, �
[-�EATI.NG PERMIT FEF fi " t �
STATF. SUR��-fARGL• $ • �
TOTAL PT�tMTT FEF $ -
IQRcc �Ise Only)
Thic A�p[Fca�ion 13ecomes Your �3aildin� Permit When Approv¢d D eceiptNo.
g.r.�UG � � 2008 y
13uildl� Ot�cial D�ce
2� hour notice Pnr all in�pe�etiorra (952) 4d7- S0, fax (9SZ) �T-dZ45
By
952 555 5555 Line 1 BURNSVILLE HEA 10:24:23 a.m. 07-23-2008 1/1
o �'r�t1 o � CITY OF PRIOR LAKE , Date Rec'd
,� � HEATING/AIR CONDITIONINGfFIRE�LACE PERMIT
�• �
� �` ,•
�� �: ea� F��� . `PERM�T lY�Q�
; _ ; x�
� - ,.,,��... � .., ; , 3 Yeltow Applxml. �
.
,... ....-..�,.,•.,.,.., . . -. .. .:
.� . .
-.: � � . : .� �� :.
� �� �:
.���5s - � �ivnv� c� �,.
- ��,� �.: . .
,. { , (
� .._�m� �;��:"' ...� - r a.. ... . -. ;<�. ���1 �. ,.; ..� -�. � � ;: a
' �- �� � .. � -
' t >'T . .' 1 ( - - Y k�
r z � r a�. �� . a 7- �` • � r' -
. . . � �:...�r. :d ��� ((( .c. - ..,.�.t j` � .+.�... .. �...�_ F v ; . ,�.,.
t S p f
� ': ��1�J'lIL��L��� �Ll �QSw'c�e,��i�./' } 4 � ' � t �� 1 ..
.�i ,x i k t ; j `a {
� r �'- ;t d� � } i 1 �,; t i- y1 � ✓ • r � t , � } �.x �Y .-Y. ._. � '��o ,, F X i � + t
�' ki:1�� �l . �L��.* t �' ���+1 ? 'u 'r ? C � .S F {` �. C.
r � a a �- � . : a��. �A� , � :.wi , 4 i � r.. . �.. : � . T . .
5 i .f Y h� �Y M' ,} �'`( �� .+� .,y s'.Y r��r.,%. . .. � J ¢ � ;�� ys:, � ,{ ,�..� Y y .t r .'ri:�.
�, - J Z �.+cd -l�< .t�Y. "`F'.ER 4 3� .�P'.6`� {
�.r�i�:<u.�:.v5_'. �l.,t l :n 5,.� e. .�'�. aa.�e:.i. �:L � �m"� ,�..:.'S•`�
_ aY`r.r. � ^ "s �i .'7 ' C^I✓�a.�i� " �1� 15 }h:?'�`� i:S:: •;i:'�' 1')i"•<�ti�.K�.. �.�s'�_
t .`�I��' ..��t�. t ' .��µ . ' , ^k��'a �~ i.t q�� "v4'f. _ { 5: , . .J ;�l������~ fP� ` �.' I �I . `
} 5 : �aIT]�� '� f a �.`� a � � z � xs �� N �� °,� � , a � . f 1� � i � v� �: s;���:,,k.�'� ����� S � r ��!'�! /�.
; . ' ' •. r'. ��! �.�� .' .. �;� ' ' x,�;. �:r . �::: � u ��� r -t �[- r
. ,,. ._. ' .. .'�..
� �
' �'f � � 1 } 4 3 {� p � f } Y f . .._y, ."C F k E � 5 . .� . . R l � �
�. + "� � u S', a r .� r x �, 4 ,t n
���5� _ - _ .+: 1.. n �. r.. t.
1 f * � � � � � � x � �. .7 ' 9 .�.�.
k�r�li��� � ` .. � � r :� T z ` . . . ._ �- .t � . �
. h � ����� h 1 �� ��. . k
. $ry t � } ,� . . k � t _ P 1 S � , i( � /. ,�+►
i i� ��' f 5 7 � [/ �
�T�axne) � (Phon�) ' �, � �� ,�
r c . � ,� � , � � . t , fs �� ti � } -� � { _ �
� r ��t1�3i�D� � r �� � , ��.f:� J� t '� �y. �" t -- t� i `� �, !'" f .�� ` '�F {�� �''' 3���
�. (y,v �`
? ! f 4 � 4 (l�C1Y[�3�� ',� 2 � � �`' 6 ` 1 ,* tj _ ' �J.{.�� 1 1.! _ .! ' ~ �.� �V4�
t
� •
• Y' � . � � .J� �. t �1 � !
�
: ' . ': , :. ,; 4
,. r .t
if �
} * r
�. {�OIIt$�.C'f�C�S0�1� d � , e t �.�Z1C� � � n e s � 5 �'
. . . .' � t. ,. , J. ] k } rt. x i+ � Y 1 . � a. 5 .YL { t . i : , f
�
} .� � : � ` � �. �
i
APP�,IC� SIU�I'A�I'LJI� :. :: , � � DA`�`�' .� C�� - -
. � -: k < ,
:
,� �
. e �
__ _... �
. _.. ._ .:,. . ,.. ..
�
�.. , _, ;
- � i a , } ...� _,� .. ,� w�. : y ,� � .� . • �;. t f � � 1 1 � c
. d'. r . �,;� � � x: 4 .� � . �, � .
t � , ������17��V' a:l��'���i'3r��7��� ....k 1 p !K� � V � �
� i .
F.L'' -
h � 1�W ��N�TRU�TI��i �� C� ItE'������� ^ Ox����'I4'�I$ ' �:
r: �� t . .. ... -.' � ' � r t �' � :. z.S .t .j• "'}',.k� t �� s kax° }'^ t v�: d � { � *� f 6 : �
�[7RNACE MAi�II,A�D:I�IODEF.. �Yy �r� � ���� � `�^7��� ��Y * ` F�.= �����
1�i t . - 'a � �-� � ,y � ?a""� ( } , I ( � / � / + Y �y. � � � w � s�-
�L� U� ' ��. Y �� Q,�ri�, �aia v.� � J Y � 1 � 3. . . M�rou' 1 L�0 �/"ff� "['�� � . b '�.7�� �
y '�.�1 1
� .�> � '�c.. w a r � P f �e-. . � '^ :, 1 � .
'��Er��' �S'�� _ �'L�.TIl��' ��.������.�1.� L +*�� = � :� T e'� � ,� , t
- � " �. � .� t X 'i r ��3�ik�� £ 17��� � rGontli�ner -
AVarm.Au �lants p Steam � � :�nits an��t���C���,;��n�o'��neroac�►`
s a : , * ,.r v� � r� � <
' ` Crfai�tty � �ca� l�ater >
, � , , � -�nfo.�uvred�i e'�a��Se�baalr�
aii�cal' Q R�ciianon ��r��lac� w��ti�og Ad`d�dotis o�r
pA�r:fi�nd�aQau�s ❑ �pecial T�ei�ce§ � � � s _
Cantilever� �o th�e �ut�side bfBwldu�gs `.
� j]�e6t Systetn " ❑ Oth�r Devices .� :
+ }, ;
lt�quur'e a $ui[dingPekt�it
; , : . . .
FIREPI;ACB MAKE AND MbDEL ' -
� F�E �CHEDUI�E
; ; Industrtal; Camxueic�si & MWtt Family ; }% o�,{ob cost - Residential, GasFueplace �49:50
� S49 50 mimmum� :' ; : ' ,
_ , ' ; -. .. , :
Residential, Heahng � A1C (New �Coastcucuon) �1�9 50 ..`' ;, �tesit�entsal Addiuons �i Alteraepns 549.50 : . .
-.._ . .:
. ,
` :$esideuhal,�Icattng0uly :�b4SU ;: Residential,.�COnI�'' 549
- , :. •
.:. ,. ; . ; , :
....:.. .. .. .
_ , .::
, . ;:
,..
, , . .
. , .. . -. �
-.
� Es�iu�ted Ca§� $ BuYlding Per�ut �# f � -
.:.. . ..:... - -
� .� .
�,
,.._. ,.. :,_.
,.., ...:: N:. .. . . ... : :.. :
.... .. .. .:. :; .
..
,.,. . : :
- :..: .. .. ... ::=:.�:�
,
...:.,. .. .:.
..
_ ... ....._. _
.. . . ,.....- :...,..
- .,. ..
...: .. ....... - -
,. .
,....:. _
..... . : .....::. >
�
,,. . ;,.:
. ;-:
.. .>;...:: _
..... ..
.,.. .. ..
�_
..
..,
:...: . . . . :. .. _, ; `
..:::..,_.:,.
:;.: _
. . . -. T . ;FEF :<;_r:;.: .:.
. . - . ... . . . . . : HE - - .
.. . _ , _. A..IN:G�'�R��` �'::;;._':;�
< ... . : , , _
s�� �suR���E � s �4lD 1N�TH ,
. .:�
� � ��1►� iF���..
- . TOTAL PC�R�1VI;iT;:�EE $
° ' oeU : `: .... . ... -
O� se0 ,.- ' .:...:... :..:... '
_.:. .:..:.; '_ '.
<:::; ::
�.. . .. . . :. ...�X) . ,.:. ,
. .... . .. ....... .. .. . . ,. .,. :. . , .. .. ..........
,-. ;,.,-.•.:..:.., ........... .. ... , .:: _. , .
This Application �Becomes Your Building Peraut Vi'6en°Approved ' r,1 �:.� - eceipf No.
, ,
- .
. . a 00$ y.-:.. ,..
>
.
Buiid(a¢OfAcial . - . .: ,:. : ,.: ' ila�e . ,
. .. .
.
• , ,14 tiour aoSce for su iaspecdon� (9S2) 447 0,: fai[.(95Z) 447-4345.
4646 Dekdta �treef.S..E.; Prior Lake,
Jun 17 08 06:29a METRO GENERRL SERVICES 763-428-2968 pel
oF Qer Date Rec'd
,, � CITY OF PRIOR LAKE
� � � SEWER AND �VATER PERMI7'
y �NNeso� r
� °„`" F ��• pERMIT NO. ��
. . � 2. Ydlow Gty .
� � � � . l. Gold Applicsnt •
Please e or rint and si at bottom
ADDRESS , ZONING (otrcr use)
1 ' � �
y � � � ` . � .
LBGAL DESCRII'TION (otfiee use onty)
LOT BLOCK ADDITION PID
OV�NER � M � �. ,
(Name) r ` ,- ! ` (Phone)
(Address)
(Address) (Ciry) {Zip Code)
APPLICANT '� � �� � ) �/
(Name) �' (Phone) ��l% :�' ")'.�•'_I `;�„2t� � !f
(Address) � � � : 1 � f ��( •��. � ��,�y
(Address) ' , (City) (Zip Code)
ry j - y Y
(Contact Person) L�� �f , ` �� (Phone) 1 �� � . ��r�5�'"�:�-I �
�
APPLICANT SIGNATURE f� � DATF i
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. � ABC [�PVC [] C�st Iron
Estimated length of sewer line � feet.
Clean out (if required) located at feet from structure.
FE�SCHEDULE
Residential sewer and water Jine connection 535.50 lndush�ial, Com'I & Multi-family 1% of job cost with a$39.50 minimum
Sewer connection only $17.50 Water conneetion only $17,50
Estimated Cost $ _���_ Bui�ding Permit #
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERNIIT FEE $ P�ID W�
����� P�Rn�r�
corr�� vso ooiy,
This Application Becomes Your Building Permit When Approved D�i� Receipt Na
D By
BIIII(IIOg OPfICIRI . DAM .��N � 9 2008 �' ': • �
24 6our notice for all inspections (9S2) 4�{ -9850, fax (952) q47-0245
By
Drivewa : NA I FAILS / COMPLIES Standard Pro osed
• Maximum width at ro e line 24' aa �
• Required setback 5' from side lot line or � �
30' from r-o-w on comer lots
• Maximum slo e 10% y, S�
• All parking areas to be paved including R-V or
s aces ad'acent to the ara e
• Location to match subdivision radin lan
Buildin Hei ht: NA I FAILS I COMPLIES 35' Maximum a 3'a �
Shoreland District: NA / FAILS 1 COMPLIES Standard Pro osed
Minimum lot area s uare feet 7,500 Ri , 7,999 Non-ri �s, ?°�'�
Minimum lot width 50' Ri 57.3' Non-ri 7S. o�
Shoreland alterations
Im nrious surface 30% Ma�cimum a� %
Bluff in Shoreland: NA I FAILS / COMPLIES Standard Pro osed
• Setback from top of bluff By planning dept. N �
• Bluff im act zone 20' From Top of Bluff /�i�
• En ineerin ce�ification submitted/a roved By City Engineer N�
• Gradin in bluff or bluff im act zone No importing/exportin �4-
Flood lain: NA / FAILS I COMPLIES Standard Pro osed
• 100 year flood elevation 908.9' Prior Lake
914.4' S rin Lake
• Lowest floor elevation 909.9' Prior Lake I
915.4' S rin Lake '
• Proposed lowest floor elevation Must be 1' above flood
elevation for new and existing
structures. If existing ��� �
stNCture was constructed
9/19/90-11/22/97 then
additional foot is not �e uired.
• Elevations 15 feet from structure Must be flood elevation or 90$,
hi her
• Road access must be no more than 2 feet below 907.9' for Prior Lake
Re ulato Flood Protection Elevation 913.4' for Spring Lake
Accesso Structure: NA I FAILS I COMPLIES Standard Pro osed
• Size 832 sq.ft. or 25% rear ard N
• Not located in front ard Materials NA
• Side ard and rear ard setbacks � 0' N�
• Maximum hei ht 15' /� l�
• Materials com atible with rinci le structure R
L:\TEMPLATE�BLDGLIST.DOC