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Building Permit 10.713
J F- W Z Z 1- rt W ~ ZWWQ Z W 2g ag � 0 k. nr■ 0aWU1 0 a ', \ ^ &U U� u.. 0 W Z I. ■ CI I x V j j-- LL N 0 p aaJ m Z y J Z apZ 0 Z o 0 w 0 F E2 p p Er- J . �i 0 0 0 = t \ E 0_O 0< I - d W a '' z zu. 11 W 8 0 ° i 0 0 d ? U W j U O O Z - O lit J W< W J W — � 4/ W W W w 1L a 2 3v,a 2 ❑ ❑ ❑ ❑ ❑ ❑ k, Lill ` re ix O w ` a a u- I-- y� �\ > Z J rC 0 14 1 W uj _� Or < 0 U. iy g v 0 . ---4 0 Y z Z O z W 1 .... - < �� 1.- 01 -z r�o a Z < v -. 4 a'0 p 0 < - � N W W -I W un I N z �p w a o a c O W W W w Op NZ 0 rt O O to V 8 a 0 O LL u O .u.z co 0 • 3�O 0 az < O a ❑❑❑❑0❑ 0 ❑ ❑ -` o f PRI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ( Q . AND UTILITY CONNECTION PERMIT U III 41'A'NE I. White File / Q '1/3 z. Pink city PERMIT NO. 3 Yellow Applicant / (Please type or print and sign at bottom) ADDRESS (( M ZONING (of fice use) r i i 8 wNi L. t< E l "R10K LAkE .1'A 1/'"I�. P- 151 LEGAL DESCRIPTION (office use only) LOT Z BLOCK ADDITION S 1 s9 " PID z5. Q 4-(9. Q QZ. 0 'C- (W /2 - 3Z6 -3z'16 OWNER fI (Name) 1‘ AMR6t -i v ` �� L K 1 Al , (Phone) (S- 4 E r l'"19 (Address) . .1: ► A . z. = E i . 4 • _ BUILDER (Company Name) (Phone) (Contact Name) ii e -r (Phone) (n 1 a- ( ~-o* .3 6 (Address) a a � Q ()4 -P 1 i Sa ri e_ Si" '. / t) e t 1 � MN • 411 TYPE OF WORK ❑ New Construction ape& ❑Porch ❑Re- Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace ;Addition ❑Alteration ❑Utility Connection CODE: R.C. ❑I.B.C. ❑ Misc. 00 / Type of Construction: I II III IV V A B PROJECT COST /VALUE $ 6C) DOl,, — " Z.-- Occupancy Group: A B E F HI MR S U 1 Division: 1 2 3 4 5 (excluding land) I hereby certify that I have hirnished 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 -. enttoned 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 off , •, .: n revoke this permit for just cause. Furthe ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. w A x 41./ /./ .1!, r/ — • A !� S / Signatur- Or Contractor's License No. Date Permit Valuation 7- - - 9 0 00 Park Support Fee # $ ` � SAC # $ Permit Fee $ 1 G $...i S Plan Check Fee $ Z '16. 11 Water Meter Size 5/8 "; 1 "; $ State Surcharge $ - 14.50 Pressure Reducer $ Penalty $ I Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Per it Fee $ TOTAL DUE tiwzD 6 25 ( 0 $ 71 1 41- This A,'. icat .n E o, / Y1 gPermit Whe Appr ed Paid / v 4-4- 9 eipt No. (y /300 Date S. 2„4,/0 B Building Official _ , to 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. Aor ® (� _ `�~i., 6 7211 - 10 Plan '! Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 i Mri r,. .4 Mn wa x 4 ' ' Ta ' -. '' 4'' '''4" fn. ,,,.. an 'a' - s, t ; " ', , '''''4' o . *. r "r''***tiS **. - ; O1 VR19+ 0 Z White - Building yl ^'N �� Canary - Engineering ES° Pink - Planning - BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT H A �' { k b i l Ni � t t- I APPLICATION RECEIVED ' * ' d' 1 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: I + 5 LI \ ( t s:'- : r� t...... ( J b. Accepted Accepted With Corrections _/______ Denied Reviewed By: Date: o2 Comments: a { e .f t ' y 4 • M S N A *.• , i 4 V ogl i ,h' "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." O tri White - Building Canary - Engineering "'INNES °�P Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT m twq m E I KiNNay APPLICATION RECEIVED 6. 1 1 • 10 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 1 4-+5S S HAD Y SAC 1 \ 1 Accepted Accepted With Corrections Denied / Reviewed By: . Vi i. Date: / o � Comments: /- 'r2- L 12c f / /ICI �'9 .r Jz'C�PS � � z. {'t2O J I06- A. f RLGPv/tar ! % ICA -6 A • e V t-.7 4r F Arodl L / N S' a cc c- r' ,J . "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." U.S. DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires March 31, 2012 National Flood Insurance Program important: Read the Instructions on pages 1 -9, SECTION A - PROPERTY INFORMATION , i, t 11. .> s.. Al. Building Ovme?s Name i x - a, • , AZ Building Street Address (including Apt. Unit suite, and/or Bldg. N jor P.O. Route arc) Box No. � ". ( ' 1 ` '; City State t444 S r / ., Y, g A3. Property Description (Lot a .. Riodc Numbers T P r o N um mb be er r, �� ' J 7 �.egat Description, et c.) _J _ L a, rt G ,.' 4 N a •. 2 SS. /1T' , Al ("41 v -F 5 Gt 6., A4. Building Use (e.g., Residential, Non•Residential, Addition, A c c e s s o r y , etc.), B S ` ' d 7 r .- c• - / A5. Latitude/Longltude: Lat`nn' ° 49/iLong. at 3'.i' " W Horizontal Datum: NAD 1927 0 NAD 1983 A6. Attach at feast 2 photographs of the building if the Certificate Is being usedlo obtain flood insurance. A7. Building Diagram Number A8. For a building with a crawlspace or endosure(s) A9. For a building with an attached garage: a) Square footage of crawispace or endosure(s) sq ft a) Square footage of attached garage sq R b) No. of permanent flood openings in the crawispace or b) No. of permanent flood openings In attached garage endosure(s) within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b in d) Engineered flood openings? E3 Y83 ❑ No d) Engineered flood openings? ❑ Yes 0 No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number 1 82. County Name _„ ff B3. Stale ,270 ',1z. b O oz C S C ©7/ i �kt,v . sir j rA 84. Map/Panel Number 85. Suffix B6. FiRM Index 87. FIRM Panel 88. Flood 89. Base Flood Elevations) (Zone Date Effective/Revised Date Zone(s) AO, use base flood depth) 274 4 odOZ C No Y. 15 )77 NOV, 19 97 X 908.5 1310. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89. ❑ FiS Profile Az FIRM ❑ Community Determined ❑ Other (Describe) B11. tnc>icate elevation datum used for BFE in Item 89: O NGVD 1929 ❑ NAVD 1988 0 Other (Describe) 812. Is the gnation buildkig gt tooated In a Coastal Banter Resources System (M � area or ❑ � Protected Area (CPA)? ❑ Yes ( No A SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ❑ Consfnxtton Drawings* 0 BuItdtng Under ConsirucBon' jsi Finished Construction *A new Elevation Certificate will be required when construction of the bu ftding 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 -h below according to the building diagram specified In item A7. Use the same datum as the BFE. Benchmark Utilized Vertical Datum Conversion/Comments Check the measurement used. a) Top of bottom floor (Including basement, crawlspace, or endosure floor) 9/.? . A' 1 feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 2xZ. 9 feet ❑ meters (Puerto Ida only) a) Bottom of the lowest horizontal structural member (V Zones only) ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) °I (c/. d • feet ❑ metes (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building ❑ feat ❑ meters (Puerto Rico only) (Describe type of equipment and location In Comments) f) Lowest adjacent (finished) grade next to building (LAG) , 4 0 feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 7 /$ . ,r ❑ feet 0 meters (Puerto RIoo only) h) Lowest adjacent grade at lowest elevation of dedr or alaks, including `j (4 , ii ❑ feet ❑ meters (Puerto Rico only) sinrokural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and seated 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 avallable.l understand that any false statement may be punishable by fine or imprisonment under 18 U.S Code, Section 1001.0 // ( ` 1 Check here if comments are provided on back of tom Were latitude and longitude in Section A provided by a 1 licensed land surveyor? tit Yes ❑ No PLACE. } SELL II Certiflefs e's Name xi 4 r ' . Cc�Y -el/ Uconse Number 0 T1 Q � HER A Company Name F.-, hC_ R, C eciekr'cil, Zakii 5 c;r►r� c,- ' yre, w ,� • , - - Address C�ty , .State f -s 1 fl Ai ; /lei fo /ct Sigra � ,�' .- Al Al l., u � 1J r- . Eckel .� Pier-we r Te1 hone FEMA t orm 81-31, 09 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces, copy the corresponding information from Section A. S` R;C'^ ?9. y ra -'yip vxky f. "a"tia'+n" ; isit .. ;= Building Street Ad ° Y`a "xz ing S dress (Mdgding Apt., Unit, Suite, and/or Bldg No.) or P.O. Route and Box No. Yp r ' °' ni q „ / S ha eac 17 Tea J 13-_, , _ -__� � ' r /� fate ZIP j.(� City S , 1„ N ' A .. t i.A: ....�._Y. 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 {' • f .nom .-- -/ -:,,/ 2- /0— /( Signature - Date le 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. El. Provide elevation information for the following and checic the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) end the lowest adjacent grade (LAG). a) Top of bottom floor (Including basement, crawlspace, or enclosure) is y.. t feet ❑ meters bove or E below the HAG. b) Top of bottom floor (including basement, crawispace, or enclosure) Is O .. 4 feet 0 meters above or below the LAG. E2. For Building Diagrams 8-9 with permanent flood openings provided in Section A Items 6 a or 9 (see pages 8.9 of instructions), the next higher floor (elevation C2.b In the diagrams) of the buIing 0 feet ❑ meters 0 above or ❑ below the HAG. E3. Attached garage (top of slab) Is O. rifeet 13 meters g above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ 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 communitys floodplaln management ordinance? ❑ Yes 13 No 13 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, 8, and E ere correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name ii addr l 3 _shad E3 e. o- c i l ; -cam i 1 5 City p r f . �' Q k State ZIP code Fri 3 7 Signet �� Dateg_ /0 — 2 o `/ Telephone c4z'D'1;;>-- Comments ❑ Check here N attadnments SECTION 0 - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's tloodplaln management ordtnance can complete Sections A,13, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items 08 and 69. 01. ❑ 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. © A community official completed Section E for a buttdtng located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ The following infonnation (items G4-09) is provided for community floodplain management purposes. 1 G4. Permit Number 1 65. Date Permit Issued 106. Date Certificate Of CompllancelOccupancy issued G7. This permit has bean issued for ❑ New Construction ❑ Substantial Improvement G8. Elevation of as - butt lowest floor (Including basement) of the building: ❑ feet in meters (PR) Datum 09. BFE or (In Zone AO) depth of flooding at the building site: 0 teat ❑ meters (PR) Datum 010. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone Signature Date Commend l Check here if attachments FEMA Form 81-31, Mar 09 Replaces all previous editions PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS t 4 4 5g5 t+a ci «< fLAtu. TYPE OF WORK 1r-c.L. USE OF BUILDING g.Es �* PERMIT NO. I 0 . - T ( DATE ISSUED ` VV. BUILDER t1Ai &A REAT wa` `- PHONE # 4 154 414`1 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT c9 , o INSPECTOR DATE l FOOTING D4 'ii - 4 Q+‘ 9 J 1 to 45. 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I FRAMING 04._ 1 75 co /c24 I [FINAL FE '.ewort -r I I FOR ALL INSPECTIONS (952) 447 - 9850