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Building Permit #12-0463
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Q `� O 0 0 J _ ` z YYZ H a� W j c O 2 0 2 O O LL a U c N p y 1- (X O Z Z ).- (pool (9 W Z ? - 1 ss z_ a N 0 a � s ; o ' � W W W w c) ,,Wa ,�W 1 cc Z - a. 2 cni;(2 qi. ■ 0 o W ,e ❑ ❑ ❑ ❑0 a a oLL ►_- \ 0 1 0 < v o �� a 0 Y V Z O J u U m j N 0 in J Z Z Z ( j w a~ , d 0 • - Z O O W z < U W W Z O C7 <zis N W 0 0• `o Q a o N z zo a ce a < v O W W Z OO Z~ '.� I 3 O O h a 0 0 LLLL.LL? 0 .. ❑ 0 c V? Q 0 o 0000 0 - X § }k { )�ww$] ¢ W 00 \ g) } j \ ? 2 �.x O ■wwm q Eq7ƒ$ E2 z § ° t 0000014 / & o o R ill _ ) A / w 0_ a -i § t§ k ;ii A 6 2 22 z 0 } CI li E 2 o o rz o 9 o R w z& z_ ??27 o k 0 2 S \ 0 w m $ w W © x a. 8 z L' �$ }2k w w ce w ‘ 1 0 OOOC \` o o § w f u W . . / } \ • \ k z . Ill § R \ � - \ � ----- w Z _ ° 3 d 2 < w �- . � \ 4 CO \b w ce § /� ' .Q \ k 0 § § § E ° ■` , 4 0 o a 0? 2 o I o o o o o U rc o o d s `) (4 pR∎ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd : TEMPORARY CERTIFICATE OF ZONING COMPLIANCE e . , AND UTILITY CONNECTION PERMIT 4 I. White File R / P 1 q R-I itr/t/ 2. Pink City PERMIT NO. /2 r 4 6,3 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) / y i fC6e 4— r C , 1,--(1 f- 2 /SO LEGAL DESCRIPTION (office use only) LOT / BLOCK ) ADDITION Mg ii n J / y / PID2,c, Q90 0 D • OWNER / L /2 - /` - C %Z �O�CGL�. (Name) � �-- �r,�/ • ! � • ��� �5� (Phone) olh Z -4 2_ - i. Mak e (Address) /- 34 2 6t (Z L r) A (X .7 (pi-G uAit �. M N 6 / - 1 0 /1 1, BUILDER f 4 _ (Company Name) A L il / i `c 4 �u ; � e rs . c (Phone) t o 7 9 Contact Name ,' / 7d 3/ - 7 .L.S7) ( ) Len �ic-'1 � Cl (Phone) r+r f (r s?o – / 9 b'' (Address) 4 /77 v 67,...,, u-c d L,k •..t A s P1,,...,,,444 5, TYPE OF WORK JO New Construction ❑Deck [Porch DRe-Roofing DRe-Siding DLower Level Finish ❑ Fireplace QC vt ❑Addition DAlteration ['Utility Connection CODE: LR.C. ❑LB.0 . Misc. , . �. _ '' T • /� Type of Construction: I II III IV VV A B 3 "Si / '°' *S° ` � ,u y f s,•.; Occupancy Group: A B E F H I M R S U - PROJECT COST/VALVE $ J A) 0. 00, 0 a Division: 1 2 3 4 (excluding land) I hereby certify that I have fumished 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 i permit for jus cause. Ft hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X eg _ . i - -: ` _ __. - co 6 3 8' ,_5 —2 / —/L Signature ontractor Li cense N o. Date Permit Valuation .e4c a5+ J �!/ /^&V D D r Park Support Fee # $ Permit Fee 4 Ir-D $ I t -106.-2- SAC # $ , --b— Plan Check Fee � $ t) �g � Water Meter Size 5/8" $ S90, State Surcharg 4 9 $ 1-1C,- — Pressure Reducer $ , �C r Penalty $ Sewer /Water Connection Fee # $ ,-4., Plumbing Permit Fee $ C c -� CU Water Tower Fee # $ .. – Mechanical Permit Fee $ ( - 4. s"--2, Builder's Deposit $ 1 500, — Sewer & Water Permit Fee $ r 6,-", p Other E ✓ i25 'x – $ 1 2 S'.. ° Gas Fireplace Permit Fee $ C S-d TOTAL DUE ehit,fio (,/ 24 2– $ 'ci• tag- 66 This ( ppl'. ati, .5 e • mes Your Building Permit en proved Paid / `4/ O O , Cr Cr C/ ipt No. 6 Z5 I Z— Date to ...,-)--7... 4.i--- ilding i ma — D 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 PI • • • i a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be b... ■111V-41111.6.11100ta 1 C i , ( ( ( 7.-- Plan ,'t g Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, M1l55372 J aa Vz • 4, • 04 p R I0.p CITY Or PRIOR LAKE Date Recd ,,, AN , z.,-. DEMOLITION PERMIT ¢, Z 9. / f�Y. . _ PERMIT NO. 11 . 3/Z (Please type or print and sign at bottom) • ADDRESS ZONING (office use) 1 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER --c, c� \ C) Y' ' S �o 1 . — L\ i g — a'1 S&> (Name) 1 \ L (Phone) IN) (Address) SI 5 e,� X S c l w ►0 Wt lip `ul, J `.� M 5 S 3 1 Z G CONTRACTOR ��,, `` 5 2. -155-g (Company Name) M ► h fn.o. Sh G Ji r �`- -- -_.L O r lc 5 (Phone) � S (Contact Name) f OCA •A't S (Phone) q (o 1 2 - 9 Pi - 39 3 (Address) Z S OO \ S 1- CS.- 4 Z 1 &A on3 v i 1( t AI N 555 3 St, i t 1 0 5 Use of Building: INTERNATIONAL BUILDING CODE ,��> /�� y Type of Construction: 1 II I11 IV (.7� A eP 6/ A Les. 1 / - -f G f4 Occupancy Group: A B E F A I M gt? S U 0c76 -S fir /NG,. /t 1 t- * G/V746 . Division: 1 2 3 4 5 VIPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION 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 ity i - accordance- t • pct ed plans. I am aware that the building official can revoke this permit for just cause Furthermore, I hereby agree that th5e o • designee may enter upon the property to per need inspection / '�' - Signature Date METRO (MCES) SAC T • ication Becomes Your Demolition D ETERMINATION . _ This Ap ! I .. Pe it When Approved �re2/o dgsgiE s CHgt+,g- ¢.19 // I•/ �4 s i Gr 4 aoosao 2.67 ( I M fri E) — 'ldtng Official ---.._. ate 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. C 7fr g ---- C— /7 Piaranin .rector —` ' Date Special Conditions. it any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372 �04 PRIp�v White - Building Canary - Engineering ^ '/NNEso' e ' Pink - Planning 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: Accepted Accepted With Corrections Denied Reviewed By: • Date: Co (2-C Comments: E vet'vh e fA eedeel Ai 4,44. nota ion /nyecti h. /c2, 41eles oT trec repaee' ,s ref are h/ en I _ 4 re erneri- e-feroW ref Aired "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� PRIp�e White - Building I �P Canary - Engineering ^NES° Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT fr //lam L—/ /.5 �=C�/ `Z ,US APPLICATION RECEIVED 61 2- /. /2__ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted ✓ Accepted With Corrections Denied Reviewed By: Date: r Z- /z 14 A/0_,, , A e Comments:. i� i�� �.d5 (->") A /'c-n P V,cL 161T Win-► <16.6yaz. IN D(c k P /2 L - r /i V. J 4 -alp ail i, A-Tr4u 6 d,4 _ _ Co,/acLie-r-& S5tka.- r c- art Ascs, s P ., "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." - I 6/6//2,` , Z5 hrs. 04 PRIp/e .. A\ e ,- \ u 1 T' &2 White - Building vy � _ . �P Canary - Engineering NNEso ! Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT n/644 LI r j APPLICATION RECEIVED 3 , _ /.. 12. The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ,� C...t / `1 / a°i Accepted L-' Accepted With Corrections Denied a Reviewed By: _ Date: CA/ z Comments: -� 4r -, - ,1 ' - 'L. - 775 / . s (A- C,.,, ),.. , ; ®-4..-► 4 See IMP ! r e Side for Additional Information! "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." • ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS 6 Surface storm water drainage flowing to the perimeter of this lot to and from adjoining properties must be conveyed to the roadway and /or to the rear o;= the lot in drainage swales within' the drainage easement. • All- bare soil areas must be protected from eroding into neighboring properties through the properly installed and maintained silt fence or bales. • The silt fence required by the erosion control plan must be installed prior to any earthwork 'being started. E The builder is resronsible for maintaining the erosion control measures until the turf is established. 6 . . The rock construction entrance must be installed at the time of t _ tibackf of the foundation. Y, • • 6: \Admin \dept info \ADDITIONAL COMMENTS FOR gLILL)ING PERMIT APPLICATIONS,doc • 4 6 7j MJP Associates, ltd. e Lane White Bear eaz Lakeke, , MN MN 55110 -■ `= PH. 651 -426 -7037 FAX 651- 426 -6643 Structural Engineering Consultants www.mjp- associates.com Tuesday, November 27, 2012 4VA Gar Hargens 5 et y Close Associates, Inc. 3101 East Franklin Avenue Minneapolis, MN 55406 Re: Construction Observations Summary report: Peterson Project, Prior Lake, MN MJP ASSOCIATES, ltd. Commission # 120302 Dear Gar: On three occasions, as part of structural engineering design package, we visited the Peterson project in Prior Lake. Those dates were 8/2/2012, 9/13/2012, & 10/10/2012. Copies of those field reports are included for your use. The 8/2/2012 site visit focused primarily on the footing and foundation walls and piers, the 9/13/2012 site visit focused primarily on the 8/2 "Action Items ", the installation of the portal frames and the first and second level framing, and the 10/10/2012 site visit focused on the 9/13 "Action Items" and the roof framing. Leon verified the 10 /10 "Action Items" were properly addressed. As a result of the above referenced site visits and subsequent communication between Leon and myself it is my opinion that intent of the structural design documents has been met. If you have questions regarding this don't hesitate to call. Sincerely, 144 4 1.1"..11111.1.11111.1116 I hereby certify that this plan, specification or report MJP ASSOCIATES, ltd. was prepared by me or under my direct supervision Michael J. Preston PE and that I am a duly registeres professional engineer Encl. under the 1 • ws if the • t4 of lin . esota. DATE: 11/27/2012 REG. NO. 20216 (Structural items only) JL 1. 3. 2012 12:24Py, ° A No. 3868 P. 1/1 D'D Date Recd e PRIp CITY OF PRIOR LAKE q SEWER AND WATER PERMIT jrfNNF6.tr • t• °peen Fils PERMIT NO 2. Yelic» Gty 3, Gold Appin.nt • _ case type or print and start at bottom) — ADDRESS ZONING (office use) 15 aq 1 F .a -,-r 61- is1- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION FID _ OWNER (Name) 64 tt a r (Phone) ie t-�'I 0 (Address) 1 SO `5 -- 12.1+, G :. . ■ . u 4 .t. .. ilt& N19 6_ q' (Address) ity) (Zip Code) APPLICANT (Name) STOCKER EXCAVATING COMPANY, INC. (phone) 9521890 -4241 • (Address) 12336 Boone Avenue Savage, MN 55378 (Address) (City) (Zip Code) Curt same (Contact Person) / / l (Phone) APPLICANT SIGNATURE e1 /r % , DATE -1 I Zr l'-.- APPLICANT PLEASE COMPLETE BELOW Size of water service inches. . Location of any couplings from structure feet. Type of sewer pipe. J ABC n PVC [❑ Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $35.50 Industrial, Corn'I & Multi- family 1% of job cost with a $39,50 minimum Sewer connection only $ 17.50 Water connection only $17.50 Estimated Cost $ Building Permit SEWER AND WATER PERMIT FEE $ STATE SURCHARGE . rh / ,®1 w . TOTAL PERMIT FEE 5 //1/ v V v //, (OCfice Use Oety) "I /i This Application Becomes Your Building Permit When Approved " Paid Receipt No. • Date By Build Offic Date 24 hour notice for all inspections (952) 447 -9550, fax (952) 447 -4245 4 pRI0 Date Rec'd 0. 4 ' /' CITY OF PRIOR LAKE PLUMBING PERMIT ` Nfiso 1. Blue Fite 2. Gold city PERMIT NO. / L y 46 1 Yellow Apphana (Please type or print and sign at bottom) ADDRESS ZONING (office use) s 2-4 1 Cdr � i-a C h LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) r e-4-E--r- ' (Phone) (Address) APPLICANT V (Name) LL YL S s Co (Phone) L, C ) - '14 P - N9.33 (Address) - T 3 o C e.i.4.r,hNj 12--.4. D E. L, 1- 04.1«01a. 1 PlYl S-C/ "7 (Ad Less) (City) (Zip Code) (Contact Person) 1 4..•-■ (Phone) t S) - ` Ye- 9 933 APPLICANT SIGNATURE , l ,,/"A,.� )10.1.4.04, DATE 9- -27- / 2 APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture 1 Bath Tub with or without shower Rough -ins i Dishwasher ;3. Water Heater Floor Drain 1 Water Softener '7 Lavatory (Bathroom Sink) Stand Pipe (Washing Machine) Laundry Tray (1 or 2 compartment sink Sewage Ejector 3 Shower Stall Backflow Assembly 2 Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler r' 1 Water Closet (Toilet) 1 -1 Other O,.J d,;, ,, FEE SCHEDULE Industrial, Commercial & Multi - family 1% of job cost with a $49.50 minimum Residential, New One & Two - Family $149.50 Residential, Additions & Alterations $49.50 The Minnesota Statutes § 32613.148 - ist $ Building Permit it "SURCHARGE" has been changed for one year effective PLUMBING PERMIT FEE $ 1 LI y. 0 July i, 2010, until June 30, 2011. STATE SURCHARGE $ 5". y ° :5e* 'the minimum surcharge fora "fixed fee" permit TOTAL PERMIT FEE $ ) S1 i. 5 is ,-, beginning July 1, 2010 PAID �R MIT This Application Becomes Your Building .Permit When Approved Paid Bs 1t" A Date By Building Official Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 10!18/2a12 13:37 9524928006 GLOWING HEARTH:IHIGH PAGE ©i' D I ' Z CITY OF PRIOR LAKE Dstte Rec'd ?i " ; : ` FIEA G/.AIR CONDITIO G/f` #GLACE PERMIT 4.4 iN CSO4,r i • t. F ink Pile � i . . :dket: c,y. R YI NO. /j- , s. Yeitaw Applicant _ ADDRE 1 of . ' � IIIt gflcl atbot4ni). . ... _ 11..V.ViLCSS l _ ZONING- (oft: USr.) . 1 .5 'C iii SZ • A-cir . 1 f mE LEGAL DESCRIPTION (odltceuse only) • • . T P'I' BLOCK A4DTI`ZQN • PM CSR — ) 1 , ' • (l4atie)- t__I, l l c 1 1 t . _ AA . - am id (1?'nonc � Q c�' - #f P I (A) 7 1 .. j ' 1 r-rlc '-k ' 01, N . 5`+ A PLICAN (Name)____C514,1,41 t, " am , . .4 .1 6e_ P hone) D — — L ` t --" 9 ) 6 (Address) ,..ii ,30_21 - _ i , . _ 1 . ;. /At 5 AFL (Add (CA?) q, (Zip 6 Contact Pexson C,J -�..1' pone) q, 7 c I.(, _ . A LTCAN'T TCrI�TA'�'CJR . • --- � - -- DA' B ..... th_ �: �. -. . - ,f _, r ICANT PLEASE COMPLETE BELOW [ B �r CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS FUP�NACE MAKE AND Ivl�if D I' FLUB SIZE ;, _ RETURN OPENINGS t ; INPU'�' OL 'PU • • - I i TYPE OP SYSTEMS BEATING OR POWER PLANT r . . • PLEASE VOTE: Mr C mdifioner dWann Air Plnnka [� Stell�i Units nod Tirepiaces Cannot E�ict'oaelt .0Cfmvicy i Ho di . tio x into Required Side Yard Setbacks. I p Radiation Fireplaces with Box Additions or X • ' Conditiou:ng , • • A Spcclul Aez:ces _ Cantilevers to the Out isle of Buildings ❑Vona. System . OthSrXlerlcea .. _ � X2 n I3nilditig>Permlt. FIRE MAKE AND �'0DEL 42".......i '� -- _2, Z i F • . SCHEDYI _ • .-... , 1% of joh•cost de rtial G Fiferdnee $49,50 Industrial, Corntnerci3l & Multi Ca ly $49.50 mitzitnunn } Residential, Beating & AIC'(Nciv Constniction) 81449.50 Residential, Additions•& Altoratiarta ' $ 49 . 50 . + evO Construction S64.50 • :Residential, AC 031y A�,y ti,, ... $49,50 ILesidcb�al, Heati O l t ' I } ?rt ®N° � ��� ' '., " 1 i • ' t cd Cost $ Bitllding Permit # X1 0 0 — . • • c s � '` �� The M•i�lresate. Statute; 32GB, l b) \[ ..,0 7 '. ' ' � • "SURC�I�,R�il:" hes becn okrar.gc:i :Fcr cm ';,.N., F . HEATING PEncr PEE $ t _ U' '• S TATE SURCHARGE $ . `"7 �S` '` year effective i �f>ti;t �, y4 1te, s±:otfi a lane :.30, 7k1; TOTAL PERMIT FEE S l it -0—. The ntlliliriom surchlsrge kr a. "d+s ice" pun (Offlc (c ugly} • Is0, heginnitt „rely 1, 2010 T hus Application BeconAll Yotlx Building Permit Whet App. overt • Paid Receipt No. • Date EY — '� pate B'atldine 0[lic4al , +I ._ .. . .. _ _ -- _n ,..:......e -__ rnel% . .Aa eacn _ - rev M411 dd7 -4hA4 . 1 i ritr CITY OF PRIOR LAKE Date Rec'd Hie.,ATING/AIR CONDITIONING/FIREPLACE PERMIT +. 41AINESe I iNnk Elk PERMIT NO. 3 Yam Applimi Ica= type or print and alga at bottom) ADDRESS ZONING (oftwr we) . , / 52. 6 1 / C4 wa le 4 Ofi cc I e /V L-: LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PM OWNER ] (N 1,-0 ; 1 Ilan) e . Pe le (.3,919 (Phone) (Addrcs) i 3426 a id 4._ Apple Vez I 16/.., NA( 55 igu-_, - -- APPLICANT (Name) r i ii. Ilk 0 41 i ii I ,t4 Nth, & AV ei) 99J (Address) _6 2Z_9 0 it y , c di. #-2y, by A-2 jilicitis /Irk /fiv ( ma) (City) (Zip Code) (Contact Person) 614e e iv/ /1/ sins (Phone) gl..2-b7o -Yelo2 APPLICANT SIGNATU ' - , li _a■—. :-_-. ..... DATE i APPLICANT PLEASE COMPLETE BELOW NEW CONSTRUCTIT . 0 REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL 4 Ina Od fie-PP-424.0 FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE: Air Conditioner Warm Air Plants USIeam Units and Fireplaces Cannot Encroach IWO! ravity ot Water into Required Side Yard Setbacks. Mechanical Air Conditioning Radiation E Special Devices Fireplaces with Box Additions or C u to iki th in e g O p u e ts rm id f e t. of Building Vent. System IS-Other Devices FIREPLACE MAKE AND MODEL C3 3 exA Lue--i C3 ) cg t.... f E SCHEDULE C ( Pl A/ .' ,je i i p, — I T --( 44 — — — - Industrial, Commercial & Multi-Family I% of job cost Residential, Gas Fireplace LI 9 — ' $49.50 $49.50 minimum Residential, Heating & A/C (New Construction) $14950 Residential, Additions & Alterations $49.50 Residential, Heating Only (New Cons(ructMn) $6450 Residential, AC Only $49.50 Estimated Cost $ Building Permit # The Minnesota Stamtes :4 326E1.148 "SURCIIARGE" has been changed for one BEATING PERMIT FEE $ year effect:re STATE SURCHARGE $ .50 July L 211,0. lin t il lune 311. 2011. s TOTAL PERMIT FEE $ The minimum siirciuirge for a "Used fee" permit Office Use Only) - _. is •.".5, beginning .10 1. 2010 This Application Becomes Your Building Permit When Approved Paid Receipt No. i i AO IA, — Building Official - Dale eiv It 4.04/Nr;d77/ , _ Date .,_ 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 4646 Dakota Street S.E., Prior Lake, Minnesota 55372 fr1/14/7. o -. - CITY OF PRIOR LAKE Date Rec'a ,,,,,,:;,.,,:„.,,,,.:_,:„.„ H EATING/AM. CONDITIONING/FIREPLACE PERMIT , FEs01� r. t'iak F�c z. g iRZ�T 1-0463. (PIenae type or print and sib at bottom) ; Y' • Amuck* ADDRESS y.r ZONING (��fi:: use) 15 , 1 f��� ___,. _ ` J LEGAL DESCRIPTION (office use only) LOT BLOCK AUDITION P 1 (ANINER (Yi . �- 1Tame) _ -` l �'�� /�. (Phone) 7c� `- �z 7 Address) 4 ` 1 r--'" I ° ■/ / I ALI a A 5st tit APP7CANT i —7 (Name) 1. t • �t.� L .. — 1, (Phone) ' r — �r7 / (Address) _/ 4th se 11 � far). } (Cit � Code) ' / 4 < Z2_ (Contact Person;) ! . ' (Ph one) APPLICANT SIGNATURE , r r DATE 7 / `� APPLI cT PLEASE. COMPLETE BELOW LOW — — ❑NEW CONSTRUCTION ❑ REPLACEMENT ❑ ALTERATIONS FURNACE MAKE AND MODEL FUEI, FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM SEATING OR POWER PLANT — �Warm Air Floats Steam PLEASE NOTE: Air Conditioner DW v ' ❑Hot Water Units and Fireplaces Cannot Encroach 1■7 icchazical ❑ Radiation into Required Side Yard Setbacks. ❑ • it Conditioning ❑ Special Devices Fireplaces with Box Additions or ❑Vcnt System Other Devices Cantilevers to the Outside of Buildings Require a Building Permit. FIREPLACE MAKE AND MODEL i:if/, t a t , 1 _ t* ► ._ ___ .. )41,6 - -T � 1 ----- -i - � � -4 , �} $�S Jab FEE SCBIEDUL Industrial, Commercial & Multi - s.miiy 1% of job c t .• + ; a'.dentiai, Gas Fire lac $49.50 minimum $49.50 Residential, Heating & A!C (New Construction) $149.50 • Residential, Additions & Alterations $49.50 Residential, Heating Only (New Construction) $64.50 Residential, AC Only '� hh $49.50 The Minnesota Statutes § 32613.148 ,ost $ 0 00 r Ga. Building permit "SURCHARGE" has been extended nntil rune S?, 'j 913, aEA.TING PERMIT FEE $ L P ' SO i The minimum surcharge for a aTATE SURCHARGE $ . S , r, "fixed fee" permit is $5..7 o — COTAL PERMIT FEE S • ^ , r ! + , This Application Becomes Your Building Permit When Approved Paid Receipt No. Date gy $utldine Official Date v 1 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street S.E. , Prior .Lake, Minn esota 55372 • a�[��' 3cJ',�d H12ih3H L'NI�'i01J 9E09is6 L0 :60 ET9Z /80/50 • 4 • • 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 For Insurance Corripany Use," Al. Building Owner's Name William and Lori Peterson Polrcy,Nunber A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Company NAIC Number 15291 Edgewater Circle NE City Prior Lake State MN ZIP Code 55372 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Part of Lot 1, Block 1 MARTINSON'S POINT, according to the recorded plat thereof, Scott County, Minnesota A4. Building Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) Residential A5. Latitude /Longitude: Lat. 44.727308 Long. - 93.429039 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. Building Diagram Number 7 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) N.A. . sq ft a) Square footage of attached garage 551 sq ft b) No. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attached garage enclosure(s) within 1.0 foot above adjacent grade N.A. . within 1.0 foot above adjacent grade N.A. c) Total net area of flood openings in A8.b N.A. sq in c) Total net area of flood openings in A9.b N.A. . sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number B2. County Name B3. State PRIOR LAKE SCOTT MN B4. Map /Panel Number B5, Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 2704320004 C Date Effective /Revised Date Zone(s) AO, use base flood depth) 7 -26 -1974 11 -19 -1997 X, AE 909.0 B10. Indicate the source of the Base Flood 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 in 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. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate wit 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 -h below according to the building diagram specified in Item A7. Use the same datum as the BFE. Benchmark Utilized LAKE GAGEVertical Datum 1929 Conversion /Comments Check the measurement used. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 910.8 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 920.5 ® feet ❑ meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member (V Zones only) NA. ❑ feet ❑ meters (Puerto Rico only) d) Attached garage (top of slab) 918.0 ® feet ❑ meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building NA. ❑ feet ❑ meters (Puerto Rico only) (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 910.3 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 917.4 ❑ feet ❑ meters (Puerto Rico only) h) Lowest adjacent grade at lowest elevation of deck or stairs, including NA. ❑ feet ❑ meters (Puerto Rico only) structural support 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 mot„ Sttrtl f information. I certify that the information on this Certificate represents my best efforts to interpret the data available.' understand that any false statement may be punishable by- fine -or -- imprisonment under- l8 -U.S. Code, Section -1D01. ❑ 4,1„ _ _ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a • ; . hce�sesl lat��wv)[Qr� f�l YeS No n Certifier's Name Peter J. Hawkinson License Number 42299 , `. ND , SU EYOR_ • Title Sr. Surveyor Company Name Pioneer Engineering P.A. (f3 4 Ns Address 2422 Enterprise Drive City Mendota Heights State MN ZIP Code 55120 6 � ��. >` Signature /<://C / Date 7 -17 -13 Telephone (651) 681 -1914 * a� FEMA Form 81 - 31, Mar 09 See reverse side for continuation. Replaces all previous editions • IMPORTANT: In these spaces, copy the corresponding information from Section A. Forinsurance Company Use: Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number 15291 Edgewater Circle NE City Prior LakeState 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 / /i Signature Date ❑ 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 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, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is . ❑ feet ❑ meters ❑ above or ❑ below the LAG. E2. For Building Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ 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 community's floodplain management ordinance? ❑ Yes ❑ 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 ❑ 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. ❑ 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 building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. ❑ 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: ❑ New Construction ❑ Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum G9. BFE or (in Zone AO) depth of flooding at the building site: . ❑ feet ❑ meters (PR) Datum G10. Community's design flood elevation ❑ feet ❑ meters (PR) Datum Local Official's Name Title Community Name Telephone . Signature Date i Comments ❑ Check here if attachments FEMA Form 81 - 31, Mar 09 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 15291 Edgewater Circle NE City Prior Lake State MN ZIP Code 55372 Company NAIC 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. 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MINNESOTA DEF'ARTMENT'OF (651) 284 -5005 St. Paul, Minnesota 55155 + � I U 1- 800 - DIAL -DL) www.dll.mn.gov LABOR VSTRY TTY: (551) 297 -4198 7/3/2013 APPROVED FOR USE Bill & Lori Peterson 15291 Edgewater Cir NE PRIOR LAKE, MN 55372 RE: TRACTION PASSENGER Elevator ID# ELV- 1010414 Site: Bill & Lori Peterson • 15291 Edgewater Cir NE PRIOR LAKE, MN 55372 Dear Sir/Madam: • Minnesota Statutes Chapter 326B provides that the Department of Labor and Industry, Construction Codes & Licensing Unit, Elevator Safety Section, inspect and approve elevators and manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from the Elevator Safety Section recently inspected your facility and determined it meets requirements of the Minnesota Elevator Safety Code. NOTE: Compliance with Minnesota Rules and the ANSI /ASME A17.1, Safety Code for Elevators and Escalators does not necessarily assure compliance with the Americans With Disabilities Act of 1990. Sincerely, CONSTRUCTION CODES & LICENSING if Paul An• ersen State Elevator Inspector c: City of Prior Lake Building Official ARROW LIFT ACCESSIBILITY ElFormCE2R This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer p1Z1.0 ' . E Builders De ost 400- scot. City of Prior Lake A $1,500.00 Builders Deposit is included in the Building Permit fee. The Builders Deposit is issued as security to insure compliance for a Final Occupancy Permit. (It is not an escrow account.) All exterior items including but not limited to grading, sodding, landscaping, tree planting, driveways, siding and painting shall be completed 180 days after the date the building: permit is issued. If the work is not complete within the 180 day time period, the City shall notify the applicant of the violation and the applicant shall have 10 days to comply or the $1,500.00 builders deposit will be forfeited and the applicant will be billed for clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. DATE: j / . 2. /' / 2_.. l 5 c- LL-- 12.463 SITE ADDRESS: 1 2 7� P A d,,l-�, C - % - V/ P ERMIT # REFUND TO BE MAILED TO: Mi c, 4 /; c 4 A; Ai„,„, Th �� �, w / 0 ell 0D1 L X 2 9/ Nd i , j ../ jn f yr2_ n00,6 6 4,1 / 6 1- 53-36 ? AUTHORIZATION TO RELEASE PLEASE REMEMBER , --- 41 soo. OC ,ynda S. All. Building Serv Amount Z,i , (3 Acct. 801.20204 1. KEEP STREETS CLEAN DURING CONSTRUCTION Date JJ 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED SIGNATURE: 4, `A, __ (A-1, ,z v :� � " «E` ", � j �t �� t� . ,r ��♦ * y 3 z fi �'^r -� n , '.` _ .. , -... F �' . 3 .`�F a : '. . +.. �.�Ff'fi S ' � y.. ..�# , a., '#.� ' aA "` �. e ' MICHLITSCH BUILDERS, INC. i tt 4770 QUINWOOD LN N ' 29265 pliWitligaPj4k PLYMOUTH, MN 55442 -2091 17- 1/910 PH 763-557-1694 oop I Im , 4 3258006327 -2:7-- Date Pay to the ( 2- 1 $ /7 06 �'--� Order o f � ' , � � � i B F I. an J / /'� !/ Doffar.S ' Back. ' WELLS Wells Fargo Bank N.A. / FARGO Minnesota _ wellsfar FOR .. 11100000 2 9 2 G511° 1:09 L0000 L91: 32580063270 AUTHORIZE TO RELEASE: s ' I" J \FORMS \BUILDERS DEPOSIT FORM.DOC 01 PRIG, ti tri Memo Date: Thursday, October 10, 2013 To: Janet Ringberg From: Lynda Allen Subject: Building Permit #12-0463 15291 Edgewater Circle N.E. The memo authorizes the return of the $1,250.00 tree escrow. The work has been completed and the tree replacement has been approved. Please return the deposit to: Michlitsch Builders, Inc. 8291 Norwood Lane Maple Grove, Minnesota 55369 Thank you. L a S. Allen Building Services Assistant Phone 952.447.9800 / Fax 952.447.4245 / www.cityofpriorlake.com CITY OF PRIOR LAKE , / /e-° se-e 14 Impervious Surface Calculations S 1^ {y d � P ' we~ (To be Submitted with Building Permit Application) For All Properties Located in the Shoreland District (SD). The Maximum Impervious Surface Coverage Permitted is 30 Percent. Property Address /.5 Fir w e ra /Yr Lot Area 4/0 57 sq. ft. x 30% = )2 2 _ 3 ***************************************** * * * * * * ** * * *** * * * * * * * * * * * * * * * * ** LENGTH WIDTH SQ. FEET HOUSE x = 2'7 ( r x = ATTACHED GARAGE x LZ = Z8' TOTAL PRINCIPAL STRUCTURE 3 24' DETACHED BUILDINGS x 2_3 I- (Garage /Shed) X TOTAL DETACHED BUILDINGS DRIVEWAY /PAVED AREAS x = (Driveway -paved or not) x = 4 Vi (Sidewal x = //5D t /la TOTAL PAVED AREAS 73 V PATIOS/PORCHES/DECKS 3% x = 3 / L (Open Decks 1/4" min. opening between // X = boards, with a pervious surface below, are not considered to be impervious) X = ire) b u'L 2.'0 t ,-4 10 c «J S D ZZ J TOTAL DECKS . OTHER PA4 k 4.° x = Z x = TOTAL OTHER SZ TOTAL IMPERVIOUS SURFACE / UNDE OVER i / Ce r- I /3/ I Prepared By te-- ( Date 3 / Company 1)� neer Ety.i A . v Phone # al-/vv PRIOR LAKE DUILDING AND INSPECTION INSPECTION RECORD ,. SITE ADDRESS 162q( L.5 0 (V. NATURE OF WORK ' F WC re Ex-1.'J . i_,1 -, USE OF BUILDING �0 ..6-- t � ' PERMIT NO. 17- r- 4 3 DATE ISSUED CONTRACTOR , 4_ i rc' PHONE 4.42 - (Y 6C. NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW �q� THE PERMIT I BY SEP O s CUM ENT/h__T- '- J ( (`� /`lam° �� � INSPECT D TE I FOOTING ..51 S7r � � � � 7 12 r � ' 1 FOUNDATION Prior to Backfill `� fv 006)`) G PLACE NO CONCRETE tnifi1 'ABOVE HAS BEEN SIGNED 1 - INS SEWER / WATER / SEPTIC %z tie r - .vim -b, 4 9 /rj FRAMING f„ ,Q fp ► l� INSULATION PP o/ki /-/ 'z/9liL- ELECTRICAL PLUMBING 1)[ lo1(g(rL R.I11. ` o � c 4 / 2 /(f i HEATING (if required(e k 4'/' s /777// FIREPLACE GAS LINE AIR TEST 1 7�� j Rt CO N WORK UNTIL ABOVE HAS BEEN SIGNED I,. 1 I FINALS GRADING (Prior to Sodding) ,/ BUN _DING FE gt A_ - 9 - 1 6/22._ ELECTRICAL PLUMBING Pt 4 '/,, 1 ) 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. FOR ALL INSPECTIONS (952) 447 -9850 1