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Expires .v ( ; This Certificate issued pursuant to the requirements of Section 110 of the ❑ Residential / III International 44 Building Code certifying that at the time of issuance this structure was in compliance with the various -,.. � 1 1 1 1 ♦ . .,\ ordinances of the City of Prior Lake regulating building construction or use For the following: , ' Y t . s ,N4.1 F4fl't_y �l ,,// Use Classification g. Permit No. Z_ Bld —,4* 0 e Occupancy Type r V T Construction A+ Zoning District "i �Sp � � -1. G 7, a 1, //1 i wiz_ LE v/ Legal Description �/ _ Owner of Building Site Address 3 2. C 9 4 �Jd �A. (1 / 4 \\ �y ! 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I Z 42 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) — 24 I t L r."■► C NCUR LEGAL DESCRIPTION (office use only) LOT BLOCK 1 ADDITION 1 - 4 - f k ✓ * 1 1 1 L�x�O PID A 3 S 00 `l 0 (Name) -Q k k" \Nty - v' 'S (Phone) (02`1 -abci a, ( Address) C0 k00 Corgko c, c � . r (lye BUILDER , /' ` 1� ` (Company Name) C-414--4- j O t C5�.7✓ )cYU , (Phone) c c - 6 - 4 (Contact Name) d D 3.k '. s)-- - � (Phone) 6`Z -- �PI . (Address) \4QC- 't 1 , v \ ? 7 \J t{'i oz. TYPE OF WORK New Construction ['Deck ❑Porch ❑Re- Roofing ['Re-Siding ['Lower Level Finish ❑ Fireplace ['Addition EAlteration ❑Utility Connection CODE: 1I.R.C. ❑I.B.C. ❑ Misc. me, Type of Qonstruction: I II III IV V ps Occupancy Group: A B E H I M S U PROJECT COST /VALUE $ 3 00 1 (700 (excluding land) Division: 1 2 3 4 t I hereby ce fy that 1 have furnished in m ion on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the above -• entio • ed pro. •r sat . c struction VII conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building offic ,1 can •yoke this per - for , st • use Furth/ore, I h by agree that the city official or a designee may enter upon the property to perform needed inspections. X AO — — / li 3D 00a(V5 / /a-,i o, Signatur: Contractor's License No. ate Permit Valuation ' 7CC•04,C)` Park Support Fee # $ Permit Fee $ . 3 • SAC # $ 2V , Plan Check Fee $ ( , y , _ - - rt , Water Meter Size 5/8" �'I - $ 5e/c. r State Surcharge $ (CO-,- Pressure Reduces---- $ " Penalty $ wer /Water Connection Fee # $ (S— Plumbing Permit Fee $ ( c f 1-y Water Tower Fee # $ ` „ Mechanical Permit Fee $ (5:+c) Builder's Deposit $ l . c Sewer & Water Permit Fee $ c - - �.�o Other y e 6 " $ 50€2, Gas Fireplace Permit Fee $ ' - T OTAL DUE $//, 46 3 �f e � a F/ �' . 2i. 1 L �✓ v This A icati. o e i Your Building Permit en A roved Paid l / , 4 (j�j, Recei t N(7. 6 y`/ if/ 41 • Date Z2/)/ 2— By ; i .- �J Building Official D. e This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy rYst be issued. S 7 G s-e / / ' &re A, r eu) e.,/ / 0 '- Planni -i_ Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 C1 11R1°, y M Whi - Building Canary - Engineering �''NVESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 71 '1g / ZL. , 1 APPLICATION RECEIVED 7. z 7 , / 2--' The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: _$ C i / l N -Obi\- ie- . Accepted ) Accepted With Corrections Denied Reviewed By: Date: F Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading Plan, 2) Erosion Control Standards "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 • Surface storm water c'rainage flowing to the perimeter of this lot to and from adjoining properties must be conveyed to the roadway and /or to the rear of 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. • The builder is responsible for maintaining the erosion control measures until the turf is established. The rock construction entrance must be installed at the time of !ibackf.illing of the foundation. • • 6: \Admin \dept info \ADDITIONAL COMMENTS FOR BUILIDIIN1G PERMIT APPLICATIONS.doc PRIp O PR/Q6 U e n7 White - Building .. �� Canary - Engineering NnESO Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 'CAM &)tJf TIZ APPLICATION RECEIVED 7. 2-7 / 2-- The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 32 o q Li/.40& ei r6 Accepted ' Accepted With Corrections Denied Reviewed By: NJ ,,`., Date: 4 /Z Comments: A /, (Le m/ i1 ,r St.", / � .vy r.J C-r c. ,■J 5r45 4 r - ce , - T ( Gs / .:L N L_. &. 0 _ _ _ — - (1 0A/ &ferl 4) V 7tr/f1PC-re A "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." 3 P RIp� ti � C.3 tr1 White - Building �P Canary - Engineering NNESO 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: 4 ,_____ Accepted Accepted With Corrections Denied Reviewed By: Date: e_0 -/2 ________,7, Comments: l r"ee Y3 ®czern. Ye _ .s 75 .„1-- liw- aw+� �tree5 "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." Aug. 1 ]. 2012 2: 41 PM No. 4351 P. 2/2 DID Date Recd -`F Jrer6 o` �� CITY OF PRIOR LAS 1 ` mi l SEWER AND WATER PERMJT �rfh� {F F. ri��n filr r. r snm. .• ;t ! PERMIT NO. F-� ,. c,.H • »P Fice,, I • Please 1 a or priftt and sib, t at bGir7'n) "" �7 rra Xi7 1 �' + ADDRESS Z ON1NO (OFilce UsC) 1 ®9 d Cr 2 L.► _ - LT GAL DESCRIPTION (ufficC us.: only) LOTS BLOCK 1 ADDITION t4 OOJ 0 i 1 1&c _ FID ._. ...� OWNER piano �p 1� {.� '� .- 1��1 {Tame) I n 1E'1 c t�1 - )1Y1. aLS ttS10 (Address) ? -'h•! i S-r _ .'s-'. I.A.1.. 5 S l01 (Addrsss) (Cry) _ - (Z,p ) _ APPLICANT (Name) STOCKER EXCAVATING CO AflY, INC. — (phone) _ 952/890 - {Address) 12336 Bootie Avetw.e Savage, 5 (Address) (Ci y) (zip code) Curt same (Contact Person) (Phone) APPLICANT SIGNATURE L, , . DATE 2)11 APPLICANT PLEASE COMPLETE BELOW Sine of water service inches- . Location of any couplings from structure feet_ Type of sewer pipe. El ABC ❑ PVC f f Cast Iron Estimated length of sewer line feet. Clean out (if required) located at • feet from structure. FEE SCHEDULE }i<e5identia1 sewer and water line connection $35.50 Industrial, Con't &= Multi - family 1% of job cosi with a 539.50 minimum Sewer connection only S17.50 Waterconncction only $17.50 Estimated Cost $ Building Permit # SEWER AND WATER PERMIT FEE $ STATE SURCFIARGE -50 PAID WITH ToTAI,'ER�'IIT FEE BUILDING PERMIT (Office Use Only) This Apptieation Becomes Your Pltilding Permit When Approved Paid Receipt No. Date By — Building Official date r 24 hour notice for set inspections (952) 447 -9850, fax (952) 447 v Ar o CITY OF PRIOR LAKE Date Rec'd 0,.,1"-- '.�' ,,,P HEATING /AYR CONDITIONING /FIREPLACE PERMIT Y ti l�YiV kSV i. r;cic rJ� y ' y z: rhv::, City PE12 t'11T NO. 3. Y A? ?Awnt (P1eaye type 01 ______ and situ at bottom ADDRESS _ _ ,... ZONING (u:iica %1x) _ag 0 ° (..C1 ekt. Ci.,rc__JbL._ . , LEGAL DESCRIPTION (eff:c use only) _ t• • • LOT BLOCK ADDITION P; D OWiV'ER i . (N'aate.) ` 1 r . f . } , Y 0- (Phone) 6 !• S .T_ l "X) — a p j q __. (Address) , ") •0 Os C E . acne. . (sx.Le, — J t) 5537D-- _ APPLICANVI f [ 1-(C: j / _.., (Name) (_72 10 (.-{ �O t - 1 Hbrik-.....(Phone) -! 5 . t -7 l r7 _ . Address : D w--.0( ( -.•—' (Add �) (C4 (Z_p Cocc) (Contact Person) Vl I dc& (Phone) - ` ` r- — 7f:, — APPLICANT SIGNATURE _ 5----.7 DATE /Pi i l 2._ • LIC ANT PLEASE COMPLETE BELOW NEW CONSTRJCTIO \ REPLACI ME.NT ❑ ALTLIZ4l .ONS FURNACE 114I A A D M OD E L -..w �_ 1 UE ?L _ -- FLUE SIZE __. -�.- ��_ RETURN OPENINGS _ w _ _ INPUT — OUTPUT TYPE OF SYSTEM IIEATLN G OR POWER PLANT !'LEASE NO'J E: Air Conditioner ❑VJarnt Air Plants ❑' Steam Units and Fireplaces Cannot Encroach S;Travily ❑ not Water irate Required y3itin Yard Setbacks. Mechanical ❑ Radiation f ireplaces wit: {t Box Additions or ['Air Conditioning ❑ Special Devices _ [vent. System ❑ pater Devices _ . Cantilevers toi:ihe Outside ot•Buildings i r . - Require a 13ui]yling Permit. FIREPLACE MAKE AND MODEL C , 1 tC. - . r - ,t FEE SC1 EIF .- ........_. Ird Conuuerc::al & Multi - Family I% of jch cost • ••'------- '' RnsidLntial, Gas Firepla �.--? $49,50 & 549.50 minimum Residential, heating & A(C (New Construction) 5149.50 Residential, Additions & Alteratiocs x 49.50 Resic',sntial, Heating Only (New Construction) S64.50 Residential, AC Only .'49.50 Tie Minties0t:a Sta:ul:eS § 32613.148 �ost $ Building Permit # 1 < • 'SURCHARGE" has been extended t - i ..t : i? j iik: ` 3 ' ._ , , HEATING PERMIT FEE $ 1- ±q • ,5 0 The minimum surcharge for a STATE SURCHARGE $ �j� - J _ 0 !cye, 'fixed Fee" permit is 1 : :.0(1 rOTAL PERMIT EEL E l'(/■(\9L i This Application Becomes Your Building Permit When Approved Paid (.Y °ceipt No, i' " } au ildut` Official Date ( Date 3Y 24 hour notice for all inspections (952) 447 - 9550, Cax (952) 447 -4245 > 4.646 Dakuta Street S.E., Prior l< ake, Minntasoca $5372 c avO/TO 30Vd HDIH /:H1'IV3H CNIY1019 9809Z61'7,96 CT:80 ZTOZ /8Z /TT ^ ' ' ' � OCT-25-2012 15:54 Fr on :D8D MECHaNIC,L 95EE75EE:098 Tc:9524474245 Fase:1 /0,0 O . !RIO Date Eec'd �= : CITY OF PRIOR LAKE PLUMBING PERMIT _ ) kilYNE.S61-1! t. 1(11 Fc { PERMIT NO 3 . Yell ow 4 Car — 4...?U ]. Yellow • w (Please type or print and sign at bottom) 1JJU SS ( ZONING (otrit:e MO 2) L I Q ( C t C LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER { (Name) _ 1 i (\(( .. 1 ' - -1E-pro-1 1 � ... 6 ; r't e (Phone) (Address) 51 Dd Co en ,mss - .& - PI A.I x e T � ��t r: �,.J •, Co .. - ;Phone) _ . _ _ __ - !U ( 5j ,07 ii.ddress) � � 0 �j t'~ h Y �- �,�} ��C�f r t J� (Address) �- (City) (zip Code) (Contact Person) ..b P 4 i S - f-A e-f 7 K. J\ (Phone) b ( — 3 x 2q - APPLICANT SIGNATURE - - - 4 2! 1- :IRATE 1) / I f APPLICANT PLEASE COMPLETE B.f :LOW quantity Ta.pe of Fixture 1 Quantity Type of Fixture `• Bath Tub with or without shower '; 0 Rough -ins Dishwasher / Water Heater Floor Drain Water Softener Lavat (kZat broom Sink) L. stand .P. , ash Ma chine) _ Laundry Tray (1 or ? compartment sink e) Sewage Ejector ,, Shower Stall Baclflow Assemb / , Sinks C. Backflow Assembly Test Bar Sink i Lawn Sprinkler Lr Water Closet (Toilet) a Other FEE SCHEDULE Industrsal, Commercial & Multi - family loo of job cost with a $49.50 tttiaitnuot Residential, New One & Two- Fan:ily $149.50 Residential Additions& Alterations $49.50 The Minnesota Statutes p 326B.1-48 " tst $ Building Permit € "SLIRCHARGE" has been charged for one year effective PLUMBING PERMIT FEE S _A] July t, 2010. until ,iune 30, 2011. STATE SURCHARGE S .5g 0 /5 L. f.S • The minimum surcharge fora "fixed fee" prrmit TOTAL PERMIT FEE S Is S5, hcginning July 1, 2910 This Application Becomes Your Building Permit When Approved J id Re t ct No. ` r Bui1diDt Official Date 1 - • y i ,■ 24 hngr ttjtite for *11 iespecttoos (952) 447 -9850, fax (952) 447 -4245 'PM 9 n` 4646 Dakota Street S.E., Prior Lake, Mlttttetota 55372 • Builders Deposit S zA 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 notifyy 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. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. DATE: 1 !1..1 l l2 SITE ADDRESS: k - I Cx rc) . PERMIT # 11. 0467 REFUND TO BE MAILED TO: - P\InyAC-A%- 1 1 � ✓ Cv 100 CCain cA oto y toy L.0 e cDc AU J TH OR IZATION TO RELEASE PLEASE REMEMBER ': 4 49 i 5'0 0.6 0 _ynda S. en, Building Services Amount 1. KEEP STREETS CLEAN DURING CONSTRUCTION ( 1(. (7 Acct.801.20204 Date 2. KEEP EROSION CONTROL IN PLACE 3. TEMPORARY OCCUPANCY PERMIT MUST NOT EXPIRE OR $500.00 WILL BE FORFEITED SIGNATURE: \ e�J PRIOR LAKE STATE BANK 321 3 �/ PRIOR LAKE, MN 55372 Ho ne Key Realty Inc 75- 905/919 ener Account 17021 Fish Point Rd SE Prior Lake, MN 55372 ORDER OF � v kc) r L $ 1 -t \'21Z1ua" 1 q V7 V Avv; nZr:zi 2 DOLLARS MEMO . 1 LA :71 U THORIZED SI N ATURE Ii 003 213" 1 :09 L90 9055'..: L111.051I ?ffi„ 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 sua ise ggpi t ern« Al. Building Owner's Name Rod Just Pol cyptt 'iier xr 4 A2. Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. C000101 'IC ir bet` ' 53211 Linden Circle _,r it A , ° City Prior Lake State MN ZIP Code 55372 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 7, Block 1 HAR WIL LEW 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. 44.723213 Long. - 93.433989 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 if a) Square footage of attached garage 740 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: ei NGVD 1929 El 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 will be required when construction of the building is complete. C2. Elevations - Zones A1-A30, AE, AN, 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) 912.9 ® feet ❑ meters (Puerto Rico only) b) Top of the next higher floor 923.4 E 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) 921.1 ® 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) 912.2 ® feet ❑ meters (Puerto Rico only) g) Highest adjacent (finished) grade next to building (HAG) 920.8 ❑ 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 information. / certify that the information on this Certificate represents my best efforts to interpret the data available./ _ --- understandlhaf rn false=statement maybe punishable by under_Mt7 adevSection -�' ec ere i commen s are prow.e. on .ac o orm. ' ere - 5 - 1 .e a o . i r.e n e ion provne..y a ,: 1 - _ -- licensed land surveyor? ® Yes ❑ No �/ AC u Certifier's Name Peter J. Hawkinson License Number 42299 HR H t E 'iD Title Sr. Surveyor Company Name Pioneer Engineering P.A. ;= 9bR a Address 2422 Enterprise Drive City Mendota Heights State MN ZIP Code 55120 <J�� -- 1:-/ r,? _.�!"- . _ Signature d / `_ Date 5 -30 -13 Telephone (651) 681 -1914 ®� 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. For Insurance Company Use Building Street Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. Policy Number 53211 Linden Circle 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 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. lithe Certificate is intended to support a LOMA or LOMR -F request, complete Sections A, B, and C. For Items El -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 ❑ 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 C Name Telephone Signature Date Comments, ❑ Check here if attachments FEMA Form 81 -31, Mar 09 Replaces all previous editions Building Photographs Continuation Page For Insurance Company Use: Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number 53211 Linden Circle City Prior Lake State MN ZIP Code 55372 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." — i - . qtr y N 1 atiAr aKT-r '` }4 't,""`�„•. _ c .fir 1 ' ft: •ass {�L0t�tpprr t � 9 rp `u:; II���7711AA as ,. I , C14i ©i.r L7o' Wo ti�lLiFl Eigi L7 �` ` ,✓ ;3� ' r �° _ � 1 77 l ';`, - • f : 6 - g i -� � ; �'_•' - . -� ,. . _ .:. _ _, _ _ �_ . . .__ .. _ _,. 1�IiY /Vlf..laJ1�aY�rIY�tlYA-. _. Y. _ _ _ _ .- m � _ � �; ` , • _._ .. ' _.. _:_ �. 0 4 " ti trf Memo AfiN socA Date: Monday, October 21, 2013 To: Janet Ringberg From: Lynda Allen Subject: Building Permit 12 -0846 3209 Linden Circle The memo authorizes the return of the $500.00 tree replacement deposit. The work has been completed and approved by our Planning Department. Please return the deposit to: Pinnacle Family Homes 5100 Condon Street S.E. Prior Lake, Minnesota 55372 Thank you. 4/Allen Building Services Assistant Phone 952447.9800 / Fax 952.447.4245 / www.cityofpriorlake.com PRIOR LA K E DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 2 I rs_c„ T— NATURE OF WORK F f ' C_e * F',v -L _ Aoi) c. ca._ .,t USE OF BUILDING irr t PERMIT NO. (2 f) 46 DATE ISSUED �4 �z_ CONTRACTOR c-A r — PHONE6(z- i—&6 / Z_ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW TH ERMIT IS BY SEPARATE DOCU NTL1 4Ct� � S ( l /� IN PE OR 1 6-' DATE I FOOTING e\AC4 b5)271)-1) 1 I FOUNDATION (Prior to Backfill) ee rflorcV0 L1- Imo_ R. Viz I PLACE NO ONCRETE UNTIL ABOVE HAS BEEN SIGNED i '�., ROUGH - INS SEWER / WATER / SEPTIC 44, '1/4 /t- FRAMING J ,Z1� INSULATION �� /� � ELECTRICAL PLUMBING Pe Kok, HEATING (if required) '` Te FIREPLACE 4 GAS LINE AIR TEST vOciu, . Q /g,/ 7 t COVER NO WOR ABOVE HAS BEEN SIGNED I r-41P Pi? FINA S /It GRADING (Prior to Sodding) t �� ; BUILDING E t'1A I is S/, /r; el3 ia` l f c7 ELECTRICAL PLUMBING ASS Sic HEATING b 6 -i74 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