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Home My WebLink AboutBuilding Permit 04-1067 O~ PIl/O", ... ~ '"" 7 - ~ t) '" .'J\rNES01.'" CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec'd /0. 1'1. o"'!- I. White 2. Pink 3 Yellow File City Appliclnt I PERMIT NO. ()if- ..If) (,7 I (Please tt.Pe or Print and sim at bottom) ADDRESS /4'/7:3 U/l1M'~ /1VC' IJ f::i ZONING (ollice use) c./ LEGAL DESCRIPTION (olliee use only) LOT 5BLOCK Z. ADDITION :J7:'r1v/ e J (.r-r PID 'Z-J t 14-. 01 (l ..0 OWNER (Name) PDt) c"S T7)Jet:::; "') (Phone) (Address) BUILDER (Company NameLL.t,!,;~ E' -'::>'./....I,p n-"" (Contact Name) 1:::;d2... !it ('.J,,::h- J) (Address) (Phone) ~3.' t./7/?-9S77ii1-.. (Phone) ?t:>3- "'1?Q - .;:;t~- 117"" TYPE OF WORK 0 New Construction ODeek OPoreh ORe.Roofing ORe.Siding OLower Level Finish 0 Fireplace DAddition DAlteration DUtility Connection 0 Misc. CODE: Dr.R.C. Dr.B.C. Type of Construction: Occupancy Group: A B Division: r E II F I ill IV V A H r M R 2 3 4 5 B S U PROJECT COST IV ALUE $ (excluding tand) .s application which is to the best of my knowledge true and correct I also certify that I am the owner or authorized agent fOf the that all const on. 1 conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building Furth ore, I he~by agre~t the city official or a designee may enter upon the property to perform needed Inspections. / J{.e;:;r /0 -1'7-(1~ Signature Contractor's License No. Date / x I Permit Valuation /9/. fV I Park Support Fee # $ I Permit Fee $ /~.ff I SAC # $ I Plan Check Fee $ .~.c/V I Water Meter SizeS/8"; 1"; $ I State Surcharge $ I Pressure Reducer $ I Penalty $ I Sewer/Water Connection Fee # $ I Plumbing Permit Fee $ ! Water Tower Fee # $ I Mechanical Permit Fee $ I Builder's Deposit $ I Sewer & Water Permit Fee I $ I Other $ \ Gas Fireplace Permit Fee I $ I TOTAL DUE $ :/20,9Y f2-0,'1./ .1 This Application Becomes Your Building Permit When Approved Paid ReceiP~. "'7 Yl (J Date /0 ./ '.11 ~ Bv . Building Otlicial Date f 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 Planning Director Date SpeciaJ Conditions, if any 24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245 t6200 Eagle Creek Avenue Prior Lake, MN 55372 ~ PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS I ~ 73 toHM~ /11/6 TYPE OF WORK m-A/IC- /U:i?'?()Vff L- USE OF BUILDING fb PERMIT NO. 04-. fa (,7 DATE ISSUED /0.1'1- d1- BUILDER I&!f;rrT ( P ~. PHONE # 7(,7. f-"'1/. Y r 7;).- NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ..,...,.,~.....JI DA1'E ('.... .. ,'!( ~ (J'e7J;frJLGI I RZd I /o/..Z7/cj" I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ,-- I I J 'FINAL I FOR ALL INSPECTIONS (952) 447-9850 ~ ~i"" Minnesota Pollution Control Agency November 3,2004 Mr. Jerry Archer PDQ Food Store P.O. Box 620997 Middleton, WI 53562 RE: St Release e: PDQ Store 216, ID#: Lh vestigation and Corrective Action 173 Commerce Avenue NE, Prior Lake, 55372, Scott 903 Dear Mr. Archer: Notice of Release The Minnesota Pollution Control Agency (MPCA) has been informed that a release has occurred or contamination has been encOlmtered from storage tariks and/or storage tank facilities that you own and/or operate. The MPCA appreciates your timely notification so this site can be handled in an efficient manner. Legal Obligations Federal and state laws require that persons legally responsible for storage tank releases notify the MPCA of the release and/or discovery of contamination, investigate and, if necessary, clean up the release(s)/contamination. A person is considered legally responsible for a petroleum tank release if the person owned or operated the tank either during or after the release, unless specifically exempted under the law. For releases of other substances, a person is considered legally responsible if the substance discharged was under the control of the person at the time of the discharge or release or if the person was an owner or operator of the storage tanks and/or tank facility at the time the release occurred. If you believe that you are not legally responsible for this storage tank facility release, please contact the project manager listed below. Request to Take Corrective Action The MPCA requests that you take steps to investigate and, if necessary, clean up the release(s)/contamination in accordance with the enclosed MPCA fact sheets. The site investigation must fully define the extent and magnitude of the soil and/or ground water contamination caused by the release(s)/contamination. For petroleum release sites, the MPCA has facts sheets that will help you or your consultant properly investigate the release and report the results to the MPCA. Unless your site is considered "high priority" (see below), you must submit a report to this office which details the results of the investigation or concludes that excavation was sufficient to clean up the release within 10 months of the date of this letter. The MPCA reserves the right to reject proposed corrective actions if the requirements of the site investigation have not been fulfilled. Refer to the following web site for related guidance documents and information, http://www.pca.state.rnn.us/programs/lustJl.html. For sites contaminated by pollutants other than petroleum, the MPCA requests that you or your consultant contact the MPCA project manager listed to discuss the investigation and reporting timeline that will be required for your site. The MPCA considers sites with "free product" (free-floating petroleum), that have affected or that threaten to affect drinking water supplies, sites where pollutants are being released to surface waters such as lakes or wetlands, sites where petroleum or other vapors have been detected within structures or that pose fire or explosion hazards, to be high priority for staff review. If one or more of these situations apply to your petroleum or non- petroleum facility, a Remedial Investigation/Corrective Action Design report (refer to guidance documents) must be submitted within 90 days. The MPCA reserves the right to reject proposed corrective actions if the requirements of the site investigation have not been fulfilled. In addition, if you know or discover that there is free product in a well, excavation, or borehole, you must notifY the MPCA within 24 hours and IMMEDIA TEL Y begin interim free product recovery (refer to guidance documents). If you have any question with regard to whether your site is "high priority" please contact the MPCA project manager listed below. 520 Lafayette Rd. N.; Saint Paul, MN 55155-4194; (651) 296-6300 (Voice); (651) 282-5332 (TTY); www.pca.state.mn.us SI. Paul' Brainerd' Detroit Lakes. Duluth' Mankato . Marshall. Rochester' Willmar Equal Opportunity Employer. Printed on recycled paper contaIning at least 20 percent fibers from paper recycled by consumers. .' c PDQ #216 14173 Commerce Ave NE Prior Lake, Scott MilU1esota 55372-9802 October 11, 2004 Proposal #041015-SM RE: Tank & Piping Removal, Scope of Work - The site was closed on 9-29-04, On 9-30-04 Wayne Transport removed the remaining product from the three tanks down to approximately I". The site has (3) 12,000 gallon coated steel single wall tanks with single wall galvanized lines running to (2) dispensers under (I) 24'xSO' canopy which will all be removed as well. The site has had electronic tank monitoring and electronic line leak detection that was in operation until the last day that there was product in the taDks. - The tanks will then be inened with C02 and prepared for disposal at Determan tank. - The product and vent lines will be excavated and disposed of as well - Soil samples will be taken for closure on the tanks and lines by Terracon . Environmental. - After the tanks and lines are removed the soil samples have been taken the excavation will be filled back in with stone and finished with 6" road gravel and 3" of asphalt. - Work is expected to begin on or about 1(}-25-04. ZOO~ 99LC 6tZ 909 XV& OS:60 tO/Zl/01 rT'\ .,., ~ '" -r -' -~ p c:.. .~ ~.;. ""'b c: ~ " - 1- r- ~. \'t ., ;) w ~ V\ /b 1\ ~ Q. I;: ~ ;:-" '::I t'\ o t ." Cuu~ '" l J ? ~ c' ~ ~ r t\ . :)NI . oj .LN3lidli1O::! 110 ~ w-d ~ If , \\:- ~ {') G G=- O- ~ +- '" ~: ~ ~ I " (\ l' ~ tt f'a o o o t , ~ -l ("" ... ~ ~ ~ ~ ~ ~ C Co l' c;. I I I \ ~ _1' - c '^ I I I -, ,. 99LC 6t~ 909 XVd OS:60 tO/~r/OT V\l '. "J. il:I l\ t ~ .fI " ..\ " . -po VI ~eport Title: Tank Site and Owner Information Report Numbgr: 43 PDQ #216 Sile 10: 4437 Tightness Test: N Manual Gauging: Auto Gauging: Y Soil Vapor Monitor: N Groundwater Monitor: N Interstit Monitor: N SIR Approve Date: SIR Vendor Nbr: 0 Other Dese: Other Flag: N Service Station/Bulk Type of Site; Underground Only Annual Tightness Test: N Vapor Monitoring: N Groundwater Monnor. N Intersnt Moniter: N 3 Vear Tightness Test N European Suction: N SI R Approve Date: SIR Vendor Nbr: 0 ...**....*".'..w4..**_.********.**** CORRESPONDENCE ....***********.....******..***....... Number: 1 Company: Type: Registration Form Dale: 01/01/1901 Person At Co: PCS: r he following comment was entered on: 05130/86 # 15- DETECTION FOR LEAKS IN LINE, SECTiON C. LEGAL DESC- LOT 5. BLOCK 2 JAMES FIRST ADDITION Number: 2 Company: PDQ #216 Type: Registration Form Date: 01/12/1993 Person At Co: CONNIE SALMON PCS; Signature: CONNIE S SALMON Tille : PETROLEUM ASST Date Form Received: 12/9/92 (CORRECTION OF OUR DATA ON TANK MATERIAL CHANGE PRODUCT SEE FORM TANKS 001-002-003 LAST TESTED FOR LINE TIGHTNESS WAS ON 4/14/92) Number: 3 Company: PDQ #216 Type: Registration Form Date: , 1125/1997 Person AI Co: DAVID G. SAVIC PCS: Signature: DAVID G. SAVICH nle : PRESIDENT Date Form Received: 10/14/97 CHANGE OF STATUS FOR TANKS 001-002-003 RECONDITIONED WITH IMPRESSED CURRENT ON TANKS AND PIPES AND ADDED OVERSPILL-ML pago 3 01 J I'uv reJ ':iNI ~O:i ~N3WdInD'31IO'-' 99LC 6t~ 909 XVd OS:60 tOn1l0i DATE nile CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED /$~/ /fte. ADDRESS /Y/7S c;..,~er(!e OWNER CONTR. PHONE NO. PERMIT NO. ~-/t)67 o FOOTING o FOUNDATION o FRAMING ~LATION ~~~L o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXlGRADlFILLING o COMPLAINT o FIREPLACE Rl o FIREPLACE FINAL o GAS LINE AIR TST o ~OM':;::.dkcu~ ~/~ U:~1'~.7 c?r~C"H) k ../,~ ,J.g._e]~-/ 4 h'J.JC; ~C d&-=rr~ dr t'~ArA-;-r;k~;"'" A..u k;.. 'r / ~....~ *-;,...d ..{l,~ .<. {. /Q..- ..j,,,,~s _.1/ 4r c (' ";riU.J> .lid ~ '* "-s . ./ I'l " ~ ,#?'"tUC.# ""./ / :#/,1,--, ,Ak Cb-rrt!':c-"'su-L .,..c.-hd- t --- ----- / ., ~ ( ~use '-- --- ------------,~ _..// -) hl/tc. .,/ ~. o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING Inspector: ~ Owner/Contr: ,.- CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY! INSNOT1 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIllE /~~~ ADDRESS /# 7.3 c;p,~1!/'<:.e #~ OWNER PHONE NO. [] FOOTING [] FOUNDATION [] FRAMING [] INSULATION ..a-FINAL [] SITE INSPECTION CONTR. PERMIT NO. c!'~ /t:::167 [] PLUMBING RI [] MECH RI [] WATER HOOKUP [] SEWER HOOKUP [] PLUMBING FINAL [] MECH FINAL [] EXlGRADlFILUNG [] COMPLAINT [] FIREPLACE RI [] FIREPLACE FINAL [] GASLlNE AIR TST [] COMMENTS: ~ r ~ /'4''''- /c.... .L4<5"r ~ee,;-, d~#(././ ..2 ff"~ ~dve /~tIIV'~d (3.7 rtVf<l'e 0e>''/ s;.~#;G ~s-~/t!:S{//&: ~,.. '" /errlfU>- ~ .c;;v/"e>/1__e~~9r . C/d>se ~~..s r A.,..r ..ft, k qff;r S~,"/ ~r!:eh r'r!:~u Vt" J [] WORK SATISFACTORY, PROCEED [] CORRECT ACTION AND PROCEED ~ CORRECT WO~~, ;~FOR REINSPECTION BEFORE COVERING Inspector: #"'7r Owner/Contr: CALL "7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANC~ CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ INfNOn CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /Y/73 OWNER PHONE NO. [J FOOTING [J FOUNDATION [J FRAMING [J INSULATION ".a-FIffAL [J SITE INSPECTION COMMENTS: _ / /~'T ,.t. /4/J / h-e ~"^ OJ ,r;; // /J ~v DATE TillE SCHEDULED ,1~~ a.,....., e yc ~ A.- ~ CONTR. PERMIT NO. 00/-,106'7 [J PLUMBING RI [J MECH RI [J WATER HOOKUP [J SEWER HOOKUP [J PLUMBING FINAL [J MECH FINAL [J EXlGRADlFIUING [J COMPLAINT [J FIREPLACE RI [J FIREPLACE FINAL [J GASLlNE AIR TST [J ~Af'OVq/ , ..~ fr"V~S ~.s r~~~ Ih ~ / , / ~ /k., ..:z .r;.,.-/~ t11~C/ld~ 0~,'/ ~~J1~ ;4~,Lrt'sv/ls rrro~ Y;,..,r.,CO""- &V;.,~.H;WJ!'.,,4 / /l~/ ~:-_.~,I A~ . .~-~ ,:....."~ 'r" .A, _ .6.-. [ ....j~ /' ...a;:;-' [J WORK SATISFACTORY, PROCEED [J CORRECT ACTION AND PROCEED ~ORRECT WORK, ~LL~ORYSPECTION BEFORE COVERING Inspector: ~~ Owner/Contr: CALL "7.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE, CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI INtlftm