HomeMy WebLinkAboutBuilding Permit 04-0080
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec" d
l-/~--(J4 \.
(Please tvDe or'Drint and sien at bottom)
ADDRESS 5Z 7 b '
)l!.' - T..?"~l'lto. -:t=..os \- "?O\~~
1. White File I PERMIT NO 04- I
2 P;,k e;<y '. OOaO .
3. Yellow Applicant .. V
.
L, ~~\.....
ZONING (office use)
el50
LEGAL DESCRIPTION (office use only)
;P/lIJ!,~t.- A-
LOT BLOCK ADDITION
PIDZS. ()(.O. o()lt{--./
OWNER .
(Name) S v-........
(Address)
5'2-"\0
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\=v-o~\ \'o',-\-
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L-.- . ~ \...
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(Phone)
L..-L
'---
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BUILDER\--...\ ~L
(Name) \ ....JIA-
(Contact Name) '\So\.. 'i-,:"~l
(Address) \ '\ S,,\S _V. 1 \~ '" <..."\.o
\.........\........:....\........ M..... c;c;o~-t
-
(Phone)
(Phone)
~ S-z.. *'>S
l"\ .. 'l)
, TYPE OF WORK
~New ConstIUction
~ower Level Finish
o Misc.
\.{l.c..
Ce,9. ,
)i!1Deck DPorch ORe. Roofing ORe-Siding
1!6 Fireplace DAdditinn DArteration DUtility Connection
PROJECfCOST/YALUE (exc1udingland) $ Z-'2-<1, "\"'0 -
t I have furnished information on this application which is to the best of my knowledge b11e and correct. I also certify that I am the owner or
or the above.mentioned ....y...nJ' and that all construction will conform to all existing state and local laws and will proceed in accordance with
~~~ aw~,.. .,' . ;~;e: ',,:. . -, .LYltis permit for just 7~e;j.7ermore, I hereby agree that the j: ~;:: "yrkSignee may
Contractor's License No.
Date
I PernritValuation <tf2.30/ooo,od 1 Park Support Fee # $ P>SO.OO 1
1 Permit Fee $ I ~33. >01 I SAC # $ I ~'5o.DO I
-=->
1 Plan Check Fee $ I , 'l', 78 1 Water Meter (SiZe sy; I"; $ 2-'50.00 1
State Surcharge $ I \5, DO I Pressure Reducer $ tf~,DO I
Penalty I $ I City SAC and WAC # $ I z...oo. 001
I Plumbing Permit Fee $ 100.00 I Water Tower Fee # $ ?oo,OO I
I Mechanical Permit Fee $ too. 00 I Builder's Deposit $ IS QO, DO 1
\ Sewer & Water Permit Fee $ 35.50 1 Other~ ~~ $ ~O.DD I
I Gas Fireplace Permit Fee $ t-jO.OO 1 TOTAL DUE Ml1AR1) Z"/B.o4- $ q PJIO. '7~ I
, 0"
This Application Becomes Your Building Permit When Approved I Paid 0j'l? I~ .-;~ /1 ReceiotNo, 1!{i-i;)
~ :kJJ~ d/I%/oi I Date ;) -1'6- By
R (/'
Building Official Date fYV) Q)Mbt\o-JT ~ f-\-E61S'
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
:ue:ds~n~byme~';;~comOWl~ate--UYc~cat;~n~C~~lian:pdallff~1LLk-.'-~t~;~be
~ ~lanning Date ' p-n ~,ifany nf'i JlJ..LoClJ) (l
24 hour notice for all inspections (952) 447.9850. fax (952) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R.1 or R-2 Districts
Reviewed by: c....tQ.V--
Building Permit #
Address:
l>~A
)
Legal: L ,B
Existing Structure? YES ~
PID:
Date: I.&o-O<-!-
Zoning:
~t2. c.<i b J ~uo. c9Cl
Subdivision:
R-I~j)
Existing Nonconforming Structure? YES I~
"..---.-
~
CONFORMS TO ZONING
ORDINANCE
, Yard se~backs: NA aMPUES
I. Front Yard (can &e 20')Yavq, w/in 150')
I. Side Yards
I.
I .
I.
I.
Sidewall exceeding 50' requires additional side 2'
setback for every l' over 50' lonq
Rear Yard
Patio Door. make certain that a future deck meets
minimum required setback
From 100 year flood elevation of wetland/NURP
eond
. From OHW (Prior or Spring Lake)
, Floor Area Ratit 9A1LS I COMPLIES
Yard Encroachments: NA I FAILS ICOMPLIES
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line (Easements),
I AlC and other equipment cannot encroach on interior
side yards,
, Tree Preservation: NA I FAILS J COMPLIES
I . Total calioer inches
I. Can remove 25% of total
I. CaliPer Inches Removed
I. Calioer Inches Preserved
I. Replacement
L:\TEMPLA TEIBLDGLIST,DOC
YES
Standard
25'
10'1
25' if abutting a street
10' setback + '2::>'
2'11' over 50' ID,
25'
10' sidel
25' rear
30'
75' or setback average of
adjacent struct~~ut no
less thae'
.30 Maximum
Standard
Standard
lf4-
\w
%:1 /dfJ
Proposed
?J7,+ '
iul
( (01 )
f\.IvC
I\.\CL.
1\.\ CL.
5'J1
Proposed
v'
Proposed
15ft;:;
K
~
~,
, Driveway: NA 1 F AILS,(COMPLlES
I. Maximum width at ~ line
I. Required setback
I. Maximum slope
I. All parking areas to be paved including R-Vor
spaces adiacent to the qaraqe
I. Location to match subdivision qradinq plan
~/ \
, Building Height: ~OMPLlES JkAILS
'- ~ r ~
, Shoreland District: NA 1 FAILS~ COMPLlE~
I Minimum lot area (square feet) ~
I Minimum lot width
I Shoreland alterations
I Impervious surface
, Bluff in Shore]and{~AILS 1 COMPLIES
. Setback from to~luff
. Bluff impact zone
I. Enqineerinq certification submitted/approved
I. Gradinq in bluff or bluff impact zone
... \
Floodplain: N~S I"tOMPLlES
. 100yearfl~tion
. Lowest floor elevation
. Proposed lowest floor elevation
. Elevations 15 feet from structure
. Road access must be no more than 2 feet below
Requlatory Flood Protection Elevation
Accessory Structure: ~JAILS I COMPLIES
. Size V
. Not located in front yard (Materials)
I. Side yard and rear yard setbacks
I. Maximum heiqht
I. Materials compatible with principle structure
L:ITEMPLA TEIBLDGLISTDOC
Standard
24'
5' from side lot line or
30' from r-o-w on comer lots
10%
35' Maximum
Standard
7,500 Rip, 7,999 Non-rip
50' Rip, 57,3' Non-rip
30% Maximum
Standard
By planning depl.
20' From Top of Bluff
By City Engineer
No importing/exporting
c::-sta1)dard
~";rior Lake
a.' ring Lake
909,9' 'rior Lake /
, 'Spring Lake
Must be l' above flood
elevation for new and existing
structures, If existing
structure was constructed
9/19190.11/22/97 then
additional foot is not required,
Must be flood elevation or
~'gher q~Cj'
907,9' r Prior Lake
, for Spring Lake
Standard
832 sq,ft, or 25% rear yard
10'
15'
Proposed
11(')'
/'
(0
I(./.r::;, ,
Proposed
If), ~r:Jlo
'viJ) LJD
Proposed
Proposed
l110
rlO t 4-rL'L-LJYl
C{l~
C111'
Proposed
FROM Dahle Bros Inc
ro,,:
......
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PHONE NO, 952 435 3671
!.and Surveyors
Planners
(952) 447.2570
~chl",2004 .
Dal1le)3rotherSInc, .. .
c/o ChuckRyim .
17595 Kenwood Avenue
Lakeville,MN 55044
. RE:. Top offooting CQtifi~!iol1.
.'"..
CE~TIFICATION:
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Mar, 03 2004 03:06PM P2
Suite 230
16670 Franklin Trail $,E.
Prior Lake, Minnesota 55372
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I hereby certifythatI did. under lnydirect ~upeJ:Vision, ~casurethe top of the footing of .'
the houseunder,constructjoii at 5;1.76 Frost Point Cirqle SE, Prior Lake, Minnesota, a,k.a, .'
'. pia Tracts C & D, Registered LlU),dSurvey Number 29,ScQttCounty, Minnesota. I .
fllrthercl\Irtifythatsaid top offootingis at elevation 909,90 N,Q,V.D, The future lowest
. floor,not yet pOUred, Will be at elevation 910,2 +/- N,Q,V.D,
..... ,.~
. ' , '.
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~ttM,swan~s: . ".
. Minnesota Registration Number 42309 .
. File Number 9779-XX2
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FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIoNAL FLOOD INSURANCE PROGRAM
ELEVATtON CERTIFICATE
Important: Read the Inslructlons on paqes 1 - 7.
SECTION A. PROPERTY ClWrfER INFORM-ATICIN
BUILDING OWNER'S NAME 'S ~
\.l!.~)
BUILDING STREET ADDRESS (1r1C~ng Apt., Unit~.. .njllor 1JIs" No,) OR P,O, ROUTE AND BOX NO,
. a:::;'2.'1u fl,~lt.,+ c./'w"'"
CITY ~~j~~_ L..l~ ~~E
PROJlEf'TY ~CRIP1; ON (Lot 1('0 llIoci< Nit.... Tax Pa",.1 Number. Legal De."friptjj<n, etc.iI ,
t'lo -p ..,01 .L.~. ~'Z-9. ~~ L'q"",,~. ~I\)
BUtl..OING USE (e.g. esiden I, Non-residential, Addition, Accessory, etc. Use a Comments area, Ifrecessary.)
LATITUDE/LONGITUDE (OPTIONAL)
( ##' - ##' - ##,##' or ##,##11##')
HORIZONTAL DATUM:
1-.1 NAD 1927 U NAD 1983
SOURCE: I_I GPS (Typ.):
U USGS Quad Map U oth.r
O,M,8, NQ, 3067-0077
Expires December 31, 2005
FQdiM~~iiQdiirol'lli\#j...jO:::::;:;';1
ZIP CODE
SI);?-.12-
SECTION B - FLOOD INSURANCE RATE ilIAP (FIRM) INFORMATION
I Bl'~~f~~M~~ME & COMMUNITY NUftlBER I 82. COUNTY NAME SeD\\-- I B3. STATE m~
I 84, MAP AND PANEL I B5, SUFFIX I B6, FIRM If'lDEX I B7, FIRM PA/'lEL I B8, FLOOD I B9, BASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTIVE/REVISED DATE ZClIE~ (Zon.AO, use d.pth of flooding)
-l-'"" /:) ,",~'2- ODO'2:=c.. H-lct '"' q-y t\t:. C\()'i\.O
Bl0, Indicate the sou"", of the Base Flood Elev~n (B'FE) data or base flood depth entered In .B9, fI Q. t!'!.~ eo_a
I_I FIS Proflle LI FIRM ~Community D~rmlned I_I Other (Describe): Lo............l.. U ,"t;;. . \~.O
Bll, Indicate the elevation datum used for the BFE in B9: l.-\{NGVD 1929 1-' NAVD 1988 1-' Other (Describe): \
B12. 'Is the bulldln9 located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1-' Yes ~o
Designation Date: .
SECTIOIl C. BUILDING ELEVATION INfORMATION (SURVEY REQUlflED) _
Cl, Building elevations are based on: LIConsWctlon Drawings- I_I Building Under Co~st"'ctlo'" L~inlshed Construction .
'A new Eievation cerliflcalSiII be required when construction of the bulding is complete,
C2, Building Diagram Number (Select the building diagram most similar to the building for which this certiflcate Is being completed. see
pages 6 and 7. 1/ no diagram eccurately represents the building. provide a sketch or photograph,)
C3, Elevations - Zones Al-A30. AE. AH. A (with SFE), VE. V1-V30, V (with BFE), AR, ARJA. AR/AE, AR/At-A30. AR/AH. AR/AO
Complete Items C3,a-i beiow according to the building diagram specified In Item C2, State the datum used, If the datum is different from
the datum used for the BFE in Section B. convert the datum to that used for the B1'E, Show fleld measurements and datum conversion
calcwation. Use the space provided or the Comments Brea of Section 0 or Section G, as appropriate. to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Does the elevation reference mark used ap'pear on the FIRM? LI Yes ~No
Q a) Top of bottom floor (including basement or enciosure) Cl \ /) ,'2... It.(m} l
o b) Top of next higher floor qlC\ ..!tlt,(m) "'
Q c) Bottom of lowest horizontal structural member (V zones only) , _ It,(m) 1 ~
o d) Attached garage (top of slab) '" \ Ci., ~ It,(m) 'h
Q e} Lowest elevation of machinery andlor equipment i:
servicing the bulld;ng (Describe In e Comments area,) '_ ft,(m) !i i
Q f),Lowest adjacent (flnished) grade (LAG) '\ 0"1 ,.a. It,(m) % ~
Q g) Highest adjacent (flnished) grade (HAG) CII.\ I.L ' .!O.. It.(m) ~
Q h) No, of permanent openings (flood vents) within 1 It, above adjacent grade . ~
Q I) Total area of all permanent o?enings (flood vents) In C3,h sq, in. (sq, em)
SECTl~ D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIfiCATION
This certification is to be signed and sealed by a land surveyorl engineer, or architect authorized by law to certify elevatkln information.
I certify thet the information in Sections A, 8, encl C on this certlficete represents my best ef/orts to interpret the clata available,
I unclerslencl that any false st&tament may be punishable by fine or Imprisonment uncler f8 V,s., Code, "Section fOOf,
CERTIFIER'S NAME ~ Po,. ~^'...."':\ UCENSENUMBER \n~
TITLE L6\AJ------S'll1"'''' I)'" COMPANY NAME \\e..\\.... C!),,~' . p, ~,
ADDRESS ~~.... I, '. '\, "1~ ',.c..~ nCITY. I.. "'snrE, Z CODE 1 . .
, rr"..~~ -1""u., ...,;uo. T""l~.. ~~\ 1~lN '!;(.?i1:Z,-
SIGNATURE . ,_, " ~ tp ,j. _c~c. ~_ DATE~ -Ih _ 6'; TELEPHONE q~ 1.41..t"1.,.;..,0-
F-EMA Form 81-31, January 2003 See reverse side for continuation. Re~aces all previous editions
'-
.
IMPORTANT: In theBe spaces, copy the correspoAding tnfonnation from Section A.
BUILDING STREET ADDRESS (Includlng,ljpt,,\J{1it, Sujl,e, ancllor B. ltJg, No,) OR P,O, ROUTE AND BOX NO,
c;"2.."tUl fN."l/\- Y(l'lo\-\.' (.;\rt.\..@
crr,!: /) \ _ \. . STATE, ZIP CODE
1",.10'" L.l111::f' ~~ '5~-n._
SECTlbN D . SURVEYOR, ENGINEER, (lEi ARCHITECT CERTIFICATION (CONTINUED)
. Copy both sides of this Elevation Certificate mr (1) community official, (2) Insurance agenllcompany, and (3) building owner,
COMMENTS L~..4- ~ a\.t,u.....{\4~'~ -rhP ~...f- V"I...~
t.b""~.,'".'.L ~~€ ~c.. 04L\"u~.L:4~ qnCl,Q
\
I 1 Check here If attachments
SECTION E. BUILDING El..EVATION INfORMATION (SURVEY NOT RE~ED) I"OR ZID\!: Ao AND ZONE A (WITHOUT BFE)
For Zona ,1,0 and Zone A (without BFE), complete lloins E1, through ES, If toe Elevation Ce.rtilicale Is Intended lor use as supporting
information lor a LOMA or LOMR-F, Section C must be completed,
E1, ElulldingDiagram Number _ (Select the building diagram most similar 10 tho building for which this certifICate is being completed -
see pages 6 and 7. If no diagram accurately represents the building, provide e sketch or pholograph,)
E2, The top of the bottom fioor (including besement or enclosure) of tha bullc:\ing Is U_llt, (m) LLI in, (em) I_I abo,," or I_I balow
(chack ona) tha highest edjacent grade, (Use natural ,rade, If avellable,)
E3, For Building Oiagrams 6,8 with ol"'oin96 (see pege 7), the next higher floor or eievated floor (elevation b) of the building is
. I_Lilt, (m) I_L.Jin, (em) above the highest edJa.cent grade, Complete Items C3,h and C3,i on front of form.
E4, The top Of the platform ofmechinery and/or equiPment servicing the building i. 1_1_1 ft, (m) I_U in, (em) LJ above or I_I below
(check one) the highest adjacent grade, (Use natural grade, If available,)
ES, 'For Zona ,1,0 only: If no flood depth number is available, is the top of lhe bottom floor elevatad in accoroance with the community's
f1oodolain manaoement ordinance? J I Yes } I No' 'I t Unknown. The Icca,l official must certtt' this information in Section G.
SECTION F. PROPERTY OWNER (OR OWNER'S REPRESEIIITATtvE) CERTIFICATION
Thli.property owner or owne(s authorized representative who completes Sections A, B, C (~ems C3.h and C3.i only), and E for Zone A
(without. FEMA-issued or communily-i!sued Bf'E) or Zone ,1,0 must sign here, The stetements in Sections A, B, C, end FE ere correct to
the best of my knowledae, I
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME :
ADDRESS
CITY
STATE
ZIP CODE
.
SIGNATURE
COMMENTS
DATE
TELEPHONE
I I Check here if attachments
SECTION G . COMMUliUTY INFORMATION (G)F'TIONAL)
The local official who is authorized by law or ordinence 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,
G1, LI The Information in Section C was taken from other documentation that has been signed and embossed by e licensed surveyor,
engineer, or ereMect who is authorized by state or local law to certify elevation inlormaljon, (Indicate the source and date 01 the
eievation data in the Comments aree below,)
G2, U A community official completed Section E for a building localed in Zone A (without e FEMA-issued or community-issued BFE) or
Zone ,1,0,
00, U The following In/ormation (Items G4-G9) Is provided for community floodplain management purposes,
I G4, PERMIT NUMBER I G5, DATE PERMIT ISSUED I G6, DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
, . ISSUED
G7, This permit has been issued for: U New Construction 1--1 Substantiall.,provement
G6, Elevation of as-built lowest floor (inCluding bl>Semant) of the buiiding Is:
G9, 13FE or (In Zone ,1,0) depth of flooding at the ~ulldlng site is:
.
'_ It. (m) Detum'
'_ It, (m) Oalum:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
.
TITLE
TELEPHONE
DATE
COMMENTS
FEMA Form 81-31, January 2003
I I Check here if attachments
Replaces all previous editions
~~
(White - Buiidins::>
Canary - Engineering
Pink - Planning
Thr ('t'nln of Ihr I.akr Counll',..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
Fm5t- PI- (]./rc/e/
/~/()'I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-rr~-t A-
Accepted
Accepted With Corrections v""
Denied
Reviewed By:
,
Comments: ~~
_/'r"N FiJ u II.l 0 I4-TJ ON
~ if~~ t-- Date: / l.;Jr~t./
+0 t. R.~. Co DE'S.. L.b717:::.~ J /'I'1AIU<-
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f'I2L>TcCf. Fi:mA lZG7'oteT /2.bC;(.t/le.b?J P/Ci"a1C...-
76 TErn!'. fEl'-TtPlc./l.TE: of t::J~/'A#CV 13'6//./'1
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I'Y\ e/U r UG, f/ 12..(();2. 77J hf.J A '-- C. D f:: ()-
"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,"
CO~i7Jyt- f2t:~P05'IBLS fi";f2..
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t:;,t;;:>, $7C!, A-jUC SfiTtJJ!5n.- f oJ1t.T6"X..
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rko KUPS I~ ST1Zf;'T;:-r-;
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Tht' ('..n'..~ of Ih..I..k.. ('ounu)'
White . Building
(Cana!)' . "nai/leer1no-:.
"inK - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPI"ICANT
APPLICATION RECEIVED
----
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
7-v'",~" f /1,_
I' r ",-'''"', '---" rr-
~7' F"~!l+, PI. c../r.
Accepted
y
"
Accepted With Corrections
Denied
Reviewed By:
/'n4-7 "5
Date:
2-1)-(")~
,
Comments: c::.... Rp.verse Side for Additional Information!
'Bu.lJ" /(,sP/Ms..M~ -{;;- .I~~l~//"/,;,., """'c/ Co,~ f c.'-f' 6-lWu'
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ClYlJ we, W 6uvl'u~ f\;<f"'\ /VI4./. Jo R.,tJJ,.J. ~/r4t..t"r
o,g Slrll',ccs rII/J'>+ (..../1 E/I&,;ituolIl 'Dtfl (;;, //J'ftd12t-",
cd 'is z- lflf7- '1&3t.? 11/".1' F,'// 0.,-1 R.o. V p"'/f'II"+ ,.{".....
k;K;uu,''II1. D'ioJ. (;r '" fee c>f' '2s-o-otJ
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See Attachment~' 1) nr~rling Phm ?) Pro!lioJ:l. Cotltr.ol Meas)lI"~
"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,"
~~
White . Building
~an . ineering
Ink - Plannln
'-'-", --
Thr ("t'nlt'r of Ih..l.ak.. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 52 7'
APPLICATION RECEIVED /--
r-
I 12.<1 li- .._.1 / / ( /0
. (:) IJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.;.. r/'
C.i >:
fA-
Accepted X
Accepted With Corrections
Denied
Reviewed By:
Q.J~ fCu~
Date:
~. /0 -04-
Comments:
,/ Pr-[}lL ~ 9.,0 (1 (0 0 0 (..JJJJ- l.n~ o--A
v
taLQ rep0~t on faya.-JL A-
vQQwl !~lLf-c [2:>00 y o.-.t-u.vJ QJLrhf'0-~ pn 0--
ft) ~C!.L 6-6 &r~CQLt( ~
o C'~a-n f!JLA
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v Ln~ t<u.. I 'rUI (l.LY) Cff' tLf2J\...U'l d
p~d ~
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"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,"
MAR-24-04 09:06 AM VALLEY AIRE
952 age 3351
p.e1
CITY OF PRIO~ LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Re<:'d
'.i .
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"i'it!:..ft ~ or DriDr IDd sim II bottom)
4'f) ADDR1!SS'
fr;;--S 2 ~c. f..,,,.;.~ \)... c.. ,...1"
~.:}~.f.'fJ l-BGAL DESCRIPTION (olllcc ule only)
NT.'/ LOT . BLOCK ADDITION
l'\:
[).t,. OWNER
~J(Name)~L-.lL R......, 1"",~
k(q . .
ff);) (...lldress) 1.9,ac:;- '-<....'^)L1~_.J lr\
It,,,,.
~: ,lfAPPLICANT
1J;1 (Name\ (J~
yF; (Address)!1-1 t I W
t'I,,1I
J,hll
3. Vallo_
~:~ I Un,l'.UT NO. ~ ,,_ V"'"
A""II~IJII ~. oVI
I ZON!NO (_.;.l I
PID
.:I\:Lptl')
(Phone)
L..lt... ..:l.Lc..
A~<-
f\A..rJ
/qOU
S'<.;; (')44
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1Cl.,r.., T....c. (phone) <('qD-4301
I.] h+-"'- C".. C;c.......J/./, . VlA IV
(Addrcu) - (City) V
(Contact Person) (\1\ l '11... (phone) li<4.l) . II ?a I
APPLICANT SIGNATURE ;?:/f5.1.;;J d /(! DATE j -1.A, 04
/' APPLIC~T PLEASE COMPLETE BELOW
(;c::~.,'I?
(211 Code)
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(QIIlEW CONSTRUCTION
FURNACE MAKE AND MODEL ..J...''^^hJ......
FLUE SIZE " , p u '- RETIJRN OPENINGS
TYPE OF SYSTEM
OWann Air Plants
OGravil)l
o;rMechanl.al
[g:I\.ir Conditlonina
titlen!. System
o REPLACEMENT
(,. ~I
c... INPUT <(~ ,O.)J
HEATINO OR POWER PLANT
o Sleam
o Hot Walet
o Radialion
o Special Device.
o Olhet Oevim
o AL TEM TIONS
FUEL rJAi
OUTPUT Y ~
g ';:
f;: ~',!
i!..f....
'I ,'.'
': ~
;;11
'I
,t, t
~, :,!i fIREPLACE MAKE AND MODEL
I ,
n
, '
'.
~ , ',.: llIdulIrlal, Commercial'" Mulli,Pamily
!., .
~!l'r ~id"lial, Hellina '" AIC (New Con.truetion)
~ '.~l.", Rt.ldcnlial, HCBtlns Only (New Canstnlctian)
PLEASE rOTE:
Air Conditioner Unit.
Cannot Enl roach into
Required S de Yard
Setbaclcs
.'.'''A_~'_'''_
.-,_..._---
FEE SCHEDULE
)% of job cost Residential, Ou Fireplace
539,50 minimum
599,50
564,50
53950
Residential, Addl,lon, '" Alle'ations
Re.idential, AC Only
539,'0
539,50
'J.J
.a..!:.
<I: :,!-:t
~~, 'V:
:'~1 ' " :: ' .
Estimated Cost S l '1j ""'- "'). c>" Building pennit #_,___
t~
r
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ C!q.~
$ ,50
$ iOD .no
~~~~
'"
(Om.. U.. Onl~)
this Application Becomes Vour Building PermIt When Approved
8uildina Omell1
Dal<
~ hour nollot ror aIIlNpeeUo.. (9Sa) 447.nJ fax (95a) 447-4~S
16:100 Eaale Cnek Avenue, PrIor La lkN !!37: ,."..
t!fLC l~ ir 0 m [
fttf MAW :6 Ii 2004
!
rN' r;
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please tvoe or Print and siol at bottom)
ADDRESS
; ~,:,:, ~::, I PERMIT NO.I'WL. It.A~
3.Yellow Applicant ~ ~
ZONING (office "',)
5276 FROST POIT CIRCLE
LEGAL DESCRIPTION (office ose only)
LOT BLOCK ADDITION
PID
OWNER
(Name DAHLE BROTHERS
(Phone)
(Address)
APPLICANT
(Name) ALTJEn FTRR~TnF. nRA FTRRSTDR HRARl'H & HOMR
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
';5113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
3/Jl/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVen!. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
D Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATNGLOPIER-HV & SL-750TR
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39,50 minimum
$99,50
$64.50
$39,50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #~WITH
$ 1~~Yl'I!m:II PERMIT
$ ,50
$
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine- Official
Date
1,-) !l1t'\l!:'I~' ", ,.' '~'I
,II 1 ',", "_I'l "1
"" , L, ~ I l.' LC" ",;
'L,' ' . .." - i'I'
i:, fl' DftPR 0 1 2004 I: i,;1 By
~ L..."-_-,
Receipt No,
24 hour notice for all inspections (952) 441r'1850. fax (952) 447-4245
['-JY._ ____~-.-...:.::'_: ---.----
P.01
APR-30-2004 02:34 PM STAR PLUMBING & EXC.
952 884 7468
. :~
CITY OF PRIOR LAXE
SEWER AND WATER PERMIT
NOTE:
1.
FILL IN THE BLANKS
Estimated length of water service (~
/11
Size of water service inch(es).
Looation of any oouplings from structure
2.
3.
_-1'lUI
YBlIIlr. _
.... am
S,W,NO'~ to
feet.
feet.
4. Type of sewer pipe. ABS PVC ~ Cast Iron
5. Estimated length of sewer line ,~d feet.
6. Clean out (if required), located at
structure.
feet
from
----~===============:======------=====----=============------=====
This application beoomes your permit when approved.
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\~ MAY 0 5 2004 ~J
Sy
FROM : BRUCKMUELLER PLUMBING INC PHONE NO, : 651 688 2160
JUN-17-2004 L1:19 CITv OF PRIOR LAKE
Jun, 17 2004 12:34PM P1/1
9524474245 P,01/01
D.te Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
tPI&UI l)'Q.C!l or "'diU: lULd 11_ at bJnom.)
ADDRESS
-52./li? ~O'S t-
;;;: ~~ I PERMIT NO. ~
"VdaoII ""'*- ., - . "f
I ZONlNG (..... uol I
?lJ~~ \. r \ ~(" ~..,.
I LEGAL DESCRIPTION (otI'... ule ooly)
LOT BLOCK ADtlITION
PIP
, OWloln
(Nallll"
(phone)
IA~)
=~, .. ,<-"" Ik.< \,\,,~.:;:;v - t, 'Xl., --(,,(, 'n
(AdWcss) ~7 ~A'\n.,;:'~l(~~ ,'- tit _1)'15'2-'3
(A4dress) (CIIy) (ZIp Code)
<<-<....., r::.zi<. ~uJc1i"'l '" \ h- fi. ..- Cas I -t.f;1: I,d!.
APPUCANTSIGNATURE ".(L:;. .tf JAA.JL ,fA..4i1,A=-DATE ~ j, '-I
- )
APPUCANT PLEASE COMPLETE BELOW
Qus.1I1Y
"6-
I
4
L'
{
I I
H
Tn- onl~run
Bat!llUb wilh or wilhoullllower
DlslIWall1er
I floor bram
I Lavatory (!llllluoom liinK)
.. Laundry tral (I or 2 comPartment sink
lifi_ l)'tall
Sinler
I 8ar lllllk
I WaterClosot(Toilot)
QU.nllty
Type or l1~tun
Rough- inr
w.. Huler
w__ Sottner
~WId flf!?" (WuIUng Machine)
Scwllje ejector
~aelCf\o\\' Anembly
I Bld:l'1ow -"'-'Diy TIlIIt
I iawn ::lpnnlcler
I Ulner
PEE SCHEDULE
Induttrirl, (;omlnOfCirl.t. M.hi.(amlly I~ .(j.b _ with. 539,50 mhIim.m Rcoldontial. New 0.." T....F....lly S9'J.50
Rcstdalllal, Addl~.nl '" AI.....iDllS $39,'0
Eslilll-o Call S
Buildln, Pomli.1I
PLUMBlNGPERMITFEE S
STATE SURCHARGE S
TOTAL PERMIT FEE S
,50
10m" tI. 0ftJY)
This Applintlo. ..co.... Your Building 'o....it Wbon Appi'o..d I Po'~
""d'" orr..oI 0... t~ [1 0 I'D .( , I J)
24 hoor .oIl.. for e1llnlpocelOlI 1m) ~7' I I r_l~iJ.Q04~)
16ZOO Ellie eNoIl A.... $.I:,. Prior Lt 51311.1114
By TOTAL P.B1
------
. - .
.
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 02. 'I VJ Ftlb~ fOt'tJt- C ~L.E'
NATURE OF WORK ~ Oe~~"t Qu~T"/t)1;)
USE OF BUILDING ~.F:' b ,
PERMIT NO. 04.0080 DATE ISSUED 1/301D'"
CONTRACTOR I>~"'L.C "1.&09, ,'NC.. PHbNE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BEL
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING !),.r!i r4S- tWf 6/)tl,.{ 7/w. ).:~~~OVI
, FOUNDATION (Prior to Backfill) ,..br~ (~\ri." / ~ I ~~ q r 0"1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
SEWER I WATI;flI SEPTIC , / ,
FRAMING W;~ 4/hJD4-f.JI.
INSULATION' ; /~
ELECTRICAL _
PLUMBING //I/}/, , 3- ~/)-(1lI
HEATING (If required) .f/{, 4- h-Ia'I
FIREPLACE pi I ik'j~
GAS LINE AIR TEST ....... IlhflZ-fN- i/';" 4-h/M
v '
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
ILATHFICUtrUU/J S7lJJJE'" I Yl/Y"'?' I S.2./-C4
, FINALS r , .
GRADING (Prior to Soddin~) /I/o.. /;;L,,r) .of'
BUILDING 1<Mf? Ift'\hl '1'H" I We.. l/J t:FZ 1.-c!:I-f
ELECTRICAL
PLUMBING
HEATING
DO NOT
.
I
.
0'1/)/2
I.I'ld'"
OCCUpy UNTIL ABOVE HAS BEEN
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, "
(P-/~ ~
G ,/1.....(1.{
SIGNED
FOR ALL INSPECTIONS (952) 447-9850
QIntifiratt of ~rtupanr\!
CITY OF PRIOR LAKE
;!El:cvarfnumf Ilf '!IluilMng JfnsptdiIln
.El"'Final Permitted D Conditional C,Q, Expires _
This Certificate issued pursuant to the requirements of Section 307 of the Uniform 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:
SINGLE FAMILY
04-0080
R3
VN
Bldg. Permit No.
_ Pid.o._l _~ NI A ., ,
~"'r-'~ - Zomng DistrIct
R1SD
Use Classification
Occupancy Type
Type Construction
Legal Description
Owner of Building
.' DAHLE BR01Jl)ERS,
c~.._..........~ '8 Nan.e & Address _ /,
ROBERT D. HUTCHINSII/
? 27_~1lillllngOfficial
Date: I
5276 FROST POINT CIRCLE
Site Address
INC., 17595 KENWOOD TRAIL, #290, LAKEVILLE
DON RYE
. City Planner_
Date:
4l~,; ,~'::-i';,;;~ 41.,>..;';' -'.":..'~.'\ """'~, --~. ,...;t,';'io,-.i.s.:...,~,;j ':','
", ',,,,~-' :"._;:.:.";;-,.,~,~~ ,l,:i~~" ",ii.';;;:., ,;:,,;;.ii i."(I,:,.
. .<.', IJr:"',~'il\;~,"~.:..:,ilii~ ;'",H;'u"Jw;!..,;-,;i, ".)~J..8.t.'l,' "
,'f"
CITY OF PRIOR LAKE
INSPECTION NOTICE
(
ADDRESS 5()...t'](,
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
D)NSULATION
.rr FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
DATE nIlE
c:r-2'-o~
li--L P12i.A- 0.,'~
CONTR,
PERMIT NO,
o PLUMBING RI
o MECH RI
o WATERH09KUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/. J:": ......0 (;,...... ..J .. h."ef'
~L <}/C
04 - 00 e
o EXlGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
14q-
o
.)if WORK SATISFACTORY. PROCEED
,
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector.
Owner/Contr:
CALL ~7.9850 FOR THE NEXT INSPECTION 2<1 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~l.7~
OWNER
PHONE NO,
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
DATE TIllE
SCHEDULED 12-1 ;1-0'(
F/t;,c., f- P",'~.f-r:;/
CONTR,
PERMIT NO,
C>'I.. Bt)
~~LUNG
D COJlllCAiNT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
COMMENTS:
6/'.-'(_ B ((..
ftj(..,) I b &"-1-- 6 y'
-
\'Ji)
nJ v-
('jV
I\{WORK SATISFACTORY. PROCEED
~ECT ACTION AND PROCEED
D CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~ _ OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
CITY OF PRIOR Ll.KE
INSPECTION NOTICE
SCHEDULED
DATE TIIII!
~,I
q:/) /)
ADDRESS
52?&> F.e.oST PO/~
OWNER
CONTR,
PHONE NO,
PERMIT NO,
o FOOTING
o FOUNDATION
o FRAMING
j1NSULl.TION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
XPLUMBING FINA~
l'MECH FINAL V
COMMENTS:
(/)
(i)
-
(11
-'
04-' - 008D
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
t1,ud~
bIlJlk.J U"l fr (
tV
f;."'4( 1'."o.j- 0: dJ?-r:lva.(
/J. u /? f)a F" c:kJ/
OQZ~S jo1SJl-r,:fn-..,
'It.u.iJ t"rn.T1J>'t l"ulII ~fll
~dd e~ft:,Wrs~d
F..x /11\ (){v..,t.,,,,-
. '
,1-\
"ffltt:" J.......
r...
'1< "",/7 t).,4, I
b~G(+ OIL
d~(
pkt:.c
v-r ft I
q-(-(/<.(
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION ANO PROCEED
, CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: V OwnerlContr.
CALL 4<17.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
.-on
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI