HomeMy WebLinkAboutBuilding Permit 13. 1319, Demo13.1261 -:,
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X Final Permitted ❑ Conditional C.O. Expires '
T,,-' This Certificate issued pursuant to the requirements of Section 110 of the II Residential/0 International
Building Code certifying that at the time of issuance this structure was i compliance with the various
ordinances of the City of Prior Lake regulating buildingconstructionconstruction or us,. For the following:
Vis` Use Classification �y
s/A F-4/1-7/1.--y Bldg.Permit No. �3_ /3
/2/50
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Occupancy Type Type Construction
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Legal Description
k153 1-0/2-42.5s /
Owner of Building Site Address
Contractor's Name&Address co 1,,a a e_ t'K
K ic)a.)&i L /AT Cf�/ , City Planner x
Building Official Date: 125/161 Date:
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& PR/04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
1,f_-_, ANs; ,, ,..,. ! '.' RTIFICATE OF ZONING COMPLIANCE / I- Q- 1.�
t" AND UT CONNECTION PERMIT ' U
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2. Pink City PERMIT NO. JJJ / 3
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3.Yellow Applicant .��./// /
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
L{ 3 LQ tr45 5-r ars c)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION 3� l/
PIT) -935 -0 `
OWNE((Name) I J a\ IL t� G`- (Phone)
(Address) CI Ile-1 R \ St ,p,1.W ,--aV'
BUILDER :p
(Company Name) (.u' 9 V estek.. 1 L UCS (Phone) ! Z-2 - 3 g(07
(Contact Name) \V'-(.e. Z Ort'i 51-0 I (Phone)
(Address) 141 q c C,UYn mkt�. Pv� t IV 64) Vii or- L Gtk
TYPE OF WORK , New Construction ['Deck ['Porch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace
(]Addition ['Alteration ['Utility Connection
CODE: 1.R.C. DLB.C. 0 Misc:
Type of Construction: I II III IV V A B QV 6)"Group: A B E F H I M R S U PROJECT COST/VALUE .00
Division: 1 2 3 4 5 (excluding land)
I hereby certify th t I have furnished' '.rmation 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-mentio.-d . .. rty and that• ... , .o: '' conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can :
� o� PRIo��
CITY OF PRIOR LAKE Date Ree'd
DEMOLITION PERMIT
• PERMIT NO. /3✓ /Z!o
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1-63 /L1 r-IMAW/ItX/1
LEGAL DESCRIPTION(office use only) .
LOT BLOCK ADDITION PID Z,j 3 cog,
OWNER
(Name) 7) �'�/,,q (Phone)
(Address) :)JS-lc /6),6-7-14S . - /
CONTRACTOR
(Company Name) 1 A S c- .. 4"--c4-4 -AC. (Phone) 65,/o1--3 6
(Contact Name) et& (Phone)
(Address) i 7 v ike
Use of Building: INTE ATIONAL BUILDING CODE
_Type of Construction: I II IIIW V AB
5./^/ Lj- M>4•1(c,y pc�ycx i-Occupancy Group: A B E F H I M R S: U
I Division: 1 2 3 4 5
X MPCA 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 acc. •:nce with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore,
I hereby agree that t - "ty official or a designee may enter upon the property to perform needed inspections.
to •Signature Date
METRO (MCRS�c7AE IFNTI` T Y` W Vffr
This Application Becomes Your Demolition IjETRNIITT`IpN ' y
Per it When Approved
Building 4f£icial Date
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.
'tanning Dir. or Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
16200 Eagle Creek Avenue,Prior Lake,Minnesota 55372
OV PRI
Ut~
Memo
Date: Monday, December 23, 2013
To: Janet Ringberg
From: Lynda Allen
Subject: Demolition Permit #13-1261
4653 Lords Street N.E.
The demolition permit has been closed on the above referenced project. Please
return the $5,000.00 demolition deposit to:
Tom Klima
8056 165th Street East
Prior Lake, Minnesota 55372
Thank you.
da S. Allen -_- P ppler
Building Services Assistant City Engineer
Phone 952.447.9800 / Fax 952.447.4245/www.cityofpriorlake.com
04 PRION
Builders Deposit
SAP • City of Prior Lake
A$2,500.00 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 $2,500.00
builders deposit will be forfeited and the applicant will be billed for cledn 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 icontrol
requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors
handout.
DATE: 111 I� SITE ADDRESS: 1 � �°"S Si-- `\ PERMIT# 13
, - `31q
REFUND TO BE MAILED TO: Coppe if Cruel., Lt-e,
/LIII 9b ( on4m.ev'ce A e.- NE Sty-5r
Pc ioy- ril a G-5 37L
PLEASE REMEMBER \I%, .r 2 560
Lynda S. I n,Building Services Amouit
1. KEEP STREETS CLEAN DURING CONSTRUCTION r,Z4, If Acct.80L2021)4
2. KEEP EROSION CONT'OL IN PLACE iir Date
3. TEMPORARY OCC P CY P - . Tom' T NO SPIRE OR$5k, , I1 r , ,, , ,1 ,1 ,'
Jil
SIGNATURE:
— Lar oppler, City Engineer
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COPPER'CREE LLCMs 3739
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DEPOSIT FORM.DOC
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July:31,2015
SECTION A-PROPERTY INFORMATION $FOR;INSURANCE,COMI?AN.4USEC
Al. Building Owners Name Thomas Klima i.'Policy Nrimierili,;iiiiI{1,,i°: r•'r;„,,
p; :`ii 'ss iili ;mlili¢i istirl& i'i E;kh„lrir'
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box NoCompany'NAIC'Number ',;ri,l;;i if"';4::
4653 Lords Street Northeast k-'-? -''.' -(41.:1,,..:.:41,44,r4.
City Prior Lake State MN ZIP Code 55372
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
Property Identification No.259350090
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential
A5. Latitude/Longitude:Lat.44.73000 Long.93.42838 Horizontal Datum: 0 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 1@
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) sq ft a) Square footage of attached garage 8¢Q sq ft '
b) Number of permanent flood openings In the crawlspace b) Number of permanent flood openings in the attached garage
or enclosures)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade
c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in
d) Engineered flood openings? ❑ Yes 0 No d) Engineered flood openings? 0 Yes ❑ No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
270432 Scott MN
B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood 89.Base Flood ElevaIoion(s)(Zone .
270432 0002 C Effective/Revised Date Zone(s) AO,use base flood depth)
November 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 0 Community Determined 0 Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: *_ NGVD 1929 0 NAVD 1988 0 Other/Source:
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? 0 Yes ® IVo
Designation Date: 0 CBRS 0 OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: 0 Construction Drawings' 0 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,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.in Puerto Rico only,enter meters.
Benchmark Utilized:Too of hydrant Vertical Datum: 918.88
Indicate elevation datum used for the elevations in items a)through h)below. ®NGVD 1929 0 NAVD 1988 0 Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check the measurement used.
a)Top of bottom floor(including basement,crawlspace,or enclosure floor) 81.,2.7 0 feet 0 meters
b)Top of the next higher floor 822.9 0 feet 0 meters
c) Bottom of the lowest horizontal structural member(V Zones only) 0 feet 0 meters
d)Attached garage(top of slab) EH 0 feet 0 meters
e)Lowest elevation of machinery or equipment servicing the building 919.8 0 feet 0 meters
(Describe type of equipment and location in Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 9.2.1 ®feet 0 meters
g)Highest adjacent(finished)grade next to building(HAG) gm 0 feet 0 meters
h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 812.1 +e feed-❑rfleters
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 %{I IIID
information.I certify that the information on this Certificate represents my best efforts to interpret the data available. lz���� hI t fur i
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ��� Ap
0 Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a ;yo ••7P1.../4.!::';i1'.!
0 Check here if attachments. licensed land surveyor? 0 Yes 0 No 4LICENSED
Certifier's Name Thomas J.Adam License Number 43414 • 1..1 AVID
SURVEYOR •
•
Title Surveyor Company Name Rehder&Associates,Inc. de.. 434'14 .:.Q,`
Address 3440 Federal Drive City Eagan State MN ZIP Code 55122 �i� .'•..�• .✓�y/
Signature Date June 13,2014 Telephone 651-452-5051 /// fM.N.���
FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions.
ELEVATION CERTIFICATE,page 2
IMPORTANT: In these spaces,copy the corresponding information from Section A. 'FOR INSURANCE,COMPANY=USE;,`;!
Building Street Address(induding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy.Number .
4653 Lords Street Northeast
City Prior Lake State MN ZIP Code 55372 Company NAIL 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 Equipment servicing building is an air conditioner.
}
Signature I Date June 13,2014
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 EI-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 0 feet ❑meters ❑above or❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)is 0 feet 0 meters 0 above or 0 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 0 feet 0 meters 0 above or 0 below the HAG.
E3. Attached garage(top of slab)is 0 feet 0 meters 0 above or ❑below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is 0 feet 0 meters 0 above or 0 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 0 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 Owners Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
0 Check here t`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 i(or E),and G
of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items 08-G10.In Puerto Rico only,enter meters.
G1.0 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.)
G2.0 A community official completed Section E for a building located in Zone A(without a FEMA-Issued or community-issued BFE)or Zone AO.
G3.0 The following information(Items G4-G10)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 0 Substantial Improvement
08. Elevation of as-built lowest floor(including basement)of the building: 0 feet ❑meters Datum
G9. BFE or(in Zone AO)depth of flooding at the building site: 0 feet 0 meters Datum
G10.Community's design flood elevation: ❑feet ❑meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check here ii attachments.
FEMA Form 086-0-33(7/12) Replaces afl previous editions.
4
PRI04.
6. 0
White -Building
Canary -Engineering
4toinsol' Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT do4(964egfie&-A---" ILe-- --
APPLICATION RECEIVED ev.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
41653 /D93"
Accepted X Accepted With Corrections
Denied
Reviewed By: Date: /0 — —
Comments: — iTee_s
we," tesait.,,e1„v, —/3fiC
"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."