HomeMy WebLinkAboutBuilding Permit 01-0476
DATE RECEIVFD CITY OF PRIOR LAKE
/tl- (, - 00 BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pi:OW~
3.Y,lioant
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE ALLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
/4(,24- CJ,I9K-LAN'O BY/(!r/ ,4 V6. te./SP
New Construction
Chimney CJ Mlsc.
8. PROPERlY AREA OR ACRES
Sq.Ft.
Fireplace LI
Alterations (]
12. NO. OF STORIES
PID 25- /15- all- 0
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
(Addres~
'l%'=> Go. 115 - 'f:1.
R-.&r-
Deck 0
Finish Attic 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
1./</1- '::>053
Rs-rooflng (] Porch 0
Ae-sidlng 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Septic 0
Addition 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETI N DATE
I hereby cenlly that I have furnished information on this application which is to the best of my knowledge true and correct. I also cenlfy that I am the owner or authorized agent for
the above mentioned props 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 off revoke e just cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform needed InspectJons.
X )
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
USE OF BUILDING
BUILDING DEPARTMENT VALUATION
Foonl
sPi/
..'"
S~.
S~.
MATERIAL ALED WITH APPUCA TlON
SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION '<"/ ~'~.tao_j
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
TYPE OF CONSTRUCTION: I /I III IV V
OccupancyGroup A B E F HIM A
DiviSion 1 2 3 4
Permit Fee ................................... S
Plan Check Fee ............................. S
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... S
Sewer & Water Permit ...................... $
. ............. $
S U
City:
Amount Brought Forward .................. $
ParkSupportFee ........................... $ e~.~
SAC ................./"l.5D.O'O.. " r I.! -
CoUective Street Fee ....................... $'~
Sewer Tap ................................... $
B~L."'-';>-?~ 75
S6c. . ~"z7. 7t.f
- (fS . e9 ~8_00
$
Pressure Reducer .......................... $
Meter Hom ................................... $
C(5"~
{~O.Il>O
( b() .eX?
JS"" . c;c;)
C{() . 00
tI!:o
\\- \'j
Water Meter ................................. $ /2.s-. 00
Sewer & Water Connection Fee ........... SIt "(no. CJJD.
7 C>
WaterTowerFee ........................... $ ~.o
Water Tap ................................... $
Builders Deposit ............................ $ / .(:;/.JC) '(J;&Y
.,
Other ......................................... $, " ,'; ^ t1fl
Totel Due .............................. $ Z (,J!,9~. >
Paid . q Reoeipt H30.s-
u Idlng perm/On Aw!t.d. {I
Date ~ - ~O
r
Date
request In the above application and accompanying documents Is in accordance with the City Zoning Ordinance and may pr requested. This document when
r constitutes a temporary Ce'1"!C8it of Zoplng compl18l1lil!.. and aIIOWs1\'~~mence. Before OCCl4'8~a Certificate of Occu~ must be issued.
~\"_'It:lJ ~ -~d--J.J\~ ~~UWI_S
City Janner Dale Special Conalllons any
24 hour notice for all inspections (952) 447-9850
/'
t
M -rf16;
Th~ Cenler or the L.ke Country
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLle~ND!PARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t /-/6L E c,e Eel:::. vi L L f-j"::
,
1(. r.()()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Accepted With Corrections
CE/-}clj
/
;-Ji:E: .
/4-/,24-
u/i J:: L /-IN I..}
Denied
Reviewed By-r ~O-<::'~1:- ~
Comments:
~,,^A
Date: ~ l/7 / tQ:J
Aw-~ ~p....- Vtvt-t.tMLR ~~lL)'tl~f1)-l2t1l!-,
~~~ 0el~.J14..Ve.... e~ ~~
$~e.- LeT I~l/\.@ .
"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."
00 'd183
Th~ CenCer of Ih.. uk.. Counery
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t3l1q/..;6
If) .
ClZG~ V 11...-f.J1S
r'OD
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-IPZ4- O/lKL/tAln /3&/JtV-j AV6 .
Accepted
Accepted With Corrections
Denied
Reviewed By: {2; ~ jk
Comments:
,. .1-\4.'... \....... ~ -r ~~.~ ~,J... (j~~ i 1\ fur ~ ,'~ e~\..\.\"c;.(. "'"
z. Sc.A. c..\\ IocR. ~\ tlJ"1i!.a..s.
Date:
I Cl - (U - '000
"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."
.---
(}(j.()98)
T"~ elf..l.... of th.. tak.. Cou.cry
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
E/-k3ji..-E
If) .
{~'661::!.. V ILL A...5
l' ()O
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-&24- Or//:::'L/lND f3E/it21j A Vb .
/
Accepted
Accepted With Corrections
Denied
Reviewed By: LL L
Date: I j- 7-00
Comments: ~eG Reve-Jesc Sf/)& rot!. /ItlPmoAJIIL WFoI?mATJOAJ
"
~ Illf7klt/l1c/lJJ3: I) IFmslotJ CoJJTRoL h1easU/!.$ z.) GlzAolu;,/ER05it:I1I/ C:lt~ fL"JJ
"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."
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
f-I/-eJ /
\. Blue. File
2. Gold Cily
3. Yellow Applicant
I PERMIT NO,1 -47(,
Please e or
ADDRESS
ZONING (office use)
/4~24-
()4L;Lr1 A/.o
t5t/~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID~-/IS~
/- [)
I OWNER
(Name)
(Address)
(Phone)
PPLICANT A PI (
ame) C. l1;v-(.. U. .-Ic.- /1 h.../
(Address) 1')0')<) ('7-"1>____. - _~
()(~~
(Contact Person) ~r... v, '-
(Phone) /Ph.- - S-fS - 7 v J Y'
,z:;J"b~f,/UI!/. g-eh-/
(City)! (Zip Code)
(phone)
APPLICANT PLEASE COMPLETE B OW
Quantity Type of Fixture Quantity Type of Fixture
Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softner
Lavatory (Bathroom Sink) Stand Pipe (Washing Machine)
Laundry Tray (lor 2 compartment sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
Water Closet (Toilet) Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
~. ..~. lOWliH rr
\NG PERM
,
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
By
Date
24 hour notice for .n inspections (952) 447-9850, fax (952) 447-4245
~
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
f-I/-d /
(Please type or print and sian at bottom)
I ADDRESS /4(, 2:4- O~.f)
; ~w ~\~ I PERMIT NO. 1-,L1b
3. Gold Applicant ,.
tlt7HJ#
ZONING (office use)
LEGAL DESCRIPTION (olliee use only)
LOT
BLOCK
ADDITION
PIDZS" - I
OWNER
(Name)
(Address)
(phone)
(Address)
(City)
(Zip Code)
(Address)
(Phone)
-Fifl'/;~ .Au.
f (City)
~/t, - )77-7'- JY
):')U2-j
(Zip Code)
(Contact Person)
(Phone)
DA
.> it- Itv--
9 !II/PI
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure _ feet.
Type of sewer pipe. D ABC D PVC D Cast Iron
Estimated length of sewer line _ feet.
Clean out (if required) located at feet from structure.
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Penn it #
-~
~G pe.~\1',
9\>'1
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
(Offiee Use Only)
This Application Becomes Your Building Permit When Approved
.-
FPt~ I
Building Official
Date
I Paid --
Qat'e
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
12/28/2001 06:24 5073344811
12/25/01 Fal O':ST FAl 812447&2&5
CANNON VALLEY MOTOR?__,___",
tIn OF PlIOIl LAn
PAGE 01
iilOOl
crrVOFPRlORLAKE
BEATING/AIR CONDmONINGlFlREPLACE RRMIT
D... JMc'.
I r:of,flJ~;;;tf-~l RIt~l
I LBGAL DBScalPTION (--_I
. l.OT BLOCK ADOmON
~=.; IPJ:KM1INO.O~
I I ZONlNGc_-.) I
~~r.Jl 'flu _ .
PED
[~= /}~1tti:
(Ad4Jeoo)
.
('*-Ill-
eno.)
APPLICANT
(N&IIIe) .
. (AGdm.)
(Conm", P."on)
III "'1rbd. .,.,
!)-4?:7i C. e-<.lkr ~ake D~
New Pra!ree. MN &;AI'I'7"
... 8-2737
952-888- 5 >>11.,
(phone)
APPLICM"T SlONATVIU!
(CiIJ'l
(PllollC)
D....TE
(ZIp Cedcl
AP LICANT PLEASE. COMPUU BELOW
, WC:::JiJC I\BfLACEMBNr ALTERA. ONS
, FUDI....CI! MAIUI Ail MODEl '7/7.L .1JtI)f tV - oY/) FUEL
YUJJS1:a 3" '(... OPENlNOS INPUT '1fJ,tItf,f) O\1TPUT7J-.~p
TYP. OF S\'S'I'BM HliAllNG OIl POW1l1l PLAJiIT
J..... Air PI..,II. ~ S_
Ornl\)p Ho' "'_
......,... . a.llui...
! Air ClOIllIillonillC S,..III Doo<I_
I 0111_ 5,...... 011.. Dnl...
FDtIlPL"CB MAKE AND MOtl!L
PL&.UE NOTE:
Air CclIldJdaner Unilll
c.a", IlI!craaallllllll
a.'I"1nd Sid. YOI'lI
SeMI"
R&SCllDULJ:
J.d.."iol. Comm....iol" MQUi."....i:y J"orjoa... 1lal4o:nIl1I. au rlnp....
Dt.SO Iftift.",u,"
_lAonriol. HUlinC" Ale 0'0" ConllNelion) 599.50 Ilaidot\lill. AlI4lli...." AI_io..
R'''d,.dol. Rcuinl0.1y (Now COII.UQl;tiQn) $64.'0 Ilaldondll. AC: Onl)
'39.50
U9.50
1:111.50
Estimated Coal' SQtl41ftl PCl'IlIIl #
'"""""'I
r'- PAlO WITH
,lUll-DING P~RM'!.
HE.A TlNO PiDtfT FEt S
ST" TE SURCHAP.OE $
TOTAL PDUm RE S
(0.....1lH 0>'71
nit ApplJatloo aOCIIII- "It'... a.lldln, .1",," Wh.. "PP",""
..nOIIll Ollclal
1Ia..
I:'
I =-~NO'
II aOQr ..11.. for 11I1IUpocd...rm) ..,.IISt, 110. (tSJ) U'~2d
FROM : I'ESENBRI i'I< CONSTRUCT I o-l
.
PHONE NO. 9524475036
Ma!:l. 29 2002 08:36AM P2
Federal Emergency Management Agency
Washington, D.C. 20472
May 22, 2002
EAGLE CREEK Ot!VELOPMENr
7765 EAST I 75TH STREET
PR.ICIl LAKE, MN 55372
CASE NO.: 02-45.1823A
COMMUNITY: CITY OF PR.IOR LAKE, scorr COUNlY.
MINNESOTA
COMMUNITY NO.: 270432
DEAR EAGLE CREEK DEVELOPMENT;
This is in reference to a request that the Federal Emergency Management Agency (FEMA) determine if the
property descn'bed in the enclosed documenl is located within an identified Special Flood Huard Area. the
area that would be i~lImdated by the flood having a I-percent chance of being equaled or Cl!.c::ceded in any
giv=yar (base floOd), on the effective National Flood Insurance Program (NFIP) ~.. : Using tbe
infOrmation submitted and the effective NFIP map. our deb.u..i..ation is shown on the attached Let!er of'Map
Amendment (LeMA) Determination Document. This determination document provides SdditionaI.
information regarding the effective NFlP map, the legal desCription of the property aDd our determination.
Additional documents are enclosed which provide information regarding the subject property and LOMAs.
Please see the List of Enclosures below to determine which documents are enclosed. Other attachments
specifie to this request may be included as referenced in the DetcaminationlComment document. If you have
any questions about this letter or any of the enclosures. please contact the FEMA Map Assistance Center toll
free at (877) 336-2621 (877-FEMA MAP) or by letter addressed to the Federal Emergency Management
Agency, 12101 Indian Creek Court, Belt~ville, MD 20705. Additional information about the NFlr is available
on our web site at http://www.fcma.govlnfipl.
Sincerely,
'\~~. ~~
Matthew B. Miller, P.E., Chief
Hazards Study Branch
Federal Insurance and Mitigation Administration
LIST OF ENCLOSURES:
LeMA DETERMINATION DOCUMI!NT (REMOVAL)
cc: State/Commonwealth NFlP Coordinator
Community Map Repository
.
FROM MESENER I i'I< CONSTRUCT ION
PHDi'E 1'1).
9524475036
Ma\:l. 29 2002 08: 36RM P3
Page' of2 I IDlta:~22.2002 lease 1\10.: 02-0~823A 1 lOMA
(I) Federal Emergency Management Agency
Washington, D.C. 20472
LETTER OF MAP AMENDMENT
DETERMINA nON DOCUMENT (REMOVAL)
COMMUNITY AND MAP PANEL INFOIlMATlON LEGAL PROPERTY DESCRIPTION
City of Prior La~e. scott County, Lot 16. Oakland Beech.... shown On a pie!. filed for record on June 1. 1926.
COMNlUNITY Mlnn_oc. by the Register of Deeds, ~Il County. Minnesota
co"'UNITY NO.: Z7043Z
NUMBIR: 270432C1l1GZC
. AFFErnD . ~.~ City or Prior WiI<..
.. :I,IAPPMi!L .80011 Cl>UnIY. ......ola .
.
DATE:11/11l11fi7
FLOODING SOURCE: LOWER PRIOR I..AJ(E APPIlOJGMATILA'I1TUDE & LONG/TlJDE OF PlltClPEA'I"l': 44.771. -113311
SCURCI OF LAT & LONG: MAPllLASI'I DATUM: NAP 83
DETERMINATION
. 1% ANNUAL LOWEST
OUTCOII1E LOWEST
BlOCI(J WHAT IS CHANCE ADJACENT LOT
LOT SUBDIVISION STREeT RElAC>VED FLOOD FLOOD GRADE ELEVATION
SECTION FROM THE ZONE ELEVATION ELEVATION (NGVO 291
SF'" (NGVD 20) (NGVO 29)
16 Oakland Beach 14824 Oakland Slrudure
- B_ch Avenue X (ohadod) 908.9 _ gog.S feet
-
Spedal Flood H....rd ANa (SFIiA)- The SFHA is an al"ell that wotld be Inundated by theftood h8Ving a 1-percent chenc:. ofbelng oquaJed or
exaoecled in anyg.,.., )'8Br(basefiood~
ADDITIONAL CONSIDEIlA TIONS (Pl.... ,.rer 10 !he _",priate section on A_.nll lor lhe additional co""ld.",~ons listed balew.)
PORTIOlIiS REMAIN IN THE SFHA
This dooument prOVides the Federal Emllfllonr;y Manag.ement Agency's delltrmlnollon rogan:llng . request for a Lattar of Map Amendmont for \he property
described abo... Using tho Inlonnation oubmilled and tho affoetilie Nalienal Flood Insurance Program (NFIP) m.p, _ h... d.lerminod th.t the
struc::lure(s) on the propet1y(ies) is/are nolloeal8d In tho SFHA. .n area inundated by tha ftood having a l..pereenl chan"" of being equaled or exceeded in
My given year (bas. lIaod). This document .mends tho otl'1oc611$ NFIP map to remove the subJoc:t proparty fron'llhe SFHA Iocetad on the ellectivo NFIP
map; therefore, the Fed.tal mandatory flood Insurance !'IIqlJfternent cloes not ap~y. HoweYIN', the '.nder has the option to contlr'lu. the ftood insurance
requirement to pnllilCt ila flnancial risk on thelOlln. A ,.,.fetrod Risk Pelley (PRP)Ie IiVlIllable for bulldtng. located aulslde the SFHA. Inlonnalion aboul
the PRP and how one can apply is encloaed.
This determination Is ba,ed on the nood data prnently available. The endOll~ dOcuments "ro\ride additional Jnformation regarding this determination. If
you have any quo.lIons about this documenl plea" centad the F'EMA M.p Asalslance Center toll free at (877)336-2627 (S77-F'EMA MAP) or by letier
add,...ed to the F.de",1 Emargancy ManagomenIAge_. 12101 Indian C...k Court. Ballsvllle. MD 20705. Aclditional inlonnation aboull"" NFIP ;a
availabl. on our web sllo al h'lp~/www.fema.g""/nflp/
'\~\!:.. '\~
. ~llhew B. '~In",. P.E.. Chief
H_' Slu<ty Bronch
podlIrallnaur..... .nd Mltigollon Administnltion Version 1.3.3 3817030151743
FROM I'ESENBR I i'I< CONSTRUCT I ON
PHCJt.E NO.
9524475036
May. 29 2002 08:37AM P4
Page 2 of2
I
lo.te:May22,2lll12
I Case No.: 02-Os.2823A
I
LOMA
(I)
Federal Emergency Management Agency
Waabington. D.C. 20472
LETTER OF MAP AMENDMENT
DETERMINATION DOCUMENT (REMOVAL)
ATTACHMENT 1 (ADDITIONAL CONSIDERATIONS)
PORTIONS OF THE PROPERTY REMAIN IN THE SFHA (This Additiona' Consideration applies to the preceding 1
Property.)
This Determination Document has removed the subject of the determlnelfon from the Special Flood Hazard Area (SFHA).
However. portions of the property may remain In the SFHA. Therefore. any future construclfon or substantial Improvement
on the property remains subject to Federal. StIIte/Commonwealth, and local regulations for floodplain management.
This atlacllmllnl provides oddlUonal Infonnallon "IllI'Cllng lIlis request. II you haW! any q....tions about this ottachment. p1e..e c:cntact tho FEMA Map
_slanca Conblr ...., rr.. at (Sn) 338-2827 (Sn.FEMA MAP) or by Ie"", addressed to lhe Federal Emergency Mllnagement Agency, 1~101 Indi.n
Cleek Court. Beltsville, MD 20705. AddIUonallnformaUon about the NFIP Is ayeUable on our _b site at htlp:/_.fery,.,llDVlnftP/.
'\~~. '\.~
Matthew B. Miller. P.E.. Chlof
Hazardo Study Bronch
Federal Insurance and M1t1gallon Adminlslrotlon Version 1.3.3 381703051743
FRa'l MESENBRINK CONSTRUCT! ON
PI-IlH: NO. 9524475036
Ma':j. 29 2002 08:37AM PS
Federal Emergency Management Agency
Washington. D.C. 20472
LOMAENC-I
ADDITIONAL INFORMATION REGARDING
LETTERS OF MAP AMENDMENT
When making detmninations on requests for Letters of Map Amendment (LOMAs), the Federal
Emergency Management Agency (FBMA) bases its determination on the flood hazard information
available at the time of the detcmnination. Requesters should be aware that flood conditions may
change or new information may be generated that would supersede FEMA's determination. In such
cases, the community will be informed by letter.
Reques~ also should be aware that removal of a property (pmel of land or structure) from the
. Special Flood Hazard Area (SFHA) means FEMA has detelmined the property is not subjeCt to .. .
inundation by the flood having a l-pereent chance of being equaled or exceeded in any given year.
(base flood). This does Dot mean the property is not subject to other flood hazards. The property
could be inundated by a flood with a magnitude greater than the base flood or by localized flooding
not shown on the effective National Flood hlsurance Program (NFlP) map.
The effect of a LOMA is it removes the Federal requirement for the lender to require flood insurance
coverage for the property descn'bed. The LOMA is not a waiver of the condition that the property
owner maintain flood insurance coverage for the property. Only the lender can waive the flood
insurance purchase requirement because the lender imposed the requirement. The properly owner
must ..-quest and 1"flctdvc a .wrltte>a waiver from tll. I""d",. before c01Ice/ing III. policy. The lender
may detcnnine, on its own as a busu.ess decision, that it wishes to continue the flood insurance
requirement to protect its financial risk on the loan.
The LOMA provides FEMA's cOlll:lMllt on the mandatory flood insurance requirements of the NFIP
as they apply to a particular property. A LOMA is not a building pmmt, nor should it be construed as
such. Any development, new construction, or substantial improvement of a property impactM by a
LOMA must comply with all applicable Slate and local criteria and other Federal criteria.
If a lender releases a property OWl1er from the flood insurance requirement, and the property owner
decides to cancel the policy and seek a refund, the NFJP will refund the premium paid for the current
polic:y year, provided that no claim is pending or has been paid on the policy during the c:urrent policy
year. Thc property owner must provide a written waiver of the insurance requirement from the lender
to the property insurance agent or company servicing his or ber policy. The agent or company will
then process the refund request.
Even though structures are not located in an SFHA, as mentioned above, they could be flooded by a
f1Doding event with a greater magnitude than the base flood. In fact, more than 2S percent of all
claims paid by the NFIP are for policies for stnlctures located outside the SFlIA in Zones B. C. X
(shaded), or X (unshaded). More than one-fourth ofaIl policies purchased under the NFJP protect
structures located in these zones. The risk to sb:Uctures located outside SFHAs is just not as great as
the risk to structures located in SFHAs. Finally, approximately 90 percent of all federally declared
disasters are cal).<:d. by flooding, and hQIIlClOWDers insurance docs not provide financial protection
f'ronJ. this flooding. Therefore, FEMA encourages the widest possible coverage under the NFIP.
FRO'1 : MESENBR INK CONSTRUCTION
.
PHONE i'(J. 9524475036
Ma!:l. 29 2002 08:38AM P6
The NFIP offen; two type.~ of flood insurance policies to property owners: the low-cost Preferred
lUsk Policy (PRP) and the Standard Flood Insurance Polity (8FlP). The PRP is available for 1- to
4-family residential structures located outside the SFHA with little or no loss history. The PRP is
available for Iownhouselrowhouse-type structures, but is not available for other types of
condominium units. The SFIP is available for all other structures. Additional infonnation on the PRP
and how a property OWDCll" can quality for this type of policy may be obtained by calling the Flood
Insurance Infonnation Hotline, 1011 free, at 1-800-427-4661. Before making a final decision about
flood insutllnce coverage, FBMA strongly encourages property owners 10 discuss their individual
flood risk situations and insut1lTlce needs with an insurance agent or company.
FEMA bas established "Grandfather" rules to benefit flood insurance policyholders who bave
maintained continuous coverage. Property owners may wish 10 note also that, if they live outside but
on the fringe of the SFHA shown on an effective NFIP map and the map is revised 10 expand the
SFHA 10 include their structure(s), their flood insunnce policy rates will not increase as long as the
coverage for the affccted structure(s) bas b~ continuous. Propeny owners would contitlue 10
receive the lower insurance policy rates.
LOMAs are based on minimum criteria established by the NFIP. State, county, and community
officials, based on knowledge of local conditions and in the interest of safety, may set higher
standards for c0D8~tion in the SFHA. If a State, county, or community has adopted more restrictive
and comprehensive floodplain management criteria, these criteria take precedence over the minimum
Federal criteria. .
In accordance with regulations adopted by the cll1lllIlunity when it made application 10 join the NFIP,
letters issued to amend an NFIP map must be attached to the community's official record copy of the
map. That map is available for public inspCl:tion at the community's official map reposilory.
Therefore, FEMA sends copies of all such letters to the affected community's official map reposilory.
When a restudy is undertaken, or when a sufficient number of revisions Dr amendments occur on
particular map panels, FEMA initiates the printing and dis1ribution process for the affected panels.
FBMA notifies community officials in writing when affected map panels are being physically revised
and distributcc1. In such cases, FEMA attempts to reflect the results of the LOMA on the new map
pllDe1. If the results of particular LOMAs cannot be reflected on the new map panel because of scale
limitations, FEMA notifies the community in writing and revalidates the LOMAs in that letter.
LOMAs revalidated in this way usually will become effective 1 day after the effective date of the
revised map.
2
>
,.
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
O.M.B. No. 3067-0017
Expires July 31, 2002
1m orlant: Read the InstructIons on a es 1 - 7.
SECTION A. PROPERTY OWNER INFORMATION
For Insurance Company Use:
Po6cy Number
BUILDING OWNER'S NAME C I C I. D I -+-
c a... e re.e.~ ~.;e- 0 ~I
BUILDING ;>TREET ADDRESS ( ing Apt, Unit, Sune, and/or Bldg, No.) OR P.O. ROUTE AND BOX NO.
/4-r;.z.. DA..,L/c...~ ~t::~ oI9ve.",...e..
CITY f'rro. {Je. HdTATE
PROPERTY DESCRIPTION (Lot and Block Numbers, Tax PIfCeI Nu r, LOQaI DescripIion, ele.)
L4>r /tQ ()A-k-L.~NO EA-Gf(
IL I U e.g., 1iBI, 0IH8S ential, Addition, Atx;essory, ole. Use a Is area, necessary.)
5 j Cle..: f,"tJ.. (
LATITUDElLONGITUDE (OPTIONAL) HORIZONTAL DAl\JM:
( #If'.1IIf - #I#.W or #I#.#I##I#If') LI NAD 1927 LI NAD 1983
Company NAle Number
ZIP CODE
S;;;,-37 z..
)'PO)'
LI USGS Quad Map LI Other.
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bl. NFIP COMMI.jNITY NAME & COMMUNITY NUMBER B2. COUNTY NAME 83. STATE
P,.../or C-a../!-e.. Z SC4>rf- C""........ t
. MAP AND PANEL IX 66. FI INDEX . EL
NUMBER ,.. DATE EFFECTIVEIREVlSED DATE ?;ONE(S)
000"2... ~ 11-11-'17 rte.
Bl0.lndlcate the source Dfth~ase Flood Elevatioo (BFE) data or base flood depth entered In B9.
1-1 FIS Profile ~FIRM 1-1 Community Determined 1-1 Other (Describe):
B 11. Indicate the elevation datum used for the BFE In B9: ~VD 1929 1-1 NA VD 1988 1-1 Other (DescrIbe):
B12.ls the building located In a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date:
MtJ
9. A ( )
(Zono AO, use depth of flooding)
9o'j
1-1 Yes IJ::t1'lo
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based 00: I-ICoostructioo Drawings" I-IBulldlng Under CDnstrucUOO" I-!::lI'fnlshed Construction
"A new Elevation Certificate will be required when construction of the building Is complete.
C2. Building Diagram Number --4- (Select the building diagram most similar to the building for which this certificate Is being completed - see
pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
C3. Elevations - Zones Al-A30, AE, AH, A (with BFE), VE, Vl-V30, V (with BFE). AR, ARIA. ARlAE, ARIA l-A30, ARIAH, ARlAO
Complete Items C3.a-1 below according to the building diagram specified In Item C2. State the datum used. If the datum ~ different from
the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion
calculation. Use the space provided or the Commerys area of Section 0 or Section G, as appropriate, to'document the datum conversion.
Datum ..A/ 6 j/J _ Conversion/Comments .IV.? ""'-
Elevation reference mark used Does the elevation refereDce mark used appear on the FIRM? 1-1 Yes 1-1 No .
Q a) Top of bottom floor (including basement Dr enclosure) 9 I 0 . ~ ft.(m) -:
Q b) Top of next higher floor 9 z,z. . -L ft.(m) "
o c) Bottom of lowest hDrtzontalstructural member 'Y zones only) . _ ft.(m) ) ~
Q d) Attached garage (top of slab) '7 Z 1 .IL ft.(m) E i
o e) Lowest elevation of machinery and/Dr equipment . ~ t
servicing the building (Describe In a Comments area.) . _ ft,(m) ~ i
Q f) Lowest adjacent (finished) grade (LAG) ") d "l . J:L ft.(m) ~ ~
Q g) Highest adjaceDt (finished) grade (HAG) 9 z.. I . Q.. ft.(m) ~"
Q h) No. of permanent openings (flood veDts) within 1 ft. above adjacent grade ~
Q I) Total area of all permanent openings (flood vents) in C3.h sq. in. (sq. cm)
SECTION D. SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed aDd sealed by a land surveyor, engineer, Dr architect authorized by law to certify elevation Information.
I certify that the inlormation in Sections A, B, and C on this ceriificate represents my best efforis to interpret the data avanable.
I understand that any 'alse statement may be punishable by fine or imprisonment under 18 U.S. Code. Section 100/.
CERTIFIER'S NAME ? /.; y t:/ ,e::: ~,../ LICENSE NUMBER /.5' 9- e... /
TITLE L. a--d S.:rV; '-' r COMPANY NAME /1 n.::>O , .f /l C ,
ADORESS 7..5'/0 H~r ,.o.4teC' DnvZITY Ec/@,., f?-....'rleSTATEHAJ ZlPCODE.s-S3-r'1
C DATE:3 -,&-a Z. TELEPHONE 'SZ-g2..J- 070<>
~FF RR/FR.~F .l:::lnJ: I=nR r:nMTIN1IATI()N
RFPI Ar.F~ AI I PRF\/lnll~ FnJTI(')N~
FI=1AA Fnrm A1.':t1 .111 nn
IMl"ORTANT: In these spaces, copy the corres ndlnglnfonnatlon from Section A.
BUILDING TREET Pi) SS (Incklding Apt.. Unit, SUte. and/or Bldg. No.) OR P.O. CUTE AND BOX NO.
../. ~Z O&J-kla..i'Ld" 8~a.cJ,. V-e J1/A
CITY .?rf~"'" Ca-k.e... STATE/1A1 SSr~ CompanyNAlCNumber
SECTION D. SURVEYOR, ENGINEER, OR AltCtllTECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company. and (3) building owner.
COMMENTS
For Insurance Company Use:
Pofley Number
L I Check here if attachments
SECTION E. BUILDING E~ATI.ON INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items El. through E4. If the Elevation Certificate is intended for use as supporting
Information for a LOMA or LOMR-F, Section C must be completed. .
E1. Building Diagram Number _ (Select the building diagram most similar to the building for which this certificate is beiDg completed -
see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.)
E2. The top of the bottom IIoor (including basement or enclosure) of the building is l-l-I It.(m) l-1_lin.(cm) l-I above or l-I below
(check one) the highest edjacent grede. (Use natural grade, if available.)
E3. For Building Diagrams 6-8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building Is
l-I_I ft.(m) l-l-lin.(cm) above the highest edJacent grade. Complete Items C3.h and C3.1 on front afform.
E4. For 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? I_I Ves 1-1 No 1 I 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, C (Items C3.h and C3.1 only), and E for Zone A
(without a FEMA-issued Dr community-issued BFE) or Zone AO must sign here. The sfatemenfs In Sections A, 8, C, end E are correct to
the best of 'SWNknowl~.
PROPERTY ER'S OWNER'S AUlIiORIZED REPRESENTATIVE'S NAME
L/"vd" &:. I"1:w
ADDRESS 75/0 H".....~~,? /",4tce Pr;j/~ CITY
~ -c: /-&..r
DA
de... j7r'a/;'-/~
"S-e-o""-
STATEf1 AI ZIP COD~S 3' <f4-
LE ON
?SZ-BZ- -CJ7oo
I I 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.
G 1. l-I The Information in Section C was taken from other documentation that hes been signed and embossed by a licensed surveyor.
engineer, or architect who Is authorized by state Dr local law to certify elevation Information. (Indicate the source and date of the
elevation data in the Comments area below.)
G2. 1-1 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. I_I The fDIIDwiDg information (Items G4-G9) is provided for community floodplain management purposes.
IT UMBE 5. DATE PE IT ISSUED G6. DATE CE T1FICAT F M IANCEIOCCUPANCY
ISSUED
G7. This permit has been issued for. l-I New Construction I_I Substantial ImprovemeDt
Ga. Elevation of as-buii! lowest floor (iDcluding basement) of the building is:
G9. BFE Dr (in Zone AO) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME
_' _ It.(m) Datum:
. _ 1t.(m)Datum:
TITLE
COMMUNITY NAME
TELEPHONE
DATE
SIGNATURE
COMMENTS
'-.1 Check here if attachments
I=FUA~nrmA1.'\1 ,1111 nn
RF=PI Ar.F~ AI I PRJ=\/I01 I~ J=nITION~
PRIOR LA~':': DEPARTMENT OF
R ~ " BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS J c.JJ.. 2'1
NATURE OF WORK ,.. l"h.. ')
USE OF BUILDING
PERMIT NO. !()- 1G.~2J:JoO
CONTRACTOR I l.( '-f7- ~~
NOTE: THIS IS NOT PERMIT FOR ANY OF THE INSPECTIONSlfELOW
1=loot Ll~uc.P""," THE PERMIT IS BY SEPARATE DOCUMENT
\.e.1tu- ,iJ:'DI\) ~ INSP CT R
B&tR.. FO ING Cr 0 I
.f"D ~ FOUNDATION (Prior to Backfill) \ro^ . tI.:;.l" I
rv-S~ PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Sot- ~~. . ~N... -t UGH . INS J:v.Q; ..
SEWER I WATER I SEPTIC , ~
FRAMING
INSULATION
ELECTRICAL
PLUMBING (,.,(,.., l.\~,
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO
1.f'I14.~
Flo& Z1~.'ou..." Car~~~~ ~
GRADING (Prior to Soddin
BUILDING,. ~.O, ~ 13 \ Oz....
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
Cbkl,... -~ j?. - -L.. ~ 4<.-
r
DATE
UNTIL ABO
I
FINALS ~..e.
I -
S BEEN SIGNED
I
Fh....1.. ..l...,..'i p.
~ -<1-0 z..
~ c7'Z ()~'
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections hav", been' approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 AJIl. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
.,
,
~.-_.~,,',,\~ ." - ~." :j.',,_'. l ,<
__ ,,' .," "'.- At,. .:' -" ~" ,",
""'-'i1.".,"~"':.' . ",,:;,"IL' ."...."'..1>..;....",~,, ,',:" ~;",...~.V" ....... ....~'., ",.".,, ~ n'~.
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED 7~z..- ~
tJ/I J::t.fiNL) d e:J1t!1j
CONTR.
ADDRESS
/ 4~ Z4-
OWNER
PHONE NO.
01, tJ4-7('
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING (!J 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
'fil FINAL 0 PLUMBING FINAL
TI SITE INSPEC ION 0 MECH FINAL
..s 0 D /77t€&
,/
~~~~..Q.
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
P.!lWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~1 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
/
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nME
SCHEDULED ~;<~86
)'ff:.q'! @~
ADDRESS
OWNER
CONTR.
1-'176
PHONE NO.
PERMIT NO.
o FOOTING ~ PLUMBING RI
o FOUNDATIO~ 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATIO ~ 0 SEWER HOOKUP
.,.IPFmAL ~LUMBING FINAL
o SITE INSPECTION J4 MECH FINAL
~I f..t
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-*-&fJ
I
t!-r--
m I
t: (I. .'1) . rll ,I tJ7-
~~
i&~ ~ ~fl(l,
,
o WORK SATISFACTORY. PROCEED
}II CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Conlr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED (p -4-0 "Z.. 9;00
ADDRESS /'iC.;y {)C(t./~1I1c18~c~ 4//('.
OWNER CONTR. Eyk U~" t 1/, 't(-..s
PHONE NO. PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
;6.c~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Cwh !3ox.. 1'9 K.
b~eh - Cge
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
lnSpectDr:~ac ,r" .o,QVner!Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
J"""'"
"
Job Address
Heating Contractor
Name 01 Tester
Date
Percent 0
Percent C02
Percent CO
Stack Temp,
-----
I
1
J
"