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HomeMy WebLinkAboutBuilding Permit 13. 1155 Yc re c cel / r ' , ✓: a / /'a a / hN� ii id �:,; ,, C rrfifh ifr of C xxityntix r CITY OF PRIOR LAKE prp rfmrt f of Puilbittg jittsprrtion - '� Final Permitted ❑ Conditional C.O. Expires ( This Certificate issued pursuant to the requirements of Section 110 of the❑Residential/❑International 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: Use Classification4Bldg.Permit No. 3 1 6 r R / 1 Occupancy Type 1 ` Type Construction V Zoning District R SZ N" Legal Description 0 �t� akc Owner of Building / �� I(�G Si ress / �� C� Contr ctor's Name&Address '' 010234—giCC Buil ng Official e� , , Date: :VI0 6 t/ C Date: ' x, POST IN CONSPICUOUS PLACE y ❑ ❑, in o o g C) ❑�.❑❑ ❑ ❑ o a p n Sl O 0 N �nzmmm p g 0 y=1 r 77 m m 3 m>c�co m m m mp t0 � n > •'yip -17 0 Z % =10D0 O y Ox z 0` 0..... 3 xl50 " o hi 0 a o z 0 73 XI RIIMIMIP XI O 0 _ 47 PZ M m m j . 000000 p A 1 Z 5 m os mxC 3 C v m' 0 ,� W � zxo;o o ; o b m o p - z =pxx -z 0 _ M p 0 0 ��00 0 3 -i m p Z z m Os y C C Z '� m a rtiw O m R A O11 O ob y x 73 0 m 1 � "i z ❑ ❑ ❑ ❑❑ ❑ R. > O � � nm p 47 z D r- v � vo m 4 m >hi 0 mm=140F N - = m • '-I r G) 1) I 5 ')3C ❑ 0 6 . • St.) C 0$1000 ❑ = O CE0 Er xi lir ° 73 ° �1 mz$ m °� gcro 73 ., ti 3r- cazx0 i b m m x Tzz ° z 0 0 'v ip , 4.14 1 _ ,. I le 'I;� > w \ N z z O C h 7 .. _ z 0 m 73 0 0 0000 ❑ ❑ y 'zf x m m m m � `oym - O c c x z N ° ° t , ma mx -0 0 A 0 o o y ' m "' 0 ,,/- zzix —Z m 0 X' o o ,..^ y000 O 3 I� cti % o z �� '" � r- � cC �_ zo m O n m Q r v �li:: (1( O Go z m 77 A 0 9I I tap 0 m On C ?ii m 000000 I' 011110M 1 / 1 ymm3Oj !" • elX 11 z ' m r in 0 0D - - . ^ n 000000 T o > - n n o ■ a O ■ � § 7111 o $ C ■q kr 7i 7) k • �, • ®_ I. � co m Mo gli § § 2rkkkk10 !ri ,J ok 0o § - z z % q / > § §ii r o $ i ► o • z 0 k k Illi �� Ilk O c O O m m m �k�� ■ _ E -4 B ci ^ \q � ��/ k | § ƒ * PI!. � L } % "23 73 § m o 0 , o § h. % t§ z§ § q z r hi Q o Z I i® r ' §§ 73 r4 g _ 0 0141 \ � r § 0 li x k 0 k0 . •/m ❑ 00000 ti / z i , Q � 71nm � § ® .| # knimM� m q z ri > 4 i => mm ■ q . , E -I a § - z § -1r o ( PRi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd e iI TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / F.., ..p. AND LIT CONNECTION PERMIT 9... /7, ,..),7 1 1 t„ ! Jy / / ra" I I. White File PERMIT NO. 3, M,...._ O�P /��e 2. Pink City / // 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 1404. OAr4-409 Owtt Aa yE et-cD LEGAL DESCRIPTION(office use only) LOT;17 BLOCK ADDITION a'w44NQ If'9W4t PID� //5 OD¢. 0 OWNER (Name) 17*JI11 FA if r (Phone) (P 12---. 66-107 (Address) MO ' j v .ii lt dA-0 DPI ve (A.vith (4 1b BUILDER (Company Name) f11Npk11I 4 1 r101) /',. `j4 (Phone) 02.- 403-9Iov (Contact Name) ItVl 4 fJPAV (Phone) SU — 34,3- 01240 A, \' (Address) CH M ileti t 4 4. gI•CIOIIr pTeo 4, • C04-20 TYPE OF WORK New Construction ❑Deck ['Porch ❑Re-Roofing ❑Re-Siding ELower Level Finish ❑Fireplace Addition ❑Alteration ❑Utility Connection CODE: [ I.R.C. ❑I.B.C. ❑Misc. oG Type of Construction: I II III IV V A B PROJECT COST/VALUE $ Zlo1 1 e7 • Occupancy Group: ABE F HI MR SU (excluding land) Division: 1 2 3 4 5 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 accordance with submitted plans. I am aware that the building official can4t'ature is permi or Just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X At 13G00 11- I Contractor's License No. Date Permit Valuation a q3 ary''�--�-- Park Support Fee # $ Permit Fee $ j`/'4^�"^ SAC # -- 1' vO Water Meter Size 5/8"; 1"; $ v _ r Plan Check Fee $ / 41q.. 91,p �C�Q• State Surcharge $ /a /' 6-0 Pressure Reducer $ /67,/OO Penalty $ - ` - Sewer/Water Connection Fee # Plumbing Permit Fee $ /5// 5 Q Water Tower Fee # .... Mechanical Permit Fee $ /5* s 4 Builder's Deposit $ � / ,00 Sewer&Water Permit Fee I $ � '•3-0 Other 7-gg E5coee,t,ii $ 5'00 Gas Fireplace Permit Fee $ �.--SV a TOTAL DUE $ , 7 _ 3 la c5- /' 41(.4 -40 .443 This Applic ion B: o e our Building Permit When pprove "e t� Receipt No. q,0 3 03 1 Date ttQ . �j By 1 .. :f U 10 lh1'I/3 wore: gx�sr-pve' s'g2Rg1674-non/ rot t97" Building Ofticit Date Pe4011160 1206-70 ,7 /a r11 $- / P %4p 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 doe ment when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupanc ust be isSned. / / /s/��� PI ning /O1 —/ .—•/3 sem 134,4<-134,4<- loVvs N't-u.7f" s/t ee� Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372 PR/04, 601 White -Building Canary -Engineering 'hH,vsso`t' (� ( p f�'�'i Pink -Planning BUILDING PERMIT APPLI •N DEPARTMENT CHECKLIST NAME OF APPLICANT /VDR-&/ " APPLICATION RECEIVED q " The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: / 74- O,q, 1 t iJAO 4V • Accepted Accepted With Corrections Denied 4) 4 r Reviewed By: A Date: /0 /0 3 Comments: 4,../k,• _ . c> Z• a2-� AFFP-o\At- OF- F -v-o�fi. r v t,1ctr J`i'm-'�%/a't t ,4� ®V. (dear" toc-t. - (.+ 10-1-1?,J IS ArT 6P2- 3 QX)r-`,iik• rt/ ma � �Uc" �-�a} ( �S�4�ri� Ano Bercpc--- fir ---reerteaen (11/2.riFic.,43-& ne---.6z,LJPeetv-)c.( 1 r a ,6 R-15,tevl - "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 'hNnvsse' �{ \D Pink Canary -Eng-Planningiing BUILDING PERMIT APPLI N DEPARTMENT CHECKLIST NAME OF APPLICANT S 1 A/ 7m-" M ALs�L APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /4-5" 7¢ OR - 9 • � Accepted X Accepted With Corrections ',genied Reviewed By: 4496 Date: /a -H-1-3 Comments: See Reverse Side for Additional Information! See Attachments: 1) Grading Plan, 2) Erosion Control Standards "The issuance or granting of a permit or approval of plans, specifications and computations shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of this code or of any other ordinance of the jurisdiction. Permits presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid." Y Ag fft White -Building 44Hn►eaoo• Al\jCanary -Engineering f Pink -Planning BUILDING PERMIT APPLI ON DEPARTMENT CHECKLIST NAME OF APPLICANT _s-/-1A/z)/-)z,` e,0 _r APPLICATION RECEIVED 1 The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /4-5 74 O,4.GAJ') & & Accepted C. Accepted With Corrections Denied Reviewed By: Date: /0 --/‘--Z? Comments: f��/Y e€r6, r-er J 02. tree- re ,Le t rept bred "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." Nov 191311:25a Preferred Plumbing,Inc. 952-447-5764 p.1 PO I i pRI� ( Date ee'd 01-, it 1 1 CITY OF PRIOR LAKE PLUMBING PERMIT ". . t3 e:.--.: k.e: . �A Luis a PFR UI NO, a.Odd � [3. 11 5 t 3.Yellow Aplicar (Please type or print and sign at bottom) ADDRESS I ZONING(office use) 144C-7q o!.r��1.,Y.e.1 is t...-4.,1� P.►�. S i LEGAL DESCRIPTION colt*use only) • i : LOT BLOCK !ADDITION PID OWNER � (Name) IJ i �� , e. �`.• (Phone) (Address) APPLICANT ! (Name) __Affs s—C r� " , l,n C . (Phone) '4 5lri s ,t (Address) .j40 o 14;10.-.. j'..'.,...' ')'r ) Pr:a r L..k t. .s'.s^31 : (Address) (City) (Zip Code) (Contact Person) !- l o.a (Phone) it,t a.- Lie V. 'ta.41‘. T APPLICANT SIGNATURE DATE 11 F t o)i 3 . APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture I Bath Tuts with or without shower a,, Rough-ins ., Dishwasher I Water Heater Floor Drain ) Water Softener L4 Lavatory(Bathroom Sink) I Stand Pipe(Washing Machine) Laundry[Tray(l or 2 compartment sink Sewage Ejector Shower Stall , i Backflow Assembly Sinks i Backflow Assembly Test -oil Bar Sink{ I Lawn Sprinkler • , 3 Water Closet(Toilet) Other 1 i FEE SCHEDULE Ind tattial.Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 • I Residential.Additions&Alterations 549.50 • The Minnesota Statutes$324.145 ^ist $ Building Permit# "MAGI 4.114E°has been changed for one D WITHi year effective PLUMBING PERMIT FEE S July 1.20/0.until June 30.2(ilt. STATE SURCHARGE $ . l D NG PERMIT The minima& surcharge fora"Bled "permit TOTAL PERMIT FEE $ it 0.bigamist/4,41,NII • Thhi Application Becomes Yoar Building Permit When Approved Paid Receipt No. l i Date By Baiidiat OM dal Date 24 hour motive for all Inspections(952)4479650,fax(952)447-4245 4646 Dakota Street 3.E.,Prior Lake,Minnesota 55372 PRI04, Date Rec'd CITY OF PRIOR LAKE3 SEWER AND WATER PERMIT 10• Z. • 1 U � tr7 NNESa 3. 1 l 1.2. Green File pERMIT NO.' Oh Yellow City 3. Gold Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 14574 Oakland Beach SE LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER (Name) Sandau_Construction (Phone) (Address)_9925 Lyndale ave s Bloomington 55420 (Address) (City) (Zip Code) APPLICANT (Name)_Krueger Excavating Inc (Phone) 952-447-8335 (Address) _P,O,Box 729 Prior lake MN 55372 (Address) (City) (Zip Code) (Contact Person) Tracy (Phone) 952-447-8335 APPLICANT SIGNATURE DATE 10-25-13 APPLICANT PLEASE COMPLETE BELOW Size of water service 1 inches. Location of any couplings from structure feet. Type of sewer pipe. ❑ ABC• ❑ PVC ❑ Cast Iron Estimated length of sewer line_50_feet. Clean out(if required) located at feet from structure. FEE SCHEDULE Residential sewer and water line connection $51.50 Industrial,Com'!&Multi-family 1%of job cost with a$51.50 minimum Sewer connection only $25.50 Water connection only $25.50 Estimated Cost $ 1500.00 Building Permit# SEWER AND WATER PERMIT FEE $ A a 5 STATE SURCHARGE $ .51 TOTAL PERMIT FEE $ fr P Ras • (Office Use Only This Appl' es Your Building Permit When Approved Paid • Date By •ZS • c• � B ►al Date 24 hour notice for all inspections(952)447-9850,fax(952)447-42 PAID WITH 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 UI!D NG PERMIT 4,04 "Ic -CITY OFPR LAKE . Date ATiNG/AIRCONDITIONI Reed• �.`E PES'' /2 . 6 . /2 E.oresilhalc Ptle pmt C�►L Q /3. ,{ ,�"� (1' yrpint: at bottom) : - a.v `/ /�13 . . ALM! ' '' 1.4�J _ !� � f� � ZO1vIWfs (ofPsce use) At C n i c. 1 sb 17"10-ATIN1-F---------CRIPTI, --J O i(office use only) LOT C"' BLOCK •ADDrTION • PID JC- / name) . ''._Arinktio, . ' . • • 9 (Pbenef ►a.-et#2 -3 :21.,_q2_,.._ 1111` ..1& tt L ?moi .APPLICANT` - • (N ) ' o . ' _ 4, : . a, . a k • ■r-1 (Phone}—9 J-'` 1-^'C7 MIIMIZAMILIAtnallq•-•(Address) A 0 (Contact Peon) t� • _ _-'"'.' �` - =J (Phone) __ --- APPLICANT SIGNATURE. : rDATE I ia ____ L• or • • APPLICANT PLEASE COMPLETE BELOW °NEW CONSTRUCTION ❑REPLACBMENT •' DALTERATIONS PURNACE MAKE AND MODEL, FUEL, FLUE SIZE _ RETURN OPS INPUT OUTPUT TYPE OF SYSTEM BEATING OR POWER PLANT PLEANOTE:Air Conditioner II Warm Air Plants Steam , Units and Fireplaces Cannot Encroach It' e c• EliotRadWater into Required Side Yard Setbacks. ■Air Camditioning • 0 Special Devices • Fireplaces with 130 Additions or :Went System - t Ca every to.tlhe Outside of Buildings 1 O , , l r `.e-.. • ,.. `• •1 afire a building FIREPLACE MAKE AND MODEL Zs� ��-?, • ..�` g Permit. — FEE . 1-ULE Industrial,Commercial&Multi Family 1%of job cid eeidcntial,Oars Fireplace $49.50 $49.50 minimum Residential,Heating&A/C(New Constiuc lion) $149.50 Residential,Additions&Alterations $49.50 Residential,Hering Only(Itew Construction) L$64.50 •. Residential,AC Only $49.50 Cost$ _ Building Permit# 4tr;A.)3eS. HEATING PERMIT FEE $ "9i. 1111' STATE SURCHARGE $ 'KID • TOTAL PERMIT FEE S _ " fid, 0 4 ' V:› This Application Becomes Your Building Permiit When Approved Paid • • Receipt No. -- Building tial ,•' ,_. ._ Date Date • By 24 hour notice for all Inspections 447-9850 • 4646 DakotaStreet S.E..Prior Lake.Minnesota 55372 hear39Vd H12i3H 9HIt rig 9009Z60396 ZE:Vi Et8Zf98/Z1 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 COMPANY USE Al. Building Owner's Name David and Judy Pahl Policy"Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number: 14574 Oakland Beach Ave.SE City Prior Lake State MN ZIP Code 55372 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Lots 6 and 7,Oakland Beach,Scott County,MN A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Latitude/Longitude:Lat.44-44-18.18 Long.93-23-22.74 Horizontal Datum: 0 NAD 1927 0 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 7 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) sq ft a) Square footage of attached garage 984 sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s)within 1.0 foot above adjacent grade within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b Q sq in d) Engineered flood openings? 0 Yes 0 No d) Engineered flood openings? 0 Yes 0 No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State Prior Lake MN 270432 Scott MN B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 270432 0002 c Effective/Revised Date Zone(s) AO,use base flood depth) November 19,1997 AE,X 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 ® No Designation Date: 0 CBRS 0 OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones A1-A30,AE,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:City San Manhole=912.1 Vertical Datum: 1929 Indicate elevation datum used for the elevations in items a)through h)below. n 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) 910.0 ®feet 0 meters b)Top of the next higher floor 919.7 0 feet 0 meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑feet 0 meters d)Attached garage(top of slab) 918.3 El feet 0 meters e)Lowest elevation of machinery or equipment servicing the building 910.0 IEI feet 0 meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 909.5 it feet ❑meters g)Highest adjacent(finished)grade next to building(HAG) 918.2 to feet 0 meters h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 912.3 Z feet ❑meters SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.I certify that the information on this Certificate represents my best efforts to interpret the data available. 0�\11111111/Ulli I understand that any false statement maybe punishable by fine or imprisonment under 18 U.S.Code,Section 1001. p` t D l-IhrO�i IQ Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a .�F�o```��""rrr��rrrtrttrrr��i, V 0 Check here if attachments. licensed land surveyor? 121 Yes 0 No -§....):..- LICENSED; LAND Certifier's Name Jeffrey D.Lindgren License Number 14376 = SURVEYOR =*= Title VP Company Name Hedlund Engineering Services,Inc. '�':, 14376 0`�z Address 3995 Pin Oak Drive 0City Eagan State MN ZIP Code 55122 9 E''AurriiiitimA Ilfltl►N�Sd� Signature I �� Date 2113/14 Telephone 651-203-6615 I U FEMA Forrh 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(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 14574 Oakland Beach Ave.SE City Prior Lake State MN ZIP Code 55372 Company NAIC Number SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Per C2.e) The furnace and water heater are located in the basement Signature \,, f �fi Date 2/13/14 S EC Tifths1 c ILDING ELEVATIO NFORMATION(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 E1-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 0 meters 0 above or 0 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 0 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? 0 Yes 0 No 0 Unknown.The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments 0 Check here if attachments. SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable item(s)and sign below.Check the measurement used in Items G8-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: 0 New Construction 0 Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: 0 feet 0 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: 0 feet 0 meters Datum Local Official's Name Title Community Name Telephone Signature Date Comments 0 Check here if attachments. FEMA Form 086-0-33(7/12) Replaces all previous editions. O� PRip� U tri Memo sozP Date: Friday, January 15, 2016 To: Janet Ringberg From: Lynda Allen Subject: Building Permit #13-1155 14574 Oakland Beach Avenue The contractor on the above-subject permit has not met the terms of the tree escrow. The City will retain the $500.00 escrow. Thank you. Lyn. S. Allen Building Services Assistant Phone 952.447.9800 / Fax 952.447.4245/www.cityofpriorlake.com Builders Deposit soro, 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 clean up or corrective work to rectify the situation. A $500.00 Tree Deposit may also be required and will be refunded if specified trees are preserved for a period of one year. By signing this I, the undersigned contractor, acknowledge that I am aware of the erosion control requirements of the City of Prior Lake as outlined in the Erosion Control Measures for Building Contractors handout. c DATE: 9/I(ffI7 SITE ADDRESS: 11'l 14 61%M 'I -yt �' Ave `0.�. PERMIT# /3..//53 REFUND TO BE MAILED TO: 4040 ,1361- ,brio,) t '• (t c'. AUTHORIZATION TO RELEASE '# NDitPe #/tWL��•' 6(16247.0o ,'M 4T'P /'1' %542n Lynda S.Allen Building Services Amount ' 1. / - /(O Acct.801.20204 PLEASE REMEMBER Date rn1ti/ 4it33.Q0 1. KEEP STREETS CLEAN DURING CONSTRUCTION 6-?(P/ O C or 2. KEEP EROSION CONTROL IN PLACE S. I-UMl'OKAKY OCGUPANUY FERMI I MUST NO I EXPIKE-OR$500.00 WILL BE l-ORIEl1 ED SIGNATURE: 4 le ✓t/ •-ffiea ��^b ar ! ?- CASH ONLY IF ALL CheckLockr"SECURITY FEATURES LISTED ON BACK INDICATE NO TAMPERING OR COPYING •=maw©-1=ra:ru ❑ ••=rata: PRIOR LAKE STATE BANK 61433 16677 DULUTH AVE 9925 LYNDALE AVE S PRIOR LAKE,MN 55372 BLOOMINGTON,MN 55420 75-905/919(-Th (952)403 9100 /47---I4-- CONSTRUCTION d_tG_1�2 PAY TO THE /'� ORDER OF �+ �/ d pP"I v ar. I^�'�� - I 7 y SL�vt-+1 owSc�wd . c yr i•�vwc�rr- J� 1 -3t"i— I•� �' ( G' DOLLARS MEMO M' "061433111 1:09 19090 5 51: 1.1,0 110 7011180 }N»NIS-+®.1.(..F.CL.Ntg NMle1la]FN.01.CM.i4,1,001.1=1Fw1MN4/^'.�h01.041Yw®a di..1)•w®WtWKiW®2P..Hb Ma®1,...aWi^a6m Wu.NNi4N�4,4.wN1.611.1.4,0lti�10,14.W0w`4nNw1!H®n+140.10.4=0.00H4 C:1Documents and Settingslamy.DES IGN11Local SettingslTemporary Internet Files1Content.IE51GW7VQCK6IBUILDERS DEPOSIT FORM.DOC DEPARTMENT OF PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 1� . `/9,,b i S NATURE OF WORK 'or. - • USE OF BUILD G _rm ' a PERMIT NO. JLC DATE ISSUED AP. . • CONTRACTOR :,t1,M ny$ PHONE93Z / 7/ee, INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSP C •R ATE FOOTING r� ci- O,L //,�� sVE. , FOUNDATION (Prior To Backfill)1.06A „ - y 1410101 ell A/ f3 RADON RETARDER I PLACE NO CONCRETE UNTI /OVE HAS BEEN SIGNED ROUGH - INS SEWER/WATER/SEPTIC FRAMING INSULATION 1:2( ( ,' ELECTRICAL PLUMBI NGAsen.4m6ihb/x)"40, At, T i ) )4..I( HEATING P I a c- FIREPLACE � ,,127��� GAS UNE AIR TESTZ ` "' %'tel RADON 111111111111111Rrytei COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED HOUSEWRAP 1201leis LATH FINALS GRADING ( PRIOR TO SODDING) BUILDING renARENVear ,P1 I I o f c ELECTRICAL I PLUMBING HEATING , DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED NOTICE This card must be posted near an electrical service cabinet prior to rough-in inspections and maintained until all inspections have been approved. On buildings and additions where no service cabinet is available, card shall be placed near main entrance. FOR ALL INSPECTIONS (952) 447-9850