HomeMy WebLinkAboutBldg Permit 03-0172
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE .. (B-
AND UTILITY CONNECTION PERMIT l-{;..J(7~)'!.~ l;l-~J-{)Y
1. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO. 03 -0/ 7~"
(Please type or print and sign at bottom)
ADDRESS
51DO C01-\Do\-\~ ST12.E.E..-r
LOT' l BLOCK
LEGAL DESCRIPTION (office use only)
ZONING (office use)
~/5})
S.E.
ADDITION CC>t...tt::~::lI.js WOO(:::) ~1 ~
OWNER
(Name)
(Address)
BUILDER I 1.. _ __
(Name) ~E.yLA1--lD ~
(Contact Name) ~\~
(Address) 110'2l Flt:>t4 Pr. ~D. .z:;.E .
TYPE OF WORK
JilNew Construction
'J8Lower Level Finish
ODeck
7- ~Fireplace
OUtility Connection
o Misc.
PIDd!7 - 0J-9- OOr?-O
(Phone)
(Phone) CJ52 - #0 - 9~ 0 0
(Phone) ~1:...
?~IDt2- LA~
o Porch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
PROJECTCOST/VALUE (exdudingland) $ $IC>I~
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
SUbm~.tte plans. \a aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter up _ the ~ 1 to perform needed inspections.
xl'. - ~ \~? 1'2-31 -O~
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
..
"'510.000,00
$
$
$
$
$
$
$
$
'it to'!. 75
ILl lO~~4
/5S,()~
1"0.00
/00,00
3 S, sa
~.f)d
This Application Becomes Your Building Permit When Approved
~..:~~
Building Official
/1~7~3
,
Date
I Park Support Fee # $ E3.'l4.s0/\/t::.
I SAC # $ iE'HJ mvu
I WaterMeter Siz~;l"; $ ,;J50,oo
I Pressure Reducer $ L/ S.p~
I Sewer/Water Connection Fee # $ IE x/!;,rIAlu,
I Water Tower Fee # $ E>lIST/^'u
I Builder's Deposit $ loOt), () CJ
I Othe. \~U::;t 1Jp.o.S 'IT ~ ,2/ZO/D2. $
I TOTAL DUE(r~lf:.:.rw~.}t,t!~O~'ilS; 905.. ~9
Paid ~/)~s7 Receipt.J4o. .f/3qz,0
Date .z ~ U-()3 By '1- . -
o
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document .
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~i~ue~. --'1-~ f\ )., O''}.. Tr.e.e emiL, ChW'l ~clnG'1 ~ 4-all Df
"". ~ I . U nee.. r<<2f tlc-eme.n t u
. t Ph lni ll. qirector. Date Special Conditions, if any
hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
BU!1-DING OWNER'S NAME
/((}ll1e>" W.. JVS-r
BUILDING STREET ADDRESS (Including Apt, Unit, Suite, anellor Bldg. No.) OR P.O. ROUTE AND BOX NO.
5/00 C""d,.t/l'S :5J,~f 5-6.
CITY STATE
trr"rt...~~ NlN
PROPERTY DESCRIPTION ~t and Block Numbers, Tax Parcel Number, Legal Description, etc.)
( ~ ("o,,"~NJ'S ~
BUILDING USE (e.g., Residential, Non-residential, Addition, ~ry, etc. Use a Comments area, if necessary.)
I{ (!IS ,'c!tM..J-" 4/
LATlTUDElLONGn-UDE (OPTIONAL) HORIZONTAL DATUM: SOURCE: 0 GPS (Type):
( #If' -#If -##.#If' or ##.##II#If) 0 NAD 1927 0 NAD 1983 0 USGS Quad Map
SECTION B. FLOOD INSURANCE RATE MAP (ARM) INFORMA11ON
B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER I B2. CDUNlY NAME /7
~~4~ ~D~ C~~
84. MAP AND PANEL B7. FIRM PANEL
NUMBER B5. SUFFIX 86. ARM INDEX DATE EFFECTIV5REVISED DATE 88. FLOOD ZONE(S)
270'132. ()()()ct C )J,t/t,rlbv 1I~/99? AI"lI8rIbr I,f~ /997 Ae / X
B10.lndicale the source of the Base Flood Elevation (BFE) data or base flood depth <,:.,11:.,"'" in B9. .
o FIS Profile ~FIRM 0 Community Determined 0 OIher(Desaibe):
B11.1ndicale the elevation datum used for the BFEin B9:8'NGVD 1929 . 0 NAVD 1988 0 OIher(Desaibe):
B12.ls the buildil1Q 1u....."J in a CoasIaI Barrier Resourt:es System (CBRS) area or OIherMse Protected Ivea (OPA)? 0 Yes ~'No DesiQnaIionDaIe____
SECTlON C. BUILDING ELEVA110N INFORMATION (SURVEY REQUIRED)
C1. Building .0;0." '" are based on: 0 Construction Drawings" 0 Building Under Construction" .rg Finished Construc:lion
*A new Elevation Co, ~r......" will be required when lXlI'lSIrucIion of the building is complete.
C2. Building Diagram Number 7 (Select the building diagram most similarto the building forwhich this certificale is being completed - see pages 6 and 7. If no diagram
accurately 'CJ.I'~ the building, provide a sketch or photograph.)
C3. Elevations - Zooes A 1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, AAJA, AAJAE, AAJA 1-A30, AAJAH, AAJAO
Complete Items C3.-a-i beJ(7N 8CXXlIding to the building diagram specified in Item C2. S1ate 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 BFE. Show field measurements and datum conversion calaJiation. Use the space provided or the Comments area of
Section D or ~ G, as ap""..",;..;e, to document the datum conversion.
DalumJ6fD '~rsionlComments
Elevation refelence mark used~'f.51 Does the elevation reference mark used appear on the FIRM? 0 Yes ~No
a) Top of bottom floor (including basement or enclosure) 9~. S:.JI.~
b) Top of next higher floor ~.l.fl~
c) BotIom of lowest h..,;"""b: stnJcIural member (V zones only) "A_fl.(m)
d) Atlached garage (top of slab) 1B-. ~fl.~
e) Lowest elevation of machinery and/or equipment
servicing the building (Desaibe in a Comments area) liA. _fl.(m)
ij Lowest adjacent (finished) grade (LAG) ttL. .iM~
g) Highest adjacent (finished) grade (HAG) q~. 2fl./P(
h) No. of ".." '10"""; openings (flood vents) within 1 fl. above adjacent grade 0
i) T etal area of all PC"IIO,oBnt openings (flood vents) in C3.h (') sq. in. (sq. an)
SEC110N D. SURVEYOR, ENGINEER, OR ARCHITECT ,",cru Il"lCAllON
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 in Sections A. 8, and C on this certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.
CE!3.TIFIER'S NAME LICENSE NUMBER
r/Dhfl t. LflJ'{.DII /981.9
TITLE C~MPANY NAME .
~. ~~"i.S' fA iNld 5"vrve'J'fJr !1'ortRer 61.f/At't'I'l,,_q 1.,1.
I NJ SS CITY " STATE
2q,. el1 hrlr/s~ 1Af/y{) Jfl~,,~/Q 1/~/9'/s /fIAI
\ SIGW,jl1RE DATE TELEPHONE
'-,IX-... ~ 7-z8"'....o~ (65/) ISI-I?I'!
;
1"cucr<AL EMERGENCY MANAGEMENT AGENCY
NAT10NAL FLOOD INSURANCE PROGRAM
ELEVA nON CERTIFICATE
Important: Read the instructions on pages 1 .7.
SECnON A. PRo...l:I\1 (OWNER INFORMATION
FEMA Form 81-31, January 2003
See reverse side for continuation.
a.M.B. No. 3067-0077
Expires December 31, 200:
Forlnsuranoo Conllany Use:
.PoIicyNumber
I CompanyNAICNumber
ZIP CODE.:
~ S'!.., '2-
o Other.
B3.STATE
Af#
B9. BASE FLOOD ELEVATlON(S)
(Zme AD, use depth of fioodilg)
tJ09 /#/1
M
ZIP CODE
$517.0
Replaces all previous editions
~~
IMPORTANT: In these a~" .; .l, copy the conesponding Information from Section A
BUILDING STREET ADDRESS (Indudilg Apt, Unit, Suite, and/or Bldg. No.) OR P.O. ROUTE AND BOX NO.
6/00 t.('J"den,S S/.ruf S. ~
CIlY
Ir/(JI" L41<~
For Insurance Company Use:
Policy Number
STATE
111/1
SEC110N D - SURVEYOR, ENGINEER. ORARCHrTECT CERTlFICATION (COtmNUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agentlcompany, and (3) building owner.
COMM~NTS L / /J I l / /
L~4 0/ descr"I,D4: or / '-"tJ" <:rtM -S <<JA7d A/tl'. 11,4/ hrl /If: ",/ /() a~~ f..c..ioa::I A, ~ b,;,,~
. .,. . .,. I
~OJ;/~/(" ,,~ f'~ I'o;%w,~t; d&r,b~" /,,,,: 5"4"/ /'~t! /;(I"'A/l/~~ .1 4 .I'J"/~J, an It"~ S(Jt;.J~
I;,,~ /1~ ~~/J Lo/ //7. ~/;;t.vO'/ b4 /c.tA!t!'r1 ';'J,~ $e;>c.dl, ..vc!'sl Ct~q/ S"dvflt,.~.sl- ~~,r~e"s lJ,.,ro,c;
fltt~~t! Ilorll,tlr/;I I'Ct~Q lie I ~"f" 11a~ eul- /''n~ (),c $"Q,d Lol IO((."../') ~herehttachments
SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E 1 through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR.f,
Section C must be c:ompIeted.
E1. Building Diagram Number _(Seleclthe building diagram most similar to the building for which this certificate is being c:ompIeted - see pages 6 and 7. If no diagram accurately
1'et--,c="L:, the building, provide a sketch or photograph.)
E2. The top of the botIom floor (induding I.x.oc.,.ent or endosure) of the building is _ fl.(mLin.(ern) 0 above or 0 below (check one) the highest adjacent grade. (Use
nalural grade, if available).
E3. For Building Diagrams &8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is _ fl.(m) _in.(ern) above the highest adjacent N . A..
grade. Complete items C3.h and C3.i on front ofform.
E4. The top of the platform of machinery and/or equipment servicing the building is _ll(m) _in.(ern) 0 above or 0 belcm (check one) the highest adjacent grade. (Use
natural grade, if available).
E5. For Zone AO only: If no flood depth number is available, is the top of the L"';;"," floor elevated in 0""'" Jance with the community's fkxxlpIain management ordinance?
o Yes 0 No 0 Unknown. The local official must certify this information in Section G.
SECTION F - PROrCl\I (OWNER (OR OWNER'S ncr'~ENTATIVE) CERnFICATlON
The property owner or owner's authorized representative who completes Sections A, B, C (Items C3.h and C3.i only), and E for Zone A (without a FEMA~ssued or community-
issued BFE) or Zone AO must sign here. The statements in Sections A, B, C, and E are correct to the best of my knowledge.
~RTY OWNER'S O~ OWNER'S AlJ1):lpRIZED REP~S':.NT~E _
~OONa" "' U\.-~ ~ ~.~~U\I nSse.. 0 \'eo
AD~SS J . CITY
S\OO (OAUO>')S S+-. S. E . 1)'(\oC\...- Lc-'G-~
~~,~\~ ~,Q~fWS~~~
COM~NT~ ) /
ZIP CODE
~yNAlC Number
t\.S~ATE
,~,~ .
TELEPHONE
ZIP CODE
rL~frl--
o Check here if attachments
SECTION G - COMMUNITY INFORMATION (OPTIONAL)
The local official who is aloJ IVI ~ by iaIN or ordinance to adminislerthe 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. 0 The infotmalion in Section C was taken from other documenIation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state
or local law to certify elevation information. (Indicate the sourte and date of the elevation data in the Commen1s area below.)
G2. 0 A community official completed Section E for a building located in Zone A (without a FEMA~ssued or """",,Jnity-issued BFE) or Zone AO.
G3. 0 The foIioYJing ;,.rVl"IO~UII (Items G4-G9) is provided for "'" ,ft"Jnity floodplain management purposes.
G4. PERMIT NUMBER
GS. DATE PERMIT ISSUED
I G6. DATE CERTIFICATE OF COMPLIANCEIOCCUPANCY ISSUED
G7. This penntt has been issued for: 0 New ConslrucIion 0 Substantial Improvement
Ga. Elevation of as-buiK k1Nest floor Onduding basement) of the building is:
G9. BFE or On Zone AO) depth of flooding at the building site is:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
COMMENTS
_._fl.(m)
_._fl.(m)
Datum:
Datum:
TITLE
TElEPHONE
DATE
o Check here if attachments
FEMA Form 81-31, January 2003
Replaces all previous editions
FLOOD INSURANCE RATE MAP EFFECTIVE:
SEPTEMBER 29. 1978
FLOOD INSURANCE RATE MAP REVISIONS:
NOVllmber 19. 1997 - 10 add base flood .. , :. u. IOIds Ind road nemes. and
1P8Ci1ll flood hazard 1tMS. to chlnge IpICiIl flood '-d __ IIIlcI ~
deIlgrllltions. to updata corporeta IIml1s and m1p fOI1nlt. and to reflect
updllted topographic information.
To delannina illloOO irlSlJrance is avaUable in Ihis community. contact Your
insurance silent or cell the Nationel FlOOd Insurance Ptogrem It (BOO) 638-&l2O.
.
APPROXIMATE SCALE
600 0
~ ~ "'"--'01
500 FEET
I
"'\
NATIONAL FLOOD INSURANCE PROGRAM
_ II
,! I I I
.Ii :;1
I.!
. n FIRM .
./1 ROOD INSURANCE RATE MAP
i'., CITY OF
I, PRIOR LAKE,
I..'
I. MINNESOTA
" (r SCOIT COUNn"
;j
r PANEL 4 OF 4
.:I I '(SEE MAP INDEX FOR PANELS NOT PRINTED)
I
I .
II' .
;1.
r
..
Federal Em.....t!t....cy Management Agency
I
./
-
-
INSTANT TESTING COMPANY
7125 West 126th Street Suite 500 Savage, MN 55378
(952) 890-7366 FAX (952) 890-5883
=co
Soils I nspection Report
March 27, 2003
KEYLAND HOMES
17021 FISH POINT ROAD SE
PRIOR LAKE MN 55372
Project: 5100 Condons Street, Prior Lake
Data of Inspection: March 26, 2003 @ 7:15 am
Inspector: David Kolstad, ITCO
A visual inspection was conducted at 5100 Condons Street. The house pad was staked. There was 1 lot In the strip.
All topsoil and soft soil was removed down to a dry bottom. Shallow hand auger probes were done on the east half
and west half to verify soil consistency with depth. Water was not visible in the excavation and was not encountered
In the hand auger probes. All unsuitable materials had been removed to a suitable bottom 50(1. The estimated
over-sizing was adequate. The lot will be cut In areas. Based on the information obtained, Curt Stocker, the
contractor, was advised that all inspected lots are approved for fill.
Block and Lot Number:
Charge Code:
Soil Inspection
Mileage
#602
#612
East end West end
Front 3' 3'
Rear 3' 3'
Side 3' 3'
Front 2Y2' 2Y2'
Rear 3Yz' 3W
Front 906' 906'
Rear 906' 906'
Excavated Sandy clay ~
Bottom Sand I Sandy clay
Relative firmness Very firm
of Botto m
1
12
Over-sizing (Based
on stakes provided
by others)
Fill requIred
(Ap proxi mate)
Depth of sub-cut
(Approximate)
Depth to Water:
Description
of salls
Instant Testing Company
~h~714,~
100 [E]
a3I11V/~NIlS31 lNVlSNI
CSSS06S XVd OS:Ol COOi:/L.;:/CO
.i _
1={o
INSTANT TESTING COMPANY
7125 West 1261h Street Suite 500 Savage, MN 55378 0 (952) 890-73660 Fax: (952) 890-5909.
DENSITY TEST REPORT
KEYLAND HOMES
17021 FISH POINT ROAD SE
PRIOR LAKE MN 55372
prolect: 5100 Con dons Streot, PrIor Lake.
Date Tested: March 26, 2003 @ 1 :20 pm
Ordered By: Curt
Reported: March 27, 2003
Field Technician: David Kolstad, ITCO
Inplace Density Test
Test Number:
1
~
Location:
Center of pad on 3'
of fill
Depth Below Grade:
Subgrade
Visual Soil Class:
Sand
Field Density, PCF:
03-01
3.2
16.2
19.8
119.4
Proctor Curve Number:
Percent Moisture:
Optimum Moisture:
Relative Moisture. Percent:
Required Minimum:
119.2
100
95
Standard Maximum Drv Density, PCF:
Relative Density. Percent:
Remarks:
Copies To:
Charge Codes: Density Tests 1
Charge Per Test
Mileage
#601
#306
#612
1
1
12
(;00 Iil
S;g'" ~ 'Y1f:ItuJfcI.,.~
Daniel J. Naught~, Profe!lsionel ~nelZr. Registration No. 20191
a3111V/~NllS31 lNV1SNI CSSS06S XVd OS:Ol COO(;!L(;!CO
White - Building
C'Canarv - En9iner!r,"~j}
Pink - Planning .
Tht" ern,,.r of .hf I.akr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
1/. /, .I
l' ....p 1 f /(~{# It. ,I f ~....
. \ - ~~~ ..".,... \~L
j i.,
liO
/
r
"'-
-.~)
i
i
....-.,- ~~
- ".-"! ..;, \
....-J~'.... C....J
APPLICATION RECEIVED
I
!
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i /' J
/- /. !< I -/ ,> ]I ; C ...J-
(j-() /j ('.;1 0 /'-- ~) ,,,,S I
."::- f.ll /)
l j (../ '~,/
Accepted
)(
.........
Accepted With Corrections
Denied
Reviewed By:
ttfJJ3
,
Date: 1- '1-0 S
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Grading Plan. 2) Erosion Control Measures
"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."
<.wwte - Buildi~
Canary - Engineering
Pink - Planning
Thr Crn1t'f or Ihe takt ('oun..,'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT J ~ laAJd kl0111e,S
1\'-1 { ,
APPLICATION RECEIVED fa. -:5/-6 ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, ;J /00 (' ~;Uc/olUS SI-
Accepted
Accepted With Corrections
/
Denied
,
Reviewed By: ~ ~f-' Date: / Id ?~ '3
,
Comments: /'~ o..d ~ -/~ '-~. ~ ~
../~ cA4~ ~ l~ t./-o 7:C'.tJ, Z ~
J 0 CI l' .
l~~ ~ ~ I'd 9d1.9 I d1- ~ ~ 9dR.9'A?'f'''o...l.
oj /~r~~~~~.~~
v, U
~~~H.~ ~/~#vt~
~ ~~ ~4-:~~~ ~ <Ja~?(
~ i-/~ ~~ ' ~- i-o Ifi- J/"A/r'- ~ I'~
~ ~Yo~./JJdf~'h~~
tn~~ ~fJ_.~~~./~~~~~
./ v '11_
~17/4v,~~~~.~~
~ ~ ~ f~ ~~..~~,.~/J~ .;.+.
"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
~. - i:'lQ!.n~ring
c.... rink - Plannin9
The Cf'nlrr of Ihe Like Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /
APPLICATION RECEIVED
I
,
.) ;'r-_.-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/f/.)
/'
I
/,.
I
.-.
/
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~R r-
;;J , J I .() ~
Date: -E'-:~C~'J
Comments:
U : fj"'-t 1_ i:ec-!-;J.,.,~ \ I .s.~'-~~' I~Q'c---~~l:L{-ILll=:.: L-x.:}'V<......
l ~
&v~\ j~. ~<~ @~ ~
v' ty€fL py-Q~ IRn~q; ;0-ho ~(l ~ pLctC-Q..o(
cl-YU~d ~ in be- 12-~
./ .\rL-Q-- r-c..p Uu.(J.fLm en-t /.:l.hQll b.Q.. ~ F lLb..
~ I .") . t)(P -0 ~ ( 4''J I' i &~W-Q 0-f3 Wpn.--l..CJL} PeAt. ~ (Yl~ .
"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."
03/13/03 THU 12:37 FAX 6128902753
STOCKER EXCAVATING
(4J 001
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I On:Q\ Fjle PERMIT NO
) Vella", C.rt . 03-172
). Cj(,ld Appli....\
(Please type or print and sir;n at bottOm)
ADDRESS ZONlNG (offitt' USt) I
5100 Condons Street
LEGAL DESCRlPTION (office we only)
LOT 1 ~LOCK 1 ADDITION
Condons Wooddsle
PlD
OWNER
(Name)
Keyland Homes
(phone)
952/440-9400
(Address)
17021 Fish Pojnt Rd. Prior Lake, MN 55372
(Address) (City)
(Zip Code)
APPLICANT
(Name) Stocker Excavating Company, Inc..
(Phone)
952/890-4241
(Address) 12336 Boone Ave.. Savage. MN 55378
(Address) (City)
(Conract Person) Curt /).u. () ~/ 0 (Phone)
.APPLICANTSIGNATUFJ!.-fJfI /J1..1 ~ DATE
APPLICANT PLEASE COMPLETE BELOW
(Zip Code)
same
3/13/03
Size of water service inches.
Location of any couplings fTom structure feet.
Type of sewer pipe.. 0 ABC 0 PVC 0 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 onJy
FEE SCHEDULE
$35.50 Industrial. Com'J & Multi-family 1 % of job cost with a $39.50 minimwn
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.5Q
#>
Building Official
Date
PAID WITH
SU'LO'NGPIS
Paid . . I Receipt No.RMfr
Iri}i~ il U [v) u: I f,)'Y /.'
o,'M8slJ-"_ ~' <--r-
By -I.
(Office Use Only)
This Application Becomes Your Bullding.Perm'it \yben Apprond.
- .' . .. ., .
24 hour potlce for all inspections (952) 44
FILE ~.Jo. 596 04/02 '03 Af1 11: 37 I D : D & D f1ECHAN I CAL
FAX:952 890 4650
PAGE 1
CITY OF PRIOR LAKE:, PLUMBING PERMIT
Date Rec'd
(l'lea~e lVoe or orinl.1Jld ci,,"" at bOltom)
ADDRESS
5/00 (}.o,JOONS 5T. :5.E.
LEGAL DESCRIPTION (olTice use only)
LOT JJ BLOCK I ADDITION WODODA l.-E / (It'll.:l.J:),,tJ'S
OWNER
(NilmeL. KEy L(fAlCJ flomE5
(Addres.~L.JJ() ;) I F/ :5H Pr. RD. ~ .
APPLICANT 1'\ ).."
(Name) 1-J +- (.) f'n.e.f1I:ldN l'(!~l Co. ;rf\-('. (Phone) ?f 9 (). 8.;) g- S"
(Audr~ss) 9/) ;). 5 Lv. IJ tv tI I ~ / # t3 SfJ V IJ 6 €. Tn j.J . 5 53 .7 t
(Addresl) (City) (Zip Code)
(Contact Person) Oo}..) f\J ~ (\ (Phone) 9 5;;>. . 8' 9 0 .... g ;).. ~ 8"
APPLICANT SIGNATURE .v~ J{.9_!:::i-~-~-,. ' DATE Y/3/t> 3
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower .
Dishwasher I
I Floor Drain
I LavRtory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
Rar Sink
Water Closet (To i let)
QUllntity
~
J
I
.5'
3.:
ul,
I
I
1../
.
~;:If<- L~
i. ~:~~ ~~~v I PERMIT NO. :;,. - / 1".JiL
l V.U"", Appll'.1l1 --.J ~
ZONING (an1ceUIC)
"
PID
(Phone)
'Ii/f). 9</00
m,;. $537,J..-
Type of Fixture
J
Rough-ins
I Water Heater
I Water Sottner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assombly
I Backt)ow Assembly Test
I Lawn Sprinkler Ll;.J fi c:> r:LJ...1
I Other
I
I
FEE SCHEDULE
Industrial, COllllllen:1l11 &. Mulli-famlly 1% ufjub C\l~l wilh II $39.50 rnillil~lum Rc:siuc:nlial. Nl:w One & rwo-I"Dmily $99.50
RcsiJclltiul, Additions & Allcmllons $39.:lO
(omce u.. Only)
[Slimmed Cost $ 1</.1)00.00
13uilding Permit # ~.3 -/7OA-
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOT A L PERMIT FEE $
This Application Uecomcs Your Building Permit When Al'provt"IJ
9'1.50
.50
/(/0.00
pd' 8'1 PAID WITH
8L StJJLDING PERMIT
-
I O_;.l I Receipt No.
.r;t1- ~(f0 rS n nn ~ IJ.
L'~~'By
DAle k
- APR 1)-3 LUUJ I U I
24 hour notice for alllnspectlon$ (9~;i;) 44'. O. fax (952) 447-4245 L.;
Ilulldlng Ofnclnl
By
2:S9Pt'1 t1ETRO tV'ry OF PRIOR LAKE tlO.069
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
P.l
.p~(e Rcc'tJ
. i . .. . (Ph;:I$f noe or Drint and sim at bottom)
I AQ~RESS.. ZONING (office \J~e)
! S I CX) (~'"\ ~ \)V'\ ..s
I. rook Pile I PER1\'IIT NO
1, Cte... Chy .
3. \'dlo.. ^rplle,"l C''\ <._ \. --. ~
~.
. . Lfl9tL DESCRIPTION (office use only)
LOf II BLOCK \ ADD ITlON \-l. t . lJ-. \>. ~ \ 'L I (0'\ r\ t'I ~ J
.' OWWBR \1 \ '" \
(Name) ~~"J ~"'~ ~ tl ,~
(A\f~~eSS) \ -, D ~ \ ~,_~ "" ~ -\'.
4
" APr~ICANT ('^. ~ o{''>.. \ ~
(liare) \' \r.t::"- A '\ ", r- __L Y"\ ~
.':', (A~diess) \ ~ '\ ~ C) \.j ~ \ L u "'-\ A V '--
(^ddre~s)
N (,\ v\ l-\/ S L-~ ~ '1...\ \..
~~ 1 ~tJ.J~
PID
e '( \ ~-
\<< \'1;;
(Phone) ~ ~ ~- "'-' ~ ~ ... q \..4 6()
SS~....,~
,~
. (Phone) C, S d., \..1 '-\ l- ~ \ d l{
~" 0- \.L.\l\. \\~ .sS~'Id.
(City) (Zip Corle)
. (Phone) <4~' '), - '-\ ~ (. ~ I \) \-\
DATE ~... ~-~
~:~.. (Cyn~act Person)
.. APJ't.ICANT SIGNATURE
, ~
.~ APPLICANT PLEASE COMl'LETE BELOW
. ~ ,;gJNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
.;.; FU~~ACE MAKE AND MODEL C f." .".......~' ........ {II! to \ ~ 0 - d.O . fUEL (I) ~+
'1.' FLV~ SIZE fJ \[ l RETURN OPENINGS , ~ INPUT \ d C\ /~C\ OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
'.
'.
\ ,:) (J a(J
:
" o Warm Air Plnnl.9
o Gravity
a MechanicAl
'B'\ir Conditioning
~Venl. System
o Slcah!
o Hot Willer
o RadiallOIl
o Special Devices
::t5-0lTlcr Devices '\ c.-.., 1 <> 1-,0 <.,-t,-
PLEASE NOTE:
Air Conditioner Ullfls
Cannot Encroach into
Required Side Yntd
Sethacks
~'!.i. I
.
';.~ Ffl\EltLACE MAKE AND MODEL
- ~
I.
.~
,
,;.. Jnd\IS~~1I11. Commercial &. Multi-Family
'. Re~ldc;rlial. Healing &. A/C (New Conslnlctlon)
R.e~idrti81, He:lllng Only (New Construelion)
'.,
:: E!llirnaled Cost .$
FEE SCHEDULE
I % or jot> cost Residential, Gas Fit cplace
S39.50 minimum
$99.50 Rcsidcmial. Additions & Alterations
SGtf.SO Residentilll, AC Only
CCl
1.5 ()~ ~ Building Penn it #
$J9.50
3iJ9.50
SJ9..s0
.~. . (Ofl(t~ Use On1)')
\ .
;. ' ':hll ArllUc:aUQIl DIIc:omes Your Bulhllug Permit When Approved
'. 1~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID W'TH
BUtlO'NG peRMrr
.'
f;"
.',,'
III
OulhllnlOffidol
r~a!rlJ~1 Recelpl NO..
I ,[ 1_[;:; .J1 .
. . .., Dale I By tt'
Dille i I i
, I - - ,
. " Z UU 1 -en '
1< ."" ..U" ,,'"" '"".,,11,", (')52) ..{y 0, r" (952) <"-"'5 l', i
J3v. _ ~
:.. _ __n. --_."::::.=.:....:J
',I.
~I .
,
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.
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and siltll at bottom)
ADDRESS
5100 CONDONS STREET SE
~. ~e:n ~!~ I PERMIT No.3 -/"1:;;'
3. Yellow Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) KEYLAND HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
5/16/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
HEAT N GLO 6000TR-OAK r.;;,..)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
---~
\1~\7 i'P ~ U ~ Ie I\U \. .
\ lid ~ ~\ fecelPt No.
tdJIAl 2 1 2003 _~jY /7"
Date r- . {/
24 hour notice for all inspections (952) 447-9~02:n ~
.50
$39.50
$39.50
PAID WITH
BUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
P R I 0 R LA KE DEPARTMENT OF
- . . BUILDING AND INSPECTION _
INSPECTION RECORD
SITE ADDRESS 5Jf)tJ ~ S.G.
NATURE OF WORK _ NEc.J ~ '1tJ,J
USE OF BUILDING ., ~ _ -. ....&b. _ .
PERMIT NO. . ,J)'?Y_ (~J . DATE ISSUED J/Z'!GJ
CONTRACTOR ICf'V~ IeMlS PHONE9S''i- {If~ - ~d
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
(Ol,.U~T" H:oo{t.. v.:a..it=(en Rz..t'on. ~ fNo. 10 ~INSPECTOR DATE
r FOOTING I ~ 3 /Z7 ~
FOUNDATION (Prior to Backfill) I ~ I '-i / t{ tLJ3
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC ~ ~
FRAMING ~ t IC?- ~. / J1IV
INSULATION r~~~~~ ~
ELECTRICAL ~
PLUMBING , W _ I ~-- (tI-a;3 :
HEATING (if required) '~. rvfJ -. ~q ~3 IfF.. L (,/VLO
FIREPLACE CfWl .1f' !rt~J to1 / {j/, & if]
GAS LINE AIR TEST rM.(V\ Q;1'1 '(VP!)/)U J.. f,P" yi\1t~( 't~~t"<0I'" vt{? (~~'~f17 ~7be~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNEDSu~~
~~IJ /f!Ilif"1UlJ S-~~GI , I f
II -:e.A Rbc~~1a &;c.o. FINALS <ftC~ f /rD C) qJ~P/Cf3
GRADING (Prior to S9dding) . U 1.7. \ -u ,
BUILDING L0! C- 7/3DtO' ~
ELECTRICAL f)I./L:!]
PLUMBING W t C-
HEATING
DO NOT
t{. I (1!!) leJ 1
(~/23 LD3 /' (, -I Ia -,,)
~ l'i t"3
~
. /'~
"""'" .....,.
OCCUpy UNTIL ABOVE HAS
NOTICE
71M'to3
7/!ftJ tif3
BEEN SIGNED
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
(!ltrfifitaft lIf @trnpanty
CITY OF PRIOR LAKE
~tparfmtnf nf ~uil~ing Jlnsptrfinn
~Final Permitted 0 Conditional C.O. 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:
Occupancy Type
R3
_ Type Construction
VN
Fire Zone
Bldg. Permit No..
N/A
Zoning District
03-0172
RlSD
Use Classification
SINGLE FA~ILY
Legal Description L 11, B 1, CONDONS WOOD DALE
Owner of Building _
Site Address
5100 CONDONS STREET S.E.
Contractor's Narne&Address KEYLAND HOMES, 1}021 FISH PT.. RD., PRIOR LAKE, MN 55372
/ ",1/J /
ROBERT D. 'lUTCHINS . . I . City Planner. DON RYE
Date: .
,
{ .~
Building Official
, ({. J. l.1
;"'-' ,
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~(()w ~/~
SCHEDULED
00-0
r /w1 JCA1 -:;;
DATE TIME
(J7 /2-)J~~
S.7
2-/7 L...
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
--- --------.
~- ~
// /_.'-~
~ L..---t ()~ M ~
--- ~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t//'t'"Y
..t- .~~...""
V~5
0(',46$/1-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~RK. ~L FOR REINSPECTION BEFORE COVERING
Inspector: i/W Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED '-)Jf~
/ rM.c:! O'lo.. ~ '\ ~..,.
~ -
CONTR.
PERMIT NO. ).-/7L
90-0
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
>>d./
/
.-
~ I
I / / ~~ _
\ C-/' l LT.- '--
~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
r~~')
-
h~
I )
I '-f' ./
~
1- V",. 1'1() +- P a.s./-. Y" +- .f;; yo
Orv.S-lrVfl4.+rtrn d~_PdS;1-
.
f i/~~
~ SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
EINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
~oj)
'3\,
ADDRESS
SlOC.) CoUD()()S
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(J?J- t(~
o EXI~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
--0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~I'""of-() V,
C-ufZ0-. ~\()F - OV\
rc:A e-t> 1fQ~ or \ \
~ 1~M2.f\ SvP...r:ACE.. i)Mv~(J rAY ~ O~.
.pG::/{ UT-f 4>P-d)'f..0\ () Y l \
;m(WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
,."",dOC /'t.. Lie OwnerlCoot<
CALL~OR ..lE~NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED '7 t'2...-S-k
ADDRESS filaJ ('1"M ~^"4.. ~
OWNER CONTR.
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
~LUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~ J/tt{~.~~ <4.0 {.., Wv{~1
~~ !AA_~
,1- v4~ _ tjp,.d) {/~~
o WORK SATISFACTORY, PROCEED
f'cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ k Owner/Contr:
U -
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
_~""_'____'~'~"_'~"""_"_"m_...~.__.~_._.~_,_,,",.,,'~,....""'~'~ "_"_'__~_~'_______._
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TillE
SCHEDULED
21-3~~
ADDRESS -61s<D 0~~ %.
OWNER CONTR.
PHONE NO.
PERMIT NO.
3-[7'2-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
" FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
jI FIREPLACE FINAL
o GASLlNE AIR TST
o
CCMMENlS:
_, tJ l/V\?~ ~i\!$(.~~ (l~lk\.~\#
Lv j "'\4.~p 1~~~/"ik~R
~ - - "'I -~
~~~ t- ~ ~ ,~
~. r ~~--\/~1~~c ."
T,.., '~ -~. _hiZ) _ '
~. ~E~ C~~(~,
-h~ .~~~"*~ .~ j~wt.
'\t:/'lMIJJ. (1_~ M~6 w3ei03.
o ~K SATISFACTORY, PROCEED
prCORRECT ACTION AND PROCEED
o CORRECT W~ ~ALL FOR REINSPECTION BEFORE COVERING
Inspector: ~4-- Owner/Contr:
CALL 447-9850 fOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
,,51tn r ~~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
A WATER HOOKUP
,. ~ SEWER HOOKUP
/0 PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE
t{ !1IJ Ie3
>;~
TIME
~f-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
. I
I~?
,I
I
I
(;M.J..t~
I
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../
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.....- -
j
(~
<; '" '" W
'\""
Ltv~ ~~v,J~, ~
"""
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:'::O:ECT ~~OR REINS::::::FORE COVERING
'-"
CALL 447-~~~O FOR THI= ~I=)(T INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
"
.
.Permil"
.JObAddr_:?/eP~~ :;r ~C
.He.ting Conttactot MI: I nO AIR
.r est..../Sign.ture
.Gas Une
Pressurized
Inspected
.Percent CO2
. Percenl 02
F ,n.llnspection .
Q!!!
Ii!!!!
Pounds
Pressure
PERFORMANCE TEST
t,;:...v~ 'P",cent CO ~
t, J 4- .St.ck Temp. / P -z;.
Dale
/
."