HomeMy WebLinkAboutBldg Permit 04-0868
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and sign at bottom)
ADDRESS ~3iz... Co"roV
p".., or L n..~.e.... ,
I. White File
2. Pink City
3 Yellow Applicant
8- Ol-eJ'I
I
PERMIT NO. Oif. 0 S ,,~ j
.s+.....~e.:+ NE:..
MN 55"3,1-
ZONING (office use)
12/5 0
/~ --:r
LEGAL OESCR)fTION (o!f~ce use only) J.- 4 3
/VW Va 41/ LlJ... '"f-# 5 W d
LOT'1ZBLOCKj{"fI'l ADDITION 01) fo
/
(Phone) (9 S" 'L) '141- to 1 L ~
~t"-~ (\<"" Lo...k ~~ Mt\J 55~' 'Z.-
?CU:;~~~Name)l11(JIIJ}/E.#5 C US 10M Bu~t/)E~.s(PhOne) ~..s-Z. 9f~ -O?z./
(Contact Na e) frJ i lie fYJ 0 nil t. ns (Phone) '-12- . 8 5"9. ~~20
(Address) 0 d 77 sh~~.p~ filA. ~37
OWNER C" (1...L k
(Name) rQ\~ ~,""TOS ~
(Address) 'f2.."L y c.. h es+ I\~+ Lo..C\L ^' E
/)()7"'O
TYPE OF WORK . New Construction ODeck o Porch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility Connection 0 Misc.
CODE: rilI.R.C. OI.B.C.
Type of ~nstroction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
OLower Level Finish
o Fireplace
$ "r...... tJJOO
PROJECT COST/VALUE ~v
(excluding land)
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-menuoned 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 can revoke this permit for Just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
x~ ~~~......., - Bc- "t.!li,O 3. 3/-2DO~
Signature Contractor's License No. Date
, Permit Valuation '~2$l)_Jooo,on i I Park Support Fee # ~ 8Si),oo
I Permit Fee I $ /'5~. S"o I SAC #
I Plan Check Fee . $ IZ~. 78' Water Meter Size 5/8"; I"; , $ 30Q,OD
I I
I State Surcharge I $ J 2- s-'. (JlJ Pressure Reducer ' $ 70, (JD
I
Penalty i $ Sewer/Water Connection Fee # ' $
,
Plumbing Permit Fee i $ I t) t) . 00 I Water Tower Fee # I $
I .'
I Mechanical Permit Fee I $ I()o.oo I Builder's Deposit i $ ISaD ,~O
I Sewer & Water Permit Fee j $ 3'5.50 I Other ' $
I "
I Gas Fireplace Permit Fee i $ .l/t),00 I TOTALDUE tJ41UD '.~.04- i $~3~3. 76 j
This Application Becomes Your Building Permit When Approved I Paid ti,-? e.7 .7/ I Re,JiPt No. ~111;-
~\ ~ ~ /J:1IOf{ I Date ~~..tJ ,- 1-1'
Building Otlicial Date
ThIS IS to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This d()cume~n
when signed by the City Planner constItutes a temporary Certificate of Zoning compliance and allows construct~n to commence. Bror: ,~uiancy, a ~tiffate of Occupancy must be
issuet\) I~"en.v/chc.s ~1Le1t Le.tT'3 tJ~ 113'3'
\ ~ 0\. ~ K I d-3 1 01f Dn~ ~ .:- ~ -'f.\-t"&--\,~ c..-\-.
- Planning Director J Da e S ial Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372-1714
RESOLUTION 04-06PC
A RESOLUTION APPROVING A 19 FOOT VARIANCE FROM THE REQUIRED
20 FOOT FRONT YARD SETBACK
BE IT RESOLVED BY the Board of Adjustment of the City of Prior Lake,
Minnesota;
FINDINGS
1. Craig Gutoske is requesting variances from the Zoning Ordinance for the
construction of a single family dwelling on property zoned R-1 (Low Density
Residential) and SO (Shoreland Overlay District) at the following location, to
wit;
6382 Conroy Street NE, legally described as the Northwest half of Lot
41, Lot 42 and the Southwest half of Lot 43, Conroys Bay, Scott
County, Minnesota.
2. The Board of Adjustment has reviewed the application for the variance as
contained in Case #04-76PC and held a hearing thereon on June 28, 2004.
3. The Board of Adjustment has considered the effect of the proposed variance
upon the health, safety, and welfare of the community, the existing and
anticipated traffic conditions, light and air, danger of fire, risk to the public
safety, the effect on property values in the surrounding area and the effect of
the proposed variance on the Comprehensive Plan.
4. The subject lot was created in 1926. The front yard setback variance is
warranted because the strict application would result in practical difficulties
for the property owner.
5. Although there are numerous 50 foot wide lots on Prior Lake, the subject
property measures approximately 100 feet in depth to the OHW of Prior Lake.
This condition does not apply to all lots in the R-1 SO use district. Thus, the
requested front yard variance is warranted.
6. The granting of the front yard setback variance is warranted for the
preservation and enjoyment of a substantial property right of the owner.
1:\04 files\04 variances\gutoske\approval resolution.doc
www.cityofpriorlake.com
1
Phone 952.447.4230 / Fax 952.447.4245
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Doc. No. A 663985
OAACE OF THE COUNTY RECORDER
sev I I COUNTY, MINNESOTA
Certified AIed and/or Recorded on
.....
07 -13-2004at09: 18 Receipt: 000000
Pat Boeckman, County Recorder 04
Fee: $ 19.50
STATE OF MINNESOTA)
)Is.
COUNTY OF SCO'IT )
-{.
The undersigned, duly qualified and Planning SecretaJy of the City of Prior Lake. h"&":"J
certifies the attached hereto is the original tnle and C...u,;,.,l copy of
RESOLUTION 04-06PC
A RESOLUTION APPROVING A 19 FOOT VARIANCE FROM 1HE REQUIRED 20
FOOT FRONT YARD S~l~ACK
Craig Gutoske
#04-76
~ owrf
Connie Carlson
City of Prior Lake
Dated this 7th day of July, 2004
'. . . I'
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Land Surveyors
Planners
K. 0' Valley Surveying Co., P. A.
~ ' Suite 230
(612) 447-2570 16670 Franklin Trail S.E.
Prior Lake, Minnesota 55372
September 22nd, 2004
Craig Gutoske
6382 Conroy Street NE
Prior Lake, MN 55372
RE:As-Built Block Elevations
This is to certify that on September 21st, 2004, I did under my direct supervision survey
the existing concrete block elevations of the residl~nce under construction located at 6382
Conroy Street NE, Prior Lake, Minnesota. And I further certify that the top of block at
said garage is at elevation 913.00 (future floor to be 913.33 +\-) and the top of block at
the walkout of said residence is at elevation 910.54 (future lowest floor to be 910.54).
Aforementioned elevations being on NGVD'29 ADJ. datum.
Scott M. Swanson, L.S.
Minnesota Registration No. 42309
File No. 9850
--.
'FEM.A
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION C:E:RTIFICA'!'E
AND
INSTRUCTIONS
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CE.RTIFICATE
PAPERWORK BURDEN DISCLOSURE NOTICE
FEMA Form 81-31
The public reporting burden for this form is estimated to be 3.0 hours per response. The burden estimate inchldes the time
for reviewing instructions, searching existing data sources, gathl~ring and maintaining the needed data, and completing,
reviewing, and submitting the fonn. You are not required to resp:md to this collection of infonnation unless a valid OMB
control number appears in the upper right comer of this form. Send comments regarding the accuracy of the burden
estimate and any suggestions for reducing this burden to: Jnformation Collections Management, Federal Emergency
Management. Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0077). NOTE:
Please do not scnd your completed torm to the abovc address.
PURPQSE OF THEELEV A1iION CERTIFICATE
The Elevation Certificate is an important administrative tool of tbe National Flood Insurance Program (NFIP). It is 10 be .
used to provide' elcvation information necessary to ensure compliancc with community l100dplain management
ordinances, to dctermine the proper insurance premium rate, and to support a request tor a Letter of Map Amendment or
Revision (LOMA or LOMR-F).
The Elevation Cerlificate is required in order to properly rate post-FIRM buildings, which are buildings constructed afler
publication of the Flood Insurance Rate Map (FIRM), for flood insurancc Zones AI-A30, AE, AH, A (with BFE), VE,
V1-V30. V (with BFE), AR, ARIA, AR/AE, AR/Al-A30, ARlAH, and AR/AO. The Elevation Certificate is not required
for pre-FIRM buildings unless the building is being rated under the optional post~FIRM flood insurance rules.
As part of the agreement tor making flood insurance available in::\ community, the NFIP requires the community to adopt
a floodplain management ordinance that specifies minimum requirements for reducing flood losscs. One such requirement
is for the commwrity to obtain the elevation of the lowest tloor (illcluding basement) of all new alld substantially
improved buildings and maintain a record of such information. The Elevation Certificate provides a way for a community
to comply with this requirement.
Use ofthi~ certificate does not provide a "Yaiv.er of the flood insmance purchase requirement. Only a LOMA or LOMR-F
from the Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal mandate for a.
lending institution to require the purchase of tIood insurance. However, the lending institution bas the option of req\liring
flood insurance even ifa LOMAlLOMR-F has beell issued by FE'i\J1A. The Elevation Certificate may be used to support a
LOMA or LOMR-F request. Lowest tIoor and lowest adjacent grade elevations certified by a surveyor or engineer will be
required if the certificate is used to support a LOMA or LOMR-F request.
This certitlcate is used only to certify building elevations. A sepnrate certificate is required for tloodproofing. Under the
NFIP, non-residential buildings can be tloodproofed up to or above the Base Flood Elevation (BFE). A tloodproofed
building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters)
below the BFE. Floodproofing of residential buildings is not pl~rmitted under the NFlP unless FEMA has granted the
community an exception for residential floodproofed basement'!.. The community must adopt standards for design aud
construction of tloodproofed basements before FEMA will gra:tlt a basement exception. For both floodproofed non-
residential buildings and residential tloodprooted basements in communities. that have been granted an exception by
FEMA, 'a floodproofmg certificate is required.
FEDERAL EMERGENCY MANAGEMENT AGENCY.
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CEIRTIFICATE
C.M.a. No. 3067-0077
Expires December 31, 2005
Important: Read the Instrucl~lons on pages 1 .7.
SECTION A - PROPERTY OWNER INFORMATION
BUILDING O~NER~ NAME 1\\ I.... .
\.:,.~A.iiC\ l,':,u+o~ ~~
BUILDING STREE1\ACbRESl}.(lncludlng Apt., Unit, Suite, ardlor Bldg. No.) OR P.C). ROUTE AND BOX NO.
\.0 ~ ~"2.. '-.A "'~ S... _~ WE'
CITY 0 \ \. \ STATE
T~~o~ \...Q.. \.e t Th~.
p~~~E\~~SC4~N.:\ anCI~ ~bers, ~ax ~r~1 NU\~~~~sc~~o~ =~) ~ 6 .
BUILDING USE (e.g., iden~Non-reSldential. Addition. Accessory, etc. Use a Comments ar~, if necess~ I
:::fl~tj~~ii~~:-!ij~mii6WQ.j,IQ:tt::::t
i:!_~;~~mlr:::.il:::.l:::!j::.!:l:::::::ll:::::::i'::~l:::1::::1:.:':':
:!:%~;1~~rrn~~:I!m!~~_t:'!::::::::!:'1!:::::!!:'!:::'::::;:,
ZIP CODe
'5s':~n L.
~ (to-\\- eo, M~.
LA TITUDElLONGITUDE (OPTIONAL)
( ##0 _ ##' . ##.##" or ##.#####")
HORIZONTAL DATUM:
U NAD 1927 U NAD 1983
SOURCE: U.GPS (Type):
U USGS Quad Map U Other
SECTION B - FLOOD INSURANCE RAl'E MAP (FIRM) INFORMATION
I B1. ~P COMMUtlIlTY t-jAME & COMMUNITY NUMBER' I B2. COUNTY NAMI:: \ \ I B3. STATE
\"'~\O~ ~"'-e "Z.,'\O'-\';rz.. ~c.e~ V"1'\t-' ,
84. MAP AND PANEL B5. SUFFIX B6. FIRM INDEX 67. FIRM PANEL B8. FLOOD B9. BASE FLOOD ELEVATION(S)
NUMBER " DATE EFFECTIVElRE:VISED DATE Z2NE(S) (Zone AO, use depth of flooding)
000'"'2- "- \\-\C\.."\"" \\-\C\_C\..., "E' ~oq,O
810. Indicate the sou.r:ce of th~ase Flood Elell~ (8FE) data or base flood depth entered in 89. (' 40....a
I_I FIS Profile L\1FIRM ~Community D~ined I_I Other (Describe): ~_-.u~\..u \3f" E' ., ... CI
B11. Indicate the elevation datum used for the BFE in B9: ~GVD 1929 1-1 NAVD 1988 1-1 Other (Describe): \
B12. Is the building located in a Coastal Barrier Resources System (CBRS) ilrea or Otherwise Protected Area (OPA)? 1-1 Yes ~
Designation Date:
SECTION C - BUILDING ELEVATION INFCIRMATION (SURVEY REQUIRED)
C1. Building elevations are based on: LIConstruction Drawings. I ~fuildlng Under Construction. 1_IFinished Construction
"A new Elevation Certificate will be required when construction of the building is complete.
C2. Building Diagram Number '3 (Select the building diagram most simil;!lr 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 A1~A30, AE, AH. A (with BFE), VE. V1-V30, V (with I3FE). AR, ARIA, AR/AE, ARIA1-A30, ARlAH, AR/AO
Complete Items C3.a-i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from
the datum used for the BFE in Section B. convert the datum to that used for the BFE. Show field measur.ements and datum conversion
calculation. Use the space provided or the Comments area ~f Section C or Section G, as appropriate, to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used Doesthe..elevaliol} reference mark used appear on the FIRM? I_I Yes L\.t1<fo
Q a) Top of bottom floor (including basement or enclosure) . '\\ 0 . ~ ft.(m) 1i
41
Q b) Top of next higher floor C\ \e. . ~ ft.(m) CI)
Q c) Bottom of lowest horizontal structural member (V zones only) . _ ft.(m) 1 ~
Q d) Attached garage (top of slab) q\~, 2... ft.(m) f i
Q e) Lowest elevation of machinery and/or equipment' :i Ii
servicing the building (Describe in a Comments area.) . _ ft.(m) ~ i
:J f) Lowest adjace!'lt (finiShed) grade (LAG) . _ ft.(m) z ~
Q g) Highest adjacent (finished) grade (HAG) . _ ft.(m) ~
Q h) No. of pennanent openings (flood vents) wlt~in 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 CERnFICATION
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, S, and C on this cettificata represents my best efforts to interpret the data available.
I understand that any false statement may be fJunishable by fine or imprisonment under 18 U.S. Code. Section 1001.
CERTIFIER'S NAME Seo rr M. SW~NS"',..J LICENSE NUMBER 'IZ30Cf
TITLE LA.""c S \l'A...\.Ibot (J!I-. COMP.A.'\J~~ S\')R"~~VI~ GC'd P ~ I
ADDRESS ,...., ~ . \ ~ \ c::!.. CIT'{) ,\. STATE I ZIP C DE
. \ W,1 D ''''''i~~ \<...-'\ \ ~ ~. ~ E f~...h~n..... 4.\W \M~ c:b'?:n
SIGNATURE ..<""..... -J,-, __ . _' _ __' DATE ~ .7 "J TELEPHONE ~ Ill. ~,
~'u_ '''-1.:e-'': ~C? """'\~l--z..~"1::>
FEMA Form a-f-31 , January 2006../ . See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy the corresponding Information from Section A. TIt~i:m~~;;;::::i~;:HMmi~iMlW~f:fiIrn.
::DI~~~E-E ADOC=:;~~""~'~ ::::1 OR PO ROUTE AND BOX N::p CDOE _E'1I
f'g , ^ a", "-.0 ~ . V'v\ ,.l '5 'Ei'?f1 "i:... _ :::::::::::::.::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
. SECTIdN D . SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) _
Copy both sides of this Elevation Certificate for (1) community official, (2) inwrance agent/company, and (3) building owner.
COMMENTS
I I Check here if attachments
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT I~EQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE), complete Items E1. through E5. 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 simils,r 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.)
E2. The top of the bottom floor (including basement or enclosure) of the building is I I I ft. em) LLI in. (em) I_I above or I_I below
(check one) the highest adjacent grade. (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
1_1_1 ft. (m) I_I-lin. (em) above the highest adjacent grade. Complet" Items C3.h and C3.i on front of form.
E4. The top of the platform of machinery and/or equipment servicing the building is 1-1-1 ft. (m) I_LI in. (em) I_I above or I_I below
(check one) the highest adjacent grade. (Use natural grade, if available.)
E5. For Zone AO only: If no flood depth number i~ available, is the top of the bottom floor elevated in accordance with the community's
floodplain manaaement ordinance? I I Ve. I I No I I Unknown. rhe 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 Se,::tIons A, B, C (Items C3.h and C3.i only), and E for Zone A
(without a FEMA-issued or community.issued BFE) or Zone AO must sign hl!re. The statements in Sections A, B, C, and E are correct to
the best of my knowfeclae. -
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS
CITY
STATE
ZIP CODE
SIGNATURE
COMMENTS
DATE
TELEPHONE
1-1 Check here If attachments
SECTION G . COMMUNITY INFOI~MA TION (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 app::icable item(s) and sign below.
G1. I_I The information in Section C was taken from ottl~r documentation thllt has been signed and embossed by a licensed surveyor,
engineer, or architect who is authorized by state. or local law to certi~, elevation information. (Indicate the source and date of the
elevation data in the Comments area below.) .
G2. U A community official completed Section E for a building located in ZOl1e A (without a FEMA-issued or community-Issued BFE) or
Zone AO.
G3. LI The following information (Items G4-G9) is prOVided for community floodplain management purposes.
I G4. PERMIT NUMBER ,. G5. DATE PERMIT ISSUED I G6. DATE CERTIFICATE OF COMPLIANCE/OCCUPANCY
ISSUED
G7. This permit has been Issued for: U New Construction I_I Substantial Improvement
G8. Elevation of as-built lowest floor (including basement) of the building is:
G9. BFE or (In Zone AO) depth of flooding at the building site is:
. _ ft. (m) Oatum:
. _ ft. (m) Datum:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
TITLE
TELEPHONE
DATE
COMMENTS
FEMA Form 81.31, January 2003
I I Check here jf attachments
Replaces all previous editions
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R.2 Districts
Reviewed bY:~ " . m
~ ,~
Date:
~ / /1IDY
Building Permit #
Address:
Legal: L i:J.. B
PID:
Zoning:
Existing Structure? YE@
Subdivision: C On ro"fS ~
Existing Nonconforming Structure? YES @'____
CONFORMS TO ZONING
ORDINANCE
YES
NO
". ,".-,:;~ ~~~:..;,~r~
Yard Setbacks: NA I FAILSI COMPliES
_ Front Yard (can be 20' if avg. w/in 150')
. Side Yards
Standard
25'
10'[
25' if abutting a street
Proposed '. '.-"'",....~
.i . ,riA l"'O~
vtU, ~L - 1"'....f\U.1lAA8 ~
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. Sidewall exceeding 50' requires Sldditional side 2"
setback for every l' over 50' in length.
I - Rear Yard
. Patio Door. provide for minimum to' deck or sign
statement indicating no deck wilr be built in the future'
. From 100. yearftood elevation ofw~trendJNU~P
pond . '.
-From OHW (Prior or Spring Lake)..
10' setback +
2"/1' over 50'
25'
10' side!
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
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. ,'-', .--,--.i~r,;.it"'.r.....-'''"-'.,-:~- ,
(~~L;~,::'U'.,
~ ...<,,>...,.,.,'.
. ,--"".""~--"';'
'~fc;. ,f';';'
, Floor Area Ratio: NAI FAILS I COMPLIES
~ Yard Encroachments~ NA { FAILS ICOMPLlES ':
c.Eaves, atlci:Gutters>oa more thall2.: feefirr widtr;t an&no'
croseii' tfian 5 feetta.aJotline (Easememts). ". ,',.e; ,
MCandother::equipmemtcannot encroaca:on.interior '
side yards. . '<::
.30 Maximum
!
Standard
Tree p'reser:V:atfQfr~lS f COMPtIES,.._
. . TotalE'caliperincnes
[., P'ermit2.5P1o" Removal
I., Galiperjncnes: Removed_,
.. Cauper.Jnches;Freserved
. Replacement
stalTd~mf
YiJ.
,"
L\TENIPLA TE\BLDGLIST.DOC
Standard.
908.9' Prior Lake
914.4' Spring Lake
909.9' Prior Lake /
915.4' SprinQ Lake
Must be l' above flood
elevation for new and existing
structures. If existing
structure wa~ cQI'lS~~~d
. 9119t9041t22ttl:tfi~ii;':;:
. 'addiffdiiatrootls~t'teqilirecf:' ~:-"'
Must be flood ,tfQ~Q~ 'c
-'-"1r-:-~' ,:;;,~,;.::.;:;:""
907 .9' fo~ P'rfOI' lake'
913: 4'fof 5tirincfE:aKEf
I Driveway: NA / FAILS / COMPLIES
· Maximum width at property line
· Required setback
Standard
24'
5' from side lot line or
30' from r-o-w on comer lots
10%
I ·
.
.
, Buildin~ Heig~COM~L1ES)' FAILS
35' Maximum
I Shoreland District: NA I FAILS / COMPLIES
Minimum lot area (square feet)
I Minimum lot width
I Shoreland alterations
I Impervious sl.lrface
Standard -I
7,500 Rip, 7,999 Non-rip I
50' Rip, 57.3' Non-rip I
I
30% Maximum 1
I Bluff in Shoreland: NA I FAILS / COMPLIES
· Setback from top of bluff
Standard
By planning dept.
I. Bluff im act zone
I. Enoineerin certification submitted/a
. I. Gradina in bluff or bluff im act zone
20' From TopotBtuff .
B Ci Engineer t
No importinQ/exPo(tinp_1 .
I Floodclain: NA / FAILS I COMPLIES
· 100 year flood elevation
· Lowest floor elevation
· Proposed lowest floor elevation
· 'Elevations 15 feet from structure
· Road access must be no more than. 2 feet below
Repufatc:ry Flood Protection Efevatibn
_."C,__.
..
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White - B"iltiir,g
r CIWVV - Enalneerhlij)
Pink - Planning
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Th. ('.nl., of rhf I..k. ('ounlt)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSI
....!
./ /;'1':;, '
/ / ,-~.., ;,<",/
NAME OF APPLICANT
APPLICATION RECEIVED
"1"7 ,,, #' '"
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activ~ty which is pro~<:>sed at:
l'( f-"
, "i"~"7 ,j /" If).. ,/ ,~,~....
._..........( .",/ ./ /..../ / i . ~ ~,.~ '<...]
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Accepted
y
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Accepted With Corrections
Denied
Reviewed By:
mJ~
Date:
R -/tJ-O,-!
Comments: See' Reverse Side for Additional Information! '
lY?t./'nk/r. ErtQ5/c;V\ G""f,..o I un!," fvr.f- /,(, ~5~1J,~4t!/
See Attachments: 1l..Grading Plan. 2) Erosion Control Measures
liThe 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."
Tht Ctnttr of Ih. tak. ('ounlry
White - Building
Cana!"( - Engineering
~K' - ~Janmny...,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
211<.7}t')!~1<<l
K .. c) "J-. L)' I
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ :) (~: __~~,./" / .) / -,-J--'
I .....--'" 11 ..
Accepted
/
)
Accepted With Corrections
Denied .--..
Reviewed By: ( ~
Comments: ~~
,)...D
,
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F'
fY\.~
~~~
U
Date:
V'\.n .. W
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~
liThe 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."
Thl' Center of the t.kr ('ounlry
/'White - Build~
Canary - t:.nglneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~ ~-6/~
~ ~ O-;2-DY
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/'23f(';:). ~ f;-J
Accepted With Corrections /
Accepted
Denied
Reviewed By:
Comments: R ~
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~~~
t:7-LI ~ ~,
Date:
ph 3k 0/
. .
"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."
CII f OF PRIOR LAKE PLUMBING PEAA.l.lJ.
Date Rec'd
(Please type or Drint and SilDl at bottom)
ADDRESS
63 ~z. r~(lr(jy ~ r.
.
I. Blue File I PERMIT NO I
2. Gold City . A IJ .AI O"'LA
), Yellow Applicant V -Z V DOV'
ZONING (office use)
LEGAL D~SCRIPTION (pffice use only)
/tIw Y1. ""&1' SW'2 4J-f'lJ
LOT,,!t. BLOCK ADDITION f/4T ZS"JI'I CDYat'by.s &v
. I
OWNER ~
(Name) r; ra.tj (;IJ roSF-~
(Address) 'fZ't.-'! che.Sr;, d T
PID Zt:"-IJ If 00 7-D
IA~ e JI ~ f{l,~r Ll1. Jt e
(Phone) &fS-2"V,/7 - 67Z8
APPLICANT
(Name) l41E.Jfr~Nt;... c.tJ/JSf.)/fiN~T>
(Address) ....:zt:>.' 'I fA. Arc: S ~ PeW f~fjtre
(Address) -
(Contact Person) .c.A.S., I UK-~r J t'cl:. GfNltiltlJr S
APPLICANT SIGNATURE ~~
Quantity
-S
/
I
<-
,
I
I
--
1/
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower _
Dishwasher
Floor Drain
I Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum
Estimated Cost $
(Phone) 'I s-z. - ]rt - '17 Z 7
1'1,(J.. S-'''7/
(City) . (Zip Code)
(phone) ~vz..t. ~
DATE z- 21-tJ'S-
Type of Fixture
I
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
-
-
-
Residential, New One & Two-Family G
Residential, Additions & Alterations $39.50
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
.50
Paid
Receipt No.
Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
1St I
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PEAAul
(Please type or print and si~ at bu~;"~)
ADDRESS
6 3 g L CdIV;(() Y sdEb J
LEGAL DESCRIPTION (office use only)
1. Green File I PERMIT NO
2, Yellow City . C7 6 (}"J
3, Gold Applicant 0 /..j - 0", X
ZONING (office use)
LOT
BLOCK
Sf{) ~ ot-lf3
ADDITION fJaIZ5"II'I ~flRoY5 i4Y j.~T 9Zr/(lJ)~ufttJ PID ZS--/I'I oCJ7-0
,
OWNER /".., ,
(Name) L7 fat. ~
(Address) 4 'lZ '1
G-u JO'S/:-e
c1 e.$ T",cJ r }A,n ~
(Address)
_ (Phone) 'l~2- '1lf7 -C?Z~
J'J/V 5 S .572-
(tiE frr6 r Vi ~~
(City)
~;;~~ANh1 C1t) 1\ r 1\ .5 C,U ~ 7U fVl (j rJ t LJ t r 5
(Address) Po Cay Z71 5AAfootet. M
(Address)
(Contact Person) fYll/--t... flto vvn e- YL- S
. APPLICANT SIGNATURE ~ ~
(Zip Code)
(Phone) '!~;!-- //~6 ,.. (/ rZ/
br"379
(City) (Zip Code)
(Phone) h I~ - S s-r - '/6 ZtJ
DATE Z"'Zl ~S--
APPLICANT PLEASE COMPLETE BELOW
Size of water service -1- inches.
Location of any couplings from structure ~ feet. CoIlTit\uo.s
Type of sewer pipe. D ABC ~ PVC D Cast Iron
Estimated length of sewer line / ~ feet.
Clean out (if required) located at ~ feet from structure.
FEE SCHEDULE
Residential sewer and water line connection .$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $ 3 s-: s-o
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
$
$
$
.50
Paid
Receipt No.
Date
I By
CITY OF PRIOR LAKE
B.EAlll~G/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or 1IJint and sim at bottom)
ADDRESS
I. Pink File ~ otd
2. Green City PERMIT NO. ..
3. Yellow Applicant
6382 CONROY STREET
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name MONN13NS CUSTOM BUILDERS
(Phone)
(Address)
APPLICANT
(Name) ,ALLIED FIRESIQE.PBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(phone)
651-633-256J
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
12/15/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
D Steam
D Hot Water
D Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
REA TN GLO 6000TRI
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID W1TH
.5aUILDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
BuUdinl! Official
Date
~dU,~ ie, ,1 ',I
! 11 D<<C 2 0 2004
L'
Ii' Receipt No.
i jJ By
L.
24 hour notice for all inspections (952) 447. ~~, fa~J952) 44J-4~~~. ___
..,.
P R I 0 R LA KE DErsARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~ ~NAo'l StlJ=,fD~ I'J,E I
NATURE OF WORK ~W ~~e"
USE OF BUILDING ' ~ ~ J) . .
PERMIT NO. 04..~(P6 DATE ISSUED B'I~'"
CONTRACTOR ~tJ~S C"1l)-. ~ISiHONE~' III ~ZO
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~l.Jc"t:;It.. i V4Il.IFt( L. J::'L, 156fir,Y;:' ~PcJc.FiU-INSPECTO'k DATE
FOOTING IV f;;" I q-Cf-dV{
FOUNDATION (Prior to Backfill) f //7/1/ I c:r - 2-14t1
PLACE NO CONCRETE UNTIL ABOVE" ~AS BEEN SIGNED
ROUGH - INS_ /7
SEWER/WATER/SEPTIC , l~~f q - 2-otl
FRAMING ~ f A J J,.- q -dt/'
INSULATION yw/ 1~'I(r~
ELECTRICAL /I . #
PLUMBING ~11f~AI (),(,., vvrJ iVY"> /WV //rJ-~~! 11.30"11
HEATING (if required) vvr I H4t(
FIREPLACE f1/Y/ t).--L-~
GAS LINE AIR TEST V1IV I j,,-q~cNl
l. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'QrH~ /~t"'II~L.S1H!6 I I
, FINALS
GRADING (Prior to Sodding) I
BUILDING 1e w.{> vY\ h l ..., -1-<< ~
ELECTRICAL ",
PLUMBING ~ ,z,ko/t<j-
HEATING 1M ~ J.-J-o~
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED ".
FIlJItA ~ ~1fAAQ NOTICE/N ~. 7:<!.C.
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
if
@ttfifiraft nf @rtupanr\t
CITY OF PRIOR LAKE
~rparfmrnf of ~uilbing Jf nsprtfion
Winal Permitted
D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the D Residential / D 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:
SINGLE FAMILY 04-0868
Use Classification Bldg. Permit No.
R3 VN RlSD
Occupancy Type
Type Construction_
L42, CONROY'S BAY
Legal Description
Owner of Building. Si,te.:t.ddress
MOIlMENS CUSTOM BUILDER_~;._ P.O.
Contractor's Name & Address
ROBERT D. HUTCHINS ,:1./../ CitY..I>lann:;-
Date: ,
(, !Vnm:cial
Date:
Zoning District.
6382 CONROY STREET NE
BOX 277, SHAKOPEE, MN 55379
JANE KANSIER
.!t-'" ~.,,},{.._ - .i,a~;~;,.J.,';;'il-;,'~:fit.';j.'1.,:i:;;':- ~~'~~'''L',;':\~;,,;'~Vl:!- '~ :-;'\
I I ~-\'II<: ~"f;::' '~""""~:;...,... ~ ;.:i;'--'''''_:';''''"'i'-'-'';'''~~' ~""~"'I ',,- 'I'I'I~~':"
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
&_?~ J-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
[J FRAMING
o "pISULA TION
....... FINAL
o SITE INSPECTION
COMMENTS:
DATE nile
SCHEDULED ~r~
/ Ot-'11V S. ~< f
CONTR.
PERMIT NO.
Ll/~
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
[J GASLINE AIR TST
o
d-
I
/ -:>>
=-~
1, 1/ '\
( l ~ )
~
--
~K SATISFACTORY, PROCEED
[J CORRECT ACTION AND PROCEED
[J CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: I/li( Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
2. -I fj",o.s-
ADDRESS
r;, 3 g" L eo", i'VV s- r
'-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4- ~~y
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
r( FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
fi) s..,J I rII.. UPv tJr ~~_.J- 'Va.~_
~ ,
atilt! PICI-l,ti!a'1 4(J"ll~/-;"'"
(i) 1=,-.1 6111ck ~~~uA-N1\1l tF~,.. Jr.,,}
~,. 5~rht.L cJ",w...~ ttltS f.c1kti
(!J) kJd Ikd. naris Q.> AMc!eJ.. .
CH) n-ud. h"'14/ F e,,4NltJ,... r~pgA- ~",J-.
f7) ?' 1-'1,
. I
NL 011\ 1--~)'-()<'
-
r~W)p vVl1-11 7--{'"fJS
I
d""+- OIL
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~R~ALL FOR REINSPECTION BEFORE COVERING
Inspector: f If'" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IIlSNOn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/b~
S/
ADDRESS
6-? J> ..2
(';~;-~ V
/'
CONTR.
PERMIT NO. ~~~
OWNER
PHONE NO.
o FOOTING 0 PLUMBING RI 0 EXIGRADJFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
o FINAL ~MBING FINAL 0 GASLlNE AIR TST
o SITE INsp,enON /7/ 0 2' yL ./' 0
COMMENTS: /~V~ h ~h~ /
,
, / ~./
,~kO /H.&J Tey ,tifT- C;; <<-
~ AL;'pd/' //7TV, /h.v:~'d/ /'
. c.,v/,( d/. 1-1"1 j ~ ~ ~, .
f)J AHed /;~ a/~~ /f~ .d/f~
/~#1tYd(:~ <f~~~~ .
(J/ /
t/ AS " ;..- ..s
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1& :;&- ~ se ~ tZ>
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I \)~ r ,4.....h~ 1/
~r- ~.rl,e- '
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT ~7U FOR REINSPECTION BEFORE COVERING
Inspector: .I'~ Owner/Contr:
v
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1___/
../::fUJ"/d"A<;- /?h~~
,/ ~/c.,
......,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INSNOn