HomeMy WebLinkAboutBuilding 03-0366
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PRIOR LAKE
INSPECTION RECORD
~fN lHL
I
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
FOOTING 4.tqlo3 < _._::~
I FOUNDATION (Prior to Backfill) I ~ I ~ (U!op
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST '2-:\tL'l(.,,~J; l L L~ Jj( 30~)i)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I-SlTM~o UllWe- I R~I ~;b~
FINALS
GRADING (Prior to Sodding)
BUILDING 0 U'.
ELECTRICAL
PLUMBING / {,
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
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
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3~t-03
; ~i~~e ~::y I PERMIT NO. 0 -;> ~03~ 1- I
3 Yellow Applicant , ~ ~
Lpk
ADDRESS ZONING (office use)
LEGAL DESCRIPTION (office use only)
,:) ~ PJD I 1
Lch BLOCK J, ADDITION
OWNER
(Name)
Sr[j~ &
C~(s;-
S'USAh
L {-II d f'l ~ I> 11'1
Raf
u{ ~ e.,
OtUA/5~IDcX. 5- -
r
L p ke.- R 0 t:l d
(Phone)
95(,-
~~ IS
(f'-( 0 -. @JlCf
(Address)
BUILDER . + ~
(Name)_V"'10' IN) c.. r.,.) + I'L, ( { 01'\
(Contact Name) ------Y.Il PI" k: /1'.1) nh ')(4'>~
(Address) 4 'j 7 :J
, \
C / {>,,'(j
c (; ,/a
E PlA
P /1,d ,~
(Phone) Cd c- 93 q -
(Phone) 0/ (. -g ~? -
L",,(C
1e?;1
gc ~ I
ODeck
ORe-Siding
TYPE OF WORK
)(rNew Construction
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
t
o Misc.
o Porch
ORe-Roofing
DAddition
o Alteration
DUtility Connection
~S~
LJ~D
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 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.
f/yv) ~
x
~
Signature
Permit Valuation
Permit Fee
Plan Check Fee
$
$
$
$
$
$
$
$
/00, 0 "CJ
I" (),O a
35. SO
0, ()O
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
-
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
~~
Building Official
3/~llfJ .3
I
Date
s3s-3
s- ~ - 0 J
Contractor's License No.
Date
Park Support Fee
SAC
#
#
Z-SO,OD
5.00
# -
#
Water Meter
; 1";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
0,00
500,0 l)
$ 5/};)./-/
I ~~~ ~~~~~ 'I'
I~NO
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 t,emporary Certificate of Zoning compliance and allow! ,construction, to, c?mmence. B,efore o~cupancy, a Certificate of Occupancy must be
."",d. .. ~ ~ Tree pr€S""'ZLo<n reflCA"<) (wed <, f0 be.
~~c: --) _f'ZI' ?J,'Jf).01-:J In~/ledl no odchh(yidl 1/1'7p.e.rv"I(;1{":, s~~tl\ee
PI ing' tor Date Special Conditions, ifany ~f/'Y)I tfipf
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 rl"Lp0 S('( '---:---:(1
16200 Eagle Creek Avenue Prior Lake, MN 55372 =-
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATI()NAL FLOOD INSURANCE PROGRAM
el..'r:VATION CERTIFICATE
O.M.B. No. 3067-0077 .
Expires July 31, 200.2
..' LATITUDE/LONGITUDE (OPTIONAL)..
(iNto ~ #41' ~#4IAI#" or ##"#4##1#0) ',.
. ' HORIZONTAL DATUM:
L_JNA01927 .I_INAO 1983
SOURCE:" L.,J GPS (Type):
I_I USGS Quad Map I_I Other:
I_I Yes ... I~
.'... '" ".' , .' " ,.' . SECTION C. BUILDING ELEVATION INFORI'!1ATION (SURVEYREQUJRED)
.C,t. Building elevaUonsare oMedon: '_IConstruction Drawlngs*: ',.1' ~uildlng Under Constructlon* I_I Finished Construction
;' ... *AnewElevationCertificate will be required when constructionofthe building is complete. . ','
. C2. Bu.llding. Diagram Number ,~. (Selec;t the buil.dlng' diagra(Tl most similar to the building for which this certificate Is being completed- see
'.., ,. pages.6 a,n97...lf no diagram accurately represemts the building, provide a sketch or photograph.)
C3. Elevations-Zones A1~A30, AE,.}\H,A(withBFE), VE, V1-V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO
COmpleteltel1'lsC3a-lbelow l,lccordlng to thebullding diagram specified in Item C2. State the datum used../fthe datum is different from
'.lhe datum used for the BFE in $ection .B,convertthe datum to that used for the, BFE. Show field measurements and datum conversion
calculatlon.Yse the space provided or.theComments areaofSeclion D'or Section G,as appropriate, to document the datum conversion.
Elatum . Conversion/Comments
Elevalion'referenc~mark used ';., .i". ,.'. .,' '.' "., Does the elevation reference mark used appearon the FIRM?
Cl,:a)}opofbottomfl.oor (including basement or enclosure) . (lrof~~ --,\\1. ~ft.(m) m
Db) Top of next higherfJoor ". . ~ ft.(m) I/J
Cl, ',., C,), ',B, o.tt e>mo, flOW, e,st ,horiZ. ont.al. s t, ru, ctu"r, almember 01. z.o,n,e,. so, n"IY,) .' _, ft,;(m,) ~ 8,Cll
)Jd) Attached gara.ge (top of slab) . . . e~~~ ~'2.." ,:~ ft.(m) ~ ~
.Oe) Lowest elevation of machinery and/or equipment.; 'i e-
'. servici~g thebuilding. .... .".'.,. . . . _ ft.(m) E ~
. Clf)Lo\'iestadjacent grade (LAG) . _ ft.(m) i ~
Og) Highestadjacentgrade (HAG) , .,'", ,', ,,' _ ~.(m) ~,.
.0 h)'No. of permanent openings (flood vents) within 1 ft..aboveadjacent grade ~
t:'j1)Totalareaofall permanent openings (flood vents) InC3q . sq. in. (sq. cm)
SECTION D ~S~RVEYOR,ENGINEER, OR ARCHITECT CERTIFICATION
'. ..'. Thl~certificaUonls'to ~eslgne~ ~ndsealedbY~.land surveyor, englnee!,'Orarchltect authorized by law to certify elevation information.'
: I 98rtify tha(the i(/fof171atiQnln SectionsA,B, and C on this certificate represents my best efforts to interpret the data available. . .
. '.' .., I understand thatanyfalse statement may be punishable by fine oi'iinprisbnment under 18 U.S. Code, SectIon 1001. '. .
,'.'...., '.'...' "CERT, IFI, E.. ~,'$NAMEO,' .'.. "\, ..I\,..,'....,",iIC!,. ,. .,., ....,".,.., .,' ,. '.. ... LICENSE NUMBER
";.,, ., '..'.... ...,~^~~.~~W\.~~ \O\~r~
· .,TITLE ' '.", "," .,,) .'.." ". .,'. .,., '.. .,' ",.,.',. ..,
. 'a
I_I Check here if attachments
SECTION E.BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AOAND ZONE A (WITHOUT BFE)
For Zone AO and ZoneA(wlthout BI=E), complete !terns E1 through E4. If the Elevation Certificate is intended for use as supporting..
, information for a LOMAorLOMR-F, Section C must be completed.
, E1..Bullding Diagram Number ~ (Select the building diagram most similar to the building for which this certificate Is being completed _
see pages, 6 and 7. If no diagri'llllaccurately, represents the building, provide a sketch or photograph.)
.'..E2..Thetopofthebottom.f100r(lncludlng~asementorenclosure) of the' building Is 1_1_lft.(m) 1_1_lln.(cm) 1_I.above or I_I below
.. .,. (check one) the highestadJf:\cent grade; .' '..
. E3.For ~u,ldingDiagramse-8wlth openings (seepage 7), the.next higher floor or elevated floor (elevation b) of the building Is
L.:.-'__Lft:(m) 1_'_lln.(cm) above the highest ~dJac~ntgrade. '. " .
.., E4'ForZoneA90nly: ',11no flood 'depth number Isavallabl~.ls lhetopof the bottom floor elevated in accordance ~ith the community's
. 'floodplain management ordinance? '-_.:.I Yes I_I No ".1_1 Unknown:. The local official must certify this Information 'nSection G.'
.' '.. . ,SECTION F ~PROPERTY OWNER (OR OWNER'S RE:PRESENTATIVE) CERTIFICATION ' .
.' ..' The property owner or owner's authorized representative who completes Sections A,S, and E for Zone A (without a FEMA-issued or
community-Issued BFE) or ZoneAQ must sign here. ..., .' .
. .
" . -, :.". '..,-,'.: ,.,,::.' " ,-' ,', ".
. PfWPERTYOWNER'S O~ OWNER;S AUTHORIZED REPRE$ENTATIVE'SNAME
.....',\ .
.. ADDRESS
... CITY
. : DATE
STATE
ZIP CODE
. .' ~', -.
>SIGN,AJUR!=. ..
TELEPHONE.
:" >\.-. COMME,~TS .
,'. . ',>:. ".
, .-:.;
., .' SECtiON G . COMMUNITY INFORMATION (OPTIONAL)
The local official who Is authorized by law oror~lnance to administer the community's floodplain management ordinance can complete
Sections A, B,C(orE), andG.of this Elevation Certificate. Complete the applicable Item(s) and sign below. .
<31.t....1 Thelnformatlo!1,ln $~ctlonC w.as taken from other documentation that has been signed and embossed by a Iicensecj surveyor,
. . engineer, or architect who I~authorl;zed by state or local law to certify elevation Information. ,(Indicate the source and dale of the
'elf3vatlondata In the Comments area belq~.)', . ..', , , . '. .
. .G2.1_1 r;.,communitY o,fficlal completed Section Efor a building lo.cated in Zone A (without a FEMA-Issued or community-issued BFE) or
,..,.."ZoneAO.. ...,... .. .,' . ".
"';;G3::I~IThe folloY'lng Inforn;ation (Items <34-G9)is provided for community floodplain management purposes.
.., -:. '.' ", ""'-' . . ,....., ' -. . ','.. .- .' , . "
.>'G4.PERMIT NUMBER G5. DATE PERMIT ISSUED G6. DATE CERTIFICATE F COMPLIANCEI
' '" .' . . ~SUED
<G7. This permit has been issued for: I_I New Construction I_I Substantial Improvement .
.. '.:08. Elevation ofas~bulltlowest floor (Including basement) of the building is:
G9.BFE or (In Zone AO)depthof f1o()~ingat the building site is: .
. .J '..LOCAL OFFICIAL'S NAME .
I I Check here if attachments
. _ ft.(m) Datum:
. _ft.(m)Datum:
TITLE
. COMMUNITY NAME. '. '
'\:::.'. "
TELEPHONE
. DATE
""':".
,-',';"
.....'.
"."'l
, ..-.......';...-,
I_I Check here if attachments
. REPLACES ALL PREVIOUSEDITIONS
, ...,.
04/01/2003 15:29 i".IU ~l.lU51j1:S;j
J..',Jl.."~'~ J.,L.,"".LJ..~I.Jo,' .:.L....a..............
-. ,I T =
= CO
INSTANT TESTING COMPANY
2003
-","
7J2S Wc~ll26lh Slrccl. Suite SOO, SII'v1l8c. M..~ 55~"1l
PHONI:: 9~2-llI,1()-73flE\ · FAX.: S1SZ.ggo.S883
Ap ri 1 7, 2003
Mark Honnens
M & M Coustruot1on
4070 Eau Claire Trail ME
Prior Lake, Minnesota 55372
Phone: 612-639-8251
Fax: 952-"7-6425
Rt: In~peotion - 2815 spr1ng Lake Ro.d
Spring Lake TWP., scott County, Minnesota
At your request, a site visit was ccnduoted on April 7, 2003 to
evaluate the a water service which intersects the footing line of the
propoaed r..idential structure under construction.
At the time of the inspection the lot had been tully egca~at8d with
the house and garage footings in pl~ce and a few coarses of
foundation blocks oompleted. Our observations indicate that a 3/4
inch copper water service, from a previous structure, lies directly
parallel and below a section of the south footing line ~f t~. new
con.truction.
To aile.. tne relative loadbearin; capacity of the loils within the
immediate area of the footin9 &n~ buried water lin., dynamic cone
penetrometer tests were conducted at 3 locations along the south
footing line of the house and garage. The dynamio cone penetrometer
(DCP), uses a ei;bt kilogram (l7.6 pound) h~er to drive a 20
millimeter diameter conical point into the soil, with the penetration
reeorde4 in millimeters per blow.
The DCP was advancod a total of 305 millimeters (12.0 inches) at
(test 11 - house/west), 276 millimeters (10.9 inches) at (test #2-
house/east) an~ 277 millimet.rs (10.9 inche.) at (teat #3 - garage
SE cor.). The composite; per blow, penetration average for each test
was recorded as: Test t1 - 37.0 MM. Test 12 - 21.2 MM ana Test #3 -
16.2 MM.
Our experience with the DCP in similar soils would indicate aN-value
of: Test 11 (N-9)J Test 12 (N-l3) Te.t 13 (N-16) for the penetration
load valu$ at .ach location. This N-value, is an empirioal
relationship we have established to eQuate th8 dynamic cone data to
the mor. f.mdliar blc~5 per foot (BPP) standard penetration soil
corin; te.t. Baled on this da~a, we would prediot a relative
loadbearing capacity of 2500 to 3000 or greater for the 80i1s tested.
In our opin1onJ b...d on the strength and bridging qualiti.. of the
04,07/2003 1~:30 FAX 8905863
INSTANT TES'l'1l'ii,;/.luuJ:.v
soils adjaclnt to and below the footings as 1nd1c~te~ or our tests,
~e would not expect significant soil consolidation from the
additional loads, which could compromise tne inteority ot the water
line at its oDserved elevation. It is our underatanding that this
line may be abandoned in the future, and a new service installed on
the north ~ide of the structure .
O~I.rvationi made on the footin;s within th. south section of the
house, indicated a unusual appea~ance and a apparent lack of stren~th
for conctete well into 72 hours of cure. We would recommend that the
masonry contractor ana concrete supplier be contaoted to address this
issue before placement of foundation block resumes.
Sincerely;
I~T
f:2IsZ sh
Insp~~~/P'HA
Ch; Code: #605 - 1 Hr. .306 - 3 (Dei) #612 - 18 M1.
"
03 - 03~t
lO,./-03
Tht Cf'nler of the Lab Country
White - Building
Canary - Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APP~ICANT
APPLICATION RECEIVED
}i'",,',{l 7' / //,t<',,!'{' I -, 't-
" . ' , /' ',~, , ,r-- A' ,,. ')' I
'-~> . /!AL{j/~L('/,~/J l..
"
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: /
~ I ~f
"', (" / ,- .("" ."," .,,-1 "',',"';.:i,i,/"I,//'t;, ,I, A /)'( il,)
'-. ' ",-"I, ) '. / ' )v ./Jr ' / /, : Ik:.J' " _I_
e) " >- I, .,.' - '~.t
Accepted
x
.
Accepted With Corrections
Denied
Reviewed By:
Nt}l)
Date:
3-2?-~3
Comments: See Reverse Side for Additional Information!
f
o
See Attachments. 1) (Tr~ciine Pl~n) 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."
Thf ("fnlfr of thf I.akf Country
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
1""1,1,, ',',i d' ,', /",1,,/,') ,'. " i-,j, ,
, Ii I / J-' C{:}"il.::.d_'1.>~~Cl~~l:c.,/.7?c
APPLICATION RECEIVED
~~~? ,- /',.
'.......,...' ,,"--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is wpposed at: !
I ~ ~i
" ..::;! "....~ "I' " "1/) "'/1,::1 :'.4/".1 A' c A, /1. 'd i)
-.'-, /1' I) /' f J..,~ " /,.-c, .i /y..-rt 'I' { I; j/ ~-"".
'" ~.... - '""', '_<1 :. 'i
Accepted
x
,
Accepted With Corrections
Denied
Reviewed By:
N.tJr)
Date:
3 - '2 7-CJ..J
Comments: See Reverse Side for Additionallnformationl
See Attachments' 1) Gnuiine P1:m, 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."
Tht ('tnltf or Iht l..kr Counlr)'
qhite - Build~
anary - t:nglneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/111-/11 rlfrn~~
3-0-0'3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is p, posed at:
, ;(LJ(~d
Accepted
Accepted With Corrections
/
Denied
Reviewed By: ~~ ~ Date: 3/...1-//01
Comments: ~~ ~ ~ ~ -~
~~ /d( ~ r~' '-h1a~~ ~
~ I~ ~~. =f~ .J-o ~
~~h>&e~~~~f?
-n~.
"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
C::m~ry ~naineering
C.Pink - lanni~
Thr ('('nler of the takf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.J
Accepted /
Accepted With Corrections
Denied
Reviewed By: a p \C' u trt(;.O(j
Comments:
Date: 1)- 3' 7 Db
(lry~:dl~ tyLQ f'i?2 tC.Lt-L-4! L'7-UI (1_ C1---(t'
../ IS ()O[~t ~U?~ mu4J ~Q. t(l {Uf1tz~
_{yeW' e Qtd ~. cul.1Q.. lJc-rf (jlLlL r- to d CC~C
6y\+trc .e~La:r '
~c/;JJLd i..J)IPQ-,rYI((L.-L~ ~lTGl-~ L..G 2q,qu)o-
n [) 0 (teLL t L GYl{"& h. CA-i'--zJ-. ,(LLLr tJrA (TL lLrux b-z
pumL~~J LflC-UL_dJLA-7[ pcc:ha- J L-L'-oJ.-K-Lif(Uzf-~
/) ~_ cL /2) -C.k~ '
"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."
CITY OF PRIOR LAKE
, Impervious Surface Calculations
(To be Submitted with Building Permit Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address '2 8/S- SRzIl'llb LA.~, Ki> AO C. EX'S7InlG)
Lot Area . IIJ 533 Sq.Feet x 30% = .............. 3, L/t,o
************************************************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
x
=
=
ATT:ACHED GARAGE
=
TOTAL PRINCIPLE STRUCTURE......................
I, / B Z Ss If-
DETACHED BLDGS
(Garage/Shed)
x
..
X
TOTAL DETACHED BUILDINGS.......................
DRIVEW A YIP A VED AREAS
(Driveway-paved or not)
I (Sidewalk/Parking Areas)
x
x
x
=
=
=
TOTAL PAVED AREAS........................................, '1 to z. G&. (:J..-
PATIOS/PORCHES/DECKS
x
=
(Open Decks W' min. opening between
boards, with a pervious surface below,
are not considered to be impervious)
x
x
=
TOTAL DECKS.........................................................
OTHER
x
x
=
=
TOTAL' OTHER.......................................................
TOTALIMPERVIOUS SURFACE
@Nn]uOVER
Prepared By .:Seo#- SNft'NSO,.J
Company Jp.-\\~ Sv.r~ IflJ Cd. jF. A.
Date O~/~)O'3
I 'Z \ \ ~ Y s~ F+ I
I 1. 31 (p :S~~ I
Phone # C15',"~"140/7- Z/5;o
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building Permit Application)
ForAll Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Prop'erty Address "''2'81S-$P(t.IfoJ~ l..1'r-)::f: R~o L. f*ofosrlO')
Lot Area /1153J Sq. Feet x 30% = .............. .3~ '1(,0
******.***************************~*************************************
LENGTH
WIDTH
SQ. FEET
HOUSE
x
x
x
=
=
ATTACHED GARAGE
=
TOTAL PRINCIPLE STRUCTURE...................... 2, Y 83 $t, (+.
DETACHED BLDGS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.......................
DRIVEWAY /p A VEn AREAS
(Driveway~paved or not)
I' (Sidewalk/jlarking Areas)
x
x
x
=
=
=
TOTAL PAVED AREAS......................................... goo '7~' (:.{,
P ATlaS/PORCHES/DECKS
(Open'Decks I;''' min. opening between
boards, with a pervious surface below,
are not considered to be impervious)
x =
X =
X =
~t.t,..K TOTAL DECKS........................................................ ......:..1 ~ & s, f1-
OTHER
x
X
=
=
TOTAL OTHER.......................................................
TOTALJMPERVIOUS SURFACE
@D~OVER
Prepared By-5Dtf ;r-Svv fl-NSot/
Company., IIklle.; StNVC-,/I41,f C<l'.If,4-;
13..'-1.5""1 56 t:4
I 9' st,' A-- I
Date 03 fis-- /0 '3
.
Phone # '75"Z'Yi7' Z5"7o
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-I or R-2 Districts
Reviewed by: ~
Date: 'b. 7. ({' '0
Building Permit #
Site Address:
PID:
Zoning: R _ I
Legal: LQ 'if F/J [, B 4- 7
Subdivision: u::'p~
LcwiQ TUL-LY\~
)-~isting StI llcttlI t:? YE~ I NO
Existing Noneonf"l ming Strlle:ture'? YES / NO
I CONFORMS TO ZONING
ORDINANCE
I
YES
NO
Yard Setbacks: NA / FAILS/ COMPLIES Standard Propo,sed
. Front Yard (setback average if in-fill lot) ~@,7'7J' ~ ?J0. 7 '1-] /
. Side Yard (25' if abutting a street) 10' 1.1."
. Side Yard (Easements) 10' r'b'! IO.~ I
. Sidewall exceeding 50 feet required additional Wall over 50") ~ -r . '?J I
side setback of 2" for every foot over 50' long
. Rear Yard (Easements) 25'
. From 100 year flood elevation of wetland 30'
. From OHW (Prior or Spring Lake) 75' or setback average of lp Lt-. ~ / pr-zp
adjacent structures no less
than 50" (00 . 05 I ree I
,
I Floor Area Ratio: NA I FAILS / COMPLIES
.30 Maximum
Yard Encroachments: NA / FAILS /COMPLIES Standard Proposed
Eaves and Gutters no more than 2 feet in width and l( 2'
no closer than 5 feet to a lot line (Easements).
AlC and other equipment cannot encroach on
interior side yards. ~
Tree Preservation: NA / FAILS / COMPLIES Standard Proposed
. Total caliper inches
. Can remove 25% of tot a! i
. Caliper Inches Removed
. Caliper Inches Preserved
. Replacement 1/2: 1
~'O-
iYLP- f> 1-r>8-Lt\'./ct----;-'Ct-VI p lct-t. '--'
L:\TEMPLA TE\BLDGLIST.DOC
--------.--------.. ...
10~~:~~O? +~,\-\-,:J L"l i'X\O--, CITY OF PRIOP LAKE q L\-l, L\ Jl\ ')
(~'r;"./ \~J' 'G\i HEA TI);G/AII~ CONDITIONII\G/FIREPL-\CE PERlvIlT
u ~_ ''/
~' ,:;.:,"\>-,. .',""7'~'/" j'
f.:..::",/<-'jY
,y/ -'-'"" "\,r
.'{",_o"/,
'--- - ~
D:1te Hcc'cJ
(., Z.3 03
?>-,
:--=)'--~---"
. ." ,~\ ,,., ,.-;.: :':, 1 ,', ,~~ ',~;~",~,;
o?~(E_,__;5P!!~i!t:!_...!~. k~....1]~~_.__,_
c---..--- ~~,-~-~..,---,------_._- -~ -~--._---~-.. ,-'-'~~~._---~-- --" .-----.----"-,---.'.-.-------.....---------------,----.-----.-----------'-------,,~-~--_..-.-,-
I LEC,,\L D:=:Sc;~I?TIO?__;~:'-:~c .'0.' c
LOT
JLCC:::
/. D D I': T C) ,,;
. ._?E)2.5._-:jll_.~)!li- I
------. ~-
','.. 0EKec~~pLAcE.. ______ .-----------.. Lq5~J..~ L{g_.:-._5:.u,~.O ------.
/ {PI SZ. _ .M.f11AL_AV 6__-:;;_EL_________1k.lQJd_Li1~~__M6f__.____;ifL3.1;)..___
(:~",~'-;::'.- ~-.,C:~" (Z:~:, CC(~-::)
" ~~~~lli- _~-(CJ~~-<{<IE~21f~---_
.__._____________. __~=_~cc=-=-=-==-~~c.'lL _~=ft?_j:.~4=,=-cc--=--
i ."~ Pi
APPLIC..\:'-;T PLL\SE CO\lPLETE In:LO'\'
'\i/ CC;~<STRL;CT[C):<
RE P LAC 1::\ 1 t:'~T
.\LTEP.:\TICY<S
}-:Lj[<~<,-\C ~~ >l.,,\i<-:-~~ .-\.
\,10 DEL ,_~_~__________.~__,_____..___~_________ F L E L .....Ai4--.----------...
Lt;[. S R~TUR~; C?E\'r-:-<GS ISPl.JT
Ot'TPLT
TiPE OF SY5TE:.i
HEATI:--;G OR PO\VER Pl..'',,);]
,_'_U_'_ ___..________.mu_
r, ",.,"". I' PLL\SE "'OTE:
LJ ~,~<.,;. ,
o I-be \\',,'cr I Ajr.~~,n;:",~~::~",U;r,i's
C ~2c"ccs tl/h.f(@f:pJAU_ !'I-,~JS-icc;'t',F(j
U O:;:cr Cc:\:CCS _~~____...____.__ I SdJac'-:s ,
'._--,-~-,-----------_.-j
O\V;::;I.-i .-\:r Pi ~:-,:S
!,~Gr~:'.'it>
-'- 1 {, ,I
i --1.-\;;- Cc~:C:i::c:-
i IVcr". S; S:C:':,
FI RE?L.,\CE \ (.\ KE ,\~D \ [ODE L
FEE SCHEDLLE
[;:;;'lS::,J[ ,
C('i~ll:-:~:-,,:i~:: L''.: \fult:-t;::ili::.
J j of j()J
\"9 -I) .,
~J, ,~, rn:r:][lil";;~;
R;:S:'~::':::;l:.:;.:, C;b Fl:C~~;,;:'::'::
)39.50
1: '1'
~ S (}.:
,-\,'C ('<;:::'.\' Cl~:-:~:
.....',,'; ,~'( I I
-::"j
RC:::;~C:::'":L:::.l
,-\,j,!itic~;5 ,-r,t,-\l:~:-::::
,,-\C Or:I'.'
S;9,50
5;950
:'~:: s: d c ,~; : ! ~:
, r: ~ :1:, :"5 .::- (,~'< c ,,'.' C.: :-:~: :-'->:.
~':]..: 51)
R:.::s: ,,:::.':1 c:::
Esc::"::c~.:i Cost S
Bu i jci~ :-,:; p~::-:;;[ ~:
6.s' (;3 f.c fc
HL\TI";(j PER'.IIT FEE
STATE SLRCH.-'\RCE
TOTAL PER\IIT FEE
S 3(f.!:.;.-C
S ~i)
~ --71:..-------
) _~-'~7C2-Lj2J?-
(OtliCt lse 0,,',)
Buildin; Offici;ll
D"t~
~ ,! R~P[~'---u,
[<~'~~ '
, '
-----~~-
DCl:~ :>' ';:' I B '/ , .
< C~;. 2.3, C',J i' .____~___i
(J
This ApplicHiol1 Becomes Your Building Permit When ,.\ppro\ed I
i
--~
24 hou~ notice for all ins[Jcctions (952) 4r-9S50, Ln (952) 4r-4245
09/14/00 THlT 12:06 R~ 6124474245
CITY OF PRIOR L.\KE
141001
GIIlt:ftl . Pll.1E
n\.LOW . A.....~1fT
DQI,D . CIT~
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
S.w. No. :3.- '3 (p "
NOTE:
Sewer and Water
contractors m~st
be registered
with the city.
PHONE: 7S;/YIfO ..kJdtJ
DATE: 6' 5""03'
aLOG. PERMIT t 03. ,~h
PID#
Appr....: CANT:
ADDu:! ss:
s I Gnj~ fURE:
SIT!; \DDRES
FILL IN THE BLAN~
1. li itimated length of water service
" :J
;.... ~..
feet.
2. S~ze of water service
I
inCh(es).
3.
I. )cation of any couplings from structure 0 feet.
'1' 'pe of sewer pipe. ABS_ pvcL Cast Iron~
f:;timat"d longth of l;e"'fCL' line. ,/0 feet.
4.
:i.
6. C ean out (if required) r located at
S ,ructure.
C) feet
from
.!..._=-::::;::
'-~====~~=2=~=~~=~~~~==~=~~==~~~~~=:B_~==~~==~~=~~~~~C===~
Tr. U. "
BY
when approved.
h' ?'o3
DATE:
, ~=~~=~~=~~.===~=~~;~~~~=~~-=~~C==~==2~~C==~=~=~~====~==~~==
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection pp.rmit.
Surcharge
TOTAL
* J;-,: ~ for either sewer or water individually is ~..,6l) plus
~1 .50 surcharge.
"k S" rler and water permits issued for new construction must be
r4, ::orde.d on th~ buildin9 pennit card at the ti!11e of issuance
b: insure that no dupl~cate sewer and water pennits are
i.~i ,med. I
OATEl: no
AMOUNT PAID
(f/
~ P""D
'lJII..DIIVG ~/71t
'S~A.1I'"
RECEJr (' #
REC/D SY
16200 Eagle: Creek Av. S,B., Prior Lake, Minnesota 55312 J Ph. (612) 447-4~~~ 'I' II ," ,,_, .,
An Equal Opportunity Employer Ii U ! G IJD IJ:, U \YJ LS I i I
l~~ JUN 0 4 2003 I~)
I . d
SEoE-oi7i7-cSS
pF\oli w~r
doc:lo EO EO unr
p, 1
vaLe Rec'o
I, ~;r\ FII. r'PERMIT NO
1, 0. ec:n CIIY .
). y.lI~'" Apf1l1c,,"1
at bOllom)
s ~ ,~~~ '1 V'\ \l~ <Z~,
I LIlOilL DESCRlP110N (om" '" o"'y)
LPJ BLOCK ADDITION
\ ~~~R \,'\ 1< f\ \..0'\0,
(A\ld{eS3) \..\~\~ f.la,Y\ ~ \ ~,:-:-'~.. Q yo "
APPpCANT N\ '^ \ ~
(N.a~le) '" '~\:f\J '"'I:, r"" --L Y'\ l
(Avd:'eSs) \ ~ ~ '-6 ~ \.j 1(.\ l ()~'- (\. V '-.
N (AddrClsl
(Cljnll\ct Person) (,\ ~ S L-" \( \... \ \..
A BPI, ICANT SiGNATURE '-Jf\ wv.-\..1 vl1;..h.
\-~, ....
tONINO "m" ".J
PlD
(Phone) q~~ ..~~ -')',.,.~ ~ ~ J
~ S S3,
(Phone) ~ S ;~, '--\ \\ -1- ~\ d. \~
~ (, u - \.L, \~ <,\\)
(Ciry)
(Phone) 9 ~ ';). -, "\ ~ t. ~ \ 'J..\..\.
s s., .~_~..~~
(Zip Codc)
DATE
AI)l'LICANT PLEASE COMPLETE BELOW
- ~EW CO~STRUCTION 0 REP~ACEMENT 0 ^LTERATIONS
rUfUjACE MAKE AND MODEL c:. l.- V"r', "'" (Y\Jc B. - 8 ~ ..\ ~ FUEL ~~
rqJEj SIZE ~ \\ L RETURN OPENINGS C;, INPUT ~ \:) l' t '~~ OUTPUT ~mL
TYPE OF SYSTEM HEATING OR POWER PLANT
. OWarm Air Plnnts
OOravity
, 0 MechonlcAI .
~Air Colltlitiontng
~Vcnt. System
o SLeam
o Hot Water
o Radiation 1\1'1 _ II J..
o SpCl:ial Device;)') ~~13 \1\ V\ ll~M
o OLher Devices \>,,'(;.... ~.\,,"'-\ fVC
~ -z,C''1u.
'^~, c...\' ~)' ~v
.'LEASE NUTE:
Air Conditioner Units
Cnullot Encl'unch into
Rel{llired Side Yard
Setbacks
FIT\EI!LACE MAKE AND MOL>EL
FEE SCHEDULE
Iml\ISI,ial, l:ommerei31 & Mulll-r:alnil)' 1% of .lob cost Residential, Gns Filcplace
$39.50 minimum
Ittsldcl'lial. llenling & Ale (New COl1struclioll) $99.50 Residenti!\l, ^t1tlitions & Allcrations
Re~id~i)!IBI, Healing Only (New Consll'Uction) $6~.50 Residential, AC Only
Estimated Cost $ \ \..p ~ ~ Q ~ Builtling Permit /I
$39,50
$J<J..50
S39,50
HEATING PERMIT FEB
STATE SURCHARGE
TOTAL PEUMIT FEE
$
$
$
.50
(Ollifl Use Only)
r. AI:''''''''' Boo.",,, V.., B.l1dh'J Pm"" WI"" App,."d
Uullllln8 Officii\! Dnle
'--',
Paid
Receipt No.
Date
By
-~
24 hour noUct for nlllnsVecllons (952) 4"7-9850, fAX (952.) 447-42.45
Rug 28 03 04:50p
Jef'f' Scherer
952-447-6735
p. 1
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
\\\ *\\\ ~C)\\<j\\~e:}\D\l
I. Blu< File
1, Gold C;lY
). Ydlow API'tic:ont
[PERMIT NO:3 -- 3 bfp 1
1
zoNING (office use)
(Please type or print and sign at bottom)
\ ADDRESS
. ~9:,\,:) ~~\\I'lj\s,.\M. ~6
LEGAL DESCRIPTION (office use only)
Pill
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
APPLICANT SIGNATURE
(phone) qcs d. -l\'-\I-!c,3 "-4
Q,\D\ lo.\.lQ "SS 3ld
(City) (Zip Code)
(Phone) ~\ ),-\\41- ~Z3
'b'la~ [03
DATE
APPLICANT \.-.. ~'\...
(Name) ~ C-.\ ,Q.,\<Z.\ \\U\\\\.)\~
(Address) '-\9>aC \\dria.f\ Q."H~ S~
(Contact Person)
,~
Quantity Type of Finure Quantity Type of Fixture
I Bath Tub with or without shower d Rough-ins
Dishwasher I Water Heater
Floor Drain Water Softner
'~ Lavatory (Bathroom Sink) T Stand Pipe (Washing Machine)
( Laundry ~ray (lor 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
I Sinks Backflow Assembly Test
Bar Sink. Lawn Sprinkler
;;... Water Closet (Toilet) Other
APPLICANT PLEASE COMPLETE BELOW
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a S39.50 minimum
Estimated Cost $
Re' tial, New One & Two-Family $99.50
esidcntial, Additions & Alterations $39.50
3 - 3(P(P
PAlO W\TH
Bij\LD\NG PERM\T
$
$
$
(Offite Use Only)
This Application Becomes your Building Permit When Approved
.P~id
Receipt No.
D~~p 0 4 2003
By
Building Official
Date
24 hour notice for all inspections (952) 44t:-?,!J50, fu (952) 447-4245
\.-~' )' -..
Drivewa : NA / FAIL
· Maximum width at
. Required setback
. Maximum slo e
· All parking areas to be paved including R- V or
s aces ad' acent to the ara e
· Location to match Subdivision aradin Ian
Shoreland District: NA / FAILS / COMPLIES
Minimum lot area s
Minimum lot width
Shore land alterations
1m ervious surface
iU-LC~ eV-Cv(c.<:J ~
Bluff in Shorelan: A / AILS / COMPLIES
. Setback from top of bluff
.
roved
.
.
Flood lain: NA / FAILS / 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
Re ulato Flood Protection Elevation
.
Accesso Structure:
.
.
L:\ TEMPLA TE\BLDGLIST.DOC
Standard
24'
5' frolll side lot line
30' from R-O- W 011
corner lots
10%
35' Maximum
Standard
7,500 Ri 7,999 Non-n
50' Ri ,57.3' Non-ri
30% Maximulll
Standard
30' setback frolll slope
less than 18%
20' FrOIll To of Bluff
Bv City En ineer
Standard
908,9
914.4 S rin Lake
909,9 Prior Lake /
915.4 S rin Lake
Must be 1 foot above
flood elevation for new
and existing structures, If
existing structure was
constructed 9/19/90-
11/22/97 then additional
foot is not re uired,
Must be flood elevation or
hi her
907,9 for Prior Lake
9]3.4 for S rinG Lake
Standard
832 s ,f1. /25% rear vard
10'
v
osed
--.J
,
I
"__J
Pro osetl
Q/7.10
v