HomeMy WebLinkAboutBuilding 06-0332, Demo 06-0333
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
+, / I t~
File
City
Applicant
I PERMIT NOO~. 033 ~
1 White
Pink
Yellow
f5tJ{) L-()fi?--US S/k7~t:/
LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
ADDITION
BLOCK
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
~&:: ,;;:;;.
170+ 28(' irt ST. vI/., Nt:" III ;;'/24"1C' (j6
(Phone)9sZ"-1'5&. Zf4-Z-
(Phone)
11A../ 5ffl07/
TYPE OF WORK
New Construction ODeck ~Porch ORe-Roofing ORe-Siding OLower Level Finish ~ FirePlace(2-
Addition OAlteration o Utility Connection
CODE:eLR.C. OLB.C. o Mise.
Type of onstruction: I II III IV V A B PROJECT COST IV ALUE $ &'75-0 6{) D
Occupancy Group: A B E F H I M R S U (excluding land) J
Division: I 2 3 4 5
I hereby certit)' that I have hlrnishcd mformation on this application which is to the best of my knowledge trut' and correct. I also certify that I am the owner or authOrIzed agent for the
above-mentIOned property d that all cons l tion will conform to all eXlstmg state and local laws and will proceed in accordance with submItted plans I am aware that the buildmg
~IiCial can revoke thlS per for Just cause F lthclmore, I heleby aglee that the CIty offinal or a deSIgnee may enter upon the plOpelty to peltOI'm needed 97;7/06
Contractor's LICense No Dat~
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $ 100, DD
Mechanical Permit Fee $ o D. 0 0
Sewer & Water Permit Fee $ 35.5"'0
Gas Fireplace Permit Fee $ 0,00
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE M~ ..Ii: i. OC.
r.." .., UJ;" 7 f'
Date 5-/Z a'
$
$
$
$
$
$
$ 1500.00
$
$
~~
5' It L? ~
ReceIpt No. 5/275'
By ~
I~,
This Application Becomes Your Building Pennit When Approved
811ildlllt! Official
~
ThlS IS to certitY that the request in the above applicatIon and accompanymg documents is m accordance With the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Pia ner constItutes a temporary Certificate of Zonmg compliance and allows construetion to commence. Before occupancy, a CertIficate "f Occupancy must be
I issued
Ghc,..,1,N\. ~- 5tot'bo-r-
Special Conditions, if any
S-/-Ob
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
DEMOLITION PERMIT
Date Rec' d
1- /1 C f(
I PERMIT NO. C~. 033.31
(Please
ADDRESS
at bottom)
4- 56 () L (; ;c?,{)
-..') .----
5/k-e-C /
ZONING (office use)
)~/5D
j:::.f
/\j
LEGAL DESCRIPTION (office use only) .
LOT
BLOCK
ADDITION
pm 2.5. 135. C/[.()
OWNER
(Name)
(Phone)
(Address)
CONTRACTOR
(Company Name) (16/c...{) L.v 6~ /C'..L),:S:
(Contact Name)
(Address) I 7 c 4- '') 0 rJ-t ...5 T
(Phone)
(Phone)
nj\/
75lJ. 2f;4'2
--uc;
'--". --'f l
..:;; C, (J / /
Use of Building:
SF:D.
/, 1<. (:!,-
INTERNATIONAL BUILDING CODE
Type of Construction: I IT ill IV V A
Occupancy Group: A B E F HIM R
Division: 1 2 3 4 5
B
S U
MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLITION ~ 11/0 c..
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 lcial or a desi ee may enter upon the property to perform needed inspecti~/; I /0 b
Date
This Application Becomes Your Demolition
Permit When Approved
~~
Building Official
</j;7h~
Da(e
/2',e:~/o ~.5/c (!~/C .:N-Z1ZC.2-(IN .SA,cE)
';r. /1 Ci~ - -fldL/
,/
This is to certify that the re uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested.
4/ J8/D&
I Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372
White - Building
CanarY - Engineering
<;::J5in k - Plan'!!.!:!ID
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:
iI" /,., /\ .. /"'/./~
\.' .,.
,;
~-'
/. .' /
Accepted
x
Accepted With Corrections
Denied
Reviewed By: ~ ~. Date: S- - 1- OC;
Comments: If/; ~ tZ/<-",~",,~ wlJ ~re.. /S- -ft:. fipW\
.s-q."~-t!:tAYe. mf.,UC /'e. ~t\ ..kv~"o-^ ~ 90>1. r' "r bier
rF/J1A ~CI,...c- A~.sz-h C~f/tt:4 6~r~ reo l~ueL
Air l]vlldluOl1er r~;.;.d vther },.leC};SIlk:,-
Units Cannot Encroach into Required
;;Sid:t~ ":il:JlI~;j S(~~t~i)~LCIrs
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."
~ ,:Bui~
anary - t:nglneering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
q&EOLO.E ICOS .
4, /1 O(p
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: /C4' ~/7 ;t:I /tAl
9-500 L O~:..oS' S77e6t;./ /1V~L-UOez::;
OCl'-1t/L / '/7 oAf
/
Accepted
Accepted With Corrections
Denied
Reviewed By: ~ ~
Comments: ~ a.Lf ~ ~
~&J - /"
--. --~A r^(J~' ~ ~7A~ ~f2t1~
~~ ~Y-4JI~~~-
{'(d2m- k~ LIt~) ~ ~ 9(J'1,'7/~ jJtkl4.:;
~~,;2~ ~~ ~t-<~~~
% ~ 7:C.o. ~ -l~ 4..<-..~tJ , ~ ~ 0:J- 6- ~
Date: 1 ftt fa G.
~~
~~~.
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."
~;~ - ;~lIdl~
. na~ - Engineer
Pin - ann ng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
CjEROLO 8/COS.
4--. / /. 0 (p
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: /G-I P/7..e-1/TN
~500 LO~S 5//C66/ /Ne-LUoer;;
DEI'--?OL 177 oAf
>(
Accepted With Corrections
Accepted
Denied
Reviewed By:
fYJ1l>
Date:
'1-)90'
Comments: See Reverse Side for Arlrlitionallnformationl
-
See Attachments: 1) Grading Plan, 2) Erosion Control Meas~es..
"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
HEATING/AIR CONDmONINGIFIREPLACE PERMIT
Date Rtc-'d
(PlUM: typ.. QJ prim Ud ~ u ~
I ADORllSS fj506 L. -,
I LEGAL DESCIlIPTION (ollicc 1M mly)
_ LOT BLOCK ADOmON
~+, /V~,
f. =- S- r PERMIT NO~. 33~ I
II ZONING_~ l
PID
~=c:r G eW""o Icl ey-O ~~ elf"'S
(Addresa) il{ 04 E fYlotf'r-,. S r - P .0- Eo\( /~x
(pbone) 4~d - 7S~ - d ~ljd
Y, lA.e (Yl"" S 0
~:~F(On.cAOY F/V"GfllAc~ ySt-01l\c (P~) 7e] - 7~t - 'dJ<j1
(Addreu) ~d~d 4rt-hvV'" st, N[. StJ.,,/~!. L"K-G Pc...vk I (Y)h S5t/Jd
(Addlbl) , '7 (City) (Lp Code)
(Conact P~n) f yn e. 1- W ~Ioev (Phone)
DATE 0g-' IDS /6 t
APPLICANT SIGNA lURE
APPLICANT PLEASE COMPLETE BELOW
W CONSTRUCTlON REPLACEMENT 0 AL TEAA nONS
FURNACE MAI<.E AND MODEL FUEL
FLUE SLZE JUZTURN OPENlNOS lNPUT OUTPUT
'I"YPE OF SYSTEM HEAnNO OR POWI!R PU\.NT
~ ~::;alcr
a.-.,1tUoa
Specjll DcYICIU
l-J1~f' /VI ~~o~Gr..K
t- J../~ J it. 000 c-o.t:
PLOSE Non:
Air CDDciJticmer Unju
Cclnot &croech iDlo
llequlrt4 Side Y IJ'd
~
FE..E SCHiDULE
ill a. Mwti.FunU, 1% or job cott llaidalliaJ. Oa futplcc
$19 50 IILiai1nwD
RC$ldcmW. 1-Ica1ifll a. Ale (NG'/W ConRNaion) S9'J :50 lnidcuna1. ~1iIZl. .t AIta'Sions
~~ldtQtW. HWlnl ON]' (N~ CooItNcnoD) S64 )0 ~CRIl. AC OlIJy
s)9,~
D9~
J)9,~
Estialucd Cotl S
Bu.ildias PtJmjt "
REA TING PERMIT FEE
ST A IE SURCHARGE
TOTAL nRMIT FU
s
s
s
,5Q PAID WITH
BU'LDI~G_ PERMIT
I:'" Sa
(ome. UKo.l,)
Tbis AppLk::anoll BccDm.a Your ~iId!at hnatf WMa Appnwed
~ 0!Iiaa.I
Dsu
r;
:u ~.u..cb lW.a ~ <"1) "'7.9151I. en ~) "7~
18 /10 3~Md
doat~m
LOUL TLE9L
90:PL 9000/S0/80
MAY-24-2006
13:41
CI1'( OF, PRIOR LAKE
CIT~f Q~ PRIOR LA1(E PLlJMBIN\.1 J:'!).Ir-o.!UA ..
,.
9524474245
P.01
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i,oviNr:R-- ;;.d J ~-------=--_.-.. phon' ? 2 - :75?=28W-
\ (rhm.) ~_ ..., _-~-~------ ( - ) 3.. ---.--- J
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~;~~~^!:..'--.~-dk~~~L ___ (~hon.l-~- f'1't:L~~
(Add"") __--~rz.5.- /.., ~ ...kL~-.-.;z:~ -~ ~2
(Add"") ~ (Ci'Y) (Zip CQ<l<)
(Coo"," p",oo) _--._~n _--- (P~OIl') _.-UU <:?-z./ ::gt::?"
.~~!S.!'~12~1"U~--"'""". ~~~~~TJl .;;:.,;z~.,gk --
ArPJ..lCA~T P'LEi\SE COMFLETE BELOW
__- T:l'.l' O!~--==T~-~J-=- Typ. .fFI~~=:::
Bath T\lb with (\\ wtthout ahow~r Rough-i,ns
- --- ---.----------- ---
__.-:- ~1\~~;6r~; -------. C---I--. ~::: ~-:~r --.-~
~ T. -cava;~JYJa.rt"o~ .:::::::=.==.:c:::=--I-= ~~Pi~ (w..h\n~ lJl_acb!':~L_
_-_--L Laundry f,ay (I ~~~!!:!~~~~.------- S.w.ge Ej<<tor ._-.-.-~
:2= 9ho'''' Stall B",,~n.w ^"'l11bly
__._ _- siill<O~------- ---..---- Backli'OWA'..iilbly fi;;-".
__- B;rSink ----- -' ----s;;,n S rinkl<< ---.---
,:=--..3 W"or C\OsOt (Toif.;;r-------. _-.L- elMr P -----.-'
..,.._,.-._._._~._-- .---...-..-.-- ,- - -- \ .-.-'
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,,'",""'. C,m",,~\.1 & 'MD,,..mlly \% of job "'~ w\'~' m.'O m",imHm R"'d,,'\'\' ,,'W 0.'" Two-V",,;ly t99.10
Rt:~;dcf\I\"I. AdclllioM &. Altcr!\til;\M ~jrl,50
Estlma.tacl CCl~t $
--.....---....--...
Building Permit # --------
pr...UMBtNGI PERM1T FEE $
ST A l'E SUp,.CBA~GE $ ,---"--'-jO
TOtAL. PERMJT F'F."f, $ -,--_._-
(omr<: I)~( Q'~l)" --'-'
['Thi~ AP~B~llitil'J!1 :ee(:tln\~ ,,;;; Building 1P~r~~~;A;~~~--l" cP';id=
--.,,,,,,,omd" _- - .,....------- DOl'
--- - ----- ..----'.- --~
1" Mill" (\OGlr.c: f(j'r' all II'l,p~diJ!ll:'l~ (c~~~ d..t1.Q~50, rfl1( \1)152) 44741ol.5
-~ccelpt N(~-"-
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U:34
CITY OF PRIOR LAKE
BEATING/Ant. CONDlTIONINGIFIR:El'L.!>.ClC PERMIT
CITY OF PRIOR LAKE
C t TY [JI" /""'1'< I \,.l~ '~I-II''''.
9524474245 P.02
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_._..M P:l----- (PbollCl.. U(Z.:::2:!:1 :f~~
A~LlCANTSIOE,TURE. ~~~~~ ~Att-"
AF"PtlCANT Pl..,F.ASE COMPLETE JJEJ.tlW
..._ .~Nml1CTloN ORBPL"c!lMlll<t -1] A).. TBlllloNS - .
FUR1'lACf.: M.A.K'B AND MonEL _~!:J--L--LP42..Ql) ....-..-"-". FUEL ---.-----
PLuti SI7.:E _'_- RETtjll.N OP11NIl'10S __.-_----- rNPUT - QurPU'r -------
rm OF SYSTEM H'EAl1NG OR ?O"lJ'..R PLANt ..-~,-
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BI~ilcli.n~ P~rmit # __.
------~..."....,
ID3.A 'fnIlG p.F..~M1T fRE $ 3 'I, 50
3T A TE SURC;H^l~J,tJa $--"-'--- ,,50
(O.....ho.,.,,' 'ro'I:A.L nllMlT lIEI' S=:--;JiErii2
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TOTAL P.02
CITY OF PRIOR LAKE r~~ \~~: \~\l
I~o~~~~~~ ~~~~~~n~ ~~~tCA~~~~a~~~S \UU ..
For All Properties Located in the Shoreland District (~J. -=-'
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address tJG ClO /~R..OS :::;/ kEET
Lot Area Sq. Feet x 30% = ..............
........................................................................
HOUSE
LENGTH
It? x
32 x
q#"Gx
ATIACHED GARAGE
WIDTH
'26
/oZ.ZG" =
z8
SQ. FEET
2bO
327Z
9~
=
=
TOTAL PRINCIPLE STRUCTURE......................
'l-t/9'l
DETACHED BLDGS
(Garage/Shed)t ~jJt/.
~/FT ;b{/~ ,
x
~ x Z~. Z LjzJ~
TOT AL DETACHED BUILDINGS.......................
tit:) 4-
DRIVEW A YIP A VED AREAS
21
/g
(Driveway-paved or not)
(SidewalkIParking Areas)
TOTAL PAVED AREAS.........................................
/'17,1
. P A TIOSIPORCHES/DECKS x =
(Open Decks Yc.. min. opening between X =
boards, with a pervious surface below, /& bB ~8t7
arc not considered to be impervious)
II X /4 = 6/-
x
x
36
g~
66j/
6/Z
=
=
x
=
TOTAL D ECKS........................................................
B3Lj
OTHER 6/oC/ P
6 x
x
It?
bCJ
=
=
TOTAL OTHER....................................................... " t:J
TOTALIMPERVlOUSSURFACE I 722/
UNDERlOVE1J'1 . I 2>061
prepared~ Date 'I/vI/o6
Compan{1ERflt4 y~ Uf/.f) 6vIeVEY1~ k.Phone # f62 -tf4L5 - ?/6/f
-;] 25 West 126th Street. Suite 500 . Savage. MN 55378
PHO:'-JE: 952-890-7366. FAX: 952-X90-5883
[T =
= CO
INSTAN'f TESTING COlVIPANY
Gerold Brothers Homes
P.O. Box 128
1409 East Main
New Prague, Minnesota
Co f(/.+O.. C ~ ..... _!
\ ( O,er t
'I 0 <;~e n\ J{\-' ~ (
~~) cAI 0\
ANNIVERSARY I
2003
May 9, 2006
~J/
56071
()G-
3~L
RE: 4500 Lords street Northeast
Prior Lake, Scott County, Minnesota
As requested, site visits were conducted on May 5, 2006 to evaluate
and test subgrade soils for the construction of a slab-an-grade
single family residence located on a lake shore lot. It is our
understanding that a previous residence was removed from the
site, and no subsurface exploration has been conducted to date.
5/4/06 (6:36 A.M.):
At the time of the inspection, the west and northwest section of the
proposed build area had been excavated, removing saturated mixed fill
soils, and other unsuitable materials. Excavation depths averaged 2
to 3 feet below proposed footing grade, with a deep, water filled
section, near the pad centerline exceeding 4 feet. Soils at the base
of the excavation consisted primarily of near optimum silty lean
clays with, an isolated area of granular in the south west.
To evaluate the relative strength of the soils, a 5/8 inch diameter
smooth probe was used to penetrate soils at random along the proposed
footing lines and across the base of the excavation. with full body
weight applied, the probes indicated a upper zone of lower strength
soils increasing in strength at depth.. Maximum probe penetration was
recorded at 12 to 18 inches within a 11 foot section of the west
footing 1 ine were above optimum moisture was observed.. A 1 3/4 inch
fluted handauger probe extended into the deep water filled excavation
near the mid-point of the pad, indicated soft saturated soils an
additional 3 1/4 feet in depth.
Soil exploration was expanded by test pits excavated within the
northwest and east sections of the pad. Soils at the base of the
excavations ranged from a moist silty/sandy lean clay within test pit
#1 in the NW, to a blue/grey silty clay at test pit #2 in the east.
Probes indicated penetration at 16" and 8" respectively.
To assess the relative loadbearing capacity of the soils, 3 dynamic
cone penetrometer tests were conducted within test pits or the
excavation base. The dynamic cone penetrometer (DCP), uses a eight
kilogram (17.6 pound) hammer to drive a 20 millimeter diameter
conical point into the soil, with the penetration recorded in
millimeters per blow. From the DCP readings, a per blow, penetration
average was recorded and a N-value derived. This N-value, is an
empirical relationship we have established to equate the dynamic cone
data to the more familiar blows per foot (BPF) standard penetration
soil boring test.
Test #1 - Test Pit NE Corner (Approx. 2' Below Ftg. Elevation)
DCP Depth Per Blow Avq. / N-Value
Estimated Load
.760 MM (27.0") 39.7 MM / N-7.7
2775 PSF
Test #2 - Test Pit East of Pad (3' Below Existing Ground Elevation)
DCP Depth
Per Blow Avq. / N-Value
Estimated Load
740'MM (26.2")
40.0 MM / N-7.7
2775 PSF
Test #3 - East Ftg. Line (Excavation Base 3' Below Ftg. Elevation)
DCP Depth
Per Blow Avq. / N-Value
Estimated Load
662 MM (23.1")
33.3 MM / N-9
3275 PSF
5/4/06 (1:04 P.M.):
The contractor had expanded the excavation to the east garage
footing line removing unsuitable soils to the underlying cohesive
soils established as an acceptable base by observations made in the
A.M. Excavations depths within the south section of the garage
footing were at approximately 7 feet, to remove an abandoned sanitary
sewer line. Probes conducted at the base of the excavation indicated
acceptable soil strength. After our A. M. site visit, the contractor
uncovered a septic tank, of masonry block construction and a
undetermined depth. The tank at 5 feet in diameter, contained
water at ,approximately 5 feet below the top ring. The contractor
will remove the tank to competent soils, and backfill as part of the
pad correction. Soft saturated soils at the west footing line, as
observed during our morning visit, were sub-cut approximately 1 foot
and backfilled with a medium/coarse sand.
It is recommended that during pad correction to the east, the
contractor call for an additional inspection of subgrade soils
and compaction testing during placement of engineered fill. Our
observations and subsequent soil evaluations on this date are limited
to the depths of the excavation, test pits, shallow probes, and
dynamic cone penetrometer tests. We therefore, are unable to assess
soil conditions at elevations which may be encountered by soil
borings conducted as part of a standard subsurface geotechnical
investigation.
Sincerely,
Instant Testing Company
~~h/
~r{ St;indish /
Senior Inspector /
I
#701 - 1 / #605 -131/4/ #306 - 3 (DCP) / #612 - 28
GEROLDB2.DOC
~' (fM/
. I / /
,,~ I /1. ~
' ~'---"'-, L-...--) '<--- -- - -)
Dennis Odens, F.E.
I!to
I~'STANT TESTING C"MPANY
7125 West 126th Street Savage, MN 55378
(952) 890-7366 FAX (952) 890-5883
Soils Inspection Report
May 9,2006
Gerold Brothers
P,O, Box 128
1409 East Main
New Prague, MN 56071
.
Project: 4500 Lords Street NE, Prior Lake
Date of Inspection: May 6, 2006 @ 11.33 am
Inspector: Ken Schaaf, ITCO
A technician from Instant Testing Company arrived to perform a visual inspection on an excavation of a
proposed house, Approximately two to three feet of highly organic soil had been removed to expose a
, fairly soft clay base which was saturated with water and offered little resistance to a % "steel hand probe.
The base level was not much higher than the adjacent lake which indicates the clay has little chance of
ever drying out. With a minimum of six feet of controlled fill the soft base should not be a problem in
constructing the slab on grade house. All of the fill was being imported with a good sand layer covering
the base to 18 inches with a good clay loam following the sand,
Copies To:
Charge Code: Soil Inspections
Mileage
#602
#612
1
15
Pads constructed of engineered fill could be subject to a loss of consolidation if left unbuilt upon over a
single winter. Penetrating frost combined with a season of freeze-thaw cycles might loosen soils to the
depth of the frost. This applies to fill composed of either granular of fine-grained cohesive material. All
pads left exposed for one winter should be inspected by a geotechnical engineer or technician.
Ken Schaaf, Soil Technician
IIco
INSTANl rESTING COMPANY
7125 West 126lh Street Suite 500 Savage, MN 55378 - (952) 890-7366- Fax: (952) 890-
5883
DENSITY TEST REPORT
Gerold Brothers
P,O. Box 128
1409 East Main
New Prague, MN 56071
Project: 4500 Lords Street NE, Prior Lake
Date Tested: May 9, 2006 @ 11 :53 am
Ordered By: Customer
Reported: May 12, 2006
Field Technician: Ken Schaaf, ITCO
Inplace Density Test
Test Number: 1
Location: 12' north and 3' east of
garage comer
Depth Below Grade: 6'
Visual Soil Class: Clay loam
Proctor Curve Number: 06-01
Percent Moisture: 15.9
Ootimum Moisture: 10,8
Relative Moisture, Percent: '147
Field Density, PCF: 119,0
Standard Maximum Dry Densitv, PCF: 118.6
Relative Density, Percent: 100
Required Minimum:
Remarks:
Pads constructed of engineered fill could be subject to a loss of consolidation if left unbuilt upon over a
single winter, Penetrating frost combined with a season of freeze-thaw cycles might loosen soils to the
depth of the frost. This applies to fill composed of either granular or fine-grained cohesive material. All
pads left exposed for one winter should be inspected by a geotechnical engineer or technician,
Copies To:
Charge Codes: Density Tests 1
Charge Per Test
Mileage
, #601
#306
#612
1
1
15
5;'00' ~ p~C.
Gordon J, Kopacek, Professional Engineer. Registration No. 7254
fIco
INSTANT TESTIN.G COMPANY
7125 West 126th Street Suite 500- Savage, MN 55378 - (952) 890-7366- Fax: (952) 890-5883
Proctor Test Report
Gerold Brothers
P,O. Box 128
1409 East Main
New Prague, MN 56071
Proiect: 4500 Lords Street NE. Prior Lake
Date Sampled: May 5, 2006
Reported: May 12, 2006
Submitted By: Ken Schaaf, ITCO
Performed By: Ken Schaaf, ITeO
Standard Moisture/Density Test
Curve Number: 2006.01
Visual Soil Class: Clay loam
Standard Maximum Dry Density: 118,6
Optimum Moisture: 10,8
Representative Of: Density test 1
Remarks:
Copies To:
Charge Codes: Standard Proctor
Sample Prep
#303
#301
1
Signed
Gordon J. Kopacek, Professional Engineer - Registration No, 7254
~~! pt::.-
,Ji /1 ..
~ , ~
.:/. ""
II to
INSTANl rESTING COMPANy
7125 West 126lh Street Suite 500 Savage, MN 55378 - (952) 890-7366- Fax: (952) 890-
5883
DENSITY TEST REPORT
Gerold BrotheJ'S
P.O. Box 128
1409 East Main
New Prague, MN 56071
Project: 4500 lords Street NE. Prior lake
Date Tested: May 8, 2006 @ 9:58 am
Ordered By: Customer
Reported: May 12, 2006
Field Technician: Ken Schaaf, ITCO
Inplace Density Test
Test Number: 2
Location: 21' south & 36' west of
northeast corner
Deoth Below Grade: 4'
Visual Soil Class: Clav loam
Proctor Curve Number: 06-01
Percent Moisture: 18,5
Optimum Moisture: 10,8
Relative Moisture, Percent: 171
Field Density, PCF: 113,0
Standard Maximum Drv Density, PCF: 118,6
Relative Density, Percent: 95
Required Minimum: 95
Remarks:
Pads constructed of engineered fill could be subject to a loss of consolidation if left unbuilt upon over a
single winter. Penetrating frost combined with a season of freeze.thaw cycles might loosen soils to the
depth of the frost. This applies to fill composed of either granular or fine-grained cohesive material. All
pads left exposed for one winter should be inspected by a geotechnical engineer or technician,
Copies To:
Charge Codes: Density Tests 2
Charge Per Test
Mileage
#601
#306
#612
1
1
15
/lilfIi;:'4tel., P~t=-
Signed //
Gordon J. Kopacek, Professional Engineer. Registration No, 7254
,IT-=
=CO
INSTANl rESTING COMPANl'
7125 West 126lh Street Suite 500 Savage, MN 55378 - (952) 890-7366- Fax: (952) 890-
5883
DENSITY TEST REPORT
Gerold Brothers
P,O. Box 128
1409 East Main
New Prague, MN 56071
Proiect: 4500 Lords Street NE. Prior Lake
Date Tested: May 9, 2006 @ 1 :50 pm
Ordered By: Customer
Reported: May 12, 2006
Field Technician: Ken Schaaf, ITCO
Inplace Density Results
Test Number: 3 4
Location: 34' east & 18' 51' west & 19'
south of south of
northwest comer northeast comer
Depth Below Grade: 0.5' 2'
Visual Soil Class: Clay loam
Proctor Curve Number: 06-01
Percent Moisture: 20,6 19,2
Optimum Moisture: 10,8 10.8
Relative Moisture, Percent: 191 178
Field Density, PCF: 113.2 114,0
Standard Maximum Dry Density, PCF: 118,6 118,6
Relative Density, Percent: 95 96
Required Minimum: 95 95
Remarks:
Pads constructed of engineered fill could be subject to a loss of consolidation if left un built upon over a
single winter. Penetrating frost combined with a season of freeze-thaw cycles might loosen soils to the
depth of the frost. This applies to fill composed of either granular or fine-grained cohesive material. All
pads left exposed for one winter should be inspected by a geotechnical engineer or technician.
Copies To:
Charge Codes: Density Tests 3-4
Charge Per Test
Mileage
#601
#306
#612
1
2
15
{I~ P~E.
Signed ,'/ '/
Gordon J, Kopacek, Professional Engineer. Registration No, 7254
U,S, DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE
Federal Emergency Management Agency
National Flood Insurance Program Important: Read the instructions on pages 1-8.
OMS No. 1660-0008
Exoires Februarv 28. 2009
SECTION A - PROPERTY INFORMATION For Insurance Company Use:
A1, Building Owner's Name Ferguson Policy Number
Roger & Susan A2. Building Street Address (including Apt.. Unit SuiIe, and/or BIdg. No.) or P.O. Route and Box No. Company NAlC Number
4500 Lord's Street
.
C~ Pr10r Lake ~ MN
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc,)
ZIPCode 55372
M. Building Use (e.g., Residential, Non-Resldential, Addition, Accessory, etc.) Re sid e n t i a 1
AS. latitudeJlongitude: lat. 44 43 ' 51 · Long. 93 26' 27 II
AG. Attach alleast 2 photographs of the building if the Certificate is being used to obtain flood insurance,
A7, Building Diagram Number-L-
AS. For a building with a crawl space or enclosure(s), provide:
a) Square footage of crawl space or enclosure(s)
b) No. of permanent flood openings in the aawI space or
enclosure(s) walls within 1.0 foot above adjacent grade
c) T olal net area of flood openings in AB.b
Horizontal Datum: IX! NAD 1927
DNAD1983
A9.
For a building with an attached garage, provide:
a) Square footage of attached garage 965 sq ft
b) No. of permanent flood openings In the attached garage
walls within 1.0 foot above adjacent grade
c) Total net area of flood openings in A9,b
sq ft
sqln
sqin
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B2. County Name
B3. State
Scott
MN
84. Map/Panel Number BS.Suffix B6. FIRM Index B7. FIRM Panel BS, Flood B9. Base Flood Elevation(s) (Zone
Date Effective/Revised Date Zone(s) AO, use base flood depth)
0002 C Nov. 19, 1997 A7 909
B10, Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
o FIS Profile ifg FIRM 0 Community DetermIned 0 Other (Desa1be)
B11. Indicate elevation datum used forBFE in Item B9: ~ NGVD 1929 ONAVD 1988 o Other (Describe)
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)?
Designation Date 0 CBRS DOPA
DYes
rn No
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1, Building elevations are based on: tJ Construction DrawIngs* 0 Buikrlllg Under Conslruction* [j Finished Construction
. A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARiA, ARiAE, ARlA1-A30, ARiAH, ARiAO. Complete Items C2.a-g
below according to the building diagram specified in Item A7,
Benchmark UtIlized C i t y 0 f Pr i or Lake Vertical Datum N. G . V . D . 1929
Conversion/Comments
a) Top of bottom floor (mcIuding basement, crawl space, or enc:Iosure floor)
b ) Top of the next higher Iocr
c) Bottom of the lowest horimnIaI sIrucIuraI member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment in Comments)
f) Lowest adjacent (finished) grade (LAG)
g) Highest adjacent (finished) grade (HAG)
Check the measurement used.
910 . Q 7 [j feet 0 meters (Puerto Rico only)
.--0 feet 0 meters (Puerto Rico only)
.=-0 feet 0 meteIs (Puerto Rico only)
910 . ~~ feet 0 meters (Puerto Rico only)
910 . 6~ feet 0 meters (Puerto Rico only)
909 . ~~ feet 0 meters (Puerto Rico only)
910 . l~ feet 0 meters (Puerto Rico only)
SECTION 0 - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land sUlveyor, engineer, or architect authorized by law to certify elevation
information. I certify that the infonnation on this CeItiIicaIe RJpI8SeIIIs my best eIfotts ID inIeqJIet Ihe data available.
I understand that any false statement may be punishable by tine or impIisoIrment under 18 U.s. Code" SecIion 1001.
IX! Check here if comments are provided on back of form.
James E. Boerhave RLS 7095
Cet:Iilier's Nall1l't . License Number
preS1aent Boerhave Land SurveY1ng,Inc.
Tltli4243 Mitoka Cir. N ~~ Lake
CIy
06
55372
ZIP Code
PRIOR LAKE
INSPECTION RECORD
,
SITE ADDRESS ~S~O ~O/t.D,r .r~r
NATURE OF WORK MnAJ (W/rH 3r1U'llN A;cN - a~....~ .~.. J
USE OF BUILDING . I=: .
PERMIT NO. Or;, 033 L DATE ISSUED
CONTRACTOR ~ 13~.s &~~ PHONE Z.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEFARTMENT OF
BUILDING AND INSPECTION
FOOTING !; /1I-()1.g
FOUNDATION (Prior to Backfill) 5 -/&'tXo
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING {if required
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
[ZAnt€ . HOMUl#1I&A" I I
I
FINALS
Jlrl/
'"'1 rUt
GRADING (Prior to Sodding)
BUILDING lMr. \
ELECTRICAL
PLUM&JING
HEATING
DO NOT
1....{-o1
l.-(,th
Il-I'~
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved, On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850