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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ~ -7-0L(
5 c..-+ /.1 ,
8f2~\4.
LEGAL DESCRIPTION (office use only)
LOT
'I'li~?
BLOCK
ADDITION
OWNER
(Name) f:c.H 8' c)1-+e(2lb/<1~ llA.Fo/.'J C
(Address) ~
I. White File
2. Pink City
J . Yellow Applicant
I PERMIT NO. 04- . 0 1011
I
I
~(L-
N.~
ZONING (office use)
(50
~A/~ ~ey 5U1[/
(Phone) q!):?- qqfv'~DqLl~
BUILDER('
(Name) JArA:J Vln{LSG b@'71b~'7.t &tc.),:::,~<;
(Contact Name) 17z./AAJ etlrl0~
(Address) 474'0 4ZI0L) jJr/e WO,,?'f)l Ro1!5l311A/5LWC--'e
(Phone) 7&"3 - S33-CJ3S- Z-
(Phone) tel! &'12~ ?-;zI-tf3~3>
p'VlAf. S-~L/ Z ~
o New Construction
ORe-Siding
TYPE OF WORK
~eck
o Fireplace
OLower Level Finish
o Misc. t.~Q. ~O
OPorch
ORe-Roofing
~Alteration
OUtility Connection
):1Addition
PROJECT COST IV ALUE (excluding land) S / (XJ 3t./8
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 O'Nner 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.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Building Official
3/11 j't;'f
Date
(;)023;;2
/- 7-0 1
Date
Contractor's License No. .
Park Support Fee - # $
I
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $ :
Water Tower Fee $ .,
# I
I
Builder's Deposit $ ---,
!
Other $
TOTAL DUE lillA, lr7l'\ 1. 1A ,04-- $/. ?q~. 88 i
I
.
//
I Paid ~ '7 tJ '1-. If t1
Date ..? U-.()~
I~~~qq
-
i
~
I
j
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 Plann stirutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. .
6-&0 C7f
Date Special Conditions, if any
our notice for all inspections (952) 447-9850, tax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
t~~
~~
White - Building
Canary - Engineering
0ink - Plan~
lht' C'l?nlrr of thE" Lake ('oun'f)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.; ......r-
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-."7"
. /
,""" /
I
,
Accepted
x
.
Accepted With Corrections
Denied
Reviewed By: ~
Comments:
Date:
~J)~. {;i
"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."
---------
lh(' ('l'nll'r or thl' t.ke ('ounfr~'
CWbile - BuildiilQ:)
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
5AWHoIGJ6
z . 4- ~ 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4/67 .sf/rlDV 8D7(lJ-j 77ZL-,
I
Accepted Accepted With Corrections /'
Denied
~ ~t.J Date: 3/(I/ot!
~CLL(
Reviewed By:
Comments:
"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."
c;;~e ; ildi
narv- - E~gin;~
Pin - annmg
The ('("nley or fhl!' t.ake. Counl...,"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.~.__. . j ,
,~) /:-; i
1- / (~; (,. -,::-
.: IJ />---> l._.-
--..,
,./'
.,:;"".--
.4-
I
-'4-."
.,'- ./
I....... -"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
It:.:)- / S -7 < :)-/4 /'.} V /<i~ I,.')' i /~l7;L:.:/L_..-'
I '/./ ~-'-," .!,.- /_ ["J'i /1 I ( "/_ /
Accepted X'
Accepted With Corrections
Denied
Reviewed By:
f)/J9i5
Date: ;2 -/7- Oil
Comments: See Reverse Side for Additional Information'
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
CITY OF PRIOR LA~KE
Impervious Surf~::e Calculations
(To be Submined with Bui'ling Permit Application)
I;; or All Properties Located in the Shoreland District (SO).
The Maximnm Impervious Surface Coverage Permitted is 30 Percent.
. . . I
Property Address t 4 (87 6(,f13~~~ I G AI ~
Lot A.rea . I B411 sq. ft. x 30% = .............. I. 5~ I
*****************~***************.**************************************
I .
LENGTH
\\1DTH
\
SQ. FEET
x = '2b,;4
---- x ----.-- = ;r~'
x -~ ----= ; i ~t '\'\
TOTAL PRIN CIP AL STH. U CTURE....................~ Uh".o4
I
~~:::I:.i;t"
HOUSE
A TT ACHED GARA.GE
NIA
~ "
t;~~,~,~< ~',f.
DETACHED BUILDINGS
(Garage/Shed)
x
x
I
I
L~
I
i
""','
TOTAL DETACHED BUILDINGS.......................
DRIVEWAY/PAVED AREAS
'co (J)rlveway-p~y;ed or not)
(SidewalkJParbng Areas).
1/:; 'Dg
x
=
x
x
"'"
2316
TOTAL PAVED AI'~AS................_........................
PATIOS/PORCHES/DECKS
x
= ~ ~~
(Opcn Decks '/~" min. opening between.
boarcs. with ~ pervious surface below,
3l'e not Gonsidl':red to be impervious)
x
=
x
=
-~- --.-------.,.-.......
TOT AI. DE CKS.......................................... ..............
a;!;o
. OTHER
x
=
'\,
-'--.-- --------
x =
TOTAL OTHER....................................................... .
TOTA.L IIVrPERVIOUS SURFACE
16~~2. J
[ 4JLJ
Date 2- 2-04
UNDE~
DEMARS GABRIEL LAND SURVEYORS
Prepared By ._____.~______._.___..__
DAVID E. CROOK. PRESIDENT
Company ______. -.1Q.3n.HARliOKLRNQ,_.
PLYMOUTH. MN 55447
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PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS i. ,J. t: ·
NATURE OF WORK
USE OF BUILDING ~ ~. . .
PERMIT NO, 04. O/~ ~ DAtE ISSUErJ.47PJ1tJ~
CONTRACTOR S,6".J~~~a(l!Jci"" )>H<1JE'-.&.h: .221- 'f3S3
NOTE: THIS IS NOT A PERMIT F R ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING
I
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I~CTOR
if
DATE
I Lf-1
r_ ]...i-011
COVER NO WORK UNTIL ~E HAS BEEN SIGNED
'-4 &. '~.-Y" I
FINALS
din}
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
'<
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved, On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850