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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-;3 - () Z---
IY3Jr DQcJ ~ Cd
t
LEGAL DESCRIPTION (office use only)
LOT IS BLOCK l
ADDITION t<VIo\P Hd\...
OWNER
(Name)
){CA.'vtd Y
.
4 ({~i1..
(Address)
uA. t IJE
(Phone) 9,f..2 -l{4J-/L/r'1
fl1tu rr J 7'-
DcJtl~
BUILDER
(N ame)
~
( Contact Name)
(Address)
I. White File I PERMIT NO 7
2 Pink City . ()7 ~O <:::/.
3 . Yellow Applicant . t-- __
r-
JVc-
ZONING (office use)
~~
-0
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
eck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $ (
tJ
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 n 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 upo operty to p form needed inspections.
x
Signature
Permit Valuation 2 ,(!(x) .~
Permit Fee $ (1l~.7<","
Plan Check Fee $ 4s. Or
State Surcharge $ 1.00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
our Building Permit When Approved
-
5--/ 3 -OL
Date
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /IS 2-fo
I ~:i~ / ~~ ;~~
~~-12(i?7-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Planning Director
By:f>e
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date: ~ 1'3 -0'2....-
I
Building Permit # 07- /0) (~
Site Address Iq32~ 0""
Pill:
Zoning:
Legal: L
B
Subdivision:
Existing Structure: YES or NO
I CONFORMS TO ZONING
ORDINANCE
I
YES
I
NO
I
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in <8(
Cardinal Ridge)
. Side Yard 10' 4Z'
. Rear Yard 25' ~ ' I
t&S . ~
. Townhouses Must be consistent with lI"it[
approved plan for
development
ANY PROPOSED DECK NOT MEETING THE ABOVE CRITERIA MUST BE REFERRED TO THE
PLANNING DEPARTMENT. ALSO, ANY DECK ON A LOT WITH A SUSPECTED BLUFF, OR ANY
OTHER UNUSUAL CIRCUMSTANCE MUST BE REFERRED TO THE PLANNING DEPARTMENT.
TIns CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLATE\DECKCHCK.DOC
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 1(/32J~ fftv..e- r +.
TYPE OF WORK ~
USE OF BUILDING Sf='D
PERMIT NO. DZ - 05"/8 DATE ISSUED 5- ts-
BUILDER ]G51~ PHONE # C/L/~~/lfe:; 7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING I~. I 6/ {p / () l-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING ~~ ;"'\. CWb''f-1 ~ ~ &17/01'"
I FINAL I /-y;/ I S-~~OG
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850