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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 Yellow Applicant
PERMIT NO.
ADDRESS
J S- oP:- ..$.:
otjb
LEGAL DESCRIPTION (office use only)
/04-/ /
LOT BLOCK ADDITION E u ;5 i-
c::i-,
PID 0.0-/1'1' O()S-6
Date Rec' d
6- ,:-c2J-
OWNER n C /I
(Name) ~1Al CU'\d ~/
&iaa. (Y)
(Phone)
(Address)
BUILDER ~ . /L. ~ -r-_
(Name) / l.u'\5+OU I..:/IHll!ir" l -l-I'\.C.-- I
(Contact Name) _-gd GtJ rr
(Address) ~l() W&~ t.6 StA,"J.-e ilD
(Phone)
(Phone) 6.5( - dIe) -q t;);)
&1 d.f1 I <<r,AJ 5r/~ I
TYPE OF WORK
o New Construction
ODeck
o Porch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
o Addition
o Alteration
_PROJECT COST IV ALUE (excluding land) $
OUtility Connection
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
I :"":;;;;;7:"" .""'d i"perooM 2006, JfJ 'f 5'-.n -0 ~
Signature Contractor's License No. Date
$
$
$
$
$
$
$
$
7-3~1- $304.
l~p~7-
Permit Valuation
#
#
Park Support Fee
SAC
#
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
TOTAL DUE
omes Your Building Permit When Approved
Paid .::Jd.tf- .J; (,
Date 7-"/ 1.-1 -z.-..-
?-?-crL
Date
I
l
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may nO~ted as request~d. This docume~t
whm ,,,,oJ by <h, Ci" '"""'.' ='''''" , ocmpm;uy Certilim" of z. ming "mpfuntt '0' ,Um, ",=ctio",o " ~. Be"" ocm['" 'cm.. ,"~ of =pm" m'" ,
oz:.z~~~ 7/;/02- ~~_ V O~ 4:.J;Jif~
Panning Director Date pecial COIOkl1tlOns, 1 any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White - Building
Canary - Engineering
Pink - Planning
The Cen1('r of Ih(' Lakt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
!Il~-<f-lll~ rga!~ U1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~tJ0 j:50~) ~~
Accepted ~ Accepted With Corrections
Denied
Reviewed BY:~-iA~~--0
Date:
7/J-ID '2-
"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.:'
O_3/~~ !_O~ Q.!l: n FAX 6124474245
CITY OF PRIOR LAKE
~002
CITY OF PRIOR LAKE
Impervious Surface Calculations
(To be Submitted with Building pmnit Application)
F or All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address 6096 I ') () II}- <;T.
Lot Area S~, 2e3 Sq. Feet ,,30% = .............. 17 I 4 iJ5
.......*******.*.*.*....*******......*..*...*..............*............
ATfACHED GARAGE
LENGTH WIDTH
6X~x
F"t[iV~ ~OOlTavx
x
,.
SQ. FEET
33&1
7:2.:3 ~
HOUSE
==
==
TOT AL PRINCIPLE STRucruRE-.........__.....-
$6)5'
DET ACHED BLOGS
(Garage/Shed)
SPR ~ POt1L X
X
2: 4~<8
'""'
TOT AL DETACHED BUlLDINGS--....-.......-....
14S"~
656&
'300
,.
DRIVEWAYfPAVED AREAS
(Driveway-paved or not)
(SidewalkIParking Areas)
DW~ X
SH)bvJ~\...\( X
X
==
=
o~66
TOT AL PAVED AREAS....-.........-.......-..............
==
P A TlOSIPORCHESIDECKS
X-
X
=
(open ~ks '/.~ min. opening betWeen
boardS. with a pervious surface below.
arc not consideted to be impervious)
==
X
TOT AL DECKS..-.........-......-.-.-.....-...-...-.. IN (Lv DbD
==
OTHER
X
X
==
TOTAL OT-mR..-............-.-............---------....
TOTAL IMPERVIOUS SURFACE { 14 Q1'1
~OVER ~ ~ L 2<;1;6
Prepared By .. ~ ~~/ ~Date ?'OM()-y2bQ)
Company ji/2./'V'1 \)' I bN?\N fCJ2\ fief <;U)lV i:!fINt-Phone 1/ 152 4 3') ) 9M
J
1
..
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS _~O 'i La { 50 +-~ 3t- .
TYPE OF WORK &f'eUA Pool e.....el.o~
USE OF BUILDING SF D
PERMIT NO. 07- - O&oB DATE ISSUED 7-3-0'2
BUILDER SUV\ ~\c....t:., PHONE # CoSI- 2'70 - 9/ :J'2..
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 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL
~~ A1~ I~,L -('~ ~. lP/'t/ot{
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850