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3 4~,-
I PERMIT NO. OZ -/Obtr
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3 Yellow Applicant
."SE
LEGAL DESCRIPTION (office use only)
~~61
LO~ e
Date Rec' d
ZONING (office use)
~ SD
LOT
(2LS 4l 39
1\ PID 2.. s- 0<.+ ..~O5' -0
BLOCK
ADDITION
OWNER
(Name)
\.().~
j-
~L
(Phone)Y~ 'Y,~1- ~~tart
BUILDER I ~ ~ ~ -Lit. ..l.-
(Name) L,..." '\ C"\.P r'\ "0' v'-\...L~~
(Contact Name) _l ~ ~ 1'"\
(Address);] ,
(Phone) ~~ lLLi'J OO~'7
"
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. perform nee d inspections. ~ ';'
X y'- -' ?f\'11
gnature Contractor's License No. Date
(Phone)
TYPE OF WORK
o New Construction
ODeck
ORe-Roofing
OLower Level Finish
o Fireplace OAddition o Alteration
PROJECT COST IV ALUE (excluding land) $ ~
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $ Pressure Reducer
0
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $
~ /27 10'--
I Da{e
#
#
#
#
ORe-Siding
$
$
$
$
$
$
$
$
$
18(, .",=:>
cuments is in accordance with the City Zoning Ordinance and may proceed as requested. This document
compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
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
CITY OF PRIOR LAKE
Impervious Surface Calculations
(fa be Submitted with Building Penn it Application)
For All Properties Located in the Shoreland District (SD).
The Maximum Impervious Surface Coverage Permitted in 30 Percent.
Property Address t!1to !?l.J77kD6rE ~Eer .6.E.
Lot Area Z 0 7/35" Sq. Feet x 30% = .............. /3335,5"
************************************************************************
LENGTH WIDTH SQ. FEET
HOUSE '28. 76 x 20.0 = 57~Z-
68,8z x 'ZS. I Z = J L/ 7~ 6
ATTACHED GARAGE x =
TOTAL PRINCIPLE STRUCTURE......................
WG3
DETACHED BLDGS
(Garage/Shed)
t./-Z,2 x
x
36.3
/632
.
TOT AL DETACHED BUILDINGS.......................
I 5.32-
DRIVEW A YIP A VED AREAS
(Driveway-paved or not)
(SidewalkIParking Areas)
x
x
x
=
=
=
TOTAL PAVED AREAS.........................................
/-f'l- 23
. PATIOSIPORCHESfDECKS
(Open Decks W' min. opening between
boards. with a pervious surface below.
are not considered to be impervious)
Z I. 3 X I Z, (J I
x
=
ZG6
=
X
=
TOT AL D ECKS........................................................
ZG"6
OTHER
X
X
=
=
T 0 TAL 0 THER.......................................................
TOTAL IMPERVIOUS SURFACE
8Zb4 I
72- I
I
(iJNDE~VE~ I
PreparedB g ~ Date 7//5 /CJz.
,. /
Company &ERflAVE lAND .5or<veYJ;!tt Phone # 152 -'115 -1/GI./
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 41 W ~UTt.~b~ St. S.E-.
NATURE OF WORK p~~ ~ ~
USE OF BUILDING fZE-S A/It- J I
PERMIT NO. 02 - / {)(P 4- DATE ISSUED slz'7lcs "l..
CONTRACTOR .J.. ~ tkN,.q.J Cc~. PHONE 1$'''~(.~'''7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
!. FOOTING I f!J ~. 9.ZQ.,r,Z--
I lij Backfill) i 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
1
,
~W,UER~EP~(7
FRAMING ([,17 /0 7 ?5<-t.l7
r .,.. _ <----
INSULATION ~ iO - 7-1~ cfL
ELECTRICAL
~
.~ .--- I~ . )
.- \..
BREPLAOE
,- -
- ~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 J
FINALS
1
~~"!J')
BUILDING W/ {f- 1S"'-rf2-
ELECTRICAL
.seGIIBnie
..IIPAJ:tao--
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850