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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
a.z,04-
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0+. 0811
ADDRESS
ZONING (office use)
KISt:)
/C,572-
dL-/ND
~~~
~sc
LEGAL DESCRIPTION (office use only)
LOT 4BLOCK 3 ADDITION WIt-O€Je...IV65S PPNOS
PID zs:
OWNER __
(Name) JOf+-tV Ii.! j"d'tfL',./-f
(Address) t L-S 72 IS) Uf/I 1. rz-k~ 7/L
(Phone)
CJ S" 2- - tt'-17 - sC@
.
.~~
(.L.
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
OAddition OAIter
....
Deck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OUtility ConnectIon 0 Mise.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have hlrmshed mformatlOn on this application which IS to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
above-mentloned 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 buildmg
official revo r~st c Ise FlIIthelmore, I heleby agree that the City offiCial or a designee may enter upon the plllpelty to perform needed mspectlons
n~~ i B-2 --oy
Signature Contractor's Ltcense No Date
$
$
$
$
$
$
$
$
$
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; I";
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
$ TOTAL DUE
#
#
#
#
ThiS IS to certifY that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constllutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isslIed
Planning Director
Special Conditions, if any
Date
24 hOllr notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY: eh,
Date: 9-'2-C)v
Legal: L
PID:
~\,,--t. ~ ~r
'5
Zoning:
Building Permit #
Site Address I cI5 7'2.
C( B
Subdivision:W;~~ p~
Existing Structure: YES or NO
I CONFORMS TO ZONING
ORDINANCE
YES
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10' ,
(25' ifabutting a street, 30' if abutting a street in If
Cardinal Rid.ge)
. Side Yard 10' 5'"
. Rear Yard 25' 3(, ,
. Townhouses Must be consistent with
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.
THIs CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TEMPLA TE\DECKCHCK.DOC
~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /h57Z LlLINO t,/Ilc.G T/ZA'/ L--
TYPE OF WORK 0 EX/L
USE OF BUILDING /2Gr /II tt-
PERMIT NO. 01-. () 6 I I I DATE ISSUED y: Z., 04-
BUILDER WAL-Srl PHONE # ~7. 5fp'o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR 9ATE /
_I FOOTING I f1l/j I f?PO / D,/ 'I
,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
t-.r I I I
I FINAL I : r'r~/ I 'J.' 1(../'01 I
FOR ALL INSPECTIONS (952) 447-9850