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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
~. ~i~i~e ~:~y I PERMIT NO. OJ- 51!::>!
3 Yellow Applicant . -, . ~
P ~/V j) 5. f1)~, ~
iN', ~i..
- fl-I,:M~ LAk--& MN
>>372-
I<
ZONING (office use)
LEGAL DESCRIPTION (office use only)
/ -J 4~"^ /~: "-0 C!)~
LOT BLOCK C-- ADDITION p~~ 0
OWNER
(Name)
MI1~1L-
So L Iz.
V/VC6'EX7
L~
(Address)
5000
BUILDER
(Name)
(Contact Name)
(Address)
PID
(Phone) 7C,3 22/-9'7b~
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
eck
OPorch
OAddition
OUtility Connection
ORe-Roofing
ORe-Siding
o Fireplace
OAlteration
PROJECT COST IV ALUE (excluding land) $
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- ntioned prope d that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aw t the buil . g fficial n revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the prope~ per needed' s ction
C-
x
Permit Valuation
. tJO
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
."0
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
1?{~~L~ tl2D~f 'I
Contractor's License No.
~-22-or
,
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /7/,95
I~~~r-(JLI 1~;"9~o L/0LlfSI
I Paid
Date
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 aUows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
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
BY:~
Residential Building Permit Checklist
Deck Additions to Single Family Homes
~
~
Date: ~~~/o '-(
Building Permit #
Site Address 0500-0
Legal: L / B z..
PID:
~~~.
Zoning:
Subdivision:
s:~
!J0ut~jJ J>.tb
Existing Structure:@orNO
CONFORMS TO ZONING YES NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in 2cp r
Cardinal Ridge)
. Side Yard 10' I
C;v-eI\ to
. Rear Yard 25'
rt.J0\ too I
. Townhouses Must be consistent with
approved plan for rJA
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
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 6:~ FhItJlJ.Jt &l:J&e ai, J: .-.
~PEOFWORK )V~~ ~C~
USE OF BUILDING - s:
PERMIT NO. DATE ISSUED a
BUILDER..M&tJt. ~i.IG PHONE#}J,!.N/- ~,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE;
l FOOTING {j2 /!.., r ." /0~ '1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
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I FINAL I, r
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S -fLu _
FORALL INSPECTIONS (952) 447-9850 _
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