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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/50 70 ~r'/1 t.-OOSrj
~ -;2/- IJ2-
I. White File I PERMIT NO I
; :;~~w ;~~icant .02 -074&
~/G
ZONING (office use)
K. I ~ .t::J
LEGAL DESCRIPTION (office use only)
LOT3 BLOCK Z ADDITION.3 eo ffl/P,V, 'TV R/tfr: ,e.(.L)t;.S
OWNER
(Name)
PIDZLJ -342- o/s-~ 0
(Address)
/10'&/ n' n/tlffGlLh .#C7'---/C-.
S'/l /VJ6"
(f,Cu, 4~ - . /LA/!_
(Phone) ~/2 - ..5 L - h~...,..-
H 7- 0/02-
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
eck
OPorch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
OAlteration
OUtility Connection
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-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 to perform needed in/iCtions.
X '- A,lv~ ~"" 14."i V ~L
SIgnature
Permit Valuation
.3
OOO.otJ
~3.2S
St/.. II
, - S-o
Permit Fee
$
$
$
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
&-2- /-0 '1'_
Date
Contractor's License No.
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 $ /38. f)~
/3 g- ,~Io f ReceiFol 3 d-d-
G::,- d- - 0 0- By
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 allows 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
Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY:
Date: {i - 2. / - 0 Z-
Building Permit # ()Z -0746 PID: 2.5-.542 -(Ys- 0 Zoning: ;t'4fO
Site Address
Legal: L -.3 B 2-
Existing strnctnre:8r NO
Subdivision: 3.e.o 41P.oA../, TV ~.J~. /c..{~C
CONFORIVIS TO ZONING YES NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE
MEETS CODE
Requirement
Proposed
· Side Yard
(25' if abutting a street, 30' if abutting a street in
Cardinal Rid e)
· Side Yard
10'
'811
/2 -
10'
25'
'-~ ".
· Rear Yard
· T oMlhouses
Must be consistent with
approved plan for
develo ment
<6 ~ r
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
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /5070 /IP~/1LOQJ'~ 772/7/ L-
TYPE OF WORK oe&::.-
USE OF BUILDING /ZeS Ak
/
PERMIT NO. 0 Z - 0 74-& DATE ISSUED t'P' - 2 (--0 2-
BUILDER 66CL- PHONE # 44- 7-0/02.-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT