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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
La a-j," ~~(
LEGAL DESCRIPTION (office use only)
LOT OBLOCK
ADDITION
OWNER /YJ / / j}/1
(Name) I / //~:l1tLC r r I~ r
(Address):5/3'S [2"./!..- /
'-1'- ..
I. White File I PERMIT NO ~
2. Pink City . () .1 - 102-.
3. Y cllow Applicant . if _ _
R,~
I-r,
ZONING (office use)
- UO
PID
.~e}
~
95"2 - s/~- 'YCI"10
~/}..- 7y-S - wi'!?
fr/~ ~L
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
Deck
OPorch
ORe-Roofing
ORe-Siding
o New Construction
o Fireplace
OAddition
o Alteration
OUtility Connection
o Misc.
OLower Level Finish
PROJECT COST /V ALUE (excluding land) $
tJCO
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,pro erty per~orm ne~;spections. '
X ~ i' -/9 -0'-.
Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
-
$
$
$
$
$
$
$
$
Sc=>oo. ~
8s.Z~
st.r'
I. 0
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other I / $
TOTALDUE~ '/Z-//.z... $ ('lS. eG
Paid
Date
/~1 ~~
,- z,..o"Z.,.....-
I ~;fJ h7,8-
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
BY:
?D&t
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date: 8"-/qv~
Building Permit # Z ...{ DZ, ~
Site Address 0 ::>
P::5-93'J ~k~R~'" ~
Legal: L B
Existing structGo
I CONFORMS TO ZONING
ORDINANCE
Subdivision:
YES
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in (, '
Cardinal Ridge)
. Side Yard 10' S2.. \
. Rear Yard 25' ~) I
. 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
INSPECTION
RECORD
SITE ADDRESS .s-~ 3S- {!C<4 rI/~tY.f tf?,. tf?~
TYPE OF WORK Dee-Ie-
USE OF BUILDING .:SF-
PERMIT N~ 1~Z.Yn DATE ISSUED f!;-- rr--o,:).-.
BUILDER _~cuL dW PHONE # ~/d.. -7t.;'3-C,/41
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSP~ DAlli
I. FOOTING I t I &-?~ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I I
I ANAL I I l
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850