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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
ICJ. ~/'O'2-
I. White File I PERMIT NO Y I
2. Pink City '02- ~I II .3
J. Yellow Applicant . t. - .
ZONING (offtceuse)
Je/SD
/~ 9q4-
/'1eJA/eo6 /lVENU6 S~
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT J Z-BLOCK...5 aDDITION
S fJ R.,J rJ~
OWNER
(Name)
F:\ I cU It '~i\
(
.......- l..-~-
(Address)
/..-1+ I~
PIDZS- /33 - 04--/-0
(Phone)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ORe-Siding
OLower Level Finish
ODeck OPorch ORe-Roofing
o Fireplace ~ddition o Alteration
PROJECT COST IV ALUE (excluding land) $
OUtility Connection
o Misc.
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 ) above-menti~ed property and that all construcnon will conform to all existing state and local laws and wtll proceed III accordance Wtth
submitted pr;an.. I, .w= """::r. uUdm, ulf",," '''' re,,'" "m porm" fm ju" "ure Furth~ure, I '..oby ."" ",,' "" "" offie.! m · ""gure m"
enter upon th' ,rope /0 perform f~' e'tiyspectiq-s _ _" . , ,
X ! . <"~, . -c I Y { , "
Signature Contractor's License No.
Permit Valuation Of). 0 ~
Permit Fee $ " ,. ~G
Plan Check Fee $ 4 s. " I
State Surcharge $ 00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~~
Building Official
/O~51 /0 2.---
( Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE' r) 10-30 ,02.- $ (IS.Uo
'if'l1If r)1
~~ //~?j:, _ 0- I ~~cej~o~<Z :>,~ I
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.
Special Conditions, if any
otice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White - Building
Canary - Engineering
Pink - Planning
Tht' ('tnlt>r of the Like Countr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
qAUJ R-ICA-tARD
lO-ZI-OZ-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I(OQCj4- MONR05 AVf,NUS SW
Accepted With Corrections /
Accepted
Denied
Comments:
~
.:::;~ ?
Date:
/11b/a z-
,
$" ~ ~
Reviewed By:
5'l:)
,
AU
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
The eenle' or the take Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
i i.
I /
I
f"-! 7--."\ !';.....___ i_._
/
1.-----
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
. L-J-
: I
'.
Accepted
j
Accepted With Corrections
Denied
Reviewed By:
~
Date:
10 -'(716 .OJ---,
Comments:
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Property Address~ l..DC1.G\'-\
Lot Area l \ \ \ 9 Sq. Feet x 300/0 - .............. -z..\~ \p
***********************************************************************
HOUSE
,
-, .
ATTACHED GARAGE
LENGTH ~DTH
U. 0 x ""2..'-\
x
=
SQ. FEET
qlqD
=
x
=
TOTAL PRlNCIPLE STRUCTURE......................
~IoO
DETACHED BLDGS
(Garage/Shed)
x
x
TOTAL DETACHED BUILDINGS.......................
1.
c;~~\
DRIVEWAYfPAVED AREAS
x
=
-
~way-paved or not)
-
(SidewalkIParking Areas)
.X
=
x
=
TOT AL P A YED .'~R.EAS.........................................
4~~
x
X
=
P A TIOSIPORCHESfDECKS
(Open Decks '/;. min. opening beC\veen
boards. with a pervious surface below,
. are not considered to be imperVious)
=
x
=
T OT.~ DECKS........................................................
~ X ~
X
=
\1-
OTHER
f~~o~O O\)<y~~, tt'f'-tL
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TOT AL OTFIER......................................................
\~'("\J\~s
TOTAL IlVIPERVIOUS SURFACE
~RlJ
Prepared By ~ i<'-I c...~
\
=
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\u.t;B I
LD1l2> I
Date
I
I
e~l cYL
Company
· Phone # Oe,,,\-, - "'l.k1D
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