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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
~/17~~
E
LEGAL DESCRIPTION (office use only)
LOT g BLOCK3 ADDITION &tU~~
OWNER
(Name)
(Address)
d
.-
(Phone) LlIj'i - 0 /i-lu5
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
eck
o Porch
ORe-Siding
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
o Misc.
ORe-Roofing
DAddition
OAlteration
OUtility Connection
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
;ter upo e prope~ t perform eded;rtiOns. ~~/I(j / {/ /
Contractor's License No. ~
Permit Valuation '-l.~.OO
Permit Fee $ 9'1.2S""
Plan Check Fee $ (,3.2..\
.
State Surcharge $ 2.oC) .
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Building Permit When Approved
Co-l~- l.aol
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1 "; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~ ~ .lfIJ . 0 ! $ /'2 ,4t,
Paid
Date
/Z~j~
I ~~oojl!'t3?~2#-
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
By{2€
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date: (.,- (~- ~(
Building Permit # PID:
SiteAddressSq....,S Ch-o,~ ~t-
Zoning:
Legal: L fB
B
3
Subdivision: Qc.teli~ ~,~ T.r-
Existing Structure: @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
Cardinal Ridge)
. Side Yard 10' /0 t
. Rear Yard 25' 36t
. 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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS m 7 5 Cr~$~J.a. s+.
TYPE OF WORK DecK..
USE OF BUILDING ~ F~
PERMIT NO. O{ -of.o02- DATE ISSUED to - 14 - ~ 00 I
BUILDER ~-e.n L/L/7~O~(;;;0
NOTE: THIS Is-NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
r FOOTING I ~ I foQ1./r;{
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
l.--z I I
I FINAL I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850