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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ORro LE
LEGAL DESCRIPTION (office use only)
BLOCK ~ ADDITION
LOT
OWNER
(Name)
(Address)
Date Rec' d
t. White File
2. Pink City
3 . Yellow Applicant
~
ZONING (office use)
gJk5D
3rd
-O.l3-G
PID
P f't 0 r
(9sJ-) ~q'O - /;7:5 ()
1\1'
(Phone)
lk
"
ll~
M
TYPE OF WORK
OPorch
)Jpeck
o Fireplace
ORe-Roofing
ORe-Siding
o New Construction
o Addition
OAlteration
OUtility Connection
o Misc.
OLower Level Finish
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~at the city official or a designee may
enter upo prope t p or needed in ections , ' , fl, f,',i\( ) I I
X jJC.- 'J-V \ ltC6 cry r;- \. l, //' 7 f.Jj Q I
Contractor's License No. . - I Date
our Building Permit When Approved
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
:)
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 $ 1.3 fl. ?f7C
$
$
$
$
$
$
$
$
I ~Yf/b-1MJ
7 -& - ~'r/(
Date
I :~/31~~~ J
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
White - Building
Canary - Engineering
Pink - Planning
The ('tnler of the take Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/J1~-1-oerJ~ ~
7-5-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
59l(d,. {Q~ fJ.-t
Accepted
Accepted With Corrections
Denied a ~f-
Reviewed B. ~~ --
Date:
7-- ~~ Caq/
Comments:
~~ +4:pQck~oJ-
"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."
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Bflh
Date: -;- !i-oj
Building Permit #
Site Address
c5'C(~ ~
PID:
Wr/c/e.
P!
Zoning:
Legal: L
B
Subdivision:
Existing Structure: YES or NO
YES
I
I CONFORMS TO ZONING
ORDINANCE
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in 50-!-
Cardinal Ridge)
. Side Yard 10'
~O+
. Rear Yard 25' .sO+- .
. 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 At"lY
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 S1Cf2 Orro~ ~~
TYPE OF WORK ~l,-
USE OF BUILDING ~
PERMIT NO. 0 t. 077---- DATE ISSUED 7- (. ,~(
BUILDER 1!JCV'c. ~ctt-X-~ ~/l. - 3;17 -5~5 5'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
.
~CTOR DATE
I FOOTING I .. I fli(DI
PLACE NO CONCRETE UNTIL ABOVE HAS BEE SIGNED
~ I I
I FINAL ' I I
Call between 8:00 and 9:00A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
Jht~-10-~ 3% 16: 38
JAMES R HlLL. INC.
b 1, I:!';:I~ b~'l.. ,... . U,,)/ 0_'
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CERTifICATE- OF SlJRVEV
EO!-
, METRO CLASSIC- HOlIES-
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