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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
9./8 ' 00
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
5512.. WOODSID6 ,eD
se;
3. LEGAL DESCRIPTION
LOT 5 e(!" -r 3fa
1. White
2. Pink
3. Yellow
File .l\
City
Applicant
Permit No.
OO.~
1. DATE
9. / B . 00
BUILDINCllHR>RMA TION
11. SIZE OF S RE
(Height) ifth) (Depth)
leI
12. NO. OF STORIES
BLOCK
PID 25-93'-0/3-CJ
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
5. ARCHITECT
(Name)
6. BUILDER
(Name)
(Address)
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft. 111~ )~
Fireplace 0
Alterations 0
Septic 0
Addition 0
Dee
Finish Atti 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
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
will con to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
e, I hereby agree that the city official or a designee may enter upon the property to perform needed ?yectionli-
X ~/~~
License No. Oete +
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
~5S ~/~
/'
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
City:
5C/ .00
~lo
.soj
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty .......................... ............. $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~
~,
Sewer & Water Permit ...................... $
uilding perm~h~p~
Date - -~
Issued
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other.............................. ........... $
Total Due .............................. $
Paid
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zo g Ordinance and may procee 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.
City Planner
Date
24 hour notice for all inspections (952) 447-9850
Special Conditions ff any
00 -o@4fJ
The Cenler of lhe Lake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
B()IC~,41 Off,e L-g../~
Cj~/9.c/t/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~5/L WOOt>SIO~
Accepted
Accepted With Corrections
x
Denied ~
Reviewed By:l ~
Comments:
7-20~?o01~
Date:
~~dedc ~~
"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."
..f'
/
'.' ,
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 5SI'L ~ ~ tc:f) 0 ~
TYPE OF WORK Dec..'c. ~~(',~
USE OF BUILDING 5+0
PERMIT NO. 00. 084-f3
BUILDER ~r\tkQ....
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
DATE ISSUED q .20 - "2006>
FOOTING 0
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
I~ I I
I FI NAL I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
DATE
I
I