HomeMy WebLinkAboutBldg Permit 00-0626
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DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File '.,
City"'i;'
A~t
Permit No.
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
BUILDING INF
11. SIZE OF STRUCT
(Height) (Width)
12. NO. OF STORIES
LOT
ADDITION
4..,~NER
e 5- 09 S'-o!.fcil
13. TYPE OF CONSTRUCTION
5. ARCHITECT
(Tel. No.)
- 5C/'" 7'
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
De
Finish Att 0
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
1 O. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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
buil . g fficial can revoke this pe for' cause. Furthermore. I hereby agree that the City official or a designee may enter upon the property to perform ne d inspecti . n~,
X ,tl'-}--(;cY'CQ../ ':-41....tI-f...! 7 .. ,. 3 c~
License No.
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDI""l2, "" ~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
\ '000. -
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ... . .. . .. . ... .... .. .... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
5(P .15
:,& . Sq
,,,\0
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
This Appli
By
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ "\4-. 5+
~J. R~I~No 3.8014-
Issued
Date 1 &J By (LIJ H
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 constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections (952) 447-9850
Residential Building Permit Checklist
Deck Additions to Single Fam; H. omes/
{Off Date: 7/ZJ (Co
PID: Zonj~ i,SiCl<.-
f) _ S. ubdivision: S!1-ro 0.1<, cJV6r'2- PfLof?8I-ry
f'-t:;PC-rtCC :\ /-IIVE
~ rS,(AJe::> U&--rc::..
I CONFORMS TO ZONING I 411
ORDINANCE ~ ..
BY:
Building Permit #
Site Address
Legal: L -1.!l- B
Existing Structnr6).. NO
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'
. Rear Yard 25'
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 . l1d1B lNVUAD~
TYPE OF WORK ~"'-A~~~!_
USE OF BUILDING ~Al(L H
PERMIT NO. OO-(a" DATE ISSUED 'fZo/t:} 0
BUILDER jE~~ ~ JE;rJ5::>,..J ,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- ...
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I~ . E~l'STI~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I
I FINAL I I
Call between 8:00 and 9:00 A.M. for all inspections
. FOR ALL INSPECTIONS 447-9850
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