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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
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
q
3. LEGAL DESCRIPTION
~
Permit No.
1. DATE
7
BUILDING I
11. SIZE OF STRUC
(Height) (Wi./
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
ADDITION
4~~ N l ba2:)1
(Address)
4CoctO PAA.~~i> ~1L
5. ARCHITECT
(Name)
(Address)
6.BUfLOER
(Address)
(Name)
- =-"
N\~I ~
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
(Tel. No.)
41./1 ~flJ7-7
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
1)12- L/lI7 - '2"z. 7
SEATS
16. PROJECT COSTNALUE
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
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 mentio d prop' rty and that all c struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 .. an revo is permit fo' cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform ne ed ins ions.
I If 00
8. PROPERTY AREA OR ACRES
Sq.Ft.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
x
17. COMPLETION DATE
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
License No.
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING ~ Aj R.
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
PERMIT VALUATION
'2,Dr'O - C" C>
S U
City:
G2.2<\
tlo. 46
I , od
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
~\JJ.OD
.I}'
Sewer & Water Permit ...................... $
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
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 .............................. $ / a..3 . 7 /
Paid Receipt No. .3709z.-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proce s requested. This document when
signed by the City Planner const~utes 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
The Center or the Lake Counlry
OO,05~~
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT _\<\)rLN i 0.&\
APPLICATION RECEIVED J""uJ \. J \ \) d 000
1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4(090 ?OJ-k..woocJ DnY'~
Accepted
Accepted With Corrections
Denied
Reviewed By:
Date:
Comments:
"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."
06 ~ ()~~V
The Center or the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT K\h"- LN i O~\
APPLICATION RECEIVED ;Tu I Y \ I) d 000
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4 ~ 9 0 'R,e,r k- \Jv<Joc1 Dr lYe-.
Accepted
Accepted With Corrections
qb
Date:
Denied
Reviewed By:
Comments:
"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."
.. . . ~ '~'-
____w....., ._. _'~
.......-.. ...'.....~-..,. -.. . . _.. '. .,. - -..~-. .'._..-.
1'.
BY: (;?3
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date: 7 - (C
Building Permit #
Site Address
PID:
Zoning:
Legal: L q'
B 'f
Subdivision:
Existing Structure: YES or NO
I ~I
I CONFORMS TO ZONING
ORDINANCE
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
I
(25' if abutting a street, 30' if abutting a street :2 S'. S-
in Cardinal Ridge)
. Side Yard 10' 'It/'
. Rear Yard 25' l/3'
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.
Tms CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L:\TENIPLA TE\DECKCHCK.DOC
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PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS L{(.~o ~,~ Dr-.
TYPE OF WORK J:~!:.l,-
USE OF BUILDING SFD
PERMIT NO. 00.0592- DATE ISSUED 7-12-20~
/
BUILDER .-Nt'OS' . ,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
.. .
THE PERMIT IS BY SEPARATE DOCUMENT
, INSPECTOR DATE
I FOOTING .. . vJ(d . ~ 1/t1(/7/l7V
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
I
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