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ADDRESS
~~1f
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
PERMIT
at bottom)
c",~, am.JLn-
PI{ 10 R..
ZONING (office use)
>T S" E
L-l4-c E
VI)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 26. 30Z. OSl. 0
OWNER
(Name)
S>J--e p h ~
(Address)
Pilips.eM.
~ 01_ (Phone)
~1 -0 (p ('I
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
OAddition OAlter
eck o Porch ORe-Roofing ORe-Siding
OUtility Connection
~ Misc. ---'pOOL.
OLower Level Finish
o Fireplace
III IV
H I
2 3
11Tt-, / tfA) ~/lJf5'
I
PROJECT COST IV ALUE $
(excluding land)
CODE:~h.R.C. DI.B.c.
Type of C~stroction: I II
Occupancy Group: A B E F
Division: 1
V
M
4
A
R
5
B
S U
I hereby certify that I have 111rnished information on this application which is to the best of my knowledge true and correct. I also cel1ify that I am the owner or authotlzed 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 thO permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspections.
f · X. R, . 9/S-/0tp
Signature Contractor's License No. Date
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(05. 30
.00
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~'7. ~ $ 30
.
Paid l~tNO &)Z.z.. 9 ()
Date I
.......
40.00
This Application Becomes Your Building Permit When Approved
~~~
Building Otlicial
,1?/fJCp
f Da{e
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
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions. if any
Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY:
Date:
r. oS o(P
Building Permit # 0 G-. ()J'()~ PID: ZS"'. 80 z... ~.]!O
Site Address 5?, 7/ ~f.J/lN~ ..sr.
Legal: L B Subdivision:
Existing Structure: @ NO
I CONFORMS TO ZONING
, ORDINANCE
Zoning:
/Vb
YES
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' .
~
. 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:\TEMPLATE\DECKCHCK.DOC