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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5_8.67
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01. 030!; I
at bottom)
~
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LOT
LEGAL DESCRIPTION (office use only)
5111
BLOCK 3 ADDITION
ZONING (office use)
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~=Name) ~ ~~c.r "J.vX:-
(~N8me) ~ Q..~n~'
(~S) '3lD ~\\ \J- ~~
TYPE OF WORK 0 New Construction ODeck
DAddition OAlteration
CODE: TRI.R.C. DI.B.C.
Type of ~stIUction: I II III IV
Occupancy Group: A B E F H I
Division: I 2 3
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hed mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoflzed agent for the
t all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans, I am aware that the buildmg
o Just cause FlIlthermore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed mspectlOns,
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Permit Val
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
ORe-Siding DLower Level Finish
orch ORe-Roofing
'ty Connection
o Misc,
V A
M R
4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
V\\iV 'LObU"Zllo
Contractor's License No,
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
This Application Becomes Your Building Pennit When Approved
~~
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BUll 1I1!l Olllclal
s:1t of> 7
Date
#
#
J"':"\ ,~,.l
#
#
$
$
$
$
$
$
$
$
$
ThIS is to certify that the request in the above applical10n 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
issue~ ~ S-~6/o7
Planning Director ' r Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
",:~--;--,--~~----;'".-- '-~'7\""",,"~"'~"
White . Building
Canary . I=nglneering
cpink . Plannlna-:::>
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/' ,.)C"'- "j "'.......- .I
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Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~
~
Date:
5;/o~ 7
(
Comments:
" J...l
,
liThe 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. II
~.".
Pink
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1(.MA/ -- -::hA~~../
.5 B~ 07
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/6350 ~ ~ fPM4-~
Accepted
Accepted With Corrections ~
Denied
~
Reviewed By: ~ ~
Comments: ~ ~
.
Date: 5;1o}, 7
~~~,
"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
o ~ Additions to Single Family Homes
ScReaJ fO f'2.C...ti
~ ~ Date: ~/iO!D 7
BY:
Building Permit #
Site Address
PID:
Zoning:
Legal: L ?
B
3
Subdivision: AJ~ ~
Existing Structure: ~r NO
I CO.NFORMS TO ZONING
ORDINANCE
YES
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10' '+aLL ..
1'3 . ~ IV -
(25' if abutting a street, 30' if abutting a street in 38' i- p~
Cardinal Ridge)
. Side Yard 10' 10,2.4 +e ,LL
~,I ~ ,.}6.R
. Rear Yard 25' 751
. Townhouses Must be consistent with
approved plan for .AlA.
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:\TEMPLA TE\DECKCHCK.DOC
PRIOR LAKE
INSPECTION
RECORD
~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO.
BUILDER PHONE # l ""Z
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE
J FI~AL
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~
I r O~
FOR ALL INSPECTIONS (952) 447-9850