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� � CITY OF PRIOR LAKE BITILDING PERMIT, Date Rec'd
D TEMPORARY CERTIFICATE OF ZOIVING COMPLIANCE � �3_ v�
" " AND UTILTTY CONNECTION PERMIT `
d ,��
`�'NES�
L White File pERMIT NO . O yti . O
2. Pink City
3. Yellow Applic�t �✓
C888 OL � 3� �t M)t[On't
ADDRESS �G c�ce �>
z � ��- GT �1� r� �-
LEGAL DESC1tIPTION (offioe use only)
LOT BLOCK ADDITiON PIDZ� 3�$, 6 0 3_�
��g �"—vT�`�'c ,�.� � S,�2ra.- �'��� d ^-� (Phone) � (2 -�74 3 - z 2 � 2 _
�Aaa�ss� 43 ? � ✓jo�� cr �� P�o� c� ..,,�...i
BUII..DER �.! C.Q� 4.Tc o�.l '�' - 3 Z2 -� 8�v
(Company Name) � S (Phone) �S �f
(ContactName) �i'�Cvc' Tu'fT�-c (pho�) �1s2 -Zis � 9cr�c.,o
(Address) l5� 4� Do i �c. t''. � w� R.o.rc � o�, .� f
TYPE OF WORg ❑ rrew consaucdon []Porch �Re-Roofing ❑ReSiding ❑Lower Level Finish ❑ Fireplace
�Addition �Alteration DUtility Connection
CODE:� B.C. �I.B.C. ❑ Misc:
1�e of Const�nction: I II III IV V A B ^ p �,---
Occupa�y Gm�up: A B E H I M 8 S U PROJECT COST/VALUE S "1 �
Division: 2 3 4 5 (eaclading land)
I Ilereby oatify that I have farnisLed 'mFormation on this appflcation w6ich is to the best of my lmowledi8ee true a� wrrect. I also certify that I am the owna or anthorized a8ent f� ihe
above-mentianed ry and that all �n�on will confaRm b� all e�osting stabe and local laws and will prooeed in a000rdance with submitted plans. I am aware Wat the boilding
official can � ' permit for ' iet. rthermore, I heieby a�ee tl�at �e city official or a desi�ee may enber upon t1�e property m peifocm needed inspedions.
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� ZO�F43 L-9 4-" S-! 3-v tU
Sigoature Conuactor's License No. Date
Pernut Vatuation � v O� U Pazk Support Fee # �
Permit Fee $ $ g Z. SAC # $
Plan Check Fee $ ` .r� . 3 Water Meter Size 5/S"; 1"; $
State Surcharge $ � Pressure Reduoer S
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fce $ Builder's Deposit S
Sewer & Water Permit Fee S Other $
Gas Fireplace Peimit Fee E TOTAL DUE ' �. . V $ S(¢"? f
0
Tlas applicarion Bemmes Y� �8ng rermic wbea Approvea Paid Recei t No.
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Q .s/ 3 d � Date B
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Buil ' Of£cial te
Thig is to oertifp that the request in t� above a�licadon and accompanying documeats is in aocordance with the City Zoning Ordinance and may pracecd as teqadted. This document
when sig�ted by the Cty Planner oonsUm►res a tempaary CertiScate � Zaning compliana and aitows construction ro comm�ce. Before occuPancy, a Certificate of Occupancy must bc
issiced.
P►mmieg D"nec�or Date Spaael Co�i6ms, if eay
24 bonr notice for all irspectioas (952) 447-9850, 6z (952) 449-42d.S
4646 Dakota Street S.E.. Prior I.eke, Minaeaota 5537Z
Residential Building Permit Checklist
Deck Additions to Single Family Homes
�---
BY: '' ��� Date: ��� a �,
Building Permit # PID: Zoning:
Site Address ,t�� ���-- � �� �, �
/
Legal: L B Subdivision:
Egisting Structur�r NO
CONFORMS TO ZONING ��� NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard 10' � Z, t ����
(25' if abutting a street, 30' if abutting a street in ' ZQ , ���
Cardinal Rid e
• Side Yard 10 ' � �'' �
J`� �a � "�O d��.aQu
• Reaz Yard 25' .
'� o ` �b �t�r�cs
• Townhouses Must be consistent with
approved plan for A r�
develo ment �"
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
OTTiER UNUSUAL CIRCUMSTANCE MUST BE REFERRED TO THE PLANNING DEPARTMENT.
TffiS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW. -
L:\TEMPLATE�DECKCHCK.DOC
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DEPARTME1�17' OF
BUILDING AND INSPECTION
SITE ADDRESS �
TYPE OF WORK
USE OF BUILDING
PERMIT NO. D TE ISSUED
BUILQER PHONE #��. � � ��
NOTE: THIS iS NO A PERMIT fOR AtdY �F THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
� �
fOOTlNG (`j'
PLACE NO CONCRETE UNTIL ABOVE HAS BE N IGNED
F1NAL. I rS �
, �� FUR ALL INSPErCT10N� (952) 44��-9850
.
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