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oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE J T 3/'
AND UTILITY CONNECTION PERMIT
V �
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'�� I. White File / /
Z r; �� � PERMIT NO. ��
3 Yellow Applicant �
Please e or rin�t and si at bottom)
ADDRESS ZONING (ot�'ice use)
� l y o � � ����. � :
LEGAL DESCRIP ION (of1'ice use only)
LOT BLOCK ADDITION � � PID
OWNER �/-
(Name) �at J`— �''� b�,f`-ced'! � t� � (Phone) ��'Z3� e�O7S
(Address) s �
BUII.,DER `�
(Company Name) � � (Phone) �5 Z- 7 S d�' Z� yZ
(Contact Name) � a� ���cro�, (Phone} 9'.S2 �'L-� d 3 G8�
(Address) / D �_ �/� �j , p_ �. � c Zv� � 2� ec.t) � M`J Lj �' 37
TYPE OF WORK ❑ New Construction �Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Firep(ace
❑Addition ❑Alteration ❑Utiliry Connection p - _
CODE:�I .R.C. ❑I.B.C. (�Misc. �`qC GC � W I�G��uS �G�N q t Z!'
Type of Construction: I II III IV V A B p CT COST/VALUE � O
Occupancy Group: A B E F H I M R S U ROJE $ � d
Division: 1 2 3 4 5
(excluding land)
1 hereby certify that I have hirnished information un this application which is ro the best of my knowledge true and correct. I also certify that 1 am [he uwner or authonzed agent fur the
above-menuoned property and that all construction will conform ro aA existing state and local laws and will proceed in accordance with submittcd ptans. I am aware that the buildmg
official c e this permit for just cause Further hat the c�ry official or a designee may enter upon th�roperTy to perform necded in ecti� s. ,
� X��. -�'� ��- C� c � 1 l 1 S ' -- S - 3/ Z
Signature Contractor's License No. Date
Permit Valuation --� 0 � Y , Park Support Fee # $
Permit Fee $ � , . SAC # $
Plan Check Fee $ �,�-,� Water Meter Size 5/8"; 1"; $
State Surcharge $ '7� Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE ,�r' $'��
This App ation Bec mes r Building Permit When Qpr ed Paid Z Re i t NO.
` Date ,
�O r(
Buildim_ Ufticial Dat
This is to certify that the ucst in the abuve applicanon and accompanying docume s is in accordance with che Ciry Zoning Ordinance and may proceed as requcsted. This ducument
when signed the Ci . ner o u[utes a temporary Certificate uf Zoning comp ance nd allows construction tu commence. Befure uccupancy, a Ceruticate uf Occupancy must be
issucd `
t�
Planning Director Date Special Conditions, if any
24 hour noticc for al! inspections (952) 447-9AS0, fxx (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372
r
esidential Building Permit Checklist
Deck Additions to Single Fan'ly Homes
BY: ' ��`�'�
Date: �-- � � f
� 14.�
Building Permit # PID: Zaning: 21 ��
Site Address
� �3� � �c�o �� �- Ti?�s-��
Legal: L B � Subdrvision:
E$isting Structure: or NO
CONFORMS TO ZONING � NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard 10' �"
(25' if abutting a street, 30' if abutting a street in '
Cardinal Rid e � l .
• . Side Yard 10 '
�e J
• Rear Yard �
SD -f
• Townhouses Must be consistent with
approved plan for
develo ment
ANY PROPOSED DECK NOT MEETING THE ABOVE CRITERIA MUST BE REFERRED TO THE
PLANNDVG DEPARTMENT. ALSO� ANY DECK ON A LOT WITH A SUSPECTED BLUFF� OR ANY
OTHER UNUSUAL CIRCUMSTANCE MUST BE REFERRED TO THE PLANNING DEPARTMENT.
THIS CAECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW. '
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White - Building
'�rNNESO`��' Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT :�,�,, � ` � f � �'* � r
` �,�a� �.. � ;�.. ���,. ,� .�"`'- �: �,,.�..-r'
APPLICATION RECEIVED "� �', • � �
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
��� . �^ .t.. T..��„ F ��1.-; '� � ��� � � .L�° ,i: i ��/ �4,...,. .�+`�. �L i,..- �``�....�.��...�+'
r
A
Accepted �" Accepted With Corrections
�
Denied :•�`� �� • . ;�,.�:���� � ��� � ,�,� �<��
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Reviewed By: ' rr''�� ��-�,,:,-� �"�' Date: °�
Comments: �_ ,�. �<'`����� �;.:� �� ,�: �� �- �; �: ,,,�, ,: ''�` �-:°�.w9f `'`� 1;,� ,,,: ,.
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"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."
R LA E BU LDRNG AND INSPECTION
PRIO K
PE TI N REC RD
IN C
S O
SITE ADDRESS 1 �
NATURE OF WORK �-�.k �'tN 5' �r�s Itit
USE OF BUILDING c�
PERMIT NO. t 1��7.� DATE ISSUE �
CONTRACTOR ��i2 o�v �.2�� �ao�s�-IS�, PHONE R�L- �o - 3686
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPE DA
FOOTING 5' �d /
��Iii��lil�rior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
C
FRAMING � t�po � �
.�. , L
+�;��G
' required)
: TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'� !� � S - �/U ,
FINALS
�f�(Prior to Sodding)
BUI�.DING
��'f�iil�r�L
��
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
_ _
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