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of P12.1 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4— 8 , (0
AND UTILITY CONNECTION PERMIT
4fI N' NE s .' z. White File PERMIT NO.
3 Yellow Applicant V O
(Please type or print and sign at bottom)
ADDRESS 4 /70,5 NE6eiitK Gig. SuJ ZONING (office use)
Pe/a42 L1 ,+l(A) ST3 72_
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER //_
(Name) 4E(/ //.) -46 eGdt-y (Phone) 611 f/ /- c, 94
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alter o ❑Utility Connection
CODE: I.R.C. ❑I.B.C. ❑ Misc.
Type of o struction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 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 1 am the owner or authorized 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 th pe it fo ause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed msp�ns
x
F e /0
Si ature Contractor's License No. Date
Permit Valuation 3 t 00 0 0 0 Park Support Fee # $
Permit Fee $ 8 8 . Z S SAC # $
Plan Check Fee $ 57 . 3(0 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ / 5) V Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
1 Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Pe mit Fee $ TOTAL DUE CmA 41q (l b $ /4-7. / /
Thi • • ■ ∎ icat g t Bee. es Your Building Permit en proved Paid / #7 / / eipt No. .57 7
1 � �, Date 4-, , /O `
B it !rig' Oftiat Date
This is to ce ify that the j ques in the above application and accompanying docu nts is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign L.�. • • the Ci lann J consututcs a temporary Certificate of Zoning corn liance d allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued �
� Li 4 g 0
an' g itre for 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
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date: '� /
BY �
I'ID: Zoning:
Building Permit # �, 7) Site Address if-7e.'
°? ( /,• ,g / U
Legal: L
B Subdivision:
Existing Structure: YES or NO
NO
CONFORMS TO ZONING
ORDINANCE MI
Yard Setbacks: NOT � CODE
Requirement Proposed
10'
• Side Yard Mill
(25' if abutting a street, 30' if abutting a street in
Cardinal Ride) 10'
• Side Yard glin 9
• Rear Yard —
Must be consistent with
• Townhouses approved plan for
develo • ment
ANY PROPOSED THE
DECK NOT MEETING THE ABOVE CRITERIA MUST PE T OR ANY
PLANNING DEPARTMENT. TOE MUT BE REFERRED TO THE PLANNING DEPARTMENT.
OTHER UNUSUAL CIRCUMS
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
, L: \TEMPLATE\DECKCHCK.DOC
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS / STONESP -Mfi- 61g..
TYPE OF WORK DECK -
USE OF BUILDING P.CS /9/e-
PERMIT NO. AO 0 ZZ(o DATE ISSUED 1. 6./0
BUILDER DEWS PHONE # 7q4., O/
NOTE: THIS IS NOT A R MIT FOR ANY OF THE INSPECTIONS B LOW
THE PERMIT IS BY SEPARATE DOCUMENT
SPECTOR DATE
I
FOOTING 1 / �z7 / �I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I 1
FINAL WC 1 Pb 3,51ia- 1
FOR ALL INSPECTIONS (952) 447 - 9850