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(..... PR/1;N CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
"c.> F ' AND UTILITY CONNECTION PERMIT _6 /2-. //
�t� X
4. q t' I. White File
NNESO PERMIT NO. / / . J 1
2. Pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
' IVY - 1 \ 1' ,i, 4 0 • tai •
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /�, [
(Name) 1 ' I� I % - (1 Coy J (Phone),
(Address) �3� � 1 c�!'1)') O p f I )r t
(Co DER V - C �'1�tC W s ],, r / 1 2'z '1 Z W
(Company Name) n TI . ,� (Phone) V'
(Contact Name) ._ ' �M L (Phone)
. �y
(Address) 1( kt S' Ve- - I A It f4/ sN 0 cic
TYPE OF WORK El New Construction Deck ❑Porch ❑Re- Roofing ERe-Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteratt EUtility Connection
CODE: R.C. ❑I.B.C. i2 f t ti f ❑ Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and coned. 1 also certify that I 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 thi rmit for just cau ur hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspe io s.
Signature Contractor's License No. Date
Permit Valuation 2 O 0 o . o O Park Support Fee # $
Permit Fee $ 73. q s SAC # $
Plan Check Fee $ 4-1_ 94- Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 1_ 0 0 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee 4 $ Other $ /_
Gas Fireplace Permit Fee 1 $ TOTAL DUE di � s /6 J $ /ZZ_ &?
This A. ica • a Becomes Your Building Permit Whe Appro d Paid /ZZ, L 9 Re 1pt No. (
// Date cl, 0. (1 B
Bi - ii Official Date
This is to certify th the request in the above application and accompanying docume s is in accor- nce with the City Zoning Ordinance and may proceed as requested. This document
when sig. 0 by t •ity Planner constitutes a t mporary Certificate of Zoning com lance and a iws construction to commence. Before occupancy, a Certificate of Occupancy must be
issued J
/ ice /- /
• -.. Dat 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 Fami Ho es
BY: ' h. ----- Date: — i I •
Building ' • PID: Zoning: i
Site Address
333 b p
Legal: L B Subdivision:
Existing Structure:
0
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 Ridge)
• Side Yard 10' 2
• Rear Yard
25'
'
• Townhouses Must be consistent with
approved plan for
development .-r"
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.
(7 \(' Ve ( 1 cD\ fp '-
.'
L: \TEMPLATE\DECKCHCK.DOC
1
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 3337 7ll4tii/7b,%J
TYPE OF WORK PEP1
USE OF BUILDING /PejA /A*
PERMIT NO. DATE ISSUED 3, /7
BUILDER ) . PHONE # I2, 232. zs�',
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR , DATE/
I FOOTING 1 r/'Z 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL I 21t6 I � /2`�/('
FOR ALL INSPECTIONS (952) 447 -9850