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of PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z � / /
AND UTILITY CONNECTION PERMIT
4'NNeS I. White File PERMIT NO . n
3 Pink City / / (, ?j /
3 Yellow Applicant ""'TTT�J
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/G *8 / S' G WAY
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ,/ au_Sck �b
(Name) � a. ( ' K . � Q.JSL�� ����(� (Phone) C I S-14 CI 3
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch ['Re-Roofing DRe- Siding ['Lower Level Finish ❑ Fireplace
['Addition DAlteratjon ❑Utility Connection
CODE• R.C. DI.B.C. ❑ Misc. 7 M
Type o onstruction: I II III IV V AB PROJECT COST /VALUE $ / Wo
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that I have fi ed information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
above - mentioned propc • and at all construction . ; form to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this •ermi 'u ust cause. Furth' • hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x / r,- , . 5"-25--
Signature Contractor's License No. Date
Permit Valuation 4000 r Park Support Fee # $
-
Permit Fee $ SAC # $
Plan Check Fee $ i Water Meter Size 5/8 "; 1 "; $
State Surcharge $ te r �' 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 -y) O _ i t i $ 7 1 9 5
r
This . licatirin ec t es our Building Permit When r' ed G
..:
,pp S p Paid /' � yS Re eipt No. G 1� / /___ -.
Date (a /, // B
- tas - f P (
Building Ofticil f----__ D to
This is to certify :tit t the requ • the above application and accompanying documents i in a cordance with the City Zoning Ordinance and may proceed as requested. This document
when signed tpy` ° e City Tian , ey onsti tcs a temporary Certificate of Zoning complia a an allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued f1 ' ' r 1
1 sift • ! r(
' 4F ning Director Date' Special Conditions, if any
24'fio 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 o es
BY: b a Date: 1
Building Permit # ' i : Zoning:
Site Address (-j4
Legal: L B Subdi *sion:
Existing Structure: or NO
0
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 ' l
Cardinal Ridge) 3Z. 63
• Side Yard 10'
_ S • f '(
• Rear Yard 25' i
• Townhouses Must be consistent with
approved plan for
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.
Ttus CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
.---- .,
LATEMPLATE\DECKCHCK.DOC
PRIOR LAKE BUILDING AND �NSPECTION
INSPECTION
RECORD
SITE ADDRESS 1(1744! sSHCE WAy
TYPE OF WORK Metro
USE OF BUILDING dry �
PERMIT NO. DATE ISSUED S. 31.I •
BUILDER .s PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
iravp� / DATE
I FOOTING I 1 ` � i
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FINAL 1 A
FOR ALL INSPECTIONS (952) 447 - 9850