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Otoi f PR Ip CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd 3 ,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~�kN I. White File PERMIT NO .
2.
Pink City ' i -log/
Yellow Applicant t
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
543c Ira ;( )6911 L vi
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) V co -4- US I u (Phone)
(Address)6(r
( C o BUILDER — ✓ t - ( Phone) 6' 0 7-41 O(�r
(Company Name) � L"1 j� Jr G
(Contact Name) ..Sc 4 vi !� (Phone)
Z
(Address) 23 2 L, e - Ave,. t tt,./ G rr1 Vt d 66.- U7( /
TYPE OF WORK ❑ New Construction t eck ❑Porch ❑Re- Roofing ❑Re- Siding DLower Level Finish ❑ Fireplace
❑Addition ❑Altera on DUtility Connection
CODE: [I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B / o�
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ 6, �� — ''t°
(excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have furnished 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 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 budding
official can revoke t ermit for cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X z OC g7 z 6 1e, )— ii
l
Signature Contractor's License No. Date
Permit Valuation 4 0.00-- Park Support Fee # $
Permit Fee $ SAC # $
1 4, ° - -
Plan Check Fee $ G 5 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Z _ 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 $ (•Z) 1i5-
- 1
This • 1 ion Becomes Your Building Permit Whe Approved p g pp Paid L ! � � Receipt No. 6 4' ZQ `,
1_1 Date to In By ( (4-
� �� l c I(
Bu ne Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign, the . y Planner constitutes a temporary Certificate of Zoning co plia cc and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
• / ' _ _ !a 7 1(
.r -'_� • D ate Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
•
it Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY - Date:
...... 41.1, ( ° ( ( I k
Building Permit # PID: Zoning:
Site Address ge40 SC,
Legal: L B Subdivision:
Existing Structure: �` /or NO
CONFORMS 0 ZONING YES NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement I Proposed
MEETS CODE
• Side Yard 10' g
(25' if abutting a street, 30' if abutting a street in . I
Cardinal Ridge) 2:1
• Side Yard 10' %
• Rear Yard 25'
• 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.
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW. '
' L: \TEMPLATE\DECKCHCK.DOC
t
\`
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS fZ« 0O LAN-6r
TYPE OF WORK
USE OF BUILDING rc--s A /A""
PERMIT NO. DATE ISSUED A i I
BUILDER .A/0 ... We, , PHONE # -caPH
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING ; rs k)o1- tkc 104 G 2 % 5 "h /,> J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
+RINEMENt"
FINAL 1 �G � // zV ,
FOR ALL INSPECTIONS (952) 447 -9850
•