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o PR /o ff CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
•. x AND UTILITY CONNECTION PERMIT
U �.
4/NNE I. White File
2. Pink City PERMIT NO. i L ,
3 Yellow Applicant
(Please type or print and sign at bottom)
x ADDRESS ZONING (office use)
1 1c51 a �y- Orde.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /U n °I" Ha (Phone) (- 152; 261 - k3)
(Address) 1 707 (O sl lJ y....d71n X 0, \ , cS l 3
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch ❑Re- Roofing ❑Re- Siding :Rower Level Finish 1=1 Fireplace
['Addition DAlterati n ['Utility Connection
CODE: 6-I.R.C. ❑I.B.C. ❑ 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
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 I am the owner or authorized agent for the
,2<
above- •nt •n 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
(Alicia - v k 'ttus •e - f• us ause. Furthermore, 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
A i Y 5/ 1 02
Signature Contractor's License No. Date
Permit Valuation .7-0c49.- _ Park Support Fee # $
Permit Fee $ 13 > 1 ^ SAC # $
Plan Check Fee $ � �7 -`t4-
Water Meter Size 5/8 "; 1 "; $
State Surcharge $ l a _ 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 f
This Ap icati Becomes Your Building Permit en Ap roved Paid 1 .-r- Co - Recei.t No. (P /
Sr �
i (
Date •'1�3� B Wi]
B one Official Date
This is to certify that he request in the above application and accompanying documen s is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig • by th . ity Planner constitutes a temporary Certificate of Zoning compf + nce and • Ilows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued, / _
. 'gad` I , c es. 1z.
•
Planning Director Date Special Conditions, if any
4 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 Fa ily Ho es
BY Date:
Building ermit # �PID: Zoning:
Site Address
Legal: L B Subdivision:
Existing 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 Ridge)
• . Side Yard 10'
1 • Rear Yard 2, — 1 `• (
f d`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.
THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
i
L: \TEMPLATE\DECKCHCK.DOC
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS
TYPE OF WORK USE OF BUILDING
PERMIT NO. iZr- k 1 DATE ISSUED ys rz-
BUILDER `C PHONE # 152.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
NS CTOR DATE
IFOOTING
1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FINAL 1 41- I ° L I2.
FOR ALL INSPECTIONS (952) 447 -9850