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o , Prtio R CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
o TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 9 e, /0
m AND UTILITY CONNECTION PERMIT
m U x
A''A'NESO I. White File PERMIT NO Q
2. Pink City 77 D
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
R 17c lc.C 5r N G✓
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) /A //‘e (,i,NZv.'✓C> (Phone) % C ` Vg — or: 37
(Address) ›tinIl c; S / 6) /t
BUILDER
(Company Name) .. drvy - f j1.'9- / (Phone) G() -3 2e _ 4 6
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ❑Utility Connection
CODE: . ❑I.B.C. ❑ Misc.
Type of o traction: I II 1I IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E 4' H I M R 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 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 building
official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
Signature Contractor's License No. Date
Permit Valuation 500.00 Park Support Fee # $
Permit Fee iii , z $ 3'6 o 0 SAC # $
Plan Check Fee .0 /& z $ 3 . ,SQ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ y 50 Pressure Reducer $
Penalty s e w k ilove $ 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 U t z ) Q i s 1 t $ 83. 00
This plicat' i Becomes You&Building Permit Whe Approv • ■ Paid _ 0 ReC • t No. l✓� v
a. Date �,3p. 10 B
4 "Iii. �O r /
-I B iildi i U lc , a ate
This is to cert that the equest in the above application and accompanying doc ents is . accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign • ' he C Planner constitutes a temporary Certificate of Zoning ,mplianc+ and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. //� ..
It& _ i
• . tin_• Director Date Special Conditions, if any
24 hour notice for all in ections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
• Residential Building Permit Checklist
/ Deck Additions to Single Fa ly Ho es
•
BY Date: . C .
Building Permit # PID: Zoning: •
Site Address
Legal: L B Subdivision: • g ( (.
Existing Structure: YES ' 4.0"0
CONFORMS TO ZONING • E • NO
•
ORDINANCE •
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard 10' g
(25' if abutting a street, 30' if abutting a street in 1
Cardinal Ridge) 15
• . Side Yard : . • 10' 1
So
• Rear Yard • • • 25' 40 f
• • Townhouses Must be consistent with 0
approved plan for
• . . development 0 '
ANY PROPOSED DECK NOT MEETING THE ABOVE CRITERIA MUSTBE REFERRED TO THE
PLANNING DEPARTMENT. ALSO, ANY DECK ON A LOT WITH A SUSPECTED BLUFF, OR ANY
OTHER UNUSUAL CIRCUMSTANCE MUST DE 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. - pppt„..fit.... _.....t.5___- •.pdA-2441,44 S 140 '4 &, •
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L : \TEMPLATE\DECKCHCK.DOC • •
PRIOR LAKE ;ESPECTION
INSPECTION
RECORD
SITE ADDRESS Z 17 b /&,5 s
TYPE OF WORK 0EC / 5HGL) Ar - - rite l e-,4-�
USE OF BUILDING /2.63 gfre_
PERMIT NO. /0 • 770 DATE ISSUED 9. / o
BUILDER (� Fid/ - / /q/L' l/Y/ A/El�, PHONE # 44Z. 3iJ, 0677
NOTE: THIS IS NOT A P RMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING - Ifo /ii p r, / 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING 1 1
I FINAL IOC- 1 � 1
FOR ALL INSPECTIONS (952) 447 -9850
•