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•d rxr CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
"' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
F" e _ ` -,, . AND UTILITY CONNECTION PERMIT
't 1 �;
-4, "it- I. While File
� NNES t PERMIT NO.
'1 / '
2. Penk City .
3 Yellow Applicant i
(Please type or print and sign at bottom)
ADDRESS • ZONING office use)
/fo 1 7S V ISIon4.r1 Oct 19 Li c Cit t•-\ \A)
LEGAL DESCRIPTION (office use only) '
LOT 15 BLOCK 3 ADDITION PID .
OWNER � r 5 <, ;�
(Name) b kg-flit b 4 Ai (Phone) 4 2 S/ 317 °/ S
(Address) /405" Vi s i dn4.i l y jifs C,'r Pr. 'o L4) - SS3 2..
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Week OPorch ❑Re- Roofing DRe- Siding Mower Level Finish ❑ Fireplace
❑Addition DAlteration GUtility Connection
•
CODE: R.C. DI,B.C. ❑ Misc.
Type of onstnietion: I II III IV v A 13 PROJECT COST /VALUE $
Occupancy Group: A BB F H I MR S U
(excluding land)
Division: 1 2 •3 4 5 •
1 hereby certify that l have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 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,) 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 ) _ Park Support Fee # $
Permit Fee $ p9. 2-.S.- SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ (- .7 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 $ Geri . j
T h i s •
o u r i,i Paid 4 7, // Re pt No. 25 7
l Date 2.4v. a B .
�J ':.r At y t t 1
Building Official Date
Thug to cc' that t ,equcst in e above application and accompanying d me is is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign , the ' • annec stitutes a temporary Certificate of Zoning omp ante and allows construction to commence., Before occupancy, a Certificate of Occupancy must be
issued.
IA
, o : • or Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9854, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
Residential Building Permit Checklist
Deck Additions to Single Family omes
BY O - Date: 44 ►
Building Permit # PID: ( Zoning:
1cQ�1� �i5(��
Site Address f T' S C i p.
Legal: L B Subdivision:
Existing Structure: 1 r 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) mil
• Side Yard 10 '
--;°( .37
• Rear Yard 25 ' Q I t-
• 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.
t � I Z 4 1 ° xf , 2
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L: \TEMPLATE\DECKCHCK.DOC
•
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS AP 7S II/J /ONAay
TYPE OF WORK QELC
USE OF BUILDINj
PERMIT NO. ! 2.7 DATE ISSUED 4 0• 22.11
BUILDER DANL. PHONE # G/Z, ZSL 308
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR /DATE
I FOOTING : (� 1 � 1 5- 47#
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
141/110114.6 1
I FINAL 1 � 1 3 - -,XS-11
FOR ALL INSPECTIONS (952) 447 -9850