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(PR ii CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
U
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �, lf2_. � AND UTILITY CONNECTION PERMIT
4 •NNESOl t " ell j0. _ 3L 7 I. White File PERMIT NO
3 Pink Applicant
/ Z I 4_10 3 Yellow Ap `
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 1 Z VU f v b /i1 al `t--
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION , PIID
OWNER "
-- - / �
(Name) / I & / Lu 2A ✓►'► -4 n p (Phone) W02 — 0 oo--- - Te
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction eck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish El Fireplace
DAddition ❑Alteration ❑Utility Connection
CODE: C. ❑I.B.C. I=1 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
I hereby certify that 1 have fltmished information on this application which is to the best of my knowledge true and correct. 1 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 th er it for ius ause. urthermore, ereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ —13.15- SAC # $
Plan Check Fee $ ?f--T , ot Water Meter Size 5/8 "; 1 "; $
State Surcharge $ / Pressure Reducer $
Penalty $
( Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's De osit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE �� i ✓ l V .tp 6� . !7 $ ( 2-z_ Z .6 /
AI r 1 . I
This) is ton Becomes Your Building Permit Wh Ap oved Paid
Z.-Z.
, /
;Ea` �,�1,, p— R- 1.t No.
L r Date B
Al ..iiiiii■—_ __ �
. uildim_ Official ate
This is to ce' ` that the request in the above application and accompanying docume is is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when si, d / he i Planner constitutes a temporary Certificate of Zoning com lance nd allows construction to commence. Before occupancy, a Certificate of Occupancy must he
issued
ZI (Z
•lanning Dire tor D e Special Conditions, if any
■ 24 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 Family II mes
BY: Date: Z I I
Building Permit # PID: Zoning:
Site Address
(7
Leg al: L B Subdivision:
Existing Structure: • r NO
CONFORMS TO ZONING NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard _
(25' if abutting a street, 30' if abutting a street in �5 . 1 5
Cardinal Ridge)
• Side Yard : 10'
• Rear Yard 25' Z
Jl
• • 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
1/2 \
PRIOR LAKE BUILDING AND ONSPECTION
INSPECTION
RECORD
SITE ADDRESS I (a Z / 2. 17/S /ONft1 ffTS (�' !IZ ,
TYPE OF WORK 0 E0‘._
USE OF BUILDING /LEj »Pt-
PERMIT NO. / Z . 440 DATE ISSUED 3. /S. /L
BUILDER �UEffMR PHONE # L /2. SOS. 5$99
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I F0 0 TING I / 46 �e�
PLACE NO CONCRETE UNTIL ABOVE H AS BEEN SIGNED
FRAMING
I FINAL 1 1°4- 1 2„13
FOR ALL INSPECTIONS (952) 447 -9850