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o f PRIG CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
F i TEMPORARY CERTIFICATE OF ZONING COMPLIANCE F. ( 6- 1
.
AND UTILITY CONNECTION PERMIT o
/2" l�ft21 �9'�/
��NN8S0�� I. White File
2. Pink city PERMIT NO. / 7 7
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
L I) . (t CI u_a k,-- T rRL taisv
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 16 , 034 . Of b. 0
(Name) N k 3e-CA s o rl (Phone) ' f'' 1 ' e 7 S 3-2
(Address)
BUILDER
(Company Name) L3TS ( tort S4 c.,v-i/ ik0 r Z n (Phone) 5s Z 7S Q- 75
(Contact Name) L $q 1+ Si•o in rn GLC /1. . n (Phone)
(Address) 1( 19' j4ci� S a ,.,!/e L3 Pr 4 a (-4
`''I''L
TYPE OF WORK 0 New Construction eck • ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish El Fireplace
❑Addition DAlterat n ❑Utility Connection
CODE: II.R.C. DI.B.C. D 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. 1 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 ca evoke t is pe it for r Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
2-0c, 7-73// g- /5
Signature Contractor's License No. Date
Permit Valuation 5-0 d Park Support Fee # $
Permit Fee $ t k—j `1 " SAC # $
Plan Check Fee $ -70 5a Water Meter Size 5/8 "; 1 "; $\
State Surcharge $
Z,5-"..-7 1 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $ N.
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $ ] _
Gas Fireplace Permit Fee $ TOTAL DUE A : T.h ' , f + $ i �l!` 11
Thi tic ' ,n Becomes Your Building Permit en Ap . ,ved Paid / RICO • (V...< ! d
/ R Ipt No. (Q
�! �� Date g_ !l
Buildine i — Dat
This is to c ti;, it t 'quest in the above application and accompanying documents in acce dance with the City Zoning Ordinance and may proceed as requested. This document
when sig d S C /'tanner constitutes a temporary Certificate of Zoning compli ce nd ows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued, s
- _ • - or Date Special Conditions, if any
2' 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 ' Ho s
4 , BY i f Date: o il., / /r
Building Permit # PID: j Zoning:
Site Address i l Qu,q-v__- ---c(2- A S D
Legal: L B Subdivision:
Existing Structure S I NO
CONFORMS TO ZONING 7 ( YE NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard 10' I,
1
(25' if abutting a street, 30' if abutting a street in
Cardinal Ridge) I I . 3
• .Side Yard 10' Z b , (
• Rear Yard 25' I 4'
1 to el�'vl
• 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 2-35
2A-xi2- f T I z. ' 3Q - - - z : 4- ,
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PRIOR LAKE BUILDING G A OF
INSPECTION
RECORD
SITE ADDRESS � �
TYPE OF WORK
USE OF BUILDING 4/4
PERMIT NO. DATE ISSUED g, lop
BUILDER PHONE #02
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
R
DATE
IFOOTING W L AB
� I i 1
PLACE NO CONCRETE UNTI O E dAS BEEN SIGNED
OMNI 1
j FINAL 1 d )e/E)1y/
FOR ALL INSPECTIONS (952) 447 -9850