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of p..../0, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U
x AND UTILITY CONNECTION PERMIT /0 I
MIA'NESOA I. white File PERMIT NO. / r
3 pink City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
-
/ 6 Ci -, , 7,1 u tT P I
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 2S 0 (Z.. 0 (t . 0
OWNER ,..* / / J ^� 2
(Name) �r Jre ,' p 4 is t1 (Phone) T��'' 7 / ^ ,J' /-1
(Address) ..S4 0.. C
BUILDER G c7 — /G,
(Company Name) (` / #' ! 0 -` �C (Phone)
(Contact Name) Cr 4 i t , 1 / (Phone) G'-f ( - a' off' ' c/ 17 (Address) 7 l2 O /�t / (P.l (.../ Cr 1 '/ : .r7 ,S J d
TYPE OF WORK New Construction ❑Deck ['Porch [Me- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
Addition ['Alteration ❑Utility Connection
CODE: JI.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II HI IV V A B 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 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 • it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X '� a 0 6 3 6 f s"d / 0 /6ri d
Signature Contractor's License No. a te
Permit Valuation k .- Park Support Fee # $
Permit Fee $ Zsp_�p SAC # $
Plan Check Fee $ 2 $ 3 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 Deposit $
Sewer & Water Permit Fee I $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE (.(Llle e /O 2 /Z) $ 4 2O '3 VI
This i at' t Becomes Xour Building Permit Whe Appro d Paid '/i .�3 Receip No4 /i 3
/ ,f Date / C�2J'//O By 7.�.,
ilk 1 ttf ■tb /0
- W B ilding Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
/G — , — /d
Plannin'.arector Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
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White Building
yI .� Canary - Engineering
NNESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED / / —' • l /
0i ' i 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/2a /Y A/,Vil - 77 ilL—
Accepted A Accepted With Corrections
Denied
Reviewed By: ,4 G Date: / / %i //U
- ei. - _A `' 0 ✓:' on- - - -- -- — — -
ommen s:
See Reverse Side for Additional Information! .
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS
• Surface storm water drainage flowing to the perimeter of this lot to
and from adjoining properties must be conveyed to the roadway
and /or to the rear of the lot in drainage swales within the drainage
easement.
• All bare soil areas must be protected from eroding into neighboring
properties through the properly installed and maintained silt fence or
bales.
• The silt -fence required by the erosion control plan must be installed
prior to any earthwork being started.
• The builder is responsible for maintaining the erosion control
measures until the turf is established.
• The rock construction entrance must be installed at the time of
backfilling of the foundation.
G; \Admin \dept info \ADDITIONAL COMMENTS FOR BUILDING PERMIT APPLICATIONS,doc
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White - Building
�P Canary - Engineering
^'NES° Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
A / / 6ti
Accepted Accepted With Corrections
Denied
Reviewed By: Date:
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
U
White - Building
P Canary - Engineering
41INNEso Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT h ___1 -.
APPLICATION RECEIVED / 0 l� ` 0
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
j APV 774/L
Accepted ✓ Accepted With Corrections
Denied
Reviewed By: Date: i Z!o fv
Comments: COA /ifi-a- 6
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ( S2..
TYPE OF WORK
USE OF BUILDING ee s /2._
PERMIT NO. O. c7 S Z DATE ISSUED is z ir
BUILDER 14. . P • PHONE # cos( -
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 �'.� JQ //?) 1
PLACE NO CONCRETE UNTIL ABOVE HAS EEN SIGNED
l FRAMING 1 / /I I iz /3 /j J
FINAL 1 .Y1 -7 ('2 -
FOR ALL INSPECTIONS (952) 447 -9850