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o PRIp CITY OF PRIOR LAKE BUILDING PERMIT, Date ec'd /
0 0 ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Z ��
v AND UTILITY CONNECTION PERMIT ///
ArIHNESOlr I. white File NO. / (
2 Pink City PERMIT NO /3 6, 7 ( 0
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
LEGAL [ DESCRIPTION (office use only), -.
LO� 7 BLOCK / ADDITION *e ( lAej d'r /Va na -1 PID -- «62 /
OWNER
(Name) 1.)s c, f' // Vow (Phone)
(Address)
BUILDER
(Company Name) I- ey Dec-148 (Phone)
(Contact Name) /1A. k 1 40 j (Phone) 63 -3 7
(Address) `"f '/lg t3( Stud- L) IU(.$iI4 .) , /INV SS 37 Z.
TYPE OF WORK ❑ New Construction 4 ❑Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
DAddition DAlteration ❑Utility Connection
..--- -------7
CODE: ❑LR.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V AB S es"`;'()
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
(excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 a e 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 submi •d 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 - ," 4 3 �� T 6 —Ze — 13
Signature Contractor's License No. Date
Permit Valuation // Park Support Fee # $
l0� 000 ,
Permit Fee $ i 3 2.. 60 SAC # $
Plan Check Fee $ 8 G _ t ? Water Meter Size 5/8 "; I"; $
State Surcharge $ 3 -00 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 6., "Z
. 7. ii W
$ 7 / ,
T '. p li t' t Becomes Y ur Buildin Permit When Approved Paid 7iZ � - G R eipt No. �p
Date --7.. t )�. /3
2
Building Off al /j_i______
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
Planning Director 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
Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY: Qi: Date: 6'l 2 4 / 5
Building Permit # PID: Zoning:
Site Address t(, C(, 3 h
Legal: L 2 B Subdivision:
Existing Structure: YES or 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 30 i -►-
Cardinal Ridge)
• Side Yard 10' 3 p t
• Rear Yard 25' 1
• 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
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD n
SITE ADDRESS I (r` Klno((rical,C
TYPE OF WORK C)oc(C
USE OF BUILDING F(.
PERMIT NO. Li �i G DATE ISSUED Ca 2Zo I
BUILDER L acsj__ PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
[FOOTING I l I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I 0 00 1 4My l 1 1
(FlNAL 1 1/ �
FOR ALL INSPECTIONS (952) 447 - 9850