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ir riti CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
y TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
11 ( ' /i,4Ai' / 3- 45Z,
4 1' HN ESOl t. I. White Pile
2 Pink city PERMIT NO ( 3 s
.
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
:SC y5 fa�v C E
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER +- ► V l CL� I '" V'-P i -eA, rVv,„ (Phone) 9 c D - `f q O - / J(p !I
(Address) 'SS ' .4, a/
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction EIDeck ❑Porch ORe- Roofing ORe- Siding ❑Lower Level Finish D Fireplace
DAddition ❑Alteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III P/ V AB
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
(excluding land)
, Division: 1 2 3 4 5 1
i hereby certify that t have furnished information on thi 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 f - mentioned prope and that all construction wi conform to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
oficial�j voke this permit f cause Further arc I hereby agree that the city official or a designee may enter upon the property to perform needed msp coons
( Signature Contractor's License No. Date
Permit Valuation (7 _ 4 "- Park Support Fee # $
Permit Fee $ (0 _ SAC # $
Plan Check Fee $ 4i Water Meter Size 5/8 "; 1 "; $
State Surcharge $ -Z — 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 1 $ TOTAL DUE $ l I ‘- C T 5
This pli , do : et � s Your Building Permit n .' pproved Paid f 1 / Receipt No g/ Z Z
Xi
( 1/F/110.— •
Date l� / By /
Building Official 1 ate
This is to c 1 that the leq est in the above application and accompanying doe men is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig ■ by the Cityi'1,, ney constitutes It temporary Certificate of Zoning mpt nce and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. % , I -
Planning W 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: Date: d s
Building Permit # PID: Zoning:
Site Address () /'?3
Legal: L B Subdivision:
Existing Structure: or NO
CONFORMS TO ZONING 'E 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)
• Side Yard 10' g\°
• Rear Yard 25'
• 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
PR10R LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
1 SITE ADDRESS CC �`°�mpow \ t t
TYPE OF WORK DC-c-1�
USE OF BUILDING (z--c A - /
f 5 PERMIT NO. (3 - DATE ISSUED & 73/13
BUILDER 1 clo Dei Ft< E 16-1 (0 PHONE # 44.-(\ y
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
PINIEROMEt- I I
I FINAL 1 1 I
FOR ALL INSPECTIONS (952) 447 -9850