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of PRio�P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /U3,/ 4-
U AND UTILITY CONNECTION PERMIT
4iivNEsoll' i white File PERMIT NO.
2 Pink city
(Please 3 Yellow Applicant
type or print and sign at bottom)
ADDRESS
I 7 '�� ZONING(office use)
S' 5� G , POD
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 2S-. 449C. 6 t( . v
OWNER
(Name) �c 1,/%4A f �.
(Phone) 6./2.--, 7y# -077y
(Address) ' \SI S _bnM c_&.-
BUILDER —BUILDER
(Company Name) & C, (Phone) ti
It V
8 �i,
`!9 ("ti 1 `
(Contact Name) TWTIP.V, ,f,. (Phone7k(Jl°2- —Co 3 G - ''/7?
(Address) �Y 1Jtk - c-4-_ S4 4
TYPE OF WORK 0 New Construction ( eck ❑Porch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace
❑Utility Connection
CODE:, 11..C. DI.B.C. 0 Misc
Type of Construction: I II III IV V AB • '5.4•"°.
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ J(>/o
Division: I 2 3 4 5 (excluding land)
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 I am the owner of authouzed 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 s pet mit for lust cause Fin th -..ore,I hereby agree that the city official ora -signee may enter upon the property to perform needed inspections
X6..r /0 l s----/3 -/
Signature Contractor License No Date
Permit Valuation �/ 0 d Uv Park Support Fee ## $
Permit Fee $ SAC # $
Plan Check Fee $ '47-q¢ Water Meter Size 5/8"; I", $
State Surcharge $
/., u 0 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 t! e'b --,---44'-'1<lfi $ /Z-Z_ G 49
This Ap ' on Becomes*i(our Building Permit When ,pprov,d t?l, a, ��
Receipt No. 7/Lb
ate �. By
Butldm ► to 5/ --(Fr ,
This is to certify I the ie. •tin t. above ai plication and accompanyi/anlliws
nts is in a oidance with the City Zoning Ordinance and may proceed as requested This document
when signed by Pik er a/mutes a temporary Certificate of Zoconstruction to commence Before occupancy,a Certificate of Occupancy must be
issued /;sairf
4
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: 40.4±S>, Date:
Building Permit# PID: Zoning:
Site Address (J y9
/ (.'7 &A-4, Cp
Legal: L B Subdivision:
Existing Structure: YES or NO
CONFORMS TO ZONING YES NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard /6' I f
(25' if abutting a street, 30' if abutting a street in I)
Cardinal Ridge)
• Side Yard 10'
• Rear Yard ` (� r . 7 `
• 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
TMENT
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD ____�y
SITE ADDRESS i / 17a1.1513���'
TYPE OF WORK
USE OF BUILDIN
PERMIT NO. / 4DAEISSUED .IV
BUILDER ��D W • PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
( F0071NG
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
WNW"
IFINAL � '')/ 1 /
1
FOR ALL INSPECTIONS (952) 447-9850