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0.PRjop CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
ti / it TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �3 ��.
L'{\�___!i, )t-Ti AND UTILITY CONNECTION PERMIT
�IN�o�
I Whitt File
z Pink City 5it PERMIT NO. /A ()
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS / ZONING(office use)
ID`s '7v T �, t 1, ..�
,4e4 L,t,, S It
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWN(Name) .--1 J h n �j L.. `t M cA 3 (Phone) (° I ci g 3 z LI —79
(Address) c 1 V r c.�t 1 feu of Il_►_.„ g
BUILDER
(Company Name) 0 t....-- _,__..v"- (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction Vick& ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
DAddition ['Alteration DUtility Connection
CODE R.C. DI.B.C. 0 Misr:
Type of Construction: I II III IV V AB /
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ — --•)
Division: 1 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 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 oke this permit for' use. rthermore,I hereby agree that the city official or a designee may enter upon the property to perform neede inspections
Signature Contractor's License No. Date
Permit Valuation 3I 6 0 U 6) (- Park Support Fee # $
Permit Fee $ o tt ?---5—?---5— SAC # $
Plan Check Fee $ 5'7 3 C, Water Meter Size 5/8";1"; $
State Surcharge $ / _410 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 $ /47, //
Appl' . .in : 7 (corn_-.Your Building Permit When Approved Paid / ( I Re ipt No. 773 L'
/ /,t Date /9 (Buildin' ficial e
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
am-+' 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
Residential Building Permit Checklist
Deck Additions to Single Family Homes
BY: Date:
Gir3 /
Building Permit# PID: Zoning:
Site Address 5F- 2.0 1J(4Qc.(4,(
Legal: L (2. B 3 Subdivision: f.A.Lcky. f JO.O. Le
7
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 Z�
Cardinal Ridge)
• Side Yard 10'
GOl
• Rear Yard 25' Z
• 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 LAKEDEPARTMENT U
BUILDING A DONSPECTION
INSPECTION
RECORD
SITE ADDRESS -557 d -772 /&/--/ Z--"J
TYPE OF WORK
USE OF BUILDING Gj ////C-
PERMIT NO. /4` . S?-O � DATE ISSUED �a-
BUILDER (�(/C�%/1 �N PHONE # 625/. . Z�J'77
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR 9ATE
I FOOTING I `+�� 7 \ti I y'
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
NEW
I FINAL I hl.c� 1 ILII L\
FOR ALL INSPECTIONS (952) 447-9850