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of PRi0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE9 i3
U
AND UTILITY CONNECTION PERMIT ' �/
4/HNEsOlt. I. White File y.
Pink City PERMIT NO. / (o
3 Yellow Applicant /�.'�.Yf
P e nC);rint and sign at bottom)
ADDRESS
Z d•(office use)
1' )Ci 93' M S5 N-) : Push
LEGAL DESCRIPTION(office use only)
LOT k BLOCK 11 ADDITION .. 5 )e,"\ ...._ PID Z 437. (? , 0
O j ,�
ame)_J L-'h�'4) t (Phone)
(Address) oft l -3--t-F742.5"---- i5.3 N V',.,,.,)
BUII,D
B omnanv Naur-P •,0.p. T.? —n.vx,.r•c- -4--S t\--- ' one) Co 31 'ii 0
.-.'ontact Nat& ii.:......a. eir jO.-A; 'hone)
2 6AliA lila c is. 4.k. O - aii R . .. . r
TYPE OF WORK 0 New Construction ODeck ❑Porch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition ❑Alteration OUtility Connection
CO E: I.R.C. ❑I.B.C. 0 Misc.
Ty of Construction: I II III IV V A B PROJECT COST/VALUE $
Oc pancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby c '' 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-me i ned . .. and tn. : 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 ca r vok this per ' for jus ause. Furthermore,I hereb agree that the city official or a designee may enter upon the property to perform needed inlpections.
X 5 Biu/
Contractor's License No. Dat
Permit Valuation l4/r Park Support Fee # $
Permit Fee $ /4 Z 2-5" SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ i j,p 0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ .54-..c-e) Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 2.2_/ 75,
This Ap lica't Becomes YourW
Building Permit h Appr ed Paid e-Zr.. l S eipt No. �( 9o17
TR
/1 4( r3 Date 5'./6_/3
uilding Official Date
This is to cert that t e req est in the above application and accompanying documents is in act rdance with the City Zoning Ordinance and may proceed as requested. This document
when sign y4 th •ty PI/nee constitutes a temporary Certificate of Zoning complia a and lows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. i l /
t WI",46. ..
--I.- 5- 13 /3
Planning Direc or 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
Swimming Pool Additions to Single Family Homes
BY: A) Date: S-7 /c
BuildingPermit PID: Zoning:
t>Lis C-7d.
Site Address f 115 j6F-fc6,2,s .
Legal: L ( B Subdivision:
Existing Structure: or NO
CONFORMS TO ZONINGi •
•
NO
ORDINANCE
IN-GROUND SWIMMING POOL Requirement Proposed
Yard Setbacks: NOT APPLICABLE
MEETS CODE —
•0
Side Yard 5',25' or 30'
if abutting a street, 30' if abutting a street in 7u
Cardinal Ridge) / _
• Side Yard 5'
36 •(f, _
• Rear Yard s�''ii ?� �f _ 10' Z-Z
• Not to be located within 6' of any principal j‘ / /�� I
structure or frost footings, including deck 7.
footings.
MEM
ABOVE GROUND SWIMMING POOL Requirement Proposed
Yard Setbacks: NOT APPLICABLE
MEETS CODE
• Side Yard 5',25' or 30'
(25' if abutting a street,30' if abutting a street in
Cardinal Ridge)
• Side Yard 5'
• Rear Yard
8'
• Not to be located within 6' of any principal
structure.
ANY PROPOSED SWIMMING POOL NOT MEETING THE ABOVE CRITERIA MUST BE REFERRED TO
THE PLANNING DEPARTMENT. ALSO,ANY POOL 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.
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BRA. �,t i., 410 i,
CITY Oh PRIOR Lr ''
:i . At
Impervious Surface Calculations
(To be Submitted-with Buildin
• For All Properties Located ' g Permit Application)
The M mum Impervious Surface Coverage Pee d District 30 P
Permitted in 30 Percent.,-----
Property Address / '' 9 e
Lot Area (N..A, — SEE TABLE)
Sq. Feet x*********************************** *******O ..... (N.A. —SEE TABLE )
******
LENGTH *************•*******
HOUSE WIDTH
•
X SQ. FEET
• ATTACHED GARAGE x
x
f/7 S
DETACHED BL
TOTAL PRINCIPLE STRUCTURE.....
DGS 4(Garage/Shed) x
x _
TOTAL,DETACHED BUILDINGS....
DRIVEWAY/PAVED AREAS
(Driveway-paved or not) x
(Sidewaik/patking areas) xaiwl�CGt --___
x
PATIOS TOTAL PAVED A-tZEAS.... ............ .. .. ................
�ORCHES/DECKS f 3'j S•F
(Open necks h min.opening between x ,.x
boards,with a pervious surface below, _ a
are not considered to be impervious)
•
X
p
TOTAL DECKS........................... diec
OTHER . .. .. ..N
.. ............
/Dl SF..
x
X
TOTALOTHER......................................................
TOTAI, IMPERVIOUS .................
RVIOUS SURFACE
OEM
UNDER/OVER (N,A. — SEE TABLE
Prepared By & )
4wil, sot
Date /zb/o7
Company Pioneer Engineering
Lot j Phone #______________6.51-681-1914
6 _ig14
Block/1_, JEFFERS POND FIRST ADDITIbN
erost/ 14-07 4-/o-o?
LAKE' DEPARO
PRIOR BUILDINGTMENT AND INF
SPECTION
INSPECTION RECORD
SITE ADDRESS / _
NATURE OF WORK v S/V✓IPM/Ni f POOG.. _
USE OF BUILDING
PERMIT NO. DATE ISSUED j.
CONTRACTOR �� 4A/ Piot.* PHONE
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
FOOTING _4a-(1
omminomma
ummimmi
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
ELECTRICAL
MEM
AIR TEST f`/(,-/i )
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
M�l 3/,
ALS
GRADING ( PRIOR TO SODDING)
BUILDING
ELECTRICAL- WaS5 fW 4 OZ.
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections and
maintained until all inspections have been approved. On buildings and additions where rio
service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850