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leiPR/DCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE (,.�_� 9�titZAND UTILITY CONNECTION PERMITt. White File PERMIT NO. I I INES��p. 2. Pink City r3 Yelow Applicant
UMn'
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
/7/7
C,.—� I d/U)b r i c=c r Or . go-rZi6_. MV Q UD
LEGAL DESCRIPTION(office use only) f �j
LOT , BLOCK 12 ADDITION �G P(,\ PID Z5 4- Jr
• DI, .0
OWN(NamS R LI 1 1 Vv2/— 404—C—it 1'L 5 (Phone) (9 (2—2 3CS
(Address) /7/7 0 t5 4 dof l ct.,--- 6:r 5'1,..0 Ocebr 6,-,1rnn/ 5337 aT
BUILDER
(Company Name) i�L_ (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction II Deck EPorch ❑Re-Roofing ❑Re-Siding ELower Level Finish ❑Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: C. EI.B.C. ❑Misc.
Type of onstruction: I II III IV V A B ,�,�`
yp PROJECT COST/VALUE $ r-OC,� .
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have 'trnished inf at' •"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-mentio pro and that. co•.. tion will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c e s permit fj t e Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
/�/
/ `
Signature Contractor's License No. ,/ Date
Permit Valuation ¢ Park Support Fee # $
Permit Fee $ l 102.. SAC # $
Plan Check Fee $ Pi'@ MS 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 $ TOTAL DUE 1fiY) q-.0.I I $ (-1 1. " ,j
This A cation B c i es 1 ur Building Permit When Appr.ved Paid / l 9� R ipt No. ep ZJG to
/ ,►(i1Iii � 'tz 7 l I Date ft; 2.1../1
Building Official "4111Date
This is to c tify that the -equest i thk above application and accompanying documents is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when sign by the Ci lanne /on notes a temporary Certificate of Zoning co .liance d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
1 'i I , I
Planning�I it is- Special Conditions,if any
��4hwr6tice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
Residential Building Permit Checklist
Deck Additions to Si4
ngle Family Horn
BY: �_ Date:
____t07 i/
Building Permit# PID: Zoning:
Site Address
171?prr,.ttc--8 /2-/,'7.(2—
Legal:
2-/i9.(L-Legal: L B Subdivision:
Existing Structure: or NO
CONFORMS TO ZONING NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE RequirementProposed
MEETS CODE l
• Side Yard
(25' if abutting a street,30' if abutting a street in
Cardinal Ridge)
• Side Yard
• Rear Yard. 25' 3S
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. _
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1 IC (4— 6 4-. 15 i '( 1°' .
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L:\TEMPLATE\DECKCHCK.DOC
•
ARTMENT OF
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /7170 SI0/4681e.MA 6/e••
TYPE OF WORK DEW
USE OF BUILDING ger 4/4
PERMIT NO. if. 21e5* DATE ISSUED #. ZO.//
BUILDER 1107C01 EMS' PHONE # Ass/
NOTE:
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
Do ovr P - - L�iZ� IN EiizsE-- `(�
" " �erEeron DATEI FOOTING Pp„r PlY? L�I7�!/
PLACE NO CONCRE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING
JFINAL tG � Ib, k-- SIC 03-
FOR
ALL INSPECTIONS (952) 447-9850