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(p 22-/17
PERMIT NO. 0 7 - tJ5~S
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
r: \I L Hl~h Ir ~f [-
Sf? f{t~Y" L..cltL
Date Rec' d
ZONING (office usc)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(Address)
4-" (\... :; "\l (il r-.. S() .0
--- '
J.-- 'W- '/~ Ir/p
)F
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction Deck o Porch ORe-Roofing ORe-Siding OLower Level FinIsh 0 Fireplace
OAdditlOn OAlteration OUtility ConnectIon
CODE: fI.RoC. OLB.Co o Misc.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
matllln on thiS applicatIOn which IS to the best of my knowledge true and correct I also certlly that I am the owner or authorized agent tor the
constructIOn Will conform to all eXISting state and local laws and will proceed In accordance with submitted plans I am aware that the bluldmg
st caLIse Furthermore, 1 hereby agree that the City official or a designee may enter upon the propel1y to perform needed tnspectlons
0-'),2 -07
Signature icense No. Date
#
#
Permit Valuation
Park Support Fee
SAC
#
#
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
$
$
$
I $
$
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
$
$
$
$
$
$
$
$
$
I P,id t;.2.-1
Date Z:Z.-I07
0,'2-1
I Receipt No~<lO <Ie.
By ~ I -
This Application Becomes Your Building Permit When Approved
~~
~OrtiClal
t,/ '2-z.{07
I Date
Tim IS to ccrtlty that the request 111 the above apphcatlon and accompanYll1g documents IS 111 accordance with the City Zoning Ordinance and may pmeeed as requested TIm document
\\'hcn signed by the City PL1I1ner constItutes a temporary CertIficate uf Zonmg compliance and allows constructIon to commence Before uccupancy, a Cntlficate of Occupancy must be
)ssucd
Special Conditions, if any
Planning Director
Date
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: t" !z.z.,!c 7
Building Permit #
Site Address I ~ 5'F .:?
Legal: L B
PIn:
F~~
Zoning:
~--
Subdivision:
Existing Structur~or NO
I. CONFORMS TO ZONING
. ORDINANCE
YES
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in I
Cardinal Ridge) ~/O
. Side Yard 10' ~ /tll
. Rear Yard 25' z.~/~
btJ{!:A
. Townhouses Must be consistent with Ai L.o II..
, --
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:\TEMPLA TE\DECKCHCK.DOC
PRIOR LAKE DEPARTMENT OF
- BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS I~ S?3 t=iilEH/lttl~ At/F.
TYPE OF WORK Nell> f)(~ t<
USE OF BUILDING ~ F:A .
PERMIT NO. 1) 7 -, t)~J S DATE ISSUED tol z 'Z.-/o 7
BUILDER -11l1rtVJt/ Y~ItIVS--~tv' PHONE #tfn" 2 z" - Zlt?t}
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPE~R /1
I FOOTING I 7/# I
_TE. UNTIL ABOVE HAS BEEN SIGNED
. I I
A
I FINAL IM/
DATE
I
I
f - 1-1fl r
FOR ALL INSPECTIONS (952) 447-9850
, .