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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2 Pink City
3 Yellow Applicant
pj,.;/o~
O~ ~~/I
PERMIT NO.
(Pk~ "prim ~;" bott~)
I ADDRESS
J 1 / lW lAJt~() 51- 5rL
ZONING (office use)
(2-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID "7""- "3CJq - Ot!) r - ()
OWNER ;!ttr:J
(Name) jvI/tt&
(Address) 'd'1/.
(Phone) /5J-JiJ- ~.:511S
BUILDER
(cOmpanYNamel%i!J ~it: l~/'"
(Contact Name) .. Itv!
.
(Address)
(Phone) 755-3/0'- Cf tCft(
(Phone) lj)- - &?:!3 ~ 7t1 ff
CODE: ~I.R.C. DI.B.C.
Type of C~tmction:
Occnpancy Group: A B
Division:
V
M
4
A
R
5
II
F
1
III IV
H I
2 3
I
E
B
S U
I hereby eertifY that I have htrnished mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or aUlhonzed agent for the
above-menuoned property and that 11 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am awar that the building
official can revoke this permit for. t cause IIthermore, I hereby agree that the Ctty official or a designee may enter upon the property to perform needed msp ctions.
Jt!tj tJo-9 b ~. q; t/~
Contractor's License No.
x
Permit Valuation 5G>CO. '
Permit Fee $ h'1 . 1""
Plan Check Fee $ 1 <#.S.f
State Surcharge $ -z. . <;0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ Itt".1't
Mt~1
Paid
Date
lJ(1)4:J
Receipt No.
By
equest in the above applicatton and accompanying d cume ts is in accordance with the City Zoning Ordinance and may proceed as requested. This document
lance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
-----.....
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
PR. lOR LAKE DEPARTMENT OF
· · . .. ...... .. .... ... ... ... · .... BUIt.DING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 4- J 2.4- W ( (,...{_O vV 'AI 000 51.
NATURE OF WORK fJOr<.ert
USE OF BUILDING /Z-6f /1//C-
PERMIT NO. 0 e . 0 Gr ~ I DATE ISSUED e. ZS. 0 8
CONTRACTOR 612&'t1Cle- HAl ItfJrtli IrlPlU>v.PHONE (,1 z. .80 :3, ?eec;
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
JtSPECm)R ~
R..
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH · INS
lO&,k
I
I
t FOOTING ~ S2-. ~.' I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
t I I
FINALS
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to roue.,..in inspections
and maintlined until all Inspections have been approved. On buildings and additions
where no service cabinet is available, card shill be placed ne.rmain entrance.
FOR ALL INSPECTIONS (952) 447-9850
2422 Enterprise Drive
Mendota Heights, MN 55120
(612) 681-1914 FAX:681-9488
625 Highway 10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX: 78J-188J
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......~BENCH MARK
/ TOP OF' PIPE
/ ELEV.=972.03
'"
./
,.
"
~
...
LOT AREA = 12,088 5.1=".
HOUSE AREA = 2,013 S.F.
COVERAGE = 16.7~
NOTE: PROPOSED GRADES SHOWN PER GRADING PLAN BY:
NOTE: BUILDING DIMENSIONS SHOWN ARE FOR HORIZONTAl AND VERTICAL LOCAll0N
OF SlRUCTURES ONt Y. SEE ARCHITECllJ^L PLANS FOR BUILDING AND
FOUNDATION DIMENSIONS.
NOTE: NO sPECtRe SOILS INVESTIGATION HAS BEEN COMPLETED ON THIS LOT BY THE
SURVEYOR. THE SUITABILITY OF' SOILS TO SUPPORT THE SPECIFIC HOUSE
PROPosED IS NOT THE RESPONSlBIUTY Of' Tl'1I:: SURvEYOR.
PROPOSED HOUSE ELEVATION
LOWEST FLOOR ELEVATION: Cj7/. 2J
TOP OF BLOCK ELEVATION: 9 7 4- "2..
GARAGE SLAB Et..EvA Tl~N; q 7 3. e
NOTE; 11115 CERTlFlCATE DoES NOT PURPORT TO SHOW EASEMfNlS OTHER THAN
THOSE SHOWN ON THE RECORDED PLAT.
X 000.00 DENOTES EXISTING ELEVATION
( 000.00) DENOTES PROPOSED ElEvAnON
_ _ _ DENOTES DRAINAGE AND unulY EASEMENT
....- DENOTES DRAINAGE FLOW OlRtcnoN
. DENOTES MONUMENT
o DENOTES OFFSET HUB
wE HEREBY CERTIFY TO KEYLAND HOMES THAT THIS IS A TRUE AND CORRECT REPRESENTATION Of A
SURVEY OF THE BOUNDARIES OF:
NOTEt CONTRACTOR MUST VERIFY DRIVEWAY DESIGN.
NOTE: BEARIt.lGS SHOWN ARE BASED ON AN ASSUMED 0,\ ruM
LOT 1, BLOCK 1, SECOND ADDITION TO WESTBURY PONDS
SCOTT COUNTY, MINNESOTA
I r DOES NOT PURPORT TO SHOW IMPROVEMENTS OR E:NCHROACHMENTS, EXCEPT AS SHOWN. AS SURVEyED BY ME OR
UNDER MY DIRECT SUPERVISION THIS 21ST DAY OF MAY, 1991t
1412
96223.00 'SWK
PION~R ,e. p.,.
John C. Lorson, l..S. Reg. No. 1982!
SCALE : 1 INCH :=0 30 FEET