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CITY OF PRIOR LAKE BtJlLDIN(; llERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND lJTILITY CONNECTION PERMIT
Dale Rcc' d
~/ _ -3 - 07
(Plcase typc or print and sign at bottom)
ADDRESS
320(" vn\ e C\ edeS:\.A/
\\t;itc hle I PI~Ri'lIT N(} 0 a ,~ 61
~:;\I~" '~;:;ka", C.. 1 .. ~I ~ OV z..
ZONING (ollicr use)
Pe.\OK LI\1<'C
f'-'IN
55 'rlZ-
LEGAL
'TllJN (oniec usc ouly)
LOT
BLOCK
ADDl.TION
PID
""----".m.-.~.l
'-:.-- .......... .........--
I OWNER
. (Name) 1f\VC:: L
. (Address) is'.::; IS'
LA) II!) K' C)v
(Phone)
65"1
LI :3 S (I G I S-
OAt'Cf2GST CC S,t\vACrE I~!N
ss:n~
I BUILDER
. (Company
(Contact Name)
! (Ad~~:~:~~)~ '2 O~"": V n L e CU?.f l E -;.l./-J
Pk'IOi' ltlVE
(Phone) ....___...._...................._,..__
(Phonc.) _~.i.S'2. .- C1(il,.!_~.?I__
SS~T2.. mmmm_ --".=J
"'i IV
1,- TYPliOY'VORK 0 New COlts!lUclion ~(X~k OPordl OR(~,Ro(Jfing
Oi\ddition OAlterationl OVrilit)' C(}llIlC~ction
CODE: IiJI.R.C. Ol.B.C. /2- 'x 13' 0 Mise
Type of C;nstruction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
DRe.Sjdinl~ DLow('r Lt'wl Fi.uish 0 Fircplace
PROJECT COST IV AL UE S \ I I;Q_~)
(excluding land)
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, I hetd'y eCltlty Ih,1I11~..lVt' l;>>nishcd il\r()rnl<ltlt)t~ ol1lhis ,lppllt';IIHJt\ which is to llw I1t'SI of my knowkdgt' trut' ,mtl rOflerl. I .t1~0 t'nlify Ih;1I1 ,1m thc OWI1(;1 or ,llllllllfil<'d ,lgent 101 Ilw
'I ,lb;WI""WIlUOllt'd 1'1.'>1'<.. - 0nd Ih.."1 aU nmSIl~t'llOI\ will wnlorm 10 '.111 c.~lSrUlH '1M." ,md k><:'tllaw,.' MId willl'll\CCt\lm ;In-o. f(.j,.mcc wilh ,ul;milli'd plans.. .'.'lIn ;lW.lle Ill,lIlhe !>llildinl:
! ~hel.ll clllll'''':~~7mltl::~,ll~~~J:-.l'Ultht~mI0lt', I lWlt'!>y il;:r~.' thatth.- <'IIY ofhC'.al or .1 dC"ltl\('(~ may mlrr upon th"l'lopt'rly 10 pt'lf<lllll l1\'clkd ;1~'r!('CUDI1S.
;7-<~C.: SignalUlC
Contractol's Ucense No.
L);IlC
I Permit Valuation
i..PermiiFce-..'.
Plan Check Fee
State Surcharge
Penally
: Plumbilll:.jJem1il l:Cc
OD. -
0.':;0
4~..~~
,'15
SAC
Park SUpport Fee
It
it
\Vater !\.Ieter Size $/8"; I";
$
Pressure Reducer
$
,..o_,______,~_...
Sewer/Water Connection Fec 1#
s
Wilter 'rower Fee
II
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r SC-\~~'.r~~\V ,iter- PCrJ;lTt"fi't,c
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Build~'r's Dc-posit
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'C ~ '1M ' '~t'\ ,llernpllr.u}' CI'l1Iltt\lfl' of Z,'fl1ng t'1 llph,r ft' ,mil .IUlI"" t'PtlsUUCUllU to i'mlllllCI,.,\: Ikllll" (I\'lllfl,mt'y, .\ Cl'llrhf,\t(' of (knlp,Ii"'\, mllslb.-
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D.ff(: 'pC\i;.tj Con~hfw'h 11.U1\
24 honr notirr for nil iUS(lrrlions (952) -1-17.1)850. fax (952) "-1'.-12-15
"C,.H. l>:Iknta Strrrl S.E" Prior L:lkr, \linncsllt:l 55.l72
BY:
Residential Building Permit Checklist
Deck Additions to Single Family Homes
Date:
G,. +. Or
Building Permit # 0 .
Site Address 3 ZO (P V,.q ~6 V f2, ue;-
Zoning:
Legal: L
B
Subdivision:
Existing Structure: '@ or NO
'8J
I CONFORMS TO. Z. .ONING
ORDINANCE
I
NO
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
. Side Yard 10'
(25' if abutting a street, 30' if abutting a street in l~ I
Cardinal Ridge)
. Side Yard 10' 4~'
. Rear Yard 25' l~(
. 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:\TEMPLA TE\DECKCHCK.DOC
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the r ,e lonlPc JrdilW1Cl.
. "
CITY OF PRIOR LAKe / '
_'-~ I ,'" f'" , \':' ..: ............. . (
I heI;ebY certify t~ site plan" au .. ..~
"' knowledge and the. i " . .
......... '-'.,*,' ,-.frl. d
I.fultesjlifil'lw ..
pIIt)rld I agree""
~res:......, Ja~1J1Jt~.rul~ wIh
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PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 3Z0cP VAv6 UtG6<-6
TYPE OF WORK ObCK-
USE OF BUILDING Ile's /1'/ /L
PERMIT NO. . Oq" 03Z-0 . DATE ISSUED &. ~...o9
BUILDER VSIUi/COV PHONE # (05/ #5. ~/S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING U u !7
PLACE NO CONCRETE UNTIL ABOVE
DATE
I FINAL
/ I
iflLl 7/?t9
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FOR ALL INSPECTIONS (952) 447-9850