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o f psi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
0 y TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
— 7 /
AND UTILITY CONNECTION PERMIT
U
A 't A l 3 I. White City i PERMIT NO. f� ¢,
0 2. Pink
3 Yellow Applicant /v ✓
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
16 L i -1 j PG I O oh": h O S-4-,(` ems- J--- rP , D✓ l <; � tom, 151/ n
LEGAL DESCRIPTION (office use only)
LOT () BLOCK 3 ADDITION V2S,e J Mr , ,, -J- f g lei PID 147. 0 ?-3. o
OWNER
(Name) Tcp, ',h Z. L 4 r'+ (Phone) c i T Z- - Z- i 0 " vC, /O
(Address) 1-1 i , lea /0 kh ∎...0 --S irt..4 Gtr, - Lq I-
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction tgbeck ['Porch ['Re-Roofing ['Re- Siding ['Lower Level Finish D Fireplace
['Addition DAlteration DUtility Connection
CODE: I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U
Division: 1 2 3 4 5 (excluding land)
I
I hereby certify 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- mentioned property and that all 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 can evo this p rmit for 1 st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ,.--&-.% 0 9/08 ho
Signature Contractor's License No. Date
Permit Valuation 4- d 00. 00 Park Support Fee # $
Permit Fee $ /0 3, 0 d SAC # $
Plan Check Fee $ 64,f5 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 4_ IS 0 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 $ / /, i5
AA i e, L1...C.. 7 / 3 O Ts Iri Building Permit When Ppt prov d Pald /7/. No. q = � ' —
Date 7 /3, /0 �• .
A_ ,� 7 to
B it ing Official at
This is to certi that the r: • uest in the above application and accompanying documents is accord ce with the City Zoning Ordinance and may proceed as requested. This document
when signed . '' • e Ci / anner constitutes a temporary Certificate of Zoning compliant and allo s construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. / J
A LL 7 (O
' Plan ;. ! - • ate 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
• • Deck A dditions to Single Fam Ho es - :
•
. , .
• BY Date: 7/( (o •
• l3uilding Permit # PID: - Zoning: .
•
Site Address ���� No �( S v - •
•
- Legal: L B . Subdivision: .
Existing Structure: ES NO , . . - ' • . - •
- - CONFORMS TO ZONING • . - . ' - S NO . • •
ORDINANCE • - •
•
Yard Setbacks: NOT APPLICABLE . Requirement Proposed • I -
MEETS CODE
• Side Yard - • . 10'
(25' if abutting a street, 30' if abutting a street in • ,
Cardinal Ridge) - - - 3 o '
• . Side Yard - 10'
• • Rear Yard • • - 25' f •
•
t
• • Townhouses • • • • Must be consistent with - . •
approved plan for
. development . . •
• • ANY PROPOSED DECK NOT MEETING THE ABOVE CRITERIA MUSTBE 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: \T_EMPLATE\DECIKCHCK.DOC .
•
P R I O R LAKE BUILDING AND �NSPECTION
INSPECTION
RECORD
SITE ADDRESS /6¢740 PfILDi"J /NO S.
TYPE OF WORK DEC1�-
USE OF BUILDING f/��
PERMIT NO. /�C DATE ISSUED /Z- /0
BUILDER Wfl PHONE # Z/ � OX0 I O
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I /43 I �� �,�id
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
( FINAL L / % ‘Y�
FOR ALL INSPECTIONS (952) 447 -9850