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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE " p
7 �' AND UTILITY CONNECTION PERMIT ' 2-9 (1
j kisr E S O�
i. Pink Cit PERMIT NO. a 9. 077 Z..
2. Pink City
3. Yetlaw Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
2 Fjoo ,41 gu) i- /2. /j, / -14.1 _
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER n
(Name) ! v"vr A X!) S ok , 11/44 -s✓z,- L (Phone) 6/Z - 2 42- - 5t b --7
(Address) 2 eo v //ii-,.ri, i e h oG-e• 1. 6 raw PA o 44i ,, ,,,/
BUILDER /0,-11-1(7724/'41-/a/-/
(Company Name) . u� . (Phone) 6/2 - 6 UGC -- 6 7 6 V
(Contact Name) Sr4 V %.:31 (Phone) 6/2 - 6 00 - S76 8
(Address) 0 03 2�r c l /.16 lh(-.. / z i-r,,. /0 j -/ 5 (
TYPE OF WORK ❑ New Construction Deck ❑Porch ❑Re- Roofing DRe-Siding DLower Level Finish ❑ Fireplace
DAddition ['Alteration [(Utility Connection
CODE: .R.C. DI.B.C. ❑ Mme=
Type of nstruction: I II III IV V A B 0 t
Occupancy Group: A B E F H 1 M R S U PROJECT COST /VALUE $ 620 U
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also citify 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 revoke this for just ca ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x_ fi r '` "4-'' 063 (.374 VZ''b /°Ct
Signature Contractor's License No. Date
Permit Valuation 1 0 0 0 . 00 Park Support Fee # $
Permit Fee $ 1 3 . ? 5 SAC # $
Plan Check Fee $ 4_1 f 9 4- Water Meter Size 5/8 "; 1 "; $
State Surcharge $ ' 0 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 $ I ZZ . /
This A, • , • , • • / k • mes Your Building Permit ` , , , , , , ved Paid /„ { ipt NO. , 9�p 8
Date z.1.0 B
;lit iter - q
Buildi • i ' D.
This is to certify that •, , uest in the above application and accompan . g docu „ „ is is in accordance with the City Zoning Ordinan and may proceed as requested. This document
when sign - • i .e J er ' Planner mnslitutes a temporary Certificate of • , : co.. ,Ran an d allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
i
0
Director ' bate Special Conditions, if any
iLAL 41,
24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Residential Building Permit Checklist
Dec Additions to Single Family Homes
BY: Date: 92 9
Building Permit # o q, 0 77 Z. PID: Zoning:
Site Address 2 8 0 /7 /C 'I q E
Legal: L B Subdivision:
Existing Structu : YES NO
CONFORMS TO ZONING YES NO
ORDINANCE
Yard Setbacks: NOT APPLICABLE Requirement Proposed
MEETS CODE
• Side Yard 10'
(25' if abutting a street, 30' if abutting a street in
Cardinal Ridge)
• _ Side Yard 10' 40
• Rear Yard 25'
• 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: \TEMPLATE\DECKCHCK.DOC
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS Z SOD yITW /C_ RAO 6 E
TYPE OF WORK
USE OF BUILDING gecr /f/Z.
PERMIT NO. l 9 0772- DATE ISSUED g Z9,0 c /
BUILDER <STEVE ,ei9A -? L - eA•J PHONE # & /Z, Go 0.&146
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
Mir 1 1
I FINAL I 1 1 1 _ a-q 3
FOR ALL INSPECTIONS (952) 447 -9850