HomeMy WebLinkAboutBuilding 02-1129
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PAID
..,
2002
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
9---30- 02
Permit No.
LOT
BLOCK
PID
BUILDING INFORMATION
11 . SIZE OF STRUCTURE
(Height) (Width) (Depth)
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADSESS .J.. {(oad ~ t:
12. NO. OF STORIES
ADDITION
(Addr:~s~~
(Address)
(Tel. No.)
9~l' 'I'IIJ . 7938'
14. FLOOR AREA AP
(Address)
'St'Yahv1~ J::y..
(Tel. No.)
6Z
(Tel. No.)
1Ylf'Pt, h'ltJ 6~:3'/3
. q 35"'
q "",
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. !:'flOJECT COSTNALUE
q () 00
17. COMPL TION DATE
/1. /. OZ
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Deck 0 Re-roofing 0 Porch 0
Finish Attic 0 Re-siding 0 Finish Basement 0
'10 ttn~ '
Yes No
I hereby certify that I have fumished 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 mentione 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
:uilding official voke this rmit fo j t use. Furthermore, I hereby agree that the city official Q a desi ee may enter upon the property to perfo"21~~~~i3ons.
License No. Date ~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
o
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/2ES/t/.e.-
/
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
-$'~ 000. 00
PLOT PLAN
o
TYPE OF CONSTRUCTION: I /I 1/1 IV V
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ...... ..... ........................ $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Special Conditions ij any
Occupancy Group A B E F H IRS U
Division 1 2 3 4
Permit Fee ................._................. $
C2? --, c-
U-.J . c-::.::::>
S4-.11
1.50
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
Subtotal ..._........................... $
This Application Becomes Your Building Permit When Approved.
By ~~ ~/.J Date /t1pih-z.-.--
Certificate of Occupancy
Issued
Paid
Date Jf. v..,.' Z--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr eed a
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a C rtificate
City Planner
Date
24 hour notice for all inspections 447-4230
White - Building
Canary - Engineering
Pink - Planning
The Ct'nlt'r or 'he L.ke COUnll")'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT AtN' ~UJ~
APPLICATION RECEIVED 9..-30 - 0 ?
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
153&2- P;SH ~ol;v'T R-@~
.
Accepted
Accepted With Corrections
)(
/
Denied
Reviewed By:
1$~ 1~
/) P f) A-TB S'!'V'-'() ~ E
Date: I rr/d./t; v
I '
7)d~ ~lfJ.:t-,
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."