HomeMy WebLinkAboutBuilding 02-0958
5" 0 0 (') 000000 "0 0 )>- -0
1II :I: ~ 0 Z_
-0 0 ~ 0 en"Tlz"Tl"Tl"Tl 0 0 ~~
CIl Z
8 51 0 3: :::jzen~OO Z m ;;Q mo
0 ;0 ;0 3: !:!!)>-c3/:~S m ::0 m ()"Tl
~ :1 ;0 '" en
m m zr!;zoz Z en ::!"O
0 en !g =!C)~C) 9 O;;Q
:ot:I >- Z z-
~ ~ -i m 0 - zO
t<::) Ui en o z 0
S "Tl ~ Z 0::0
;:tJ >- 0 =!!;
~ 0 -'" 0 z 0"
~
"Tl 0 0 mm
~ 0 > .~
;0 r
~ ~ r
"Tl "0
~ :I: 0 ;0
~ m ;0 0 000000
z ;0 0
~ m m m 3C"Oen;:e3C"O
~ >< Z m mr~>mr
~ 0 OC ~OC
en
;0 CS z ~ "0 :I:3/: m:I:3/: "0 0 en
~ en m "Tl!!!;o;;Q;o!!! m 0 0
"0 ::J 0 ZZ:I::I:-Z ;;Q Z :I:
::J ~ m CIl ~ >1i)00 Ii) 3: .... m
::t
~ 0 () 0 r"TlOO ;0 :::j ;U 0
~ 0 Z -"'''' - Z C
0 ;:t zcc r
e; OJ ~"O"O 9 m
Z :1 m 0
~ "Tl
N 0
~
~ :I: ;0
m
~ 0 0
c: t-J
;0 0
en < 000000
m
~ Z ;0 1i)"Tl"TlO~ I t~
)>- z >;;;;0 ~ Ci iil
Ao 0 Ii) ~mm3/:1i)
S;: < _"O"O"O~
~ )>- ~!;!;!;o
Z
() )>-ooz:;;
~ !'l _mm~_ -1
;0"';:0 r
~-_ r i
enz z m
~~ C)
\lo~CO tuOjU, CreeJ/_ {:wv
DATE RECEIVED CITY OF PRIOR LAKE (>(\~ LA 0/
BUILDING PERMIT, 5S 61L
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
ApplicaDl
B- \ -02
'<wd1'9,s-~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
2. SITE ADDRESS 5lo3'45 ~wre.st- (our-\- sf
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
LOT
PIDdr'''d61- OOkl
12. NO. OF STORIES
ADDITION
4. OWNEF\.
..j \ \Y\
5. ARCHITECT
Ct .S:
(Tel. No.)
Fireplace 0
Alterations 0
(Address)
J3lJi1 5ne\.,L. (V) avv
ffiu'\ '1 - II '~. (r\ N g:SLI
Septic 0 Deck 0
Addition 0 Finish Attic 0
(Tel. No.) tJ;\ ~
1;}\- d(X'O
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
New Construction 0
Re-roofing J Porch 0
Re-siding)t Finish Basement 0
SEATS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Depth
10. CULVERT SIZE
Yes No
t-
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 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 evoke this permi for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X d-Ol~d.O\od.. 8~I-od.
License No. Date
Front
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN --- SURVEY 0 COPIES
PERMIT VALUATION 0;500,-- PLOT PLAN 0
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
...., '0 . 0 0
Tot~1 Due ....OV'................. $ -L l'_
Paid 7 t, . Receipt No.
- 0 -OJ- By C,./
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as rested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850