HomeMy WebLinkAboutBuilding 06-0239
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
4- .& . (J'J
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
5.
3. LEGAL DESCRIPTION
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
(1t/?0Z3C;
1. DATE
/(Jf{ 5S 3
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID 25. 31&;. 005. 6
13. TYPE OF CONSTRUCTION
ADDITION
r:J1Jj
(Ad~r~~ ._
(Address)
mN-D
5SS8 h1if~
Septic 0 Deck 0
Addition 0 Finish Attic 0
"--
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA
Sq. Ft.
14. FLOOR AREA APPORTIONMENT USE
10. CULVERT SIZE
Yes 1uIoe.AlL
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 nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am awar that the
X . perTM for' st us rt rmore. I hereby agree that the city official or a ::t:l7YJ:3nter upon the property to perform~ 2'P ti n .
Ucense No. Date
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II 1/1 IV V
Occupancy Group A B E F H IRS U
Division 1 2 3 4
I.~,C-f
City:
Permit Fee ................................... $ 02.,OO(), 00
Plan Checking Fee ......................... $ 73. 7 S
State Surcharge ............................. $ 1-/7,' i
Penalty ....................................... $ I, (;) 0
Septic System ............................... $
Other ......................................... $
Subtotal............................... $
f l
tf~10\;
A-.
This Appli tion Becomes Your Building Permit When Approved.
By ~'Date 1(7/tJh
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
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 ......................................... $
Paid Tota~Z...t.?........~~~~i~;..O~
Date "I- /11. 0&
122.~9
S/~
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
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certifi
City Planner
Date
24 hour notice for all inspections 447-4230
Special Conditions ff any
~
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS I~Z 12- F6~ TA/~ (J)u/t,/
,
TYPE OF WORK ADo .., I-J/EIAJ /IV liJOd /IllS
USE OF BUILDING s: F:' /)~
PERMIT NO. 00.02...39 DATE ISSUED -1/'144,
BUILDER .....,iJlJ. b.n-IJ~ /iI~ · PHONE 'H9s--z. f.1r-""
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~ I 'NSPECTOR I DATE
E Nb CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING /Y/lItJII.G lET, /~lMB' I
I FINAL
I if6 I Lfi/01>
Call between 8:00 and 9:00 A.M. for all inspections I
FOR ALL INSPECTIONS (952) 447-9850