HomeMy WebLinkAboutBuilding 08-0149
~ 0 0 ~ 0 000000 "0 0 > -0
l/I :I: ~ C z_
"0 0 0 en'TIz'TI'TI'TI 0 c ~:;!
CIl 0 i:
g 0 !l c:> =izen~OO z m ::u mO
> 0 ::u :U !: !!!>c!l:iS m " m 0"11
r :'1 ;:a ;" zr>zcz Z en -4
l'I'! r m C1> m 9 en -"
:lI:l t 0 :... Z ~ :::!G')~G') O::u
-4 z-
l'I'! > .-i -i m 0 - zO
~ ~ in en o z 0
I 0 0"
S co -I .n -I Z
co :... 0 :::!>
~ (II 0 0 r
0 z .-i Z 0"
'TI > c::> t" mm
~ 0 z ;u
::u c :< vJ
~ -4 " .'0
~ :I: ::a ;:0
~ m 0 c::> 000000
Z ::a 0 c:')
:::l m m m In :l!:"en~:l!:"
>< m IT1
-I Z C 1:) mr~>mr
:lI:l en \::i oC: -IoC:
::. ~ Z ~ " :I::l!: m:I::l!: " 0 en
~ en m 1\ ~!!!"",,!!! m 0 0
c ~ " :J 0 ZZ:I::I:-Z ::u Z :I:
::! m CIl -I >G')OO G') !l: -4 m
::t 0
~ 0 () r'TIOO ::a ::j ;U C
-4 0 Z -"" - c:
~ 0 a- m Zc:c: Z r
Z :'1 m ~"" 9 m
~ 'TI C
N 0
~
~ :I: ::a
m
~ 0 0
c: 0
;:a < 000000
en m \'0
S! z ::a G')'TI'TIom
Z .-- >
> >~~o~ -4
Ro- G') ~mm:l!:Cl ' m
C W
~ < _"'ll"'ll"'ll$!
;;; > ifi>>>c ~
Z >ooz:;; ~
""i 0 _mm-l_
~ rn ::a'TI;:a r ~i
-1-_ r
enz Z m
-4~ G')
\ 'J; 1h 1/
CIA TE 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
Permit No.
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
1&2..35' A I<l<!..v/w /)I?III~ $. {;..
1. DATE
. ~D#1-61>
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
LOT
BLOCK
PID
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
I<Ar<A1\
5. ARCHITECT
(Name)
(Name)
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER (Name) (Address) .-t"" . /l (Tel. No.) 2.-701-
A ~ 1 ~GC:r\Ju(),(!jIlI.-.",/)St(dE..IOO
mER/e4/J 4.}/,(IL!YQG CavrR4crpf5, e.l{~AlSI//U..G-1 -:6337
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Porch 0
inish Basement 0
SEATS
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
9. PROPERTY DIMENSIONS
Width Depth
No
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 ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin o' ial can revoke is ermit for just cause. Fu hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
.9-.o/fbQ.383 0'1-'1-07
License No. Date
x
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
o COPIES
USE OF BUILDING
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 a 4
Permit Fee ................................... $
V
R S U
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 Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City Planner
Date
Special Conditions ff any
Gas Fireplace Permit ....................... $
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 proc d s requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, aCe' ca of Occupancy must be issued.
24 hour notice for all inspections 447-9850