HomeMy WebLinkAboutBuilding Permit 99-1120
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
IZ../SD I
PID25~93l/--0/A-() I
Bdt.lN05> I
(Address) (Tel. No.) I
11~4D .t)(o.ll-<t A"e. jlJ.lJ. l.JtJ7.737/1
(Address) (Tel. No.) I
I
&~~
DATE RECFIVED
9/"1/91
. OIRECTlONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
/<<-'If) ~/"p.~
3. LEGAL DESCRIPTION
LOT
"LOCK
/"le rES fill/LJ
ADDITION
4.OWNER I~e\l;"~me) 5.-\-(&IL"
5. ARCHITECT (Name)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9q -112--0
1. DATE
A"o'
I-f- i9
BUILDING INFORMATION
11. SIZE OF sTH;';l;"ruRE
(Height) (Width) (Depth)
1tJ. W.
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
6. BUILDER
(Address)
15. NUMBER OF UL,;L:UPANTS OR SEATS
~ L (":::\ ~ "Z....~
~1"0{V\ -/71)0 - n ),.":t ~.J. ~""'~rh (./1--S-41-o:;,tf SEATS
7. OF WORK Fireplace 0 Septic CJ Deck 0 As ofing",\ Porch ["] I
New Construction 0 Alterations LI Addition CJ Finish Attic 0 Re-siding 0 Finish Basement 0 ./16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9. PROPERTY DIMENSIONS /10. CULVERT SIZE I 17. COMPLETION DATE
Sq. Ft. Width Depth Ves No I
I hereby certify that I have fUmished information on this application which is to the beSl of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above me~:1.:ed property and thai all nstOJction will confonn to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that Ihe
:ullding OffiCi~'r; revoke Ihis pe . it for. ca,:;e. Funhennore. I hereby a~y~~~t{;ee may enter upon the property to PO~+qq~
() .n""e .-=_,;_."li~",eNo. Dote .
(Name)
(Tei. No.)
OCCUPANT~
FOR ADMINISTRATIVE UlJE
Front
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
SETBACKS: Required
Actual
B,ok
BUILDING DEPARTMENT VALUATION
Side
Side
USE OF BUILDING
,ees .-"l/.e...
OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION zm.crV PLOT PLAN 0
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
s U
Permit Fee ................................... $
7<1'lt
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty .......................... ......... .... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
1.1....5
Sewer & Water Permit ...................... $
City' J./ Am;tlughtForward .................. $
\. c.;~. ~ff4'. ..~~.~~.~.::::::::::::::::::::::::::: :
!\. 0 \COII S~~~~:.F~~..::::::::::::::..:::..:::::
\) $
--.-/ Vpressure Reducer .......................... $
\~M ................................$
,y Water ................................ $
,V Connection Fee ........... $
Water Tower Fee ........................... $
WalerTap ................................... $
This Builder's Deposit ............................ $
By Other ......................................... $
Total Due .............................. $ 7rn. 0 0
Paid 70. ()c! Rece~.Pt o. 3("ot51.
Issued .
Date q/1/r'1 By
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 Is requested. 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.
CnyPlanner
Dale
Special Conditions if any
24 hour notice for all inspections 447.9850
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