HomeMy WebLinkAboutBuilding Permit 95-0046
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY! --S
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ID [g@[gOwlli
PRIO-t' ~ I ,; ,------- : ~ITV OF PRIOR LAKE
~ f. I MF.;; 3 -1995 .:'! jBUILDING PERMI~
I>1IUI i I TEMPORAR~/F/CATE OF ZONING COMPLIANCE
. AN I ITV CONNECTION PERMIT
. Permit No.
(of^.( OF SLltVG'-t ..
1. While
2. Pink
3. Yellow
File
City
Applicant
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
q~4~
1. DATE
3 q5
BUILDING INFORMATION
11. SIZE OF STRUCTURE
'(Height) (Width) (Depth)
4. OWNER
3. LEGAL DESCRIPTION
I. :LOCK L PlO .tS-l'lf- dLf- D
ADDITION .a/~ --'. '1&~ Lj..t:1J Ildd..~
(Address)
335'\
(Address)
13. TYPE OF CONSTRUCTION
LOT
12. NO. OF STORIES
5. ARCHITECT
\ '
o-.rr Ce
-b 10 -
3115
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
l ' (Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
Fireplace 0
Alterations 0
Septic 0
Addition 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Reroofing 0 porcHJ(
Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED VALUE
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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 will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 ial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform eed inspections.
. ~ 3 , ,
Signature Ucense No.
x
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA Ll
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET ~
USE OF BUILDING (\::c..-~ I".. ;".,c.c.....l.--
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
SETS
PERMIT VALUATION
/~ b
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
Amount Brought Forward .................. $ ;J ~ ~ "-
Park Support Fee ........................... $
SAC ......................................... $
PERCOLATION TESTS Ll
COPIES
TYPE OF CONSTRUCTION: I II III IV(3b
Occupancy Group A BEl ~
Division 1 2~
Permit Fee ................................... $
city:
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................. $.;L <7'1. <'-"8
/7/. 0 C
J I \. l ~
7~ S'"''->
Check if
Deferred
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom .......................... ......... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due.. ........................... $
Paid Recel t No.
By
Your Building Permit When Approved.
Date ~ - (..- c:; ~
Certificate of Occupancy
Issued
Date B
uest in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as
~ a temporary ~~ ~~p1iance and allows construction to commence. Before occupancy, a Certificate 0
Date Special Conditions ~ any
24 Hour notice for all inspections 447-42309:00 a.m. '10:00 a.m.
C;S-L/0
White - Building
Canary - Engineering
Pink - Planning
The' Crnter of fh~ Lake Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~-JL ~ rnr-
APPLICATION RECEIVED --.313/15
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Slft.) ~d~~f/ (J~
Accepted
Accepted With Corrections
f-
Denied ~
Reviewed By:
Comments: .-1-, Rz-~ \ ..L.e...
~ ~
Z , (2.z:p ~
Date: ~-~-q s:-
.. ,1'V1~-t-~/lATl~ (~"~c:...~~ ~
(..,"" ~-1 ~"G ~~-E: -
p(~ ~V,,'^-..l 1'\~~~..
"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."
. !tAr'-''': ,:-,-'~~:""-~'~T> ..:.:,......;'-< ~:.~-'~'.';;ff-":'j.<,..'~../r&~."I~F... _,_...!~' hi""':' P,
White - Building
Canary - Engineering
Pink - Planning
The Center of the L.ke Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT J\;' ...... '(r/../
APPLICATION RECEIVED,,-,l3 / f':J/
, /
.".-
?\ ...-.,...........
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,~ /' '
,., 'I( U / I t. I' 1
,':J-.-)} 73. it. -: ). il/l L . e....-.
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~
Comments:
Date: ; ~ '7~ 9-S-
liThe 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. II
\-"'l\;:':"./,','..,
Th. C.nl.. of Ih. Lib Connlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT h ~ 'fk-.~.~ ;( (H;--
APPLICATION RECEIVED 01.3 / fs'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.33 t '/1/70 /h<rn.f~. !1u~
Accepted l/
Accepted With Corrections
Denied
Reviewed By: V ~ ~
Comments: /1tl11.L--
Date: (3/7/75""'
liThe 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. II