HomeMy WebLinkAboutBuilding Permit 95-0240
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I [I ! rlEJ 1::]__._- CITY OF PRIOR LAKE
l~) I ..... ,:!~UILDING PERMIT,
II ~ ~~ "~mrFICATE O..F ZONING COMPLIANCE
U A U CONNECTION PERMIT '=t - ~J ~
Permit No. 5 - .;l ~ U
J
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
'I Ztv 0 Qv'~C7C ~,.,/'-
3. LEGAL DESCRIPTION
LOT
ADDITION
4. OWNER
1. DATE
SI ~ 'S-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Wic:llh) (Depth)
12. NO. OF STORIES
PID ;<.1; -1J3~ - (J L/ () - 0
13. TYPE OF CONSTRUCTION
,d eR ("
(Address)
<;ZG,o Qv~?<
(Address)
(Tel. No.)
/it'r-<~ G.(~ qVU~,fy'<
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft. 7S-o 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Reroofing 0 Porch 0
Finish Basement 0
6. BUILDER
(Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
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
buildin cia n revoke this it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
9. PROPERTY DIMENSIONS
Width So Depth I $""'0
10. CULVERT SIZE
Yes No
Ucense No.
Date
FOR ADMINISTRATIVE USE
Front
Baek
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
SETBACKS: Required
Actual
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
7 I . (pO
Check if
Deferred
Amount Brought Forward . .. .. ... .. .. .. .... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ......................... .......... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
11.~{)
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl H R M
Division 1 2 3 4
City:
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $
q~j'30
2.7.Q-:;,-
. ~~
Permit Fee ................................... $
mit When Approved.
Date C, - 9 -C( ea
Total D~e .............................. $
Paid . ,D Rece! t No.
9 f(
Date
B
Issued
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
signed By the City constitutes a temporary Certificate of Zoning compliance 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.
QS -02t/-D
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Tht Ctnl.. of Iht Lib Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~J.A,v ~
APPLICATION RECEIVED SJ4/~~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constructi?ct~Vity which is proposed at:
L/24() 001AWJ;z~b
Accepted
Accepted With Corrections 'Y-
Denied
Reviewed By: ;l~
Z~orj~~
Date:
b- f- YO
"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."
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White - Building
Canary - Engineering
Pink - Planning
Th. C.nt.. nf th. Lib Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ,)1..-,/ &~r
APPLICATION RECEIVED S*/2/,,/Ir-1.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constructio~ctiyity which is proposed at:
L/l~ () o(jJ A }-1A.J ,-JI{~ 10
/
Accepted
Accepted With Corrections
Denied
v~~
rJlfJLL,
Date:
s/J//r~
, /
Reviewed By:
Comments:
"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,"
I . j
L-/ j
White - Building
Canary - Engineering
Pink - Planning
The ernler of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT -::.j~'~ . / /~. i1'
APPLICATION RECEIVED !)12..t/l~J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for constructio'Vlcti~ity which is proposed at:
II- iJ 1\ J / . 1 /
7 2. I' (/ X:.1 f It' it LI '..... ./ /l L .l.........-"
Accepted /
Accepted With Corrections
Denied
Reviewed By: J:.J:0/GHAEL- LE:.EJL
Date: S/ZC,/199.5
Comments:
"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."
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