HomeMy WebLinkAboutBuilding Permit 95-0498
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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CITY OF PRIOR LAKE
OCT 2 1 ~ BUILDING PERMIT,
TEMPORARYtCf:RTIFICATE OF ZONING COMPLIANCE
..~_.__._.- ANb"t.trILlTY CONNECTION PERMIT
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
6(fJtf?~ /70l:::' 771--'. ?r,'(gv Ltt~
3. LEGAL DESCRIPTION
1. DATE
/d~7 hs-
/4"rr ~71/0/..
LOT l, BLOCK
ADDITION Z;; "'>~ l..~
4. OWNER
?-e ~......
5. ARCHITECT
7
PID ~~ -II{ - DC) ~ - b
JAddress) Jt-
?t::J~r /5~ 5"r,....
(Address)
(Tel. No.)
"10/ /-~.;t/ S-
(Tel. No.)
--- -----
6. BUILDER (Name)
(Address)
(Tel. No.)
7. TYPE OF WORK
Heating 0 Plumbing 0 Reroofing 0 Porch 0
Fin' Attic 0 Residin~ Finish Basement 0
10. CULVERT SIZE
Yes No
Width
1. While
2. Pink
3. Yellow
File
City
Applicant
1./18
'1'5- ~
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) ,. (Width) r
/d /~
12. NO. OF STORIES
/
{Dept~ t:7 ,.
13. TYPE OF CONSTRUCTION
(../ CJ cJ
14. FLOOR AREA APPORTIONMENT USE
po %'1' ~ /Y1f01.0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ~TIMATED ~UE
~ ?~-t:J. -
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 men' ned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans.
building offici n revoke this perm~ ju e. ermore, I hereby agree that the city official or a designee may enter upon the property to perform n
X ~-~ II}
Signature Ween.. No.
PLOT PLAN LI
AmountBroughtForward .................. $ 27 (,,3
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Side
Side
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CU~ OR CROWN
OF STREET K,Q~ . .tf- ( f-
USE OF BUILDING
S; "
TYPE OF CONSTRUCTION: I II III IV tS5'
Occupancy Group A BEl H~..f1
Division 1 2~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION fJ50. 0 CJ
City;
Permit Fee ................................... $
2'1. ?e;:-
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
.:'8
-:;-
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
o COPIES
Check if
Deferred
o Sewer & Water Connection Fee ........... $
o
WaterTowerFee ........................... $
21. . to ~
Permit When Approved.
Date J()"'-30-~
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 2'1. Co 3
Paid I ::J9. ~3 Receipt No. .,:; 7lf (.. ('\
Date Id-/~q /q" By ~
above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
s a temporary Certificate of Zoni~g co3JPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
/O-:SO.c:;~
Date Special Conditions ~ any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
Issued
9S~J/? t
White . Building
Canary . Engineering
Pink . Planning
Th. C.nl.r olth. Lak. Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~~~~ u..LJ
APPLICATION RECEIVED ~/2, 1 III} ()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
t b b '/ In'.:JL JL.
Accepted
'><---
Accepted With Corrections
Denied
Reviewed By: ()2a.~
Comments:
I. QJ..Q. ~. l'tA~~~ L.cJ VA.
Date: /0 - 3:? - 96
t'"bYlAd!~tJ
u
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."