HomeMy WebLinkAboutBuilding Permit 95-0518
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY! c.~;''''-
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CITY OF PRIOR LAKE
BUILDING PERMIT,
EMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. q~ - ~t!>
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ApD~ESS .
1/ ~ rvl7r~ AV'-e
3. LEGAL DESCRIPTION
LOT DC/. T'- (J T . A BLOCK /
ADDITION V A L ~ A nlll
4. OWNER (Name)
/'/lon/}.f JLI<
(Name)
1, DATE
3/ C(J-
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
PID
s-" '~OO5'-O
LCJ T Y
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
'0 w.J'~'
(Address)
/ C if. I j)., 1tr11"1t
(Address)
(Tel. No.)
IfS { tJ C
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Tel. No.)
fl"\
7. TYPE OF WORK Fireplace 0
New Construction 0 A1t rations 0
Chimney 0 Misc. e-
8. PROPERTY AREA OR ACRES
Sq. Ft.
Septic 0
Addition 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
Reroofing 0 Porch 0
Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS -~
16. EST~ATEDVALUE 101',11 t'C.1lJ<:.
if JOO . DO
17, COMPLETION DATE
6. BUILDER
(Name)
(Address)
(Tel. No.)
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes 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 will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
build in offi' can revoke thi mit for I cause, rthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
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
_'Deck...
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A BEl H ~ M
DMslon 1 ~
Permit Fee ................................... $
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ',ID"Z.C). O~
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
PERCOLATION TESTS 0
SETS
COPIES
City:
Amount Brought FOlWard .................. $ s;,~ . q 1_
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Ucense Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o Water Tower Fee ........................... $
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Slot . 00
35".10
. P> I
Subtotal............................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ BCi. cr. {
PaId .? Recel tNo..L ~,r
'1/ / ~
Date 1'1/
I the request in the above application and accompanying documents is in accordance w~h the City Zoning Ordinance and may proceed as. uested. This document when
p. r const~utes a temporary CertifICate of ZoniQ9 compliance and allows construction to commence. Before occupancy, a Certificate 0 upancy must be issued.
(1-1'/4,') "'F"ootl~ ~\HlKIl... llAd~. - ~~~ S'P~ 1'5 -4t:tt(
anner Date IJ 'II sPe\ial Conditions ~ any
24 Hour notice for all inspections 447-42309:00 a.m. .10:00 a.m.
B 1. lL-
Check if
Deferred
Issued
qJ - 516
, f; I \
n
Thr Crntfl of lhr ,Lakr Counlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engjneering, and Plannin~fDepartments have reviewed the building permit
application for construction activity whicn is proposed at:
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Accepted ./
Accepted With Corrections
Denied
Reviewed By: ~. tv1tGHP--eL FFJ.t-
Date: \ l/lIo/199'.s-
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."
White - Building
Canary - Engineering
Pink - Planning
Th. C.nl.. of Ih. L.... Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
l'~ ~~U
II/jJ/CjJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l~qJ\ V!li~~tt ~~
Accepted X
....,., -----
Accepted With Corrections
Denied
Reviewed By: G?- o1i!..~-
Comments:
Date: tl-/c.f-~-
"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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The Cenler ollhe Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
~
"
;i~ '
NAME OF APPLICANT
APPLICATION RECEIVED
\'~ ~~
II/jJ/'1J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
}fog~ \ 0~0)J:t- ~
/'
Accepted
Accepted With Corrections
Denied
Reviewed By:
It R4aW1
IltntJl ~
Date:
11/;5/95
. f
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."