HomeMy WebLinkAboutBuilding Permit 00-0226
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FillED IN
I
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2.S1TEADD~W-.S- ~PA?/NC 4/-<. HLJ
3. LEGAL DESCRIPTION 0 12. NO. OF STORIES
L{ ~lOCK 5 PID ~ $'-133-0851'
';)p (\ ~, ~ Cj Q" \~<;\+c/ 1e;:lJ.~j}~f.T~
~~~:: ~ 39S" ~~:f.,vS J.j)JrE /2b. ~o/b -5"/<,/:J-. 14. FLOOR AREA APPORTIONMENT USE
(Name) (Address) (Tel. No.)
6.~~~~zy ~P.-i2;;;;;)W3~~~ q;;--W~0
3,'/ ,~/S~ ,
7. TYPE OF WORK' Fireplace 0 Septic LJ Deck 0 Re-rooflnnfill" Porch 0
New Construction 0 Alterations 0 AdditIon 0 Flnlsh Attic 0 Rs-sldlng 0 "Il=mlsh Basement (]
Chimney 0 Misc.
- 8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yas No
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. '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
bui~icial ca evoke this e it for ju cause. Furthermore, I hereby agree that the city official or a desi~e may enter upon the property to p,rf?rm 'l.e.,ided i~ions.
X ~l ~ j;;J,/e egu '-f -,ot-VU
License No. Date
$~1
;;;;7000
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. DATE
L/ /'~/UO
;
LOT
ADDITION
4. OWNER
>>1111 t<.~ f
5. ARCHl rsCT
.....-
o
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit NO..J1!"'l - O~ 6
BUilDING INI'ORMA TION
1,. SIZE OF STRUCTURE
(Height) (Wldlh)
(Depth)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
MATERIAL FilED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
o PERCOLATION TESTS 0
Q SETS ~
Q COPIES :\;I- . f
2.::;<:5V .CJU Q ~
City: f""mou roug . .... $'
ollectlve Street e..............".".
ewerT . ..............\u:
educ .......................... ft
......il...... ,....................$
....... '......................;:
o action Fee ........... .;:
SETBACKS: Required
Actual
Front
..ok
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
USE OF BUILDING
.ees '7 ~
SPACES REO
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
Permit Fee ..........~i~~~~.~..~...~..~..~... $ '14 7 ~
Plan Check Fee ............................. $
State Surcharge ............................. 'I:
Pena"y ....................................... $
Plumbing Permit Fee ....................... $
I'?J~
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $'
..................................$
Builder's epasit ............................ ct
Other ......................................... t
Total Due ............................... "'7G.. 00
Paid '1l.&O Rece;ptNo..,7ISC(
Issued . A )
Date 'f I, alrflJ By /, 11
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning brdinaJce and may proceed as ested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate f 0 upancy must be issued.
24 hour notice for all inspections 447-9850
Special Conditions W any
Date
CRy Planner
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