HomeMy WebLinkAboutDemolition Permit 94-0002 ��� ``; CITY OF PRIOR LAKE
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� �' DEMOLITION PERMIT z. ei� - c��
� � 3. Yellow - Applicant
, �.�n �'O I i C-� �7 ►���
� Permit No.�� � �'"
DIRECTIONS 1. DATE BUILDING INFORMATION
SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN 7. SIZE OF STRUCTURE
BEFORE PERMIT ISSUED L/ O
(PI � s� � or e and sign at bottom). '7 ` ��'� 9 � 8. NO.O STORIES
2. SITE ADDRESS 9. TYPE OF CON TRUCTION
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3. LEGAL DESCRIPTION O� — O 10. COMPLETION DATE
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LOT BLOCK PID �� � �� ��lZ'� �
ADDITION �L�� � /� K S / � � � + �/
4. OWNER (Name) (Address) (Tel. No.)
p E� a Ti�c ,e S Ti9� r i N� /�S�/2C-D O.r �lS 2a.� D '�/ ��l -� G 3 a
5. ARCHITECT (Name) (Address) (Tet. No.)
6. CONTRACTOR (Name) (Address) (fel. No.)
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I hereby certify I have furnished information which is to the best of my kno edge true d 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. 1 am aware that the building officiaf can revoke this permit for just cause.
Furthermore, I hereby agree that the city -"`�'�� �r a designee may enter upon the property to perform needed inspections.
x 7F ��c� CLOSED DUE Tp d � � o �
Signature �ACTIVITy g�30/O1
METRO SAC UNIT DETERMINATION � --.�+=-� V�`�' ��" MATERIAL FILED WITH APPLICATION
O Site ResWration Plan �l ��
�=�L .-�\ v� - � w.. Q Utility Abandonment Plan �
O Sewer Abandonment
USE OF BUILDING SITE RESTORATION PLAN O Water Abandonment
�,A�2�� �,�)a� 1(J Accepted by l�► �2� O Electrical Abandonment
Rejected by O Other �� � �
CREDITS �` "'��- `�
TYPE OF CONSTRUCTION: I II III IV O Park Ded. Credit ................................................ $ ��• a�a
Occupancy Group A B E I H � M SAC Credit ......................................................... $ gOa. �a
Sewer & Water Connec. Fee Credit .................. $� Oa, ap
Division 1 2 � 4
Water Tower Fee Credit .....................................$ �O�.c�
Other ....... ................................................... $
OTAL CREDITS
This applica' es your ,2
demolition ' proved ........................
$ ^
By Date �� — issued b Date � � 7^
This is to certi t the req in the above and accompanying documents is in accordance with the City Zoning Ordinance and
m y ro eed requested.
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City anne Date Special Conditions if any
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