HomeMy WebLinkAboutBuilding Permit 98-0023 �pF pR �O/� ` � DATERECEIVED '� CITY OF PRIOR LAKE 1. White File
� "Y \� 2. Pink City
v , rn BUILDING PERMIT, i� 3. Yellow Applicaot
TEMPORARY CERTIFICATE OF �
ZONING COMPLIANCE
' AND UTILITY CONNECTION pERMIT Permit No. BP 'J�►.3
DIRECTIONS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FlLLED IN '_ Z U �,�--, c�"
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) BUILDING INFORMATION
2. SITE ADDRESS ZONING 11 SIZE OF STRUCTURE
! L /� � p I �C Ge �. Q✓1 -� s; � p� �Hei9��� M�h) ��eP�
3. LEGAL DESCRIPTION �� 12. NO.OF STORIES
LOT 7 � A 6 J� BLOCK 1 i �v' /�✓ pl p el �� /� A � U�lJ �
13. TYPE OF CONSTRUCTION
ADDITION ...-.�-�"' .' •
4. OWNER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
ss �-/�!7- 2 �) �
5. ARCHITECT (Name) (Address) (Tel. No.)
B. BUILDER (N� e) , (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
n s � . � i �� � - � �d I OCCUPANTS
7. TYPE OF WORK Flreplace D Septic O Qeck O Re-soofing O Porch O SEATS
New Constnicdon d Alterations O Addition O Finish Attic O Re-siding,� Finish Basement O 16. PROJECT COSTNALUE
Chimney O Misc. � � � ,j 7 �
. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. C MPLETI N DA
�q. Ft. Width Depth Yes No ���- �
1 hereby certity a I have Infortnation on this applicadon which ts to the best ot my knowledge true and correct. I also ce t I am the owner or authorized agent for
the above men o p a that all constniction will �ntorm to all existlng state and local taws and will proceed in accord ubmitted plans. I am awere that the
building offic� ca revo 's ' or �ust cause. Furthertnore, I hereby agree that the city offlcial or a designee mey enter up roperty erform needed inspecdons.
. �x ZS/ � /�p-q�'
Si�eture Lk:ense No. pa(e
� � FOR ADMINISTRATIVE USE
..� tBACKS: Required IAL FILED WITH APPLICATION
Actual ,: SOIL S O ENERGY DATA O
Front 6ack side side ; � ,
BUILDING DEPARI'MENT VALUATION OFF STREET PARKING ILING LOGS O PERCOLATION TESTS O
�
SPACES REQ. LANS 8 SPECS O SETS
USE OF B 1 DING
��� � SPACES ON PLAN s `"' SURVEY O COPIES
� � r_) f 1 �` PLOT PLAN O
PERMIT VALUATION �
TYPE OF CONSTRUCTION: I 11 III IV 1� `' ' � '
Ciry: ught Forward .................. $ � lo �� ��
., �
Occupexy Group A B E F H I M S U SAC ....., rt Fee ........................... S
oivieton 1 2 (� a ,
'`�'`-�............................... s
Pertnft Fee $ / � I • ( .J Collector Street Fee ....................... $
Plan Checking Fee ......................... $ Sewer Tap ................................... S
2 �/ License Check Fee ......................... $
Stete Surcharge ............................. $ � Pressure Reducer
......................... $
Penatty ....................................... $ Meter Hom ................................... $
SepticSystem ............. ................. $ Water Meter ................................ $
Other ......................................... $
Sewer & Water Connectton Fee ........... $ �
�/ � r ., Water Tower Fee ........................... S
Subto 1 ............................. $ (�
WaterTap .................................. s
; •
This A�iplic� i s Your Bui ing Pertnit When Approved. Builder's Deposit ............................ $
By n ''• Date /' 2 U' '�U Other ........................................ $
✓ Total Due .............................. s • U
cert�r�cace or o��pa�,cy 3
Paid •Q U Recei t No.
��
� "' � Date ��).() � B /
This is to certify C�at tlie request in ihe above applicatlon and accompanying documents is in accordance with the City Zoning Orclinance arrcl may proceed as uested. This document when
signed by the Criy Planner constftutes a temporary Cettificate of Zoning compiiarxe and aliows construction to commence. Before occupancy, a Cett�fftcacede ' Occupancy rtwst be issued.
CAy Plenner Date Speciel Conditiau 8 arry
24 hour notice (or all inspectbns 447-4230
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