HomeMy WebLinkAboutBuilding Permit 98-1246 �OF PR ��R� DATERECEIVED' �
CITY OF PRIOR LAKE �. wt,;� File
v ,�m BUILDING PERMIT Z. P'°'` c"
� 3. Yellow Applicant
T�MPORARY CERTIFICATE OF
' ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. �" �
DIRECTIONS 1 •
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) QC�t � 3 �y 9� BUILDING INFORMATION
11. SIZE OF STRUCTURE
$• � l� � r� ` �� rC'1�.� .J 1 � � (Height) (Vlfidth) (UePth)
3. LEGAL DESCRIPTION 12. NO.OF STORIES
LOT BLOCK PID L���! ' D� 3' �
' � 13. TYPE OF CONSTRUCTION
ADDITIO "`'�
R (�lart�e) ' (Address) o.) 14. FLOOR AREA APPORTIONMENT USE
W at -S 6 �
5. ARCHITECT (Name) (Address) (Tel. No.)
ER ame) � s•' 15. NUMBER OF OCCUPANTS OR SEATS
- },. .
` OCCUPANTS
' SEATS
T�� Freplace O Septic O Deck O �;": Porch O
New Construction O Aft rations O Additio O Finish Attic O Re-siding O Finish Basement O 16. PROJECT COSTNALUE
Chimney O Misc.
S. PROPERTY AREA OR A RES 9. PROPER DIMENSIONS 10. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished infortnation on this application which is to the best of my knowledge true and correct. I also certify that 1 am lhe owner or authorized agent for
the above mentioned properly and ihat all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware ihat the
buildi fficial can ke ' t f jus �cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfortn ne ded in cJipns.
X � �,
�-• FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIA D WITH APPLICATION
Actual SOIL TES ENERGY DATA O
Front Badc Side Side
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING O PERCOLATION TESTS O
SPACES REQ. O SETS
USE OF BUILDING
SPACES ON PLAN O COPIES
�� PERMIT VALUATION 0• a T PLAN �O
TYPE OF CONSTRUCTION: I II III IV V �mo 0 0 ............. $
Occupancy Group A B E F H I M R S U C �'
Divisbn 7 2 3 4 Park Suppqt fee ... ................. $
Permft ................................... $ Z'¢ • 7 S SAC .... a :...... �.. .................... $
Plan Ch�k Fee $ Collectiv ee ....................... $
............................. I Z, Sewer ............................... $
State Surcharge ............................. $ � $
Penalty ....................................... $ ressul�6 Reducer .......................... $
Pl umbing Permit Fee ....................... $ Meter�9m ................................... $
Mechanical PertnR Fee $ WateiMeter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Pertnk ........ ............. $ Water Tower Fee $
GasFirepla P rtn .. . .... $ Water Tap ................................... $
This Appl' on ' ding Permft When Builders Deposit ............................ $
By ata � ane� ......................................... s
Total Due ....... $ � �o • �
Certificate of Occupancy .......................
Paid `7 (p - � Receipt No. '3 3 'L.
Issued
oete 1 o r 3�?$ Bv �t�
This is to certify that tlie request in the above applicatlon and accompanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requested. This document when
sic,�ned by the City Planner constitutes a temporary Certificate of Zoning compliance and allows constructlon m commer�ce. Before occupancy, a Certlficate of Occupancy must be issued.
City Planner Dete Special Caiditions if arry
24 hour notice for all inspections 447-9850
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