HomeMy WebLinkAboutBuilding Permit 98-1364 �OF pR ��R� DATE RECEIVED
CITY OF PRIOR LAKE �. w��e File
v ,�m •� ' BUlLDING PERMIT � y + 2. P'°'` c"
� 3. Yellow Applicant
� TEMPORARY CERTIFICATE OF �
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. `��- �� �
DIRECTIONS t. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FIILED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) / O 3O �� BUILDING INFORMATION
�ITE ADDRESS 11. SIZE OF STRUCTURE
� 5`'13 G�DA v� p S. E J�R�o,t L cHe��t, cw��,, coewh>
AL DESCRIPTION 12. NO.OF STORIES
LOT BLOCK PID �-���� a
13. TYPE OF CONSTRUCTION
r
AD TION
ER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
v Su.sA.� ic S �9Co-00'�io
5. ARCHITECT (Name) (Address) (Tel. No.)
DER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
� � � � - ' OCCUPANTS
OF WORK Flreplace O Septic O Deck O Re-roofing Porch O SEATS
Construction O �Alterations O Addition O Finish Attic O Re-siding � Finish Basement O ' 16. PROJECT COSTNALUE
Chimney O Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 17. CO ATE
Sq. Ft. Width Depth Yes No
I hereby ceRify that I have tumished infortnation on this application which is to the best of my knowledge true and corts�L I also i t I the owner or authorized agent for
ihe above mentloned properly and that aii construction will conform to all existing state and local laws arxl wilt procMG ' acco n submitted plans. I am aware that the
buil ' fficial can revoke this permitjor'ust cause. Furthermore, I hereby agree that the city offiaal or a designee nter upo the properly to perfor�need d insp cUons.
,� ' � ��/d 3v S�
+- � ature No. �te
FOR ADMINISTRAT E U
SETBACKS: Required FlLED WlTH APPLICA710N
Actual SOI O ENERGY DATA O
Front Badc �de
BUILDING DEPARTMENT VALUATION OFF STREET PAR G PI G L S O PERCOLATION TESTS O
— SPACES REQ. S& SPECS O SETS
USE OF BUILDING o
SPACES ON PLAN SURVEY O COPIES
PERMIT VALUATION � �� PLOT PLAN O
TYPE OF CONSTRUCTION: I II III IV V unt BrougM Forvvard .................. $ • �
Occupancy Group A B E F H I M R S U ��'
Di visbn 1 2 3 4 / r SUppOrt F8e ........................... $
PermitFee ................................... $ / 7r" ,J C ......................................... $
Plan Check Fee $ Ilecdve Street Fee ....................... $
............................. � L� Sewer Tap ................................... $
StateSurcharge ............................. $� $
Penafty....................................... $ Pressure Reducer .......................... $
Pl umbing Pertnft Fee ....................... $ Meter Hom ................................... $
Mechanical Permit Fee $ Water Meter ................................. $
Sewer & Water Conneccti�on Fee ........... $
Sewer & Water Pertntt ...................... $ Water Tower Fee $
GasRreplace Pertnft ....................... $ Water Tap ................................... $
This Applicatlon Becomes Your Building Pertnft When Approved. Builders Deposit ............................ $
By Date Other ......................................... $
CertNicate of Occupancy Total Due .............................. $ .
Paid . D d Receipt No. �II
Issued
�te !1 1 Br
This is m c�tity that the requaSt in the above application and accompanying documents is in accordance with the Cily Zoning Ordinance and may proceed ue�ed. This doa��ment when
signed by the City Planner c�nsGtutes a temporary Certi6cate of Zoning compliance and allows constructlon to commence. Before occupancy, a Cerbficate �caipancy must be issued.
Ciry Planner Oate Spec�el Condkians fl arry
24 hour notice for all inspections 447-9850 9r �L
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