HomeMy WebLinkAboutBuilding Permit 98-1433 OF pR ��R DATE RECEIVE� CITY OF PRIOR LAKE 1. White File
v ` m ~ BUILDING PERMIT 2. P'°'` c'
� 3. Yellow Applicant
' TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No.
DIREC710NS 1. DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN j
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) I f' j` ��� � BUILDING INFORMATION
2. SITE ADDRESS ���� 11. SIZE OF STRUCTURE
% S�� �.'l�.. S� cHe�nt> cw�an,> c�h)
3. LEGAL DESCRIPTION 12. NO.OF STORIES
LOT r�l BLOCK PID ��-! � r�I �� r /
� r,, �,- 13. TYPE OF CONSTRUCTION
ADDITION W � R �
4. OWNER (Name) (Address) � (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
�'1. t "4 . S� �l •2�3 \
5. ARCHITECT (Name) (Address) (Tel. No.)
6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK lace O Septic O Deck O Re-roofingl� porch O S TS
New Construction O Alterations O Addition O Finish Attic O Re-siding O Finish BasemeM O CT COSTNALUE
Chimney O Misc.
8. PROPERTY AREA OR ACAES 9. PROPE DIMENSIONS 10. CULVERT SIZE COMPLETION DATE
Sq. Ft. Width Depth Yes No
I hereby certffy that I have fumished information on this application which is to the best of my knowledgs e a orr I Iso cert I am the owner or authorized agent for
the above mentloned property and that all construction will confortn to all existing state and Iocai laws will roceed cco submitted plans. I am aware lhat the
building o' ial can re�this� rmit for just cause. Furthermore, I hereby agree that the city official or esignee ma nter up property to perforrn needed inspeCtlons.
X /•��r� ,._.--- rI B 1-tb- 4�
S• ,�,e Sa oa�e
R AD ISTRATIVE USE
SETBACKS: Required MATERIAL FIIED WITH APPLICATION
Actual SOIL TESTS O ENERGY DATA O
Front Back Sid
BUILDING DEPARTMENT VALUATION OFF ST ARKING PILING LOGS O PERCOLATION TESTS O
SPACES REQ. PLANS $ SPECS O SETS
USE OF BUILDING �� �— SURVEY O COPIES
SPACES ON P
PERMIT VALUATI `-�� PLOT PLAN O
TYPE OF CONSTRUC110N: I II III IV V Amount Brought Forvvard .................. $
Occupancy Group A B E F H t M R S U ��' `
Park Support Fee ........................... $ �
Division 1 2 3 4 ,
PermitFee ................................... $ � � � � SAC ......................................... $
' Collective Street Fee $
Plan Check Fee $ .......................
.............................
SewerTap ................................... $
State Suroharge ............................. $—� . 7�S $
PenaUy ....................................... $ Pressure Reducer .......................... $
Plumbing Pertnit Fee ....................... $ Meter Hom ................................... $
Mechanical Permit Fee $ Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water PertnR ...................... $ Water Tower Fee $
Gas Flreplace Pertnit ....................... $ Water Tap ................................... $
This AppRcatlon Becomes Your Building Permft When Approved. Buiiders Deposit ............................ $
ByDate Other ......................................... $
CertMicate of Occupancy Total Due .............................. $��., , d'n
Paid ��, --- Receipt No. �U � 8" S
Issued °"'['
Date ( • By
This is to cerdfy that the ►equest in the above applicatlon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requ . This documeM when
signed by the Cily Planner constitutes a temporary Certificate of Zoning compliance and allows c�nstrucdon to commence. Before occ�ancy, a Certlficate of ncy must be issued.
City Planner Date Special Conditions B any
24 hour notice for all inspecUons 447-9650
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