HomeMy WebLinkAboutDemolition Permit 95-0008 O pR ��R� CITY OF PRIOR LAKE
� y 1. White - File
v , m DEMOLITION PERMIT 3. Yelow - pplicant
Permit No. C�
DIRECTIONS 1. DATE �� ...ZG .-�,�' BUILDING INFORMATION
SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN 7. SIZE OF STRUCTURE
BEFORE PERMIT ISSUED
(Please print or type and s9n at m). 8. NO.OF STORfES
S! / D�� �2✓c,c-�,a.�c.e_-,►�-- SS3 7 2-�'7 �
2. SITE ADDRESS 9. TYP OF CONSTRUCTION
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3. LEGAL DESCRIPTION
)� t0. COMPLETION DATE
LOT BLOCK PID �>'��'`I — ��`'� �
ADDITION �oS � ec `a �.C���. // � 3- '9�
4. , O p WNER (Name) (Address) (fel. No.)
(.�i� OF �+O�ti �( td O L-� irtG_._ �7 - s/a 3 e
5. A ITECT (Name) �ddress) (fel. No.)
. �- ,I,✓ � �o o s �. �. . /�-��/c.�P�s' `�3� -S'sa B
6. CONTRACTOR �n�m (Address) Rei. No.� yy � _ y ,� 3 a
G; ✓ O � 2�`ore..- �r�,e�--
I hereby certify I have furnished information which is to the best of my knowledge true and 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. I am aware that the building official can revoke this permit for just cause.
Furthermore, ! h reby ree that the city official or a designee may enter upon the property to perform needed inspections.
x /D -" 2G ^ �'i�"
Signature Date �
FOR ADMINISTRATIVE USE
METRO SAC UNIT DETERMINATION �/ 1.� ���_ MATERIAL FILED WITH APPUCATION
O Site Restoration Plan
O U61ity Abandonment Plan
O Sewer Abandonment
USF�,QF BUILDING SITE RESTORATION PLAN O Water Abandonment
//
/ U� ��� l ��'���--� Accepted by � Electrical Abandonment
Rejected by O Other� � � �� � �
CREDITS 1� � �'�`�'
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TYPE OF CONSTRUCTION: I II III IV � Park Ded. Credit ................................................ $��_
�
SACCredit ......................................................... $
Occupancy Group A � E I H� M ��
Sewer & Water Connec. Fee Credit .................. $�� ctic�
Division 1 � 3 4 ,,`, -+
Water Tower Fee Credit .....................................$ ��_
o�
Other.................................................................. O
This appli es your TAL CREDITS
demolitio ' ved ........................ $
By Date �� �� `- (� Issued by Date l c5 '� /
This is to certify that the e uest in the above and accompanying documents is in accordance with the City Zoning Ordinance and
may ro as reque
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City lanner Date Special Conditions if any