HomeMy WebLinkAboutBuilding Permit 00-0448
DATE RECEIVE9
011 /46~
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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1. White
2, Pink
3, Yellow
File
City
Applicant
JUN - 5 am
Permit No. 00- 0 LJ~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS .
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3, LEGAL DESCRIPTION
1. DATE
#1/aO
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (WIdth) (Depth)
12. NO, OF STORIES
LOT
;LOCK
,PID ss- en\.- ()i...)t./-Q
ADDITION
4. OWNER I (Name). JJ, J . (~ddress) . A 1..
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5, ARCHITECT (Name) (Address)
13, TYPE OF CONSTRUCTION
/f~OO.p
(Tel, No,) . 14, FLOOR AREA APPORTIONMENT USE
/~/5() #1' /!t:ldLa #VtL-S ~
(Tel. No.)
6, BUILDER
(Name)
Fireplace 0
Alterations 0
(Address), (Tel. No,)
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/JJI/;/l~apabs ~ /hili :>,J~~tJ
Septic 0 Deck 0 Re-roofing~ Porch 0
Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
,
.&woe/' /LJof/~ ~LL
7, TYPE OF WORK
New Construction 0
SEATS
Chimney 0 Misc,
8, PROPERTY AREA OR ACRES 9, PROPERTY DIMENSIONS 10, CULVERT SIZE
Sq, Ft. Width Depth Yes No
I hereby certify that I have fumished infonnation on this application which is to the best of my knowledge true and correct, I also certify that I am iIle ownet or authorized agent for
the above mentioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans, I am aware that the
building officijll can revoke this pennit for just cause, Furthennore, I hereby agree that the city official or a designee may enter upon the property to perfonn needed inspections,
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Signature License No. Date
16. PROJECT COSTNALUE
/49/:3, tXJ
17, COMPLETION DATE
rd2 0 100
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
BUILDING DEPARTMENT VALUATION
OFF:
CLOSE FILE
10/28/03 MP
MATERIAL FILED WITH APPLICATION
IL TESTS 0 ENERGY DATA 0
ING LOGS 0 PERCOLATION TESTS 0
NS & SPECS 0 SETS
WEY 0 COPIES
I PLOT PLAN 0
Front
Back
USE OF BUILDING D " \~
Yl..b ~'L
SPAC
SPAC
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 ..-, ~ J. '7 S-
Pennit Fee ................................... $ f "-I.
City:
Amount Brought Forward . .. .. .. .. .. .. .. ... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............ ................. $
State Surcharge............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
J. :;v-
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Sewer & Water Pennit ...................... $
Water Tower Fee ........................... $
Water Tap ............................... .... $
Builder's Deposit ............................ $
Other......................................... $
iotal Due .............................. $ '7 t.... ~
Paid ~(I utJ Receipt No, ~J b34
Issued - ... ~
Date ' ~ By t,
This is to certify that the request in the above application and accompanying documents is in accordance with the City zonin~~cJ and may proceed a{r quested, This document when
signed by the City Planner constnutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certificate 0 cupancy must be issued,
Gas Fireplace Pennit .. .................... $
es 0 BUildingpenn~'tW n r'~~-
Date P'lT
.{
Certificate of Occupancy
City Planner
Date
Special Conditions W any
24 hour notice for all inspections 447-9850