HomeMy WebLinkAboutBuilding Permit 00-0481
MIl
ro / I L,
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/2<6
I
File
City
Applicant
1. White
2. Pink
3. Yellow
Permit No. () () - 0 4?( I
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
14Ci~Lf ,~--S ~ I\v~ 1"\0~.
3. LEGAL DESCRIPTION
LOT
Q
~'(N'"
BLOCK
~h are.
ADDITION
4. OWNER.......,..., (Name)
J .eCl h f ~
5. ARCHITECT (Name)
1. DATE
bl/4/07J
,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
\
7_~~
PID a S" ~ n s - ()l"ld. - f\
\ ~i- At)\i\)
13. TYPE OF CONSTRUCTION
(Address)
2C/..t:A:A-"h , 10 t.u
(Address)
(Tel. No.) 14. FLOOR AREA APPORTIONMENT USE
It..fqq<-( e Sh1f('/tvt:
(Tel. No.) 'I'I7-<...f'f( l'
6. BUILDER
l'-<r-luS< r
(Name)
~O() fi' '-'
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
(Address)
3050 Lv aoofArf
--.--
, I On:lCl'l
Deck 0
Finish Attic 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
Septic 0 -
Addition 0
tfq 'J- 3 f'Y2.
~s
Re-roofi'lg Porch 0
Re-siding 0 - inish Basement 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
17. COMPLETION DATE
1 O. CULVERT SIZE
Yes No
I hereby certify that I have furnished information on this application 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
:U~th~ permit fO~~' I hereby agree that the c;};I(Ji'Ji a ),nery~ter upon the property to perltf; ~i C/ztions.
~ianAtlJ'" License No. Date
SETBACKS: Requin
Actl
CLOSE FILE
10/28/03 MP
BUILDING DEPARTI
USE OF BUILDING ~.~12.
mMINISTRATIVE USE
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
Side
CING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN 0
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4 ry 4, 1.5'
Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
(,.as"
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Gas Fireplace Permit ....................... $ Water Tap ................................... $
Thi~' i Ion _ . g permit7rz:;ioved. Builder's Deposit ...................... ...... $
By Date V b'D Other ......................................... $
/1 ,~
Certificate of Occupancy pa~ 7r~"'"'''''''''''' ~~~~i~: ~o~ i 7 ~ 1 ,
Issued Date L I J- Lf / rJ[) By (~ )
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~rdinanJe and may proceed ,s ~ qu;sted. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate cupancy must be issued.
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections (952) 447-9850