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May.11. 2011 11:16AM QUIRING No. 6533 P. 1
a .i rxta CITY OF PRIOR. LAKE Date Rec'd
DEMOLITION PERMIT , / / //
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4,..„. 4r) .
ONES
PERMIT NO. / / , 4. 7
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1 ADDRESS . wee e use)
i g 4'6 8 5 d y '} 1 Prith, LJ
LEGAL DESCRIPTION Write use only) .
LOT - BLOCK ADDITION _ - Pro 25. 04 (. 004 .0
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owrn t „,�ecsa�, pF i t, c- 1(ti ��) 6 I a - ?30 - 2 6 5”
. (Name) {t
carry cTOR �� 6 . "614 g(11 1
(Compa Name) r" YIVA' 7C. S 1t +tL* (Phone)
(Contact Name) , t;% S - _ - - -- • (Phone)
(Address) 1 Ch.
K _ Le cal gt. Cr r _ [tilt.,
the ofBu ldmv' ? NATIONAL BUILDING CODE
Type of Construction: 1 11 IR IV V AB
(j. ,o a C.t>r .- Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 •
MPCA NOTIEICATION OF INTENT TO PERFORM A DRUOLITlON - • -
t
I hereby certify m that I have furnished informatics), on this application construct�rt�w and correct. I also certify that to all existing state and local laws
1 a the owner or authorized agent for the above-mentioned property and that all
and will proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore,
I hereby the . :142,i: gal • a designee may eater upon the property to perform needed inspect ca s.
• • Signature Date -
t'_ c..f.�R. "�.,� .�. ��i :✓ T : •. 1. "� d r y .: -
This Application Becomes Your Demolition r ... • 74.;" .%
P , it When Approved �-z 0 ,c- ; /�
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Building Meld ,a 5A (Aftrr To & C/ iva
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Tits is to tb*tthe mom Oa the *bow zppli:atioa and a000arpsityiei *moo= Is to amocdaace with tha City Zoaiag Ordinance and may i rcc d as
/ / . —//
g
/ r � , Dad special Conditions, if say
34 hour notice for all Insp
nspectioas (952) 447A854,fax (952) 4474245
16200 Eagle Creek Avenue % Prior Lake, Minnesota 55372
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White - Building
Canary - Engineering
MLNNESO Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /oe 'i 7" Se-k(//&&:5
APPLICATION RECEIVED 5 1/.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
(257 Dom. 6 64- 6 .
Accepted Accepted With Corrections
Denied
Reviewed By: .J /'`v Date: 6 2 ' 1
Comments: 1° C�-W2-04.
� -- -- Tier, E 5
46 T 30 ialeolf 6, Tom-
r 7Y S i c.9 6-40 /N 1�)A-40. .
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIp
White - Building
� P Canary - Engineering
LANES° Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted / ` Accepted With Corrections
Denied
Reviewed By: # Date: - - I/
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
May. 11. .2011 11:16AM QUIRING No. 6533 P. 2
''
g A Site Restoration Proposal For Demolition
APPa
Address: $4
aleeir boxes below:
•
a Fill s nation to grate •
--------- - _ - •'(-.Sod ..aU bare song .. .• .. • ••- -. - .
'A Erosion control (see handout). erosion control until turf is established.
Mt v Cap sewer below .dc.* Mark location. Licensed contractor required.
NA a Cap water below grade.* Mark location. Licensed contractor required.
ph a Call City of Prior Lake Public Works Department (Call 952,447.9843 ox
952,47.9844) for water meter removal. ,
NA. o Cap gaa * (By gas co a
NP. a Disconnect electric at meter. (By electric company)
to. a Pump and fill cesspool/septic tank. Certified contractor required.
Nt. t Abandon well. Certified contractor require. Existing well
1 Remove a fisting structure foundation. ands, materials. and debris. **
sf Provi dust control by following means:
Water mist from a water lY i.e. neighbors, water tank)
2, Enclosure
3. Other _:
Comments: (provide survey or sari+ sit eplan ) .
` t,St cwt. ' rt�r • " . 3 ` ' i .' . j t ` defiers • is i -6.,;4.....,,N, 40 Ir.* w *gm. •..
dk A PROVED
BuiIdin 0 V ate Zg /(
Zoning Date
Grading .n,_ Date._
*Capping of utilities must be inspected.
** Final inspection and approval of restored site required. Deposit vilil bareUtmed after
approved fmal inspection,
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