HomeMy WebLinkAbout16535 Tranqulity Ct Permit V C
� �F PR�pR ` DATE RECEIVED CITY OF PRIOR LAKE 1 , White File
�J . Pink city
U m / S 2 �' BUILDING PERMIT� , 3 . Yellow Applicant
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
t oz Own, � — AND UTILITY CONNECTION PERMIT Permit No . O
DIRECTIONS 1 , DATE
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 07 QdPWOo i. SEEM n Z� BUILDING INFORMATION
2 . SITE ADDRESS J c4 3j TPAS .1 (t) U ( l._I T L4 C -Dr . jiv 11 . SIZE OF STRUCTURE
^ j ►1e�iv j A NY G 'S- ST• <5u (Height) (Width) (Depth)
3. LEGAL DESCRIPTION 12 , NO, OF STORIES
LOT BLOCK PID Z "y 7Onown 063
13 . TYPE OF CONSTRUCTION
ADDITION �� iC�J �F� � -� 1I
now
4. OWNER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPO T ONMENT USE
i_r V M t %notTS l, '
5. ARCHITECT ( ame) (Address) (Tel . No.)
6. B ILDER (Name) (Address) (Tel . No.)4�Is- L 15 , NUMBER OF OCCUPANTS OR SEATS
EMSL:jEt%lf: MEt 1to 71 otli No 7ol OCCUPANTS
7 . TYPE OF WURK Firepi ce optic O Deck O Re-roofing O Porch O SEATS
New Construction Alterations O Addition O Finish Attic O Re-siding O Finish Basement O 1PROJECT COSTNALUE
MS 00
Chimney O Misc. 5 _ s I �� oc3 C)
8, PROPERTY AREA OR ACRES 9, PROPERTY DIMENSIONS 10. CULVERT SIZE 17, COMPLETION DATE
Sq , Ft, Width Depth Yes No
L - r
I her y certi th jp fumishe4 inform lon on this/etpplication which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for
th above n nod p rty that �aEjionst conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
uilding o " iai n r v k t ' p it or "fist c se. Furth rmore, I hereby agree that the city official or a designee may enter upon the property to perform neede inspections.
nat License No. Date
MEN
FOR ADMINISTRATIVE USE
SETBACKS: Required MATERIAL FILED WITH APPLICATION
Actual Front Back Side Side SOILTESTS O ENERGY DATA f]
BUILDING DEPARTMENT VALUATION OFF STREET PARKING PILING LOGS O PERCOLATION TESTS O
SPACES REQ . PLANS & SPECS O SETS
USE OF BUI DI
S r SPACES ON PLAN �® SURVEY O COPIES
PERMIT VALUATION 'T �l 000 . 1� PLOT PLAN O
TYPE OF CONSTRUCTION: 1 II III IV V Amount Brought Forward $
City: 9 . . . . . . . . . . . . . . . . . .
Occupancy Group A B E F H I R S U Park Support Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Division 1 2 3 4 _ SAC
Permit Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ • � �J Collective Street Fee . . . . . . . . . . . . . . . . . . . . . . . $
Plan Checking Fee . . . . . . . . . . . . . . . . . . . . . . . . . $ e 2 .
Sewer Tap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
License Check Fee . . . . . . . . . . . . . . . . . . . . . . . . . $
State Surcharge . $ caCr'
Pressure Reducer . . . . . . . . . . . . . . . . . . . . . . . . . . $
Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Meter Hom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Septic System . . . . . . . . . . . . . . . . . . . . . . . moos . . . . $ Water Meter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ Sewer & Water Connection Fee . . . . . . . . . . . $
WaterTower Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . $
ubtot 0ecesYou*rm
. . . . . . . . . . . . . . . $ Water Tap . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Thi Ap ti Buildi g Permit When Approved . Builder's Deposit . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
By Date & � Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Certificate Occupancy Total Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Paid 30450l� Receipt
Issued
Data B
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee as requested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner Date Special Conditions if any
``^^'' 24 hour notice for all inspections 447-4230
OF PRI91
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7
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White - Building
Canary - Engineering
The Center nF the Lake Counln Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
. vi A �Q t� Onwtn
APPLICATION RECEIVED
The Building , Engineering , and Planning Departments have reviewed the building permit
application f-or construction activity which is proposed at :
l� �— ' �
Accepted Accepted With Corrections
Denied
Reviewedy : Date : � — l 0 —6 �e
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 . "