HomeMy WebLinkAboutBuilding Permit 93-0319
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b~ ~OR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.____;1.-/ AND UTILITY CONNECTION PERMIT c ? ,.
Permit No. -{ .;:::. - ~ I i
v C{ ? - [; 2-.J C>
V6 c/i S-E
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3. LEGAL DESCRIPTION
/((
1. DATE
7 - 2.3-?3
1. White
2. Pink
3. Yellow
File
City
Applicant
PID
~5-)~ S:t)J~-O
(
LOT
ADDITION '1 r
4. OWNER /J (Na e)
'Cu..;! C,
5. ARCHITECT (Name)
. (Tel. NO.) l.(
. ?0fQ-f LcJ~
(Tel. No.)
13. TYPE OF CONSTRUCTION
LV () J)of .
14. FLOOR AREA APPORTIONMENT USE
W s;.r.'I"Zo., -.
6. BUILDER (Address) (Tel. No.) I.{f( 7 -{p Z '1 ( 15. NUMBER OF OCCUPANTS OR SEATS
I ck =T;.s.i f>f'~NIi~ &::/e. iu. t 17 -)/{, C; OCCUPANTS 2.-
7. TYPE OF WORK Fireplace 0 Septic 0 Heating Plumbing 0 Reroofing 0 Porch 0 SEATS
New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Residing 0 Finish Basement V 16. E;STIMA TED VALUE
Chimney 0 Misc. s-:. (},{) t)
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE 1 . COMPLETION DATE
Sq. Ft. Width Depth Yes No ~~7 . 5
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 aocordance with submitted plans. I am aware that the
buildi . aI ev e this it for just cause. Furthermore, I hereby agree that the city ofllclal or a designee may enter upon the property to perform needed inspections,
J Cj-2J-9.J
Uoens8 No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Bad<
Side
Front
PROPOSED GRADE FOUNDATION OFF STREET PARKING
IN RELATION TO CURB OR CROWN
OF STREET SPACES REO.
USE OF BUILDING (;.....,z+.. J:-I ~ SPACES ON PLAN
F?:..,~ L PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV ?!J
Occupancy Group A BEl H@M
Division 1 2 ~
-:1.
City:
Permit Fee ................................... $
<:::l{. D ~
"(
Plan Checking Fee ......................... $
or
..... { ~
I . ';;$; ~
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
q ~. ~~
Check if
Deferred
Subtotal............................... $
This Aplication Becomes Your Building Permit When Approved.
By
Certificate of Occupancy
Issued
Date
Side
MATERIAL FILED WITH APPUCAnON
SOIL TESTS 0 ENERGY DATA 0
PIUNG LOGS
o
PLANS & SPECS 0
Cl~~
SURVEY
PLOT PLAN
o
o
Amount Brought Forward .... ..... ... . ..... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Ucense Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o Water Tower Fee ........................... $
Water Tap ..... ........... ................... $
Other ......................................... $
Other ......................................... $
Total Due .............................. $
Paid 0 j 0 Recei No;
i
PERCOLATION TESTS 0
SETS
COPIES
0D.Cot:::!.
Date
This is to certify that the request in the above appIlcaIion and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as r
signed By the City Planner constitutes a temporary Certlfjcate of Zoning compliance and allows construction to commence. Before occupancy, a Certllicate 0
City Planner
Date Special Conditions ~ any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~Ib-
9-~9-cr3
APPLICATION RECEIVED
The city of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
16~~. 0 7 ~.'- -f!---<--<L-~) ~ ~~
Comments:
+ ~r;;nied
by: ~
~{Z
Accepted with Corrections
Date ( ~, ~ - 91~
\=;'.,.... " ~ \-. (,....r -r'_.~ ~. ST' .
Accepted
Reviewed
b~~~-".J+
liThe 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."