HomeMy WebLinkAboutBuilding Permit 93-0362
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Q7 '\. . ~ r ')
Permit No. ~ -.::::I...c> r;:;I--
OCT
L'
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 I
f.,- c....lte..--
1. DATE
tJ-/tf-93
1. White
2. Pink
3. Yellow
File
City
Applicant
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Hel~ (Width) (Depth)
LOT
ADDITION
PID 05'-;:1, / ::.::;~ fb?l-()
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
I
5. ARCHITECT
(Name)
(Address)
6. BUILDER
JAddress)
" :?t-
Septic 0 Heating 0 Plumbing 0
Addition a Finish Attic a Residing a
7. TYPE OF WORK
New Construction a
Chimney a Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
I hereby certify at I
the above me oned
building Q can
X
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ESTIMATED.VALUE
, / dO,- tdJ
17. COMPLETION DATE
2,-J ...03
(Tel. No.)
Reroofing 0 Porch 0
Finish Basement a
10. CULVERT SIZE
Yes No
ich Is to the best of my knowledge true and oorrect. I also certify that I am the owner or authorized agent for
to all existing state and local laws and will proceed In accordance with submitted plans. I am aware that the
, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
/ f- J'I-- 93
Ucense No. Date
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Front
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING ?'.2/z..-_ C I~L~C---c ~:::.
(/...::..:bC:'-4 b .o~<>-":'~
TYPE OF CONSTRUCTION: I II IIIIV0j)
Occupancy Group A BEl ~M
Division 1 2(!.l4
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
City:
Permit Fee ................................... $
5:,,-4' . c> C'~
Plan Checking Fee ......................... $
. /" ...-~
I. 0 ~
State Surcharge ............................. $
Penalty ....................................... $
Septic System ............................... $
Check if
Deferred
Other ......................................... $
s.s:-. ~ ~
By
Your Building Permit When Approved.
Date ! ( - ;.). _ C'h
Certificate of Occupancy
Issued
Side
MATERIAL FILED WITH APPUCATION
SOIL TESTS 0 ENERGY DATA a
PILING LOGS a
PLANS & SPECS ,J-.
SURVEY 0
:s,o~ ~
PLOT PLAN
a
Amount Brought Forward . ........ .... .. ... $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
Ucense Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
a Water Tower Fee ........................... $
Water Tap ................................... $
Other ......................................... $
Other ......................................... $
Total Due .............................. $
Paid Receipt No.
Date By
e application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
m Certificate of Zoning compliance and a1IOYiS construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
II-Z~'.
ome S~~C~tionSijMy
24 Hour notice for all inspections 447-42309:00 a.m. '10:00 a.m.
PERCOLATION TESTS 0
SETS
COPIES
c?-
s,~ .. ,,=.:;;:
~.~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~1J)~~ __.db A
/{)-- /;f ~ 9L1
The City of Prior Lake BUILDING Department has reviewed the
building permij application for construction activity located at
/j~0L/ Lc-~~/~ '__ )~~"- 0____ .
- +~
Accepted 'ed
Reviewed by:_ .. --~
Accepted with Corrections
Date ~/ I-:J~-"l~
Comments:
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. II