HomeMy WebLinkAboutBuilding Permit 93-0403
CODE REOUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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DIRECTION
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom
2. SITE ADDRESS
q 1.:30 frO s/ 'f
3. LEGAL DESCRIPTION
LOT ~<<--Hc." 23
!.aRe- ~.,
BLOCI< 'T o:.v.1 <;k,p
\ t:; PID Rc,,'1 22
~2:-: ~,3-'/)O~ ~
)
ADOmON
(Tel. No.)
'l($-7632
(Tel. No.) /
4i'2-. b2 ~7(j 0
(Tel. No.)
4.
(Address)
C... bov e...
(Address)
New Construction 0
FlreplaceO SeptlcO HeatlngO PlumbingO ReroofingO PorchO
Alterations 0 Addition 0 Finish Attic 0 Residing 0 Finish Basement 0
+
ChlmneyO Misc.
8. PROPERTY AREA OR ACRES
S . Ft. loA f!..
10. CULVERT SIZE
Yes No Y
9. PROPERTY DIMENSIONS
Width 67. J Depth 6 <{ t. 72
1. White - City
2. Pink - Applicant
3 . Yellow - Assessor
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT
USE
15. NUMBER OF OCCUPANTS OR
SEATS
OCCUPANTS
SEATS
16. Es,TI~ATED VALUE
O.OOf),fJO
17. COMPLETION DATE
I herlIby certify that I have lurnlshed Intormatlon on this application which Is to the best 01 my knowledge true and correct. I also cerllly that I am the owner or authorized agent
lor the abOve I ed property and that all construction will conlorm to alle.lstlng state and local laws and will proceed In accordance with submitted plan.. I am aware that
the bulldln IIlcla an revoke thl. permit lor just ca!,ae. Furthermore, I hereby agr.. that the city olllelal or a design.. may enter upon the property to perlorm needed Inspee.
t~ns. ~ h
X - , Signature. /1 9. ~le
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
Back Side Side
PILING LOGS 0 PERCOLATION
OFF STREET PARKING fit TEST 0
PLANS & SPECS SETS
SPACES REO. COPIES !L
SPACES ON PLAN SURVEY 0
VALUATION I ~ '" ()~~ PLOT PLAN
Amount Brought Forward. . . . . . . . . . . .. s 2Cf ~. ( ~
Park Oed. . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Sac.................................. S
Plumbing ... . . . . . . . . . . . . . . . . . . . . . . . .. S
Sewer Tap. . ... .... . ... . ... .... . ... .. S
Sewer Hook-up. . . . . . . . . . . . . . . . . . . . . .. S
Water Hook-up. . . . . . . . . . . . . . . . . . . . . .. S
Meter Horn. . . . . . . . . . . . . . . . . . . . . . . . . .. S
Water Meter. . . . . . . . . . . . . . . . . . . . . . . . .. S
Check if OSewer & Water Connection Fee. .... .. S
Deferred OWater Tower Fee.... .... . ... .. .. ..... S
Water Tap. . . . . . . . . . . . . . . . . . . . . . . . . . . . S
City Fee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
otal Due.. .. . .. .. .. . . .. .. . .. .. SZO:::Z 0 .
Recel t
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING-K..~ ~~
PERMIT
TYPE OF CONSTRUCTION; I II III IV
Occupancy Group A BEl H ReM)
DlvISIOrQ) 3 ~
Permit Fee . . . . . .. .. . .. .. .. . .. .. .. . ... s / 7 I. D ~
Plan Checking Fee. . .. .. .. .. .. . . .. .... S I l \ . I -:::
State Surcharge...................... S ~. c <:::::.
Penalty . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Septic System.. . .. . .. . . .. . . . .. . . . .. . . S
Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. S
Subtotal.. . .. . . .. .. .. .. .. .. .... s 2.q ~. t:::::"
City:
Date I(-~&-~
Thlala to certify that the requeat In the abOva appllcat~ and accompenylng docu.....nt.I.ln accordanca with the Ity Zoning Ordinance and may proceed aa ueated. This docu.
...,t wIWIalgned By the City Planner conatltuea a temporary eertlllcate 01 Zoning compliance and allow. c!onstructlon to commence. Belore occupancy, a Carltl"eate 01 Occupancy
muat be Isaued.
City Planner
Date
Speela' Conditions if any
2~ Hour notice for all in.pections 447-<1230 9:00 a.m. . 10:00 a.m.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
. Jl+;./
~a~)te~
APPLICATION RECEIVED- i , ~
NAME OF APPLICANT
~: l~,:~~,_ ; / -/9 - 9.5
,
The City of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
4/5IJ /-<ltJ~~. V?~
Accepted ~
Reviewed by:
Comments:
+
Accepted with Corrections
Date / I~ ~~-I ~
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"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."
SCALE: 1"-100' 0'
I
N89.35'24 "W NORTH LIIE OF THE SOUTH 841.72 FEET 7 vt/ 678.8
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589.35'24"E 678.8
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fZ2Z PROFt:JSE/) (!.OI./:57 R:JCT/J:.
I twe_ certify that this lurvey. plan or
report was prepared by me or under my
direct supervision and that I am a duly
ReQlstered Land S\lrveyor under the
Laws of the Stote of Minn.sota.
.
.
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'~('J~'Y-
Mn. Reg. No. 1~3~
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BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/
i\ I
./YCLAL ~lc~YL; v)
//-/~_ CI ~ '
, -
APPLICATION RECEIVED
The City of Prior Lake PLANNING Department has reviewed the
building permit application for construction activity located at
~/// ~ ~ () . /4;0 ~ ~.k-y/ f-)
Accepted
/
Denied
r . ~ccepted with Corrections
14~/ Date I J - / q. 9:;
Reviewed by:
Comments:
II ~ 19 -1;
"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."
~
,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ,~p~~ ~,el
APPLICATION RECEIVED / / - /9 -LJ...3
The City of Prior Lake ENGINEERING Department has reviewed the
building permit application for construction activity located at
.J/3JJ /# :7~' 77 ~-.,
AccePted~ Denied
Reviewed by:=-r: ~~
Comments: 1/ tJYlR..;
Accepted with Corrections
Date /1/~3(f3
"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."