HomeMy WebLinkAboutBuilding Permit 94-0373
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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Permit No. .121 ,... "3t-z ~
m@~"--
~-
-~CITY OF PRIOR LAKE
BUILDING PERMIT,
RTIFICATE OF ZONING COMPLIANCE
ILlTY CONNECTION PERMIT
AUp~~ti~R
AN
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITI:,ADDRESS 11' ,7
1i-fJ. '10 L'tU/d/e.vJclttK. /-t\.. N.t.
1. DATE
1Ik1 Ii, /11J
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
LOT fItt,.
PID ~S-~\S--O':l~-O
JJ.J..elf/L .
p:el. No.)
~45' - ~ ~ fit,
'""2-
BLOCK
~ C?~~
(~me)
CA...#l~rl-K.(' t!..
(Name)
4~
ADDITION
4.~WNER .
~-Utu ~ fU d
5. ARCHITECT
IAddress)
<7v.zte~.1l1-t
(Address)
1. White
2. Pink
3. Yellow
File
City
Applicant
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
(Address)
(Tel. No.)
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. ES'fIMATED VALUE
2sC/C' ~
17. COMPLETION DATE
.:r a...t\ i q (t ~
(Name)
Sd...n1 i..
Septic 0
Addition 0
Reroofing 0 Porch 0
Finish Basemeni)4
Fireplace 0
Alterations 0
Heating 0 Plumbing 0
Finish Attic 0 Residing 0
9. PROPERTY DIMENSIONS
10. CULVERT SIZE
Width 0"1'<1 I
Yes I~L>
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 accordance with submitted plans. I am aware that the
bUildin~fficial can revo.ke ,this Pfmit f9( just cau~. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perfor~ needed ins~ions.
X ~~ C. tj/~-;t{L Y-/I- ~ -
Signe)Cire License No. Date
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING lOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $ ~
Total Due ;.o;.s5..................... $ Cj/J. ~
Paid 7t>,;$ Y Receipt Noo)l/..bl
Issued f fI- mS-
Date ?f..- 3/, C; By
This is to certify tha~the r uest in the above application and accompanying documents is in accordance w~h the City Zoning Ordinance and !nay proceed as requested. This document when
S~d ~ the City PI const~utes a temporary Certificate of Zoning com Iiance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
&; " ~-/S--
City Planner Date Special Conditions ~ any
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
U~ OF BUILDING
n~.~~
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
PLOT PLAN
o COPIES
o
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A BEl Hl!!b. M
Division 1 2~
Permit Fee ... ......... ........ ......... ...... $ 54. Or<)
Plan Checking Fee ......................... $~
State Surcharge ............................. $ I . 25'""
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
SewerTap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Check if
Deferred
o
o
Subtotal............................... $
'1D.~
r Building Permit When Approved.
Date ~ -/~-9 '-/
24 Hour notice for all inspections 447-42309:00 a.m. '10:00 a.m.
q 'f~3 7,-3
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT .BUULr 1J;. .J:k.-nk/
APPLICATION RECEIVED f/v/?q
The City of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
/L/29LI .~ (~."jta'?-1rr1. l~l'~ 1 [.;
Accepted ';2 Dlied
Reviewed by: ( 0 -.....~~
Comments:
I. ~~~ C(.it.c~ ~~~ ;::'"""-~ ~ .
~ ~oQ. ill__ p\~ ~\J~~ N~ ~A
Accepted with Corrections 'X
"
Date 8 -(g-:... 7' L-{
1.4~~ -
"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."