HomeMy WebLinkAboutBuilding Permit 94-0382
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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Permit No. ~ - 38- 2..-
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N.JG ~~~A
CITY OF PRIOR LAKE
BUILDING PERMIT,
ERTIFICATE OF ZONING COMPLIANCE
UTILITY CONNECTION PERMIT
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 (J . r'"
. I T:::.l:~ I L St:;;..
3. LEGAL DESCRIPTION
L-
O~\~
l,DATE
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1. White
2. Pink
3. Yellow
File
City
Applicant
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
LOT
BLOCK ~
~
ADDITION
PID 33-\~e -03~-O
.cl ~ c:\' r~~
'(Address)
bJ :4
(Address)
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, ESTIMAT~ALUE
4--.
~..A...-C,), ,-
17. COMPLETION DATE
5. ARCHITECT
6. BUILDER
(Address)
(Tel. No.)
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
Depth
. 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
onstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
e ore, I hereby agree that the city official or a designee may enter upon the property to perfo~ needed i'fR ions.
~ - 15:' 't'.
Ucense No. Date
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
x
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING
:i:...~"..t~ ~ Roc.\c.. ~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A BEl ~
DiVlSiorU/2 3 4
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o WaterTowerFee ........................... $
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Permit Fee ................................... $
J'7. dc)
Plan Checking Fee ......................... $
State Surcharge............................. $
. '2';-
Penalty ....................................... $
Septic System ............................... $
Other ......................................... $
Subtotal............................... $
11.7-S
Check if
Deferred
This
By
uilding Permit When Approved, t
Date~-/7~q
/
/7.2
Certificate of Occupancy
Issued
uest in the above application and accompanying documents is in accordance w~h the City Zoning Ordinance an may proceed as requested. This document when
onst~utes a temporary Certifi~e of ZoninJl. ~iance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
p-/?-(5
Ity Planner Date Special Conditions ~ any
24 Hour notice for all inspections 447-4230 9:00 a.m. . 10:00 a.m.
q~-,J q2-~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ o....O..J... f) O~
APPLICATION RECEIVED
The City of Prior Lake BUILDING Department has reviewed the
building permit application for construction activity located at
Accepte~
Reviewed by:
4r~ Accepted With Corrections
Date &-/?-?L(
Comments:
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4.11.. LA- ~
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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 fo~~ 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