HomeMy WebLinkAboutBuilding Permit 94-0506
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D rn @ rn D'Yi [fcCITV OF PRIOR LAKE
,I .___n___q BUILDING PERMIT,
II~' . EMJrC3t\8~ERTIFICATE OF ZONING COMPLIANCE
i AND Uli~~ty CONNECTION PERMIT . c ) . ~ r-.... {
~ I Permit No. (~- ~ '---''C:>
New Construction 0
Chimney 0 Misc,
8, PROPERTY AREA OR ACRES DIMENSIONS 10, CULVERT SIZE
Sq, Ft. I (PDQ Depth ~I Yes No
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 me ioned 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
building 0 I can rev ' , or just cause, Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections,
X ..::--- /O/,.{:) It/y
Signature Ucense No. Date
/ -- /. ---
Amount Brought Forward .................. $ ~ ~ _ ""4 ~
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 ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
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
~700
1. DATE
7 tJ 4",. \I7"Z"
/1~_
/nc-
3, LEGAL DESCRIPTION
/J.' - . J~l" ,I .
1-/' l. ~. BLOCK
ADDITION ,:' ;" i- ;,; ,. .,d.L.
PID'
LOT
,,--,
L,
4, OWNER
A(~
5, ARCHITECT
(Address)
(Tel. No,)
(Address)
(Tel. No,)
<1 "} I
(Lf
Fireplace 0
Alteration~
Septic 0
Addition 0
~ (1el, No,)
~ Gi'a.~J;..c,
Heating 0 Plumbing 0 Reroofing 0 Porch 0
Finish Attic 0 Residing 0 Finish Basement 0
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Side
Side
Front
Back
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUILDING r-..a-. N"'-- -\- ~" " ~ '-
OFF STREET PARKING
SPACES REa,
SPACES ON PLAN
PERMIT VALUATION --::s:. .) Oc.~
TYPE OF CONSTRUCTION: I II IIIIVG)
Occupancy Group ~ I H R M
Division 1~ 4
City:
Permit Fee ................................... $
~~_O~
-4~.9.c
I. ~
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
Subtotal.............................. $ / ~ s;;: _..4 c;;:
Check if
Deferred
By
as Your Building Permit When Approved, )
Date / 1- 'Z.. -0, .l{
Certificate of Occupancy
Issued
Paid
1. White
2, Pink
3, Yellow
File
Cily
Applicant
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12, NO, OF STORIES
13, TYPE OF CONSTRUCTION
14, FLOOR AREA APPORTIONMENT USE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS jJ- SETS
SURVEY 0 COPIES ~
PLOT PLAN 0
This is to certify that the r uest in the above application and accompanying documents is in accordance wtth the City Zoning Ordinance and may proceed as
sig~ By the City Planner ~es a temporary Certificate of Zoning Cfmpliance and allows construction to commence, Before occupancy, a Certificate of
/ (-z.-~~
City Planner Date Special Conditions ij any
24 Hour notice for all inspections 447-42309:00 a.m, '10:00 a.m,
t/l/-S1 h
White - Building
Canary - Engineering
Pink - Planning
Thf Cfnlfr of Ihf L.kf Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ('L-;- ~ dJl~)k-./
APPLICATION RECEIVEd! i O!.:<Si1'i
The Building, Engineering, and Planning Departments have reviewed the building permit
application .!9r construction activity which is proposed at:
/ ~ 710 0 J')~ (lL~/'
Accepted
Accepted With Corrections +
Denied ~.
Reviewed By: _~_
1 .'----
Comments: __, ~ I ~->--::",. <:::::::,.
~~
_ ,L..
(;:::.. rc:::. . " :::::::;;..
Date: 11- ;).. -- 9~
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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."
+
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