HomeMy WebLinkAboutBuilding Permit 94-0553
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEAL TH AND SAFETY!
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\\\ ~ollMty ceRTIFICATE OF ZONING COMPLIANCE
,i i ,U AND !111111LITY CONNECTION PERMIT
.... V'l Permit No.
1. While
2. Pink
3. Yellow
File
City
Applicant
CfL/- 553
1. DATE
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
4/ ,f) Lo'r;b
/Z(t/!'
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) lith)
12. NO. OF STORIES,tI/ A
13. TYP OF CONSTRUCTION
(;
14. FLOOR AREA APPORTIONMENT USF:,.j
(Depth)
6. BUILDER (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS JJ/' A
7. TYPE OF WORK Septic 0 Heating 0 Plumbing 0 Reroofing 0 Porch 0 SEATS
New Construction 0 Addition 0 Finish Attic 0 Residing 0 Finish Basement~ 16. ESTIMATED VALUE f)
ChimneyO Misc. '2- 5DO L~_
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS I 10. CULVERT SIZE 11/ 17. 99MPLETION DATE
Sq. Ft. N A Width N~h Yes No IV / A J4.~ /t1t"C;
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 a 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 official revoke this rmil 1\>r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~ ~")w tr1Jv'/v/\ J Z J I 11;ij.
. gnature License No. Date
I
PID
~ U"'3 D<>I.-O
~RjJ(
3. LEGAL DESCRIPTION
LOT
ADDITION
4. OWNER
5. ARCHITECT
(Address)
'j) ~dJ
(Address)
I'/e
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
SOIL TESTS
o ENERGY DATA
o
Front
Back
Side
Side
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS ~ SETS
PROPOSED GRADE FOUNDATION
IN RELATION TO CURB OR CROWN
OF STREET
USE OF BUlL
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
SURVEY
o COPIES
1$ 2 S-CO.OO
PLOT PLAN 0
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .........................................$
Collective Street Fee ....................... $
SewerTap ................................... $
License Check Fee ......................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
o Sewer & Water Connection Fee ........... $
o WaterTowerFee ........................... $
Occupancy Group A BEl H r(i)M
Division 1 2/i)4
Plan Checking Fee ......................... $
State Surcharge ............................. $
Penalty ....................................... $
Septic System............................... $
Other ......................................... $
SLI. 00
'b 5. 1 b
t.2.~
Permit Fee ................................... $
Subtotal............................... $
qo. 35"
Check if
Deferred
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid {).d-.;-
Date C B
This is to certify that the request in the above application and accompanying documents is in accordance wtth the City Zoning Ordinance and may proceed a
signed By the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate
ing Permit When Approved.
Date /2-- 7-qr
City Planner
Date
Special Conditions rt any
24 Hour notice for all inspections 447-42309:00 a.m. .10:00 a.m.
q 1/ -.~ 53
,.. I
White - Building
Canary - Engineering
Pink - Planning
Th. C.nt.r of tho L.k. Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~) ,b-.tt:.~A /~j
APPLICATION RECEIVED uJJ./ q .t.f
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4/ bO X~tjaJ-Ji '1, G'
Accepted With Corrections
~/
Accepted
Denied
Reviewed By: ~ 114.
Comments: p k~ .AJi-f.
r~ ,
1- ,-,Ii t fA..;
'rh
o
b c. S. e/w'..(~~ t
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t,pt.JUv^ Date: I Z -- 7. q c(
M D dJ ~UAA_L-{t~.L~,-j lr,.ifr f <; .
t~J!!. _..k "'" & '''^ f C4
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"The J:;suance or granting of a permit or approval of plans, specifications and
comp~.ations shall not be construed to be a permit for, or an approval of, any violation of
any of \he 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."