HomeMy WebLinkAboutBuilding Permit 07-0449
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RATE Re~ElvED
CITY OF PRIOR LAKE l \1U1
BUILDING PERMIT. "\
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTlON PERMIT Permit No.
L While
2. Pink
3 Yellow
Fi~
City
^pr1iC&ll1
Ct ((p ,0 7
07. () #9
'.DAnt
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST Be FILLED IN
BEFORE PERMIT 1$ ISSUED (Please Pflnl 0' TyOQ and ~ign al Oollom)
b Cf 07
BUILDING INFORMAnON
11. SIZE OF STRUCTURE
tH1li9h'1 tW,dlhl (Ooplh)
2. SITE ADO~ESS
I t:;, 2-1
p~ t/. e' ' /...fi. AJ €:~
12. NO. OF STORIES
3. lE~ OESCRIP'T10N
lOT
BLOCK
.__PIO_
13. TYPE OF CONSTRUCTION
. /?€R ot?~
14. FLOOR AREA ,\PPORTlONMENT USE
ADDlTION
4. OWNER
(Name)
(Name)
(Tel. No.)
.S' q62.-~U?~~
(Address) (Tel. NO.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New ConstruCllon 0
Chlmney::l Mlsc:.
8. PROPERTY AREA OR ACRES
Sa.Ft
Fireplace n
AIlerallons 0
(Add'ess) (Tel. NO.lqs:z....--,O
/2-2c.f7 N/C4JW, Av. SO. 7.
'1U'5 8UIU.);vluE InJJ
Septic 0 DeCk r:1 Re.roof\f\
Mdirlon a Finlsn Allie C1 Fle-sldlng 0
PO'ch 0
nlsl1 a...semenl 0
S€ATS
16. PROJECT r'r~NALUE
)001 a, bY-
17. COM I.ETION DATE
6. BU1LOER
(Name)
Amfl!lCAIJ ~Ull/:lJlG I
9. PROPERTY DIMENSIONS
W,dth Dep\h
'0. CULVERT SI:!:!:
Yes No
I hereby certify \helll\ave Ivml&hlld 1f\'ormaOOn on Ihis application willen is to The best 01 my knOWIe<lge "'-'e and correcl. I 011:;0 certify that I "m lhe owner Of lIuthoriz.ed agenllor
lhEl aOQve mentioned property aM \hat :lU eons\ru(;\lon will conform ~ all exlSllng S[;lte and \Qc&llawo and will proceed ill sccol'dance with submitleod plllns. lam awe'" \hal !he
bulk:li 0 I can nwoke Ihl e tlor JUSt calise. Furthermore. I heroby agree \halthe eity olflcl~1 or s designee may enler UpOIllhe p,operly 10 perform nCed.ld 7n pec~onS.
x', '2-o/tpq 3f53 b/I./-. 07
SIg>.'U<1l u..".. No. 7 D.1..
FOR ADMINiSTRATIVE USE
SETBACKS: Requll'9<l
AcIual
Fronl
BUILDING DEPAf'lTMENT VAl.UATlON
!lat!<
5Ide
MATERIAL FlLEO WITH A1>f'UCAT1ON
Sid. SOIL TESTS 0 ENERGY DATA C
PILING LOGS 0 PERCOLATION TeSTS 0
PlANS & SPECS 1:1 SETS
SURVEY 1:1 cOPIES
PLOT PL/l.N n
USE OF aU/LDING
OFF STfleET PARKING
SPACES Reo.
SPACES ON PLAN
PE~'-AIT VALUATION
noPE Of coNS'mUC1lO,.: 1 n 111 IV V
OooupencyCroUP A B E F HIM R S U
~ , Z 3 ~
Permit Fee ................................... S
Ci1';.
Amount Broughl FoI'W;ird .................. S
P,r1c S~o" FIl" .....................,..... S
SAC ......................................... $
Colleolive Slrocl Fee ....................... $_.
SewerTBP ................................... S
S
Pre5&Urtl Aeduc:er ........... ............... $
Meter Helm ........... ..... ................... S
Waltrl.Aeler ................................. S
Plen CheCk Fee ............ ....... .......... $
Slals surcharge ............................. S
Penally ....................................... S
Plumbing Perm~ Fee ....................... S
Certlllcale 01 Occupenc:y
Issued
sewer & Waler COrtnec\ion Fee ........... $
Wale' T~r Fee ........;.................. $
W,1I0,Tap ................................... S
Bvlld.... Deposit ............................ $
0111., ......................................... S
Paid Tolal ~ .....:............~:;;;..:
0.1. to. (. ,I
ThIS 1$ Ie oer1lIy """N request In \he a~ .~lIOn and ec(OfI'Ipanyl"ll doG\.tmenls Is In acco<~nce wllh Ihs CRy Zcnng Oltl\n'''''''' d ""'Y pi"
signlllS lly lh8 CIty Planner (X)nSlltUleS alempO<lJI)' CeT1lr.ea18 of zonitlg compliance and ,lows eonslIucllon 10 commence. Belore CCCl()llncy. a
-
Mechanical Permll Foe ..................... $
Sewer &. water Permit ...................... $
GaS F1~'1lC8 Permit ....................... $
ThiS AW'Ca1lOn Becomeli Your &Ullcllng Pe""h When .r.pproved.
By ~ DBle
Cty Plannaf
Dele
s...cQl CondlllO'lS ~ ant
.,. _., ............",.. ~lOf\I 447-9ll~