HomeMy WebLinkAboutBuilding Permit 00-0041
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
_ _ ...~/ , ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.. - a 2000
. 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
..1975
1. DATE
;} - 3 - 00
IZ/ SD
3. LEGAL DESCRIPTION
LOT
r e. C <;LJ (lQ
V
~+
ADDITION
PID ~es - {Qj - DD7- 0
...sP;Z/N~IUJ1J1:::::... p~ 2N.O
(Tel. No.)
~~~Jt'O- rz~71
(Tel. No.)
BLOCK
4. OWNER
(Address)
:a.(A.<..
(Address)
(Name)
~<;
5. ARCHITECT (Name)
s~
6. BUILDER (Name) (Address) (Tel. No.) S'(;;.~S-fO
(,fbss 'RRP~ fJ1tt,f+- 500 J;;'T((~~-rR., EVf)fS~I1~
7. TYPE OF WORK
New Construction a
Chimney a Misc._
8. PROPERTY AREA 01
Sq. Ft.
Re-roofing a Porch a
1-~idinQ)<<.. Finish Basement a
CLOSE FILE
10/28/03 MP
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
~/9'
Permit No. {)Q -(JDtf-/
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
I hereby certify that I hE:. st of my knowledge true and correct. I also certify that I am the owner or authorized agent for
the above mentioned roperty and that all conslrucuOII Will \N'''v"" 'v v.. V~'_''',<> ~,ate and local laws and will proceed in accordance with submitted plans. I am aware that the
:uilding officia .. 'A~ t~ ~Suse. Furthermore, I hereby agree that the city OffiC:J~ als? mal e~~n the property to perf~ ~3~~~ons.
-- ;.r-- Sign License lIlo. Dete
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ...................................!t.
$
Pressure Reducer .......................... !t.
Meter Hom ............................ ....... $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ "7 tJJ .Ct)
Paid Receipt No."lt7 ee
Date 2.-'3 - 00 By PI'<
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
USE OF BUILDING
f26.
J
A/R
I
PERMIT VALUATION
J. S'r>O .Ot:r
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
R S U
City:
1 t./. 4.<)
Plan Check Fee ............................. $
State Surcharge............................. lI'.
I.~~
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... ~
it ....................... $
e mes vJ,~ Permit Y'ihelJ..6Pproved.
~-"-"'''Date .--~-~
"'
Issued
MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA a
PILING LOGS a PERCOLATION TESTS a
PLANS & SPECS a SETS
SURVEY
PLOT PLAN
a COPIES
a
-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850