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HomeMy WebLinkAboutBuilding Permit 00-0585 DATE RECEIVED CITY OF PRIOR LAKE / ,/ BUILDING PERMIT, '7 J<3, 00 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2, Pink 3, Yellow File City Applicant '} .../' If/I ':;) Permit No.~S , 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 ~qa3 3. LEGAL DESCRIPTION LOT \ ~ BLOCK ~n fJr- ~{n Jo/'\'\ . ~J. (Addr~:sf) II ... l-S +- fJlIA,WA. (gq1-"> _~I (Add ess) . ADDITION 1. DATE ry Ita/o-o BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (WIdth) (Depth) t-H II ~A4- ~~o* 12. NO. OF STORIES PID a.s- - 0 I'1~O\ -1) 13. TYPE OF CONSTRUCTION (Tel. No.) 1/'11- 'I1tJ1 (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE J~fd 7. TYPE OF WORK Fireplace 0 New Construction 0 Alterations 0 Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq. Ft. 6. BUILDER (Name) (Address) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS (Tel. No.) ~)'r5r1tAS+ ~~~:~g 0 Porch 0 . Re'si~ Finish Basement 0 'f'f1- YbV I SEATS 16. PROJECT COSTNALUE Septic 0 Addition 0 Deck 0 Finish Attic 0 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No 17. COMPLETION DATE I hereby certify that I have fumished 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 and that all struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am a are that the :uilding officiaJ lIthi pe r j Furthermore, I hereby agree that the Ci'Jfff2.~ i designee may enter upon the property to perto n ~ i pections. License No. SETBACKS: Required Actual BUILDING DEPARTMENT VAll USE OF BUILDING ~TRATIVE USE CLOSE FILE 10/28/03 MP MATERIAL FILED WITH APPLICATION SOIL TESTS 0 ENERGY DATA 0 PILING LOGS 0 PERCOLATION TESTS 0 PLANS & SPECS Ll SETS Side n.D~ AJ~ SURVEY PLOT PLAN o COPIES o SPACES ON PLAN PERMIT VALUATION TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R S U Division 1 2 3 4 City: Amount Brought Forward, .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ '1L.{ ,1 S- Permit Fee ................................... $ Plan Check Fee ............................. $ State Surcharge ............................. $ , .as Penalty ....................................... $ Plumbing Permit Fee ....................... $ Pressure Reducer .......................... $ Meter Horn ................................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... $ Gas Fireplace Permit ......................11$ . ," /1 ThiS~PPIi e me~" BUildi:' p.';e.rmtt.. ,"Wf Approved. By '"'. . I Dale . ' " ,>'/<~ Certifice e 0 Occupancy . Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ d Total Due .............................. $ ~ b . ifU Paid '7 L, . dD Receipt No. 2> 7 ~ 7 '1 Issued Date ~J lrile(/) By (~ This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning ~d- may proceed as uested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of upancy must be issued. City Planner Date Special Conditions n any 24 hour notice for all inspections (952) 447.9850