HomeMy WebLinkAboutPermit 97-0299
5c..ott lhTOO \ \A
7. TYPE OF WORK
New Constructio~
'6h1,mney CJ Mist:.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 10. CULVERT SIZE
Sq.E"\- -00'"2"1 Width ~ c., Depth 8~ Yes ~ 8- 2~-~
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 prope 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 officia can re this permit fo st cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
-.3'--ZQ-99
Date
DATE RECEIVED
LOT
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. Dt TE
3 y:, qD
/7{)t;f )!/U'~5dtcf (ll('~d&N la/Ie
/)/..- .-=\ I (>/\ \ ({ ()
PID G'"Y:J - JO< 6 -(jd - _ ~
MAR 3. U f~~9
,tI
:CTIONS
CES NUMBERED 1 THRU 17 MUST BE FILLED IN
, ucFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
3. LEGAL DESCRIPTION
;( 'J
~-/ BLOCK ~
. ADDITION jJ /11 0\/] t-t-l III fa rYaAj~
4. OWNER (Name)
~tt Ihrctio
5. ARCHITECT (Name)
(Address)
-"'2JL.SD ~~ A\{G
(Address)
(Tel. No.)
~17-L/92~ ':;:n..,l:J 1
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
'2.\LD5'O )lb)n ~
Fireplace CJ Septic CJ Deck CJ
, .Alterations CJ Addition CJ Finish Attic CJ
(,'2,,-#qZ~ ;!/.Y7'3
Re-roofing CJ Porch CJ
Re-siding CJ Finish Basement CJ
!..".
?C
License No.
Amount Brought Forward .................. $ ?
Park Support Fee ........................... $
SAC .. . . . . . .. . . . . . .. . .. . . . .. . . . . . . . . . . . . . .. " $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Pressure Reducer .......................... $
Meter Horn... .... .... ........................ $
Water Meter................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other......................................... $
Total Due .............................. $
Paid Receipt No.
~ ,
FOR ADMINISTRATIVE USE
SE.r~ACKS: Required
. Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUllDING~ ':::::f1:>
-.-~ ' , -..
'.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy GroLlp A B E F HIM R S U
Division 1 2 3 4
Permit Fee................................... $
City:
()
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas FfrepUtce1t'.... it ......~.. ............. $
1h~ ~""'~. . e~me..s. Y., ,B.. uilding Permit V)I.tJ.e n Al}prov~""
B\j' T'\/f' \.." Date V -.' - ((
^...rtlficate of occupancy!
d
Date
I. White
2. Pink
3. Yellow
File
City
Applicant
011- ")01.(""J/
Permit No. L- .
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (D~
2~ ~ ;)F-\
12. NO. OF STORIES
I
13. TYPE OF CONSTRUCTION
~ t="~
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS J
. ,,11\
SEATS
16. PROJECT COSTNALUE
17. COM'Lt-r~Nc:g}E
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA 0
PILING LOGS CJ
PLANS & SPECS CJ
SURVEY CJ
PERCOLATION TESTS CJ
SETS
COPIES
....
PLOT PLAN
CJ
(J
By
T . . to certi 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
tgn by tll6" Plan er constitutes a temporary Cert~~c Ite of Zoning compliance and allows yq,nstruction to commence. Before occupancy, a Certificate of Occupancy must be issued.
'-. 3 30'11 /111 !1,C I R ~CIt11 Pt lM~.,,:t '- L.), d '..-1:.. ,'v'' L.r ~ c(
City Planner . I ~ate (J Special Conditions if any
24 hour notice for all inspections 447-9850