HomeMy WebLinkAboutBuilding Permit 00-0778
QAT" R"""'Wn CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
Cily
Applicant
Permit No.
00-0779
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 /1 I
333/ \i.Bdf? ('/flC. e...
1. DATE
f5 J a'o lev
I
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
.$. \1).
3. LEGAL DESCRIPTION
\3
Vr..L.-
12. NO. OF STORIES
LOT
BLOCK \
~r\ ni~ t-\ r Jfl
L. / / i!A.--~(Av;I~ CQ. ~
PID ;;2"".- III-Dn-o
13. TYPE OF CONSTRUCTION
ADDITION
5. ARCHITECT
~dJ
(Na;'.j()
(Address)
(Tel. No.)
t:t9 -440-9i61
I
14. FLOOR AREA APPORTIONMENT USE
4. OWNER
(Tel. No.)
;) (Address) ':'1_, ouzg (Tel. No.)
.J)1W01d!:j.J 1'11'"- _} <JJT
l;:j:Jdwg~,J':J-h21:;'~:~~ sZf:?6 ~fcf-,J L;e_~ingCJ1b3 p::::-~I
New Construction LJ . , Alterations 0 AddltiO~ 0 I Finish Attic 0 Re.siding 0 Finish Basement 0
ChimneyO Misc. hJ...L... ~~-for'J.4-..j.,o,J
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 ~'~ff~enlioned 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
~uildin~i::: ~e:ke thi~; ~se. Furthermore, I hereby agree that the~fr~4-ab~e may enter upon the property to pertoreej;e;ms.
.. S9"lture Ucense No. . Oete .
6. BUILDER
(Name)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Fron'
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS CJ ENERGY DATA CJ
PILING LOGS CJ PERCOLATION TESTS CJ
PLANS & SPECS CJ SETS
SURVEY CJ COPIES
PLOT PLAN 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
1<1::5 A. / P-
I
OFF STREET PARKING
SPACES REa.
SPACES ON PLAN 30~ . -
-"'I -.
PERMIT VALUATION -J'~ ~. ~ """-" ., ~
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ........ ............... $
Sewer Tap ................................... $
$
Division 1 2 3 4
Permit Fee ................................... $
14.15
4B54
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
50
Mechanical Permit Fee ............. ........ $
Pressure Reducer .......................... $
Meter Horn ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ............ ........ $
:: :rep{c1r'Y1: ;... ;"i~"" $ n When ~pk~d/ _ .--( 1_
By ---.~E Date I~.J~
IrJ"lr'lSfI..
Water Tap ................................... $
Builder's Deposit ............................ CI:
Other ......................................... $
Total Due .............................. $ IZ-lf. 04-
Paid "'-< n'7~ ~ecel t No ":<:ll?Cl--t
Issued -l- - '"'
Date ..,-
ThIS IS to certify that the request In the above applICation and accompanYing documents IS In accordance With the City ZOOlng Ordinance and may procee as requested 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 Occupancy must be issued.
Certificate of Occupancy
Cijy Planner
Date
Special Conditions ff any
24 hour notice for all inspections (952) 447.9850
"
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 333/ Vf1L-6 CJt<.CG6 oW
TYPE OF WORK F/ Je6 eE::;; I ul<Y177 ON
USE OF BUILDING I< E5 /l / k:
PERMIT NO. 00 . 077 Py DATE ISSUED p., - ? 9 - 00
BUILDER /'1//VN (!/)NSTR.U~TIOI'I-'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
'_-~III".wG I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
, FRAMING I I
, FINAL
/.-f~ /0, Z ),6'0
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
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