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HomeMy WebLinkAboutBuilding Permit 99-0032 City of Prior Lake Inspection Notice ADDRESS 16660 ANNA TRAIL SE SCH.EDULED OWNER CONTR DATE TIME 10/25/99 A.T. PHONE NO. PERMIT # 99-32 TYPE OF INSPECTION RE-ROOF COMMENTS: .....0--- Work Satisfactory, Proceed o Correct Action and Proceed o Correct Wark, M Reinspection Before Covering Inspector: C;;/ Owner/Contr. DATE RE@EIVED CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CE.RTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. While 2. Pink 3. Yellow File City Applicant Permit No. ~ ? - 0032..... 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 \~l~O 1. DATE I-IS-qq BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) h)r\f"\O ~r ~&, :) ( Y (' l-or- f..A.,J/-fJ ~ '$ ~ U2.-- . 3. LEGAL DESCRIPTION LOT 10 12. NO. OF STORIES ADDITION BLOCK JO. A.tJNA PID '2 S" - Orz r- 010 -0 A,)u \C' PIl.\cIL LA,-~ 13. TYPE OF CONSTRUCTION 4. OWNER (Name) mn f1 ~ 5. ARCHITECT (Nam~ Wed )6Lr (Address) (Tel. No.) II Lr7 - ~O l'l....- (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE (Address) 6. BUILDER (Name) (Address) (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS Y\ 1 ~ f"J'-.. \:-\ ~ 7. TYPE O~ WORK Fireplace 0 New Construction 0 Alterations 0 Chimney 0 Misc. \Q~~ S\'Oiv'\ ~ Deck 0 Finish Attic 0 .... g"\e~ -'7b'~-Ut Re-roofln~ Porch 0 Re-siding 0 ' Fi~h Basement 0 OCCUPANTS Septic 0 Addition 0 SEATS 16. PROJECT COSTNALUE 8. PROPERTY AREA OR ACRES Sq. Ft. 9. PROPERTY DIMENSIONS Width Depth 10. CULVERT SIZE Yes No 17. COMPLt: IIUI-l 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 entioned property and that 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 icial can revoke this PTit for just cause. Furthermore. I hereby agree ~tJhe city official or a designee may enter upon the property to perform needed inspections. X U.. . !JJ1~ <F :J..Q/Li34;)'S- j-/J-1? Signature License No. Data FOR ADMINISTRATIVE USE SETBACKS: Required Actual MATERIAL FILED WITH APPLICATION Front Back Side Side SOIL TESTS o ENERGY DATA o USE OF BUILDING (ltS' ~" OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION PILING LOGS 0 PERCOLATION TESTS 0 BUILDING DEPARTMENT VALUATION PLANS & SPECS 0 SURVEY 0 SETS COPIES '2 SuO. .. PLOT PLAN o TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R Division 1 2 3 4 Permit Fee ................................... $ S U City: Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC ......................................... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ 14 -,-) Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ l. '2.-) Sewer & Water Permit .. .... .1.............. $ i~..$~ ~ 'Iding Permit When rov '4 Date I 7 Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Total Due .............................. $ 1 G::. Paid .., (p, - Receipt No. '3434 \ Date l! I ~l i l' By (2... D t':\- 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 constnutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued. Pressure Reducer .......................... $ Meter Hom .......... ......................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ This Appli By Certificate of Occupancy Issued City Planner Date Special Conditions W any 24 hour notice for all inspections 447-9850