HomeMy WebLinkAboutBuilding Permit 99-0182
City of Prior Lake
Inspection Notice
,"
SCHEDULED
ADDRESS 16204 ST. PAUL AVENUE SE
OWNER CONTR
DATE
10/25/99
PHONE NO. PERMIT # 99-182
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Wark, Call for Reinspection Before Covering
Inspector: V/ Owner/Contr.
~
TIME
A.T.
DATE RECEIVED
t-\h, i 8_
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONltiG COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2, Pink
3. Yellow
File
City
Applicant
Permit No.
qC;-/~ Z-
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 J.1. ()!
/ ~ -;( aLl -p rtv.dl/1o...t
3, LEGAL DESCRIPTION
LOT -?..- BLOCK
ADDITION- ~!5
~
4, OWNER C. ~ame) ,
" J-r-'---"^ ~
5, ARCHITECT (Name)
6, BUILDER
(Name)
~ 1111 t)h~
7, TYPE OF WOf
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Chimney 0 Mise,
8, PROPERTY AREA OR ACRES
Sq,Ft.
';/IB Icre;
, I
(2. - 2-
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO, OF STORIES
PID ZG-Q:;f3 -Ol~-O
.4f;YV.
(Address) I? -/ (Tel. No,)
& 2t1L/ -If ri:u4l~ Utt 7- ;)41 "6
(Address) (Tel. No,)
13, TYPE OF CONSTRUCTION
14, FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No,)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
?~J. ';tJQ
".
Re-roofin~ Porch 0
Re-siding 0 I Finish Basement 0
SEATS
16, PROJECT COSTNALUE
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 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building o~ ~voke t~is permit ~~e. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neede.d inspect.ions.
X { A JU-.-u. Wt~ ~- (1) - "'fCf
Signature License No. Date
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
J
U:s /\ (f-
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee ................................... $
V
R S U
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty......... ................. ..... ........ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
SOIL TESTS
o
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
~.-
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
"{ 4-.1<;
\.~
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... L
.... ----.........
..... : ;t Wh~3frJ-1
WaterTap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ~'4~~~
Paid i f - J Receipt No. . (VC/
Issued If"
This is to certify that the request in the above application and accompanying documents is in accordance with the c~:~on~'~!d~aL~ !nd may pr:~d as re'::!!re~his document when
signed by the City Planner const~utes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cert~icate of Occupancy must be issued,
This Appli
By
Certificate of Occupancy
City Planner
Date
Special Conditions ~ any
24 hour notice for all inspections 447-9850