HomeMy WebLinkAboutBuilding Permit 99-0244
City of Prior Lake
Inspection Notice
DATE
TIME
SCI{EDUUED
10/25/99 A. T.
ADDRESS 16181 FILLMORE AVENUE SE
OWNER CONTR
PHONE NO. PERMIT # 99-244
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
'1J Correct Action and Proceed
:spect:orrect W o9?r Reinspection B::e::::::g
DATE RECEIVED
\'I~ (~ \ \j-j'J
CITY OF PRIOR LAKE
BUILDING ~'ERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1 DATE
~ 3lltl9
Kf
PIrt:9~ -l<n - 0 L[t( -0
2. SITE AI~i~ I HI I vYlD ~ Au-e
3. LEGAL DESCRIPTION 4-
LOT d. BLOCK . I
ADDITION 'Drmr&.)~l(e: Hils ~
~E1
5. ARCHITECT
(Name)
IYJA- <..10 LL -.,
(Name)
(Address)
It, /7/
(Address)
(Tel. No.)
/jcf7-<j('77'S
(Tel. No.)
".:) /)11h () rL f..
6. BUILDER
(Name)
(Address)
(Tel. No.)
~11- t--L IS
7. TYPE OF WORK
New Construction 0
!!o ('j-f.' /J 1ft :JMJ 4 Ilf. /J1 N ('1.2 - ;173'7
FirePla~ Septic 0 Deck r:j Re-roofin~ Porch 0
Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
C?1-~l{L{
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
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 ~ial can ~,v~ke;pis perm~t for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X tfl2Mr-r 'j/~ .,2() lj S 4U ;i-3/~ 99
Signature License No. Date
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING j2ts frU(
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUcnoN: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~~~~i~~...1...~...~..~...~. 14.r;
1'd.S-
City:
Plan Check Fee ............................. $
State Surcharge............................. ~
Penalty....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0
PLANS & SPECS 0
PERCOLATION TESTS 0
SETS
COPIES
SURVEY 0
PLOT PLAN
o
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ 71,.;-CO
Paid f0. CO Receipt No. _ 3l{~~
Date3l31(91 By ~
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 reque~. 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.
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions n any
24 hour notice for all inspections 447-9850