HomeMy WebLinkAboutBuilding Permit 99-0245
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A. T.
SCHEDUEED
ADDRESS 16197 FILLMORE AVENUE SE
OWNER CONTR
PHONE NO. PERMIT # 99-245
TYPE OF INSPECTION RE-ROOF
COMMENTS:
Jtf' Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct /n1 for Reinspection Before Covering
Inspector: ~ V Owner/Conte.
DATE RECEIVED
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.31"
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
2,SITjc;l~~ HI {t11/D~ A-t.H
3, LEGAL DESCRIPTION J r
LOT { BLOCK '---j
ADDITION '-r)VroKsV'; lIe. ~ lIs
4, OWNER . (Name) --1../. _
fl7 " -f (I h 7212.t.J11 A
5. ARCHITECT (Name)
tJ
PID ~5-(e1-oL[C{-D
{ftl
(Address)
/6/91
(Address)
(Tel. No.)
!l/J m O/l.( -/'/d-,:)I1-<;
(Tel. No,)
6. BUILDER
(Name)
(Address)
(Tel. No.)
i).u.L ~
7, TYPE OF WORK
New Construction 0
/J)-J 7J7
Re-roofingJQ Porch 0
Re-siding 0 Finish Basement 0
Poo-<(;::rJe 0
Alterations 0
:JD R- drf Ai, ;r1 A1
Septic 0 Deck d
Addition 0 Finish Attic 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. qC( - dlf c;
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 furnished infonnation 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 ab~ve m ntioned property and that all construction will confonn to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building 0 al can re~e 9ljs pennit for just cause. Furthennore, I hereby agree that the city ~"iciall2!. a designee may enter upon the property to perfonn needed i~ections.
X olfUu.,...v'Ht..u I ~ /3,$ c.j<?,/-., . 3'- .f1 / - 7 <J
Signature License No. Date
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
SETBACKS: Required
Actual
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING~.oc; It; rt.
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
Pennit Fee ................................... $
{l/, 7C:;-
I.d-~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter................................. ~
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid T7~u:C;6............~~~~i~;~0$ ~~~;g
Date 3/3(1 qq By OILtU
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordi~ance and may proceed as requestgd. 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 Pennit ...................... $
Gas Fireplace Pennit ....................... $
This Application Becomes Your Building Pennit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850