HomeMy WebLinkAboutBuilding Permit 99-0258
City of Prior Lake <
Inspection Notice
.,.
SCHEDULED
ADDRESS 16240 FRANKLIN CIRCLE SE
OWNER CONTR
DATE
,10/25/99
PHONE NO. PERMIT # 99-258
TYPE OF INSPECTION RE-ROOF
COMMENTS:
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o
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Work Satisfactory, Proceed
Correct Action and Proceed
Correct Work, Call for Reinspection Before Covering
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Inspector:
Owner/Contr.
TIME
A.T.
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEIVED
Am ..
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
/0 J f..{d ~/'h t1K./;V) C/o
3. LEGAL DESCRIPTION
LOT 5. BLOCK '2 rc..J
ADDITION 'R \7Y)~VII {G H1 (I? ~;.....-
4. OWNER (Name)
~ J!ta~~ K.tZ ~
5. ARCHITECT (Name)
1. DATE
,-/-1-77
R-\
PID ~5-lE;1~ 0(3-0
(Address)
I ~;J. "p I~/'Y-. Yl k I;..,
(Address)
(Tel. No,)
e/'.
6. BUILDER
(Name)
(Address)
DC: ""'~X k oJ
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Misc.
8, PROPERTY AREA OR ACRES
Sq. Ft.
I~.? t.t~
Septic 0
Addition 0
Deck 0
Finish Attic 0
9. PROPERTY DIMENSIONS
Width Depth
(Tel. No.)
(Tel. No.)
r/7\ ,,1:.. (/~ Cr_
Re-roofing ~ Porch 0
Re-siding 0 Finish Basement 0
1 O. CULVERT SIZE
Yes No
1. White
2. Pink
3, Yellow
File
City
Applicant
Permit No.
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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
-:it S-O ZJ
17. COMPLt!'rION 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 pr rty 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 official can re this pe i for just cause, Furthermore. I hereby agree that the city official or a designee may enter upon the property to p~rform eeded inspections.
X ~ -/-~~
~ognature License No, Date .
SETBACKS: Required
Actual
Front
Back
BUILDING DEPARTMENT VALUATION
USE OF BUILDING t2t. '/ Itl (,
FOR ADMINISTRATIVE USE
Side
Side
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
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Permit Fee ................................... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permn ....................... $
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
City Planner
Date
24 hour notice for all inspections 447-9850
Special Conditions ~ any
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
City:
Pressure Reducer .......................... $
MeIer Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Receipt No.
-)~ .()L)
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Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 110 .O{)
Date t.f -{ ~ c; By q tU.-,J
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 reqUeKe,d. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Cert~icate of Occupancy must be issued.