HomeMy WebLinkAboutBuilding Permit 99-0281
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A. T.
SCHEDULED
ADDRESS 15787 SKYLINE AVENUE NW
OWNER CONTR
PHONE NO. PERMIT # 99-281
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~- Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Wo~k~Call5ryReinspection Before Covering
Inspector: ( . 1-/ Owner/Contr.
-.y
QATE REC~
CITY OF PRIOR LAKE
BUILDIN.G PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- 2Bf
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
~FORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
ly-'SITE ADDRESS ...
/-'578"7 S:f'v //~ ALMA" ~ tv.
3. LEGAL DESCRIPTION '
~ BL?C{ 5 PID 'Ls- - \ 4-3 .. O~ .0
~DDITION ISl:..f\AO V (~ , ~ ADD
(~OW.~ / (Name)
////ch~t":.1 A
5. ARCHITECT (Name)
1. o;;EI~ he;
If' ,
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
13, TYPE OF CONSTRUCTION
(Address)
kr~/V?
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
-'"'
t.. ~UILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
5'WtMe-
7. TYPE OF WORK Fireplace D
New Construction D Alterations D
Chimney D Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
Septic D
Addition D
Deck D
Finish Attic D
Re-roofing \t: Porch D
Re-siding D ~nish Basement D
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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 above mentioned 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 ~ff.9'l.&a~ok~.'S pennit for ju se. Furthermore. I hereby agree that the city official or a designee may enter upon the property to pertonn needed inspections.
y~~p ,y'-~ -9OJ
ignature License No. (D~
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS D ENERGY DATA D
USE OF BUILDING
~
I
.A / fl..-
I .
OFF STREET PARKING PILING LOGS D PERCOLATION TESTS D
SPACES REO. PLANS & SPECS D SETS
SPACES ON PLAN SURVEY D COPIES
PERMIT VALUATION 'Z.5W. .- PLOT PLAN D
BUILDING DEPARTMENT VALUATION
TYPE OF CONSTRUCTION: I " III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Pennit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
l-'f. 7 c;-
1.215
State Surcharge ............................. $
Penalty....................................... $
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Paid Ti;/,~lc;~..........~~~~i~;~o$ 3~~'-
Date -Ie. ~ '- ' By (LI) 1+_
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~ed. 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.
Plumbing Pennit Fee ....................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Pennit ....~..... ........... .
Gas FirePI~&erItA.... ..... ..." ~ ~
;hiSAPPIi~ ~itWh~hov
y. . I
Certificate of Occupancy
Issued
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850