HomeMy WebLinkAboutBuilding Permit 99-0358
City of Prior Lake
Inspection Notice
DATE
TIME
,
SCHEDULED
10/25/99 A.T.
ADDRESS 16750 BLIND LAKE TRAIL SE
OWNER CONTR
PHONE NO. PERMIT # 99-358
TYPE OF INSPECTION RE-ROOF
COMMENTS:
y
o
o
Work Satisfactory, Proceed
Correct Action and Proceed
Correct Work, Call for Reinspection Before Covering
@
Owner/Contr.
Inspector:
~~
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
.J'
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
. 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
Jh79j ~i^"t:> ~ -neAIL-
3. LEGAL DESCRIPTION
Permit No. ~'l- '358
1. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTUHE
(Height) (Width) (Depth)
LOT
t,
BLOCK
'P(2-<CJfl-
2-_
S~-'"Tt~
PID
-z.S' -01(- 0 ~3 -0
12. NO. OF STORIES
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER (Name)
.::::Jt F F S77>4:6R....
5. ARCHITECT
(Name)
(Address)
I~ 7s"7:> 8 t. tND LK. h!!l .
(Address)
(Tel. No.)
t./y7-(PZ 17-
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
~LP
7. TYPE OF WORK
New Construction 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofin~ Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
d 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
at all struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
rmit to t cause. Furthermore. I hereby agree that the city official or a designee may enter upon the property to perform n?de? i~spections.
:? - . q-/y-?f
Signature License No. Date
x
SETBACKS: Required
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
12e'S>
I
A If-
I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS 0
SURVEY 0
PERCOLATION TESTS 0
SETS
COPIES
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
"2,'5<:::)0. -
PLOT PLAN
o
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Permit Fee ................................... $
'14.1<)
Plan Check Fee ............................. $
State Surcharge ............................. $
\.L~
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
$
This Appli
By
.......~$ / I
i ingpermitWhen~.
te
I
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
(~,-
Paid 1 ~. -: Receipt No. ~ <)0 ""Z..fJ
",'00 0." +f It\; 1"1'1 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 requested. 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.
Certificate of Occupancy
Total Due .............................. $
City Planner
Date
Special Conditions W any
24 hour notice for all inspections 447-9850