HomeMy WebLinkAboutBuilding Permit 99-0405
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 17280 SUNRAY CIRCLE SW
OWNER CONTR
PHONE NO. ' PERMIT # 99-405
TYPE OF INSPECTION RE-ROOE
COMMENTS:
6 Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector: _ gJ , Owner/Contr,
_.,._-------"'--~-_.__..._..~_._-
New Construction LJ
Chimney LJ Misc.
\8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yas No
I hereby certify that I have furnished 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~b ntioned pro~e that all construction will conform to all existing state and local laws and will P, rocead in accordance with submitted plans. I am aware that the
buil . 9 offici can revok is tor just cause. Furthermore, I hereby agree that the city officIal or a designee may enter upon the property to perforr~needed inspections.
X_ WW" oO.~qq .<j-J'l_~'1
~ S~ ~~NO.~'
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:7:RI7~V;D
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CE_RTIFICATE OF
ZONINQ 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 al bottom)
12, SITE ADDRESS
/lZgD $",., Rf"" ~\12..
1. DATE
.q -/o,.q q
3. LEGAL DESCRIPTION
&;
ADDITION
"'0000 te>V
I
1<;"(
PID J.;:--18S- 00&-0
BLOCK
LOT
4. OWNER r (Name)
{(PI + ::>1tvt"1I\5
5. ARCHITECT (Name)
(Address)
y"'~
(Address)
(Tel. No.)
417-S7S0
(Tel. No.)
6, BUILDER
(Name)
(Address)
(Tel. No,)
RIC71+TWI'\,-/
7. TYPE OF WOR~
1200 [. 76/1t tAv<
~s3-004"l
,<k, F ,rJIY
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Re-roofing. Porch 0
Re-siding 0 Finish Basement a
1. White
2. Pink
3 Yellow
File
City
Applicant
Permit No.~Lto6
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
~ - J<..OQ p-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PR~JECT COSTNALUE
~S2X'1 -
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Baok
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO
SPACES ON PLAN
PERMIT VALUATION
z.. nru . <IU
USE OF BUILDING ~~
K/1L-
."
I MATERIAL FILED WITH APPLICATION
SOIL TESTS a ENERGY DATA [)
PILING LOGS a PERCOLATION TESTS [)
PLANS & SPECS a
SURVEY [)
SETS
COPIES
PLOT PLAN
o
Permit Fee ................................... $
74-. 1 ~
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ......... .............. $
Sewer Tap ................................... <1'.
Pressure Reducer .......................... $
MeterHom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... !I:
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $ ,(,. cJ1)
Paid fl(, cf7J Receipt N"J'; r 0 (. I
Date 0/"'- ./.er,tj By Y.)<./"--'
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning 6rdinab and may proceed as rCquested. 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.
TYPE OF CONSTRUCTtON: I 11 III IV V
CccupancyGroup A B E F HIM R
Division 1 2 3 4
s U
City:
Plan Check Fee ............................. $
State Surcharge ............................. <l:
I. 'L~
Penalty....................................... $
Plumbing Permit Fee ....................... '1:
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... ~
This Application Becomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
Issued
$
24 hour notice for all inspections 447-9850
Special Condrtions ~ any
CRy Planner
Dale