HomeMy WebLinkAboutBuilding Permit 99-0589
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDUL},D
,
ADDRESS 17264 SUNRAY CIRCLE SW
OWNER CONTR
PHONE NO. PERMIT # 99-589
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
o Correct Action and Proceed
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MAY L 0 1999
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
c; q -Sl?'/
1. DATE
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 C' j\ ,
\ -rd..~(')L\ ~Vv~~L\
3. LEGAL DESCRIPTION
LOT ~ BLOCK .
ADDITION fjJ()O(/U/t'.I./ / /.I.:..-
4.0WNEf\- _ (Name)
"e.UsJI0
5. ARCHITECT (Name)
~\5 \'\:)
6. BUILDER
(Name)
\\\.~K\-~~ ~\~
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
cs-~C)- <i ~
BUILDING INFORMATION
", SIZE OF STRUCTURE
(Height) (Width) (Depth)
~\ Q..
/
PID ~l) - /'65-' tJ~:-J' ()
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
(Address) C" (Tel. No.)
\'G..ln'-\ :::A.\~\Lf'..\ aR..~\ -'-\.~Cl
(Address) (Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
15, NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
\~()l)1;::; '1\J1\-. ~T
'b <; ::.- COlt ~
SEATS
Septic 0
Addition 0
Re-roofin~ Porch LJ
Re-siding LJ Finish Basement LJ
16. t\'t'l~CT COSTNALUE
J\'>~(X)O~
17. COMPLEllON DATE
DeckLJ
Finish Attic LJ
Chimney LJ Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes 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
~~bo~rn.entiOned prope~ and t!'at a." construction will conform to all existing state an~ 10~1 !aws and ~II proceed in accordance with submitted plans. I am .aware that the
ling I e'1\'ft this permIt for Just cause. Furthermore, I hereby agree that the City J.!!.IC?lal or a deSIgnee may enter upon the property to perform needed Inspections.
X ' l~., l f:sq,\'1 '" -,:~,n-<19
\S9l1ature License No. Dale
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING JOe, If//(
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Back
SOIL TESTS
o
o ENERGY DATA
Side
Side
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
PERMIT VALUATION
PILING LOGS 0
PLANS & SPECS LJ
SURVEY LJ
PERCOLATION TESTS 0
SETS
COPIES
dc::rf). CO
PLOT PLAN
o
Division 1 2 3 4
Permit Fee ................................... $
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City,
Amount Brought Forward ..................,If,
Park Support Fee ............. .............. ~.
SAC ......................................... ~
CoHectiveStreel Fee ....................... <t
Sewer Tap ................................... <t
.
Plan Check Fee ............. ................ $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
74.7<)
/.dS"
Pressure Reducer .......................... $
Meier Horn... .... ............................ ~
Water Meter ................................. <t
Sewer & Water Connection Fee ........... ~
WaterTowerFee ........................... $
Water Tap ................................... <t
Builder's Deposit ............................ $
Other ......................................... $_
Total Due .............................. $ -/&, ro
Paid 'it:" cXJ Receipt NO,;?' ",-2,1(,/
Issued
Date 7 -';!{J ..Lf r By () Yt ~
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 req~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.
This Application Becomes Your Building Permit When Approved.
By !late
Certificate of Occupancy
City Planner
Dale
Special Conditions W any
24 hour notice for aU inspections 447-9850