HomeMy WebLinkAboutBuilding Permit 99-0606
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 15850 EAGLE CREEK AVENUE NE
OWNER CONTR
PHONE NO. PERMIT # 99-0606
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector: W Owner/Contr.
J" PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
/'
va fumishe information n 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
that all rue. n will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
t ca harmere, I hereby agree that the city ~cO OJ a .s.~3/7r upon the property to perf::fJ;;ed;-Ji}rjiOOS.
.-L Signature Ucense No. 7 - . 06.19
Amount Brought Forward .................. $
Park Support Fee .... .... ................... $
SAC ......................................... ~
Collective Street Fee .......................~,
Sewer Tap ................................... ~
$
~1
5;S:;;'
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING 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 at bottom)
2. SllE ADDRESS
15"f-~O CAGLE ClL:c~.... Av'b
'4E1) 1Cf
(
NE
3. LEGAL DESCRIPTION
BLOCK
,{\;\ I kyJ t>>- fuw.yj.>
4. OWNER (Name)
cD fVIPtlLtl NI
PID 2..'1 -0 S2. -() let -0
LOT
ADDITION
SH~I
1/(pO I
(Address)
111 A-SO.v Ie ~ ME [) J{.
(Tel. No.) " I ~
~~/-:J-9?'
(Tel. No.)
5. ARCHITECT
(Name)
(Address)
6. BUILDER (Name)
(Tel. No.) f, S- (
(,.2t:> ~ 341 ~b
71\-1 C::~ +:NC
(Address)
17 SS f3 E1€-J<:t:. L € Y
sr. ?A /.-( L I J41 N
Septic 0 Deck n Re-roofin~ Porch n
Addition LJ Finish Attic 0 Re-siding n Finish Basement 0
7. TYPE OF WORK Fireplace 0
New Construction 0 Alterations 0
Chimney 0 Mise
8. PROPERTY AREA OR ACRES
Sq.Ft.
I hereby certify th
the above menti
building official
X
/
SETBACKS: Required (j
Actual
FOR ADMINISTRATIVE USE
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ........................... .... .... $
/4.1r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty....................................... $
Plumbing Permit Fee ....................... $
\.'2.1
1. White
2. Pink
3, Yellow
File
City
Applicanl
Permit No.
qq - (pa6_
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
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS l] PERCOLATION TESTS LJ
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
o COPIES
o
Pressure Reducer .......................... $
Meter Horn ................................... :t
Water Meter ................................. :t
Sewer & Water Connection Fee ........... ~
Water Tower Fee ........................... $
Water Tap ................................... !I:
Builder's Deposit ............................ $-
Other ......................................... $
Total Due .............................. $
Pa;d 7 ~ . dO
Dale r;;/v-I/Qtj
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Gas Fireplace Permit ....................... $
Th;s uild;ng ~:I~;I WJ>et!P;F1fr (1
~ ~ f f
Issued
7tJ.cJO
Rece;pl No. .?>S" s J 0
-1M--
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~uested. 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.
City Planner
Date
Special ConditiOlls W any
24 hour notice for alt inspections 447-9850