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HomeMy WebLinkAboutBuilding Permit 99-0611 City of Prior Lake Inspection Notice DATE 10/25/99 . SCREDULED ADDRESS 17103 SUNRISE AVENUE SW OWNER CONTR PHONE NO. PERMIT # 99-611 TYPE OF INSPECTION RE-ROOF COMMENTS: ~ Work Satisfactory, Proceed o Correct Action and Proceed o Correct Work, /":)or)einspection Before Covering Inspector: L..r Owner/Contr. TIME A.T. ~1 ;;R;;119 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT ?Vhv1i:t ~ 7/0 . 00 I. 2. 3 White Pink Yellow File City Applicant Permit No. 99-tP1/ 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 n I 0-1, .~U h n~ce M/t S l-J BLOCK 3 HLL..L...':. 1. DATE 5111 /qGt g.\SD BUILDING INFORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) 12. NO. OF STORIES LOT PID 2(';-112..- o4Cl-C) 4.0W:tf (Name) ; l!~HITE~)V7j~~e~)Y\ (Address) 11/ O~)'IlnnSt. /k..R, ,S;,W (Address) (Tel. No.) 4l-jl.RbD~ 13.TYPEOFCONSTRUCTION . do~ , 0 .fJ:WW:4 \t'lIl.Q.\-g~1 "I'II'\../' 14. FLOOR AREA APPORTIONMENT USE ADDITION (Tel. No.) 6. BUILDER (Name) 7. TYPE OF WORK New Construction LJ Fireplace 0 Alterations 0 (Address) \bN[.Cli4 R.D o JrIJ . YY\ f\_ <\'\,::j?" Septic 0 Deck 0 Re-rOOfing~ Porch 0 Addition 0 Finish Attic 0 Ae-siding LJ Finish Basement LJ (Tel. No.) 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS f(\ l 0JJe..)\ {\ 'n\ tt'<Ul:'f 01'2- ~'b'V -dio 00 SEATS Chimney 0 Misc. a. 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 the above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. J am aware that the building offic~can revoke ltlis permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ~ections. X -'Ilillo/LAf ~;g~ ').0 /4TJ,~~i~"" No 5/17 /~'! . ~ 16. PROJECT COSTNALUE fCp11?fl 17. COMPLETION DATE Front FOR ADMINISTRATIVE USE MATERIAL FILED WITH APPLICATION Back Side Side SOIL TESTS 0 ENERGY DATA 0 OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0 SPACES REO. PLANS & SPECS 0 SETS SPACES ON PLAN SURVEY 0 COPIES PERMIT VALUATION ?~) UU PLOT PLAN 0 SETBACKS: Required Actual BUILDING DEPARTMENT VALUATION USE OF BUILDING eF-<; IJd Ie- , TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R DMsion 1 2 3 4 S U City: Amount Brought Forward .................. $ Park Support Fee .... ....................... $ SAC .........................................$ Collective Street Fee ....................... $ Sewer Tap ................................... $ $ Permit Fee ...................... ......... .... $ Plan Check Fee ............................. $ State Surcharge ............................. $ Penalty ....................................... $ Plumbing Permit Fee ....................... $ 14- ,1 <e:1 \. 2.. ':) Mechanical Permit Fee ..................... $ Pressure Reducer .......................... $ Meter Hom ... .... .... ................. ....... $ Water Meter ................................. $ Sewer & WalerPermit ...................... $ Sewer & Water Connection Fee ........... $ WaterTowerFee ........................... $ Water Tap ................................... $ Builder's Deposit ............................ $ Other ......................................... $ Total Due .............................. $ -j~. dU Paid I G,. OV Receipt No. :3 5 33 CO DateS-/2..'~-/qq 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 at?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. Th, n e~n "~'~'~'e~'t Whe B ts Date'- Certificate of Occupa!cy Issued city Planner Date Speciai Coodilions ~ any 24 hour notice for aU inspections 447.9850