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HomeMy WebLinkAboutBuilding Permit 99-0642 City of Prior Lake Inspection Notice DATE TIME SCHEDULED 10/25/99 A.T. ADDRESS 16951 WILDERNESS TRAIL SE OWNER CONTR PHONE NO. PERMIT # 99-642 TYPE OF INSPECTION RE-ROOF COMMENTS: "er-- Work Satisfactory, Proceed o Correct Action and Proceed o Correct Work, Call for Reinspection Before Covering Inspector: ~ Owner/Contr. ---,---- ! iJ~); DATE RECEIVED CITY OF PRIOR LAKE 6/2.-7/qQ- BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2. Pink 3. Yellow File City Applicant Permit No. qq-~+2- DIRECTIONS 1. DATE SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN $/;>'7) 9<} BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) BUILDING INFORMATION 2. SITE ADORES! I l,; ~ IU, T",w 1</5D 11. SIZE OF STRUCTURE tq~/ (Height) (Width) (Depth) 3. LEGAL DESCRIPTION 12. NO. OF STORIES LOT Zo BLOCK I PID 2.S'-.31e- 0'l..O-0 NILD6A!?N6SS PONOS 13. TYPE OF CONSTRUCTION ADDITION 4. OWNER (Name) (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE 5. ARCHITECT (Name) (Address) (Tel. No.) 6. BUILDER (Name) (Address) ;;I;~)I (i) 15. NUMBER OF OCCUPANTS OR SEATS A(...,U~;V HrJMGS IzL/-3.$ PRIJ'l/aeroN OCCUPANTS >~ 7. TYPE OF WORK Fireplace 0 Septic 0 Deck 0 Re-roofiii~. Porch 0 SEATS New Construction 0 Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0 16. PROJECT COSTNALUE Chimney 0 Misc. 8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS I ,10. CULVERT SIZE 17. COMPLETION DATE Sq.Ft. Width Depth Yes No I hereby certify that I have furnished information on this application which is 10 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 stale and local laws and will proceed in accordance with submitted plans. I am aware that the building official canlVOke ~s permit fO~ cause. F*~ore, I hereby agree that the city official or a designee may enter upon the property to perform ~~7~d in~tlOns. X ' r.]. . . - .:s-.2-" '4'-;"- Signature A" - License No. 0810 V FOR ADMINISTRATIVE USE SETBACKS: Required MATERIAL FILED WITH APPLICATION Actual SOIL TESTS 0 ENERGY DATA 0 Front ."" Side Side BUilDING DEPARTMENT VALUATION OFF STREET PARKING PILING lOGS 0 PERCOLATION TESTS 0 A'JI:- SPACES REO. PLANS & SPECS 0 SETS USE OF BUilDING /86.s SURVEY 0 COPIES , SPACES ON PLAN PERMIT V ALUA TION Z nnM/V PLOT PLAN 0 TYPE OF CONSTRUCTION: I II III IV V Amount Brought Forward .................. $ Occupancy Group A B E F H I M R S U City: Division 1 2 3 4 Park Support Fee ........................... $ Permit Fee ................................... $ '7<1.7S- SAC ......................................... $ Plan Check Fee ............................. $ Collective Street Fee ....................... $ f.'"t.) Sewer Tap ................................... $ State Surcharge ............................. $ $ Penalty ....................................... $ Pressure Reducer .......................... $ Plumbing Permit Fee ....................... $ Meter Horn ................................... $ Mechanical Permit Fee ..................... $ Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Sewer & Water Permit ...................... $ Water Tower Fee ........................... $ Gas Fireplace Permit ....................... $ Water Tap ................................... $ This Application Becomes Your Building Permit When Approved. Builder's Deposit ............................ $ By Date Other ......................................... $ Certificate of Occupancy Total Due .............................. $ 7(,. () Cl Paid '7c.. CI1.J Receipt No. ~r-q Issued Date ->1Z,7! qq By ~ ~ / This is to certify that the request in the above application and accompanying cIocuments is in accordance with the City Zoning Ordinance and may proceed i. 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. City Planner Date Speclal Conditions if any 24 hour notice for aU inspections 447-9850