HomeMy WebLinkAboutBuilding Permit 99-0706
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 16361 NORTHWOOD ROAD NW
OWNER CONTR
PHONE NO. PERMIT # 99-706
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~
./' Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector:
tjO
------T
Owner/Contr.
~~
.I2.ll,n:l=u::r.l=l\rI=.Q
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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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
"3" Norfl.o.lIootl fl.).
\ '6J,O/'1't
/C/~
3. LEGAL DESCRIPTION
PID ~. /4/, 039.0
LOT
~2-
/I/O x:TH 11100.0
BLOCK
ADDITION
4. OWNER (Nam.)
{t1AR/Lor" ~ //1' I~ J
5. ARCHITECT (Name)
(Address)
'I.HI lIi1rt/.w.o.i ~
(Address)
(T.1. No.)
'11/7-27"
(T.1. No.)
6. BUILDER (Name)
BAltc :l"e/ oIS", r;(S
(Address)
1700/ F,j/. JO...,.t ru. SF-
S,oId,. 111'1
(Tel. No.)
6/21f'1" '7JO
7. TYPE OF WORK
New Construction 0
Fireplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Rs-roofing " Porch 0
Re.siding 0 Finish Basement (]
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq -70to
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES I
13. TYPE OF CONSTRUCTION
T~.".ft ~.tt..,(
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT.
SEATS
16. PROJECT COSTNALUE
"'1,17'
17. COM;'/~O:; If;
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished 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 aOO will proceed in accordance with submitted plans. I am aware that the
building offici~a~ rev~e thi rmi r just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed j'1spections.
X f(~ 2Q173'f7S' //0/'1'
~ ~~ . .~
Amount Brought Forward .................. $
ParkSupportFee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
S
Pressure Reducer .......................... $
Meter Hom ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................!I:
Other ......................................... !I:
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
zru-v- (/'l...I
USE OF BUILDING
RES ~/L
TYPE OF CONSlRUCllON: I II III IV V
Occupancy Group A B E F HIM R S U
City:
Division 1 2 3 4
Permit Fee ................................... <I:
74.7~
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
I. 2- r-
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
;5 Fr r a. .""11 :J.~I~~i:t~itW~.f7&frcJ
, # I /
Certificate of Occupancy
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS [] ENERGY DATA []
PILING LOGS [] PERCOLATION TESTS []
PLANS & SPECS [] SETS
SURVEY [] COPIES
PLOT PLAN []
-n.OO
Paid 7(, _ (J7J R.c.ipt N<+ . 3,S cJ. zj"p
- . h ~
Dat. tI:J 0/ tf q By "IJ..--.--
This is to certify that the request in the above application and accompanying documents is in accordance with the City zoning'Ordinlnce an~ 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.
Total Due .............................. $
24 hour notice for all inspections 447-9850
Special Conditions W any
City Planner
Date
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