HomeMy WebLinkAboutBuilding Permit 99-0865
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 15873 FREMONT AVENUE NW
OWNER CONTR
PHONE NO. PERMIT # 99-0865
TYPE OF INSPECTION JU;-ROOF
COMMENTS:
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o
o
Work Satisfactory, Proceed
Correct Action and Proceed
Correct Work, Call for Reinspection Before Covering
yO
Owner/Contr.
Inspector:
~~
DATE RECEIVED
7/IZ../Cf'1
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)
12.SITEADDRESS /rff)J C" l!l .
.:> 1'" /'ei"""'ttf' /1\1< I!/.I,J
1. DATE
7-/1- -0, C{
J'?!.(s.o
3. LEGAL DESCRIPTION
6
BLOCK
VtE:W
I
2,.J()
PID 25 ~2 </.1- ()()8-0
LOT
ADDITION
15L_
4. OWNER (Name)
rkV-f. fh..,: ~ ,';,.1/
5. ARCHITECT (Name)
(Address)
ISfr'7J fre/VwJ.A.1l- A/N
(Address)
(Tel. No.)
~tftl-7.-"'Y7
(Tel. No,)
(Add'.SS) . I. I_II LTe!. No,)
11..1A11V1{.J>11..(.-ri/'t~j, 7P'7-
.4.4e/II.'''''' a",,'kJ/-.'1 &,JI'Note/ illNMviL'-'- ~ST)7 6'15""i
7. TYPE OF WORK Fireplace 0 Septic D Deck D
New Construction LI Alterations 0 Addition D Finish Attic 0
6. BUILDER
(Name)
Re-roofin9)f Porch 0
Re-siding 0 Finish Basement (J
di: Jb'f-C
7C.OeJ
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qc:;- 8(05
BUILDING INFORMATION
11, SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13, TYPE OF CONSTRUCTION
~~f<.~!ffl
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
/'6",.f"'tPd -
17, COMPLETION DATE
Chimney a Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Fl. L-- 7 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
tfle above mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware tflat the
bUilZlcial c~'l!'1'vok. this p.rmit 10' just cause. Furthermme, I h.,eby agree that the city official 0' a designee may .nte' upon the property to pertorm n.eded inspections,
X -~ L-6/A"q'JJi-3""" -rJ--<; 'i
. Signature License No. Date
FOR ADMINISTRATIVE USE
Amount Brought Forward .................. ot
Park Support Fee ........................... $
SAC ,........................................ $
Collective Street Fee ....................... It
Sewer Tap ...................................It.
$
Pressure Reducer .......................... It
Meter Hom ................................... $_
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ...........................4'.
Water Tap ................................... $
Builder's Deposit ............................ It,
Other ......................................... $
Total Due .............................. $
Paid -; ~ . (J () R.ceipt No,
Oat. -711 zJ qq By ~
This is to certify that the request in the above ar::4)lication and accompanying documents is in accordance with the City Zonin'g Ordi~ance a'nd may proceed 4 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.
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
"2-nf() . <:J'-'
USE OF BUILDING
/ZE,$" n/L
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A S U
City:
Division 1 2 3 4
Permit Fee ...................... ......... .... $
7<1. -r>
Plan Check Fee ............................. $
I.'Z..~
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
:i~aZ 1:~t~.CiJ~;,~i~~.;.~it whejAPp,cN~/.i
By ~~17l1A. Date '77(1,;./ 't 7
1 / / I
Certificate of Occupancy
Issued
MATERIAL FILED WITH APPUCA TION
SOIL TESTS 0 ENERGY DATA a
PILING LOGS Cl PERCOLATION TESTS Cl
PLANS & SPECS a
SURVEY a
SETS
COPIES
PLOT PLAN
Cl
7r,.tJO
..351:0 5V
24 hour notice for all inspections 447-9850
Spectal Conditions if any
City Planner
Date