HomeMy WebLinkAboutBuilding Permit 99-0898
City of Prior Lake
Inspection Notice
ADDRESS 16541 DULUTH AVENUE SE
SCHEDULED
OWNER CONTR
DATE
TIME
10/25/99 A.T.
PRONE NO. PERMIT # 99-898
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, ~~nspection Before Covering
Inspector: (,/// Owner/Contr.
7
QATF RH'FIVFn. CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING. COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
11-$1.5
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
2. SITE ADDRESS
1&'>4/ D:.JL..t./TH A-Vt"O
3. LEGAL DESCRIPTION
1'. DATE
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
P~ferL~~
LOT
ADDITION
:t.LOCK
me: lei., ~ &NVJS
PID '"Z C;.10'Z. -037-0
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
4. OWNER (Name) (Address)
~.fYI , tol'f'~
J~J~, ~..lZ!.P
.-
5. ARCHITECT ( ame) (Address)
6. BUILDER (Name) (Address)
(Tel. No.1
L/:JO- ~~'t5
(Tel. No.1
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.1
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
Fireplace 0
Alterations 0
SepticLJ
Addition D
Deck 0
Finish Attic D
Re-roofingJ( Porch D
As-siding D / F~ish Basement 0
SEATS
New Construction D
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES /9, 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 pro;t;:e and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
building offi,:!al ~n revok is permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X odJ 4~1 '7-:H-'/'I
. , SiQnature License No. Date
16. PROJECT COSTNALUE
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
PERMIT VALUATION
'Z..~Q?
MATERIAL FILED WITH APPLlCA nON
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Front
Back
Side
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
126<.
.
I
.A-/~
OFF STREET PARKING
SPACES REQ.
SPACES ON PLAN
-
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
OMsion 1 2 3 4
Permit Fee ............................... .... $
..., 4. 1':;-
Plan Check Fee ............................. $
State Surcharge ............................. !I:
Penalty............................... ........ $
Plumbing Permit Fee ....................... $
t. z.""-
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Horn ................ ................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... Cf::
WaterTowerFee ........................... Cf::
Water Tap ................................... ,II:
Builder's Deposit ............................ <t
Certificate of Occupancy
Other ......................................... $
Total Due .............................. $
Paid -, "--~ Receipt No. 3")-"-B<::
I~ h
Date"" 3. (rr By t!d..+
,
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 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.
'7G.. t.:Jl;:J
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
.