HomeMy WebLinkAboutBuilding Permit 99-0912
City of Prior Lake DATE
Inspection Notice
. .1 0/25/99
SCHEDULED
ADDRESS 16925 BLIND LAKE TRAIL SE
OWNER CONTR
PHONE NO. PERMIT # 99-912
TYPE OF INSPECTION RE-ROOF
COMMENTS:
e::( Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector: 9~ Owner/Contr.
TIME
A.T.
DA TI= !:::1I=r:ElY.ED.
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
Permit No._99- 9/?
1. DATE
2SITi'tfldSc;- A/irrllak'r\. TF.
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..
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
KI-sP
3. LEGAL DESCRIPTION
LOT
BLOCK .5"
S oc..I7H-
12. NO. OF STORIES
/'/
?.eIOL
4. OWNER (fVr .('
;NU.t, u I
5. ARCHITECT (Name)
PID 2<:;;'-017- ~9..3~O
~Address~
I r;,qd:. Pi, rei la.ke -rr.
(Address)
(Tel. No.)
O"I:J)
(Tel. No.)
I ~E ~ 9,O/"STRUCTlON
. fI (1,
I 14. FLOOR AREA APPORTIONMENT USE
ADDITION
(Address) (Tel. No.)
I ;)d!-I'7 tvt'ctJI1e+ U /9>h01"'/Pi51
A~. ~'f1Jrrby/ltp ~I
7. TYPE OF WORK Fireplace 0 Septic 0 tJeck 0 Re.ro6fi~ Porch 0
~~:~:;~nJ~::D Alterations 0 Addition 0 Finish Attic 0 Re-slding 0 Finish Basement 0 1-11' PROO~~TNALUE
,n/).-. .
B. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS /10. CULVERT SIZE 11. COMPLETION DATE
Sq. Ft. 8' :)::f Width Depth Yes No ,I
I hereby certify thafl 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 a ve mentioned prope and that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
bull icial can r voke i e 't r just cau e. Furthermore, I hereby agree tha~:~r ci!;y official or a designee may enter upon the property to perform needed inspections.
X '2 (("q~>1:2., U"",..No ~
6. BUI{!;ner (iJ.;;.etAJ'tar 'fIj
&~C-forS :I:.17c.
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
- BUILDING DEPARTMENT VALUATION
USE OF BUILDING
PES n-/L.
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
2 t7J(.)_ ~
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
S U
/tf."1J
City:
Amount Brought Forward .................. $
Park Support Fee ........................... ~
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ........................................ $
Plumbing Permit Fee ....................... $
/. z..r
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom ... .... .... ........................ $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Sewer & Water Permit ...................... $
~_o '~~='''ifrfJ
Certificate of Occu ancy
Water Tap ................................... $
Builder's Deposit ............................ $
other ......................................... $
Total Due .............................. $ '7 t;. (7(/
Paid7~. dl1 Receip;w. .3.s-,f ~
Date 7b 7/qq By If~
This is to certify that the request in the above application and a~""", '...... 'ling documents is in accordance with the City Zoning brdlna,{ce anclmay procee<tJs 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.
Issued
City Planner
Dale
Special Conditions if any
24 hour notice for all inspections 447-9850