HomeMy WebLinkAboutBuilding Permit 99-1019
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 16605 NORTHWOOD ROAD NW
OWNER CONTR
PHONE NO. . PERMIT # 99-1019
TYPE OF INSPECTION RE-ROOF
COMMENTS:
P Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector: t;P Owner/Contr.
-~---_._-----_.-------"..~--. -
New Construction 0
Chimney [j Misc.
8. PROPERTY AREA OR ACRES \9. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yas No
I hereby certify that 1 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 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 that the
building ~iai can revoke thi~pennit It>r juW cause. Furthermore, I hereby agree that the city official or a des,ill.nee may enter upon the p'operty to pertonn needed insp~ns.
X . j ~ ~~--{~ LJ:J XI . 'if. -) ') -"'I '(
Signature License No. Dale .
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING .cOM?L1ANCE
AND UTILITY CONNECTION PERMIT
nA TF RECEIVED
6/7/f1
1. DATE
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bonom)
\2SytDtR;ls- N~.D~
3. LEGAL DESqRIPTION
LOT :< ~. p/o A- BLOCK
ADDITION dO ;e77fWo(JO
~ - 1/ .'1 q
K/So
PIO ?<';;-I.}/,-ocB -()
(Tei. No.)
~I~ D...
(Tei. No.)
\4. OWNER . (Name)
m: Ke..
\5. ARCHITECT
6. BUILDER
_ ~U\. (~ddress) 1 I J_
('n~/r,'~~O,~
(Address)
(Name)
(Name)
(Address)
(Tei. No.) 1581 .~ ~ j;J.
s~
q ') 0 l p.tIJv\rA ~ ~,
Re-roofing.QI' Porch [J
Re-siding [J Finish Basement [J
7. TYPE OF WORK
~
-~
Fireplace [) Septic [)
Alterations [) Addition [)
Deck [)
Finish Anic [)
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
9f' -/0/1
BUILDING INFORMATION
11. SiZE OF STRUCTURE
(Helghl) (Width) (Depth)
12. NO. OF STORIES 1
13. TYPE OF CONEi-TRUCTION
~~
14. FLoOR AREA APP~RTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
$. ')ro.6^
17. COMPLfTIC)N DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Amount Brought FOIward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .......................!t
Sewer Tap ................................... $
~
Pressure Reducer .......................... It'
Meter Horn ... .... ............................ It'
Water Meter ................................. $
Sewer & Water Connection Fee ........... lI:
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ !t,
Other ......... ........ ........................ $
Total Due ............................., $ /5lJ.1s
Paid />lJ. 7" ReceiPW9. .3s I( K' (..,
Issued . Date Po /r"1 Jqq By A" M-----
Tho is to certify that the request in the above application and .ccompanying doouments ~ in accordanc' with tho City Zoni~ ~ may pr~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.
Front
Back
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
z <;aC) ,rJ7 ---
USE OF BUILDING
~e3 o/~
TYPE OF CONSTRUCTION: 1 11 III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... $
17J. 7 s::.--
7<./ . '1)
City:
Plan Check Fee ............................. $
State Surcharge ............................. 'l:;
Penalty.............. ......................... $
1.-z..Y
Plumbing PelTTlit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Pennit ...................... $
This
By
e .,t ·
m~:jj(~~:,~i~~.i:t";it ~I rfl1Cl
I
Certificate of Occupancy
MATERIAL FILED WITH APPLICATION
SOIL TESTS Ll ENERGY DATA Ll
PILING LOGS [) PERCOLATION TESTS [)
PLANS & SPECS Ll
SURVEY [)
SETS
COPIES
PLOT PLAN
Ll
City Planner
24 hour notice tor all inspections 447.9850
Special Conditions n any
Date