HomeMy WebLinkAboutBuilding Permit 99-1070
'City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 16252 LAKESIDE AVENUE SE
OWNER CONTR
PHONE NO. PERMIT # 99-1070
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~. Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Cpall for Reinspection Before Covering
Inspector: a Owner/Contr.
t/
6~1
B7~;71q
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. q'f' ~
/07'0
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT 15 ISSUED (Please Print or Type and sign at bottom)
2, SITE ADDRESS
/bJ..\"2.... t-.u..~s,~.. .A-.'l, ,)?
1. DATE
8f^7/cn
Ie/SD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
3. LEGAL DESCRIPTION
23
L /},kE-Sf oS
12. NO. OF STORIES
LOT
BLOCK
PID ,2s-oqr.,,-/J/l.-O
ADDITION
Plrt<?..IC-
13. TYPE OF CONSTRUCTION
5. ARCHITECT
(Name)
L-a.. '\ 1
(Nam~
(Address)
r.~ ) , I en IA
(Address)
(T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
4. OWNER
(T.1. No.)
6. BUILDER
(Name)
(Addr.ss) (T.1. No,)
"(HI B"",')~t..." 6,;.
EJ-?V'o.l~4,M.rJ 'i'O$lUO:('
Deck 0 Re-roofingll-. Porch 0
Finish Attic LI Re-siding LJ Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
f.k>"^",, Ow,^~"'~ ~V/)~rp
7. TYPEOFWDRK Fireplace 0 Septic 0
New Construction 0 Alterations 0 Addition 0
Chimney Ij Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
OCCUPANTR
SEATC::;
16. PROJECT COSTNALUE
x
19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Width Depth Yes No
ava ~'s d 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
pro d 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
va Ihis ~it fo' jusI caus.. Furth.nno'., I ha'aby agree that 'h. city official 0' a d.sign.. may .nl., upon !h. property to p.rtonn ~ i'Ji}.OflS.
\ ~ ~ I U bCr. (1f ~)
Signature Licen'se No. Date
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
Side
MATERIAL FILED WITH APPLlCA nON
SOIL TESTS (] ENERGY DATA (]
PILING LOGS LJ PERCOLATION TESTS LJ
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
/PF.-S Rj'/i"
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS Ij
SURVEY Ij
SETS
COPIES
"2- ,,7)'J aU
PLOT PLAN
"
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM A S U
/,1
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Division 1 2 3 4
7 i-
Permit Fee .................. ............. .... $
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
7...-)
I
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Sewer & Water Permit ...................... $
~::tJIJf~7~. ~........,~I~~';.~itWhenPro~'l
By /,,/,S, Dat. g b 1
, /
Certificate of Occupancy
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Due .............................. $
Paid 7&.0 0 Receipt No...5-"003l'P
Issued
Dal. 6!7_7/Q'1 By rUe? -
This is to certify that tile request in the above arfllication and accompanying documents is in accordance with the City Zoning brdinande and may proceed ~~-:ested. 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.
'7(" ,0 0
City Planner
Dale
Special Conditions if any
24 hour notice lor all inspections 447-9850