HomeMy WebLinkAboutBuilding Permit 99-1098
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEI;>ULED
ADDRESS 16427 NORTHWOOD ROAD NW
OWNER CONTR
PHONE NO. PERMIT # 99-1098
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~ Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
Inspector: ~ Owner/Contr.
~~
DATE RECEIVED
9/3/01
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CE~TIFICATE OF
ZONING .COMPLlANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
99-/()98
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) ,)
2.S1TE ADORESS \ (0 '-I ~ '7 N D Rt l uJ '" ~ d 1\1 N. w
3. LEGAL DESCRIPTION
59
/110 E77-IW (';0 0
(Address) JI
1(..,4-':)1 (\jbttb..,l<"cf M
(Address)
t.DATE
1/3/11
n' RIS..o
---I(,,;c.; LAK_
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
BLOCK
PID25"-It.f 1- 03r;,.-O
13. TYPE OF CONSTRUCTION
ADDITION
~ (Nam.)
~" (r~p, Ad
5. ARCHITE'cT (Nam.)
C\"k...
(Tel. No.)
H1-
(T.1. No.)
14. FLOOR AREA APPORTIONMENT USE
51;;J.5
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction D
Fireplace D
Alterations 0
Septic D
Addition 0
DeckLJ
Finish Attic D
Re-rOOfing~ Porch D
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES 19. 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 property and that all construction will conform to all existing state and locallaw$ and will proceed in accordance with submitted plans. I am aware that the
building ~ci~an revoke this po/'flit for just cause. furthenn5 I hereby agree that the city official or a designee may enter upon the property to perform n~~.
X C .-..% ~ ~ -./ \' (Co - C-~ L-.t....r....l-
'" Signature License No. / Da e
17. COMPLETION OATE
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
Front
Back
Side
Side
SOIL TESTS
o ENERGY DATA
D
USE OF BUILDING
H//L
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION -----.2- r7J7J _ cr7./
PILING LOGS D PERCOLATION TESTS D
BUILDING DEPARTMENT VALUATION
PB
PLANS & SPECS D
SURVEY 0
PLOT PLAN 0
SETS
COPIES
TYPE OF CONSTRUCTION, I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
Permit Fee ................................... ct.
S U
City:
Amount Brought Forward .................. $
Pari< Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
7cf. '1 ("
Plan Check Fee ............................. $
State Surcharge ............................. $.
/ . !.-\
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
Mechanical Pennit Fee ..................... $
Sewer & Water Permit ...................... $
:: :r~a1 A:: .~Jit~i~.~..~it Wh.n ~pro~",
By _~i.; Oat. er/;c 1'1 /
I I '
Certificate of Occupancy
Issued
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Total Du. .............................. $ '7(,. () 0
Paid '7 r,. 0 0 R.c.ipt ~J~ Go 07 0
Oat. Cj/::d99 By ~
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 a~uested. 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.
City Planner
Date
Special Conditions ff any
24 hour notice for all inspections 447-9850