HomeMy WebLinkAboutBuilding Permit 99-1137
City of Prior Lake
. Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 16093 NORTHWOOD ROAD NW
OWNER CONTR
PHONE NO. PERMIT # 99-1137
TYPE OF INSPECTION RE-ROOF
COMMENTS:
~
o
o
Work Satisfactory, Proceed
Correct Action and Proceed
Correct Work 11 einspection Before Covering
Owner/Contr.
Inspector:
DATE RECEIVED
9//.-,//71
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
L White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq. //37
DIREcnONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
1.DA7E
3
3. LEGAL DESCRIPTION
LOT CJ I BLOCK
/V0/277fWC)oD
A/ &1/
Je / S:LJ
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
PID 2.5-p.lI- 0(00 - 0
ADDITION
13. TYPE OF CONSTRUCTION
4. OWNER
h1
(Name)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6. BUILDER
(Name)
(Address)
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction 0
Rreplace 0
Alterations 0
Septic 0
Addition 0
Deck 0
Finish Attic 0
Ae-roofing
Re-siding 0
Porch 0
Finish Basement 0
SEATS
16. PROJECT COSTNALUE
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.FI.
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
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 aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
:uildin official can re. ke this permit tor just cause. Furthermore I her that the city official or a designee may enter upon the property 1D""2f_"itf~.
License No. Date
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
eo nl-K-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
PLANS & SPECS 0
SETS
COPIES
SURVEY 0
Z>ov.c/V
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 3 4
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
Permit Fee ................................... $
7';' ? r
Plan Check Fee ............................. $
State Surcharge ............................. $
Penany .......................... ............. $
/.7...r
Cling Permit Whe~~v~
Date q (j
I
Pressure Reducer .......................... $
Meter Horn ................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Certificate of Occup ncy
Issued
Paid
o
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 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.
City Planner
Date
Special Conditions if any
24 hour notice for all inspections 447-9850