HomeMy WebLinkAboutBuilding Permit 99-1174
City of Prior Lake
Inspection Notice
DATE
TIME
10/25/99 A.T.
SCHEDULED
ADDRESS 15805 FREMONT AVENUE NW
OWNER CONTR
PHONE NO. PERMIT # 99-1174
TYPE OF INSPECTION RE-ROOF
COMMENTS:
4 Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, Call for Reinspection Before Covering
@
Inspector:
Owner/Contr.
.......
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16. PROJECT COSTNALUE
CCI"r)
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/17. COMPLETION DATE
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I hereby certify thai 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 oVauthorized agent for
the above mentioned property and Ihat all construction will conform to all existing slale and local laws and will proceed in accordance with submitted plans. I am aware thatlha
building off~,1 ~a~ &e~~ke this permit f9r iyst ~,~7f' Furthermore, r hereby agree that the d.t: official or a deSi~nee may enter upon the property 10 perfol(Tl ~ee~d in~eclions.
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J'lgnalureU License No. Date .
..
. .
DATE RFC:FIVFD
CITY OF PRIOR LAKE
BUILpING-PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I:
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':CTIONS i\',; [I '. '
, '
;ES NUMBERED 1 THRU 17 MUST.BE FILLED IN
I-_,-ORE PERMIT IS ISSUED(Please prin~or3Yp.~ sign at bottom)
12. SITE ADDRESS c. ,] st. P t. I~J
\-.) oD'S ~(f0'Of"\\ P\Ve
3. LEGAL DESCRIPTION
4-
1. DATE
q - L ) -11
/,- (,-:U
LOT
/
2,- - 2 ' '-'7 - {'}/~i - 0
PID _~! '"1' C
BLOCK
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ADDITION
14. O~NER
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15. ARCHITECT
6. BUILDER;' '
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/SC;'INU
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(Name)
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(Name)!
(Address)
f ;:-,. (Tel. No.)
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(Tel. No.)
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(Address)
(Name);
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,
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(Tel. No.}
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7. TYPE OF WORK
t Fireplace 0
Alltratlons 0
Deck 0
Finish Attic n
,
Re-roolin~. Porch n
Ae-siding 0 Fmish Basement 0
. Septic 0
Addition 0
New Construction 0
Chirnney 0 Misc.
8. PROPERTY AREA OR ACAES
Sq. Ft.
19. PROPERTY DIMENSIONS
Width Depth
110. CULVERT SIZE
Yes No
I. White
2 Pink
J. Yellow
File
City
Applicant
Permit No.
9<'7 //7j
BUILDING INFORMATION
1,. SIZE OF STRUCTURE
(Haight) (Width) (Daplh)
12. NO. OF ST~S
13. TYPE OF CONSTRUeTION
, t.p (OC)-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
FOR ADMINISTRATIVE USE
MATERIAL FILED WITH APPLICATION
Side SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
Amount Brought FOlWard,.... .~~. .......... $
, it'.;
Park Support Fee ........................... $
SAC ......................................... $
Collective Slreet Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer .......................... $
Meter Horn ...... .............. ...... ......... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
Water Tower Fee ........................... $
WalerTap ................................... $
Builder's Deposit ............................ ,t
Other ...........,...,...........,............, $
Total Due .............................. $
Paid -7t-, () () Receipt N9.. ...3C Z s S-
Dale 'l/? ",/ /V '/ BY:W
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 con~tltutes a temporary Certificate 01 Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
_ PERMIT VALUATION
USE OF BUILDING
k'E..':::: /-// K-
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A' B . E . F 'H I M
Division 1 2 3 4
Permit Fee ,.,.,..,........................... $
v
jj. S u'
7<1 ?c,-
Cily~
Plan Check Fee .................... ......." $
State Surcharge ............................. $
I. Z r,-
Penalty....................,...,.,.... ........ $
Plumbing Pennit Fee ....................... $
Mechanical Permit Fee ...............,.,... $
Sewer & Water Pennit ...................... $
Gas Fireplace Pennll .....~........,........ $
This J.3!'..(~ecoi~y"",k~~ing Permit ~hP?1,PPr,ovftoc,
By A_~v;., ~ '-- ~yc~ Date 1/ Z If/1 J
i/ "
/
f':p.rtiflcale of Occupancy
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CilyPlanner
Dale
SpflcialConrlirions if any
24 hour notice lor all inspections 447-9850
$
/v.CO