HomeMy WebLinkAboutBuilding Permit 99-0749
City of Prior Lake DATE
Inspection Notice
10/25/99
SCHEDULED
ADDRESS 16980 WELCOME AVENUE SE
OWNER CONTR
PHONE NO. PERMIT # 99-749
TYPE OF INSPECTION RE-ROOF
COMMENTS:
%' Work Satisfactory, Proceed
o Correct Action and Proceed
o Correct Work, 9U)!orleinspection Before Covering
Inspector: CY Owner/Contr.
TIME
A.T.
~~
DA 11= j::n:r.j:;IYEQ
~;;7J;'J
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. While
2. Pink
3. Yellow
File
City
Applicant
I DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
I (., '1 (),n LU (UO,...., f;. .A. ~ fi.. Sf..
3. LEGAL DESCRIPTION
Permit No.
99-74'1
1. DATE
IrlB-qq
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
lOT
ADDITION
4. OWNER
,.., l'.:...,-r..o
15. ARCHITECT
6. BUILDER
BLOCK
PID 25-2'17...- 001- 0
13. TYPE OF CONSTRUCTION
(Name)
A..IL
(Name)
11..q9>n
(Address)
wtt..u;.onl- fIIVf.o .,~
(Address)
(Tel. No.)
~r~\ 41./7 - 9/2.<1
rri No.)
14. FLOOR AREA APPORTIONMENT USE
(Name)
(Address)
(Ter. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANT~
~ '\="ru i:Olo Ii-"=>
7. TY-PE OF WORK
New Construction 0
Fireplace 0
Alterations 0
6,"'57-
Septic 0
Addition 0
Deck 0
Finish Attic CI
Re-roofing k' Porch CI
Re-siding CI Finish Basement CI
SEATS
16. PROJECT COSTNALUE
Chimney CI Misc.
18. PROPERTY AREA OR ACRES /9, PROPERTY DIMENSIONS 110. CULVERT SIZE 17. COMPLETION DATE
Sq. Ft. Width Depth Yes No "1 _ I _ q C1
I hereby certify that I have fumished information on this application which is to the besl 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
:Uildi~ :ff~a~v~ :h:s~~for just cause. Furthermore, I hereby agree that the city official or a designee may emer upon the property to pet": 18~~pec1ions.
nature license No. Date
FOR ADMINISTRATIVE USE
I SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOil TESTS 0 ENERGY DATA 0
PILING lOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY 0 COPIES
PLOT PLAN 0
USE OF BUILDING
~ fl/.e
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 4l1Q.OOO~
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
DMsion 1 2 3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... ~
Collective Street Fee ....................... $
Sewer Tap ................................... $
$
/(OZ.2..,
Plan Check Fee ............................. $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
5.60
Mechanical Permit Fee ..................... $
Pressure Reducer .......................... $
Meter Hom .................... .... ........... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $
Other ......................................... $
Sewer & Water Permit ...................... <t
Gas Fireplace Permit ....................... t
This Application Beoomes Your Building Permit When Approved.
By Date
Certificate of Occupancy
[1O"-2~
Total Due .............................. $
Paid ./~ 7.;?'~ ReceiptNo...3~/e
Issued _ ~"'.AI
Dale ~/r?It:f'1 By-JBOC--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed7a.s 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 W any
24 hour notice for all inspections 447-9850
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