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CITY OF PRIOR LAKE
INSPECTION NOTICE
.,
DATE
/Mn
</095 EM/ CU9/ /L.&
TIME
SCHEDULED
4~
ADDRESS
OWNER
CONTR.
J
CJ? -/~:J V
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
.I 'A 0 GASLlNE AIR JST
IV' X H/eV
C,.OMMENTS:
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b~ ~ r~;J-
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)
I
I
I
I /
11 /
IV /
Y
CEED
~ PR~CEED
R REINSPECTION BEFORE CqvERING
----
Inspector: I ~ - . Owner/Contr: -
CALL ~7-9850 ~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFE~!
INSNOTI
,
'~
I. Pink
2. Green
3. Yellow
File
City a~or./'
contrv
TYPE OF STRUCTURE.
Two-Family
Industrial
Public
Multi-Family
Other
Date
Site Addntslt
lot . II B1oCk<' 5'" AddiIIoft
ONnI(t'.NaIne..~~~~O,
Addr...'~
He8l1nO Contractor
Addr...
-
TeItphon8 . (612)
Furnace Make & MOd. , \\'.r\~
-8Ite ,;~\ \~"~,~,'.',...',', ... ". .
Conn.Load \~\, " " ~~".
Fuel. FIu(l~&
S_~\~L~~t
- . IX)'
_m~ '. .."",i
Input OUtput,.
1 % otjob cost ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
nEe 2. 1 \g;!j
~-'-
~:~~ State Surcharge on the bottom of this application.
Edr.
Cfm.
REQUEST FOR INSPECTION
SENT TO HOMEOWNER 1/03.
NO RESPONSE. CLOSE FILE
,~"Record mlJst be submitted with buildinQ permi\ number before build-
llI'Ool=uPancy will be issued.
F< ":">:~ <,>
,.;.~;~,,7' BEQUIRED with number of supply and return openings listed per
'~ ........ "'pening. New structures or additions send floor plan with supply
own. HEAT LOSS CALCULATIONS, PAYMENT AND
IE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
)R LAKE, MN 55372.
s are 8 a.m. - 4:30 p.m.
_ _ INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-4230
AJteralloM
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