HomeMy WebLinkAboutBuilding Permit 03-0108
<rr~rfifiraf~ of @rrnpanq!
CITY OF PRIOR LAKE
~tparfmtnf of ~uilMng J/nsptdion
~Final Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time afissuance this structure was in compliance with the various ordinances afthe City of Prior
Lake regulating building construction or use. For the following:
Occupancy Type
R3
Type Construction
VN
Fire Zone
Bldg. Permit No.
N./A
Zoning District
03-0108
Rl
Use Classiiication
SINGLE FAMILY
Legal Descript"w
L6, B3, DEERFIELD 8TH
ROBERT D. HUTCHINS
....-:: Building Official
$(' -).S---()3
D. R. HORTO~" 2086>1
j/f/f./
Site Address 5104 PONDS EDGE T"ANE S. E.
KENBRIDGE CT., SUITE 100, U.KEVILLE
DON RYE
Owner of Buildin2:
Contractor's Name & Address
City Plannf'r
Date:
Date:
j
.~-~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
SI ty.;
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nilE
SCHEDULED 1<' .Jf,;ry
(l()II1.JS~d0~
CONTR.
PERMIT NO. -Z ---IrK'
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
S;J 11'YY.~'S
--
/ _I
/' /' / I\~~
\... ~(. I;...
--
-
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-.::::,.
h~)
------
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: .!1t.-flJ..t-b) Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~/(]L,
V?a>1~S"~,,,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FDUNDA TION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
..IB"1IIECH FINAL
COMMENTS:
(j) <; a~) -+ 1 /-rr)
DATE nile
7-fK
?-/Oe-
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
fhr
,*V.,,~;J n<-r.,r
^
(\;,
c:;[
, '
, I
/ f 7
-
1
... )itWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: I/IP 7- J/,O)Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TtIlE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
)-q ..if;?
ADDRESS
Sloc.r POl{dCclCK. 4!!I!J
OWNER
CONTR.
PHONE NO.
PERIIl1T NO.
7-lmr
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
'PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
, "e""YM.
r(Jd;0,tJ5
o WORK SATISFACTORY. PROCEED
,d"'CORRECT ACTION AND PROCEED
o CORRECT^W~. CALL FOR REINSPECTION BEFORE COVERING
Inspedor: V VI / 7-0.. '0") OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1bW
ADDRESS S\D'i PoD{)SkD~ 1-....,
OWNER CONTR.
PHONE NO.
PERMIT NO.
/'):,,~ {~
o FOOTING
o FOUNOA TION
o FRAMING
o INSULATION
'fi! FINAL
/ rr SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o ~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
R~ ~ j)A.,,^~...yO tU..~€... ~P.oN\. ~U~-(~,.x..jT100
v?(..!dLl...f:. .
'4.JJ Dt<..Jl... l?:Ar~ S1J/"l~L-K (lAl,8-S
CN-p...fl:::> ~y( ~ - 0 V-..
"J() If ~u:r.., I')t.. <;,ex.,
"
.
o WORK SATISFACTORY, PROCEEO
)i.. CORRECT ACTION ANO PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
,nspector:41Jv1 A-.1f Owner/Contr:
CALL 447- 50 FOR T~E ~EXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
,"""'"
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT lor /3 ~ 03
White
Pink
Yellow
File
City
Applicant
(Please type or vrint and sign at bottom)
ADDRESS
5/ O~P~.A/ , L..7U! L~tT.
. {j
LEGAL DESCRIPTION (office use only) ^
LOT (p BLOCK J ADDITION IAx~dL
~
OWNER
(Name)
(Phone)
(Address)
BUILDER D R I \ '\'.
(Name) '. Tt1.l ~ .. Lf\ L. .
(Contact Name) ~/( ~'v,d:::Sor-.,
(Address) ~~lt(~~~~~lOO
,
I PERMIT NO. OS-O{o g
ZONING (office use)
t(J
PID 0[5- .399-m5-~)
(Phone) cr"";'2.. -49;;: -, gD~
(Phone) QS2- ').;Zjp- 1'?i?J.t.
TYPE OF WORK
)g' New Construction
ORe-Roofing
oDeck
DPorch
ORe-Siding
DLower Level Finish
o Fireplace DAddition DAlteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ ~q ~K
DMisc.
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 ....v......~J 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
ente p n the property to per inspectir;. / lA, ItJ ~
~ ~og57pf;:7 ItA ::'>
Signature Contractor's License No. - , Date
1/
I Permit Valuation 11I200,ooo,o~ I Park Support Fee
I Permit Fee I $ 1553.75' I SAC
--=-
I Plan Check Fee I $ ItJOC}.9l{ I Water Meter ~;'l";
I State Surcharge I $ 100, 00 I Pressure Reducer
I Penalty I $ I City SAC and WAC
I Plumbing Permit Fee $ IDo.oO I Water Tower Fee
I Mechanical Permit Fee $ 160.00 I Builder's Deposit
I Sewer & Water Permit Fee $ ,~S:-5o I Other
I Gas Fireplace Permit Fee $ 4" .{J d I TOTAL DUE /
This Application Becomes Your Building Permit When Approved
~fficial:jdt- ~(,:~
~~ />
I Paid X'I.:/ '1 . 1'1
I Date . ~, - J ::l, - ~
#
#
I
I
I
I
I
I
I
I
$ f3, 7SQ, 10/ I
#
#
$ ASO,tl~
$ /275. 0 <:)
$ "So .0 <:)
$ 1fC:;.OCl
$ 1'2..00.08
$ 700.00
$ 1500,00
$
- . ,
Receipt No. <1'1 - 1'5'-1
Bv ~.
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 as 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
BS~ +,JJi-J
Planning Director
1/.2?/o3 -./~e ~ ~~,
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
.,
.. Job Address 4/'W IiA Va..-
; .
Heating Contractor #1lw7~
Name atTester ~Il.B
Date 7//,iJ
Percent 02 /1. 3Z
Percent CO -HI"I/
Percent CO, fr~
Stack Temp J/4~
Combustion air is adequately supplied per
U MC Sec. 606 ~-
input Jilt (/JJ
,
Thr('rnlunflhrl..bCoUnll')
CWwt6 - RlJildi.jg;>
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
OR~
f- /8- 3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity ~h is projlOsed ,.1:
J!)/{}Lj /-fn7~ct~
I
Accepted
Denied
Accepted With Corrections ~
Reviewed By:
~ k~ Date: //~g
At1-r::f J.( ~ ~~ I
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
"
~~
White . Building
Canary . Engineering
ceJnk . ;:;ianrllr'IQ::>
Th~ ('''nl... of Ih..I,.kf COUnl1')
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
..----..---
NAME OF APPLICANT
/ / r._~./
-;>
APPLICATION RECEI"l=n
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,!
,
L . I j>
/ .,,,", "..,/
Accepted
/'
Accepted With Corrections
Denied
Reviewed By:
3".,
. "L.
~
;{.. . .{}J-I
Date:
I /~F~ 3
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~- Building
Canary . !:n9m!.er;;;V
inK - t"'lannlng
Th~ (-..nltr of Ih..I..kt COunlf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHEGKLlSr
NAME OF APPLICANT
(~2:
)+ ()C~jl/'; )l/
APPLICATION RECEIVED
I
1-.
/ ";",:,' ~-
, --
-~
'--.../
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whiyh is proposed ~t:
/ ,,:' /' I ;'
'. ' I - " /' 'l;"'( " ?
, ... -' L )( ~..." r"'-:;! I / ~) "~I f t"'., (: ~
,/ {./ 1 / "(~J/ ./ / ',_l' ':_"~/-- '" "1- -"""
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
1/IJ48
Date:
1- ~ 1-03
Comments: SAA 8.alLer!';p Side for AdditionallnformRtinnl
See Attachments' 1) Gr::lrling Plan, 2) Erosion C;ontrol Measnres
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
f~1
.''''NuO'''''
CITY OF PRIOR LAKE Date Rec't
HEATING/AIR CONDITIONlNGIFIREPLACE PERMIT
#?O~
~.
../ .,,- ~
{ .~ --.;:;> Co
i~f:w ~~i~' l!.E~~TNO. 3-108- I
ZONING (ollice ose)
(Please !VOe or nlint and siRD. at bottom)
ADDRESS
S/Ot/' A/Zhe~--e:.
LEGAL DESCRIPTION (office use only)
LOT L:BLOCK --3 ADDITION
Pill
OWNER -n, L.
(Name) 1:)" 1\ or+Oh
11>8l00 ~br\d~e.,e.:t-
I APPLICANT , .
(Name) A. \ho..n+ Me..c.ha.n I coJ
(Address)3~D K.enntilec- Lx Sw-k.l E;;11t\a.tl M.N
(Address) -:; (City) (Zip Code)
(Contact Person) ,jt++- 'Z..lMm.eY'~ . (Phone) ffi l a.J15z- 2..1,5
APPLICANT SIGNATU~ .~ 2J..iu..mJ~ DATE .
APPLICANT PLEASE COMPLETE BELOW
81NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL '""Br~ q2,'/. . FUEL ~Na:l-. aas
FLUE SIZE '1..'12... "PI! e,.. RETURN OPENINGS INPUT 1M. lJDl) OUTPUT :iJ:J: tl:JD
(phone)
(Address)
LA..kf,vi lie.
M~
5'5~i.fq
. (phone) .JdSl 1./..52..- 2./7.5 '
55/2.:2..
TYPE OF SYSTEM
DWarm Air Plants
DGravity
8 Mechanical
KAir Conditioning
IZVent System
HEA11NG OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential. AC Only
$39.50
Residential, Heating & NC (New Construction)
Residential. Htaiing Only (New Construction)
$39.50
$39.50
Estimated Cosi $ -.:1DOO. O~
Building Petntit #
(Office Use Only)
HEA11NG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
t/ .$0
~141{)~.
'lNG A~'Jof
~~"'q.
Building Official
. ~reiPt No.
Dat. 1 4 2003 ,f1i
24 hour notice ror all inspections (952) 447-98~f8_X (952) 447-4245 ~-J
_~u_
This Application Becomes Your Building Permit When Approved
Ijar.18. ~003 '~IPM
GEN= RVAN PLUMBING AND HEATING
No 6553 P ~ 3
:~L~ V~o-t<",.
- I \ '"
(,J !--.J t1J
,.:....,..r:--: ._
...,.,..".... 'l''''-
~~\~;ti~~i/l.NJvE a 0 ~ '"
.
Date Rec'd
CITY ,OF PRIOR LAKE
SEWER AND WATER PERMIT
; ~:,;;. ~~... I PERMIT NO. '::) - 10 S"
3. Gl:lld Appllr..w 'V f(
(P1eas~ t'n)~ Of" 'Prin[ and sle;nat bottom}
I ADDRESS-; 0 L/, P(fY)dS pd 07 r= (.-fA. ~ E
J
LEGAL DESCRIPTION (otlice Ule only) r...-, n
LOTCo BLOCK,) ADDITION ber:.v-A- e lei O'TFC
ZONING (office ",e)
PID
OWNER
(Name) DR JL~~o~
.... ~.'
"ctQm )...._-&"
(Phone) _ 052 - q <i5'r /8 "Ii
(Addre~s)
20 'acO KeVlBK\ lY::e.. Cr s.-f' J tv'
(AddIe,,)
Lal!e.~ ,lie.,
(City)
0~U
(Zip Code)
APPUCANT
(Name) Genz-Ryan Plumbing & Heating
~hon~ 651-423-1144
(Address) 14745 So Robert Trail
~dress)
(Conract Person) . / ()AYl O~~
'_rCANT SIGNATURE/":
Rosemotln~. l1N 55068
(ary) (Zip Cod<)
65J-423-1144
( -:::s-& --() ~
APPLICANT PLEASE COMPLETE BELOW
r
Size of water service iuches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at __ feet from structure.
feet.
o Cast Iron
Re:udennal sewer and water hne,connectJon
Sewer eonnection only
l?EE SCHEDULE
$35.50 Industrial, Com'J & Multi-family 1% of job eo,t WIth a $39.50 O1JUlmum
$17.50 Water connection only $17.50
Estimated Cost $
BujJgmg PermIt /I
SEWER AND WATER PERlvfIT'FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
50
(om" u.. o.ly)
I This Application Becom<:s Your Building Permit When Approved
PAID ~
BUILDING' ITH
PERMrr-
L-
Building OfficiaJ
I Paid I Receipt No
-[ ~ 0 \IJ-EE- ~ By
Date JF\::J l..::I II
24 hOUT n<!t1ce for lllllnspections (952) 447- G~~ ~~ A7~g~ j
~
Iii
V1J
By
.--
€~:
''>:''IJvN soot'"
~~\\~:t.~1~\2.; 10
III ar . i 8. 2003 ' : 2 i PM
GENZ RVAN PLUMBING AND HEATING
No 6553 P 3.3
Date Ree'd
CITY'OF PRIOR LAKE PLUMBING PERMlT
J BI.... Fil.
l,('l(lld ('..iIV
1 Y.lIQW A\1idiQlJ'lt
iPERiYITT NO. 3 - (Og- I
(Please t\l?!:: of'Drint3I1d Sle'Jl at botrom)
ADDRESSS / () L/
P(/'()oU1-rXLaif
u --
LEGAL DESCRJPTION (office use only)
LOTU; BLOCK ~~ ADDITION )).eeAe! d
GvLSb
I ZONING (olli",,,,,) I
R-R
PID
OWNER
(Name) DR Horton Custom Homes
(Address)
. (phone)
QC,2 - q 9~ - -7'i5DC
'2o'S(.oC KLVlB~1 j:)Ge., C. Sre IDO
UI~...LVfJlG iMl.J 5C64u
APPLICANT
(Na.m.e)-Ga..........-1?'~P...T"I 01.......'h4'....3: 1:. u""....,..;u.g.
(Address) 14745 So Robert Trail Rosemount
(AJl.dress) (City)
(CO!ltactPerson) _/ OAlY1} A ~'::::::"r. /"'>.. . f'lne) 651-423-1144
APPLICANT SIGNATURE 07UY1 ~ j OJ LY ([):::fj;;Q~ :3 7S:-tS3
... -- -.-----....
Quantity
t-
O<
{
. I
.~
I
I
I
'-<
(phone.) ~ ~, _b.? ':1:_ 1 , L..l.
MN
55068
(Zip Code)
APPLlCANT PLEASE CO]VfPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks -
Bar Sink
I Water Closet (Toilet)
Quantity
;'5
f .
01-
,_,J-I
I
,
Type of Fixture
Rough-ins
Water Heater
Water Somer
Stand Pipe (Washing Machine)
Sewage Ejector
Back:t1ow Asse:mbly
Backt10w Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Indll.,stnal, Commercial &. Mulu-fannly 1% of job co~tw1th a $39..50 minimum Re!ildential, New One & '[wo-Famlly $9950
Re:'>idcntial, Additions & Alterations $39..50
(OffiCI!: USf: Only)
Esnmated Cost $
BUlldlllg Pemu!;;
PLUNrBING PER,.lVlIT FEE $
STATESURCBARGE $
TOTALPE~~TFEE $
PAID WITH
BUILDING P,!::!:?w.,.
.50
..-
This Apphcation Becomes Your Building Permit When Appro ~ U ~P~lf ill ~ ~'J
n Date I~
Building Oflia.1 Do<<!, II M R 1 8 70Wl 'I
. L.J
24 hour notice for alllnspec'jons (i11lV 447-9850, fax (952) 447~12 ,S
I
'4J
-tJ
Receipf No
By
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
; ~;,:" ~::, I PERMIT NO. ~- '0 '8'
J. Yellow Applicant V (,
(Please t:v1Je or orint and siu at bottom)
ADDRESS
ZONING (office use)
5104 PONDSEDGE LANE S.E.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Namp1
T) ~ HO~TON
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DRA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW A VENUP
(Address)
~OSEVIT T P
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
4/29/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TlONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
D Radiation
D Special Devices
D Other Devices
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN GLO SL-750TR-C
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential. AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$ .50
$~ - m rc: r~
I~' I ~ l ~ ~ U \!J U; \ "
'\~\id \ \eceiptNo.
D MAY - 1 2003 l J J
~rte ~y
Date t _ '-,-J
24 hour notice for all inspeetions (952) 447-9~::. \7~.) 447-4245
PAID
eUILDIN, WI.,.,.,
G PIE~""n"
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
(1
PRIOR LAKE
INSPECTION RECORD
'Po~c. eJe;~ '-IV
~' - v
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING, ~ -
PERMIT NO. D~- (J/of) DATE ISSUED
CONTRACTOR ~ 0 IJ PHONE~. fJ'Y
NOTE: THIS IS NOT A ERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
'FOOTING I Iliff-' I )-V7 i
f . ..'
I FOUNDATION (Prior to Backfill) I f1/V.I rvt1 I g. - >~O >1\ - t7?<l7
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNE
ROUGH - INS
11I1( /
!/1/(l-
V{;jf/
SEWER / WATER / SEPTIC
FRAMING
INSULATION
ELECTRICAL I
PLUMBING t),(,.. A IT, '~'2sU- tk"lb
HEATING (if required) j
FIREPLACE I
GAS LINE AIR TEST I
- S -(~-cf1
S-/r:tf{
5 'I/o -03
GRADING (Prior to Sodding)
BUILDING ,/.-w- p u..,j,1 tf-{
ELECTRICAL
PLUMBING
HEATING
DO NOT
III/P
~
t/I~
11111(
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
J2e7 9.03
JA/f
s -8'-t^7
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OCCUPY UNTIL ABOVE HAS
NOTICE
BEEN
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SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850