HomeMy WebLinkAboutBuilding Permit 99-1052
APPLIANCE
PERFORMANCE TEST
Locate near the furnace manual
LP Gas Natural Gas L
Job Address -1-40 t..{ d 'Quehl",J -fR,
Heating Contractor", <Cc3ft borzib()
Name of Tester .;St^~"""
Date ~-9i-oo
Percent O2 -', ~
Percent CO --.0
Percent CO2 ---.9. d..
Stack Temp, _ 370
Pressure a lb - ""3 .S ~ c:
White - City Copy Tag - Site Copy
r I I
!,"7;<~':'-"ii">.,,:-.~'~'. ~;::--;;" \~;J'. "I,. 'j,'~!,.. "."~~.,,, ""\' .,..J':'.):\I',IiIiI"~.- -,~~",~,,,,,;""""_'~,, '.;1>.- ,.,'..,.~.,;.~I""""";"':",~-"", :'.1',;., ....,,~,'.'~rl
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L ~;! QLtrlifirott nf f!DUllpanry 1, ~:
1,'1 CITY OF PRIOR LAKE .;q}'
_, 'l )
. >~! ilepartment of jiuilbing 3Jnsptction ! ~:4)
I' I ~ Ph.. Ponni""" 0 C"",,iO_ C.O. ""'''~ i li:
1- : This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code~Ji)
~.. ! cmifying ~hat at the time ofissua?C~ this structure was in compliance with the various ordiTUJ1lces of the '~.~.'.'~ I
..; : City of Pnor Lake regulating bUlldmg construction or use. For the followmg: ~~\
",I~
1 \,' UseClassiw...nn Sin;>le Familv Bldg. PennitNo 99-1052 i.li
j: ! Occupancy Type R3 Type Construction VN Fire Zone N / A Zoning District R l~' ".' I
. I -...
. Le al~'." L7, B2, Maple Hills Second Addition 1.1..1
I . g ~nptlon ·
. I ilL
.'': I Owner of Building SileAddress 1404:1 Rl'Jebird Tr~i1 ;'
Ii...,: ContrllCtor's Name & Address Homewor~ 'partners. Highway 694. New Bri,>;hton. MN l' ~
~;,t: Robert D. Hutchins {;7.:;r. ~ityPlanner Jenni Tovar I. ~,
r":. I t'? Buildi/,g Official Dale' ~. ·
I'.> Dale: /)l..:?'.tJD .
~. I I
~. -: _ _. _', ..' .... ." ... ._:'-"........... '.. . POST IN A CONSPICUOUS PLACE
(k'!" -, t. "',.~:'C:'t,_t:,; ~:.:~- !.., ~,~' ~""-,~~' ,,~- :,.. .
~=---=~~ ~-..;::
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS \40~ 2. E~,i-t:l 1/2.-
OWNER
CONTR.
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
~EWER HOOKUP
PLUMBING FINAL
MECH FINAL
COMMENTS:
Pl~
~~~ 1~ :::~
~ fuJ"-1f. ~
~~^~::::t
-hv
-kt.,
Y"~
DATE
~
TIME
q;3Q
9q - 1052..
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
I.Uc.v'ti-
c-!1,A
~
~--f~
REINSPECTION BEFORE COVERING
InspectCl :
OwnerlContr:
CALL 447-9850 FdR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD~ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNOTl
II
-~-_._---~------------_._--~-----_.-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/ Lj{) 'I z.
2LUc l5'ILLJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
'0 MECHRI
. jlrWATER HOOKUP
)lICSEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
(
COMMENTS: fJ.S ~ 4l
f)~' / <' "K" fl' ~
.;0' ~ ,,~
DATE TIME
9~Jo-'l?
.
.
.L:oo
99 -I/)c;?~
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
./' /r/C!- S::;:ak
~~
~~
m ft.~j;~ ~~ ~.L/
14?~~~
13.') /~ d~ ~J;. ,..,-1)
"'-oJ) "......... 1. ~
~~ .ffu,
u
-".R.:f1 .t-o ""'>^.~
(/
.
LK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Wor CALL FOR REINSPECTION BEFORE COVERING
Inspector: rt t ' Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
II
~~~..,_~__.e__..____"'_._____'_'_"_~____'_'_.'""_ ---"_.._.~._.__.~._..-
o FOOTING
o FOUNDATION
o FRA G
DILATION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
SCHEDULED ~
8/Uf>J i'rd '1a,-J
CONTR. /h/HewtJ"K:.. ~/'hl'rs-
7j-~;J .
~RADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
PERMIT NO.
CITY' OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/'1()L/- :2_
OWNER
PHONE NO.
COMMENTS:
ruvhJ?/I Y I ~ /JK.
h>dd.itll /~ /lk
,IJ
,')/lJrlt
/""
../
../
/'
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~1K. CA~L ~ REINSPECTION B,:::,E COVERING
Inspector:, ~~"'",,"'ontr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
II
--_,0- ~"_______' ___0.__.,_,
B~\
DATE RECEIVED
~/~h'1
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2t~EDD~~ ~h~Ee;I/l..b IRe.:\L
3, LEGAL DESCRIPTION
LOT -:S-c..V"--N
ADDITION \fV\ ^ l> 'vL.
~a.;O(
h.le.
';7 J 11
1:;.,
5"$":17 /r
BLOCK -t \Jo.l 0
\+\ L\...S d- ,oJ l>
PID
AU
d-ti ~'f.3 D/(,O
6, ?Y'LDER (NAme)
~~O")< 1/#'1''''''''5
}-f.E hl'1llLA
7. TYPE OF WORK Fireplace 0
New constructio~ Alterations 0
Chimney 0 Misc.
B. PROPERTY AREA OR ACRES 19. PROPERTY/DIMENSIONS I 110. CULVERT SIZE
Sq,Ft.d..l"OOO A~ Widlh165 Depth 11-5 Yes '(;)
I hereby certify that I have furnished" ,;......"."'.......1 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 Pro1Et6 and that all construction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I a aware that the
building officialfan revoke is pe it for just cause. Furthermore, I hereby agree that the ci~ officijlJor a design~eJma~ ,nter ~n the property to pertorm eed insJ4ections.
X :::L.. . _____ rT -t2..3f' .;){fJ.., ~If 7- 'r"1 f ,. ~ '1
~ . Signature --- license N"o. Ie
4. OWNER
(Name)
5. ARCHITECT
(Name)
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
5FD
(Address)
(Address)
~o,(:rdr1.)~
8,u'tk-/.." M~ 17'51/;)-
SeptiCttJ Deck LJ
Addition LJ Finish Attic LJ
~
I)p...->
(Tel. No,)
(Tel. No,)
(Tel. No,) /,'5/
/p~(p ?>IOO ~
Re-roofing CJ Porch LJ
Re.siding CJ Finish Basement CJ
FOR ADMINISTRATIVE USE
Back
Side
OFF STREET PARKING
SPACES REO,
SPACES ON PLAN
Side
PERMIT VALUATION
9Cf , C(')(') . Ot:l
Division 1 2 3 4
TYPE OF CONSTRUCTION: I II III IV V
OccupancyGroup A B E F HIM R S U
City:
Permit Fee ................................... $
PtanCheckFee ..................,.......... $
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Pennit Fee ,..Jq~\Q,5.,~.. $
. ' 1f'lo~t.
MechanIcal Permit Fee ..................... $
Sewer & WalerPennil ....~,'I.:.lg{~. $
APlI . (')0
5'?a. en
'-1'\,50
l 00. CiO
/ nO _ CJ6
26 ' "5D
~
Issued
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No,
99-/052-
BUILDING INFORMATION
11. SIZE OF STRUCTURE , ,
IHe'lJl/ I (Width) t,D ID.plh) cJ. (.,
12, NO, OF STORIES I Y2-
13. TYPE OF CONSTRUCTION
~it'\C\\~ f' AM,h/
14, FLOOR AREA APPORTIONMENT USE
I:JOO ~,..,.-
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16, PROJECT COSTNALU,
/1.:.-0,000 W/tAJI~
''l~7rf DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS LJ PERCOLATION TESTS LJ
PLANS & SPECS LJ
SURVEY (]
~.
COPIES
PLOT PLAN
o
Amount Brought Forward .................._of:
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee .........,............. $;
Sewer Tap .......,.................,......... of:
,,~" $
Pressure Reducer .......................... $-' 46.00 .
Meter Ham ........t"'........................ t
Water Meter ..~~........................... t ~5" . ~ D \
Sewer & Water Connection Fee ........... $-.1,. 20D ..cf{~
WaterTowerFee ........................... $_/I'){').~
Water Tap .....,.,........................... $
Builders Deposit ............................. I. <:;(')6. C)(j .
Other .....................................,... $
Total Due .............................. $ 72-0f> .VJ5
Paid , l. 08 . " ') Receipt No, ')'3. QP (
Dale cr I, 3/91 By /tOft
~so.oo'
I n SI"l .dO '
the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This docuinent wh811
s temporary CertifirmmmPliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issu9d.
Date Special Conditions n any
24 hour notice for all inspections 447.9B50
Sop,28 '99 11:46
".., .I.u,..,.s" "-'""1"BV 14: ZU .t"A.I, ".L~44.1 "~4"
FAX
p, 1
~4LX ur ra.l.ua LAAD
..v....
-.......IE
,........ . aPP\fCal'
-- , ...'
CITY 01" PRIOR UtD
SEWER AND WATER PERMIT
NO. eJCl-IOS 2-
NOTE: S@wer and water
contractors must
be registered
with the City,
APPLrCAtlT: /?J~~ be.c~'''/ ~~ PHOtlE:M~-r,.;l8'r.:<g,3t!'
ADDRESS:. ,5"? 9(.) d/..wIf- k. DATE:....i/~eJf.9
S:rGNATURE:~ "91f t?~ BLDG. PERMIT j/ 99-1052-
SITE ADDRESS: ItJ6 '1:1 A%.~ "j"I,J Tt-- II f!. PIO'. 25-34-3- 0 fer 0
WoL IN THE BLANKS Ii?I
0/0
2.
Estimated length or water service
I" .
Siz@ of water service inch(es).
feet,
~ .
3. LocatiGn of. any coupling.. from structure - f@et.
4, Type of sewer pipe. ABS PVC >(, f~a..t Iron
5, Estimated length of sewer line ~ feet.
6. Clean out (if required), located at
strue:ture.
feet
from
=======~s_~_____________________________~=======~_____------------
__::13 a~coc:.0\l:~it,::-:~pp~ed;8~ 9 q
______~_____=_~~~=__~====_1L~~=_===_~~____________===========~---
('Jo~"~ ,
FEES: 'f'...\\..J,:.\,V\~.. Sewer and water line connection p..rmi~.
:,-p....\.)..:......'\ ' Surcharga
, ~ ).e....."",'\ TOTAL
* Fee f01:either sewer or water lncHvldl,lally is $20,00 plus
$ .50 9~rCharge. --
* Sewer and water permits issued for new construction must be
recorded on the building permit oard at the time otillsuance
to insure that no duplicate sewer and water permits are
iSBued.
DATE PIUO
RECEIPT .
AMOUN,T PAID -1>"'\.\'
REC'D BY /- ,,~~ p'i.~W\\ \
\eU\\,.\J
US200 Balle Creek A'i, S,E.. Prior Lake, Minnesota 553721 Ph. (612) 447-42301 PAX (612) 447-4245
, AD Bq.... Op"""unil)l Employ...
.
"
--~ ,....~,- .~. .......,~
..'-....)f".-.--."
,'.>.. ~-,._,........
GREEN. F1l.E
YELLOW . APPLICANT
GOLD. CITY
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
NOTE:
NO, qq-1D52-
Sewer and Water
contractors must
be registered
with the city.
APPLICANT: LL"L VC:;"A~ S< 4h..L
(Jf9~ Ji/Jbl- /~ ::;>2
( j / ['
I~ 1"//1-.-.:1_____",,' (" A--lf-c' ..,J.-:z-
ADDRESS:
PHONE:
,gk/L,'/-DATE:
V77- 5 1/11.{
<1/Z0/00
PERMIT # 1'1- Ie 52...
SIGNATURE:
BLDG,
SITE ADDRESS: i4( 47 fYLuP P"lkU TkLpID# 25-'::4"'::'- CIIc-c)
FILL IN THE BLANKS k'
1, Estimated length of water service
--L;/)
feet,
2. Size of water service
J
inch(es) ,
3. Location of any couplings from structure
-
feet,
4. Type of sewer pipe, ABS PVC I..---" Cast Iron
5. Estimated length of sewer line 1/0 / feet.
6. Clean out (if required), located at
structure,
feet
from
------------------------------------------------------------------
------------------------------------------------------------------
This applicat~~y:,~~~?~ur permit when approved, ~
BY ,. F H&>_ DATE: <7/2 q //9
..,.p-,
.",/
===========7r=====================================================
FEES:
$
$
$
35,00
,50
35,50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $~1,~0 plus
$ ,50 surcharge,
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued,
DATE PAID
RECEIPT #
AMOUNT PA~t)~\~~~tRt-A\1
REC'D BY \e\.W
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Perm" No. qq-/OS2.
Prior Lake, MN 55372
Date
HEATING APPLICATION I PERMIT
II / / P, / qq PID # 25 <~ <1-3 ,- 6/ ro - 0
S"e Address
ILJOL/-Z. BLL'St3I;<20 7k AlE:
lot 2 Block .z. Add"ion I'1/7PU;::: /7/L-1- Z NO !'lOON
Owner's Name I-fOf1G i-V{)e~~ p/l12.-rNe;,e:s
Address
Heating Contractor S);;/../ fie. ( ?CJ~() IJ
1/' - -
Address ""'<:,}{)O ro,:.eht.a.,k<:> 1<1,}
Telephone # G2/)_ ~<:;"-..J. .:J~"l7
Furnace Make & Model HetL AJ -/-.::5'0 7 S'TYPE OF SYSTEM
. -rSCl~O Warm Air Plants
Model Size Gravity
Conn. Load~'i~ Mechanical
- Air Cond"ioning
Vent. System
t-.W~~ mtu
Fuel .. ""A-I.
~l(
Flue Size
Supply Openings I 1
Return Openings r;,
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Input
Edr.
Cfm.
Output
Other Devices
TYPE OF WORK
A~erations
New Construction
Replacement
Repair
Est. Cost $
Est. Comp. Date
Building Perm~ #
'1q- /052.
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
, PJl-\O Wlir\
\ eU\\.O\NG pe.RMli
Receipt #
TYPE OF STRUCTURE
I. Pink
2. Green
3. Yellow
File
City
Conlractor
Single Family
Two'Family
Industrial
Commerci::.1
Multi,Family
Public Other
I
Fee Schedule
Industrial, Commercial & Multi,Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1% of:f(jll'1'Osl.l$39~ m':'m"m\ __
'\". "." ''I':" ".17.? ~
$99.50 l' '_,. ., .5
$64.50 - '-; ,
$39,50 DEe I 3 919 !!
$39,50 !
I.
$39,50 .,_____ ";-:;,'
.-.-^<.--.-
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough,in and one final inspection,
Additional inspections will be billed at $35,00 each,
House Heating Test Record must be submitted with hllildinn mmnil nlJmhAr before build-
ing certificate of occupancy will be issued,
J-lEAT CALCLJLATIO!l!.S. REQUIRED with number of supply and return openings listed per
room with CFM's per opening, New structures or additions send floor plan with supply
and return locations shown, HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372,
City Hall business hours are 8 a,m, ' 4:30 p,m.
ALL WORK MUST BE IN!SPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans,
" JcPoI-t:-JJ~
Appl;
f-
....,
j;]-7 -qq
Date
1~.37q~
Date
~
re
Bur ,.
Offical's Signature
>~,,"'" _....~.
- e-' _,..,.___
,."'~,__.".._~" ......__,. C.",._. ~,~
,....-"..,'~.......~.1.-':i-+-- "--~""'~"~ --~-.'.""'''--~..'-~
./ ~ ./' '. .~_. ~.? -.'
Th, C,nlu of lh, L...., Counlry
White . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
"
"
I,' 1./
~
,~
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~', t.._. .
/ i -'
Accepted /
Denied
-'"
Ro"'owedB, (,/~ ~
Accepted With Corrections
Date:
f?/ 3d J cyj
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."
/'
Q9-1052-
White <-Building
Canary - Engineering
Pink - Planning
T~ C.~lcr. of lh~ l.ak~ COllnl".
BUILDlN~ PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/iONS WOK/<::: , PAI2.TNSf2..::.,
S/Z4jqc;
I '
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4()42
[3 ~ {/ E /3 / K: 0 1/< (-7 / L--
Accepted
./
Accepted With Corrections
Denied
Reviewed By: ,hiotu..T'EI<. EM."'.....,"""
Date:
, ,
g/1/'l'1
Comments: l<u..JoFF Y'tvST" at: Co..."..,.'Cll '-0 '1"'0
,
~LO~ Di:AINA"E. ~ cJT7LJ"v
fA~f:t\ot.EAJT"..:5 iJs ,4(t,..(' H AS PtlAcr /c..,qL .
_")EE JiJfOIt(IA.,q-rlO"-J <":'IN ,...~t: R'e-\JEIt~E:
5'~
<~F ~'T"rlAc.wW'\otUtr<~: l. FiNAl.- (da..l'to(. IN.5~C./i.t...J JN~t!1f("""-I4"'r"'^ I 2. ~140/AJ/. R_AAJ
3. Ell.o.~'<l.... f'.~",rno L MEA""...t: ~
'1-. UC5/t:"JAJ CCNT'1l0'- f1 A .,.,
"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,"
----;--~
99-1052....
Th~ ("t'nlu of lht' l.b Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/10/'-16 WOleK- PI9RTN6f2.S
e/z4-/QCj
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4{)42.. 8Lt/E/3/.e.O 'TIe/-7/t.-
Accepted
Accepted With Corrections ~
Denied ~
Reviewed BY( ~ J)(hr
Comments:
I. \(~ r,ll ",H-c<.c~ ~~~
1, s.,,..,Q. f;.,."..... ~ ~<;..J.." ~ -.r9... ~
5. Two I=',~ 'r~ *-~." ~,
4, M,,-:'-^-~"'-''^- b-o~"?>..A Q......,~
Date: '1- ( - 'i?
s~t1- fuc. 4.J 1--,'> t-
"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."
" ,
_"'_-,-~ _..,~_'" m_~"_________________"__
II I
PRIOR LAKE
INSPECTION R'ECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 14042 E/ofJfoc'& ~'(
NATURE OF WORK AI"".) ~dn::h
USE OF BUILDING SFD
PERMIT NO. q1 - I CJs-z.... DATE ISSUED cr. ( -q;t
CONTRACTOR ~~,.""- y~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE ~ERMI:J~Y SEPARATE DO:~~O~NT DATE
I FOOTING \ft, {\/~_\1 ~ 01,1 CJ-zl-9'7 I
I FOUNDATION (Prior to Backfill) I {;Fr. Ij 11_ / /1~1
PLACE NO CONCRETE UNTIL ABOVE'/HAS BEEN SIGNED
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
I PLUMBING (JJJ z.iyf,; UtS,Ctf /6/./f1 {.;/J I'::J./J~('S
HEATING (if reqlNed) (AJ ~.!/"QV (L)J .1:;,);4(1 I
FIREPLACE' . (j. I (/ I
GAS LINE AIR TEST 10 lo>,1<1/n I
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
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ROUGH - INS
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GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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 lliervice cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M, for all inspections
FOR ALL INSPECTIONS (612) 447-9850
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