HomeMy WebLinkAboutBuilding Permit 03-0415
-. .. ........
,~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS "'3 i J '{ ~Ca.Jd
v ~
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
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
I. F.......J ~~~ i~V"I
DATE TIME
1::/5:nr
.~- L/lft
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
~ FI;=:~N:k
~ GASLlNE AIR TS
o
6'=: ./.0 <2' Co c;...L ~ Jh1
o WORK SATISFACTORY, PROCEED
XCORRECT ACTION AND PROCEED
o CORRniEORK' CALL FOR REINSPECTION BEFORE COVERING
Inspector:'" Owner/Contr:
CAL - [47 /so FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3~\1
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED
'-to,
y
CONTR.
PERMIT NO.
'i, - c..f (,{
o PLUMBING RI
o MECH RI
o WATER HOOKUP
eRHOOKUP
PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMM~TS:
(, !LDMAJl.~f
'2. 0(..0
~I
Q ~~....... ",......,.r-
o ~ SATISFACTORY, PROCEED
/CORRECT ACTION AND PROCEED
o CORREfflRK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: { J I 'VJ Owner/Contr:
CALL \J7 ,/so FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""""
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File L Wh'" FiI,
2. P'.' c'" I PERMIT NO. O''?-04jrt
3. Yellow Applicant ~.......;JI
(Please ~~ or vrint and sign at bottom)
ADDRESS
39/9
,(! (''Tq /
.,J
. LEGAL DESCRIPTION (office use only)
LOT I BLOCK ;.. ADDITION
OWNER
(Name)
(Address)
TYPE OF WORK
/er.s s
Nt.J
i (''II.: I
-J
r f'(>J' ;-
PID).5 - 3N -0/1- 0
(Phone) ~S-/- "/01:> - ~1I6 ()
(Phone) !//;2.. -J6!- 7"/2-
Ct$. ,tilV 177 N SSJ;l. 2..
v
(Phone)
/.JtJm fA J'
SiAdl'
;l..{){)
BUILDER II
(Namp) f.A./eNf/1J~III/V
(Contact Name) G "tn""
/
(Address) Itf? F f It:; :z.v-... 1>1" /J f
--
~ New Construction
DDeck
DPorch
DAddition
ORe-Roofing
DAlteration
o Fireplace
DMisc.
DLower Level Finish
PROJECT COST IV ALUE (excluding land) $
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 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 building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;teruponth~07nee ~ If'S;'
/ Si Jdire Contractor's License No. Date
,
rr1o//.(JtJtJ.01J I
$ /-',;) ~.:J~
$ 7'15.;rr .
$ ?tJ,5CJ
$
$
$
$
$
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Park Support Fee
#
SAC
#
~
-----
I Water Meter ~; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
jlJd. fn)
100.0 (J
~S;S- 0
ijtJ. (J()
Date Rec'd
4--9~tJJ
I ZO~/(Dffi"",') I
ORe-Siding
DUtility Connection
$
$
$
$
$
$
$
$
I~ 7~ 00
d~a . 0 a
4~ () 0
J.:lt'J I!J. B 0
7(J/J. " ()
$.:!; 3,34.53 I
~~
This Application Becomes Your Building Permit When Approved
~
~F~7
Date
..- __'.... ,.1 ,-..___
I Paid, ") 2f:J"'" :J ')
I Date tJ - :J-. 'i ~, ~
I Receipt No. Lf LfU '"} g
Bv tA--
U
Building Official
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
~~ 7'~ ~ ~
Planning Director ~ ;(j1J.3
~':I 9.2."
- Special Conditions, if any
24 hour notice for an inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
-'.--------
White - Building
Canarv - Enqineering
(l'ink_ - Plannin!i::>
The ('tnlrr of Ih. L.k. (:ounlry
6UIlDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I .: .
I'? (>J
,~, I
./ /';It f\.//,J
1..-' -
- /-{.3
4-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
_311 (} If. t: (1) t- 1/ r) 5-)
Accepted
Accepted With Corrections ~
Denied
Reviewed By:
~
~
Date:
'ljJJl03
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 al'}Y 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."
~~
,ryihite - Buil~
Canary - Engmeellng
Pink - Planning
Tht(-tnlt'roflhrl.lbCouofr)'
BU.ll.PING PERMIT APPLICATION DEPARTMENT CI-lECKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
vlWJnttN;J
4---- 9-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
311q /ZGfi!'7C- PAS J
/'
Accepted
Accepted With Corrections
Denied
Reviewed By:
~
.....
?u$
Date:
~ /; Jij /)3
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."
,
I,
.<,-'t""''''.r<<''''
'r' -"..,
. "-.....r~ ."-..............1il<---1.-,----"".........;"...-."'~.........,liliiS(~.J~.>ti4i ,~;.,.j,~~.
-"',.-..- '.,-
~~
r
I
Th~ C"tonl'" IIf 11l~ l..h Co.nlry
White - uilding
~ '-ana~~na'nNrln'P
fllnk - Planning
BUILDING PERMIT APPLICATION DEPART~NT CHECKLIST
NAME OF APPLICANT
?rDJ J nIT 1v';J
~- 9-05
APPLICATION RECEIVED
Accepted
Accepted With Corrections
Denied
Reviewed By:
lJ44i3
Sa !i1",)" h'/f.
Date:
'-I-~;'o 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."
lU(~VUl l'I~U ll:a I'M ~ll44IHO
<.1 n UI' YKIUK LA~t.
il!l 001
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
1 D"-c: Ill',
J. Gold Cil1
, y".. "Pr1t"'t
I PERMIT NO'~q/ _S-I
q>lme ~ or .rine and liII! ~t bontnnl
I ADDRESS3914 Q.~...\ ~~ \-\\.J
I
J
ZV!'lIu....v Coftla:\MC)
LEGAL DESCRIPTION (olli.. ... only)
LOT \ BLOCK.;;t, ADDITION ~ ~"'\"
\~\~'('(\~Y\ ~om~ . (phone) 6SJ-'iO(.,-tf'IOQ
(Adcln>ss) 12<t5" "fb.z.o... k. ~\~cQDO ~Y\ ,\M", ~~J:;Zr:z
~;~~~ANT LJ~e1 ~\b~ ~ \\~~. . (Phone) g/~!f51~/SbS
(Addrt-ss) 17/D V\~b.r.ct~ ,~J. ~~, 55:/;;2/
~ (A~) -- (City) (Zip CodcJ--
(Cont.ct Person) "eel \-\.~?..~ I' (phone) t.s-/~ -/5d:,S
APPLICANTSIGNAroRE -L2~ DATE I.JP3j03
. __.t, .__~_.,
.u?UCANT PLEASE COMPLETE BELOW
I Type of Fixture I Qvutity
I Bath Tub with or without ,hower Rough-ins
I DishwllSher I Water Heater
I Floor Drain I Water Softner
I Lavatory (Bathroom Sink) I I Stand Pipe (Washing Machine)
i Laundry Tray (I Dr 2 l:ompaztment sink I SllWage Ejector
I Shower Stall I Baekf10w Assembly
I Sinks I BacJd10w AsscrnblyTCIt
I Bar Sinlt 1 Lawn Sprinltler
I Water Clos<.-t (Toilet) Other
OWNER
(Namel
QU8Dtity
,;J..
I
,
q
,
r
I
I
n,
Pro
Type of F1xt1lre
FEE SCHEDULE
lndll"lrial. Cammer!;l..1 ~ Multlafamil)' I~. Of Job i;Ost With I S39.S0 minimum RCSldentlaJ, New Onc &. Two--Famil,. S99.S0
R""identi.l. Additions &. Alt...,ions $39.50
Est;motod Cost S Building Ponnit it
PLUMBING PERMIT FEE S el.lt~-fl1)
STATE SURCHARGE S .50 ~G Is,~
TOTAL PERMIT FEE ~ ~ ~~
~ ~ lfu l~ U \fi-g ~ I' ..0. ~I)-
This Application Beeomes Your Buildinc Permit Whn ApprOved 'Paid 'II Receipt No.
I n ~PR 9, 8 2003
U\ I Date .J\, By
Dllt
,By_ -
:4 hOUl iJDtit'6 fo)".n in.pedlo,,, (95%) ...~, utJil, \"~I "".,-41'5
L d vWS0098vONiWE11S. Istl EO Hv (03N1I L9t0-m-1S9 DNIlV3H ~ DNI8Nilld 13ZN3,~ NOBd
(omu UI<< Only)
15\l1lIc;J1ns omtl._
....~ . -'-"
~ P!~Jo""
(11--.. l' \
..::.... \ \-:"\
= if\ ~
"-lr ~~J
"'--!...V \I S ~~
APPLICANT: W~e\ ~~
WORESS: .37 I ~ j-~~ ~> ~W.
co :~~.~~.:~c: ..... 'If!:~f!~---'=-----~--
----
Q.Hor:ltJII.-1"III;.J:
'n:.u..ow . A""\.,.lf~1CT
G-Ot.D . ctTT
CITY OF PRIOR ~KE
SE\.fSR I>J1O WATER ?SRMIT
NO..8-t-fe
NOTE:
Sewe:!:' 2nd Water
contractors must
be reg istercd
with the City.
PHONE fJSJ-lJ9-.-J Sb.5
'f J;>. 3/D 3>
DATE:
:::..:r: .
")'::'''':l'A' ';'"':0 ~
~ ..~..~._-
FILL I~ THE
E L.'~'l:",S
'30
fee~'.
l.
2.
3 .
Es~i~ated !eng~h
of water ser~ice
Size of wate~ se~vic~
I
i"c;,(es). "rv\
from st=~c~ure ~/V\
PVC ~ Cast Iron
sewe!:" line 3(:)
Location of any coe~linss
feet.
4.
~ype 0: se~e~ pipe.
A3S
5.
~s~i~a~ec length
fee~~JlIL
2.~ ~fe~t
f =- ,,,n
of
6.
Clean out
st=....lc't:"..l:::-e.
(if
rec;:u i. rec) ,
loca~ec.
====~====~====================;===========;=======~=======~=~=~=~=
T~.:s a;plicaticn tecomes :{ou= pe~~t "..:h.en 2pproved.
B':'
DATE:
=~===========================================:===~=~==~======~=~==
F::=:~:
S
5
S
J5.00
.50
]5.50
Sewer and wa~er line connection permit.
surch2::-g'"
TOT.".L
* ~~~ f~~ eithe~ sewe~ C~ water i~cividually is 520.00 plus
S .50 s'.l::-char:;e. -
S8we= 2~C ~ate~ pe~its issued fo~ ne~ cons~~Jct~~ must be
reco=ciec on the bu~l~ing pe~i~ ca~d at the ~:~~ua~ce
~o i:i~:.:re that. no c.l.;.pl~ca~e se.";e~ ?.r.G. .",at - OIIiG~J.Iii/ c.::-e
::'SS. :.lee - 1[;\ r~ (;0 (' , '-. '1 P~Fi.
I);::':;: ?'.:) ~) u; l~) l~ II ,; I,! ;'.~~OUN'!' :;.'.:D 'A,frr
I ~,l APR 2 8 100'1
IBY - "--:=:=.:=:::c.:c:-_.
*
P,~::::I?'! #
tj-
?:::C' 0 S.!
-._-r- -: . ,
'r' .........'" - -. ":'- ':'..., "..... _l_--:--:r '7.'~:\. ..:::'''''. L...... l-:~:
8 d vWS0098v .ON/vH] 18 1S E] EO n:v i03M)
L9EHSHS9 JNIIV3H 11 DNI8Nfl1d mN3,~ NOB.:!
MAY-0B-2003 02:55 PM STAR PLUMBING & EXC.
952 BB4 7468
P.01
- .....
........ ~........
.... an
CITY OF PRIOR LAKB
S"'''A.<< AND WATER ,,~~..
S.W. No.
3-Lj/5
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: 3~ & lft-~.I PHONE: 9;)~- PliV- Y'/'i''l
ADDRESS:.M~g-.lAJ. ~DATE: t;--S--03
SIGNATURE:~Q. ~~ BLDG. r"'^'Ll.T'
SITE ADDRE~ 39 If.} ~fJ~N(J,PID'
FILL IN THE BLANKS
1. Estimated length of water service
I"
,?o
feet.
2. Size of water service
/
inch(es).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC K Cast Iron
5. Estimated length of sewer line ~O
feet.
6. Clean out (if required), located at
structure.
feet
from
=========--=====--- -- -----==----==------~==----------===----=--~~
This application becomes your permit when approved.
BY
DATE:
================--------====------=~--~==============----==--====
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
Sewer and water peraits issued for new construction must be
recorded on the buildin~ permit card at the time of issuance
f~s~~~~ ~Imrrt"if rVf~]..cate sewer and water pe~e WffM
~ .c; U l'J LS ] BUILDING PERMIT
DATE PAID .) AMOUNT PAID -
RECEIPT' RECIO BY ~Jtr
vu
*
IBy
~-------
16200 Eagle Creek Av. S.E., Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
A.. Y:;"..,al n"nnt'tn";',, J1'Yn"'I"I"..-r
MAY-29-2003 07:16 PM STAR PLUMBING & EXC.
952 884 7468
P.08
_......
...... - ...-........
.... . err<
CITY OF PRIOR LlUCE
SEWER AND WATER PERMIT
s. W. No
'3 -C//::)
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: 3'~ ff4. 'r;j-~ ), ""'wM.: 5t)~- Rfl~- <(1'Y'j
ADDRESS:.&lK~:f1"4A" ~DATE: b"-S"'-tJ3
SIGNATURE:~fL.~~".)'} BLDG. PERMIT'
SITE ADDRE~ 391'} r P~II,tJ.PID'
fILL IN THE BLANKS
1. Estimated length of water service
/I
,5LJ
feet.
2. Size of water service
I
inch(ee).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC K Cast Iron
5. Estimated length of sewer line ~O
feet.
6. Clean out (if required), located at
structure.
feet
from
======__-=========--====----=====-----======;:::::;;====-- _,.-=-:-r-- ,-.-..-.- ---"'"
This application becomes your permit when approved.
BY
DATE:.
=======================_=-.----~=====__'_- _.__=====_____--==:eo:_==.===
FEES:
~
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
individually is $tp.~~~lUS
'lJILDING ~
Sewer and water t'~__its issued for new construction must P.JiR~"r
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued. ~~
DATE PAID AMOUNT PAl 0) \? ~ ~ \l ~ ~
RECEIPT . REC' 0 BY ill 1\ IN 02 2003
By --- - ------=:
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4 FAX (612) 447-4245
*
Fee for either sewer or water
$ .50 surcharge.
*
An 1=4'....,,'111 ,-....,...,..I"tnni'tv Pw....I,....._
06/2.\/03
09:46 FAX 6518949955
_____ WE~ZEL HEATING & AC
CITY OF PRIOR LAKE
REA TING/AIR CONDITIONINGIFIREPLACEPERMIT .
I4J 00.1
Date Rec'd
lE-~ ~~.=, I PER1\1ITNO'3~ l/IS- 1
(Plc:a.se!"'P~ orori:Dt andsien atbortom)
ADDRESS
'~n/9 .~~~/
/695
n/vJ
LEGAL DESCRIPTION (offiee",< only)
LOT
BLOCK
ADDITION
pm
OWNER ).
(Name) /A //'/5/7'2-1/,/,4
,~~c
(phone)
\ ZONJNG (oll\c<"")
(Address)
AA
,tsl ;r.4~999'l
.:851ZZ...
(Zip Code)
APPLICANT / j /
(Name) /~#/Y'?2? . ~-r/~
(Address) . .4/..:/. ?'k/ ~ j;,).,//
(Ad:j, L /
/)dC/' /~~
APPLICANT SIGNATURE ~ / pV./
(phone)
~r''''f
(c;j(y)
(phone)
DATE J~
/ -
(Contact Person)
APPLICANT PLEASE COMPLETE BELOW
)3l'EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL ~/-//),I /-:.<:;/ ~~.7D . FUEL ,;i./c;1-
FLUE SIZEc2 - .j' lIVe. RETURN OPENINGS ~ INPUT 7.5"aO OUTPUT /rtf/"LO
If/I: O/'/::"/ TYPE OF SYSTEM HEATING OR POWER PLANT
4;/-IHO/ DWann Air Plants D Ste"",
DOravity D Hot Water
1~30 ZMeehanie.1 D Radiation
j&\ir Conditioning 0 Special Devices
DVcnt. System 0 -Oilier Devices
FIREPLACE MAKE AND MODEL
.- - -
. -,-
Indusltinl. Commercial & Multi-Family
FEE SCHEDULE
1 % of job COSt Residential. Gas Fireplace
$39.50 minimum
$99.~O Residential. Additions &. AIUrations
$64.50 Residential, AC Only
Residential. H!;3.til"lg & AlC (New Construction)
Residential. Heating Only (New Construetion)
Estimated Cost $
Building Permit #
$
$
W [1 rG [2 0 ITl ~ ~I
This Application Becomes Youc Building Permit When Appcoved
.1 I 'liI'N 251'01 1/11
D.'. ~y l Dare . ... . ~J By
24 houc notiee for.1I inspection' (952) 447-9850, fax (952) 441-4"" ..
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.50
(Ollie. U.. Only)
Building Orticli.1
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
PAID WITH
BUILDING PERMIT
Receipt No.
()~
....0-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or orint and sian at bottom)
ADDRESS
3919 REGAL PASS
L Pink Fl I I
~. ~~~ i;~,~", PERMIT NO. OJ' - c f/5
ZONING (office use)
LEGAL DESCRL.: u~N (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name~ AT UE[\l:;'Yl;I'P,c::.TDP DBA PT1?P.<:::tDF HJ:i'.ARTH & FOME
(Phone)
651-633-2,111
(Address)
2700 NORTH FAIRVIEW AVENUF
(Address)
(Contact Person)
BRENDA HUSTON
ROSEVILLE
(City)
(phone) _651-633-2561
55113_
(Zip Code)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
7/23/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
D Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN GLO SL-750TR
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, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID WITH
.5<PUlLDING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildine Official
Date
,----....~.1 ,---
II!'Rd'~
!U}~
, ,
1!~atellJl
III .
Li~ U 'iJ) lE ! ~'i~eceiPt No.
3 0 2003 II ~y
"
24 hour notice for all inspections (952) 447-! ~. fax (952) 447-4~_~5_.._
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUJLDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR PHON
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING -' I
I FOUNDATION (Prior to Backfill) I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ()("Pt>
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
It:>
/J
rA
Ph
_ rr$
~
I2tI- -
7-'2?
e-I
,
. S-/"7 /0 ~
?-2e!
I
I
.....
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
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~
UNTIL ABOVE' HAS
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 service cabinet is available, card shall be placed near main entrance.
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1-15
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850