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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS --1Jd Lit!) ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DME nUE
SCHEDULED gj 2-7 /5Y3
~ 1AN>.J1f>
........ -
CONTR.
PERMIT NO.
~-4?~
'-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
~ FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.V~- ~ M'J ~~
~tyi~~~~
/1 ..~. ~ 11,.-, .,,-
~ - /_/~ '~.
. ~Y7~
e~ IJJ ,--tj LL .flNis'
Q'~-D:3 S1I--
o WORK SATISFACTORY, PROCEED
~~RRECT ACTION AND PROCEED
Y' CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: '2.. ~~ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOn
DATE TIME
1)z6~
iL{Lto~ ft;)~af,~~.,o. 0~/~
CITY OF PRIOR LAKE
INSPECTION NonCE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
'3 -Ci. 7~
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
J ~.fIREPLACE FINAL
k- ,)6 ~ASLINE f.~S.I Zb1~
o tt"{a.~ ral
,
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
. ,
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
~. ~e~n ~:~ PERMIT NO. /)'1 - 9'7fP
3. Yellow Applicanl l/.r U I
(Please type or orint and sil!;ll at bv~~~)
ADDRESS
fLit! oB 8rtP()K tv\e,..,-e Bl N \J
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~
PIDdS- 3e'1-0Ss.....0
OWNER
(Name) 'RIc...K e-( \~5
(Address) 1'I7'~~ t3~k. ~-<.[c:
(Phone)
?5;J- 'I1t-677;)....
gl i\J kJ
APPLICANJ;
(Name) r rP- e I- tt..A /
(Address) t..( 3 4~ B
fy 5-1.., ~ .>
r
5 JJy tJ~k
(Addrfss)
(Contact Person) t;k".,vr _ /7 ./ ~
APPLICANT SIGNATURE ~~
'v~
APPLICANT PLEASE COMPLETE BELOW
Arcf/c..c-c... DNEW CONSTRUCTION 0 REPLACEMENT Ji3.bL TERA TIONS
FBRNM;E MAKE AND MODEL /11,,)- ~ .J I, "l.- ()VJ{ r'J 10 tI.. r IV FUEL fi/ ~
If . ~
FLUE SIZE L/ RETURN OPENINGS INPUT "5(,. t>tJt)
/
HEATING OR POWER PLANT
R.)
(Phone) '19-133 - / 116 8
H6()k\......~
, (City)
.5 > ~74
(Zip Code)
(Phone) ') S-;l- 933'- /lr~
DATE 7..... d2 ~'-6.3
OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
DGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o 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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ ---'20 0 _ fd!!;-
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
3CJ-sV
i ". .50
LiDI
lice Use Only)
Building Official
Date
Paid L;o I ----
Date '1- dLf- ")
Recei~ f 72)
By ~
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372