HomeMy WebLinkAboutBuilding Permit #00-0085
~6
CITY OF PRIOR LAKE MAl N FI L6' 1. White File
BUILDING PERMIT, 4t 00.. oo~: ~:ow ~:~licant
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT Permit No. 00 - 009;5
DATE RECEIVED
ttiJ J I
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE ADDRESS
:]3/(, G/v/vw4.1fr rrfAl'/
3. LEGAL DESCRIPTION '
/vw
LOT ? BLOCK
ADDITION b/ y Iv fA) 4 rt r
4. OWNER (Name)
~
a Nt'
PID ~5- 311J- 0/0- ()
ado!
13. TYPE OF CONSTRUCTION
(Address)
5. ARCHITECT
(Name)
(Address)
6. BUILDER (Name)
t,J eNS' /'It Iff /V AI'
IJO/T'~.f'
7. TYPE OF WORV Fireplace 0
New Construction Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq. Ft.
/' (&;qress) ,\. r
/89..> r/pZIJ:- U
{ A I' () IV /l7 /V,
~ptic 0 Deck 0
Additign 0 Finish Attic 0
1. DATE
;1-/J-;J.o{) ()
~2.5.D
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
(Tel. No.)
(, 51- ~ 0" -.yj/ () ()
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
17. COMPLETION DATE
I hereby certify that I have fumished 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 c#ial can revoJe thO pe.rm rmiitt 11 just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~~ ~ ~j .....r- j'Y53' . .;2-11-00
~ ~~ ~~ ~
// FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATION
16. PROJECT COSTNALUE
MATERIAL FILED WITH APPLICATION
Side
SOIL TESTS
o
ENERGY DATA
o
PILING LOGS 0 PERCOLATION TESTS 0
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 100, OC:;O . OC)
USE OF BUILDING
.s~A
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee................................... $
City:
Plan Check Fee ............................. $
sa? ?,~
~7kJ1
5'0 .00
State Surcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $ /00 .f!) (5
Mechanical Permit Fee ..................... $ / 00 .t) 7)
Sewer & Water Permit ...................... $ 15 .. SO
Gas Fireplace Permit ....................... $ l./ 0 . f) C)
Th~ 4~.. "'ur Building Pennk When Approved.
By (J~ (~ Date 2-~
Certificate of Oc~
Issued
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PLOT PLAN
o
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ....~.................. :
Meter Hom ................................... $
Water Meter ................................. $ I 2G" I r.J ()
Sewer & Water Connection Fee ........... $~ () .CIJ...e
Water Tower Fee ........................... $ 7 dO .612
Water Tap ................................... $
Builder's Deposit ............................ $ - 0
Other ......................................... $ .
Total Due .............................. $ 5-f30,9. 'ti2
Paid Receipt No. ~c. ~ q ea
Date '3 -~..~ By ~.
~Q:20 6'
/,L1JO . ~
4S- _ e6'
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
sign d by the lty Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
~ ~ ~ 2 -l ~ -{f)u
City Planner '" Date Special Conditions if any
24 hour notice for all inspections 447-9850
Thl' Cl'ntl'r of thl' takr Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
vVE\!5 M A \! '\v
2//1(00
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
331 (0 qLV f\'lNA (~R _ R-A\ ~
I
Accepted ~
Accepted With Corrections
Reviewed By:
(- <~~
~
Date:
?,. (7 - 2o""~
Denied
'-"
Comments:
S'e~ ?<'vA\1 -ft
liThe 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."
Thl" Cl"nll"r of Ihr Lakr Counlry
White - Building
Canary - Engineering
Pink - Planning
BUll_DING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\ i ~\: ,/-' r"" ' / '\ i\' :
\. \, \,~, \j -J .! t' ! ; ,\;
, I
2/ f I I ( C.
! (
",. The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
"~')-:1 i i I.." \/' 1 ' E i ..--.J
",:0/ ""~! I t.[ I, ~'i L. ~ f \ f\ ( ,- ~
.,. I
j ; ,'\' I L
I ~__t \ ..-
Accepted V'
Accepted With Corrections
Denied
Reviewed By: ~ ~
Date: 2~ I f$~
. Com~l\ts~_ _
r^~af&.JrJ- f~ ~e-d -~,O 'Pv ('~~h~S
~ ('"l ~ L. c) '- P. rJ.Mcl i'Jf(J( qJB/J- .~
~J/ L~IA~ ~ AAhu-8Y1..
(Jrep&~Q ~yt94~/e. ~~ /t)~LA~~ Lht .
~~ <>1 v\AF'~~ ~ ~~\J~/e~
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
. Thf ('fnln of Ihf l.kf ('ounlry
White -Building
. Canary -Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
\A! == \i6 f"'l A N i\J
: '-;J!ll In C
. .. . I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33 I .(0 6 L 'vI N~'^'Jf-\ TE K 'RA \ L,,~
. ,
Accepted
Denied
./
Accepted With Corrections
~ .:.. _ _~ _ _ _ . _.J "'_ __ , ,_ __ ~ r-. _ _ . _ . .
n~vl~w~u oy. w'tL.u./L . r:....URf.~,.,,"NAJ
1'"\_1._. 4 I ~_ '- _
Uc1lt::. ~/' IIUU
. ,
Comments: -5u ~,.,. Fo~ ~ GI...'iHwltrf:'.ll. Iti~,,_ FoR. 'Ib'w\~
, .
JAlFottoft1ATlotJ f COMl\1E.VT'S.
liThe issuance' or granting of a permit or approval of plans, . specifications and
computations. shall not be construed.to be.a permit for, or an approval of, any violation of
any of the provisions of this code orof any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not bevalid.1l
'<Ii
Job Address 331"C 1~/1 ~ f ~ ./
Heating contractor~,-t -z: 4 yv"
Name of Tester ~ f.{ - C~ .
Date b.f .$ -(5)0
7
<6
o
25So
..
Percent 0 "-
Percent CO2
Percent CO
Stack Temp.
MRR. 6.2000 11:11RM
GENZ RYRN 6513226147
NO. 475
P.6/17
I. ... JliJc
2. 0aJ4 cty
3. Yd.. ~
() n .. ()() Bb
."
CITY OF PRIOR LAKE
. PLUMBING PERMIT
Applicant: ~,~ - e ~
Address: l..!:!7U C s--.U er,li!!rtf!_r' "Tv!-.L-
.0 Signature: ILl fl ~ D --
Legal Description: lot I Block ~. .Sub 25 - ~ - () I 0 - 0
Site Address: ",,35/l(J ~~~ -re.I1(L 12..25D
Bunding Permit # 0 () - cro..f}'::;- PID # 2..::) - ~ - 0 f 0 -Q
NOT~ This permit wJI1 not be processed without complete information.
FIXTURE UNITS
#
Phone; l.e.S J - 4- 2.3 -, 1tJ4
~...,-
TIM Cm.... at 11M La_ c..."",
Quantity
2-
\
\
~
\
\
~'." "~' ; /) -
i '.~' r
I....
(_J
. 't
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floer Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 ccmpartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (tenet)
Quantity
Type of Fixture
3
I
RQugh-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector.
Backf10w Assembly (RPZ, Cauble Ctleck. PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
I"'t:r: SCHEDULE
. Industrial, Commercial & Multi-Family
(1% of Job cost, $39.50 minimum)
ResidentiaJ, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$
SS9.50 $
$39.50 S
$ .50 ...
GRAND TOTAL
.~'r\ ~
$ I.~n \N\ ~,?{\~\\
/' \"r'l. G '(~\
( u\\'O\~ .
\~
~::t
TI1h pcnnit is granted upon the express condition that said
COnu.ctClr, shall cDmpl~ in all rcspecq with the C1rdinances
o( the State PlUlmo 12.. cl tha amepd~ts tben:of.
: - ~ 3f7 filO DATE
.. r ." ' AL u:.$T
Call for all. pections 24 hours in advance.
MAR 0'
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 J Ph. (612) 447-4230 I FAX (612) 447-42~5
An Equal Opt)Qrwnity Employer
$~J~11~rl . CITY OF PRIOR LAKE' '.~-1
Ii .r. \~ - 16200 Eeg'. Creek Av. S.E. PermltNo. tJn " ()08t:> .
. .. Prior Lake, MN 55372 ·
~ ~ HEATING APPUCAnON I PERMIT SIngle Famllv
cL ~ I ..IDO Commerdal
Oale o~ UI . PID.25-3(o5-010-0
IQ sae Addn~ 331 !,; h II }fH.L(\ 'T(J Ie... 1'" .AI I __ P ?Sp Fee Schedule
~ lDt 7 Block 2.. Addition ~L"N,^IA"T"ER- -z;Jt)
0' '.
Z OWnefsName (l ),_J~ ~() .~.S
Address ~q~ 'P\P(7..~ ~ Sri'. 2flf) ~rJ
. ...
....ling Conlrlldof ('?<x-iz - L~
Addl.. U1l\-~ ~~~~.:r'" -~hf'--, f~rYYJ ~'ill(~
LD~\-L\?b'" \ 'U L.
Telephone' .
For..- Make & Model , fl,.A '" ~~
Modal SJze . ~ 2?J01- ~-"? c;-
TYPE OF SYSTEM
Wa.m Atr Plants. )(
Gfavlty
Mechanical
AIr COndJl1onftg >'
v. nl. Sy....m
HEAliNG OR POWER PLANT
Steam
Hot Waler
RadIation
Special Devices
Conn. Load
~ Fuel '^/Af(}}~ FlI. SIze LJ If PA't,hf-
ill
~ Buootv ( - .
{T}
@ Return Op.nlngs , L-/
~ Inpul1t;~ tmD Oulpul' , 1\ 1mf')
a:::
N
Z
W
t!)
_ _ po _. e>>penlngs
Ed,.
OIher Devices
Cfm.
TYPE Of WORK
E X
a: Replacement New Conslrucllon
~ AleranoM
..
;:: Repelr Est Comp. Date
~ EII- Cost , Buldlog P,umb II
lSl (" pp..\~t~m,.l'<Wf
~ HEATING PERMIT FEE'
ill
a::: STATE. SURCHARGE . .50 l eU\LO\
<I: ... ._.;....
E TarAl PER'_UT FEES $ Receipt "
TYPE OF STRUcnJRE
x
Two-Famly
Industrial
Publro
1. JIlBt)
1. Ore.' .
J. Yc
Pile
011
CuIIrnd<<
Mulll-Famlly ,
Other
Industrial. Commercial & Multl-Flmtty
RealdenUa'. Heating & AC
ResldenUat, Heating Onlv.
RasldenUa'. r."u Flreptace
Resldenl's1, AdfiHona & AlleraUons
Resldentfal, AC Only
t% of Job cosl ($39.50 mini mIA'll)
199.60
$64.50
$39.50
$39.60
$39.50
c.D
Remembe1 to add the Slale Suroharge on the bo\1om 01 ibis apprlcanon.
~
:E
The.prlce of your healing permIt IncJudu one lough-In end ene IlnallnspecUen.
Addlllonal -'.peclJonl wWl be blled at t35.00 each.
House Helling Test Record mus, be aubmftted wfth bulTdlng IlIUDII flLlOlbIt before bulId-
Jng certificate 0' ocoopancy wIR belSlued.
1-1-= AT ~.I n. n ATln"f~ Il.l=nf ,fARl wtlh number 0' IUpptv and retum ope nlngs listed per
room whh CFM'. PI' openfng. New elNctures or addilTons send ftOOl plan with supply
end return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPUCATIONS MAY BE MAilED 10 THE CITY OF PAIOR LAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. UN 65372.
CIIy Hall buslnsN hours are 8 I.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN\iND FINAL) · CALL CITY HALL
\
447-4230
I hereby apply (or a mechanical systems permit end I acknowledge thai the
'n'orm81Jon above Is complete and acculate; thet Ihe wortc win be 'n con'~rmlnce
with the ordinances and codel of the olty and with the .'lle INlldfng/mec:hlnlcal
codee; lhal 'hla form do.. not become a permit unl1l stgned by the BUILDING
OFFICIAL; that Ihe work wIll be In aoootdance with the approved plan In the
case 0' all Y'ork which ..qulres review and .pprovel 0' Plane,
3 fAr fa
3!7'rO()
Bate
,
Bulldng 1caJ's SIgnatuI8
FEB.29.2000 10:36RM
GENZ RYRN 6513226147
NO. 289
P.4/5
~ PR~O
: .:... 07\~ ~
f p.., "
.... ~~ '<. ~ r:
~N!P
_....
'ftI.L.aW .. Al9l..lCAIII'
8GLD . ._'.
CITY OF PRIOR I.aAD NO. 00 -OO~5
SEWER AND WA'r~~ PERMIT
NO~E: Sewer and WatQr
contractors must
be registered
wi th the ci ty.
..~
APPLICANT: H Y/7-- P ~ PHONE:tpSH~'Z.~~II~1..l
. ADDRESS: Iu~-r 'T~ ~tYlSU.nTDA'l'E: z./-z..q/5D
- . . "SIGNATURE: .......---..... BLDG. PERMIT t 00 -0085
SITE AODRESS:~ ,,<:::>~~'n'i"P~ 'T1l2.1.- PIDi~-3Co5- OIO-Q
FILL IN THE BLANKS
40,
1. Estimated len~th of water service feet.
,H
2. Size of water service inch(es).
J. Location of any couplinqs frQ~ s~ruc~ure feet.
4.. Type of sewer pipe. ABS 0 pvc X' Cast Iron
5. Estimated length of sewer lin~ ~' feet.
6. Clean out (if requi~ed), ioe~ted at feet
. . s.tructure .
from
::~ apPlica}1~: ==U~==it";~::~7 (~~___
FEES:
$
$
$
35.00
..50
35.50
Sewer and water line connection permit.
surcharc;e
TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 ~urchar2~; .
* Sewer and water permi~s issued for new construction must be
recorded on., t.he building permit card at. the time or issuance
to in5ur~that no duplicate sewer and water permits are
issued.
(:)
DATE PAID
RECEIPT.#
AMOUNT PAID
. -
REC/D BY
/rtln~~~\"(
f eu\\..O\NG
~
II
. 4629 Dakota St S.E., Prior Lake. Minnesota 55372' J Ph. (612) 447-4230 Fu (612) 447-4245
AN EQUAL OpPOfUUNITY EMPLO\'ER
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS s..SI~ G \jVlwd:u. . k.
NATURE OF WORK t\)fuJ~
USE OF BUILDING ShFA
PERMIT NO. DATE ISSUED '2.- - te3"~~
CONTRACTOR ~.Q.M.S~ ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING ), dt, ~Lb ~!~1PO, . (;Y;i~i:nR
FOUNDATION (Prior to~~ckfill) V-.7fJ3/1
PLACE NO CONCRETE UriilL ABOVE HAS BEEN SIGNED
ROUGH~JNS
SEWER I WATER I SEPTIC ~] 7/-;;;
FRAMING ~ ~~7 !r//i
INSULATION Ih. ~\\i OIl ~( /;b'<.--1)~1 '&? ,/"~, eg,5(VIJ!D
ELECTRICAL V1~' \ r..L. ~
PLUMBING U ,yf~
HEATING (if required) tj;2 ,~/~7titJ
FIREPLACE · '1
GAS LINE AIR TEST ~\oJ+ ~, 6/!/t'D
i I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~i.rJ
FINALS
GRADING (Prior to Sodding) ~ \0 rl,Y I 0 0
BUILDING \,~o, ~ ~/, JDD ~, ~/;J. 7/~ Ilk I - .
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy
DATE
/t'/8tf/M1
b:r,
.~
UNTIL ABOVE
NOT.ICE
~/J.a/tJV
. ~ ~ 7-/Jrn
HAS BEEN 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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
,f...11' " '. "', , " '.. ....,.,~,.., '':If;4''h,:\,'014''~~. ,~," ;~;.p"J:.;'r,,,,, ", .,~ ", "1>!,\ . .' A~"t~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 331~ ~Vl~
U
OWNER CONTR.
PHONE NO.
PERMIT NO.
0;~
TIME
'1:~
0-8.5
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~WATER HOOKUP
o INSULATION . 0 EWER HOOKUP
o FINAL PLUMBING FINAL
o SITE INSPECTIO MECH FINAL
COMMENTS: (f) ~ M ~,
I '
~~.
~-~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~I
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
{rid
TIME
10 :l(;
ADDRESS ,~~ (,., ~~
OWNER CONTR.
PHONE NO.
PERMIT NO.
()'''is
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
. ~NSULA TION@~ 0 SEWER HOOKUP 0 FIREPLACE FIN,AL, :1P
~ ~INAL N -t': , ~ .JLUMBING FINAL ~ ~ ~ T~~?
o SITE INSPEC IV (g)Jl=MECH FINAL If9 ,... ~.
COM~~TS:O ~ ~~ 4/.~~J
IJlY .~ $- ~ (ro ~. ~~.4"~
(!) ~~'_ ~ -<111 f";;~ ~ ~ ~,*i;
(if) ~-~ ~ fJ~~ cn~ ~
~~~I
@),~( '~J ~~/~
-r ~ c.C, 1 (J / +-J.ft 8,/ ( / CJ"U
~~
eM1 ~ wittE. ~r
&/a-c,~
( (
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ CORRECT WORKtALL FOR REINSPECTION BEFORE COVERING
Inspector: . ~ ( Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
#
QIyt1"41I-~r rrtl / :I
CONTR. MI/:5P/tUl1J
PERMIT NO. ~-tJ&'.s
~D/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
CI,'rY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 33/(",
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o jHSULATION
rY' FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(~/~X l~ ~
DATE TIME
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~'K, CALL FOR REINSPECTION BEFORE COVERING
Inspector. J~~~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10130/871
, I
A v'V:
ADDRESS
33110
~T~
~
Itf-.
OWNER
PHONE NO.
PERMIT NO.
~ .-?5
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
l!! 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
o GASLlNE AIR TST
o
COMMENTS:
~
pq WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. 0, Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI