HomeMy WebLinkAboutBuilding Permit #00-0224
~
DATE RecEIVEQ
APR - 4 2000
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No. OD -0 zz4--
- 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 .-r
3317 (;/YN4..Ja1l'r lrtf,./ /YtJ
3. LEGAL DESCRIPTION
LOT $Y BLOCK
ADDITION~/V/V wa1(1r
,
4. OWNER
(Name)
5. ARCHITECT
(Name)
6. BUILDER (Name)
WfIVJmQ/V/V
}JO/t'lf'j
7. TYPE OF WORK Fireplace 0
New Construction rJJ.-- Alterations 0
Chimney 0 Misc.
8. PROPERTY AREA OR ACRES
Sq.Ft.
1. DATE
{-3 -0101..' 0
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
3
~ /V~
prD rJs- 3t,S - 6';"Y- 0
q//17,'o#
13. TYPE OF CONSTRUCTION
(Address)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Address)
(Tel. No.)
(Addre,s~)
/8r> 1'/t1~v.. Pr
~a flll,A/ /ll/V
s~Jfc 0 Deck 0
Addition ~ Finish Attic 0
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
!;.j-/- ~()". '7t'OtJ
Re-roofing 0 Porch 0
Re-siding 0 Finish Basement 0
SEATS
16. PROJECT COSTNALUE
9. PROPERTY DIMENSIONS
Width Depth
10. CULVERT SIZE
Yes No
/
17. COMPLETION DATE
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct I also certify that I am the owner or authorized agent for
the above mentioned property and th~t construe' n will conform to all existing state and local laws and will proce in accordance with submitted plans. I am a. ware that the
building officiaj;#n revoke this ~ ust cau . Furthermore, I hereby agree that the city official or a designee . y enter upon the property to pe~orm needed inspections.
X ~ ) ~ --/. I /-$/ S;~ ~-3-.2 00 D
- - ./ V J11'ture ...... '- - ~cel1se No. Date
1/ FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
~SFfI-
Back
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS CJ SETS
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
SURVEY
PLOT PLAN
o COPIES
PERMIT VALUATION
I~o.~oo .e>> G
r
o
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 ................................... $
Plan Check Fee ............................. $
State Su rcharge ............................. $
Penalty ....................................... $
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ..................... $
City:
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ..~:~................. :
Meter Horn .......... q .,t................. $
Water Meter ........1l'.................... $
Sewer & Water Connection Fee ........... $
I 2t; .DO
1,200 .C'6
7~O"t91:J
~.~
4UJd .00
88ft 2.C:;-
S!J~.. 2J
5() .00
~O~
ILkJ .()O
/ tJCJ _ oCJ
~.SO
~~
4' I',
Sewer & Water Permit...................... $
n ~/l~I;~.~~:nq.r;;o
~BUil( Date _ _ ~
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit............................ $
::~:i~;~~~.~:~~~~o:~
Issued ~. - I~ .'
Date 8: /..oJJ By I )
I '-
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning rdinance and may proc d as rested. This document when
signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certifi ate of 0 cupancy must be issued.
City Planner
o
Date
Special Conditions if any
24 hour notice for all inspections 447-9850
...
(fZJ -0 ~z,~
The ('enter of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\ \J' S (\ :: {l i I t (\J 1\)
4- /4/Gu
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
) t C," .... ., .- <:....."M.]; ...-,'.-1..
,-) -,..~ I ~J ~. j L. \//\/ l \.; I \ I t~ ,<-- "- ·
I
Accepted
v
Accepted With Corrections
Denied
Reviewed By:
~~J~
Date:
tt-[l,-t9D
Comments:
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.1I
~
~ - Ozz4-
The Cenler of Ihe I.ake Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
IN ~N S Hit /vN
4-/4-/00
I ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
G!LV!\J WN', c~~. I R-.
I
Accepted With Corrections k
33 ( CJ
Accepted
Denied ~ //4 )
Reviewed BY:(~/,,-
Comments:
Date: t.J -11- 7~d
~.\4. ~~~~ LJJ
~ \Pi ~
s,.,..r4'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 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."
6() - OZZ4-
Tht ftnttr o.f tht Lab Country
White - Building
Canary - Engineering
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
\\Ie-f\J s ~.llt IV r,)"
4-/4/oD .
I .I
APPLICATION RECEIVED
. .
The. Building, Engineering, and Planning DepartrT')ents have reviewed the building permit
application..for construction activity.which.is proposed at:
3'31Ci (:Y.1 c..VI\J~Vf\-rb >>~-: I R-.
! . I .. .
Accepted.
./
Accepted VYith Corrections
Denied
Reviewed By: ~f-T!:Jl&ItE.511414.NN
Date: "1/0/00
Comments: -.SeE ~ Bu,t-Ot~ f=U"".T roll _tt1< ~i..vAJt4J41"EA ~Il-
ritl
CDMMWTL.
I .l~
AJFoit"'tttT'loAJ '. 'A~"./ M.6Jr<;. .
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 ot this code or other
ordinances of the jurisdiction shall not be valid. II .
,.
'<i
Job Address 331''lG/~ItI.V-01t~
Heating Contract6~A~ flvt;l ".
f{ ~. fl,.
'3- 4-
"7
c:tJ
Name of Tester
Date
Percent O2
Percent CO
Percent CO2
o
~
3/4)
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input
~Lr: "~' , r\,r
"'. r I u~ t\r I v ~ tt:c-.. ~. .~
/
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I
CITY OF PRIOR LAKE
. PLUMBING PER","
Applicant & rn it - P ~
Address: JlJ..'1 U <" ~ ~ t.J?I-
SigftatUre: ~ l.ll, ~ 0 ~ -
. L:agaI Description: La! b ~ Black ~ Sub r~ k ) V\ l~ v ri.>"4 ~
Site Address: :2, ~ I q 61 ~~A-i ~ -r te- '--
Bunding Permn #I (}O - CB ~ Y PIC' ~ ~ - 3 (.s-: () ~4-n
NOTE.: This permit ~II not be processed without complete infotmation.
FIXTURE UNITS
MAY. 24.2000 6:59AM
GENZ RYAN 6513226147
n.c c.....- .I ,lie .... c..irY -
-....~
Quantity Type of Fixture Quantity
l Bath Tub with or without shower 3
\ Dishwasher \
\ Floor Drain
2- Lavatory (bathroom sink) l
I Lan')dry Tray C1 or 2 compartment sink)
\ Shower Stall
\ Sinks
Bar Sink ,
.,,~ "
~~ .2- Water Closet (toilet)
~ ..,.
,. .f~:
01
.,;
~~.
. ;,.. " .
.. . ~. .;.
0'" .
. . ~ ~..
rei: SChl:.uULE
. ......
So Inchalakd, Commercial 1& Multi-Farmly
(1 % of job cost. $39.50 minimum)
Residential" New One & Two Family
Residential. Additions & Alterations
state StnCharge
:, L.-;:i;i
$99.50
139.50
,-
'S
GRAND TOTAL
~~'{2A~
-NO. 348
P.4/11
I. ... ..
:L GaI4 Qw.,
3. YeIIaw ~
# C11J ~ ();:y I~
Phone: f.D <i' f - 4 'Z.. ~- l' 4l..J
~~'\ ~'o~~
Type of Fixtu~
ROlfgh-ins
Water Heater
Water Softner
Stand PIpe (washing machine)
Sewage Ejector.
BacIdIow Assembly (API. Double Check, PVB)
Backflow Assembly Test
lawn Sprinkler
Other
~
~ ~. ~... ')1'
~ . ..;t. ~
:1 ;; ~.\ .."rJ.. .. ~
:04.....'!I../(I1 "
r. . ." ~. :oJ'
$. /
: 1-
$ /.50 O<~~~
/ Jit.~ ~
$
, ~
This permit is ~.~_.ed upon the "r'.-s condition CbaE said
contractor. mall ~.....ply in aU . ""ra:rs with the ordin~
or: lIIe Slife P1l1111biDC Code aIld the ~':2.-~~
. · -rirNO.~~'if:U DA'm
J_ A (1 ; ~ .l' rl..t ~: 'n J.l ) A4 l~"
&.. for all ~ns 24_ hours in ad-.
16200 Eagle CreekAv. S.E., Prior Lake. Minnesora 55372/ Ph. (612)' 447-4230 J FAX (612) 4474~S
- AD EqW1l OPfJot'tUDity Employer
@-..
i-: ...
.~:~
'* k', . . CITY OF PRIOR LAKE" · ~
o ,Wi" 18200 E8g'eC...JcAv.8.E. PellllllNa.(?) - Cb1d t
\: '4 . Prior. ..., MN 55372
::: '-.: HEAnNG APPLICAnON I PERMIT Single Family
~ ' , ~"' 3 Cunmefdal
a: Date n_7..L\, H J PID, ;;J.S - b'S'- (jdL{-f)
r. 0
slI.Adcir88l, ~\~ (.;lllN'\ll")PrTe..R.- ILL
CD 0 M r-cl.
~ Lot SC Bbdc,'Z) Add.lon \.:') ~ ,(\ \ A H'1\-k If" R Ar\l\t\)
2 D.;..nNaml, \.uIfY:...~n' ~
Address, ~~6 \)\f\T~~ ~(L <:),-e. ZOa 0 EnAPr~
H.~lna Conlractor. ()yJ Jrw-. - ~ ..t lA 11\
-=- .
'Mc,;.ss, 'U1U~ ~ ~~ -r-~_L-
Telephone. I loS\ -l\L...~- \ \ l\ U 0 -
I -, I. i
Fu,n ICI Make & Madel' \.R,^ If'\r') 'f-.
Model Size G,~:2..}~ --,~
TYPE OF STRUCnJRE
l. IlIkW:'
l. eM, i,."~
J. Vi .
Ale
OIJ
c...nc..
K'
. lWo-Faml1y
fndua1rfal
MUtl-Famlly
Other
Public
Fee Schedule
Induatffal, Commercial & Muftl.FamKy
ReeTdenlfal. HeIUng & AC
Rl8ldeala~ Heating Only.
Aesldenllal. au Flllplace
RMklenllsJ. Addllfon,-& Alleratlons
ReeJdentJal. AC Onty
~l_rl1aUY\' ,"
o' .,' 'Remember to add Ihe State Suroharge on the bOUom 0' lhis appIca~lon.
TYPE OF SYSTEM
Warm Al, Plants X
GlavJty l
Mechanical .
A" AIr CondJtlonlng X 2. l 1"'1. ~ I
.. 6v<!...r"1\ VenL Sv".m -
..
'. HEATlNO OR POWER PUNT
Steam .
Hot Waitt
Radlallon
Spedal Devlcts
Conn. load.
~ Fuel ~ \A'r. ~ue Size
--t .
~ SuFPir Openings \ \
N
~ Re1um Openings L\ .
\D ' .
z ~put 1~,ntO OUlputJoOl2D
<I, -
>- .
(k: 0 Edr. ,
N
Z
W Ofm.
l!)
TYPE OF WORK
~ AII.retton.
~
~
r: A.pltr
. RepfaClrn.lnI
. , EsL Com~. Dell
OIhel Device.
New ConstlUctlon
x
~ Eel Cost . . 87Udl P8r~~ 1#
re HEATING PERMff FEE'
~ STATE SURCHARGE '. / .50
~ rO~M::~E~MIT FEES $ /"
(.._Y: -;
~
.. . I
r, 0 - Odd~
. ~~~~
RaCI~I~~
~, -
1% of JOb coet('39.60 mInimum)
199.60
'84.60
-139.60
139.60
$39.60
_1."-
p- I
Q
The.prlce or vour Ileatlng permit Includes Dna rough-n and one lInal hspecUon. .
Addt&onaJ jnspactlons wJll be blUed at '35,00 ~8Ch.
.;. Haus. Helling Test Record musl be IUbmltted wHh bulking RIImll DIIIDbAl before buDd-
Ing cellillcale 01 oocupanoy will be MaUld.
~f:AT ~._.I ~. II .....In~..~ AJ:"'I.A~ wJt.tt number of supply 8nd 'elINn openIngl hied PIr
"room wIth CFM'a per openfng. New sltuctull8 or addiUona .end 11001 pIBn with supply
and retam lacatronl shown. HEAT lOSS CALCULATIONS. PAYMENT AND
APPUCATIONS MAV BE MAILED TO THE CITY OF PAIOR lAKE, 18200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 66372.
~
:~ .
City Hall bustnel. hours 8 re 8 8m. · 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) · CALL CfTY HALL
447-4230
t hllebvapply lor B mechanical 8vctem. permit end J acknowledge Ihet the
tnlo,metton above I, comple18 end BccuratBi Ihallhl work wrtl be In conformance
with the oldln.naes And code. oJ Ihe city and wlth Ihe atall bulldJng/mliJhanlcaJ
codel: thai 'hi. 101m does not beoome a permit until stgned by the BUILDING
OFFICIAL: that lhe work wlJl be In accordance with lhe approved plan In the
ca~~ orr"=rk which lequlre. 'evlew and apPloval of ptans.
V\JiJ.",\ l 0- · '. !i', 2Lt Iw
. ~puca SIgnature . --1 Dale .
(^fJl1- l~rJI.J,1~ S/~L//1JlL
O. ulIdlng omtra Sl9na'fure . , Dele I
RPR.17.2000 6:51RM
GENZ RYRN 6513226147
NO. 908
P.5/5
~PR~
~(7)\<\t\
. i-t ~
. .~~~~
-- .....
YILLDW.. ~
......... ,
CITY OF PIUOR IAICE
SEWER AND WATER PERMIT
NOTE:
NO.ru -0d84
Sewer and Water
con~ractors ~ust
be registered
with the city.
APPLICANT: ~2-- ~ PHONE:.L6\-U~ -fI4'-1
ADDRESS: 141~ C!.o-. P:Qq".o-r--rvu- ~I' DATE: 4..j/1 ~,
SIGNATURE:~ ~-/"- BLDG. PERMIT t1Jl)-{)~~4
SITE ADDRESS:3:::l\~'f(\h'IM71\fl ~~IDi~-~- 6;i.L/-0
FI~ IN THE BLANKS .
- 40'
1. Estimated lenqth of water service
I ~ c
2. Size of water service inch(es).
feet.
R172Wl
-
. '. )
"'.~: )
3. Location of any couplin9s from s~ructure
4. Type of sewer pipe. ASS PVC X Cas~ Iron
5. Estimated length of sewer lin~ ~J feet.
6. Clean out (if required), located at feet
structure.
feet.
frcm
=
----......= = --....
=..-...-==.";..~-'--_.., ,. .
Thi;5 apP,lieation j'Efomes y(,-ur 'Per1llit wnen approv~. 1...
BY ~ .' - hL..i ~'oi fa')1A~.I) DA,TE: 4 / J '2./rTD
. _______ L__'__ - _. / _ t_
- -~--....,.- -~=-_...- ... - .... -...--- ------
FEES: $ 35.00 Sewer and water line connection permit.
$ .50 Surcharge
$ 35.50 TOTAL
* Fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be
recorded on the bul1din~ permit card at the time of issuance
to insure that no dupl1eate sewer and water permits are
issued.
. -~"\
~ )
. .......-
DATE PAID .
RECEIPT I
AMOUNT PAID
REC'O BY
. 4629 Dakota Sl S.E., Prior Lake. Minnesota 55372 I Ph. (612) 4474230 I Fu (612) 4474245
N'I EQUAL OPPOR1'\JNlT'i ~
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 33.14 ~",-u.~....... It-
NATURE OF WORK ~~~ ~..
USE OF BUILDING ~FA .
PERMIT NO. n(J - ()? 24- DATE ISSUED t/-II -~o
CONTRACTOR L~. ~ "".-A 6-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING r:rr.k~6J."%> ff;r. 6/3/~(j'W-fA:81zz.j(JtJ
FOUNDATION (Prior to Bat'ckfill) (h ~ A f)jlm
- PLACE NO CONCRETE UNTIL <<B-OV~. HAS BEEN SIGNED
ROUGH ~f..JNS
Lf lQ.t fta"'l
I '
'1- ?..o d
? ~ <.f'rJ 0
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if re~)
C'
FIREPLACE ~~b~E~ .
GAS LINE AIR TEST ~
?/~/0iJ
I
~.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
_~._____u
,... ~--- "'
FINALS
GRADING (Prior to Sodding) N CS. s, 4 - t. j
BUILDING,..tA~'fr/~ f;,.. 1/<7#bll
ELECTRICAL
PLUMBING ~, CJ /rJ-?!IW
HEATING a" 4/"- ~
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electric,1 s~rvlce 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
Qttmfteau at (Oem: mnry
CITY OF PRIOR LAKE
Ilepartment of .uilbing .Jn~pettion
wFinal Permitted 0 Conditional C. o. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances o/the
City of Prior Lake regulating building construction or use. For the following:
R3
Occupancy Type
Type Construction
VN
_ Fire Zone
Bldg. Permit No.
N/A
Zoning District
00-0224
R2SD
Use Classification
SINGLE FAMILY
Legal Description-L8. R3. GLYNWATER 2Nn ADnN
Owner of Building Site Address 3319 GLYNWATER TRAIL NW
Contractor's Name & Address WENSMANN HOMES, 1895 PLAZA DR., EAGAN, MN
JENNI TOVAR
ROBERT D. HUTCHINS
ro \", Bui1di~ Official
Date: n. \dl.v-.IJ 01. - J. 7 -D-:J.. Date:
POST IN A CONSPICUOUS PLACE
City Planner
, I
. .
f ~ f,
!,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~"3 ] q
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
O~SULATION
)i!r FINAL
o SITE INSPECTION
COMMENTS: ,
eJ,c>.&.€
'-
1~L\e"'"
DATE TIME
SCHEDULED ~ -'):7 ...0 ~
&-1~v\ wah..,r J {'
CONTR.
PERMIT NO.
a>-OOl.;;24
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 GASLINE AIR TST
o
~ p-
CLOt
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, (;ALL FOR REINSPECTION BEFORE COVERING
Inspector: h " ~ Owner/Contc
CALL 447-9850 FOR TH: NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
.-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5..::5 -~ L
ADDRESS
33/? G I V YI Wo, {.~ r" TI'.
CONTR. VV <-"'5~C,,1YJ 1-/0#1P
PERMIT NO. O(!) - Z.Z '-/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
.!1 EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
CUrb 13~)t( - r9/(
(; /'wLll1C, - ~ K
J
Ire~_\ I p" s.aAI
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: /1~ ... - Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
<J21uv ?,'.1(}
33/ 't G1L'1tJ WA-1 e:;;/L
./
CITY OF PRIOR LAKE .
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULATION
~ FINAL
EJ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~ PLUMBING FINAL ti)
-~ MECH FINAL (j;)
Il$~L~ ~~
81~ ~ "to .qy... a~.~
( ~ J,.J ~ (J-d ~ 0 .
Kalf ~",,-bo ~.
e:-! '~-~~'"-
~ ~ ~"'...~~..:+-""'i:-'-'~;~~'~"'#-":-
~.-~~;
4]
A . c.'"
~ -V-~
DATE TIME
()-,;J.:;J-t.f
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~~I.1() 6 ..~
. __ .,_,,+~-r.;~~~~>~'~-
· 11.
,. ; ...;r
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. &- j
Owner/Contr:
V'" /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
1~tlOd 1(' 30
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f. 0 MECH RI 0 COMPLAINT
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o PLUMBING FINAL 0 GASUNE AIR TST
o MECH FINAL 0
SCHEDULED
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
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o CORRE,-T ON AND PROCEED
o CORRE 'T WO ALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
REQUI EMENTS ARE FOR YOUR PERSONAL HEAL TH & SAFETY!
INSNOTl