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Home My WebLink AboutBuilding Permit #00-0318 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT DATE RECEIVED APR I' 21m 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 t./ bbLLf~ ~tt.I~ 3. LEGAL DESCRIPTION LOT ~ ADDITION j,(lt>aD t.I~ 4. ?~NER (Name) V I~I ~SIV\O 5. ARCHITECT (Name) ~~ If,Mf~ 6. BUILDER (Name) 1. DATE tj,/i/,a () 1R 1- BLOCK t-( PID 015- 3 \'1- (J~3-0 ~ 3U~OlTrW (Tel. No.) qfJ,.... J20~ ~ J!,M.t5 .gttH J(~~ ~.,-SW# {ll. 'f!tJ-OCJ.>S' . Rl3-roofing 0 Porch 0 Re-siding 0 Finish Basement 0 7. TYPE OF WORK New constructio~ Chimney 0 Misc. 8. PROPERTY AREA OR ACRES Sq. Ft. II. ~ 3 g Width 9/,11 Depth I 'f'i. 8 Yes No ~-l- frO 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 e above mentioned prope II construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the bUl . ial can r this permi Just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. Z& \b 2.. '30'2- L!-/ "I-tJO Signature L---- License No. Date OFF STREET PARKING SPACES REO. SPACES ON PLAN PERMIT VALUATION It ~~ CX!)O. 00 (Address) () (Address) r'Q., 'fL lA.t:.i (Address) Fireplace 0 Alterations 0 Septic 0 Addition 0 Deck 0 Finish Attic 0 9. PROPERTY DIMENSIONS SETBACKS: Required Actual Front Back BUILDING DEPARTMENT VALUATION USE OF BUILDING SFD 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 .... ......................... $ '1~;} .2S- (p, C). c..f (,. 5'7 . CSO State Surcharge ............................. $ Penalty ....................................... $ J 00 . (!) (> I Of) . 06 Sewer & Water Permit ...................... $ '35' · ~ V Gas F epl ce e it ......d.............. $ '6;? · ~ " Thi 0 m~ing Permit ~n ~pr,C:,c:;o By .. Date I.J..- -" - _ Certificate of Occup:l Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ (Tel. No.) (Tel. No.) 10. CULVERT SIZE FOR ADMINISTRATIVE USE Side Side 1. White File 2. Pink City 3. Yellow Applicant / Permit No. n O-O~ / -- BUILDING INF04N 11. SIZE OF STRU9.!~E (Height) '231 (Wid,,'!y' (Depth) sa ,,, 12'Si~r~y 13. TYPE OF CONSTRUCi'lON ~~.tJ;WJ 14. FLOOR AREA APPORTIONMENT USE 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS SEATS 16. PROJECT COSTNALUE 1/r5;OOl:J 17. COMPLElfON DATE MATERIAL FILED WITH APPLICATION SOIL TESTS 0 ENERGY DATA 0 PILING LOGS 0 PERCOLATION TESTS 0 PLANS & SPECS 0 SETS SURVEY PLOT PLAN o COPIES o Amount Brought Forward .................. $ Park Support Fee ........................... $ SAC . . . . . .. . . . . . . . . .. . . . .. . . .. . . .. . . .. . .. .... $ Collective Street Fee ....................... $ Sewer Tap ................................... $ CitV: ~~ \~~ 8StJ.f:) f!:) l,J OO.LJ t!J ~.. $ Pressure Reducer .... ~.................. $ 'I(i".tJ C> Meter Horn .............................. ..... $ I ::1$. D 0 Water Meter ................................. $ J" 2tJo.tfJ6 Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ 10 0 · 00 Water Tap ................................... $ Builder's Deposit ..",/\;,;.;;................... $ ~ () () ..IJf!:C) Other .~~.~~R':...... $ ~ee. 90 Paid T~'~q ij(j:.7("".~:,~;~o$i7~~.1/ Issued ~..'! Date J) By J This Is to certify tha.1he _ in .he above application and accompanying -'met11s Is in aCCOfdance with !he City Zoning' 0, nanee and may proceed ~_. This -'ment w!len s. bylhe. ,"annercons1ftules a _rary ~e A~ oomPlianee~;w- ,/'lnJcOO: to rJZ7P:k~~be Issued. City Planner Date ~ - Special Conditions if any - 24 hour notice for all inspections 447-9850 (51) "03/ f6 Thr Crntrr of thr Lakr Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT l(ocl Cr<:..C"_Ir_ \\0 r-nE: S. APPLICATION RECEIVED A pI ill Lf j c) ()OO The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: L/ 6 (; Lj /'P,:"\. r k:. V'\J n c' ''"[)l " ve . . Accepted Accepted With Corrections V- Denied R~viewed By: ~~ Date: 0- ~ .-~ Comments: :I:H~.(LL ~~~ ~N& .dsr--/y)'l{::J Lt~L <:9~ ~ 4- ~U~ ~u..SllD 13([ .p~fZSrutv'f;:.Vj, t-J~ (~~ l6 t3>~ ~e- IN. . \ H-IS~, ,,' · '~~.~ 1A.tt ~\ 'Q~<QU(~~(). 22."<iO'V<.-L L..M-l ~~ ~~s Th i3 ii- ~f>~-Avb::J4 1.{"H ~ \ ~ 7 .'~'-f 1 4- ~ 11 L8t.u-S'\ -1Y"~... A~\J~~~~1u.e- 2-t.4 Wi~ -=C~-< cl- S\~V\,~~ ctybP<:$ * '-J 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." jl-0311 Tht Ctnttr of tht Lakt Country White - Building Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 1( OC ~l (_.r~_ \ Lu.m e..~ APPLICATION RECEIVED ^'Pri I 4 I dODO The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: '1604 YOvlc.. V\tfJTId Dn'lee. Accepted -^- ___ Accepted With Corrections Denied ~ Reviewed BY:~ ~m~nt:u Date: ~- ~- )"CPO #c.cW 1fr..-oO~ 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 val:id." ,:.:liii.i:",tll..~~"',~:>';'.:iI:~""""~._"""'''''''''~'''''''''''''':''''''.''''''''':Wi~'i'-;~,.;.I..'.;"""..........<!.U:,~"..~'.'..",;,.... ~'- '~~ ~..... ,.. ~~ ""'~'.ol ':c ~'~ '" . ~ '"); ~.." ' .c" .e -.L.:-';":.';, .'. ~ ./ 00 ~D3l<:( Th~ ("enl~r or iM "'k~ CO~nlry White - Building Canary - Engineering Pink ' - Planning , , , , BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT 'Roc ~l (re..\' 'r \ L:nne.s, APPLICATION RECEIVED ApY'1' '-/. l ;.;)000 The Building, Engineering" 'and Planning Departments have reviewed the building permit application for construction activity which is proposed. at: ' . ' L/60 L/ 0(U-- C. V\t rmoDr1Ve. Accepted ./ Accepted With Corrections Denied Reviewed By: JJIfLTElZ.' EWRE.S,.."..,..u.J Date: S/'/OO Comments: Al~ SToItJll't W"TEIl RuAJcFr: ' "'os"- (JE COAJV~l"E:~ ~ rAdJC".....>> 0 , ..J)cth'E ~iE. 'JNF04.MATI~ "AJ rNE. R€.ufA..SE.. $IDE... /' '- .-$E...E. A:z:Dl'~J1'S '; l. hN"L (;It.AO€'" 1~"IOAl /JIfoIU1Ai'".oN z. aRA-o.",c. A.A~ ~. EJt.os '01\) Co/ltlra.ol-M~ASu~~~ '1-. &.;)S I.A...) CO AIIlto(.. liltN 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 provision's of this code or other ordinances of the jurisdiction' shall not be valid. II tlJol{JJr~ *Heating Contractor METRO AIR ~ *Permit" * Job Address -.i *T esters/Signature *Gas Une Pressurized Inspected · Percent C02 * Percent 02 Final Inspection - \ Date Time PERFORMANCE TEST 7. ?/Ip 11, V~/D · Percent CO .Stack Temp. Pounds Pressure c?% J'" Date / //', '~ ~~. - CITY QF PRIOR LAKE S r.. ~ ~. 16200 Eagle Creek Av. ~ ~ Pennft Na. ()() -0 3( 6 ... Prior Lake, MN 55372 \: --- HEATING APPLICATION I PERMIT <1 -- ~ - <J 1) PtO t, 0... She Address ,'"" \0 0 '-\ i' "'-~w t)(\ ~ t\ ,r lj) L.m 6t Block ,'\ Addnion. ~ ~ 0 ~ r: ~ "\ q ~~ -\. l, ~ ~- ~ Owners Name . ~ ~\ \l (., rCL~ 't ~ u ~ ,f., z Addr.ss ~~ q"\ ~ ~\Y" ~\ ~r ~ () yo- --'1llt \~ \ 1\ \. . Hellmg Contrador , ~ \ ".., t\,,.... ~ \"\ \ Address \\" ~ ~, ~, ~ L \ t O('~ .\ y t 1->,~: fJ' \ 4 l(, I ' Talephone' , ~"'~-~\~~ F\D'J1ac& Make & Mod 81 C ~.,. W'"'; ~ \00- MadllSiD ,"X~ ~() Conn. load , S ~ ;J :3 3 Fuel N G\,~ RUI Si%. ~ 'I C Supply Openings \ \) Retum Openin;s. S- Inpul ~ t) . n Ot'\ Output 1 \1\. u. t\Q ~ Date ct::: H ([ o ct::: I- W E Edr. ctm., ) ~w S- TYPE OF $V:. 1 eM Warm Air Pants. X Gravity , Mlchanlca1 Air Conditionin:J VIm. System ,X HEAnNG OR POWER PLANT Steam Hat Wid.. Radiation , Sp8cal Devices Other D8V~'" Altaridions R.r'l "'" ,"'" ~.111 'TYPE OF WORK New Construction .~ . & ....-J.. .:.:-, _ TYPE OF sn:.UCTURE 1. Jlbak. 1. CinD ), YcDDW - J:u. Chy CaIcnam Sif'\gle family X . Commerdal Two-Fam~y Industria' ?ubfic Mun;.Fam~ _. _ ., , Oth9T Fe-e ScheciuJe lndustrial, Commercial & Multi-famjiy Res;dential. Heating &. AC ReskientiaL Heating Only Residential, Gas r~plaC9 Residential. Adcfllions A Alterations Residential. AC Only 1,. oC job cost (Sa~.50 minimum) 599..so S64..50 S39.50 ~9.5D S!9..50 Remember to 3dd the State Surcharge on Vae bOl~m oIlnis app6cation. The price of your healing permit ~cludl& ooe R)U9h-in and ane final inspe=:tion. Adcfrtional inspections WJl be biled at S35.DO ..,.""'- House- Heating Test Record must be submnted wIh ~,nrfintlltA!!!lil nnmhfl!t before buDd- ing certifiCille of ~pancy wi be issuecL H = AT .r.A' ~ II ATlllN~ Rcn ImR1 with number ot $UPPfy and ratum openings rtSted per room with CFM'S' per opening. New 1t1Uctun:s or addftiont send 1Io0r ptan wtDr supply and ~twn locations sbowrL HE.JJ" LOSS CALCUlATIONS, PAYMENT AND APPUCATIONS MAY BE MAIlED 1'0 THE CITY OF Pnl0R lAKE, 15200 EAGLE CR=::I( AVE. S.E. PRIOR LAKE. MN S53n. City Hall ~ hours are e 10m. . 4:30 p.rn. ~ I I ,WORK MUST BE INSPE~ I c.Li (ROUGH-IN AND ANAL) . CALl. em HALL 447-4230 -.... 1 rn r:e [F;' n "C\' r1 [g" -----..1 r.., : '~. l/ ,.~... i-"~' ! ~ r~~_>~~__::="1.bi 0 ~?-, ~ : i 1 : '"- ci'RIO ! -'! t<<W _ 3 2OOOC1TY OF PRIOR LAKE $ \ ,; PLUMBING PERMIT pp ~o. (') - 3/<8 J 'L_ --..,--.- ., '-. 1 '. ._, ' \ _._.------ ,.~. !~c..,\le.Y-e......Y- .0 \u..W\b'\ Y"\9\, Phone: q t,,? t- -~\ --4> 1~ . Adenu: vt'd y \~ t{%, V'\",a,...- \...a,.iG"C. n. c_"", t.aM c...." . /..,~ BlgNtu,.: ..." / /f .' . , ~c)0\~ CYec~ lAgal' W Black {j _Sub fJ){)(Xit0Of4UESt )-\Oyyre~ 8It.AddI'8l&:4-\..p04PCLV"~WOcri Dr, \Jy.\t,>y. ~_~~ 'J ~d. Building Permit. ,PIC" 0( S --. ~ I r; - ();} 3 -0 NOTE: This permit WIll not be PP"""---ed wtthouI complete informadon. FIXTURE UNITS I. a_ 1. ~Id ]. .....a- .... C., AflPIAla* Quanttty Type of FIxture Cuanliy TYt)8 of FiJrture I Bat" Tub -'" or whhout Mower ~ Rough-ins \ Dllnwuher \ Watet Heater Fico r Drain Water Softnel' 1- Lavatory (baltlroom .'nk) Stand Pipe (wasning machine) \, Laundry Tray (1 or 2 ~"m."t sink) Sewage Ejecto, \ Sr.owe, Stall BactdIo\\' Assembly (RPZ. Couble ChOCk. PVB; l SI,. Bacldlow Assembly Test s... Sink Lawn Sprinkler 2 Water Caoeet (toile') Othe, IncI mrneraiaJ & MuIrf-Family (11C. of job eo. , minimum) ~-ldenllal. New One , TWO A-.Jdenllal, Adctltlone & Alterations Slate IurcPtarv- s s s s .50 GRAND TOTAL PAID - 8UI.D'NG PEhl ... 1'hI. p.nnk .1 ~ upaa me CApleSt condirion thal said c:annctof. ... .......)' ia II. "p&1I whh the ordinances of die s.... Plumbin. c.t. ud die IIBllldmcnct ~reol. . _ aEaIPT NO. .1/- /" -OU ,DATE 01' / _4. .aST Call '9r all iupR1iD113 24CbOun ill Mdvlftce. 16200 Eagle Creek Av. S.E... Prior Lake. Minnesota 55372/ Ph. (612) 447-4230 I F~X (6l2) 447-4245 All Equal OpparamiEY Emplo,er ~~ ~NE~ i GREEN - '..E YELLOW. APPLICANT GOLD - CIT" CITY OF PRIOR LAKE No.~()-03fe> SEWER AND WATER PERMIT NOTE: Sewer and Water contractors must be registered with the city. APPLICANT: FiJJlfL G~lJiJ.E .:IAJc ADDRESS: --13.L1l ~ s-r.1f"J, S.fII}Kw;'~ SIGNATURE: ?/~~.J/)~ SITE ADDRESS: f&'t>~ jJl1~KIJ2.IJ"LJ f)/tU!r SE PHONE: 761-~3-1;1 t::J'Q DATE: 9/~J 00 BLDG. P'roriT # 3( B PID# FILL IN THE BLANKS /-5 J 1. Estimated length of water service ~ feet. 2. Size of water service J inch(es) . 5. 6. Location of any couplings from structure feet. Type of sewer pipe. ABS PVC )( Cast Iron Estimated length of sewer line h5J feet. Clean out (if required) , located at jJ feet from structure. 3 . 4 . ===============]t~============================================== ::is apPlicatiJr~~ permit :::::apprOV~d: ~ . err) tf/ I ------------------------------------------------------------------- ------------------------------------------------------------------- I 35.00 .50 35.50 FEES: $ $ $ Sewer and water line connection permit. Surcharge TOTAL * Fee for either sewer or water individually is $~V.Eo 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. RECEIPT # REC'D BY pAlO W\TH BUILDING pERMIT DATE PAID AMOUNT PAID 4629 Dakota St. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / Fax (612) 447-4245 AN EQUAL OPPORTUNITY EMPLDYER PRIOR LAKE INSPECTION RECORD SITE ADDRESS 4(1)4 ~ \:}, NATURE OF WORK j}e..) USE OF BUILDING ~~ PERMIT NO. Oll-- fi?JlTO DATE ISSUED t!::)-<..-?ood CONTRACTOR ~- (\\-,..k- ~I r NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT r)EPARTMENT OF BUILDING AND INSPECTION 9(57:- . . FOUNDATION (Prior to Backfill) .~, . q / / 61 a-o PLACE NO CONCRETE UNTIL ABOVE HAS BEEN' SIGNED ROUGH - INS SEWER I WATER I SEPTIC (h:h c; / IdI tJ1J FRAMING _ ~/c ~ /O~r,-o en- t 1//)/31/,-0 INSULATION~~t..~. ~( /1 If/it) j~ ;/)/3/;'" , I ELECTRICAL I - ',9. . j PLUMBING ~ HEATING (if required) ~ f\ ~r{.". ~. \\,. /)C> ~ I FIREPLACE . GAS LINE AIR TEST FOOTING h,lNSPECTOR , ~ COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED ~ ~. I() I~~/M Idl:r4./~ J ., {o 1~(I)lI' GRADING (Prior to Sodding) .. BUILDING,cc.6..,j( tit I~ ~ I ' ELECTRlCAL PLUMBING HEATING DO NOT OCCUpy UNTIL ABOVE HAS NOTICE FINALS fI(l; I zj ~/tJi I I J} :r - If -- 0 J ) /d:r~ 9/~/ . . I I .. . IU 1~/6lJ ~Y;(fltrl . I 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 C):OO A.M. for all inspections FOR ALL INSPECTIONS (612) 447-9850 ~ _r!~ :..:~-=::~_:_~~ ~ ':~.li"'" ~.1''''''-f'",'IO .,.,. ~'Tl,"""'iI',""'."'; "'.~ . . CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED DATE TIME 9 -/~ -(;)1 PM tj (P 04 Pc.,r.Y- wocd' DI'. RtJ(,t.. CrceK CO - 3/g ADDRESS OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION ~FINAL 'D SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o F'LUMBING FINAL o MECH FINAL COMMENTS: 6,&c/~ -r,1::.. ..(\f'T H C) trI e..) fJ{ ~RAD)JILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o >('WORK SATISFACTORY, PROCE.ED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ ....:" - Owner/Contr: CALL 447-9850 FOR THE NE:XT INSPECTION 24 HOURS IN ADVANCE. INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION DATE TIME SCHEDULED 9- J-f'-1 8. '&- L/bO<! p~ CONTR. PERMIT NO. o I~LUMBING RI o IMECH RI o WATER HOOKUP o SEWER HOOKUP o I~LUMBING FINAL o IMECH FINAL ()-- 3)~ o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o k-rm~-A~ (/- ~ ~. - r7,L ~ f5~ ~~ ~ COMMENTS: ~> Y-'( \T.AP · ~~ o ~ WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR R,EINSPECTION BEFORE COVERING <~-\ - , Inspector: Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTl DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED 'it' r I DtJ 11 ~ ~ fJA~/L..wDoD bR...- ADDRESS 4 ~ {J '{ OWNER CONTR. PHONE NO. PERMIT NO. 0- 3L1 o FOOTING dn\ Il' FOUNDA TIOt-(1S.) /0 FRAMING o INSULATION o FINAL o SITE INSPECTION o IPLUMBING RI ~ 0 IMECH RI MWATER HOOKUP SEWER HOOKUP o IPLUMBING FINAL o IMECH FINAL o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS:(i) J;t;,-J - ~ ;;I:; ~ ~ ~_ 0 - 1EilJ1~~ ~ rf, \~ , ~-~ ~~~b__ ~-",c;;f- ~ (ffJ -f. i" c-;... ~~ - (J - 0 ~ ~.~ ~.. '-J If ~-', :x:z r...t:4d.c.~J:::.. Nt! Ii · 5:)' .R;- f+., ~* ~ 4J ~ ()~ _ ~tM:. A.rt ~ V' J) 5t" ~'r -ic .'Jt::.." ~ ..r;,.;.:.... . . "-D ~ ~ pIlr,....... . J).. tI ILCJ . ISr ~..~ / .) o WORK SATISFACTORY, PROCEED .- CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR RlEINSPECTION BEFORE COVERING ~( Inspector: Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE' FOR YOUR PERSONAL HEALTH & SAFETYl INSNOTI ADDRESS -sI~ ()~ DATE TIME SCHEDULED ~ 9,M() ItJ: (!) ~ y:; M-~ wOO tJ CITY OF PRIOR LAKE INSPECTION NOTICE OWNER CONTR. PHONE NO. PERMIT NO. D-.W o FOOTING 0 IPLUMBING RI 0 EX/GRAD/FILLING o FOUNDATION 0 IMECH RI 0 COMPLAINT o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI o INSULATIO~ @ 0 :SEWER HOOKUP 0 FIREPLACE FINAL 'jr[ FINAL {J!!Y ~ IPLUMBING ~~ 0 GASLlNE AIR TST o SITE INSPECTION .. IMECH FINAI..(f!!:/ 0 COMMENTS: ?,/ d et I (f) ~ .~ ;J..,;, ~~ ~~ ~ o-v4)_.~.'1 . ~ f~ck<>, ~ I~ ~p.d-. p~ ~/ (X,~ ~ ~JJJ .. ~)) ~ .:?'~~ ;< tJ () *~~.~:~ :--~~ ~~.f.",,1YI-:/ /~, _ -jt?~ r 4Jf;.~ ~-1. ~ / T~ ,Ip~t- /JJJ!.A fo S>~, _' P~~A-J ~~ -- or1 ~ ~ ~ ~ JI) ~~. ~ p~ ~.JhO' ((1) 4~ ~ -r~, -~ ~ ~ 0LMI; U 1-b.11h.A./ iA ~, /".dl . t - & I' ....- () {o{,I ~ ,M.of".1 .. ~ 4tt tJj./0ei -~, ~l vtJtOtiA ~ ? {~::E~~T~S;~~:~:: ::~~::~ f~. ) ~~RRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~' Inspector: ~l Own er/Contr: I CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTI