HomeMy WebLinkAboutBuilding Permit 03-0555
/'
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT '1_ /Q-CJ 3
L White File
2_ Pink City
3. Yellow Applicant
(Please tvDe or orint and sien at bottom)
ADDRESS
?Oqt.., ~ mArPlir .1.....'>1 p ~6.
LEGAL DESCRIPTION (office use only) [\
LOT t:) BLOCK 3 ADDITION U(p.,.A,ll. f?rU
OWNER
(Name)
(Address)
BillLDER....... n 'L A -r
(Name) .J/ 1<.... Tl~t1lY' ..lJ\..L
(Contact Name) ;;t,..} ilL E.-.~~'
(Address) '2.-08hb l<',,-brq?tltt.-c--I-. ~.IOD
. - L....iyJ/l:.1f;. 1IVi.i1\ c:l-.l..},o./...
TYPE OF WORK
-)Z1 New Construction
DLower Level Finish
o Fireplace DAddition DAIteration
PROJECTCOST/VALUE (excluding land) $ 11~. 1.11 0
DUtility Connection
o Misc.
(Phone)
(phone)
(Phone)
DDeck
DPorch
DRe.Roofing
I PERMIT NO. (')3-05551
ZONING (office use)
1<1
PID :A.,," 3qq-O~'-I-'o
.;. .
0IQ...4Qb-"'7Q,Q,Q
,,\b"'Z.- z.:u",- I ~~4-
DRe.Siding
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
authoriz agent for the aboveMmentioned property and that all construction will conform to all existing state and loca11aws and will proceed in accordance with
submi d lans. I am aware)hat ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter pan epropertytopelj~., I. ,I, dinsp .ons.
x
Ii'
[ Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Pee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
..rl;7 ~. non.no
$ /q/q. 3~'
$ .
Q 2...Z. 5Ji>"
$ . ~OO .
$ ~
$ I tJ 0' Ot:l
$ /(JodJO
$ '$'>,5'0
$ 'It:JtlIO
This Application Becomes Your Building Permit When Approved
~ 9~{..; 4boftJ'3
Building Official
Dati
dJAo 0 57, ~ 'J
Contractor's License No.
I Park Support Fee
I SAC
I WaterMeter~; In;
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
'if:5 aib'. t{J
€-a-/:J"<3
I Paid
I Date
~/C;-D~
Date
# $ 850, flo
# $ 127~.iJO
$ 2So,oa
$ If 5". Qo
# $ JZOo.OO
# $ 70a.lJa
$ IS-OO.oo
$ I
. $'.62-'5. 4-3J
t
UU5dJ-b
"f- .>
U
I ReceiptNo.
Bv
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
~hen signed by the City Planner consti~ a .-...r-..... Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ ~~ .t//.?(}~.3 ~a.J( ~ ~.
Planning Director I Date Special Conditions, ifilny
24 hour notice for aU inspections (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
~~
White - Building
Canary - i:nqineerlng
c ....nK ~ r"lannlh~-'
Th~ ("~nlpr <If lhp I...... ('ounlry
BUILDING PERMIT APPLICATION DEPARTMI;NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D I;" f!or/-oN
<;-/'73
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
$'096 POA/d 5 c/Ct6 LA/
,
Accepted
/
Accepted With Corrections
Denied
Reviewed By:
~
~
Date:
#d~:r
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."
,
~
~~
(1Nhite - Buildlnv
t.,~. .~. I ::....Jneerlng
Pink - Planning
Tht' ('''OII''f of lht' I..kt' ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLlCANTD R ffOf ~v/J
APPLICATION RECEIVED ~ -1'11- 3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
$"0 96Pt7tVd s eJ4~Lv
,
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
~ ~J)';J
R~ a.U
Date: 1/7117//'3
.~ - 0.....;(;;- ,
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."
~~
White - Building
o,narv - cny,neerlnp
F'l'nk - t'lannlnY
Thll' C"..nl"r of IH 1...11' CO..lry
BUlI..DING PERMlIJ\PPLlCATION DWRTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D /;: lIor-io/J
<'../ - /~- 3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
$'0 '::;6 PoIJd s e,jqe..- LA./
Accepted )('
Denied
Accepted With Corrections
Reviewed By:
1W/-J3
Date:
Lj.-Jj -03
Comments: See Reverse Side for Additional Information!
See Attachments: 1) C'TTadinl!' Plan. 2) Erosion Control M"'''::''XPQ
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the Jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
..
,.
. 'Jd '7 ~ ~....6- ~
..lng Contractor ~~~ flf~
Name of Tester .4:,""h :6
/~d
f/,(});
~
-- .
S)tt?~
/~tJ ey-
Date
Percent 0,
Percent CO
Percent CO,
Stack Temp
\
Combustion air is adequately supplied per
UMC Sec, 606 Y~J
input -L/f6ln grGJ
>
/
t
\
\,;11 i OF PRIOR LAKE
HEATING/AIR CONDITIONlNGIFIREPLACE PERMIT
Date Rec'd
~G
A/7c6d~
~~
~7Y#
;=.. ~~,"'" I PERMITNO'3_SSC:I
ZONING (a_use)
(Please tvDeorbrint aIid simatOOttom)
. ADDRESS.
<=;'p
"'"
LEGAL DESCRIPTION (oflla! use only)
LOT~LOC0 API:>InON
PID
OWNER DR HORTON
(Name) - 20860 KENBRiDGE CT
(A(\d:ress) LAKEVILLE, MN 55044
~r;~~~A/hA..I ~ /1b,.A44"'~-..-e (phone) L::,.,:;/- ""'~--.:?7/.'S"-
(Address) . i::::~ 6.J1'1A.1 ~~ t!. //./. ~4<<...t" 5$"/-?-?
- (Address) . (awft.. (Zip Code)
(contactperson)A~.a~;~~~ / (phone) ~~/- S/~--r //<"
APPLICANTSIGNA~_ _' -'-:.~ .b- ~ DATE
(phone)
APPLIC~ PL~.ASE.(;()l\mLETE BELOW
~WCONSTRHION ...OREPLACEMENT o ALTERATIONS
FURNACE MAKEAND MOPEL. . .<~r~jI. ..9J~.. FUE~~;e, ~
FLUE SIZE . ?..RU~RETURNOPlfm.1GS . . INPUT~OUTPUT ?~~)
TYPE.OFSYSTEM HEA'I'ING OR POWER PLANT
O\VIirlnAltPlants o Steam
J..O Q"iavily 0 HotW.ter
8,Mcchanical GRalli.tion
~jrC"nditionU;g 0 Special Devices
~nl; System 0 Other Devices
PLEASE NeTE:
Air Conditioner Units
Cannot Encroach intll
Required Side Yard
Setbacks
FIREPLACE MAKE AN)JM;ODEL
[ndustri.I, Commerci.1 ~ M:uili-Pamily
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39,50 minimum
$99.50 Residential, Additions ~ Alterations
$64.50 Residenti.l, AC Only
$39.50
$39.50
$39.50
Residenti.I, Heating ~ AfC (New Construction)
Residenti.I, Heating OnlY (New Construction)
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
7~ ~BuildingPennit #
:6; PAID WITH
$ hY. ~,;/~UILDING p~
$ ....50 r;;:FlMIT
$ t?
Estimated Cost $
(Office Use Only)
BuUdlnl Offieial
Date
tUU:J
,rax (952) 447-4245
!rF
This Application Becomes Your Building Permit When Approved
24 hour notia! ror .11 inspeclions (952) 447- ,
By
Jun, 2. 2003 12:06PM
GENZ RVAN PLUMBING AND HEATING
No,5677 p, 15/36
,
Date Rec'd
CITY .OF PRIOR LAKE
SEWER AND WATER PERMIT
(P1c;;uc:~ ormmt and siRlJ,"atboUQm)
ADDRESS Ej)q { n (\ .
\.f v0YttL6 'eJ0& lJr), <Sf..
~ E'w ~ I PERMIT NO'3-55.!T1
ZONING (offico ."')
LEGAL DESCRIPTION (office us. oaIy)
LOT ~LOCK 3 ADDmON ~f7d,j fj fh
PID
OWNER
(Name)_'l'\'D u__..__ ,....,""QUl 1J911l....~
(Address)
2.oSUo ~i?>i<-\!:6e. Or Sn,.1N\
(Addresl)
(Phone) _ Cj62-Q85-i8f1A
La.41l11le.. ~U
(City) (:z;o Colle)
APPLICANT
~wn~ Genz-Rvan Plumbing & Heatine
(Phonc)
651-423-1144
~d~~~) 14745 So Robert Trail
~~) ,
(Contact PeJ:son) . ()V\ IeLS i1 t1A!U
".!CANT SIGNATURE 0111~ 1'ulJ /l
Rosemount, MN
(City)
55068
(Zip Cad<)
(Phone)
DA'IE
651-423-1144
(()...1-03
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet
Clean out (if required) located at feet from structure.
feet
o Cast Iron
FEE SCHEDULE
ReSidential sewer and water bne connection $35,50 Industrial, Com'! & Multi-f3ll1lIy 1% of job cost with a $39.50 minlD1UD1
SewerconllectillJlonly $17.50 Water conncction only $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $ .
TOTAL PERMIT FEE $
.50
Bl.lildillC 9aicisl
Dale
PAID WIT~
BUILDING PERMIT
, ~.tpt No. I'
~I q&-/ I
(0_ U.. Oaly)
! This Application Becomes Your Building Permit Wbell Approvel\
1
-~
14 hour notic. ror slllaspcctlo,," (9S) 447-985' I, . (952) 447..424~
By
-_.."--'
Jun, 2, 2003 12:06PM
GENZ RVAN PLUMBING AND HEATING
N0.5677 P, 16/36
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
'-
1 Bau. Jilol
.- """
,. v.now ApfIicuL
I PERMIT NO. 3-5651'
!Ple.... ,"". Or 1XUlt and simal botlDml
I ADDRJESSfJ):[(p . ~ edG(u LhSf.
ZONING (offic:e;;..)
LEGAL DESCRlPTION (office use OIlly)
LOT ~ BLOCK 3ADDITION ~f:pl ~
Pro
OWNER
(Name) DR Horton Custom Romes (phone)
qe;2 - q 'X ,,, -ifSlJD
. (AddreSS)' ZO~(oO kb1B~~DGe.. C. Sre.ltJO
u:du.viIlG VlAN .5ful-J LJ
APPLICANT
(Name)('IiI~.,._1):...- In.._~.._~ c.. u.e.a..t.i-:,,_:
(Addr~)14745 So Robert Trail
(Addrl:Ss) ~ .
(Contact P"lSon) C.iUe.iXh . I ^
APPUCANT SIGNATURE ('1)..L/ " '. A- ~
Quantity
f).
I
I
S
I
t
(
,~
(phon~ ~<'_h?'_"hh
Rosemount
(City)
MN
55068
(Zip Code)
(phone) 651-423-1144
DATE _6~ 1J-rl.q_,-=._
APPLJCANT PLEASE COMPLETE BELOW
Type of Fixture Quntity I
Bath Tub with or without shower ,,? Rough-ins
Dishwasher , . I Water Heater
Floor Drain I J I Wafltr Softner
1 Lavatory (Bathroom Sink) I I I Stand Pipe (Washing Machine)
I Laundry Tray (1 or 2 compartment sink I Sewage Ejector
I Shower Stall I I Backflow Assembly
I Sinks I I Bac.kflow Assembly Test
I Bar Sink I I Lawn Sprinkler
I Wafltr Closet (Toilet) I I Other
Type of Fixture
FE:ES\.-.tl)!,.uULE
Indus1na1, Comm....".' 8< Mula-family 1% of job .ost with. $39;0 minimum Residential, Now On. &. Two-Pamily $9930
ResidentW, Additioru 8< Alterations $3930
Estimated Cost $
Building PelDllt #
PLUl\.1BING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
PAID WITH
BUILDING PERMIT
.50
(om.. u.. Only)
This Application Becomes Your BuUding Permit When Approved
~'''".',.
Buildi"8 0l6cia1
I rm ~ ~. li; U' ~ \~ ftf~eipt No
,D... I [ " JUN U 470011 fit)' iJv/
. I
24 hour DOti.. for.\I i..p.dioDS (952) 447-9850 fox (%2) 447-4245
By
-,
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
l~ ~""",IPERMITNO'3-5~1
~ ~ orvrlnt and sim atbottoml
ADDRESS ZONING (olliceuse)
5096 PONDSEDGE LANE
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
vWl~r..A
(Name D R~HnRTnl\T
(phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOMP.
(phone)
651-633-2561
(Address)
~700 NORTH FAIRVIEW AVENUE
(Address)
(Contact Person)
BRENDA HUSTON
ROSEVILLE
(City)
(Phone) _651-633-2561
55II3_
(Zip Code)
APPLICANT SIGNATURE
BRENDA J./USTON
DATE
7121/03
APPLICANT PLEASE COMPLETE BELOW
xO 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
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
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
Industrial, Commercial & Multi-Family
P~.-I
FEE SCHEDULE 8UILOING PERMIT
1 % of job cost Residential, Gas Fireplace $39.50
$39.50 minimum
.OO~ "","""Mili'-"q7J .: ~ $309.50
$64,50 Residential, AC Only /J) I.!: (f} ~~_,
/)/1;,0.
Estimated ~~~~~~ciiE BUiIrg Permit # .50 '8 Ul 22 ZOOJ LI:71/;/
TOTAL PERMIT FEE s ~ /!;.
(Omee Us. Only) .~
_App'.....B~Yoo"..""'._.W>nApp..... ffi! Y """p'N" _,'
fMe."" . 1 By Iff"
v,
REA TN GLO SL-750TR-C
FIREPLACE MAKE AND MODEL
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
BuildiDI! omdal
Date
24 hour notice for an inspections (952) 447-9~fax..(952) #7-4245
---....--..---....... -,.-..
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
POIJc! ~doe I..N
SITE ADDRESS .5.0..!!1..1.
N~UREOFWORK~~
USE OF BUILDING
PERMIT NO. as. 555 DATE ISSUED
CONTRACTOR --I2..Jl ~"'+OAl PHONE aa&,- 13"5"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INl~;~
I FOOTING {Iff ~-/(.;ff'?
, FOUNDATION (Prior to Backfill) I I/l//// I S'~t5'rlJ/l,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I/I/Y -:
~J
DATE
.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING Ut~~ rvf 5-~1J,rd) fII.;'V-' 7~'VJr/\
HEATING (If required) tlf) I r Jf~. . rJ1,
FIREPLACE Vlf'V/ 7 -vi-VI..
GAS LINE AIR TEST [/lIlf/ 7-)..q.()'7,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
6-:Jrel"t
1-}/1-0>
?1- - !--en.
,
I
GRADING (Prior to Soddlnll) 11- U>-~
BUILDING 1tfll'1f ~
ELECTRICAL
PLUMBING
HEATING
DO NOT
fVf)
~
/ I
fj/;:JI/, )
L(/.2}6r
q-J-.~{J<.
10-'3--0'3-
SIGNED
I/VV./
. I"1/y' /
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in Inspections
and maintained until all Inspections have been epproved. On buildings and additions
where no servlca cabinet Is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
@:trfintaft of ~ttUpantl!
CITY OF PRIOR LAKE
I @.~arfmtttf of ~1tilMug J'usptdiou
Fi'Final Permitted D Conditional C.O. Expires
6n~s 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 of the City of Prior
Lake regulating building construction or use, For the following:
Use Classification
SINGLE FAMILY
Bldg. Permit Nn
03-0555
Occupancy 'JYpe R3 Type Construction VN
Legal Description L5. B3. DEERFIELD 8TH
Fire Zone
N/A
Zoning District
Rl
Owner of Building
Site Address 5096 PONDSEDGE LANE S. E.
Contractor's Name & Address D.R. HORTON. 20860 KENBRIDGE CT..
ROBERT q. HUTCHINS City Planner
Dale: I' f 1 Mding ~Cial ~ L V Date:
/i!-ji6 , POST IN CONSPICUOUS PLACE
SUITE 100.
DON RYE
LAKEVILLE
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
SOP0
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
NAL
o SITE INSPECTION
COMMENTS:
../ /'
~O
/
DATE 11ME
SCHEDULED ~~~
~h~ke L_
CONTR.
v'
PERMIT NO. ....0 ?~,J
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
../"? //
LoA#r~/e Te
/'
--------
/'
( ..-,/,
" e-/d-S e
--
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
------ ------
"')
.//
/'/ /e
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector. ~~ - OwnerlContr.
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOrJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~q, a..c!.l~'"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
kFINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o Pj..UMBING FINAL
&JAIIECH FINAL
COMMENTS:
-
(f)5.4,J ./- r .....u '5
DATE nIlE
If). 7-(1)
~
o EXlGRADlFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
1)."
,
~""-'-..-I-
r f.:C..~ (/-1 /-; (
~tJ.~ h€r<",t!
11~:1d,(j.3
o ~RK SATISFACTORY, PROCEED
JlfC;ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
Inspector: r1If
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1J<SNt)f1
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DATE T1IIE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~-~7-o3
PHONE NO.
6(') 9t; ~rd5 ec!~ LA
0/
CONTR. _J) .1<- I:h.LkM
PERMIT NO. (, .3 - s-S-S-
ADDRESS
OWNER
lJ FOOTING
lJ FOUNDATION
lJ FRAMING
lJ INSULATION
of! I'lIIAL
lJ SITE INSPECTION
lJ PLUMBING RI
lJ MECH RI
lJ WATER HOOKUP
lJ SEWER HOOKUP
lJ PLUMBING FINAL
lJ MECH FINAL
~WNG
o COMPLAINT
lJ FIREPLACE RI
lJ FIREPLACE FINAL
lJ GASUNE AIR TST
lJ
COMMENTS:
6r<aj~- 0 t:
Lv/~ &'1- _i,,)K....
)( WORK SATISFACTORY, PROCEED
lJ CORRECT ACTION AND PROCEED
lJ CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
InSpector:#~ - OWner/Contr:
CALL "7-9850 FOR THE NEXT lNSPECTlON:M HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
"""""
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
t)Y~IMIM~
DATE T1IIE
SCHEDULED
CI-U -<J3
t;(J1 ,
q,.1d5"~
CONTR.
PERMIT NO.
~- ..;&:)
D' PLUMBING Rl
o MECH RI
o WATER HOOKUP
o JEWER HOOKUP
'PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
Y"/Jn?u. p,C
o WORK SATISFACTORY, PROCEED
JJI CORRECT ACTION AND PROCEED
o CORRECT ~m- FOR Rr4>ION BEFORE COVERING
Inspector: r fIr 1-;'" Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
.-on