HomeMy WebLinkAboutBuilding Permit 03-1247
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3_ Yellow Applicanl
<g>-;},J-O""O
fPERMIT NO'o3-1~ 7
q'lease ~ or print and sistO. at bottom)
ADDRESS
/Lfas3
J-/-q Ci., L .)~ C, rcLe..
ZONING (officeuso)
~[)
LEGAL DESCRIPTION (office use only)
LOT 8 BLOCK I ADDITION w;ld; Nor-/-k
PID a5- '10 4- ()OR-C
OWNER
(Name)
(Phone)
(Address)
~~~R (1JJi~ Lr.klA R,,)/~s
(Contact Name) & ve C--J.L~ "-Ad"
{}
(Address) 2ZB3 /.Ac;c..", 4-v-e
I
(Phone)
(Phone)
q>z-W:,~ -! /,//
ft,/ z. - J 23'- 'It? z..t.
Lo.~vr/tr t'nn. ))o'ltf
TYPE OF WORK
J2( New Construction
OLower Level Finish
ODeck
OPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
DAlteration
Dutility Connection
OM!sc.
PROJECT COST IV ALUE (excluding land) $ 3' "Q 0 00
I hereby certifY that I have furnished information on this application which is to the best of my knowledge b11e and correct. I also certifY that I am the owner or
authorized agent for the above-mentioned r.~"'-.-J and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plara. I am aware that the building official can revoke this pennit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter ~property to perp,n needed inspections.
l' I).-...-e / ~~j,j,. - (Jb '7 ~ Sf - J <>t -03
,.,- L, Si2Mye Contractor's License No. ~ Date
I Permit Valuation BW7J tJoO I Park Support Fee # $
I PennitFee $ It/4.q~,/S _ I SAC # .$ / !i- 76'.-
Size 5/8"G
I Plan Check Fee $ l5cJtJ,.al/ Water Meter $ 3()().-
I State Surcharge $ IR/J,- Pressure Reducer $ '70.--'
I Penalty $ I City SAC and WAC # $ 1;::)06.-
I Plumbing Permit Fee $ IOtJ6, --- I Water Tower Fee # $ -7/10.-
I Mechanical Permit Fee $ J /J/J., -- I Builder's Deposit $ J500,- I
I Sewer & Water Permit Fee $ 3S.S0 { I Other lIiJ. &1 $ I
I Gas Fireplace Permit Fee $ l(1)__ I TOTALDUE 4.0' SCf5'1o<-!7'11
I) ~
This Application Becomes Your Building Permit When Approved I Paid ~"Z.J G-j I Recei"0o. ~v/Y
~;7~ ?bArJ I Date 4. / '? (f? / Bv 1_'
J (;
Building Official Date
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 signed by the City Planner constitutes a t~."r~."") Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ . ~
-~~?
Planning Director
~,J/~
Date - Special Condftlons, i{any
24 hour notice for all L.. ..:.:.__" (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'JPA3
f
,
~~
White . Building
Canary - Enllineering
t1>ink . Planning;::>
Th~ ('''nln of lh.. L.kr <.'ounlry
.!rulLPING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
I I- / ,,' , /> ". / '
., pr CJ (:t-e,,?/J~0-(2 //))/t..-- . It') n .8'
vi
.Sf 1- () ..3.
APPLICATION RECEIVED
..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ~
/1#53 - /~0.a4 /c:i'.ld~ ,'<~A,/.'!'~
Accepted
Denied
fleviewed By:
Accepted With Corrections ~
Comments:
~ -::f~i-
6tJ a-d
Date:
913~J
~
,.,,0.''''''-''''-
'r-
"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."
~~
<1Vhite - Buildin"'-----"
Canary - ~ng'"l!8ring
Pink - Planning
ThC'("C'nlf'rof lhr 1..b('ounCI'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT l2p..cI~&d/'rHc-.--i/,~ "'-.0....
APPLICATION RECEIVED ;;?- .;?-/~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction acti~~;~i~ propos~~ ~~
Accepted
Accepted With Corrections
/
Denied
Reviewed By:
Comments:
~~
;(~
9~ Date:
~ - m::t.;;- ,
9h';';;:3
, .
"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."
.. '.
Tll'C'llltffMI....I..Ir.'CINntfy
White - BulldlRll
f""1..:8nB'I. - I:nYII.....u1y .)
Pink - I"IUhlllng
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,: I /' .>
.' // :v.'v ,,.', . i I J, .
_....lA. ...t"'-"'"'(.Al,~-'l/JA.-./I ~~~rZ.
<:) -' 0/7
0' "",,/- .v
/ ........,...-,
" "/-'.f_
,j .
-/.-/'''J-'::,,';,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: ...
,
I
i':;;A~-2 ..' 1.- /.' 1
;".'{) ';7::;> - /J {;<~{2-..i / t:j /2:'(_ . >:::-.P1..,<..1. .:-J...
Accepted
Denied
)(
Accepted With Corrections
Reviewed By:
1J14~
Date:
') /j t/t'J ~
Comments: See Reverse Side for Additinn~1 Infnrm~tinnl
~ee "-tta~hrilf~nt!l' 1) rl'Mlcling Plan. ?) PTnRinn Cnntrol Mell.!I1ITI''''
'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. '
18/87/2883 12:28
5877445555
BADGII ~XC
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~..".
~ .. ,... . .\. ' .." . fl.. II.......'........
PAGE 81
Oate Ree'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I~~";~~~~~~,UI~\
\-b. c. S
t..~
c~.~
I LEGAL Ol!SCIU?llON (olll"... only)
I Lor aLOCK -'DDmON
I OWNER
, (Name)
I (Addles.)
Cu.o.~~
~133
(AddruI)
c.....6.~ l31dr~
1M:.
I A P PLlCAN"t-:--.,
I (Name) . ,......,. "l.. ~ A E- X t"el 0 <:;. V:- _
I -T' .
(Addres.) 8"37S' c..v '7c.rH-1 S~
(M~..)
(CcntaaPerlon) Sc--~ &L'~
I APPLICANT SrONATURJ!.. ,~~ ~
--.,',,'.---
i~' ~~ I PERMITN03_/,;)l/~
I ZONlNG I."" ..,} I
PID
- . -
. (Phone).. 'i ~1..._~7_~
J.~ s-ao<t'-/
10..,\ IZlo c...)
(phone) <;;;"01 -7 YL(_ ~ a~. r
I-.~~ ~Yt.
(Clry) (Zip Code)
(phone) ~0/-7l.('-(- 5'&(;(f
DATE l D - 7-() .~
-
APPLICANT PLEASE COMPLETE BELOW
Size of Wl.lor service -\..-.,.. i1lChu.
Location ohny touplings from ltrutlllre - feel.
Type of sewer pipe. 0 ABC ~VC 0 Cut (ton
EstImated 1enith of sewer line _50 fe~
Cle811 out (if required) located al feet from slIUtlUre.
FEE SCHEDULE
Reoidcntialuwll and w"o, lint COMoollon SlUO Indull,.ill. Com" '" Muhj.family IYo of job 0011 with I Sl9.~0 mll'lIrnum
s.~,o, eonnoetion OlIly S 17.50 Wiler eonn~ion only 517,$0
~tim&ted Cost $
BuJldia, Pennil M, . ....
SEWER AND WATER PERMlT PEl!
SiATE SURCHARGE
TOTAL PERMrr IJ'tl
IOrfltll' \.:u 0..1)'\
,.
.
! Thll AppllCllion Bc,om.. Vour Bulldln. P.rmlt Whln Appro..d
I
I Ildl4l.,om..l Dlle
S
$
S
.~
~fE & fEn ~ 71]
'UIJ OCT 0 8 2003 I !I
L'
<i-+~J
v
'. PAID WITH
BUILDING PERMIT
..'1 PIID
, I DIIO
,.....~NO.
, .-
I~""
a h.ur ..1Ie.l.r IlIln'p"ti... (PSJ) .."9150, In (951) U1"1~
" ,....
. .
11/10/2003 13:49 9524401740
____ 01/29/02 TOE 11:19 FAX 812447424$
~= ~ Il'ERMlTI'O.""<-
J. __ ....... ..J
I~~;;-::;;SS ~e. C/~e
ALTA CLEARWATER
CITY OF PRIOR LAG
PAGE 01
rm 00%
Date Ree'cl
CITY OF PRIOR L.&-TCI'. nU).J...i4IIG PERMIT
/;?J( /1
ZONING~_
LEGAt.PE~ON (oIIco_~
LOT JtOa.
(N~Cud~/7 Ul Wj?M' ~~<-' (' (PIIoDe)$l)7- iv~-~~..v/~
CAddaeu)e~. ~x /.~ /~.,.(- .!'?"'_/: <. <f:p-Y&;.- J/~l'-
]
=~~Rt-w....l~ P/~. ..".I..-r/~ (Phcme)~- ~4~.~/')
CAd*-);:9~ ~('/~';~/ R/:I. ~~/d"e-t:." s:bz:,
(I,'" ~ (CIty). 1 (Zip Cade)
(CoIIacI:Paso~ J}~ O::?A/ I' Ph~k. (PIIoDe) ~-~4-"7 I~O
APPLICANTSIGNA~1-I ~A4J;?_ _.__ DATE /1 ~Qk-:_.__
. -, , r ""-. - -. . .. I -. -:"., . -
APPUCANT PLEASE COMPLETE BELOW
TypeOl'RtII... QII....6t)
BI1Il1'lb Wilhi wllIi.iilii:"" _ ..
QIala.
''J'
I I"
I .
I .~
I '
I {to
\ "~
I ~
AuUA.U.UI.(
PIP
'l)peofr.""".
D;',,:., ,J,",~,
KoIJah-ita
-~_lk8Ia'
WlIlIel"J",,,...
SlIDd. ~ twalllDp: MlIdWIe}
~bIy
~fftciw AsIaIlli(y Tat
i.aM~
l:liIIa-
,,- Oiaii
. ---. - "115.
Lava'IDrY \,.. ,:,.." ,Sink)
r.iiiJnr n.,. (i or:2 .., ii,
~~.
Sfab
S.SiDk
I W.- CIo_ (Toilllt)
;, LB.
FEI: S.-'.....E.
. 1adllSlrill, Com1llUdoJ a Multi-fwily, I,. of job COIl with & sa,.so min.......
\OIIIao \loI: 0Id71
II, . J. .:. 1"lIew Oae a Two-hRil,o S99.SO
RaIdIiuiaI. AddIlloIlS" A\lInIi_ Slll.SO
E.._~. ,..1Cost 5
BulldiIIg Pmnlt "
PAID Wln-t
BUilDING PERMIT
PLUMBING PEIMlTFEE S
STATESURCHAR.GE S
TOTAL PJ:ItMJT FEE' $
.so
-"OIMII
, ]11: r; ~ 2~;: II ::;~
/
"IllltA A" .... .. " .. Y...r....... P_it WIIea", .
.....
zu......."',...- .". )~~flI,,(M2)"'.a4I
11/18/2883 13:49 9524481748
ALTA CLEARWATER
PAGE 82
. ,~,
,.~~~, . ",': .!. "
DstB Bee'd
CITY OF PRIOR LAD
BEA.. 1.1 ,'",lAIR CONDm...',I,,,.IIGIFIREPLACE ~~,.m
, .
a:. ~ 1.f'DJ._....O.: .'.J.,.. /~JI7
J._",- .-, . .a./O<I!
ll'laIl:_ar_IIlIlJitUf_ .
/~':3 ~JJ' LaRe O~~ "W'MG~1IOl1
I LIlGAL~........... ~-.,(..,.oat;)
LOT Bt.OCK Aw'....uv.... pm
~~A/tJ ~~;lar ~4-S~~?
Wdtl:ss) ~~~x-.I;'a, L/J<7r;:;d::t~ ,,4/A/ ~6-,?/.'J""z"p
~ /.1 ~ / ,!.- . I LJI'. :',.':, . ~.....!'2_'//~4Jii,:;:..;:," b
(N1fmte~ ./ ~ / -- ..., r /A:. (Pboue)~ ,..77V ~,r!?7;
(Mdms)L1-;j~ ~~/ /b/. ~h-~/dk ~~;'-3-
. (Mdaea) (OIl) : Qlp c.dt)
(C_~V2L!/ ~t>h~):r f;:\~, (Phane)~-.v4b-,~77~
"PPUCANTSlGNA~~ ~ DATR- .
APPUCANr pt.~.lAT_ COMPUTE BELOW '
I~~U"'''VL' O~a:NENT. DALi....A,tiONs. '.
FURNAC2~~~#N.t1Y QS-/~I.?' ;r&::: -o~rz. . roiL/!/l!i'ffl.-' /7p:1
'f'UlESIZE '2, UTtJIN.<""'utGs ---L?- INPUT Q00U) 0lJ11lUT ~ lr--r-::.
.
TYPEOF:.n,ul6t lDAtINGo...,. "", ,PLANT
"EAJr"- ~s-
. BolW_
Ior_;. ,,',I . 1- .....
~~I' -"'. 8pocloI1)n;ooo.
fiSt'- ~ OdIl:rDaricel
......,.,..A.CEMADANDMODEL ""1
ft.IASI NaTE:
Air c-lillIlMr t1lritI
.~IILII'I'I., ....
11.I ~Iii.II!!Ildi! Y-.I
!k1111CM
1Dd.IlriIl, ....... ..,Ial.t.Mulll-Fllmily
1laldcalI&I. Hcocilll '" JJC (N... CeL\1IlI'I<1i...)
Rasldallilll.IlalinIOnlY (New C. .... . . ;,. )
FII&.",,~.!.,I.,...E
I~ Of job .... ResI/leftdIII. GII PInlpIIlCC.
5391..50 miniM'III . ..., --.... .
S91UG ~ ALldIllGM I: AI ".:. ,,.
S64..50 ,.V'..I, 1Ir;;, DIlly
S39.S<1
S39.5O
S39.5O
, .
EstiIlIM Colt S
&IlIdJIIIPmllit .
PAID WITH
BUILDING PER~ liT
HEATING PERMIT PEE
STATE SURCHAllGE
TOTALl'DMlT I'D
lOIIIII \lie 00lJl
nII......l 111 J..
S
$ .50
$. . , ,
~~v l: ~ ;~O~ Ifg
, '" <"2)"' .... en (H2) ...,..JAS
By_
,y.............It....."., .
..... 0lIideI
-
14 ..ur lIo1ia1 '"' In' ,
FIRESIDE CORNER
#6717 P.001/002
CITY OF PRIOR LAKE
I-lEATING/AIR CONDITIONJNGIFIREPLACE PERMIT
Datc Rec'd
1.4053 HASS LAKE cmCLE
J:~ !L I PERMIT NO. ~-ldLI~
I ZONJNGtol!iceuoe)
CPrease Dee or mint. IDd, silrJllIt bi7noml
ADDRESS
LEGAl. DF..5CRJPTJON (ollice UK only)
LOT BLOCK
ADDITION
PID
OWNER
(Name.l
CU1)DJGAN CUSTQM HOMEl'
_ry'hone) _612.3284826
(Addrm)
APPUCANT
(Name) AT IIl;q <Jll~lJ.lUJJlA ~Il H2ARTH II. HO""
(Phone)
651.6~~.2561
(AddleS$)
2700 NORTH FAIRVIEW AVENUF
(Add'...)
(Contact Person)
BRENDA HUSTON
ROSEVILLF
(el..,,)
(Phone) _651.633.2561
55113_
(Zip Code)
APPlICANT SIGNATURE
8..RENIJL4_HU~rON
DATE
5.27.=l13
APPLICANT PLEASE COMPLETE BELOW
XO NEW CONSTRUCTION 0 REPLACEMENT OALTERAT10NS
FURNACE MAKE AND MODEL FUEL
FLUE: SIZE RETURN OPENINGS INPUT OUTPUT
TYl'E OF SYSTEM HEATING OB. POWER P.LANT
Ow""" Ai, PI""",
OO....ity
o Meehan ieal
OAi, Conditioning
OVent. Syslem
o Steam
o Hal W.ler
o fu1dialion
o Special DOYiees
o Other De.ice.
PLEASE NOTE:
Air Olnditioner Units
Cannot Encroach into
Required Side Yard
Setback.,
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR.O~
Industrlal, Commercial 8t Muhi.Fami.ly
FEE SCHF..DULE
1"/" orjl)b cost ResjdentiaJ~ Gas Fireplace
$39.50 minimum
$99.50 Residential, Addition. 8r. Alterations
$64.50 Resldenlial, AC Only
$39,50
$39,50
$39,50
Residential. Heating 8r. NC (New ConSTruction)
Residential, Healing Only (New ConlllrUttion)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
PAID WITH
BUILDING PERMIT
(om.. II.. Only)
Tltls Application Becomes Your Building permltDW.,h,en Appro.ed -2:~ Z\loOIOi3g \ ~ ';r,,,,:CCiPt N;1O-
Hufldlltlt I)fJ'jdal . ~
2-4 ho.., n<>tlco ror Alllnsportl.n. (952) 447~ 150', ra. (952) 447-4245 ~ '1
Sy_-
-------
~ .
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
.
INSP,ECTION RECORD
SITE ADDRESS /~ · 1/ AAS L.AJ&t. (!,j~)e
NATURE OF WORK ~
USE OF BUILDING ~ -
PERMIT NO. ~ ~)-:-I.~DATE ISSUED ,
CONTRACTOR JL!..t - PHO~-,*. ~.,. l/I).
NOTE: THIS IS NOT A PERMI OR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
/J ,INSPECTOR
I FOOTING I 11' ID 9"-~
, FOUNDATION (Prior to Backfill) I f/' JI I /'C' Y'
PLACE NO CONCRETE UNTIL ABoVE HAS BEEN SIGNED
ROUGH - INS
fl.!)
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (If required)
FIREPLACE 2 CJ~ :k
GAS LINE AIR TEST~,Jl J:jJ PP /7' Lt
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
.rnAET ~ I!Ote1J-- I
FINALS 'IA.
GRADING (Prlpr to Sodding) l\
/. /,/ 11 II,!
BUILDING I.c...o '1'eI fIf-l-a: v.}
ELECTRICAL r
PLUMBING
HEATING
DO NOT
/C!'-F
-
!/l/Y /'
12- 8-0\
"
.....
/.p ...../~
~lJ
(fD
/z-t/
/2 -?-
.
\.p :\J\ ,1:14'
~
~....,
t/I7 ~
/-2h
BEEN SIGNED
,
OCCUpy UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical servlca cabinet prior to rough-In inspections
and maintained until all Inspections have been approved. On buildings and additions
where no service cabinet is evallable, card shall be placed near main entrance,
FOR ALL INSPECTIONS (952) 447-9850
Wi
-\~, J
\ .
Ql~rfifitat~ of OOttUpantl!
CITY OF PRIOR LAKE
_ ~epadnnmf of ~uilMng Jfnspedion
~al Permitted D 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 of the City of Prior
Lake regulating building construction or use. For the following:
Use Classification
Occupancy TYPe. R3
SINGLE FAMILY
Bldg. PenmtNo. 03-1247
Type Construction
VN
Fire Zone N/A
_ Zoning District
RISD
Legal Description
L8, Bl, WILDS NORTH
Owner of Building ~ Site Address 14053 HAAS LAKE CIRCLE
Contractor's Name & Address _ CUDDIGAN cuS~ BLDRS., 22133 LOGAN AVE., LAKEVILLE 55044
ROBERT D. HUTCHINS (J iJ) _ OtyPlannec DON RYE
C Buildin,ll Official \J t
Date: ~}-I"J(/ Date:
POST IN CONSPICUOUS PLACE
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED I <27-a} }6.016
ADDRESS !t{O'\) H.Il<; lJt.t, Jj---""
OWNER CONTR.
PHONE NO. PERMIT NO. g -"2 rp
o FOOTING o PLUMBING RI o EXlGRADlFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE Rl
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL ~LUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION MECH FINAL 0
COMMENTS:
I. M4.1A..~ 5os:~,(. (I~ d- f....\:, ~014d. t'''''~~
~_ P,...... "'_ -i () r-~ d- t:lc~. r~.b .
;e.. ~th-.. &~a-t-n} pttCk--
L(. ~~'_ DL& - l'\...-..h..... ~"ci-cQ P.J....., ~r
~. ~........:k - G,~ 1l.V!1f.' bsC........~,R
tJ" 9....l~T~ 'f-~~A..1k- pL.....
'--
/'\ - .
~..t~7
~~ i~~w
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
~CORREC . CALL FOR REINSPECTION BEFORE COVERING
Inspector: .
Owner/Contr:
CALL 985 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE_
CODE RE7MENTS ARE FOR:::: PERSONAL HEALTH & SIIFETY!
,tj'
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED t- 2/-nj
ADDRESS 1"/.t)5~ I.Iut Ik (I.If""
OWNER CONTR.
PHONE NO. PERMIT NO. ~- /24/
[] FOOTING [] PLUMBING RI [] EXlGRADlFILLING
[] FOUNDATION [] MECH RI [] COMPLAINT
a FRAMING [] WATER HOOKUP [] FIREPLACE RI
[] INSULATION ~EWER HOOKUP [] FIREPLACE FINAL
[] FINAL PLUMBING FINAL [] GASLlNE AIR TST
[] SITE INSPECTION MECH FINAL []
COMMENTS:
~~
z.... ~~.._ ~\"......... .,.J;-- ~/?
\
~ WORK SATISFACTORY. PROCEED
...Cr",ORRECT ACTION AND PROCEED
a CORRE"[f2RK' CALL FOR REINSPECTION BEFORE COVERING
Inspector. \.\ OwnerlContr:
CALL' -9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
Il<SNO"
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS Ii{ (9 ~3
OWNER
PHONE NO.
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
~ fiNAL
[J SITE INSPECTION
SCHEDULED
I-kfA <
DATE nME
C- ;JJ-()l.{
,
L~ e/l/
L(lt:A{f~ ..
PERMIT NO. ---l'? -/~ 7
CONTR.
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
COMMENTS:
{~/~~~""'J ~r;
~ - (91<....
.g(EXlIIIIiiiilIluNG
"'b~T
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASLlNE AIR TST
[J
r.x. WORK SATISFACTORY, PROCEED
Vc;\ORRECT ACTION AND PROCEED
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