HomeMy WebLinkAboutBuilding Permit 00-0726
Chimney C] Misc.
8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS \10. CULVERT SIZE
Sq. Ft. Width Depth Yes No
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 that all co struction will conform to all existing slate and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin~icial can revo~e this rmit for ju ause. Furthermore, I hereby agree that the city official or a deSiQn.ee may enter upon the property to perform needed inspections.
X /J ~ . / ~50 ,j'-,,;>-dO
/ Signati!re . LICense No. . Date
V
~1~~:~:
CITY OF PRIOR LAKE
BUILDING PERMIT,
. TEMPORARY CERTIFICATE OF
Ill., ZONING COMPLIANCE
,~ UTILITY CONNECTION PERMIT
DIRECTIONS J 1. DATE
SPACES NUMBERED 1 THRU 1/ MUS'{ k:S1C ..II......:...; i'"
BEFORE PERMIT IS ISSUED (PleaSe Print or Type and sign at bottom) ?" ,- ,.;J - () tJ
2. SITE ADDRESS j
I ~ > (" 5 /J r,,'1 A- s/"# t' L<.IV" Q,6(SD
1
3. LEGAL DESCRIPTION
/'7
ADDITION G I u. N W
,
14. OWNER (Name)
15. ARCHITECT (Name)
6. BUILDER (Name)
tJ~
fJ cs-n--h
7. TYPE OF WORK Fireplace 0
New Construction ~ Alterations 0
/
.7
rP/
PID,..15"- 3& 7- OJ 7- 0
q cI tP"
LOT
BLOCK
<{ 1'.,~
(Address)
(Tel. No.)
(Address)
(Tel. No.)
If 7 _/;t~ ~
~ Deck 0
Addition 0 Finish AttiC 0
(Tel. No.)
(;51_'/O'VYOO
Re-roofing 0 Porch 0
Re-sldlng 0 Finish Basement 0
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Back
Side
Side
Front
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION
.,,~ooo.o<:>
USE OF BUILDING
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
00.072(P
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
13. TYPE OF CONSTRUCTION
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
17. COMPLETION DATE
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0 SETS
SURVEY
PLOT PLAN
['l COPIES
['l
TYPE OF CONSTRUCTION: I II III IV
Occupancy Group A B E F HIM
Division 1 2 3 4
Permit Fee .............. ..................... $
Amount Brought Forward .................. $
Par1< Support Fee .... .... ................... $
SAC uuu.u.uuu...uuu...uu.....uu $
Collective Street Fee ............. .......... $
Sewer Tap ................................... $
Sh" $
Pressure Reducer ......................... $
MeIer Horn ................ .... ............... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $~ ~ .. CCiL
WaterTowerFee ...........................!t ? 00. DO
Water Tap ................................... ~,
Builders Deposll uu...........uu..uu... $ - 0 -.
Other ......................................... $~O _
Paid T;'~~~<~.Ou..u~~~i~;' ",~i(q.,o
Date ~'I f!~nJ By ~~
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 Is requested. This document when
signe e City, r constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
ug, !f!). ~
anner" Date Special Conditions if any
V
R S U
City:
Plan Check Fee ............................. $
State Surcharge ............................. $
Penally ....................................... !t
RS<O .0(3
SSl, . tfD
/.(,7.~
100 . t:)b
/t)" _ t!:)O
.
st; . &"0
Gas Rreplace Permit ....................... $ '10.. Dd
ThiS~~ Beco~r B ;ldillY Permit When Approved.
BY~ Date .J1.4'--~
Certificate of Occupancy
Plumbing Permit Fee ....................... $
Mechanical Permit Fee ............. ........ $
Sewer & Water Permit ...................... ~,
Issued
24 hour notice for all inspections (952) 447-9850
eQ::, .00
J~ '0"" f""lD
l/f'.oo
I'2.CfJO
..
Job Address 1~5?P.",qr.(1/J)(~I'J(
Heating CDntracto6t',.1 ~ )" y t> I"
J< - c. -
/2.~-c>a
7
6
"b
'350~
Name of Tester
Date
Percent O2
Percent CO
Percent C02
Stack Temp.
Combu,stion air is adequately supplied per
UMC See, 606
Input
.
r
~_._~._.._._---_._._--_....~_.._----
~1
00 .01Z>>
White - Building
Canary - Engineering
Pink - Planning
The- Crnltf of lht L.b Country
BUILDING PERMIT APPLICATION DEPARTMENT CHfCKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
luc f\~0An r\f'\ ~..-^
(~I bJ- .;;;;; ,.0 ()( '\ r)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
\SS(Q S <1Z...YN'I ~ \ c4.- \ ~J\.(l
Accepted /'
Accepted With Corrections
Denied
Reviewed By:
Comments: :::",
I;' t4rn A.~dr.
~rad d&nt.-
~e r.f? Ihr~t!!
Date: (~r.a?
S/c# W A~~/
~ tl~"klA -k.' I. hRtJ/ &-ttU 1/I~tth;" .:b1~"h~ .; C~y A
3. Ero<;'It>;t {;~/ ,.,y;A~I/~f ~ k'.n:Jf.-OA r;,,~/ ~"'C-...
"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."
~1
OO'Ol~~
TheC..nlerofth..l,abCounlry
White - Building
Canary - Engineering
Pink - Planning
aUILDlNG PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT W q (\~Y"A.O 1'\1'""\ ~
APPLICATION RECEIVED ~1 M Q; ~{) n 1)
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
IS-SeD S "'1Z..YNl ~ do \ no J\O _
Accepted :><...
Accepted With Corrections
:::::" By.Qv~k
Comments:
~ 165(,,( ~.~.....~J..-- ~. -L Of_ I 5''''"'-'--'u c.~c-,
Date: B r(i,' ~o=-
"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."
_~.O~X PRIGii' <:
f: y
~ u ~~
ThO' C..nll" of lh.. L.b Counlry
DO -0 lQ.(P
White - Building
Canary - Engineering
Pink - Planning
.BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
! \ \
\. t), 1\'. \ p, (: l\{"\ C'i"'.U'..
APPLICATION RECEIVED
: \ \ j I\ \ ~>.+- 'co'>! ,-..) (' c. t,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
\ S"'\ C. .~.. ~yTY'\ ~ , d L'_ Ln 'f\ 11 .
~ .
Accepted
~
Accepted With Corrections
Denied
Reviewed BY:~ I~~~
--
Comments:
Date: pj- tt)-~
"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."
CITY OF PRIOR LAKE
16200 Eagle CreekAv. S.E. PermllNa. e:x'"l-{)'1::)~
Pllor Lake, MN 55372
(J)
.... -
~ ~ HEATING APPLICATION I PERMIT
a: Dale Cjl,,\~ PIO.~-3h'7-ClI7-(J
CD SneAddreas \Ef.:::L,S ~!'.IN'--L~
~ Lei n Block \ AddBkm OJ 1 <J~l.,/.p ff ,~ ~ 1_
z:
OWne(s Name \ l 'il DN...vv-Y\ 01\ '^ ~ -,.,rA [} "'"
Address \ ~qt;:) ~\'" u.. ~ ''''''?/"';f'o. (\:.A.("~","N
Healing Ccntraclar ~ tf)"} - ((.1 Y." V'\
()
Address llt:1U ~ ~ fu~':1 J-f or -r1fLL- l'r,.,,~. ~
Tel.phanall IlJhl- u.?n~ l\L\-U
Furnace Maka & Model L~)..... TYPE OF SYSTEM
r ,,: I Warm Air P Janis '(
Madel Size ~~..J. ?'., '=l..-/~ Gravlly
Mech anlcal
Air CondHi<>niflg 'l( 2..""l. Tn.)
4" f-NLVIT Vent. Sysl.m
HEATING OR POWER PLANT
~Heam
Hol Wet.r
Rad..t"'n
Special Oevle os
Conn_ Load
~ Fuel Nil-I r """~uo Size
UJ
N
N Supply Open'lI9s
[T)
....
1jJ Relu,n Openll1lls
if Input IS ,ClUO Outpul l c('). rn.-11)
>-
Ct:
NEd,.
z:
w
Ul Clm.
II
L-j
Other Oe.leas
TYPE OF WORK
:E
:75 Ahratlons
'<t
;g Repair
'I..
Replacemanl
Esl. Cc mp. Dale
New Conslmcllan
IS} Est. Ccst $
IS}
IS}
N HEATING P/'.RMIT FEE $
. .
If) .
"! STATE SURCHARGE $
Ul
:J
a TOTAL PERMIT FEES
0() - t'l'l d c..
f PAlO WITh
BUn.DlNG PERMI i
. Bulkllflg Pe,mk .
/
/.50
$/
./
Aacaip! "
TVPE OF STRUGTURE'
I.PiIlli
1.. Gte
J. Yclt.
File
C~r
eo,,*1dlI1
Single Family
Commercial
'/...
. Multi-Family
Public Other. ~
Twa.Femily
Industrial
Faa Schedula
Industrlll, Camm.rclal & Mulli-Family
R.sldllJ1lial, Halting & AC
Resldanlial, Healing Only
Rasldenllal, Gas Flreplaca
Resldanlla~ Ad";lions & Alte,alklns
R esldantll~ AC Only
;~~~a..r~cas[i@Ofilno~; ~
$64.50 [ ..
I' .
$39.50,/, .28_
$39.50 Ii i
"
$39.50 , ;
II.-
i
Remember la add Iha Slala Surcharga on "a bottom 01 this Ippllcat[an.
Tha.p.lca 0/ vour healing pelmll Includes ona ,ough.in and ona tlnltlnspeclion.
Addillonlllnspaclions will ba bmad al $35.00 each.
House Healing Tas' Rsca,d intis! ba submlllad wllh I1I!1l!fum 1WIllit!lUlllt!M balora build-
Ing car1illcale 01 occupancy wltl ba issuad.
HEAl: CALCULATIONS REOUIREO wilh number 01 supply and ,alurn openings tlslad per
room wllh CFM's pa, opening. New sl,ucluras or eddmans send Door plan with supply
and return localions shawn. HEAT LOSS CALCUlATIONS, PAYMENT AND
APPUCATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. SE PRIOR LAKE, MN 55372.
,
Clly Hall buslnass hours a.a 8 a.m. - 4:30 p.m.
ALL WORK MUST liE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply lor a mechanical syslam. parmi! and I acknow/adg. Ihatlhe
Inlannellon abow Is complete and accurata; thallhe w()lk will ba In conlormance
wilh lha ordinancas and codas ollhe clly end wllh Ihe slola bulldlng/machanlcal
codas; Ihallhls lo,m doe. nol become II permll unlll slgnad by tha BUilDING
OFFICIA : thai the work will ba In accordanca with 'he apprpved plan In Iha
cssa 01 a work which ,aqulras revlaw and approval of plans.
\A .~~ ~{JCJ
(c · ,_., · 8/~~CL7J
AUG. 25. 2000 10:44AM
GENZ RYAN 6513226147
NO. 138
P.4/19
/
CITY OF PRIOR LAKE
PLUMBING PERMIT
Applicant: (:1.,p 'nz.: ~111.Y')
Address: \u'uc:... ~ t2WI"", vi..... ,012-'-
Signature: "-.1,,/,, _" GLJ
I.". ~~:~~d~::~ti~~ ~.s,B~~ ~ ~ Sub ~7N~I~tr .
- ,~.
BuildingPermit# I'Y'"J - ('n~c.. ,PID# &"\-.3e-..7-017-()
NOTE: This permit "(ill not be processed without complete information.
1'"." I ~RE UNITS
I. Blgc
:l. (;old
.3. YellDw
m.
C1.,.
"ppIi.".
T~ c....'....r ...... L-Iw C._I".
# nn- () ry,;:;g..,
.Phone: ~1~L('Z=:'-1/4U
1"20 r.. .
D L5 \S LS i :cl....
_28m
j'
Quantity Type of Fil<ture Quantity
I e Bath Tub with or without showar ~~
I Dishwasher
I Floor Drain
2- Lavatory (bathroom sink)
I Laundry Tray (lor 2 compartment sink)
\ Shower Stall
\ Sinks
Bar Sink
2- Water Closet (toilet)
Type 01 Fixture
Rough.ins
Water Heater
Water Sollner
!
J
!
Bacldlow Assembly (APZ, Double Chec;k, PVBJ
Stand Pipe (washing machine)
Sewage Ejector
8ackflow Assembly Test
L.awn Sprinkler
Other
FEE SCHECULE
Industrial, Commercial & Multi-Family
(1 % 01 job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$:39.50
/
/
/ .-
$ / .50 1'f\\O ~RtA\1'
$ / BUILDING P ,
S
$
$
GRAND TOTAL
,
.
:11I1s permit is &rOll"'d upon the e.pross condition a.at said
con_tor, shoJI comply in oJl respects with a.c ordinances
or the S"". Plumbing c:: d the II1lI dme a..reof.
; IPT O. DA ore
16200 EOlglc CrcekAv. S.E"
I fDr 1lI1 inspecti ns 24 hours in ~dvnnce.
r L:lke, Minnesota 55372. I Ph. (612) 447-4230 I FAX (612) 447-4245
An Equ~1 Oppol'tunicy Employ.r
I
------~- '---"'~~-"'"----"-----'--'-~-"'-"---
AUG. B.2000 11'14AM
13 PR~
-~/~~\
y C"J) CI'1'Y OF PRIOR LAKE
"tJ .,,~ 15 0 ':In rc; ,-. i:lI"oWJ:..t< AND WATER PE:RMIT
IVN 5 ~ 1.5 W L~..:J..J .j
- ---- ---__ I,
i
i U-&. J;
i ../ !
i. ,;
AP~:':.........:~",,_ ~hl~ ~/J\r~ PHONE:J.:J5H,J.2.'3-"14L.l
ADDRESS: 14"i.IE,~. li:.......f'-'T" --r"''--.fC,..s.'''''''''lJtJ.r ..,.""-'il DATE:"&')'R \~)
SIGNATURE: 'A 1~_ 0",-- .BLDG. PERMIT 11 an-O'7 ~Co.
SITE ADDRESS: Ir=.f~.)~ ~~Ir.L W PID1I_Q5-.~c.~- ()1'1.-0
1-
2.
3 .
- 4.
5.
6.
....
GENZ RYAN 6513226147
NO.4B3
P.B/9
-'I'ILE
'nU.a.. . ~...
--.~
. -
No...on - 07 C)c:,
NOTE:
Sewer and Water
contractors must
be registered
with the City.
FILL IN THE BLANKS
- , I
40
Estimated length at water service
"
Size of water servrce I inCh(es).
Location of any corPlinqs from s~ructure
Type of sewer pipe,. ABS ' PVC:: )( Cast Iron
. ,
Estimated length of sewer line~
C::lean out (if required), located at
structure.
feet.
feet.
feet.
_feet
from
- ------~~
...... --=:==-=-
~ '_ =--:z
.-
This
it wnen approved.
. C' ~TE: ~).
BY
FE
-- I
- ----'--7 --:
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
.,-_._---.--------------~=---_._~-..-----.~--_._------=
$
$
$
....
I
Fee for either sew~r ~ water individually is $20.00 plus
$ .50 surcharge. I
Sewer and water pe~its issued for new construction must be
recorded on the buildin~ permit card at the time of issuQnce
to insure that no dupllcate sewer and water permits are
issued. /"
/'
/
./
RECEIPT #
P~\O'l'J~T PAID' /
&U\\.D\tlG REc' 0 By ./
./'
DATE PAID_
, 4629 Dakota St. S.E.. Prior Lake, ~iMesota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
AN '01' IAr n~crn""",, cum ~
J
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS f~~~ ~s.::.....d-o -t::.____
NATURE OF WORK CJ ~
USE OF BUILDING SFA
PERMIT NO. IJ(). 07C-fo DATE ISSUED .9 -I C, - Co 0=
. ~
CONTRACTOR W<2J-."...... -............. ~~ R\otolE ~ '~I - <kJ'~ 'f(/0cJ
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I R/,;L-1/~
'FOUNDATION (Prior to Backfill)f~ I ~ f/.JPj/m. I fh., 3/3/ /CtJ
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - tNS
I~
I ,
I (-I-
I
~(~I 47~
I
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~ I I
FINALS
. /I~
6tr.r J'2/ 7 ~ 0
I
INSPECTOR
I FOOTING~ ~j It>/n(ri)
t5.-..
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if reqUired)
FIREPLACE
GAS LINE AIR TEST
GRADING (Prior to Sodding)
BUILDING -r.c....&> ~J1 ~/J I~I
. ,
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
~
&
h:r.
DATE
PI ZZ/4 ,
/'//~h"
I;~ ? -00
/6- sl-cd
1//b./mJ
1./ l'
\
I
I D <30 - -:;D
------
v
j
1<)')0--0\
f;/7/0~1
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
i~,;-"""~"'- ~
'c. ......~~.;,.-:~ t", ;"'_"10; ;.."... :","..",. ,..;:. .,:,........,
I,J, .'1/:.....'.. "-"',. ....,., .".-,", "",..to ,""
~ :. .' ..
:t.! QLtrtifiruu at OOrrnpanry
CITY OF PRIOR LAKE
J)tpartmtnt of 1iuilbing .Jn~ptction
ZFinal Permitted D Conditional C.O. Expires
This Certificate issued pursUlJ1lt to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issUlJ1lce 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 No R2SD
R3 Type Construction VN Fire Zone N I A Zoning District R2 SD
Ll7, B1, GLYNWATER THIRD ADDITION
Occupancy Type
Legal Description
Owner of Building
C'ite Address
15565 BROOKSIDE LANE
Contractor'sName&:Addrcss~SKANN HOMES, 1895 PLAZA DR., EAGAN, MN 55122
ROBERT D. HUTCHINS
_ City Planner
Date:
DON RYE
",--..." ;, .,.",
-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
_rEo )
~/
TIME
ADDRESS
15565 BROOKSIDE LANE
PERMIT #00-726
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: -;f;- \)~ Owner/Contr:
t
CALL .447-9850 FOR THF NI;XT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4< SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
1"2...7.00 3:ml
ADDRESS
/S.5?o 5' e/e..oo/C.SIOS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Q-i'?,;(P
o FOOTING ..n::\ 0 PLUMBING RI
o FRAMING ~""MECHANICAL F"",,",L..
~NSULATION /.'f"O\ 0 WATER HOOKUP
INAL ~ 0 SEWER HOOKUP
o FOUNDATION .4\j\O_SEPTICINSTALL
o DEMOLITION ~LUMBtNG FINAL
o FIRE PREV, 0 SITE INSPECTION
f;OMMENTS:@ ~ ,I :~" -~<1:;;..;r-;!'
~ J,,' L1<--- VJ<"
(g(d ~ ~ ..." AI"1J,-., -t'LA ~
cj oW ~~'~ -h..k
~- rJ Ju..uJ ~
~~ ()~ ~L~'L,
@"'~I
r--,'::7Y' ~.~"-_.
/VT.C,O.
V
f'-....
~
-~..
I' I fA.? .
~
. .cMJZ.
~
o WORK SATISFACTORY, PROCEED
)I CORRECT ACTION AND PROCEED
~ !'!!! I W}l"'K. ~FOR REINSPECTION BEFORE COVERING
Inspector: f~ ( Owner/Contr:
o EXCIGRADIFILLlNG
o LKSHQREANETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
&1~
CALL 447-4230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS JS<;h. ') 8 ~ I rJ....p
DATE TIME
~ ;):071
La.~
PHONE NO.
CONTR.
PERMIT NOC1)-I"J 8 C,
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ECHRI
ATER HOOKUP
SEWER HOOKUP
o LUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:(/) ~~ ~ .
!pj (I~ .;..0 ~ ~ ~
d) ~ 71.:.' ~
(jI)J f~~~ ~ ~';pe {..",
. ~ ~~~(~)
t
62.' ~4)J /V~_,
(~A,.T, -tJl>v~ .
1(( . T7, "K" - VLO
~~trf);L'4-/~~
\5-'// .
I
1/
o WORK SATISFACTORY, PROCEED
Jf CORRECT ACTION AND PROCEED
o CORRECT ~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: { ~" Owner/Centr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/