HomeMy WebLinkAboutBuilding Permit 99-0920
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
.QATl= Rl=r.J:.rlED.
7/Z~/91
I 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
/~7 /2... eL//I/0 Lr9K6
3. LEGAL DES~TION
LOT -5
/, 1 ,'1-1
ADOITlON LA/~
BLOCK ~
Po 1-11.. ~d'
4. O~R ~ (Name) . (Addres~)
~ , i...uL Ph -fA?-/J>- -i. ,-- / "-
5. ARCHITECT . (Name) , ~ddress)-I
.~ 35 vr C~ A-v-<! r-~_L-
6. BUILDER (Name) (Address)'
$/l!k'
Septic 0
Addition 0
Deck 0
Finish Attic 0
-nzrJ I L--
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
qq- qzo
1. DATE
7-;Jj-7~
BUILDING INFORMA nON
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
,€15D
12. NO. OF STORIES
PID 25-338-011-0
Side
USEOF,IlUILDING L f U""- ,^ ~<A
PJL"I'-- -S.E,[) I
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
&/.J.. -~~?-.f~ 5-
(Tel. No.)
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
Rs-roofing 0 Porch 0
Ae-siding 0 Finish Basement 0
16. PROJECT COSTNALUE
17. COMPLETION DATE
7. TYPE OF WORK Areplace 0
Newconstru~ Alterations 0
Chimney 0 Misc.
18. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumished information on s Iication 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 prope,: ~~~.h all constru . con all existing state and local Jaws and will proceed in accordance with submitted plans. I am aware that the
:UildingOffiCIa~~.%baU . Fu 0, herebyagreethattheCitYOffiCialora~~dteSn.U:le-t::n'ope7r12T"~~~~ns.
/'''' ~ Signature ~ - ""-- license No. Dale
FOR ADMINISTRATIVE USE
SETBACKS: R:~~:~ . W ~
BUILDING DEPARTMENT VALUATION
PERMITVALUATJON
TYPE OF CONSlRUCTlON: I II III IV V
OccupancyGroup A B E F HIM R S U
Division 1 2 3 4
Penn. Fee ................................... $_! I ?'()"'7 . ~S"
Rl{j.7/
9a.0()
Plan Check Fee ............................. $
State Surcharge ............................. $
:::~:~.~~:;;~~~.:::1t~r.i.?:: :
Mechanical Pennit Fee .'I/i!-(d..... $
Sewer & Water Permit ....r..~.f..~... $
Gas Fireplace Permit ..r1.-:.r~..... $
100.06
1.00.00
;SS,SV
L/ 0 .00
This
By
acorn
ilding Permit When.hP~)f.pd.
Date P, -'1-77
Certificate of Occu ancy
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
I Pl'l.ffYI . ()C)
City:
~~~
ro\?}
/
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collective Street Fee ....................... $
Sewer Tap ................................... $
Pressure Reducer ..%:1................... :
MeIer Horn ................................... $
l=lS-D.on
l 6 C;(,) .DO
4s. DO
Water Meter ................................. $ I as. 00
Sewer & Water Connection Fee ........... $~f'll(") _t"')~
WaterTowerFee ........................... $ '7.tltJ. at')
Water Tap ................................... $
Builders Deposit ............................ $ 1,500 .OCJ
Other .::~r.~..f(~;,...................... $ SOD. oD
Total Due .............................. $ A 1- 14 4-6
Paid &' d f &/. 7' (, Receipt No. -3 ~d 7 ~
Issued Date <? /7/9<1 By--l~
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 J;;;;~sted. This document when
signedOh ~~ a temporary Ce~~ ~Onlng compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued.
, . _ . VZ] . . . .
City Planner Dale Special Condlllons if any
24 hour notice for all inspections 447-9850
..
"'Permit,
.Job....'..)1> 112 J?I,i'ld &t.1<l~ r;
'He"""""""""",, ~O AIR
"'Testers/Signature -1i-jl/~
Oat.
Time
P~'"
Preaure
"Gas Une
Pressurized
l",poc1od
.Percenl C~
PERfORMANCE TEST
~-:?
7,/
"Percent co
o
.;<J ()Ej
.. Percent O2
"'Stack Temp.
Fin.' Inspection
Oat.
'.
,,~'ill'fitlt"'M -,
A,'""~ ,I ." " . "..,. f../
"
MEMORANDUM
DATE:
TO:
FROM:
Wednesday, August 18,2004
J arret Ringberg
RE: Building Permit #99-0920
16712 Blind Lake Trail
The Tre
returned
Thanky
.,.:~
III
Tht ("tnlt( or Iht L....t Counlr)'
(;'lv. 920
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~r
. NAME OF APPLICANT
APPLICATION RECEIVED
6/t.-ES EN!.
7/Ze/QQ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/v:7/2- 8L//'V'O LAKE- ~.
I
Accepted
./
Accepted With Corrections
Denied
Reviewed By: LJ......-o. !'"..."....AN.\
Date: gi3o/97
,
Comments: .R"",or. MoIST BE COM''''' 0 -ro
,
AAlQ ,qL4~ DltAI..JACE: ~ "'riLl,.......
tASEwo1E,.,rr.s A~ "'.'_l,:t'. -'as H1.Ac..,....,c4l-.
SfE
IrJfolt'MA1'"k'l^' .?AJ ~f\JC.t<...€. SlOE.
~ATr.qo,I"'F~ = '- hNAL ~AOE 1~5.PlcntJl\J LAl;:an""'Ar~AJ 7_ f},IlAQigL... f/,_4Id
3. f""an:<'I...'.J c"....,TA.OL MFA~lJaE:5
4 E"1l0~IOlV COAITR.DL. PL.-AN
"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 \0 give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~~
99- 9Z0
The ('enlera' lhe L.kt Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEEARTMENT CHECKLIST
NAME OF APPLICANT
G / t.,-E55 ENI.
7/Z8/QQ
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/G7/Z- &L-I/IIO L-/1K.6 /J!?...
Accepted Accepted With Corrections ~
Denied
0J!L k-
. j'
Date: 8 - c.f -17
Reviewed By:
Comments:
I. I2JcJ.1.r-n:.~ ~~
"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
Canary - Engineering
Pink - Planning
Thr Cnlrrof Ihr I.akr("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/
,~
::;~:
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.r/," .>' / ~L
/..:'/ (,,/
.I -'-j 2" ;::::" ,,-;?)
~-'.f '; . \..___ ~
Accepted
1/
Denied (J /JJ, II
Reviewed By: ,'7 J. ~
Comments:"*' .41 ~ Uhit yyw 5>+ i:x-
WL;f-e-o
Accepted With Corrections
Date:
S/d-7//')
Jot hv>'Y" <5 i ck
5c/briJ<
"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."
HIe
QJy'
Com_
1._
2.0-.
l._
CITY OF PRIOR LAKE
. 16200 Eagle Cl1llIk Av. S.E. Permh No. qq - q Zo
Prior lake, MN 55372
TYPE OF STElUCTURI;
Single FamUy X
MultI-Family.
Two.Femily
Industrial
_ HEATING APPLICATION I PERMIT
..,
0.: Date . \~- '). ~ -~ '"
N 5118 AddYess \ \.. \ \. )
~ lDl 3 Block Z Add'lfllln W/I.-067eN6SS PONDS 2~
2 OwneJ'sNama {'\.~ (;.\'9..<:
AddlBSS --:l'\ SV\~ (liIdn.... A-v\ fl\'f"fl-,,',,", h",
Haatlng Conlrac:lDr \"\ {~ ~\.... ~'(\ \.
Address ~n ~ ~ t'\ '\.{ 1...\ t ()(l.v., \\ V \ V r; iT' ~ l.t.llL
Talephone' '-\\\~ - i \~~
Furn_ Makll UoIodal S............: \"..
ModIISlz8QI\ V.Q ~o
'S~~"'~
Olhey
Public.
CDmmercial
PID II Z5 - 3'313 - 0/1- 0
~ \:",\ \." \~ \.rc...J,.
/2./'ED
Fee Schedule
,,,. of job
$99.50
$64.50
$39.50
$39.50
$39.50
Industrial, Comman:lal & Muhi-Fam~y
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
RBsiclenllat, Acldhlons & Alleretlons
Resldennal, AC Only
~ / I
Remember 10 add lhe Slale Su ~ " . ' on Ihe bottom 01 this application.
TYPE Of SYSTEM
Wann Air Plants J4
Grav\ly.
Mec:hanlcal
P<< Condhloning , ",
Vent. System
HEAnNG OR POWEfl PI.AN1'
Steam
Hot Walar
Radiation
S}lecial Devices .
The price 01 ycYr healing permit Includes one rough.1n and one final in... _.~....
Addhionll inspections wiU be biledllt S35.oo each.
House Heating ,eat Recolll mull be submittecllMlh IwlIlIinlllllllIllillllllIlblll before bulld.
ing cer1ilicI.le of cccupencv wiD be Issued.
l1E!lI CALCUUU'IONS REQUIRED wIIh number o'supply and return. openings fisted per
room wIIh CFM's per opening. New IlllUcturea or addltions send 11001 plan wilII'supply
and I1IIum locations ehown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPUCAnONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 162.00 EAGLE
CREEK .AVE. 5.E. PRIOR LAKE, MN 55372.
City Helll!,uslness hOUT8 al& B a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-/N AND RNAL). CALL CfTY HALL
447-4230
Conn. Load
Fuel ~~ \-
c:. I,
Rle Size J
\"\
'6
0uIput '\ I ,O!ib
Supply Openings
Return Openings
i:!:i Input '6~ l\~t1
IT
o
~
f-
W
E
Ed.. .
Dlha! DevlcBs
''\\\ ,
Clm.
TYPE OF WORK
.~.
I hereby apply for a mechanical system. permit and I acknowledge thai the
Inlonnallon lIbove la complele and accurale; Ihallhe work will be in conlormance .'
wllh Ihe olllin...c.es and code. 01 Ibe city a.nd whh Ihe alalB bulldin9lm.chani~'
codes; thai this lorl1! doltS nol become a pefl!llt until eignecl by the BUILDING.
.. n. lL OFFICIAL; that Ihe worK will be in accordance wilh the applO\led plan In the .
(J\EIi.~. BUlldingPermU '\ -, - 920 cue of all ~ork w~i.ch_requlr~. ~11l!' a.nd approval.at pIM...' ::. . ".,.... ~ "
~:.:/.~".:..d . . .....M . ;~,~ ';/~ '\ i~~t::..-. ...~":: ..'.:....:.:.~r, ~iii(~';':'.:
;,~~PERMITFEE. .....-:.;O~!..'i~~,'{ "\\~I)'li~.'.>" ':\~.....l,~.':\...r:...
N .",".,. '.' 50 ~~"'G~' . ~. ".. ',. ,.':...:'.'DeIe.,,'.,.i.,'~'
...:...sTATESURCHARGE $ , . filS';:"'" ..:.... ..,','. .'..";. .' .., .. '-":''''h.':--'?%;.~' "',;;;,'.~..".;'
~ ...... ',.. . ,,- . . ""4A . "'/0 "."". ... --.
U ~I..~..:,"'".-'.'" .'. . _ t\, .. ; .. ';X/""""-. . /1 .:;...-, -/ '.
o '.....TgT~..PERM!T FEES . R_,-'I . . ~"f'G ~ s~gnatura - 'DeIt~. ';, " , :
. L :' _ . ''";: .'~~ -. '--.'.'. -~ .:..... -',-. ./'.-...___.....~.;-,L.~.L. :~.
.. 't.t:;;r....c:t..}-.~~ -.. . :~_i";Z;.~-l~.t~~:h! ~:;:.t<.~~...l ~'~~'~i',r. .' ~~~-c~.~-:~::-~:;.:r:;-.;~~:.~;.a!-....:. ,f.~'f.:;~'!.~'~'.?:' "i;f'fg,;~""; ....;-:;;,i~~.',;.~~#!ii~r.fi~
~~.,3:if>~~~.7i;~...~.flh~ v.~~ - ~';~\~~fl~~~1:~~~J'",~--:.t'.:.~J:'1-&;.l'~ ?-~'-"" "?~ ~~..~ .~. !. -.
:_.._~'"'....:'..... w'''''"ltc'".~,~'' ~_, _.1: _...... _ _ . ~t...~~,~~~~-:;.;~~.;::~'::.:{!~..fj;.~;J.;;;_ . I ~ ~~ ~ 'tt~L""""". . I .. '.. - t
E
fi!i -'bralDns
IS)
New ConstructiDn
Rep\acemenl
~ . Repair
. . Ell Comp. 0IIta
GREEN-n..E
YELLOW .. APPLICANT
GOLD-CITY
CITY OF PRIOR LAKE No.Jltf, qZO
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT: .J ~ ( ~ t:')(C
ADDRESS:Dlh':"},fc~.~~P 7 lr\ kk
SIGNATURE: V )~~~'C-/C---
SITE ADDRESS: 1~71] \X'Jt'\ltJ-LJ.{D
PHONE: '7;) n)7 LJ {-k,
DATE: 9bD cJ?
BLDG. P~RMI; # en ~q.),()
Tvu,' I PID# 2.5-33B-OIl-()
t<lSD
FILL IN THE BLANKS
1. Estimated length of water service y{)~
feet.
2. Size of water service
inch(es) .
3. Location of any couplings from structure [)
feet.
4.
Type of sewer pipe. ABS PVC~ Cast Iron
Estimated length of sewer line Y)-;eet.
5.
6. Clean out (if required), located at
structure.
feet
from
------------------------------------------------------------------
------------------ -----------------------------------------------
BY
your permit when approved. .. ~
DATE: ~O/ 99
This
----------
----------
------------------------------------------------------
-------------------------------------------------------
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $~~.~o 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.
DATE PAID
.-'..\
\'1\ \. e,:\
AMOUNT PAID r-I>.\O . \e' ;..,,\
. \'NI..:A
REC I D BY ~U\\..O \
RECEIPT #
16200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE
PLUMBING PERMIT
APPlicant:C1eQu:u )r~..fc.y \>lQ_+ \+tl"1
Address: /1 (J 9'~'''':> i , "'\ VJ ; ~~ '< r"1 d! 4.--G
Signature: ~I Ln-<--. ~,,~~
Legal Description: Lot Block
Site Address:_ //1171)- '~\\'orl La.1L< fVL
Building Permit # q'l- 92-6' PID # 7" - 3":3.?' -
NOTE: This permit will not be processed without complete information.
Thr Crnlfr of Ihf L.kr Coonl!')
Quantity
I
I
I
6
I
,~
1
/~
FIXTURE UNITS
Type of Fixture
Quantity
I. Blue File
2. Gold City
3. Yellow Applicant
PPNo. qc;- <(2--D
Phone: L-jL-17- ?9.<.[)
IJVI (V' l&IUJ
Sub
611-0
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
BackflDw Assembly (RPZ, DDuble Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
.50
Bath Tub with or without shower
-)
I
, \,'
, ?:'~\) (-
\t,0,J .
This permit is granted upon the express condition that said
contractor. shall comply in all respects with the ordinances
of the State Plumbintifllic nd e me ents thereof.
o;;;.----R . II aq DATE
ATIEST
/
Call for all i pections 24 hours in advance,
16200 Eagle Creek Av. S.E. Prior Lake, MN 55372/ Ph (612) 447-9850/ FAX (612) 447-4245
An Equal Opportunity Employer
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (lor 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
PRIOR lAKE
I'NSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
.
SITE ADDRESS' It.. IlL- 'K\\J ~"-.t \'h
NATUREOFWORK k)h\ ~
USE OF BUILDING c;:,FD
PERMIT NO. 99-'771:) DATE ISSUED ~-tj-")'1
CONTRACTOR ~< ?k.f-~U<::'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING (l\),uft ~~/c.--~. rvl/t,foDI fA, I 9~/PAJ9
, FOUNDATION (Prior to Backfill) I ~/}(f ?6> ./9- 9
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH~- INS
(/!/ .,je.l/'Iq
(/ {fj( Iz/,v/~.
f)P /z/.rlt "-
tOJ///3/M
1/ I//I///f!
//
GAS LINE AIR TEST 7V flit /"4
COVER NO WORK UNTIL~BOVE HAS BEEN SIGNED
I I
FINALS
We s-/c./oo
~ 0. SI}2-/~
.
I;J ?(,
OCCUPY UNTIL ABOVE H S
NOTICE
GRADING (Prior to Sodding)
BUILDING ?(XJ ~/>Ioo
ELECTRICAL
PLUMBING
HEATING
DO NOT
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
. -~ ..". - -...
.., --~ .
INSPECTOR
DATE
m ['7;(,'1/&
.
" ?\~\1
BEEN S\G~ED
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
8~/s-of
I (pt"[ /2.. lS1i~ ~ "IjL
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
piNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TillE
erCf-CfW
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
- .
h'1 0 - I J''I--1llI+- l?~\urll\..
('.~,
, .
~~..(..~-
..../WORK SATISFACTORY. PROCEED
~RRECT AC AND PROCEED
o CORREC 0 . CALL FOR REINSPECTION BEFORE COVERING
Inspectc . ~ Owner/Ccntr:
C L~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
lN$NOn
~ 3~OO
Bt-IN 0 ~,J-" /~
CONTR. (t'J -54- oty
99 - 092-0
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
J(P 7/2.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATIOTII""
jl(FINAL r.J
/0 -SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o P.JAlMBING FINAL
~CH FINAL ~
DATE TIME
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: ~ tloo.- ~ ~ ok-
~OIIldA &-c5.0\'\ ~ .
~-': ~~ w r'~~ ~lJ/~DMW
~Y'\&.'fO\\ of'\. (~~e.. ~~
Lc.wQ.'Y'I,:/ 6\^. ~. s1r1L <If- ~~
+" (::/..J..;-,dRtM /:.-=. - '
o.rv-.e. -If'~v-.?Kc.-:l--tc/~O\'-l r b:4s~
~...+o ~\. CL \II..e..0 ~~ / t-J, : ti;J~
) tz>.\ +~ ~ ~c:t .vfM.JJ ~(k KM;/
~J ~ ~
. ~ q~ cn,- {-" )c~ .
C4~ <::::r ~4 t-\ V ~ 0 I'L
o WORK SATISFACTORY. PROCEED
o CORRE ACTION AND PROCEED
~CORRE T RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
, Owner/Contr:
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
-3~A TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED Lo:~
ADDRESS \1....112. & \,h/1 La lu. --r;;a~ )
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~~R HOOKUP
PLUMBING FINAL
o MECH FINAL
~~:~~
(lJ {~ \~o..c.h InMI.
l~ C ~\UA-~
()
1 \J\..
qq -q2.0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
ri v- /'A.,,\r.
RY. PROCEED
EED
REINSPECTION BEFORE COVERING
Inspector: OWner/Contr:
CALJ 447-9850 FOR rHE NEXT INSPECTION 24 HOURS IN ADVANCE.,
COD~EQUlREMEITS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
V 1_011
QLtttifiratt at (@nupanry
CITY OF PRIOR LAKE
1JBtpartmtnt af ~uilbing 3Jn~ptctian
~Final Permitted 0 Conditional C.O. Expire~
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:
Single Family
99-920
Use Classification
'=1dg. Permit Nr'
Legal Descriptior
R3 Type Construction VN _ Fire Zone N / A
L3, B2, Wilderness Pond 2nd Addn.
70ning District
R1SD
Occupancy Type
Owner of Building
Contractor's Name & Address Giles
Si"'Address 16712 Blind Lake Trail
Robert
D. H'[tCt:S
Buil~g 0
1/ ~G ~o
f (
Enterprises, 23545 Cedar Ave., Farmington
/7 L I Jenni Tovar
r- G::-City Planner
55024
Date:
08"':