HomeMy WebLinkAboutBuilding Permit 03-1229
CITY OF PRIOR LAKE BUILDING PERMIT,
T~MPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
'6- ;;LI- 03
I. White
2 Pink
J. Yellow
File
City
Applicant
IPERMIT NO. 03 -/zz1
(Please'!vp~ or print and sign. at bottom)
ADDRESS
11...\\20
t-hc.." Lck
Crele.
ZONING (office use)
1ZISD
LEGAL DESCRIPTION (office use only)
LOT 4 BLOCK I ADDITION /AJ; gs /Vor ft,.
PID :/.5- tfOlj~ ())lJ-.(}
)
OWNER
(Name)
(Phone)
(Address)
BUILDER elL f) I L:>, I
(Name) (d,tiA~..V\ (~i-d,,- pGo.~ 1.Je~')
(Contact Name) Il<<-\Je. c....L../r;(}"'^-
(Address) -Z '21 3? 6&.4.1\ ~II'€ {/"k~~/l,..
I
(Phone l.
(Phon!,
1<)2.-4(,/1- /'/1
rbZ-12f-lj~u'
M
?))air;
TYPE OF WORK
Otl New Construction
DDeck
DPorch
DAddition
ORe-Roofing
ORe-Siding
DUtility Connection
DLower Level Finish
o Fireplace
DAlteration
o Misc.
PROJECTCOST/VALUE (excluding land) $ 'f?<;-; 000
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 construction will conform to all existing state and local laws and will proceed in accordance with
:.Jbmitted plans. I am aw~~ the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;te'D::to/~~ections /76CJ ~_ /7-0~
............ I. Signature Contractor's License No. Date
V
1 Permit Valuation c'3~"ll (')17) /1 1 Park Support Fee # $
,/ I Permit Fee $ ..:Jd.S3nS"j I SAC # $ /~75--
1 Plan Check Fee $ /4 ~ l.f - CfU I. I Water Meter Size 5/8"e $ :3 tX), -
I State Surcharge $ 1&;),-5"'0 I. I Pressure Reducer $ /It> _ -
1 Penalty $ I I City SAC and WAC # $ Id-OO,-
I Plumbing Permit Fee $ /00. - I I Water Tower Fee # $ 1a:J.-
I Mechanical Permit Fee $ //7/J.- 1 I Builder's Deposit $ /500.-
1 Sewer & Water Permit Fee $ 3c;.So I Other $
~0
I Gas Fireplace Permit Fee $ 4() ,-- 1 TOTAL DUE t q I~'O $ 9cXJ/, 0CJ
This Application Becomes Your Building Permit When Approved I Paid ;/'''1.20 I. " 't Receipt No. Q5/"03
~ ~~ 9,/3/a '3 I Date . "'/_LS/O 1 Bv /:!/'If.#""~'.~~
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 documenl
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~ ::{~
Planning Director
/
/.I2.LJ.J!) aJI ~~.
.. S-peciai Coo\1tioos, if any
24 hour uotice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
r~~~3
,
<---J
~\
White - Building
.rl:~I"I~FV - f;t1aineerlna)
Pink - Planning
Thr ("rnIP, nf lb. I..kr{'ounlry
BUILDING PERMIT APPLICATION DEPARTMt;NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,/. _/ 1'.
/~, j, /. ..
./ L-<....._l.__l...{/ _/ c< c..4~"J'-~~"
. '&,... "-/'/"-'41 <, ," /'
.. //,,;~2 /t..-.'/;;: ""{O /"._-"".,,-:
r? --; 1-'>;::;;:
J-:\'~.-." ~~'-...J
.... '..........
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/71/ ,_, i ,
( u.- --,/1 /'"
'77)(/t~. __/,_~_>(_r~
//,,-)/\
I .-,/ /;;<..u
/'., - ,../
/_.;.",//,,71 ,ft
~_..."c:..",- v'</'.,..-- .-"L,,......'
Accepted
X'
Accepted With Corrections
Denied
Reviewed By:
IJ11-J')
Date:
9//6/t0
Comments: See Reverse Side for Additionallnform::ltinnl
See Attachmp.nt~. 1) Grllning Pbn, 1) Fro~ion rrmtrol Measures
"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."
-----_.__._.,'------~.~_.__._-~-~------~_._---
s~~
White - Building
Canary - Engineering
rf'jlll< - .-,ann,i'i9:::>
Thr ('~ntrr or Ihr I.akr ('ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/
/./f I l
,.
/
,
/.
J~
C I ,)-,
) ~ ,f~'(. Z
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~,7;'-/ r,-_
/ i /
/ // /
()
(l.__
Accepted
Accepted With Corrections
/"
Denied
~
./
(/ .
~ 9.JL<-l)~
;(I e.-O a.JLf
4J~ aDo' R.o.vtl.
~
Date: ~/~ ~
Reviewed By:
Comments:
I
d)'1 ~.
..
.
"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."
6~~
CWhite - tsullalnq ~
Canary - t:nglneering
Pink - Planning
rhr ('fnlt'r of thr L.kt' ('oun.,.,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSr
NAME OF APPLICANT
APPLICATION RECEIVED
I!tdtb~ ~/~
R-d-/-If3
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction aC;;~h is p~~ ~
.
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
r,j? r
~ ;1<-iJ~
J!~ ~~
Date:
ji1~3
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."
12/11/2883 13:83 3524481748
ALTA CLEARWATER
PAGE 81
Dare RK'd
CITY OF PRIOR. LAD PLm..ul>.,lJ..G pERMIT
~::;. 1l'EllMlT NO.oSTRIj
)"y.... ~ ...
rl"htarMeor'fIIiIIEas:im ~iLf . .
7..w~ rM.RJ La~ C/~/~ I ZUl."OUC-""
LEGAL DESCL.: ~:i...~T(olIioo"""'JIl
LOT BLOCK
Au'Ul.u.v.tl'
l'ID
~=CUd~~ .a~~, ~~J(}!hotJt)~4':ZPXA4I,f92f(;
(Addre&sl . P Ii h)x /rz" L 11hJ:'1a/# / ud(' . ","A~.0- ~a::f /)
'=~/&~.h~~ P&. cjfl-M~e)!::L~7-89?-/)
(Ad4teft) 19;;2(.1J/) M biPLJpY//7 Rdv rh i)y I J Ice.. .<; <. \ -< 7 ~
f), (It" '~l (Clly) (Zip Code)
(CoaucIl'tnoll)l /t{rdh l I/.hV ;,,~ (PhoDe). ~L/7-~ ()
APPLlCANTSIGNA'fURE_ ~J ~ DATE !~-Jl~
'" - ( -.....
APPUCANT PLEASE COMPLETE BELOW
Q1IanUt)' AJI''' al'ilm.... QuIItltJ
BID 7UUil:l'.., I jIboC~/,;'"", J
Dishwuber I
Floor Dram
~lI.i,r:-,\-:-;:ii Sink)
~ ~..n.I~j ~ {I or 2. compaI1IDeIIt .iulc.
ShoWer "'WI
SiDks
ii.. iini:
. W.i:er ;:;:.:i. (Toile!)
,
-:;}.-
TypeotPlmln>
~~ "
WIIl:T 5oflDt:I'
~~uhbiDg~}
_B ~
t:~' Test
~
I
FEE s...u-.JLJ:
Indu!lriaI,Comm...w.t. Multl4>mily.IYoofjob co1l with. $39050 minlllnlln
IteSlden1il1..N.... One a: Tw<>-F....ily S99-S0
RosidOlllW. AddIIlolIS It AlllmlioM SJ9.jO
E1thnaecl Cost S
Builditlg Pennit N
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMlT BE
$
S
S
I-
i Patel
i
PAID WITH
tiUILDI~ERMrr
(Oftk. \I.. Ooly)
DIs App__ JIeto.- Ynr ...."'c l'en8it -Il... _I
1l.ealiP.' N<I.
. ... .
.'
~EC i 5 7003
By
...... 0IIitiII
i
:l4 ao.r...tlco (or -'I ;"opoctlo"l'5Zl4o&"!lII50. flnt (!In) 4o&,.uu
-
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
(Please tvoe or urint and sim at bottom)
ADDRESS
i ~:w ~~;""' I PERMIT NOB-(;?d-Y I
14120 HAAS LAKE CIRCLE
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name CUDDTGAN CUSTOM HOMES
(Phone)
(Address)
APPLICANT
(Name) ATJ.TRD FTRFSTDR DRA FTRRSTDR HEARTH &. HOME
(Phone)
651-633-2561
(Address)
?700 NORTH F AIRVIEW AVENUE
(Address)
~OSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE "
BRt=NDA HUSTON
DATE
10/2&/0.3
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
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
FIREPLACE MAKE AND MODEL
HEATliGLO ST-HV-IPT
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$3950 minimum
$99.50
$64.50
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
Estimated Cost $
HEATING PERMIT FEE
STATESVRCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
$39.50
$39,50
Ii; ..,PAID /lit,
. U/f..,)fl\i '" . 7"rH
. G::;~~Mr;-
(Office Use Only)
Buildine: Official
r.Pai~'
. u,
i p~teoc
Date ,0U ' T 2 8 7nm
24 hour notice for all inspections (952) 447-~O, fax (952) 447-4245
1:....:./
"---- -.---.-..-.---
[,:-~'-m:ceipt No.
",1,,11
This Application Becomes Your Building Permit When Approved
l1!y
rr
83/12/2883 18:33 5877445555
BADGER EXC
PAGE 81
- .... _. ~ ~ " I.. ',.0. ~ .. , .. .. .. ...
.. . .. .... ..' ~ ....~\ ..,"\" I...
..........
CITY OF' PRIOR LAKE
SEWER AND WATER PERMIT
Date Rcc'd
~~ or oriJlf Irl4 Wltbocmml
ADDRLSS
: ~=. ~,~ I PERMIT NO:? _ I'" Cfl
1, c.l. A"'*"", \) r:xC?'-,
,
Ilf(~D
t-tc.Q S
I ZONn'iOl.'"""'-:;;;'1
L,c.k> Ci rJz.
I !.EGAL DI!SCRJ:l>110N (om<< u.. '""1)
I LOT l(SLOCl< ( ADDITION tAJ;ldS I\),wt"'h,
PID
I OWNER
I (Nam,)
I (AddJe.,)
I
G...~Il'~ Cu.S~
)
;;l.::L \ :> 3 1..o"/;./Y'. f'tve
tAdc1rtul"
13~J..w (PhOTIc) .'1.!S'2- Y(.9-
L.~
tClrvl
I~([
sn;'-I~
(tlo Co..)
I APPLlC~
I lName) ~"JCo!A p y
. (j
I (Addm.) 'R ::n .~ W
(Adel'..,)
(Con,a", Perl on) .S:......:.L ~_ ~,'~
1 AJ>PtlCANTSIONATURJ:~i.<.. p .I~
f~
('c..~~
7 01-7-, ...si-(-~
(phone)
._.-._ DATE
(Phon.) Sc)'7- 7Cf Cf. ~-~~--.
LGlt1.:,Jo../p ~O y,6
(City) (~C<<Ie)
507-7VLf- ~ r::-
Cr--:-/.-< - ~ ")..
APPLICANT PLEASE COMPLETE BELOW
Size of ~t.r service .J.- inches
Location of &IIy co~pllngs from ltructure - feet.
Type of sewcr pipe. 0 AB C mvc 0 Cut Iron
Estimated lenith of sewer line 57) kIt,
Clell1l out (ifrequired) located at _ feet from structure,
FEE SCHEDULE
R"idenu.1 "''''lllld water 1i.M OOM'Ollon Sl!.lO InduHI'IOI, Corn 'I &. Mvhi.(amily 1% of job 0011 with. BUO minimwn
s.~" conn<<tlon onl) S17,50 Wile, connection o~l) $17,50
E.timated Co.t $
Bulldinc Penni' It, ..-,
SEWER AND WATER PERMIT PEl!
StATE SURCHARGE
TOTAL PERMIT FEE
s
s
s
'IQ
PAID WITH
BUILDING P~RMIT
lomer L:u Only)
1
ThiS Application Seeom.. Your Bulldlnc Permit Wh.n ApproHd
lulldl'" amelll
rrtr~i;l , , '" ',n--I!leceipt No.
I '\ I, ;.J I \' ,., '.i,-' :'
I I I I I I --; I.!!j _
I.Fife (!l:Ir b#. ,
\>." u+-^-r . Q onJ] i' 1\
1,1 JL .l VTl1 l~j
1. ".ur utltl tor aill"'p.CIJDII. (PSI) .t.'~ !tOI r.. ("'1) ."~1~
By .--:_~_._.'---_.._-----=
12/11/2883 13:89 9524481748
ALTA CLEARWATER
PAGE 82
.
CITY OF PRIOR LAKE ' ..
BEATING/AIR C.''''~''''''''''''''.I,jU.I,GlFlREPLACE PERMIT
:....,",'. ...'
lkfll Rft'd
~::.. ~ l'~~O.~, '
J........~ .
~""!ar__Ii...I[_ . .
I AD;;J?t? ffd~J ide ~ I tJ..,.~.lJ(_~ \
,
LllGAL DESCRJPI'ION (clllco ... acIJ)
LOT BLOCk'.
ADDmoN
pm
(N:,;.)..wa;~h /.:}L~ ~/ f- _(;p-:i;:iPa?f.;1./A.
~Ad4ress) f'dl!?i "!\:{j (AlVlSrlAj /-S' M.t:J t\:"~i:;r 1J/A1 (; .
~ Jx;%~r;:~ ~{f?1;/lfl~1'.~1r:.
(J {A46$)G /..., / (QtJl : - (ZipCllde)
(CoaraclPenon)Jj,(f~ ~~6 (l'\IllIIe) 79-- qC(/)~;;;77'7
APPLlCANTSlGNA~.~~l, ,___ _-: DA.TB-~. /;;.-//-& :
APPLICANT PLEASE COMPLETE BELOW
Q!JNEWCONSTR.UCI1ON OlU!PLACEMENT~. DALlEltATlONS. '
FmNACEMAKliANDWODIlLL.earU)\/ /",.;,,s-JAAP-4t3c: DW roE. AJ~~
FUIE StZE .~ 'RETURN or "",,,..,,s"7 lNPl1T .2. /'u (J75D OUTPUT
-.
TYPE OF SYSTBM
. ~Alr P1aaI!l
M~~;:'"
-~
I'l&EPLACE MAKE AND MODEL
Hl!AIlNG OB.~ ~ ,,"'"'- PLANT
js-.
RolW_
tlodillliQa
Spociol DcriaI
CdI<< Dovlao
PUASl NOTE:
Ait~Unit!
,CamlIt 6at.iudd>. iIm
~SioleYllrll
~.,,'~\..;
-. - - ,."..-. -'-
-.- -.-...,..-- -."
IndllJlriAl, COl1IlIIercial It Mvlrl-FlIIlily
Il.aidalllll. HtIIIllg &. AlC (New CoftIlnlcIlCIIJ
Retldontial, HOIIling OnlY (/'Icw CclnslnleliOll)
E&tlmllll:d Cost $
FEE "...........DLE
) % of Job llC" 1l...ldeIldal, G.. rucploce
U9,50mlnl,,",m . ,-,-_.....
$99.50 llLoldelllial, AdditlOllll .. A10ftl101\!
$64.50 RcsidCll'iIl. AI; 0nI)'
C9.SO.
$39.50
539.50
'-
HEATING PERMIT FEE
STATE SURCHARGE .
TOTAL PIRMlT I'D
B1l11d1llg Perm;! #
. PAID WITH .
~'~k.:..
, '~rmllrIJ
$
S
$
,;
-..-
-
r-
;
.1 i, 11'1I4
JDal.ltL 1 0 WU,1
;/7
, . alIIlIipt No.
_UJeO\llJl
TllllA,pllmtioa J ",., Ylllt" IlIlldlllC Jlmalt""'" A :
By
:u ....r ftotl..ror .n i...pftti....I'52J "1~~1'u: (9S2l "7~24S
PRIOR LAKE
,
INS~ECTION RECORD
SITE ADDRESS J~lAtLLId.~A.Ke. .t2il'r Ie..
. ~
NATURE OF WORK Ne w
USE OF BUILDING SF (> .
PERMIT NO. ~- / z.:z,.q DATE ISSUED
CONTRACTOR ClA.d~AJ PHO~~~'
NOTE: THIS IS NOT A PEFU.iIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I FOOTING
INSP~OR
tr 11
DATE
1
I
"
SEWER I WATER I SEPTIC
FRAMING IAll L-
INSULATION
ELECTR"ICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
7~..&
IA J7 UIT
tit J *7 too
lL /7 193
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
llATNI../ /!IIlFM/IB) S'fIIJII ~ /<(/c I
FINALS _
I GRADING (Prior to Sodding) I N '~I"l
BUILDING '1"f I' f( I~
ELECTRICAL r'"~':""';' "''?y \,
PLUMBING I 11/._
HEATING I fI()J
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
7 -2r'J
,
8-1'2.-<:4
,
I t z.~~
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.
FOR ALL INSPECTIONS (952) 447-9850
---'------_._-~_._-~.~--- -- '-----,..__.,---~,----_.._--,_.,_.
QIrrtifiratr of @rrnpanr\l
CITY OF PRIOR LAKE
~1jlCtrfmtut of ~uiIMug Jlusptdiou
CfFinal Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Unifonn 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
Type Construction
SINGLE FAMILY
VN
_ Bldg.PennitNo. 03-1229
Fire Zone N/A _ Zoning District R1SD
Legal Description. L4. B1, WILDS NORTH
Owner of Building
Contractor's Name & Addre"CUDDI GAN CUSTOM
ROBERT D. HUTCHINS .,)/'j
Building Official V /
Date: I; (\ (' I
Site Address
14120 HAAS LAKE CIRCLE
BLDRS., 22133 LOGAN AVE., LAKEVIL~E 55044
City Plan''''-
DON RYE
Date:
7-;;~1
,
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS J 4/1...0 H-o..~'? L~
OWNER
CONTR.
S. 1~7
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
".c,FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
9CMECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
1.._rL,~\....~. ~/,.. (l~.J..
2. H<<..t& ""orc....... (').: \ L.D M.""v 21{ 'I!JJ ~. 11'~
~~h {)~c:;~
'l. ,h........L Gt.....L.., " "'-'Sf
~ ~L U\jo>- fo
~ ~-' (ii. i-.n :L.:;.
7, ~ -&-\1Ul.<^
I/JKJ~"< ~r- till-
S/, \....\.., 'M,..J
f{,.......
~/
I. RA'f
. t
~ (I1Ltil~
D. rrJt ~j)
I
7&
'!5-1-01
- c;y~ 'O.-r '"g}"",W
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
X CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor:
Owner/Contr:
THE NEXT III1IPECTlON 24 HOURS IN ADVANCE.
ENTS ARE FOR YOUR PERSONAL HEALTH .l SAFETY!
llaNO"
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
7-21q
ADDRESS 1'11).0 H,,< Le;/I, ('~.j
OWNER CONTR. C(~..tIj'_
PHONE NO. PERMIT NO. (') ~ - ~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
oBE:lINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
CO,iW;NTS:
b~-f")K
ll~/1
"
~-III,cI
<..,rtl,u
c.r<- "'WCd' ~ <.,141,.-..(-
fti,( I f'I(/-1- VI'" /.,-, {(iN., r-
, ,
~E.o' """w'j)owLING
o CtJ'~'..AiHT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
RtJ.'/dr +-ffp""""".v
a,.0 c"', ..../c." I-(~
*RKSATISFACTORV, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
lnspector:d~_ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.-on
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
I Z. "l<i~
I;:<J'
ADDRESS 111;(19
t]aq<;. ~ IJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-li),~<;
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
D FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
llIt'f>LUMBING FINAL
~D MECH FINAL
D EXIGRADlFILLING
D COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
D GASLINE AIR TST
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COMMENTS:
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2. _ c.....u c,1- 'M Tll V l/d7-'f'B<t7Z.
-.- .." . -:;2 jI ('I 1r.t! =( ,= ~
GI:-,-(1.fC.l,.~ CI~.~"/v1
o WORK SATISFACTORY. PROCEED
~ CORRECT ACTION AND PROCEED
V'i::r-GORR~' CALL FOR REINSPECTION BEFORE COVERING
Inspector Owner/Contr:
CAL 9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.--v
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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