HomeMy WebLinkAboutBuilding Permit 00-0987
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvoe or orint and si,gn at bottom)
ADDRESS
3.Js? (;' /yN b.hl7tr
While File
Pink City
Yellow Applicant
Date Rec' d
. /I ' 3- OD
...."'..~
~~'P
71'4 J')
ONING (otTIccuse)
Je2:;.o
LEGAL DESCRIPTION (office use only)
LOT 9 BLOCK Y ADDITION
hi!"N l.Ja1f~
/
/<'~
d
PID ;;Z:F- Jtt>5- OY/-a
OWNER
(Name)
(Phone)
(Address)
BUILDER,. .
(Name) Wt'NS'A/\aNN
(Address)j8'15 /'I/KZP-
;LJ UP e.5
d r ,'1/('
SIAl/I'
CJ.oo
(Phone) 65/ - ~Ub - .yYo 0
C'qN'/V IJ1N .,SU;L
rJ I
ORe-Roofing OR~-Siding
,
,
TYPE OF WORK
--
fj1\J ew Construction
ODeck
OPorch
OLower Level Finish
o Fireplace
OAddition
OAlteration
OUtility Connection
o Misc.
PROJECT COST /V ALUE (excluding land) $
I hereby certify that J 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
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter up~he prope;1:to p orm ne d inspections.
X /1 ~ /-'/ S-Y //-3- 0 ()
/ Signature Contractor's License No. Date
..,... L.-... I!>"S", oC::OO .cO
Park Support Fee
Permit Fee $ 1.1L.';;)..~S-
Plan Check Fee $ '7s.s At.
State Surcharge $ ~'7. 50
Penalty $
Plumbing Permit Fee $ JOO.Orl
Mechanical Permit Fee $ Lon. CO
Sewer & Water Permit Fee $ 3'<\ ~
Gas Fireplace Permit Fee $ t:(o . 00
#
$ 850.~
$ I.Lt:)o.~d
$ 1Z.5~ 00
$ t/t; . 00
$ I /:Jon I"'(L
$ I)nc.lrJ
$ I._L)OO~
$ .
SAC
#
Water Meter
Size 5/8";
1'"
,
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
$ Z 'lq;')7 /
I ~~c~~t, ?GJ
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and ma~ proceed as requested. This document
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
issued.
Bepes YOu:. Building Permit When Approved
1(- rs ,2Poo
TOTAL DUE
Date
I Paid 7. 7"1() . 7 /
I Date '//- ? /-:.-4--?.l
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
..
Job Address S6)ija~
Heating Contractor?;~ kr--
- .. ~-
Name oITester ~. (. ..
Date (0-2-01
Percent 0, 7
Percent co <:9
Stack Temp. 16~
Percent co. 'Z3'
.
t-o. (f187
Tlt~ C.nlp. or 110. L.k. Counlry
White - Building
Canary - Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~v 6/VS /1/7 f1 tJ rJ
1/. _-=3 .()()
, . -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33Sq h/_V/\/WA /61<.:. 772/}/G
I i
Accepted
/
Accepted With Corrections
Denied
Reviewed By: L L L
Date: /1- /.3 ---00
Comments:
5~e~~l3?'>6 5/0E fV/Z IlmJ1/0Jt//k- C;/7J/77G'1/S
"
A-tm-r!l/7Jn)~: /) GRJ7P/.1A'? PulA} Z.\ECI2slo~ Co/Ji7Zf)L J.AJfD/'mf1nfJAJ
3) Em~/f)1) COIi/TROt.. fit7/lJ
"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."
~~
(j () ,OQ?;1
Th"C..nl..rof Ih.. LabCounlr}
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t. V 6- jV::; ;VI rl tJ IV
/ I. .~ . ()()
. ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-? ;;;> r-q
~ ---' --"
I
hi y/\/ tv/iTEK-
77c~/71 L--
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
CA t(j,p~~."
'" '
Date:
LL/~ 31 &t'J
Comments:
--4ft4t~ ~}C-.L~Ci2 \fhe ~IL~80( r9~
~ C-.U,~, ~ \kJ(~ ~ ('UAJf/lIAhTev-
~ ~~~p
Pr~ St;y-LJ&J./'P ~- ~tJ.~j.)~ ~U r3e
1A9~ tAJt~. IA- ~~~( ~
~ ~~_ ~tJl'YtOWI.P--vN L."
fi) ~\ ~~ ~~~l~~ ~~~,
'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
C6.D181
Th~ C..nll'r of thO' L.k.. Country
White - Building
Canary - Engineering
Pink - Planning
aUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSI
NAME OF APPLICANT
APPLICATION RECEIVED
W6/'/S 1-1/1 j\/ N
/1-.3.()Q
. ,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
3351 61_Y/\IWA / t/IC..
lImIt..-
Accepted
Accepted With Corrections .:>('
Denied
~
Date: //- /3- Q~C)
Reviewed By:
rz:;s:a.(( a~ti ~~ --
"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."
ro~ I>R@.
~
~ ~ .HEATING APPUCATION' P.ERMIT ..
~ Date 12h D\{<[) PIOI 2.&'i-.3f6-n4(-O
Sle Add/lw ?p-m (' ~ U..IQ uMl' JIL ~n...L-
en U
::: 10I Block Addllon l'5- 3105 - 04(- 0
. -
2 Owne(.Name \~: ~~~,.
Address I~QC UUA- ~ t=ef.::i>'-~
Heeling Conlr8CI0r & XYL - - {J J.,lc'\ JI""\
Address1Y:lUh ~ (J esr.J-t;-r 17) J _ f rr-q ~lnr
Te!lp/lone' lQ C\ - - W 1. ?-:, - II W 4
FurnlOll Make U40del I .I ~ Yo. TYPE OF SYSTEIt',
\ W.m~P~ ~
Model Size ~~, u-I ~. GravtIy.
.. . .. MecI1enlcel
Alr Candklonlnl _'I 3 -ro ('J
VenL SVIlem
IlEATlHG OR POWER PLANT
Sleam .
Hot Waler
Rldlallon
Spedal Device.
CITY OF PRIOR LAKE
. 16200 Eagle Creek Av. S.E. Permh No.
Prior Lake. UN 55372
nr) -oQ61
TYPE OF STAUCTl!BE
1.1'1"
:l.ar.
1. yel....
~1'IIo
a.,
Com: Load
~ Fu~l_tJ 1'l'fGt" Flue Size
~ SIIpp/J Openllllll I C1
~ Rllum Openings p..,
\D
a; lnpul/CD1ffiJl) Oll1pIJl q /rtsm)
>- -
tt: Edr.
N
z
~ crm.
OIherDevte., \lu\~ 2. D All WORK MUST BE INSPECTED (ROUGH-lN AND FINAL). CALL CITY HALL
('rrry..rnJ.Jr rn 44p ~Jii'hn~
'i
TYPE OF WORK
E
Ih Alllellons
m
OJ Repair
RejlIac8ment
EsL Camp. Dale
IS) Est.~'
IS)
re HEATING PEAMlTFEEJ
\D
STATE SURCHARGE ,
U .
~ TOTAL PERMIT FEES $
New ConS\lUCtion
. BulldllllJ Permh .
nn -OQ01
.50
PAID WITH
R.CO'PIII_BU\l.DIN~ PERMI"t
SIngle Family
Commercial
V
'\
Public:
MLlti-Fam~v
Olil"
TWG-Famllr
Induslrial
Fee Schedule
t % of Job cosl ('39.50 minimum)
'!Ill-50
$84,50.
$39.50
$39.50
'39.50
Industrial, ComllllllclaJ & Mulli-FlmIIV
R..ldentia~ HIIUng & AC
Residential: Healing Only.
ResldenUaI. G88 Fireplace
RllSldenllal. AdtlltlOllS & AHerallol\8
Rasidentlal, AC Onlr
~
Remember 10 edd lhe Stala Sun:harge on the bohom 01 IhIIeppllc:allon.
DEe -6 D)
_._ L/
The. pllee 01 yow healing perml! Includes OM IOIlgh-ln end one lInallnlpacllon.
Addlllonll (nspecllons will be IlIled al $35.00 ttat:h.
House Heatln. Tell Record mual be ,ubmlUed wllh I!IlIIlfn!lIlimlllIlllllllw befora buHd-
log cartiflcels 01 oa:upancy wlIl be /81ued.
IiEAI CALCULATIONS REOUIRED with flUI1Iber 01 supply and ilium openllllll bled per
fOom wUh CFM's per opening. New sl.ruc\urea or additions sllld IIoor plan wIIh supply
end relum locllons a'-n. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE ClTY OF PRIOR LAKE, 18200 EAGLE
CREEK AVE. S.E. PRIOR lAKE, MN 55372.
City Hall buIlne.. hOURI are 8 a.m. - 4:30 p.m.
447-4230
I herebv epplv lor a mechenlcal syslems permll end I acknowledgs Ihallhs
lntormlllon ebow la complele and sccurate: 'hallhe work win ba In con/ormance
with Ihe ardlnancl' and codaa 01 the 'clIV and w1lh Ihe ilal. bulldlnglmechenlcal
codas; lhallhls lorm doe.. nOI become a permit untilelgned by Ihe BUILDING
OFFIC/Ai' slthe work will be In accordance wilh the epproved plan In I.he .
cae101 rk whlc requires review snd approval 01 plans. J
!Jl /1) , J7 /fD
. rAp a1l11e Dal
\..... 1"2.-[3-00
Oalo
14:22 651 633 8884
FIRESIDE CORNER
CITY OF PRIOR LAlCE
HEATING/AIR CONDITJONINGIFIREPLACE PERMIT
#6543 P.004/005
Date Kec'd
~. ~ ~:~ I PERMIT NO. p -Cj'r '7 I
J.Y~II_ .4pp1i.-1. {/ ,-
(Please .;vu~ or orint &ad sillJ1 at botIDm)
ADDRESS
's.;1Sr
0~... w(~:h,
7;;,
LEGAL DESCRIPTION (011I.. ..". QIllyJ
T.OT '1 BL.OCK Jj ADDITION f?Iri I~' c?;vJ
OwmR /.\ V
(Name) W/h.Jblr;,,,,
. (Phone)
ZONING (offi<.",,)
R;:), SD
PID,+ ') --:), &5 -vL/f-~)
(Acld.ress)
APPUCANT
(Name) ALLIED FlRES!DE: DB~ FIRESIDE ,-"""",,,,R
. (Phone) 651-633-2561
3QSEVTU.E MN
(Ci\y)
(Phone) 651-633-2561
i:;l;1'"
(Zip Cod<)
(Address) 2700 N. ""IRV:1;EW AVENTJ'"
(Addles')
BRENDA llI1STON
(Contact Person) . . ~ 1
APPLICANT SIGNATURE ~_i-L.=-
._- ,
_... --
__. DATE
7/>/rJ,
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACEMENT 0 AUERA TIONS
FURNACE MAKE AND MODEL FUEl.
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OW"", AI, PlodS 0 Sleam
OGmvily 0 Hot Wat#r
J M.chanical 0 Rodla'ion
::lAi, Condilioning 0 Sp..ial Device._
JVent. Sys<orn . J 0 Othe, nevic..,
FIREPLACE MAKE AND MODEL 1:J:d;J (;t... ..~m-
Industrial. CommCl"clal & Muld-Family
FEE SCHEDULE
I % of Job cost Residential. Ga. Firepl""e
$39,'0 mlnim"m
$99.'0 R.esidential, Addl~Qtl. & AI.lOralions
$64.'0 Resldendal, AC Only
R.esidondal, Heating & Ale (New ConsttuOllon)
Resid.nllal, Ho:atlDg Only (New ConstNclion)
Eotlm_led Coot $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
(om.. Vie Only)
This Appll..,liDn DOC(llllc, Vour Building per",lt When Approved
I P.i.d
I Dale 7-:J -() I
Blllld'.. OllId.1
DAle
Z4 h....r notice for ollln.pecli.n. (9SZ) 447.9850, fD. (95Z) 447-4245
PLEASE NOTE:
Air Conditioner Units
ClIIIlIol Encroach into
Required Side Y.rd
Setbacks
539.50
$39.50
$39.50
SU/l.;1/.D '~"
I Receipt No.
I By
sc-
Appfieant: ,....,p YYZ-- (), _ifi Y"'\
A~dress: I'!rYC::- ~ ~[,.yPr: -rIP-'
Slgnat1Jre: __ -" ~, _.....-l
Lagal Description: Lot ~ I':llock "lut.-
Site Address:, .~-:L.J;::A. e:JU""" Wp,.r-, 19_ -rdU _
Building Permit # f\OIJ ql{4:1J Plo It 25- 310 5 - 041 - 0
NOTE: This permit ~II not be prdce;sed withoUl complete information.
FIXTURE UNITS
DEC. 6.2000 2:33PM
GENZ RYAN 6513226147
r
CITY OF PRI:OR LAKE
. PLUMBING PERM"
,
. .
Quantity Type of Fbcture '1 Quantity
I Bath Tub with or without shower I
I Dishwasher I I
I Floor Drain I (2j(
U Lavatory (bathroom sink) I )
I Laundry Tray (1 or 2 compartment sink) I
"2- Shower Stall I
I Sinks .1
! Bar Sink .1
?-) Water Closet (toilet) . .1
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family $99.50
Residential, Additions & Alterations 539.50
State Surcharge
GflAND TOTAL
NO. 119
P.3/12
1.11ao
2. Gold
:J. v....
R10
Clty
^-
# JJ() -OQ87
Phone: LP~I -t/-'Z~'-111.f4
'l~ V'Y"%)f.l C!: ~~^'.o~
Type of FIXture
J
Rough-ins
Water Heater
Water Sottner
Stand Pipe (washing machine)
I
I
Bacldlaw Assembly (RPl, Dcluble'Checl:, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
Sewage Ejector
This permit is granted upon the ..pft$1 condition lil.ll said
eonUllelOr. .11aII comply in illl ....pee.. with lile orclilli1ll.,..
of the Stare P1umbilll.e amc:nclments Iller..f.
-_ RE . 1'2..-8'00 'lATE
J/L. - A T'T'EST
Call for all illSP!ctions 24 hours .in advance.
16200 Eagle CreekAv. S,E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponllnity Employer
.. ~.
$
$
$
'.50
\0 WITH
PA "'G PERMn
BU\\.Db.. ,
$'-
$
r
}
I
. '.
.. ( .
\
,
, 'I
. L.
DEC - 6 2000
NOV. 21. 2000 8:21AM
GENZ RYAN 6513226147
NO.613
P.3/3
..... . ....
....... . ...... IOLIIT
'aat.II-Cl'TIf
CITY OF PRIOR.LAXE
SEWER AND WATER PERMIT
NOTE:
NO.OQ-07'g?
Sewer and Water
contractors m~st
be registered
with the city.
APPLICANT:/::l.....V\:; - "l.J' J"'l Pll.l.......'ol~ Y:Q.t:/Alt'_ PHONE:~I-LL2..!.-/ rl.\.U
ADDRESS: r4,1JE>::b /b.,pJiZ:r ""1"",-, (b,Si'~,"'r '5"~CIolil_DATE:
SIGNATURE: BLDG. PERMIT ji
PIDji J,:!J - 3 ~5- 0 L/ ( -0
SITE ADDRESS:
-
1.
Estimated length,of water service
,"
Size of water service inch(es).
C-ftj"u '\AOfL 7;'
FILL IN THE BLANKS
. ,.
40
fee.t.
,
2.
-:;
._~'
3. Location .of any co~plings from s~ructure
4. Type of sewer pipe. ABS pVC X Cast Iron
5.~ Estimated length of sewer line~' feet.
6. Clean cut (if .required), located at . reet
.: str~ct~re.
feet.
-
from
L ~ ..
~--~---:.-._=========--~_.:--__;;;;::===z======~_~~~_-==____ _.__
.
.--==:=;;
This application becomes yo~r permit wnen approved,
BY
D~TE:
===;;::;O;:;:;;=::=.=--===-=-'IlOlO;;;;;;:---:...-.-----....;;:;___=====::;a;__,_
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connectio~p~rmit.
Surcharge
TOTAL
· Fee for either seWer or water individual~y is $20.00 plus
$ :50 surcharge.
RECEIPT ji
I
Sewer and water ~ermits iss~ed for new construdticn m~st be
recorded on the b~ilding permit card at the time of' issuance
to insure that no duplicate sewer and 'water permits are
iss~ed. PAID VVii!,
DATE PAID 11- ;)-I-OD AMOUNT PAID ,BUiLDING PERCVllf
REC'D BY if-
.
. 4629 DBkclil St S.E_, Prier Lake, Mirme$OliI 5537i I Ph. (612) 4474230 I Fax (612) 4474245
AN EQUAL OPPORTUNITY I!MPI.!lYER .
PRIOR LA~
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .' <..-5>'7 C("'I"W~' II-.
NATURE OF WORK -}. )... '-- ) 0
USE OF BUILDING ~',~ ~ t='A-
'"
PERMIT NO. /}()-(Jtlf37 DATE ISSUED /(-I.?-?,..,....,.."
CONTRACTOR L.J~ '_ ./-/0........... {,C;I-'10(,- S/'(/DO
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING ,( ~ 9 t1'O
. .
, FOUNDATION (Prior to Backfill) I:&:J /- f,?}oo I ~!tKJ
PLACE NO CONCRETE UNTIL ABOV'E HAS BEEN SIGrlSED
ROUGH - INS
SEWER I WATER I SEPTIC I
FRAMING I ~
INSULATION I b 11M
ELECTRICAL I ~ ~\ .
PLUMBING I
HEATING (if required) .LAt J I ~~~ '7 ~1
FIREPLACE' L!.-- "1\""",\f:.\J. I ~ ~.?-'-" 1':li~O(
GAS LINE AIR TEST .1 ~ J\l ~ 1 )""4 ~q
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS '~
: ~ ;~ .VOWI
I I
I ef;> ... ~().M,lI I.
I ~jj~ D
OCCUpy UNTIL ABOVE HAS B~EN SIG
NOTICE
\
"'1~
"'J~~/I)l
"tJ41cl \
"
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~~1JDl
IOJD2tt or
~ Ii
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 ~h~1I be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
DATE TIME
SCHEDULED /0 tfi- ( :5: 3:::J
3 359 4-,~
CONTR. J :J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
tJ -9%'1
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
^' 0 INSULATION ~SEWERHOOKUP
n tlirFINAL JJ'J'LUMBING FINAL
o lllTE INSPECTION . MECH FINAL
COMMENTS: w\QMOw\t"'Je..r O~
1.s..<:.uF +P4' L,O. rhAt-~1
-IT1"e& ~ ~a:L fer cbelof~~ +
f.3 )OI)O.;t
. ~
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOSCALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ / Owner/Contr:
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE..
11'1SNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 3:3 5 q
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED 1~)I,:;:1ol
()-) U vl /..()ll+e.or Ii,
I
CONTR.
TIME
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
I S.SU P (,0
rJns.,o .Llp
.Il(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:'1; .0 fl.Lk1 Owner/Contr: ...
CALL 447-9850 FdR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH ~ SAFETY/
"""""
12-7-cJ(
33Sr (;{VIJWuWTrt
.
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
6rruie... ~ J:...
f..J' In 131?~- /JY
DATE TIME
LAI(ASIl1~n" .
lJn~
~X1GRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto~(" - -
. owner/eonlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI