HomeMy WebLinkAboutBuilding Permit 00-1059
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CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.
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
/?,..:?6Y ~..::-r'>=-'~<J ~/"'~ ~
3. LEGAL DESCRIPTION
1. DATE
/~/p-O
tel
BUILDIN FORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
12. NO. OF STORIES
LOT
ef
BLOCK
~
PID 2Z::; -372. - (').z:;{)-o
ADDITION
14. OWNER (Name) (Address)
15. ARCHITECT (Name) (Address)
6. BUILDER (Name) (Address)
,<?~. ><C"f>'t::YV;~. ";-~6~ .....''S'S..$'ll..,i............
.-=-~ .....n/V' ~M
..::l~,III(~~
..:z "".a
13. TYPE OF CONSTRUCTION
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
(Tel. No.)
Deck 0
Finish Attic 0
(Tel. No.)
~_ ~~o-/
"'~-..;?~-?'/~
Ae-roofing 0 Porch [j
Re-siding 0 Finish Basement 0
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
7. TYPE OF WORK
New Construction rJC
Chimney CJ Misc.
la< PROPERlY AREA OR ACRES 19. PROPERTY DIMENSIONS 1100 CULVERT SIZE
Sq. Ft. Width Depth Yas 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 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 upon the property to pertonn n~edrl?~ions.
X a-..~ ~ --?__57&~ /",/2;/tH:/
, Signature License No. "'Date
Fireplace 0
Alterations CI
Septic 0
Addition 0
SEATS
16. PROJECT COSTNA..blJE
9't?) rt?'5
17. COMPLETION DATE
FOR ADMINISTRATIVE USE
SE1lIACKS: Required
Actual
Front
Baok
Side
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGY DATA 0
PILING LOGS 0 PERCOLATION TESTS a
BUILDING DEPARTMENT VALUATION
USE OF BUILDING
sFA-
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PLANS & SPECS 0
SURVEY 0
SETS
COPIES
PERMIT VALUATION
11.OXJ.o<l'
PLOT PLAN
o
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R
Division 1 2 :3 4
Permit Fee ................................... $
S U
City:
Amount Brought Forward ...................cr,
Park Support Fee ............................t 85O.ot1.
SAC ......................................... $----1.: I (}().OO
Collective Street Fee ....................... $
Sewer Tap ...................................!I:
.
Pressure Reducer ...%.................. $:
Meter Horn ... .... .... ................. ....... ~
4r:: 00
Plan Check Fee .... ......................... $
State Surcharge ............................. $
Penalty ................................... .... $
ml.oo
540.1<:;"
II C; .'.;-0
Plumbing Permit Fee ....................... $
Water Meter ......................_._........ $ l 'J. 5". Qa
Sewer & Water Connection Fee ........... $~ tjO . ~
Water Tower Fee ........................... $ tJ 6C) .on
Water Tap ...................................4:
Builder's Deposit ............................!I: l. 5' 0(") .oJ-
Other ......................................... $
Paid T7~ii~..;~...~~~~I;;.. ;i3~~' F
Date n, tE' -' cfl} By 'il'trL...
request In the above application and accompanying documents IS In accordance With the City Zoning Ordinance and may proceed ~~:ested ThIS document when
nar consmrn: a temporary Certl~te J!;Zom~g compliance JIIld allows c~ru:A c~rn...mf(nce. BE'JO. r" oc~u. . ancy, a Certificate of Occupancy must be ISSUed.
.~._~. 1~'{,",/igQ ~ ~{:_
Cny Planner Dlt~ -. Sp8clal'"Clfrid~lons any U
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Issued
24 hour notice for all inspections 447-9850
JAN. 29.2001 12:31PM
GENZ RYAN 6513226147
NO. 037
P.6/13
-.1'&1I
nLUlW . AHUC&II"r
tIOlJ) .. c;n"
CITY OF PRIOR LAlCE NO. ()D ~ (Q54
SEWER AND WATER PERMIT J
NOTE: . Sewer and Water
contractors ~ust
be reqistered
with the City.
APPLICAN'l': c..,JI"l~- '?Lf nPI"'n:'nl~_ li(]lrIJ1"~ PHONE:),,51-L.j.2."'!.-IIL.l-ll
ADDRESS: ILl"11./6t'_ I2r-A1i2:f" -r~, I&!.e"""".nr ~Olt.liI_DATE: 112'1/",
SIGNATURE: Il 'k:.' JI-\l ( )./'- . BLDG. PERMIT * On .( 057
SITE ADDRESS: 1"'7'F-,~""r.Q...Ol"'o. l 1:--_') PID#
FILL IN THE BLANKS
40'
1.
Estimated lenqth of water service
,"
Size of water service inch(es).
feet.
2 .
3. Location of any couplings fro~ s~ructure
4. Type of sawer pipe. ABS PVC X Cast Iron
J
5. Estimated lenqth of sewer line~ feet.
6. Clean out (if required). lOCated at feet from
structure.
:-::::::=1;tE:~:-':;:::,~p~r~~; tf/~~
. .
====____=~======~=~---==--r-=--=~===----=========----====~===
feet.
FEES:
$
$
$
3$.00
.50
35.50
Sewer and water line connection permit.
Surcharqe
TOTAL
* Fee for either sewer or water individually is ~20.00 plus
S .50 surcharqe.
*
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
RECEIPT #
AMOUNT PAID
REC'D BY
.- \N.\\~.~\1
f'P"- G T'~' .\ ~
e1J~D\~
- 4629 Dakota St S.E., Prior Lake, Minnesota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
I\N EQUAL OPPORTUNiTY EMl'lDVER
FIRESIDE CORNER
#5403 P.003/008
Date Rec:'d
I, PInk
.......
~, .,..,lo;N
~.." I .: J!.......~dT NO.O-/CGY
ZONING (offia: ."'1
/<(
(Pk...., ~ 01; orint ond ,i....t botlDm)
ADDRESS
/1.Jn J{)-,-,#.d ~
I.EOAT. DESCRIPTION (om"" _ only)
tOT ;; BLOCK .J--. ADDmON~~ d rv:t
u
PIDd>- 3 7'd-- ()5{;-D
OWNER
(Name)
fb #. '1./oJ;;;;..
(Phon.e)
(Address)
APPLICANT
(Name' M.LIED FIRESIDE DBA FIRESIDE CORNER
(Phone) 651-633-2561
(Address) 2700 N _ FAIRVIEW AVElilI''''
(A~r"'.)
BRENDA HUSTON
(Contacr Person) d..
APPLICANT SIGNATURE ~
J
p..:;-:-
~'lSEY.:IL..T _1:1,. ..",.,
(city)
651-633-2561
':-1:"::
(Zip Cod.)
(Pbone)
DATE
APPI..ICANT P'_EASE COMPLETE BELOW
~EW CONSTRUCTION 0 REPLACEMENT 0 At TERA 'nONS
FlJRNACE MAKE AND MODEL fUEL
FLUE SIZE RETIlRN OPENINGS INPUT OUTPUT
l"iPE OF SYSTEM REA TINO OR POWER PLANT
OWorm Air Plants 0 St.am
OOmvit)' 0 Hot Wore,
o Mc:<:hllllielll 0 Radl~on
OAI, Condilionina 0 Specl.l O....ic..
OVon~ System 0 Other Dovie...
PLEASE NOTE;
Air Condi.tioner Unirs
ClIlII1at EncrQaeh into
Reql1i~. Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
1:J.Pd /J ~(J
.$1..- 7..n>ne.,.
Jnd~SU"il1l. Commeroial & Multi-Family
FEE SCJWUl.E
1% of job ..,st R.esidentlal, OIlS Firepl...
$39.50 minimllln
599.$0 ll.e,jdondlll, Additions" Alu:rotlons
$64.50 Resldonlilli, AC Only
$39.50
Resldenllnl. Heating & Ale (Now Cooslnlollon)
R..,ldentlsJ. awing Only (New Construction)
539.50
539.50
Es1imated Cast $
Building Pennit #.
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
S
$
$
.50
13Ul1 ~AID l1',">-
. '-IJING p 'N
€r. "
1111'1;'
10m,. 11.. Only)
Tbls Appli...rJon Becomes Your BuUdlnl: Permit Wh." Approved
D.re
I Paid ~
I Date6 -7-01
I Recebt N<!.--
a.lldl"" omet.1
IBY~
24 h... MIl.. fG' Rllln.peell.G. (952) 4~7"'.l850, rn. (952) 447-4245
-~_..~~--~~-----
JAN. 9.2001 12: 39PM
GENZ RYAN 6513226147
,~O.225~,19
TIr ~IW -! .'II,\"t.u Cd...,,,
CITY OF PRIOR LAKE
. PLUMBING PERMIT
Applicant: ~ \(17.- f4:LLJ n '
Add....: ~~ r~- ta:Jra,f'"" -no J _
SlgnatunI: '~"
l.eg.1 Description: uf :~ ~ Block :z.. 'SuI- . "rved1, ,h) 2r"\D
SiteAddnllS:~'2...e:,1 ~t?.Ae..On """j"), se.. '
Suilding Permit #. , PIO It
NOTE: This permit ~II not be processed without complete information.
FIXTURE UNITS .
Ille
a".
""-
#_m-{f)5q
Ph~n.: LPql - t...f2"?:J-'uY.t+
"""r..~ ~ IYJ r- ,~7:lID~
1.-
:L ClaItI
3.VeUow
- ,
QLl8.ntlly Type of Fixtunl Quantity Type of Fixture
\ 8a1h Tub with ar wlthaut ehower Raugh-ins
\ Oiahwasher 1 W.ter.Heater
{ Flaor Orain ,. t'L II Water Saltner,
~ ., Lavatary (bathroom sink) I Stand Pipe (washin~ machine)
\; Laundry Tray (1 or 2 compartment sink) .' " Sewage Ejector .
\ ,Shower Stall Blckftow Assembly (RPl, Double Chsck, PVB)
I 'Slnkl Baclcflaw Assembly Test
,....-~~ Bar Sink Lawn :Sprinkler
-" 2- Water Closet (toilet) Other
I,"
. ..
..
FEE SCHEDULE ..
. Industrial, Commercial & Multi-Family.
(1% of job cost, $39.50 minimum) , $
-,
Resl4entiaJ. New One & Twa Family $99,50 S
R.sldential, Addltians & Allerations $39.50 $ . .
.
Slate Surcharge $ .50
; r 1'1\10 Wll1-1 MIl
~RAND Tc)T AL $ . ~G pE.R \
~\ \\\.0\. .
i
; .~':""':",
.
'Thi. penni.1s ......tod uporr ,h. ""p..... oo~ditian that Aid ;
can!rootar, .Iion comply in 'all r..pec1l with the ordinaJIC"
of tho State p.lumb'JIfE" tho Im...~.nta th.....r,
---- ; 6. { -' 7-' 0 ( DA.'Itl
/. . A.TT'5ST
Call for all in~ectians 24 houn in advance.
1l$200 Eagle Creek Av. S.E" Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Op""rtunity Employor .
~
. <
.,...../
CITY OF PRIOR LAKE Me
16200 Eagle Creek Av_ S.E. Permit No. 00- I05Q
Prior Lake, MN 5,5372 I
HEAnNG APPLICATION / PERMIT
Date 2-\ lCi\ b I PIDII..2,5-372- 050-0
SiteAddress '117~\ '\)eQjr-neJd 'Ur S-E.
Lot '5 Block 1_ Addftion
Owner's NameD jZ. H-D r +t~'l
Address ~4-5q \'\f a5~,hiYlO\imD r '=*7J)~ ~C1IL c:f5 J z.:l.
Heating Contractor r-+ t l', L.wf- MLc.NvrucU J
Address 3iJ5D J(Ul nWec..'~ ~ PitLf\ (l/V\J 55i2~
Telepllond I L61 4'71-- 1.17'5 J
Furnace Make & Model 8.r0t.t-nf TYPE OF SYSTEM
."'70'2. i/ n Vb'" '4 Warm Air Piants
Model Size ~ T-...n L tJ 7/) Gravity
Conn. Load '2-1 , 3~q Mechani~1 : '
, L ' i1llel . Air Ccnditlonmg 'l...-:Uln ~J--
Fuel tJu.;r Flue Size:::r Ds'iB Vent. System '2-- &) D CFM.. lii-h
Q ~$
Supply Openings D, HEATING OR POWEll PLANT
Jl 5mam
Return Openings ., Hot Water
'7~ 1\1\ D' c: Radialion
Inpu! ...J4..!~P ~ Output:; ( R. IT['D Special Devices
Edr.
elm.
~l5b
Other Devices
TYPE OF WORK
Aaeralions
..---
Replacement
New Construction
Repair Est Comp. Date
Est. Cost $ 30cC ' (51) Building Penna fi
HEATING PERMIT FEE $
Do -(05Q
/
PAID W\iH
eU\\.D\NG PERMIT
,
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
Rece ipl 1#
TYPE OF STRUCTURE
1. Piltk
2. Oreal
J. Yella..
,
.
File
Cry
Contmr:tDr
Single Family
Commercial
,
.
.
.
Multi-FamUy
~
Two.Family
Incfustrial
Pub6c
Other
.
<
"
Fee Schedule
.
.
Industrial. Co... ..~....al & Multi-Family
Residential. Healing & AC
Resilfential. Heating Only
Residential. Gas Fireplace
Residential. Additions & Alterations
Residential, AC Only
.
<
1%.01 job cost (S39.50 minirTUm)
$99.50 PLEASE NOTE: ~
~
$64.50 Air Conditioner Units CaruK <
139.50 Encroach Into Required SidE:
$39.5C Yard Setbacks. ~
$39.5C ~
.
~
Remember to add the State Surcharge on !he bottom of this application.
The pri"e of your heating permit inclulfes one rough-in and one final inspeetion.
Additional inspections will be biUed al $35.00 each.
House Healing Test RecoJd must be submitted with bW!lDog I1m!I!iI ~ before build-
ing certificale of occupancy wili be issued.
l:lfM CALCULATIONS REQUIRED with number of supply and return openings listed per
rOOm with CFM's per opening. New structures or addilions send floor plan with suppiy
and return locations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hali business hours are S a.m," 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
447-9850
I hereby appiy for a mechanical systems permit and I acknowledge that lhe
information above is complete and accurate; thatlhe work will be in conlormance
with the ordinances and codes 01 the city and with lhe slate buildingfmechanical
cDdes; thaI this form does not become a permit until signed by lhe BUILDING
OFFICIAL; that the work wili be in accordance with the approved plan in the
case of all WorK which requires review and approval ot plans.
C~~ '?'R1~1Ur~ (It~ z.1J3..Jm
I Date
l-Z,I.Of
Date
~
~
~
k
c:
.,
...
"
~
c:
"
r-
..
"
"
IE;
<:
<:
'"
PL. F~ 447- 4248"
Th., C.,nl.,r of Ihr Lak., Counl!')
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. Ie!.. j-f0I2TV1J
1/. /3.()O
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Accepted
Denied
/;7Z5/
V
L)f:-.. LK-;:::-I t:.- L1:;. D 12... .
Accepted With Corrections .
Reviewed By:
J..LJ....
Date:
/1- 22 -OD
Comments: . ~Er;:: R~ ..slOE: Fo,e AOOII1f)J..JJ:h... Cnmm~.
/..;A '7t-ufftM mll'>c.be. rrdi;w...o1 hke. f~1JY>~ I~ ('f)/J/Jed-ed.
"
iEE /IT/1k&lJ~~ I) GfYlOI/!/6!i;:JAJ 2)ERo~/JIJ/ L&~l.$g;,9/,e~
3) .E~0.nRf)L. /b:;/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."
~.
Tht (:..ntn of Ih.. L.k.. Counlry
White - Building
Canary - Engineering
Pink - Planning
"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I . 1'-
,
I--li I ) --/'---;r 1'\./
I \.,. I'- '--...-
/ j.
I~'(()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/72..:-:: j
I
, <'~u ,.. /:- f
__ I '----- \.~.
( --'
,
jj I-.: .
Accepted
/
Accepted With Corrections
Denied
Reviewed By: ~L~
Date:
/Z-/6/6(9
Comments:
No (-J(JY)~ &-t-11v ~U2\t.-Ve-l kcJLA"w,
^~~k<. l ~lAtJJ ~MYtJ~~ (''7V-e./ ~
PfM ~~~n
_ ~?~e~r-'~ ~ ~~Itv1~ {)t
Al)~'lSf (~ ~~ ~ ~eJJ
&.,L,..b~~ t..
"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 Crnlfr of Ihr L.kr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. ;;2 - Hoe I uN
//- /3.t)O
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/72.5 J
I
DEEK!..R 5 LD D 12.. .
Accepted
Accepted With Corrections
Denied --r,;:J /7
Reviewed By:C~J/~ "7---
Comments: I
j2....A.l QII a\tCtc~ A.- -$0 D">.~
.
Date: -LI- '2~ .2p-e>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 01" 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."
PRIOR LAKE PEPARTMENTOF
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 1'7~"/ ~.,...,rndr~ :[\-.
NATURE OF WORK t..lo..1
USE OF BUILDING ~S~
PERMIT NO. . DATE ISSUED 11-20-"2000
CONTRACTOR 'L.L^ uSI-":l5('~ 7/1(-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I { _ INSPECTOR DATE
I FOOTING fT-t1 II } ~I J e I
I FOUNDATION (Prior to Backfill) ~ I fj,. .)/1 1/t> I I t:n _ ~/P&~/d r
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC L!
FRAMING /I:1tf7
INSULATION ~ ~.)A1
ELECTRICAL (
PLUMBING V-fk ~/<l/Ol /?/.-r ~. MII/OI
HEATING (if ret(uired) ILa, 6/lo/Q( P6 ~_ r..1 (i /01
FIREPLACE' . U".. t::7~ ,. (pl/ 1/t:!71
GAS LINE AIR TEST ~~,f~. ~. (.({i/o/ '
.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
l~ I I
FINALS
?J'/f _
t2tr. fjf It.f {b ,- if;;.,
GRADING (Prior to Sodding)
BUILDING 1. t.CI, ~ 4f.! 1'51 () I
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS
NOTICE
4~
0/(11IB)'
Co .91 DI
, ,
16 . !. , J
/Ob311f7
f
?~/.:r I
'i'11l//ol
.
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspectionshav~ 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:d"0 A,M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
=-<'"==""""""~''''''''''''''''~='''_'''''''_='=_'''''''_'''"~_"""""",,,,,''''''''''''''''''''C.
DATE TIME
/tJP3!d, A ,I'
/'7;)5/; 5:~ ,s-, 57 ~V lH,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO. th:,/ll<:;? t.(J.l.f.62,
r ' ,
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
COMMENTS:
o EX/GRAD/FILliNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLiNE AIR TST
o
~
f
('/I WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
:S::~:ECT ~~LL FOR REINS~:::::::FORE COVERING
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNorl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS / '19:~ ,"l "? S-5 ,~ 7
/ /
OWNER
CONTR.
DATE
TIME
I.
~~
,A.T
PHONE NO.
PERMIT NO. ~/O 59, /"f}, h~ ~z-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
COMMENTS: S6"Q
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
p. 1;:, L
(J) ~ ~~7j'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
14 CORRECT WORK,YLL FOR REINSPECTION BEFORE COVERING
Inspector: (:J;;r / Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE TIME
CITY OF PRIOR LAKE
INSPEOTION NOTICE SCHEDULED ~ A /r,
ADDRESS / )1c;1- 51 J)e-er(',~d j}~
OWNER CONTR. D R 1-/(J4()f";
PHONE NO. PERMIT NO. ~ - /Oc<;" J
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
I"l"FINAL
/0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/:!" EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/7;;'S-1 Culh R/J"A-ol<
17)$3 Cur to BL'H- - 01:::.
/l ;'$'5 Lu~1o &-,_ iY t:..
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X WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector$~~
uwner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
OA TE TIME
CITY OF PRIOR LAKE I
INSPECTION NOTICE SCHEDULED 7~-() ,?-;30
ADDRESS /'7.;< ll!JIJ-t:; I ~(!d2
OWNER CONTR.
~ c~ Fl"1
PHONE NO. PERMIT NO. n ~ t1:!.A a
- - ,
D FOOTING D PLUMBING RI D EX/GRAD/FILLING
D FOUNDATION D MECH RI D COMPLAINT
D FRAMING D WATER HOOKUP D FIREPLACE RI
D INSULATION a:"\\ D SEWER HOOKUP D FIREPLACE FINAL
D FINAL Kt9 ..a-PLUMBING FINAL D GASLlNE AIR TST
D SITE INSPECTION D MECH FINAL D
COMMENTS:(1) ~ fZc.:J ~
~~u~~ ~~
fU..tJ., -. ~
~~
~
~
D' WORK SATISFACTORY. PROCEED
)l() CORRECT ACTION AND PROCEED
(D' CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: n.- I Owner/Contr:
CALL 447-985~ ~dR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7;;l5/
OWNER
PHONE NO.
SCHEDULED
DATE
~
Dv,
TIME
A-T
~
V
CONTR.
PERMIT NO. CJ() - /05"'7
o FOOTING 0 PLUMBING RI
o FOUNDATION~ 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
)lI FINAL I:i) 0 PLUMBING FINAL
'0 SITE INSPECTION 11Y ,11{ MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:CU Q....~'~ ~ -"'tt-m--ZV' .0"
cP ~ f-fMJ ~ ,..lL;~.~
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,-- :,.~
~/IS/ D! )
o WORK SATISFACTORY. PROCEED
"- CORRECT ACTION AND PROCEED
b CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ