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Home My WebLink AboutBuilding Permit 00-1062 ~~ DATE RECE=IVFO 11-13.00 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 1. White 2. Pink 3. Yellow I DIRECTIONS SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom) 12. SITE ADDRESS /'7..:?6"7 1Oo':L:'~. ~~ ~/(/,g-~ 7. TYPE OF WORK New Construction e( Chimney 0 Misc. 8. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE Sq. Ft. Width Depth Yes No I hereby certify that I have furnished information on this application which is 10 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 aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building OffiCia' ;vo~~rmit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed i. ......"'............ .... X ~ ~~5lSS7 .,,//~/~ , Signature Ucense No. ,. Date 3. LEGAL DESCRIPTION ;- LOT BLOCK ADDITION 14. OWNER 15. ARCHITECT 6. BUILDER ~.A.o:'"..-.<;,-1I .E;e../1 (Name) (Name) (Name) to. At. ~~..,N'K': Fireplace LJ Alterations CI 1. DATE / / -..z - e::>-O BUILDlN FORMATION 11. SIZE OF STRUCTURE (Height) (Width) (Depth) t:2/ 12. NO. OF STORIES ~ PID zs -37;>, -OS~.::O ,.,?:!::5!. 13. TYPE OF CONSTRUCTION (Address) (Tel. No.) 14. FLOOR AREA APPORTIONMENT USE (Address) (Tel. No.) (Address) (Tel. No.) ""~1f.A~~~~~..y ~ /?7/V~/.,:1.:l -.;6/--"~-7/~; , Re-roofing 0 Porch 0 Re-siding 0 Finish Basement 0 15. NUMBER OF OCCUPANTS OR SEATS OCCUPANTS SEATS Septic 0 Addition 0 Deck 0 Finish Attic 0 16. PROJECT COSTN~E y~ R"P~ 17. COMPLETioN DATE Water Tap ................................... $_ Builder's Deposit ............................ $------,+ Other ......................................... $ Total Due .............................. $.5.7/ Z . /S" . Paid 57. 12--,/~ ReceiPtN~/,<7ff3 9 Date I V 1.f -1/1) By A'ft.-./ certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed~s ; uested. This document when the C' Planner constitutes a temporary Certifi~te ~ Zorjng compliance allows co ction to commence. Before occu~ncy. ~icate ICCUpaRcy~t be issued. ~_.:._.:... IW'..{~. ' 'tiw-- ~1LCV\..c... City Planner Date Special Conditions if any . . SETBACKS: Required Actual Front BUILDING DEPARTMENT VALUATION USE OF BUILDING SEB-' TYPE OF CONSTRUCTION: I II III IV V Occupancy Group A B E F HIM R Division 1 2 3 4 Permit Fee ................................... $ Plan Check Fee ........ ..................... $ State Surcharge ............................. $ Penalty ....................................... $ Plumbing Permit Fee ....................... $ Mechanical Permit Fee ..................... $ Sewer & Water Permit ...................... $ Thi By FOR ADMINISTRATIVE USE MATERIAL FILED WITH APPLICATION Back Side Side SOIL TESTS 0 ENERGY DATA 0 OFF STREET PARKING PILING LOGS 0 PERCOLATION TESTS 0 SPACES REO. PLANS & SPECS 0 SETS SPACES ON PLAN SURVEY 0 COPIES PERMIT VALUATION crt.oat:> ."'0 PLOT PLAN 0 S U City: Amount Brought Forward .................. <t Park Support Fee ........................... $ At::;o. ""'=>. SAC ......................................... L_-111 (')0.00 Collective Street Fee .......................!l: Sewer Tap ...................................!l: Pressure Reducer .~k~..................: B3\.Co "'r4 o. /5" 45.& I 4f:;.ao /00.00 If) t;, DO 3S . r:n C/,o ~ '00 Meter Horn ... .... .... ........................ ."= Water Meter ................................. $ Sewer & Water Connection Fee ........... $ Water Tower Fee ........................... $ I::2S.0t"l , I "l.l'lt'l .t"V'\ 'iN{ t"'n me Your Building Permit When Approved. Date J I-?,/'J. '-0 - Issued This is sign 24 hour notice for all inspections 447-9B5O Th~ C~nl~t of Ih~ Lah Couolry White - Building Canary - Engineering Pink - Planning BUI\".D1NG PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED I D .;e. 1-/ {)!2 I 0 IV' / / - /3 - () () The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7255 ()~bkF/c.-cD De Accepted Denied Reviewed By: L LL 1/ Accepted With Corrections Date: ~ Z -IXJ _ Comments: .5t::E 11J/;/IJ WEAr (J 'lZ5/0amaL?~.) EQe (flfll//J~f73- "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 Tht' C"ntt'r of lht' Lakr Country BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT D 12- HOe / ON 1/ - /3 . on APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7257 DF:ER_F/5LD DR- I .f Accepted Accepted With Corrections >( Denied Reviewed By: C10 ~A_~ Date: ~1-7r')-LcOl1 Comments: ~~ ll"11.C::;\ "flol!'\\~ b:.\- ~\~ ,. so...~ Gte-. "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 Tht C"nlt'. of Ihr Lakt' C.~ounll')' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED [) ;.d:.- l-fO e I () rJ / /. / -~ . () () , The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: Accepted /7257 V Of /" / I- Flc~7-/0 1..)/<:'- Accepted With Corrections - ....- Denied Reviewed By: Date: r~ / c::. / &c0 ~ Comments: ~ ~ ~/1MJT S~ -1. 72~1 ~-P~a W; ~ (~~.. ~es< (' .LJYvt.r:;-;-'Ovt.( "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 Me "f'I, '(','-'2- 16200 Eagle Creek Av. S.E. P"rmit No. ~ Prior Lake, MN 5.5372 HEAnNG APPLICATION! PERMIT Date 2-\ !{( I b I PID#-2,5- 372- ('J.c)3- () Site Address '/1 YiiIJ{'H -htld 'lk SE . . lot ~ Block /It.--- Addftion Own"~s NameD R- i-tv (+t5Vt Address :;~ \I\I a.<J^vLVlI\blD 1':l:i]U.j UcOtr.tn '3j fZ:Z. Heating Contractor 1:+ m ~U1i- 'r'J\U>rli'vV''v1 6;LjJ Address ....3li)~.;D W.1 nil)ec/)j~ UU)tLl'i IVV\) 5'5fZ-7 'CI" llc ~1- '7C= oJ T elsphone It I L..) , '.7 i.' '- I :J Furnace Make & Model _ p.wLJtL-r"f TYPE OF SYSTEM ...,0,., "VI' I ~.,1 / ~. Werm Air Plants Model SIze :>Y:')f...H l L'.~ ..ft, 1/, Gravity Conn. load ,z,1" 3 ~ tl Mechani~I, _ " '^ ' , . I CI r . . Air Conditioning J.. "'f"bl'l Kn",~J.lJj- Fuel /'0u..-t' FlueSize L/iL6S5 Venl.Systllm L. &)D(F~,}h g Hell T1NG OR POWEA PLANT +tV'. s 4 Sleam . HctWater Radiation Special O"vices Supply Op"nings Relurn Openings Input 7L. DN OUlput31J rTf.' Edr. C1m. Y;ft Other Devices TYPE OF WORK Alteralions New Construction --- Repair Replacement Est. Comp. Date C{ BuildingPennH, n~~1 D~ L Est. Cost $ .--7i't',;" ,,?UL')(,... HEATING PEAMITFEE$ STATE SURCHARGE $ TOTAL PERMIT FEES $ .50 PAID WITH BU\I..DING I-'ERiv1\i Receipl # TYPE OF STRUCTURE 1..Pi1lk 2. Gr~ J. YeUow , , , , . . Rio 0" Contmcmr Single Family Comm"rciaJ Two-Family Industrial J..---" Multi.Famlly other Public , c ~ Fee Schedule industriaJ, Co,..".~.";"J & Multi.Family Residentla~ Healing & AC Residentia~ Healing Only Residential, Gas F/l'eplace Residential, Additions & Alterations Residential, AC Only , , . < 1%of job cost 1$39.50 minimum) $99.50 PLEASE NOTE: ~ $64.50 Air Condi lioner UniTs CaruK < 539.50 Encroach Into Required Side ~ $39.5C Yard Setbacks. ~ $39.5C ~ . . Rem"mberto add the Stale Surcharge on lI1e bottom 0/ this application. The price 0/ your healing permil includes one rough-in and one final inspection. Additional inspections wm be biUed al $35.00 each, House Healing Tesf Record must be submitted with lllli!l:liI!!I R!!!I!iI number berore build- ing ......, ~:.......... of occupancy will be issued. ~ , , , !:lEAT CALCUI ATIONS REOUIRED with number of suppiy and return openings lisled per roc>m with CFM's per openin9. New structures c>r addilions s"nd floor plan will1 supply and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND APPLICATIONS MAY BE MAlLEO TO THE CITY OF PRIOR LAKE. 16200 EAGLE CREEK AVE. S.E. PRIOR lAKE, MN 55372, Clly Hall business hours are 8 a.m" 4:30 p.m. ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HAlL 447-9ll5O I hereby apply lor a mechanical systems permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the city and wilh the state buadingfmechenical codes; that this form does not become a permit unll1 signed by the BUILDING OFFICIAL; that the work will be in accordance with the approved plan in the case 0/ all work which requires review and approval of plans. A" Jj U '1 '1---LtV1.JJ!JJ./r J11/JU'-' (In.M) ? / / q /0' ~rm,~WlYure ~ /f/)J1/YY . 2-Z/-ol Buildin10lfiCal'S Signature . Oate c ~ ~ :z , c :z ,- '" .. " lEi e: e: ... PL. FA.;L 447- 42..48" FIRESIDE CORNER #5403 P.DD1/DD8 CITY OF PWOR LAKE DAte Rec'd REA TING/AIR CONDITIONING/FJREPLACE PERMIT l:~?:. E:..., I PERMIT NO. !) -/0 G?t- (Pl..... 'I:E';. or milll ",,4 iii'" .'botlnml ADDRESS I ~O_NJN,G(oIIk.""" " /);;S1 Jf)~~ LJ/luk _ LEGAL DESCRIP1JON (oll'lc. usa only) LOT .sr BLOCK~ADDITION I OhJ/l.J~J M:d-- f . . ( OWNER (Nam.e) (A<I.duso) Q;)R- ~ (phone) APPLlCANT (Name) ALLIED FIRESIDE DBA FIRESIDE CORNER PID";<~/ ;a1~ -6~3-~ (Phone) 65l.-63"-'~j;1 (Address) 2700 N. FATRV'[EW l>~ (Addre..) (Co P ) BRENDA IItJS~DN ntact erson _ APPLICANT SIGNATURE ~,_.EJ. /)J,~_ ~1:;1''?- (Zip Code) "QSJiOY.,U.T.l" '!I'" (CilY) (Phon~ 651-633-256l. DATE . APPI_ICANT PLEASE COMPLETE BELOW ~W CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS fURNACE MAKE AND MODEL FUBI. FLUE SIZE RETURN OPENINGS INPUT OUTPUT 'TYPE OF SYSTEM HEATING OR POWER PLANT OWann Air Plams J Stepm DClrtvi'Y J Hol W oler o MochPnical :J Radialion OAi' Condltionu,g 0 Specl'l OevkC$ OVent. Sy,r=:n 0 Other Dovleo, FIREPLACE MAKE AND MODEl. -AJ,fd.N t;;t'.D ~:.. 2ro ~ IndusTrial. O>rnmeroiol & Multi-FllITIily FEE SCHEDUl.E 1 % of Job COSI Residontlal. Oas Fireplace $39.50 minimum $99,50 Ro~ide.nliol. AddllJons &. ^Ile",Uons $64.50 Residontial, ^C Only Rosidontial. Hootinl &I AlC (New Construcllon) ResidontioJ. Hellling Only (New Con,tl'1Jetion) Estimated COSt $ Bundlng Ponnil # HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ S .so (omce U.e Only} This Application BecolDes Yo..r Building Permit When Approved rp.jd~... nulldlng omd,l . Date (D ~7~O( Do.. ~4 ~our n.tlt:<: for Allln.pe.lion, (952) 447,9850, fox (952) 447-4245 PLEASE NOTE: , Air Con;clidau"" Uoils Conno, En.Cl'Uach inID Required Side yatd Setbaclcs 539.50 $39.50 539.50 r . PAID WI' ...SU/UJING PE, II~.. j . I Reeeiol No. IBY~ .J CITY OF PRIOR LAKE . PLUMBING PERMIT Applic8nt: ~V1?~ - R-La..Yl Add,..s: .JWu.~ . ,'?'l (l rf7 Jd r T L,( Signatu"':...11 'n Adl,..J. _ Legal DHcrlptio;:;: Lot' c....=J~ Block 2- Sub """'\'P;V"~ t:!. /IN"'I Slt.Add.....:..J.:72..~.., ~~ c"E, BuildIng Psrmlt # .PIC # NOTE: this psrmit will not be proceBlied without comPlete~nformation. .' I FIXTURE UNITS JRN. 9.2001 12:40PM GENZ RYRN 6513226147 TtIr Cnur., ... LOt CGqn'rr :. ., I NO. 225-' --P. 24-- I. JIao ilia :I. Claw a", s. v..... .......... . ## no - It'Jb? Phone~ LP6/- Ln.3- I (If.L/ ~VY"hIl VYr S9"'lCaS? ".,:' Quantity Type of Fixture Quantity Type of Fixture I \ Bath Tub.with or without shower Rough-,ins J \ DlshlNlISber I Water Heater I , I ROlli C~n ~\\ , , , Water Soltnllr J 2 -I lavatory: (bathroo!h sink) , I stand r;'lpe ,washing machine) \ I Laurldry Tray 11 or 2 compartment sink) Sewag, Ejeqtor . 1 \ I Shower Stall Backflow Assembly, (APZ, Double Check, PVB) I \ I Sinks Backflow Assemllly Test .~, I Bar'Sink Lawn Sprinkler ',' ! I Water Closet (tonet) Other , 2- i .C" 'FEE SCHEDULE . . ~ _ ." .industrial, Commercia,1 "Multi-FamAy . 11% of Job cost, $39.50 minimum) , -, ResidllntJal, New On." Two Family Residential. AddltJonsi" Alterations , 599.50 $39.50 State SLlroharge " ,- ., GRAND TOTAL .~. " . ., ,~..-I This permit t.;JII'lIntocl upan .he cap...... condiaon lila, .aid conlrllolOr, """I campI in all U with tIlo ordin..,,:o. of tho Star. Plumbinll 0 ltnendmOllls therc,of. - :RIi ,~q,(fV DATIl . ----- _ A'rI'EST ons ,24 hours in advance. . $. $ $ $ - .50 r : PAID WI~MIT ~U\\.D\NG p .. $ j' I 16200 Eagle Creek Av. S.E.. Prior Lake. Minnesora 55372 , Ph. (612) 447-4230' FAX (612) 447-4245 . . An Equal Oppominity Employer JAN. 9.2001 12:41PM GENZ RYAN 6513226147 ...... ---rID. 225-' -P.25'- --- ... - .' _.OU! ' ......... . -..:.Irt MLII ~ err., CITY OF PRIOR LlXE SEWE!/. ANI) WATER PERMI'!' NOTE: NO. 00 - 10hZ- 'Sewer and Water 'contractors must .be reqiatere4 with the city. APPLICAN'1':..St'.,.,~~ "trrl P,u.....bl..xs- ~"'A.)r~ PHONE:~"!t-II~ ADDRESS: r ~~DATE:~' SIQNATUR.E: ' (J . __ ~LDG. PE~I'1' * . . SI'X;k ADORESli: lV~j"o, ~ ~PIDi#! FILL 111I THE BLANKS . " 1. ..' Estimated lenqth of water' sexvice 40; I" 2_ Size of water ..rvice inches.). .feet. PAID WITH aU\\.O\NG PE.RMIT> .'~' -, ..'", ",:.;.j 3. ' Location of any couplinqs from s~ructure 4. . Type of sewer pipe. ABS , /Ir-.' 5. . E~timated length o~ sewer lin. ~ 15. . Clean Glut e if, . required) , located at . , st:;ructure. feet. PVCX' Cast Iron feet. 'feet from , "i . ::::=:::::::::='lfli7~~,~::-~::~:~::::..:~:::::~~e=--=..e=====- BY: -! /lElL O~TE: /- q.- ()O i /7 " e!!!!!._____ - _._"'~~--====o-~~-===..~-====-======-=======-=~--~-~~====s=-..-= . ' - FEES: l? $ $ 35.00 .50 35.50 . "Sewer and water line conJ;lection permit. .. Surcharqe ! . , TOTAL .r-- , , , .:......,. Fee for'~ither sewer or water individual,.li :i8 $20.00 plus l? .50 1I1olrcharqe., - . Sewer and water permits issued for new constt~ction must be recQrde~ en the b~ild1nq,permit card at the'time of iss~ance ,to insure that no .duplicate sewer and water permits are , . ills~ed.' , ' . i OW\i'r\ :r DATE PAID AMOtJNT PAID' '~~~~\r.. pE.RM\ . . au''" . RECEI~ # REC'O BY * ... . - . 4629 Oakcta Sl Sf. Prior Lake, MlnnlllOtiI 5537:i I Ph, (612) 447-4230 I IV (612) 4474245 AN !QlJAL OPPOII'l1JNITY 1iMP!D'f'ER - PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRES.S 1111-15'1 n.."l'"Cp\~ Dr-. NATURE OF WORK _r-JP'-,\ USE OF BUILDING ~r-~ PERMIT NO. ~ DATE ISSUED I J -:J/) -2at> CONTRACTOR . D. 'It. ~t-~ <-Sf - ~~G. - 7/!j~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE I FOOTING I~, I 1/3/ /01 'FOUNDATION (Prior to Backfill)~ I #+. ;r/I:3/o( I~. #01-Olli/ PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING I? fI. -o/'l?' HEATING (if required) JJJ._-P6-~'f/f1/ FIREPLACE . ~O\J ~ GAS LINE AIR TEST ~~. ~.p, f7;r. [,( \ l/# I . COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS C'6\)~ ~ GRADING (Prior to SOdding) BUILDING 1-:t..bl"lc.M ~/S~/DI ELECTRICAL PLUMBING HEATING DO NOT tJ, (f, t$:, ~/~~k, ffir, - ~- ~ ~ c, \;t~ \ O( U~-% fk, ~/II/07 lolfflof 1~/:J3!o1 / f//31tJl s:/ d-~ I BEEN SIGNED / OCCUpy UNTIL ABOVE HAS NOTICE This card must be posted near an electriclJl !,er~ice 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 ~==~ ~~---=~ - - r_", ,j , '.,' "'!~~_. ' "l!1 .. ~ - - -.... -''''''-"rr - T- -n' '" -_ .:.) ".< I ,., I ."" I,. .<1 ,d .,-,.1. I "Zl', :i':1"~~I~Isvr;;j~'1 .;;9'"~I"~:I.....,I~..:j..-';;I~d."". I" \, :~'I' <:~' <!~ tr~ r"'",' - '.~~... I ~"""~ '~&' .~. -.'""... ,~. -f"Aifil."~~~'''''''~ ~';, ','; L - I -,:-~ (,~i: QLedifiruu nt <mccupanry I ~-; ._ ,lJ ~ :t~[ CITY OF PRIOR LAKE (~; '.~~ lltpartmtnt of lSuilbing 3Jn~ptdion - f~! t(Final Permitted 0 Conditional C.O. Expires ~ '( \.~ 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: Use ClassificatioIL- SINGLE FAllILY 00-1062 Rl Bldg. Permit No N/A Occupancy Type R3 Fire Zone Zoning District Legal Description VN _ Type Construction L8, B2, DEERFIELD SECOND Owner of Building 'itcAddress 17257 DEERFIELD DRIVE S.E. Contractor',Narne&Addres. D.R.HORTON,_3459 ,IASHINGTON DR. SUITE 204, EAGAN 55122 ROBERT D. HUTCHINS jU 'I DON RYE _ /1'::).. L City P anner BUildin~~iay ) / /tJ/dl '? Id / Date: Date: ,.', ,'-;;,IIiiIoiil;,', ;;"",,:, ".. ,,",,,' ",' .... ~.~, I.," ' ,.~ ;"'': " - ,. ,,," '... I I I I I J INSTALLED BY I";aS Line By GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER_ GAS DESIGN CONVERSION \t,)..~1 HOUSE Oe,""r{.': ~\~ H EA T1NG TEST RECORD ADDRESS OCCUPANT HEAT LOSS SOLD BY Electrical Work By TYPE OF HEAT APT. _FLOOR <1WNER DA TE HTG. INST MAKF ~('o-I ...-; Modol_ ,,:) LJ.\\J""::><..c-'O .MAKE OF BURNER Model Max. BTU Rating MAKE OF FURNACE. Mod.1 Serio I _ INPUT C<t .0<.:>"> CONTROLS THERMOSTAT \\"~.~,-'0... He.. Plu. Val.o _ c... s '"'- Limit Limit Setting :t. -:).. (\ Fan Setting _ Pilot Type Pi lot Mak. Pilot Model _ Pilot Timing L. W. Cu, Off 3.S- Vent Size KIND OF LINER Draft Hood 4" Filte,. S;zo I(.~').<::> >( 1 Chimney Location Chimney Construction Inside_ Smoke Bomb Draft. H/ .1'\ Door Pres sur- JOB#. CITY _ SUBURB A.\\; ~-'" ~,.,J.... . SIZE NONF 1-'\"" ; \-<. , Regulator _Number Outside Wiring Tes.Ta. }.J-/-,\ lighting Inst. Dot. T Bsted Company Testing Nome of Test.r ~.;;)~-<::>\ Frederickson HeaHng & Ale, 3650 Kennebec Dr., Eagon, MN 55122 \C..c.:_ :\.A\<.~ - " Pressure Porcen. CO2 --.Jr. '::} Percent O2 ~? <- Percent CO 0 Input CFH Stock Temp. Form 235 -., S- "'? DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS / 7 d-~? SCHEDULED ~ &~ {, I J: &"0 OWNER CONTR. PHONE NO. PERMIT NO. t)o - I 0 (q Z, o FOOTING o FRAMING ~ o INSULATION VFINAL ti'" FOUNDATIO o DEMOLITION o FIRE PREV, COMMENTSIl1J Q)~~. o PLUMBING RI @ '6t MECHANICAL FN " b - WATER HOOKUP f\ o SEWER HOOKUP o SEPTIC INSTALL o PLUMBING FINAL o SITE INSPECTION ~, ~-&J o EXC/GRAD/FILLING o LKSHOR~ETLAND o COMPLAINT o SEPTIC FINAL o FIREPLACE o ~c ,0, ii.U qls~/o/'\~ ~~~ ~ ~ ~(, ~ ~_:.-c.SJ -- , o WORK SATISFACTORY, PROCEED ~CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~ Inspector: Owner/Contr: 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 /~d-5'7- 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 o SEWER HOOKUP ~UMBING FINAL o MECH FINAL DATE TIME f/I3--oj .d;3lJ ~ U' 0,- /(J b .;l. o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS@ ~ ~ ~~ ~ {iJ ~~ +tl' ~ ~. lAl~ M~ o WORK SATISFACTORY, PROCEED It CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING ~( Inspector: Owner/Conlr: I CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNon CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI