HomeMy WebLinkAboutBuilding Permit 03-0412
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
(Please .!V.Ee or print and sign at bottom)
ADDRESS
37/3 If('q~/
v
LEGAL DESCRIPTION (office use only)
LOT .y BLOCK J-... ADDITION
OWNER
(Name)
(Address)
BUILDER
(Namp) I"~ h~ NJ' /}? tF NN
(Contact Name) (:;' <'i ,.. y
(Address) /' r; 9 ?J
; S- /7, Zc-
/.c f'l
/Vt-J
/I" <(~ I
-.J
JJO)?\ l" J'
I.White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. 03 - 0 4/ zl.
(1rrs/
Date Rec'd
4-1-03
ZONING (officeu,,)
.el
PID ~5- 3i't. 0':0.-0
(Phone)
(Phone) t,~- J- -yol.. .y~iJ iJ
(Phone)&I.Z- J~ 7- 71./..2
['fA qQA/ /1lA/
--'
I)"...-u, S'...,'r/J.:l1J 0
TYPE OF WORK
-
lB'New Construction
o Misc.
DLower Level Finish
PROJECT COST IV ALUE (excluding land) $
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
;teruP7r;;-;:,pe,?~ IYFr
-- [.7 / ...8Ignature Contractor's License No.
V.._
Permit Valuation 'ifJ 5"8' 0 () O. 0 0 I
$ ?~/K. c;5-1
$ ~57.~"..
$ 7Q. 00
$
$
$
$
$
I
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
-
100.00
100.00
3'5'. <;)0
I.fO. ao
This Application Becomes Your Building Permit When Approved
~
~
Building Official
t//lr/o~
Date
DDeck
DPorch
ORe-Roofing
S)/;)..:l...
ORe-Siding
DUtility Connection
Date
$
$ 12.. 7~.oo
$ 2$'0.00
$ LIS;. 00
$ , z..oo, () lJ
$ 7(J(), 00
$ l'SfJO. DO
$
~500. / /
I Receipt No, Y4U:'f'X
By ~j
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
D Fireplace
DAddition
DAlteration
Park Support Fee
#
#
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 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
"'"~ J 1~f-- J///rAJ gtJd &td ~
PTanning Director
SAC
~
Water MeterCSiz~; 1 ";
\ Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
'Jo~Uc/' 1/
U~ hLq :.. 0......,
#
#
Paid
Date
-'-".,,,..,.
-
Th, C,n',r 0' 'h, 1..1<' ('oun,,,
White . Building
...-l,,,narv - t:nRIOeer,nq:>
prnJ< - - Planning
NAME OF APPLICANT
BUILDING PERMIT Ae.PLlCATJON DEPARTMENT CHI;CKLlST
~1/ 6/V S ;vI;-J;J ;\/
4--9-0~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.:39/3 /aG/fL-- ,-t//1J.5
Accepted
x:
Accepted With Corrections
Denied
Reviewed By:
/Yl4B
Date:
I-/-,ll-o 5
Comments: ,See Reverse Side for Addition;::!llnformationl
/Yl'lIh r::,-I" Drivewav Must Have A C"n~r"t" Ar;mm",,.,i:l
See Attachments: ]) Grading Plan, 2) Erosion rnntrol 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."
ii~~
White - Building
Canary - Engineering
~Pink _ - PlannIng .;>
Thf (-"olt'r of Ihrl..kt' ('ounl!)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I( f: /l r;t /1/;\.1 /\.//
It ~-j
4- (j- C~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/~ (,; /..' //. t (7-11 / _ / // / J (
'-..__, ,,--",,, / ~,_ ",' {._" ,.-J
Accepted
Accepted With Corrections
.-/
Denied
Reviewed By:
Comments:
~
pt~
.
q~p...., Date: Lj / I?!, '3
dOl ~:_ ~~,
----.J 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,"
~~
CWhllll - Buildii\D
Canary - Engineering
Pink - Planning
The ('fnlnof lhf I..h(.'ounlr,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WEj\/S ;v?/1/J;vI
~~ 9- o?,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
39/3 /ZEGI'lL- p/1J5
Accepted
Accepted With Corrections _
/'
I
Denied
Reviewed By:
~ ::/~I-- Date: Y//?~f
~ d-f' ~ .~---=t-,
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."
10/24/01 WED 11:22 FAX 6124474245
CITY OF PRIOR LAKE
~OOl
Dlte Rec'd
CITY OF PRlOR LAKE PLUMBING PERMIT
I.""" 'lit'
I. Golf til1
J y,llcrw APP!,(VII
I p.c,AJ~,rr N01'_ l/(~ I
q'lme.!'? or .rin, and .m. at bcflDm)
ADDRESS 3 i 13 ~~ ~cs,S.s. \\\~.
_ LVI"ll_O (.tIle....' I
LEGAL DESCRIPTION (office UIe only)
LOT If BLOCK;;).... ADDITION ~~ ~~
Pro
~~~R \~\eJt\Sm~~X\ ~OTY\~ CPhone)b5)-lfD(.,-l/lIOQ
(Address) I !3C}S- 'f>b:z.o-. h-. ~\~,Qba ~V\ /VA.", SS""J;;'rz
~;;~~ANT ,j~cl ~\'-D~ ~ \\\~~. (Phone) (;D/-fs)~/5bS
(Address) 17JD 'A~C\~~ \~, ~\'\..~, :::c,/;;2./
~ (A~) (City) (Zip CodeJ--
(ConcaaPerson) \Tc:.el \-\.~~~....' (phone) tS-I.-LtD-15/.:;S
APFUCANT SIC NATURE ~ DATa qj;l.::,}rY!7
. ~LlCANT PLEASE COMPLETE BELOW
I Type of FiXtare I Quntity I
Slith Tub with orwithoul showl.'T RoUgh-ins
DishwllSher I I Water Heater
Floor Drill" Water Softner
I Lavatory (Bathroom Sink) I SllII\d Pipe (Wil5hing Machine)
Laundry Tray (1 or 2 compll1tllltnt sink Sewage Ejector
Shower Stall Backflow Assembly
Sinks Bar:kflaw Assembly TeIt
BB1 Sink I Lawn Sprinkler
I WaterT Clo"", (Toilet) Other
I Quantity
I .;;..
I I
I I
I q
I ,
r ~
I I
I ~
Type oU'Ixtan
FEESCHtDUl.E
Indu3trilll, Commercittl &. M\Jlti-famlly lY.otjob l:ost wiril a SJ9.:iO minimum R.e:sid~ntull. NC'w One: a. Two..Funily $99.50
Rdlidential. Additions &. AI(eJ'1,(lons $39.50
(Office Un 01llY)
Estimllted Cost S
a"i lding r.nn it 11
~~~
.50 . '1:1114".
PLUMBING PERMIT fEE S
STATE SURCHARGE S
TOTAL PERMIT FEE S
ThiJ Applialjon 1Ieeome, Your Buildinc Pormi! When Appro.od
i ~,~ llJj It Ii. \i) I:~ I ,Ii ~mipt No,
~li:APR ? 8 ono, i ,: ~y / j-
~ II LA,)
:4 h.u,' ..otict for ,II in.peeli... (95Zj w"i.. :s.:;, ill.. (~5J) ....~-42'5
d l>ELES0098l>O~/WEllS/O;EI EO.Ell> lulll) L9 :~';;lS\1~IS9lJNllV3H~ 9NI8NfI1d mN3,1I WOHj
B"Udl"lOm"..1
PUt
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please !=rvc:. or orlnt and sim at bottom)
ADDRESS
3913 REGAL PASS NW
~. ~:" ~::y I PERMIT NO. (-'" - I 1('" j.
3. Yellow Applicant ~ L-f I ~I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALl .lED FIRESIDE DRA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55Il3_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/26/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
DWarm Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent System
HEATING OR POWER PLANT
D Steam
D Hot Water
D Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN OLO PIER TRC & 6000TRI
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39,50 minimum
$99.50 Residential, Additions & Alterations
$64,50 Residential. AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39,50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
"'AIO WITH
8UILO/NG PERMIT
(Office Use Only)
Buildine: Official
Date
"iI'ltfil: r) ~I:: r
j U j IT; \.1[1 " II
~ate _,
,II' JUN j, '7
:.1
l[: I ~ leceiPt No,
')nnO i I'~. y ~
{vc"l , ,r (r
~I ~J
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-9150, fax (952) 447-4245
06/2V03 09: .15 FAX 6518949955
WENZEL HEATING & AC
~001
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
i ~:. Fo'i,... I PERMIT NO. '3 -L/ld-!
q?lei:Uep..'pe or DrintilIJd$im at bottom)
ADDRESS ZONING (oJlic'''''1
39/.9 .:;lJ~ j Ms-s
. /
LEGAL DESCRIPTION (olllce uoe only)
n)~
LOT
BLOCK
ADDITION
PID
OWNER )
(Name) /A ,/'/S~/V4
/knJ.P'<
(phone)
(Address)
. APPLICA."lT / j /
(Name) /",,,./?,,,--/?;:/ . ~r-#-k1
. /
4A' J ?'/d </b~r/
(Address) /
(/1"A/ ~jg;
APPLICANT SIGNATURE - J -",:v./
(phone)
hc;1 Ri4~9XC7"?
(Address)
AA
~rv--,
(0lEy)
4J5)ZZ-
(Zip Code)
(Comacr Person)
(phone)
DATE 1M
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REP1.ACEMENT 0 AL TERA nONS
fURNACE MAKE AND MODEL ~"L.I~/ A"'5"/ ~7(.) FUEL ~crl-
FLUE SIZE.....? -: :?' 'f'U"'c... RETURN OPENINGS G,. INPUT 7-)aX;l OUTPUT 6fJ/XX)
/f/e O~/ TYPE OF SYSTEM HEATING OR POWER PLANT
4>h'HO;f OW3lTTlAirPlants 0 Stoam
OGravity 0 Hot Water
1~30 )!fMoohanical 0 R.diuLion
~ir Conditioning 0 Spe{;jill Devices
DVc::nt. System 0 .other D~\'ice3
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
RequiTed Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
InduSlri.l. Commorcial 8< Multi-Family
FEE SCHEDULE
I % of job cost Residontial. Gas Fireplace
$39,50 minimum
$99.50 Residential. Additions & Alterations
$64,50 Rosidontial. AC Only
$39,50
Rt:siljential. Heating & Ale (New Connruction)
Rt~identia1. Hetlting Only (New Construction)
$39,50
$39,50
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE ~ rr P I" n ~rc: ]
TOTAL PERMIT FEE Lb ll!J U; U \iJ U; ]
(~ullieOnl~ ~
Thi.o Application Become. Your Building Permit When Approved l U ~~ 2 5 ZOff3 I I
Ey I Date
$
PAID WITH
BUILDING PERMIT
R.eceipt No,
By
f1Q
~
Building ONicial
Date
24 hour notice for:Ill inspections (952) 44'7.9850, fax (952) 4474245
.---'
G,MU1. "'..r:
'U!.UJ:l"" .. A,H\J("".A__,
f;,Ol.D. err.,
C!,:!:,Y OF P~!OR LAKE
SEiiER ~j1D WATER ?E?l'!IT
NO._?;.-t/ !;:}--
NOTE:
Sewer and wat:er
contractors must
be registered
.".ith the City.
PHONE:r$S)-1f9-~JS6S
DATE: Lf)::l.3/tB -
ADDR'::SS:
~ -=~,.~,:,,~.~~-:.:..
-= =-:r:=. ?::?:~:::":' :
F:LL IN T~E BL~~~S
J.
Lccatio~ of any co~plings
from
30
inc:o.(es). ., ~~
s~::-:lC~Ure YJ I 'A-
PVc v.. Cast Iron
3D
fe-=t::.
1.
~sti~a~~d leng~h
of wa~er ser~ice
I
2.
size 0: ~a~er se~vics
fest.
4.
~:pe o~ sewer pipe.
A?S
5.
~s~iMa~ed length
of
se.~~e=-
line
6.
C!.ean
cut
(if
re~irec.) ,
locate",
Eee~ ~ IlIl..
at ~feet
f:-c:n
s",=-='.].c-:.u::-e.
-------------------------------------------~----------------------
------------------------------------------------------------------
T~~s a~plicaticn cecornes ~ou~ per~~t ~~e~ apF=ovec.
B"
DAT=::
=~============~===~====~==~==~===================~======~;;;======
:~:::s:
s
s
S
35.00
.50
35.50
Se~er and wa~e" line connection pe~mit.
Su:::-charg2
TOT."-L
w ?ee fc= e~~her se~e" c~ wate~ i~cividually is $20.00 ~lus
S .50 s'.l=c:.a~:;e,
w
S~'.Je::- aile wate~ pe:-:=tits issued fo!'" nel',.J cons~r...lc~ion lnUSt. be
=ecc=dec on the Duil~ins pe~l~ ca:~ e~ th~ ti~e of issua~ce
t~ i~s~=e that no cuplicate S2He= a~d Nater pe~i~s a~e
issue::.
, 'm ;>J"" 0'''- ~lIJ~-fJO Is
'I~;nj [i~ IG" rc: 0 rf! i~ "1- ... - ~G "If
"'.. ,U "lJ Lr; l'1p,~ I, s '{ t>J:\~~1}-
" By,.~PR,?8 2003.,J ,.,-.\:"r-=q::
, ".,
." , ::
D;'.":'';: ?~.: J
P.~:=::?:- #
(: d vW~0098l> 'ONl>HllSO~El EO nl> I,G3NiI
L9EHSHS9 JNIIV3H ~ JNI9)ll[l1d 13ZN3NI NOH.:!
MAY-0S-2003 02:57 PM STAR PLUMBING & EXC.
952 884 7468
P.03
_. r&II
....... .. ar-~.....
... .an
Sewer and Water
contractors must
be registered
with the City.
APPLICANT: 3~ ~ ~t4,.I PHONE: 7!5'~-Pf?4(-~/~
ADDRESS:.&.il~. '~DATE: :5'-....S-83
SIGNATURE:~12- ~ t:t< .-/ BLDG. a.A..IT I
SITE ADDRE~S:-'.39l'3 ~~M'1d PIDt
V
FILL IN THE BLANKS
CITY OF PRIOR LPJtE
SEWBR AIm WATER PERMIT
NO'l:'E:
S.W.No :5 - Lj/,?-....
1. Estimated length of water service ,5(:)
"
feet.
2. Size of water service
.I
inch(es).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS PVC K Cast Iron_
5. Estimated length of sewer line ~O feet.
6. Clean out (if required), located at
structure.
feet
from
=======:=----==--------------~----==::::;:.:::==----~._---===----=----====--~
This application becomes your permit when approved.
BY
DATE:
===========~====_______2=_
-=----~--=::===- -~==I__,.____~===s'==
FEES:
~
$
!;.
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $20,00 plus
$ .50 surcharge.
sew"...r. "1'11 _tuJts issued for new construction lIlust be
rec.,mtjdrrO~ th ' l inq perait card at the time of issuance
to : inJ;Ur~ tbat ! Ipllcate sewer and water permits are
iSSll'!if'MAY 1 2003 PAID WITH
DATE FA: ~ 3 AMOUNT PAID BUILDING PERMIT
*
RECEIPT ~'I
REC'D BY
/L
~"
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
6.n J:n".l Or"nnrt1".;h' ~",,~ln......r
PRIOR LAKE DEPARTMENT OF
. . BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ::J913 JIft1JSS
NATURE OF WORK
USE OF BUILDING. _
PERMIT NO. . D11EJSSUED I
CONTRACTOR ."RAlN PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING ~ ~. <)b, ,~,~ t<S1.4..
I FOUNDATION (Prior to Backfill) q vk/k Pm I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
tJr;
f1/~
,'r-'/./ > .
~ ...."
-'
INSPECTOR
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING U(b PI; ,,-'"<.7
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
/).-
/"/f ?- 'T
!If>
OC
(]...I
DATE
S-f2..
~/7 /(/'$
,-/6
~ - t€
r
$~U>
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
NC "i.JA/
((4J
GRADING (Prior to Sodding)
BUILDING J'"'-'f J-- "H~h
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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.
'.1
(fi !L-
f)I4-
(tb
FOR ALL INSPECTIONS (952) 447-9850
~-'Z")
f3 /J-t /ef3
8-~~
QIrrtifirah of Ol}rrupanr\I
CITY OF PRIOR LAKE
~rparfmruf of ~uilMug Jjusprdiou
)7Final Permitted ~: Conditional e.O. Expires _
This Certificate issued pursuant to the requirements ~lSection 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:
Type Construction VN
_ Fire Zone
Bldg. Permit No.
N/A
_ Zoning District
03-0412
RI
Use Classification
Occupancy Type R3
S:NGLE FA.'lILY
Legal Description
L4, B2, REGAL CREST
ROBERT D. HUTCHINS
,/',
HbME,t;,
I I J /
Site Address
3913 REGAL PASS N.W.
Owner of Building
Contractor's Name & Addre\\E~SMANN
1895 PLAZA DRIVE, SUITE 200, EAGAN, MN 55122
DON RYE
City Planner
C' "jr
B~il<;Jing Official
i' {
I
~
Date:
Date:
'.,1.'>- ,,~
~
I
~ 0u.~
'4L('~~-j::o ~)~~ ~JV\~4
, ~f\ ~1Wk /ff=-L~~~
r ~~",o_ UO'A~~.1 .
(-~~ V?-lk. ~
- v
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'10l~
t.Qp", ",j2
.U .
CONTR.
OWNER
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
/f! PLUMBING FINAL
o MECH FINAL
COMMENTS:
_0 ~4~/ThTr21fr.(~.
~tit7fr-~ . ,
L-" s/~
I~UV\
3,
DATE
~
\D.-~
TIME
7, -L( I 2--
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
(jy'MV
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspedor: ~ OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNO"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1/t;/(; ']
/
ADDRESS
3'1/3
ReCt,,1 Pc,>j
<J
PHONE NO.
PERMIT NO.
1/1 / (VI ~ tJ1'C- 11/1 r/.12i:JJP
(I) ~- '-/0
.:i(EXJ~,LUNG
o COMPtAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
OWNER
CONTR.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
3, '7 n &d<. - 6t.-
t,A is" ~ / /') 7e
3,7/~
0r/dL<. ~ l~ f-
C-J ?:, En ~ - rr; f'.--
fJ717
f..r/'~ - 0 II
'Lv/t, 0/{7#-- - () K...
~9/!
f;n,d. u7L--
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cI wnRlUlATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector. /' / / ~./...~ _Jwner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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