HomeMy WebLinkAboutBuilding Permit 03-0318
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ~ (3-03
See Main File 0(-
; ~;~:' ~::y I PERMIT NO. /\ ?0.3/8 I
J. Yellow Applicant I u...:>
(Please type or print and sign at bottom)
ADDRESS
30Si.J.? i\A~ ) E:5T1 L- L '81'1 E;--
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK 4- ADDITION
12~~i
OWNER
(Name)
(Address)
Cr2..r~ .-
ZONING (office use)
f?.1
PIDZS- ?8Cl-(j~-D
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(Phone)~L Llllq. IoCJco
(Phone) (P\2. {~~I~.6'::::2,~
L&\L-eVII\<-.- c:;JD~....".j
I
(Phone)
BUILDER n \ /' \ I
(Name) L-O\ F;l:1~ t ..1.1'< Ttbffi~
(Contact Name) ~~Jch e... ~ \rY)OI.Q.-
(Address) -:::ta?.f'J { 8\L.E;::Vl\ \<- 1?:>\vcl
~?fO ("JDt.). -
J I
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cert fy that I am the owner or
authorized agent r above-mentioned property and that all construction will conform to all existing state and local laws and will p Deeed in accordance with
submitted plans. am a are ~~lldmg OffiCIal can revoke thIS permit for Just cause Furthermore, I hereby agree that the City ,ffiCtal or a designee may
ente e pt pe ~etfo( ~;;;;e;;~ (d.[Y1 ;;2/ /3/153
-Signature' - -- -, Contractor's License No r Date
I
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A&, 779.3/
I A
Receip{)4~. t7--..::e-t (,J
By -1-- 1-
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TYPE OF WORK
~New Construction
DLower Level Finish
D Fireplace
PROJECTCOST/YALUE (excluding land) $
DDeck
o Misc.
Permit Valuation
~2....36100D,~ol
$ 1'"7 t.. t... :5'5 4
$ \\ LiA. zc...1
$ 119 .00. I
$ I
$ /00.00 I
$ 100.00 I
$ "3'5-'50 I
$ 40,00 I
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
~
~/-;J
~/d- '-1/0'3'
Date
Building Official
I Park Support Fee
I SAC
I Water Meter (SIz7578JI";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE /,Jt1AD) J - za--03
DPorch
DRe.Roofing
( JRe.Siding
I JUtility Connection
#
#
1'Z..75.oo
0150. Oil
l.fS.oo
IZOO.Do
700.00
DAddition
DAlteration
#
#
..--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceec as requested. This document
~~~:bY:Ci~ p;:;;, a "mpo.~ C'rti:;;~~;m;liance and illoW:Zion to~oce O'~C" ofica" ofOceupanq must~
Paid
Date
t. 7'7 9: J /
""J.,;;;JfrC) f
Date Special Conditions, if any I
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245 -l
16200 Eagle Creek Avenue Prior Lake. MN 55372
_______..______._._.____,,__'_'.'.~,__._~... ~...._"___~......_~u..__ "_..____~___~_.~_
Planning Director
.l.~~:(PR[O"'<
i- ~
U ;-n
.
White . ~l,Iilding
'-':lIlJllOl'. t:na.neerln!{)
Pin-r- . Planning
Th~ ('fI'n"', of lhfl' I..b ('OIl"Ir)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.; , < , f I- -- (' <1/< H r <--
;' f; l , - '" 1..-' ,I! \ ,"~ :IVI L< <-,
t., _ ,~J ...'.... '-1 \./........ ! t VI I\"'''-"''''
- I~ /'\'?
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The Building, Engineering, and Planning Departments have reviewed the builc ing permit
application for construction activity which is proposed at:
.--, ,.- '-I ' '}< .<\ - .- <'--1 ., 'i' ~ i'---
" i:A '--- -. IV I n_. '<<< I { i ,'r' !'-l \-
_j ( ,/<_<-,'11/ I, t" ,<c) \.... <..::, 'J ..,. \ I V
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
MtJ
Date:
3-/7-(;>3
Comments: See Reverse Side for Additional Information!
nrivpway Must H::!vp AJ:&nr.,ptp Approach
See Attachments' I) ('Tl",r1;ng PI:m, 2) Erosion Control Measmes
"The issuance or granting of a permit or approval of plans, specifica1ions and
computations shall not be construed to be a permit for, or an approval of, any ~iolation 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."
.._~.._~ '-~T'-
~1
See Main File
White - Building
Canary - Engineering
CPink - Plannin~
Th.. ('enl... nf IhO' I..k.. (-ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
....' f- ._"''
let: (<I t;,
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L.-~.- _.-' ...J.-'
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The Building, Engineering, and Planning Departments have reviewed the buill ling permit
application for construction activity which is proposed at:
:.-:; ye(i ~I f\ JE c ~Tl \.~ L-l\ I J r;
Accepted
Accepted With Corrections /'
Denied
Reviewed By:
~
~
Date:
~/~LJJ03
,
Comments:
See Iviain FIle
"The issuance or granting of a permit or approval of plans, specificc tions and
computations shall not be construed to be a permit for, or an approval of, any' riolation of
any of the provisions of this code or of any other ordinance of the jurisdictior. Permits
presuming to give authority to violate or cancel the provisions of this cod ~ or other
ordinances of the jurisdiction shall not be valid."
~~1
See Main File
"hr ('.nl..,.ol Ih..I..k.. Counlr)'
<:::Jo1l>i\f.: 1- ~uildin.s:>
Canary '- Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
C.lOL"l,l1GJ6 C/l-Y HoMbS
2--- I~ - 03
The Building, Engineering, and Planning Departments have reviewed the buill ling permit
application for construction activity which is proposed at:
305h f1AJBST1~ ~ArJb
/
Accepted
Accepted With Corrections
Denied
Reviewed By:
~
Date:
-=I~
Comments:
See-Main File
,;< / ,;ul //) s
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"The issuance or granting of a permit or approval of plans, specific1.tions and
computations shall not be construed to be a permit for, or an approval of, any liolation of
any of the provisions of this code or of any other ordinance of the jurisdictioll. Permits
presuming to give authority to violate or cancel the provisions of this cod 3 or other
ordinances of the jurisdiction shall not be valid,"
83/18/2883 11:11
5877445555
BADGER EXC
PAGE 82
Date Ret'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(l'~u,,~. O'''nIlt<<:nd'Wa'boCrotlll
I ADDRESS
I 3')' s-G, fY\c. i r..?'he
L.o~
I LEGAL Ol!SCIUPl10N (011I,.... anly)
! LOT 7 BLOCK <..f ADOmON
R (" c. c-R.
Cr~
'J
OWNl!R(1 I
(Name) _ ",.{ .)./".1/
(AddIes,) ,C{ :Po
C:ti, ~
, ,
J...cJy.u7lit e II )t'~
(Ad<1rt..,
APPLICANT "':J ~
(Namc) r'l QJ~4^-' C-XC:U.U(;J7~"i
(Ad4ra') l? ?i " I ~ ""? Ll ~ S +r..ru:t-
(M4IvI)
(Cantae:! Penon) So.-.-J...j S"/Y'O'Y"'I
i APPLlCANTSIONATURE _,;xe..-]...., ).L-xr~--
, On~ ",. I PERMl" NO
I, "011.... t:.., .'
'.e...l "',.,.,,_
~-<1}% I
I ZONlJ'lO '0.,;;;.;)1
PID
(Phone)
J~
9)) _ '-fbY-C'PCb
. ~..
S:SU'r V
(Z4> codo) .
(~Ityl
(Phon.) 5-()1 -"";'YI./ - SS.,,("-
1-..0 n~da.A SSD Yc..,
(City) ezil' Code)
S-(j7-t'ul/- ,s~S-' \'
(phone) "t' 'i .J
DATil ?-l?- 0,3
APPLICANT PLEASE COMPLETE BELOW
Size of walor service .!::L-. inches.
Loudon of any coupJines from structure SO foet.
Type of sewer pipe. 0 ABC c:1PYC 0 Cut IroQ
Ultimated leneth of sc:wer lfne ..:::::.. feet.
Clean our (ifrequlredl located at ~ feet from SlrUcture.
R"idcntial uwellJld water line oOMcolion
~wor ,onnetrion only
FEE SCHEDULE
S3J.50 Industrial, Com'l &. Multl.family 1'10 of job cost' lith a 539.50 mizllmwn
SI'.50 Waltr 'onn~lon only 517,'0
Buildinc Pannit N. ..-..
Estima[Cd Cost S
SEWER AND WATER PERMIT PEE
StATE SURCHARGE
TOTAL PERMIT FltE
lome.t.:.tO"ly)
y
I nl. Applltllion Be.om.. Your 8Ulldln.l'"mlt Whon Apprond
I
I
Buil4i.. om.11
$
$
$
. I
5:43PM
GENZ RVAN PLUMBING AND HEATING
No 7057 P i4 is
~ CITY OF PRIOR LAKE
REA TlNG/ AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
J!""(:~":->l\~""
;\I':.:~tt~\\\,;,\")"
J Pink
1,Ci('c""
), Yellow
~:~ I, PERl\nT NO! ::l -3 0 J
Ap()l1u.nt. ....-.J 10
I
z )NING (offi",,,,,,)
q'lease tVD! OJ on.tlt and sim a.t bottOm)
ADDRESS
3xS0 Muj f0t-i G
LVI.
LEGAL DESCRIPTION (offico u,o only)
LOT -3 BLOCK 4- ADDITION
1
I
WlYI 55'oL{~1
I
_ (Phone) _1167-L/;?--3 ij~L/4' __
r<.pU'fV)Jl1M1~ I VJl~Vl f5g)7,p~ _
(aty) t} ere)
(phone) ~Vj]-4o-3~ (C '-f
310l1Io:~
APPLICANT PLEASE COMPLETE BEI,OW I
\&,EW CONSTRUCTION 0 REPLACEMENT 0 A1 TER"'- TIONS I
FURNACE MAKE AND MODEL \.....QJ/Wi D'X b 2..(11& ?:> - T5 FUEL
FLUE SIZE RETURN OPBN1NGS 'X . INPUT 75UJP.9_ OUTI'UY (oqIV[~2._
TYPE OF SYSTEM HEATING OR POWER PLANT
'riwarm Air Plan,. 0 Steam
OGravity 0 Hot Water
o Mechalllcal 0 Radiation
~ir Conditiomng 0 Speclal DCVJCcS
DVem S)'srem 0 Other Dcvlce'
~~d C-..jQ.(6 +
~'::- ro1J.e~ ~[;hL-]J2.rM~~V\C
(Address) 1~2J) ifJl(fVrllt Blvd.. I LrAJu,Vllb
(Phone)
PID
~:~~AN' -gevro__ ~~UVl
(Address)_ \LI7~li)J~DII}&i~ - iJlLt
f\ I. (Adf'''S) ,
(COntacr Person) \JV\ ~I,\-h. ~.(S
01'~) ~
APPLICANT SIGNA11JRE
DATE
PL.EASE NOTE:
Air COt dirlOner Ulllts
Cannot Encroach ultO
Require d Side Yard
Setbac~ S
FIREPLACE MAKE AND MODEL
Industnal, Commorclal & MultI-Fanllly
FEE SCHEDULE
1% of Job con Residenow. Gas F\replace
$3950 minimum
$9950 Resldentlal, AddlllOn.s & Altor,lIOns
$64 50 Residential, AC Only
$3950
ResIdential, Heatmg & AiC (New COO5>trwctlOn)
Resldentlal, Heating Only (New Construction)
$3950
$1950
EstImated COSt $
Building Pennlt #
Building Otncial
D~(t
$
$
$
I 001 ii I U; U6 i~ II WI ~ ~. eipt Nf'
_ MAR 2 fi (no] .. I.
J _ . I
.50
SUI ~~~~ ~7"H
'E: f:l"",.,.
HEATINGPE~fiTFEE
STA IE SURCHARGE
TOTAL PERMIT FEE
inm{e U,c goly)
l:lv
24 hour notlce for all inspections (952) 447.985l), ;3:1 t:i'O;')";~ I-",~"''':;
J
rr-
V
'1
I
,is Applic.tion Become. Your Building Permit When Approved
- ---1"--'-'-'--
Mar.~i. ~003 5:49PM
~\.~~~~~:\;~.,.
GENZ RVAN PLUMBING AND HEATiNG
No.7 057 P i 5 '5
?
Date Rec'd
CITY OF PRIOR LAKE PLUJ.VlBING PERlVIIT
;;;::,: ~:; IPERi\1JTNO~3_3)81
1 Y!l!.!OI:ll AFp1I~t I
I
ZI )NlNG ((JtnJ;e m<:)
iPlease lVDe or PMt.md ~j.20 at bottOm)
ADDRESS
3ZC)(o ~e&n'G llI\.
l.EGAL DESCRIPTION (office use only)
LOT :s BLOCXL.{ ADDITION
~oJ., C\CU&t
. ~:':e~R ro ( !.e~c0 r Ity Vtvmes I he .
(Address) Iq2lJ L{(.k(Ylllf~ Blvol, IIILV-OJ/{/V
~~;~~ANT ~flI\Z ~YIAVI_.
(Address) I Li7 ~'5 ~, ~D ~i T ~l . I
(Address)
(Contact Person) r Jfj WI~ V f7;CU\
APPUCANTSIGNA~E (11 j ~
Quantity
1
I
1.
I
,
:l
PID
1
I
rnn g:;o +-1
1
(Phone) lt01-4if3'- f / fiLl
P-.vv: VYWiJl,VIl. VV1Vl sslO(aY
(City) (~ip core)
(Phone) ( t7 f5/- L()- 8- I A LjL
DA ~~E _'Did I / d ~
I
(Phone)
~/l
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
Type of fixtlilre
Rough-ins I
Water Heater 1
Water Softner 1
Stand Pipe (Washing Macljlille)
Sewage Ejector I
Backflow Assembly I
Backj]ow Assembly Test
Lawn Sprinkler 1
Other 1
\
l( -:I-
I
FEE SCHEDULE
JnduMnal, Commerctal & Multi-family 1 % of Job cost wIth a. $3950 minimum Residenual. New Ooe & Two-Famdy SSl950
Resldential, Additions & ,Alterations $39 50
(Oilier.: 1)~t Only)
Estimated COSl .$
BUlldmg PermIt #
PLUMB1NG PERMJI FEE $
STATE SURCHARGE $
TOTAl. PKRMlT FEE $
50
PAID IJIJrp., .
au 'LOIN"'." f'1
" I:lr:....
.....".,.
Building Omdal
'-"). .14>;,L. ,-" I' I.. . 'I Receipt NOI
11"" 'e' I" I
I 1-" l::? L, J U.,.
, Date ': By
J ~ MAR 2 5 ln03 .~
24 hOl.lr notice for all in~pectjon.o; (952) 44j ,9850, fa.:x (952) .4-$7-42,15
,By
Thi. Application Becomes Your Building Permit When Approved
0,,,
I-ea--
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
3856 MAJESTIC LANE
; 5:w ~;~;""' I PERMIT NP., ~ - 3/~ I
I
ZONING (office use)
_ (Please tvDe or orint and sico at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name COT.T.F.GE CITY HOMES
(phone)
(Address)
APPLICANT
(Name) AllIED FIRESIDE DnA FTRESIDE HF.AR1'\f~HOME
(Phone)
05]-033-2501
(Address)
?700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
APPLICANT SIGNATURE
BRFN/)A HUSTON
(Phone) _651-633-2561
DATE lO/2R/O~
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPU r
TYPE OF SYSTEM HEATING OR POWER PLANT
PLE, ,SE NOTE:
Air C )nditioner Units
Coon It Encroach into
Requ red Side Yard
Setba oks
I
I
OWarm Air Plants
OGravity
o Mechanical
DAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
D Other Devices
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR-OAK X 2
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
ai.Ji/' J)~~ W/,n..,
... ~'Wi~ . .
I -.:; ':)I2P.n
.,v/!,..
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HuUdine Omcial
Date
r-
i f' r~id
Ii' }) ~
.1'
i! 'I FalJCT 2 8 2003
! Receipt roo
By I
u
u
~u _
24 hour notice for all inspections (952) 447.~~.850, fax (952) 447-4245
" './
L......,_~__
r-
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS --3B 5~ W1 ;ri L.A..~e
NATURE OF WORK N d f~~
USE OF BUILDING ".
PERMIT NO. t.?3 -'-Q3/fL- DJ\TE ISSUED 2ial/ JIJ~ .
CONTRACTOR ~G GirLHNMft P~~'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONSBEL:OW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF See J If ain File
BUILDING AND INSPECTIO;l'l
INSPECTOR
DATI
I FOOTING
, FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGN ED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
,PiJ 11-17
Pp
Fa
fff_
f/h
/.r -;> rJ
6-2)
/(-(7-(
~
I
j I/Ij
l
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNE[I
I I
FINALS
IVr5-
,/jJ 43
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
-
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
.
fJ
'of~'
(( (9
SIGN :0
This card must be posted near an electrical service cabinet prior to rough-in ins peG lions
and maintained until all inspections have been approved. On buildings and addi :ions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
QIrdifiratr of <IDrtupanq!
CITY OF PRIOR LAKE
@,tpztrfmtnf nf ~uilMng J1nsptdinn
~Final Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code eel 'ifying
that at the time of issuance this structure was in compliance with the various ordinances of the City ~ : Prior
Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
Bldg. Permit No.
_ Zoning District
Occupancy Type
R3
VN
N/A
Type Construction
Fire Zone
Legal Description
L3, B4, REGAL CREST
Owner of Building
Site Address 3856 MAJESTIC
Contractor's Name & Addr"" COLtEGE CITY HOMES, 7920 LAKEVILLE BLVD.,
Date:
ROBERT D. HUTCHINS
j/1 !/~~Iding Official
1\ .,]I.LI
, (
DON RYE
City Planner
Date:
03-0318
R~
I
LANE I
LAKEVTLL~
I
I
I
55044
~~
I
J
DATE TIME
CITY OF PRIOR LAKE ufOc
INSPECTION NOTICE SCHEDULED
ADDRESS J1f'i/ _
.
OWNER CONTR.
PHONE NO. PERMIT NO. "?-?-(t
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RJ
o INSULATION ~RHOOKUP o FIREPLACE FINAL
o FINAL ~UMBING FINAL o GASLINE AIR TST
o SITE INSPECTION ECH FINAL 0
COMMENTS:
~KSATISFACTORY' PROCEED
~ ;~:RECT ACTION AND PROCEED
o CORR{;jCT K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: I / Owner/Contr:
CA L JI,rs,OJOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
COD\;J;~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
~ lNSNOTl
DATE TIME
CITY OF PRIOR LAKE ~I:</
INSPECTION NOTICE SCHEDULED
ADDRESS JiS6 ~7tt~'C L,I"t-
OWNER CONTR.
PHONE NO. PERMIT NO. ~? -]/f
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ULATION o SEWER HOOKUP o FIREPLACE FINAL
INAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
",tOMMliNTS:r ,; /, .'
~:) A/~~d ~/~~C4/ an.. (_ .
?:) a// ~y o. /d~A/k'; "h~ I
, ~4 /.6r 4'''''' ~r dif ~...-.-
~ c;;;// c9~6.l h 62 " _
. -,
(ffJ Ahe/ ~r,,4', ,17;".,/ .
_ r 4&7(',// :L cr-S-q --/ ~ /I J
~) feed t4/t e.S a;J //,~~" ..,/" I'd.. I
,;,_ -4- /;c/,,( .:>ils..?:..." -k> 4 .~t"'n~d..\
~ ~/ ~..,.'t, 4-/t:..;N:! ~.' ~/f' /;)'<",@'I
__~ r/cr ~~'r~;~.b~, _ "'\ I
(JJ t'-U,{~"e /,I~ ~< ~c ffi-c"''''"f,J- c:-; I
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./'1./ f) Ad ___ /
C .;-/1 dor //// ~y~-r,(J<k\
o WORK SATISFACTORY. PROCEED
~RRECT ACTION AND PROCEED
r-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
~ TIMe
CllY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED It
r38cq/J t1f
ADDRESS ,:L ~--
OWNER CONTR.
PHONE NO. PERMIT NO. ~- ){f5
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH Rl o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE Rl
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~NAL o PLUMBING FINAL o GASLlNE AIR TST
TE INSPECTION o MECH FINAL 0
COMMENTS:
n
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/WORK SATISFACTORY, PROCEED
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o COR CT RK, ALL FOR REINSPECTION BEFORE COVERING
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Inspeeto 'I Owner/Contr:
CAL ~85 I FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE R~ENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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Heating Contractor 6-,"'7Z /
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Job Address
Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp.
Combustion air is adequately supplied per
UMC Sec. 606
Input