HomeMy WebLinkAboutBuilding Permit 03-0537
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
1. White
2. Pink
3. Yellow
File
City
Applicant
I PERMITN~. 173-.5371
(Please .!YE:e or vrint and sign at bottom)
ADDRESS
l/...lQi{3 j..J:I!c;:dc.. (>:{)e)~. AluJ
LEGAL DESCRIPTION (office use only)
Date Rec'd
l;-t,-O-3
I Zp~[rceu,,)
PIDJS ~~o1- 044{)
I
I
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I
(Phone) QS-;;}- i{3~ . "7 cO (
(Phonel.h(~- 701 ~ ~c.u 'f
/1?'~ s--s--/~kt
I
fe.Slding
DAlteratlOD nitty Connectlon
PROJECT COST/VALUE (excluding land) $ ,irf)8-SOC!
LOTL)t-~LOCK I ADDITION S-r-e{J,l.~ <'),"jT~ .
fh , 11 /'c..l) C.L> ......( I
(Address) --Jc..o{ r Us J~ ~'j-0er; -j -
OWNER
(Name)
BUILDER J
(Name) If? "f),., /\<V( f?,.0W',,"J.
(Contact Name) ::J'eM Cc,.i(,.LjO
(Address) ')(;.Ol 14<,.- J /... ,J C<l.L c.-)
TYPE OF WORK
~ew Construction
~wer Level Finish
o Mis,
(Phone)
AuJI-c /e,.A
.v
Qt>eck
.mEorch
ORe-Roofing
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cer ify 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 p "Gceed 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 u n e fa to perform needed inspections.
x
Perm Valuation
Permit Fee
Plan Check Fee
I State Surcharge
1 Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
-.-
,.
If' ~ ~9. "M.d"l
$
$
$
$
$
$
$
$
1711-?rs;1
III '5. '50 I
/I L(. $"0 1
I
I
1
I
1
1lY),oO
10a.dO
SSS- 0
~(), "0
This Application Becomes Your Building Permit When Approved
~~ :/~ (5/~3
Building Official Date
~-L~-c>3
I Date
I
1$ 7~0,,, 0
1$ /z.75:aCJ
1$ 30a. 00
1$ 70, lJ 0
1$ /2.CXJ, 0 0
1$ 7"d.lla
1$ /'<)(JO, (J lJ
1$
1$ q,l/h. ~5
I
I ReceiPt Nb.
Bv I
~eplace
DAddition
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may procee I 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 Ct rtificate of Occupancy must be
~ningZ:~rJ S/u;d3 d,,,, ~ial~ ~~
24 hour notice for all inspectinns (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Re-~37b
Contractor's License No.
I Park Support Fee
1 SAC
1 Water Meter Size 5/S(V
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
#
#
#
#
MUtb 1.11. ^'
Paid
Date
/
~~
Main File
White
Canarv
'---"in k
Th~ Crnlrr nf lhr I..kr ("ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT IlJ ," /
APPLICATION RECEIVED -6 / (.
I
. ,.--
f !,,(.
,), i ~............
The Building, Engineering, and Planning Departments have reviewed the builc ing permit
application for construction activity which is proposed at: ~'
/1 /
/ ,. \. ,.. "-
'---.-/
Accepted
Accepted With Corrections
e-/'
Denied
Reviewed By: ~ ~f-' Date: S-~ l?"M:;>
Comments: A,c. ~ ~ ,.:;-1 ~L ~1.4-,'-r;oJ
A.-J- ~ ~ "'). Jt& -' (,,~ "'j Lf p--, 'P'~. -: "JI
-' ~L~ , ~ J WiN:~ uJ.d.J.
~ LJd4 ~ ~ O.L.,_r b k
M.>..>t. '1 '~ ,.:l- r
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~";4!--1"Y'" .-+:-':1 ,
"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."
. ---l~---'-
J
Main File
~ite ~ BuildinQ-,
Canary . ""Engineering
Pink . Planning
Th~ ('rnln of lhr L.kr {'ounl~'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVEo-C / hi 03
. I
YlJt I2m1cd1.
~
The Building, Engineering, and Planning Departments have reviewed the build ing permit
application for construction activity which is prdposed at: ~
/~/c; ~-I3 M.Ltv'1" ~ ~
Accepted
Accepted With Corrections z..-/
Denied
,
Reviewed By: ~ ~r- Date: 5/~3
Comments: :;gt..uY~ LUA.... A./GZ<-J I.R.C. l-o ~,
/":/J" ~ ~J . L7?~ ~,
. ----./'f"' I
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"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 tiolation 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."
. "-.------.--~----.-------..-~--.-~---__________r-.-------'----------~
~~
Main File
Tht Crll'''' of lh.. L.k"Counlry
White Building
t" c~""-n. + EnRineeril],gl
''y'nK Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT n}t /:
APPLICATION RECEIVED~S-/ {./ (I~.
,.,-1
.(
/;...
The Building, Engineering, and Planning Departments have reviewed the build ing permit
application for construction activity which is proposed at:
I~~', :7.7 /I<~~)
." ,,"'f~'.'A l
,.,'.""",-<: ':><..-L..r'
Accepted
->\
Accepted With Corrections
Denied
Reviewed By:
/II't\()
Date:
Comments: ..see Reverse Side for Additional Information!
/1J('J/'" F/( (
,....,.
S, /L(-o.j
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See At1a&bments: I) C'JTadinl1: Plan. 2) Erosion Control Measures I
"The issuance or granting of a permit or approval of plans, specifica ions 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."
From : JECHEEXC
PHOtlE 1,10.
612 89263'36
A'"9. 05 200~ 6: 01Ar1 F01
;...(!ILr. I,"'".',:,-~"_:"
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,nata na:.'4
\... . "J... .',
J'" ';',' ':~~ ...'
CiTY OF PRIOR LAKE
SEWER AND WATER PERMlT
, ,,_. "', I PERMIT NU.' ~ 5117
1, V,lll"" t.lly , ,.JIO.,
l loool" "1'1'1\"&111 lJ. ,;
d.3<531
\
I ZON NO(olllMuu) I
~"~~~~. .v'.~(olllcell.leonly) ~
tC;~I~loC::K [ ADDITION ~~. __on,
. ',' ,~..: .... '.~ '~""';''':''..,,}.'J\
~E~I1I~ Q,OJt1~+- ...-----,...--
~it:r#,:~~~"!<~DtoD~.' ~;'il u, '11;fi\ ~....-
~t ' ..,...' "7 " r
~.l<M''''"", : "II (Addre..\
~:iAf.tri~~Alt'i}'~"'i.'"
J.>PLlCANT'-,::;;:'
Name,'.:<"i";;.J ~\.;P.... E\'C'.
k.~~~il';!t'i'l''2ln'"'' PI
~)(.~" o..~' (" . 4P. {' -
lI\M~i,J{i1~~f;"'" (Addle..)
z::~.~./:v.;...:\~;.
~~"~'t;"'(~.I,~,... ",
:ontact Per;on)
~")'Mit~~~~;'V.,)'Jr1:~"
,PPLICANT SIGNATURE
PIO
;"h'
{1'/~
.....
.. (YJWl\c) .
In ."'-__ ... .--"."_cc".""',""_u.
'1...
APPLICANT I'LEASE COMI'L"~TE BELOW
Size of water service I inches.
. Location of ftny couplings from structurc .J2_ feel.
. Type of sewer pipe, 0 ABC [0'I'VC 0 Cast Iron
Estimated length of sewer line 3.12 feet.
Clean out (if required) loculed at_...... feet from structure,
clldentlalllwer ond water lin~ connection
ower connection oaly
FEE SCIIl~I>lJ u:
$)5.5(1 IllduSlrial, (;001'1 & Muhi.!~mlily
$17.50 Waler conncction only
I % of Job cost wllh a $31 .50 minimum
$]7.50
Estimated Cost $ ::J:511.._
Building I'"rmit II
SEweR AN\) WATEK PERMII' 1'1':1:
STATE SURCHARGE
TOTAL PERMIT I'm,
$
$
$
..-. .,-
....-lQ
<9~ '9.z
" '~(~~h
~'''Y
~~)..
., ....
IIDu U.. O.ly)
Ih/ll"II"IOffiCla.
[t'~'~' 'r[~trI[~7 ~/rl~-r~.'PI No, /1:' /
"I)';j;-.----... :1 lr '" v
- -.-- . At1fj--p r
24 h.IIJ' 110';" 10..11 ;"'1',,,,;,,", (;;2l H'~ "), I" (~52) ."...iN; .. ~I \' "Z;
8y ________~_~-:I
Thll AppllcatloD. Become. Your Building: Permit When Approved
'. ..
fIRESIDE CORNEF
#1999 P'.006
l'P'ea.!t1l'.: ra! or prilJt and ~a.n It bottom)
ADDRESS
CITY OF P TOR LAKE
HEATING/AIR CONDITIO fGIFIREPLACE PERMIT
FIRESIDE:' ;!~,"~ IPERMIn:o. 3-5371
DRle Rec'd
HEARTH6-HOME~
J 494,3 HILLSIDE CIRCLE
, ZONlNGCom<<usc)
LEGAJ. DESCRIPTION (ollice "s. only)
LOT
BLOCK
ADDITION
P1D
OWNER
(Name
MCDONALD CONST
(Phone)
(Addre~")
APPUCANT
(Name) ALU'illflJl.I;:illl.E ORA PfR~:lJ'.A.lIDl &. HOMP
(Phone)
651.633.256J
(Ad.dress)
2700 NORTH FAIRVlEW AVENUE
(AMrm)
(Cont.3ct Person)
BRENDA HUSTON
ROSEVILLF
(City)
(Phone) _651.633-2561
551]3_
(Zip Code)
, APP1.TCANT SIGNATURE
BRENDA J..IUSTON
DATE
8/22/0_'
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 At TERA TIONS
FURNACE MAKE AND MODEL FUEL
rUlE SIZE RETURN OPENINGS INPUT OUTP! IT
TYPE OF SYSTEM HEATING OR POWER PLANT
ow,"" Air PJ""t,
DGravily
o Mechanical
OAfr Conditioning
OVen" System
o Ste~m
o rim War.er
o R.di'llOn
o ~peei'l Device,
o Other Oevjces
PLF. "'SE NOTE:
Air (:ondi\ir.>net Units
CanT Ot Encroach into
Reql ired Side Yard
Setb.cks.
FIREPLACE MAKE AND MODEL
HEAT N OW 6000TR-OAK X 2
Indu'tri.I, Commercial & Multi. Family
FEE SCHEDULE
1% Qfjob CQ~t Residential, G:lS FirepIBce
JJJ9,50 minimum
$99.S0
$64.50
$39.S0
Re~jdentiaJ. lie3ting & NC (New Construction)
Residential. He,"ing Only (New COnstnlclion)
Re~ld(;ntI8,1. Addi~ion5 & Alterations
R<.<idential. AC Only
$39.50
$39.50
eU/J ~/D
,)~ l1.771
o j:)~ 1f
~4.r1]-
Estimated Cost $ Building Pennit #
HEATING PERMIT FEE $
STATE SURCHARGE $ f~, ro r..;i~ rWi rc f-,;
TOTAL PERMIT FEE S 11 U i Ls L;) If: 11 l'.1 It "')
(om" u.. O.ly) /' '~
Thts Application Becomes Your Building Pcr:mll When.ApprQ}'ed I ~ ~Ud1J ~ ; LUUj !m:ceipr No. I
A J1eoril, ~ lJ"me ice/1m 08 . rnn .-if W
~. 'W' \ 11uilder DIl,i.';' n ~te Jtr.",
~/l, nVlrr.fI"2'On;~rvifl:wAven~h RaRJl}F'I]c MNS.511111'ho e....o.:u,.:l......~-""......l i. i"'b.s.&8..a. /
""""," ,c,.u;;, 3850 We~t Hjilj,''!ta~ JJri~W".'ijlIRlrM1fldlM~~1r!1JlP-;~'5it.jj~~15HM~4"2~~2.890-5408 !r-"41!'f'~,?,;K(I,'i'1
""\O,,,.rr~lrh~1I5n.r.,m !\f~ Cflntl')('((lr rJt1!n~ II. 201/91"'1
__ _ .~_.___~~___.____--~~""&. 1:1'.l..U1< LA.K1::!;
I4J 001
CITY OF PRIOR LAKE
REA TINGI AIR CONDITIONINGlFlREPLACE PERMIT
Date Rec'd
:. "l..~
:!.,Cit....
l. Y..ll_
~:~ I PERMIT NO. 13- L-3'71'
Appnc~nl ::J
I
ZO -lING loffic, US,)
CP!e:!~t: t'fpe or ~...n[ lII.d sim at bQttcz:n~
ADDRESS
//f9,'F'2,
d//g/f,Jp
C;/' .
^ I ' \
/V, kJ ,
LEGAL DESCRIPTION (oti'ioo 'So only)
LOT
BLOCK
ADDmON
PID
OWNER (\ ;r'-.
(Nam<) ~(,~)(\h 10 l\.)
L-D,0!;', I.
(Addms)
APpIlCANT j{)
(Narn<1 (;,..." j //111 //1'"
(Addrcss).--Q/O/(l 6J h.AJ
(.'.dd,.",)
o if'
()II!'"'
(Phon<)
~'
u
~ (City)
(Contac( P<rson)
A~
2th:-~
(Phon<)
APPLICA."lT SIGNATURE
DATE
,,;'
APPLICANT PLEA.SE COMPLETE BELOW
OWIltIllAirPlonts
OGrovil)'
o Meahs..nical
DAir Conditioning
OYent, Sys~
OSteMn
o Hot W.ter
o R.di.'lon
o Special Devices
o .Other Deyic:~s
FIR.EPLACE MA,KE A}4D MODEL
IndlJstrial. Commercl.a.1 & MuJti~?amil)'
FEJJ:SCREDULE
1 % of job co~t ~ndt;:l'\tie.L Gas FiT~pltl.ce.
$39.50 minimum
$99.50 Residentitl,.,Adciitions & Ahcrations
$64.50 .Resid'::nti~l~ AC Only
S39.50
ResidontiE.l, f-bating &. AJC (Nt:w Connroction)
Resi.dential. nt-a'!\ng Onl)' (N~ Constf'Jctior-.)
S3 9 .50
$39,50
Estimated Cost S
Building ?cnnit #-
BEATING PERMIT FEE
STATE SURCHARGE
T01'AL PER.1YUT FKE
$
$
$
.50
el fIt '~/D
'", i/,\, .111,..,.
_ Gt:Ji, 'Y
'J:/4t1)-
(O!t'iCt US~ Only)
Bui.lding- OniciRI
ru~ ;;';cl0 Li U ~ LC I .
U~ D~WG 2 7 2003 ~j
24 hoo, not;" for 0/1 ,n'podi".. (95') ~~.:.o, fo". ~9S2) _~"45 j
D!te
! R.eeelpt Nt
By Ocr
Tbi.s A~p!ic:l.tlon Bet:omes Your Building Permit When Approved
ZOO~
lIIV a311011.LNO::>
9LZ909tTS9 XV~ LT:LC IlI~ ~OOZIZZI80
'-"'-
F~OM)~EN~EL PLUMBING & HEATING 651-452-0J67
I
(WED) 9 J' OJ 7:5L/ST 751iNO 4860053574 P
Date Rec'cI
CITY OF PRIOR LAKE PLUMBING PERMIT
q"le.te ~ or orint aod aiI!ZI at bottOm)
I ADDRESS
14'45 !If(.(.Stt)E.
f,it.. No IIJ.
: ~~ ~~~ I PERMIT NO:? -537 I
J, V.I.... "wilt..! - I .7
I . .
ZONING [ollk....)
LEGAL DESCRIYTION (011I", UM only)
Lo-rf4 BLOCK I ADDITION $rE/2.l-IAJr..
-5curJ.J
~~e~R Idcf)~-4L.f) ~ t>>J.sTJ2tJ~ (phone) Q5Z. 4&2. ~ 7",1
(Address) 7'01 '[45 "JI ~T W" I'JpAoE. VALlEY, tJJAl!
APPLICANT I. , _ .. i1A I
(Name) ~~E:L. "(lE..u.lAAJ/CAL (Phone) 651- 4sz- IS'S-
(Address) I ~ t:1!JG.AAJ PIA.) I 55"/2/
(Contaa Person) d;;- 1A0 ' ;~~~:) , (Zip Code)
APPLICANTSIGNATUKE bla~~..:..~" DATB 1/3.Au
I
Quan tit)'
I
I
I
4
I
:3
,
~
PIP
APPLICANT PLEASE COMPLETE IELOW
Typll of Fixture
Bath Tub with or w ilhout shOwer
DishWllsher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 comparoneiit'sink
Shower Stall
Sinks
Bar Sink
Waler cioset (Toilet)
j~aaDtity
I I
Type ofFjxtur.
Rough-ins I
Waier Heater I
Water Softner I
Stand Pipe (Washing Machine)
5ewa~e Eimor I
Backftow Assembly I
Bacldlow Assembly T~1rt
Lawn SDTinkler I
~her I
I
FE!: SCHEDULE
Industrial. Commer""d II:. Mulli.famlly lY. of jOb co,t with 1. $J9,~U minimum
~esldentl.11 NeW' One: & Two.Far Iii)' S99.50
Relidenlill, Addllio.. & Alrerl"C 'S s:J9.S0 ," Iv
BuilclingPOT1Tlil~.12J...S57 ~rf ~
$ PAIDWITH O~~ fJ1 c.,{'/--
~UILD/NG PF.!lMIT f' ~p ()p1~
(Olli<< U.. Ooly) ----- C
ThiJ AppliclliOll Become. Your BuilclinE Permit When Approvod 'r~'l ~i~;': ::~ IJ . -i-~ Ii"!:
,1i II
,:IIJ ~1Ct" V 4 LUUj U ii
Dale U -.-it
~4 ho..... ~~G~;t\1 :l.1 ~Jl ~li'IHCtiO" (tSZi -.'" ~~.!lLrlll~ \'JSl1_w""U~':L.__r
~--~. -~". .
Estimat.d Co., ~
PLUMBING PERMIT FEE
ST A IE SURCHARGE
TOTAL PERMIT FEE
ReoeiPl No.
By
8Ulldl"lomritl
PRIOR LAKE
INSPECTION RECOR[)
. .
SITE ADDRESS I "q Lf 3 HI LLSI be Ct 0. E ":"W.
NATURE OF WORK NEU ~.T ItJ.lC"'O~ I
USE OF BUILDING S .1='". J\. I
PERMIT NO. ()3 ~Oc;"?-Z DATE ISSUED 15/-r.8UrJ
CONTRACTOR M,Cbot\At. 0 I"~,,.. PHONE~2. -~,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTI :>NS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF M flJ AJ
BUILDING AND INSPECTION
'Fii...G
INSPECTOR DATE
I FOOTING ilt I 7 +-.2 C(
I FOUNDATION (Prior to Backfill) <vI<. f~ PI.;' I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC ~ #~ 4.s ~AA
FRAMING f/IJ If __ q.u. . q k.q tL:8
INSULATION fl7 to-tt
ELECTRICAL I91-t.. I
PLUMBING f//J:, 7':");> I
HEATING (if required) ~ q II ')."1Lef!...
FIREPLACE ~ I
GAS LINE AIR TcST1~ r p ~ ~ /.2-~ 1()3
COVER NO WORK UNTIL AB<?.VE HAS BEEN SIG~ED
ItJd~rult.ED J1dNG'/sntMJ ~ "'c:.-.~I I
I FINALS Y I
:~~~~:~ (Prior to Sodding) ~ ;;} :IV;:
ELECTRICAL . I
PLUMBING W c.. fil:.h J i- + ( - I!)?
HEATING "(117 II f22/ptf
DO NOT OCCUpy UNTIL ABOVE HAS BEEr4 ~ IGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in 'nspections
and maintained until all inspections have been approved. On buildings an, j additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
QI~rfifirat~ of <IDrrnpanru
CITY OF PRIOR LAKE
~eparfmeuf of ~uilMug Jlusperfillu
~ Final Permitted D Conditional e.O. Expires
This Certificate issued pursuqnt to the requirements of Section 307 of the Uniform Building Code ce 'tifying
that at the time of issuance thIs structure was in compliance with the various ordinances of the City t f Prior
Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
Bldg. Permit No.
Date:
Date:
03-05.17
~UD
I
14943 HILLSIDE CIRCLEIN.W.
ST W., APPLE VALLEY 5$124 .
I
I
I
N/A
Zoning District
Occupancy Type
R3
Type Construction VN
Fire Zone
Legal Description
L14, Bl, STERLING SOUTH
Owner of Building:
Contractor's Name & Addre5'~MCDONALD C~STR.,
ROBERT D. HUTCHIN{/ff}
Building Official ~ V
Site Address
7601 145TH
City Planner
DON RYE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~lJtL\~(~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
, -
~
~\
}
oJ
(
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
~..! WATER HOOKUP
SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
IL~. -: ~
~ crt-
(~~,
DATE 11ME
~/c;jo3
I if" .on
~
'!J -q t.t b
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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I C.A:-D,
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-~
^
Ua.t.>M- ~,\S Jy"eJAA. ~~
o )lI6RK SATISFACTORY. PROCEED
t;( CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR R~I'12fTION BEFORWRING
Inspector: ~;Jb'eAH' '1 &'2c/)~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
UUNO"
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I L/ &f Ll '3
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.8"FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED I~
l-\;lI",~ {\.'r
CONTR.
PERMIT NO.
""? - c; ?7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~RHOOKUP
LUMBING FINAL
MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
t. (:;-.,.,.1 G~...J~ ~ ~ ~
"
5012 ~(N...... (5 'C
o WORK SATISFACTORY, PROCEED
~ORREcT ACTION AND PROCEED
o CORRE~l: CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CAL 7_~O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IN$JIIOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
II ~ JlI-tJ'f
ADDRESS 1'i91fJ f!d/srf:t. f:/r
OWNER CONTR. /Y1c.l1l1J!!1!J/
PHONE NO. PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
f)j(~!.LING
V'O"'c~T
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
f.,r.,tr () K
I..,/b 6';-ol{ _
t"?{WORK SATISFACTORY, PROCEED
~ \:ORRECT ACTION AND PROCEED
o 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/
"''''''"
Job Address
Heating Contractor
Name of Tester
Date
Percent O2
Percent CO2
Percent CO
Stack Temp.
He; 4) //, f5ijJ..
Controlled Air
'1.J
is II.tlv 1J7
~,Io
1J
~40