HomeMy WebLinkAboutBuilding Permit 03-1301 & 1399
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvP~ or print and siJUl at bottom)
ADDRESS
Date Rec' d
9/951-03
~. ~;:~. ~:~ I PERMIT NO. 03-I2.D I
3_ Yellow Applicant :.J
5J.O/~
P A/Kl-r fJ civn1- ~~
. LEGAL DESCRIPTION (olliee use only)
LOT
ADDITION
~ T ZL-S #aq
BLOCK
OWNER, L vJ
(Name) lr7oR6-T jI- -DJIV>' rd>i'iLA S
(Address)
BUILDER ,7
(Name)~6-FIlJ t'/>/J<; 7 /)/J 12-b TI?5;.
(Contact Name) ~DI_ ^ /k-I'~JI'- IV
(Address) 8 () 7c; ;(Ef-./Tl.JUl T CJX..
TYPE OF WORK
~ew Construction
DLower Level Finish
o Misc.
11Z/S;ffi"U~) I
pm.;? 5" ~ () (P() - 0 ( tJ-r..)
(Phon*~ t;/Z,. Z70. Oqe'l
(!.,dJ - ~ s? - af.;J. - I.f 38.,;;..>
(Phone) 1$".2-'7l.11 -'If)3C/
(Phone) "l5')- 9<//-q5-3 ~
~-S4' 3 b
LL,.C,
/3l.J>16-TN
DDeek
o Fireplace
DPoreh
DAddition
ORe-Roofing
DAlteration
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 agen~~or -",~ oo..t. I :-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans I . aw that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;terup~ .:~--J rfonn needed inspections. 2c>2418'71,;3 8-;1.1-63
/ ~ / / Signature . Contractor's License No. Date
/
I Permit Valuation '
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
L./?/t:j. ()O~
);l 9#f(. i!5
I q/l:,. 30
~~LJ. on
I DO --
IOf), - I
35,S-DI
iio.-- I
This Application Becomes Your Building Permit When Approved
~
:;,~) ?//~~
.~
I Date
Building Official .
I Park Support Fee
I SAC
I Water Meter Size 5/8"6
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid "qff"'" ,<tf'
I Date /0 II.OJ
$
$
$
$
$
$
$
$ I
$~, '0 b4-. -I-S" I
, i _
17 -"5H7
#
#
#
#
ORe-Siding
DUtility Connection
-
- .
I~O;. ~~
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
~~ds~edbyiliec~~p_~eomtirot~atempmarycmm;~;~~;liancean~~~:~~W
Pl*in Dir tor Date Special ~itions, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 \ /
\' 16200 Eagle Creek Avenue Prior Lake. MN 55372 \ /
,~~
CITY OF PRIOR LAKE
DEMOLITION PERMIT
1. While
2. Blue
3. Yellow
. File
- Clly
- Applicant
Perm~ No. () 3-/311
DIRECTIONS
11. DATE
BUILDING INFORMATION
7. SIZE OF STRUCTURE
SPACES NUMBERED 1 THRU 10 MUST BE FILLED IN
BEFORE PERMIT ISSUED
(Please print or type and sign at bottom).
92,'1.{)J
8. NO. OF STORIES
2, SITE ADDRESS
sz 0 I
rtulJ'T
,PT.
zS. O~O. 0/0. 0
9. TYPE OF CONSTRUCTION
3. LEGAL DESCRIPTION
'0. COMPLETION DATE
LOT
8LOCK
PID
ADDITION
4. OWNER (Name)
Mt:nrl-S
5. ARCHfTECT (Name)
(Ad'SS)
. 660~b . 1-//1/011-
~ (Address)
(Tel. No.)
(Ter. No.)
95"Z. 9~/. 9S-J~
6. CONTR~~~Name) (Address) (Tel. NO.). ) .) ..-
/7~tpi/ ('Lj/l/J77(,..,. f';079 /t;t:;v/l!~ U,e'l PcoonlfVCiJZ)rv S.,;:)4-3fJ
I hereby certify I have furnished infofmation which is to the best of m/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 procee in a rdance with submitted plans. I am aware that the building offICial can revoke this permit for just cause.
Furthermore, agree that the city official or a designee may enter upon the property to perform needed inspections.
/
Signature
q-.-l.9~o3
. Date
x
METRO SAC UNIT DETERMINATION
FOR ADMINISTRATIVE USE _ $
aVo $IS/000.00 ~ 9. 2-'1.(1::1,.,--
MATERIAL FILED WITH APPLICATION
CJ Site Restoration Plan
CJ U~lity Abandonment Plan
CJ Sewer Abandonment
USE OF BUILDING
SITE RESTORATION PLAN
Accepted by
Rejected by
CJ Water Abandonment
CJ Electrical Abandonment
CJ Other
Division
2
4
CREDITS
Park Oed. Cred~ ................................................ $
SAC Cred~ ......................................................... $
Sewer & Water Connec. Fee Cred~ .................. $
Water Tower Fee Cred~ .....................................$
Other .................................................................. $
TOTAL CREDITS ........................ $
TYPE OF CONSTRUCTION:
II
III
H
IV
R
3
V
M
Occupancy Group A
B
E
This application becomes your
demOl7 pannil when approved
BY~~
Data't!);; ~ ?
Issued by
Date
This is to certify that the request in the above and accompanying documents is in accordance with the City Zoning Ordinance and
may proceed as re e d.
~,
to. (.0];,
Date
Special Conditions if any
.-.'.'.
FEMA
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSlJRANCE PROGRAM
ELEVATION CICRTIFICA TE
AND
INSTRUCTIONS
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
PAPERWORK BURDEN DISCLOSURE NOTICE
FEMA Form 81-:n
The public reporting burden for !his form is estimated to be 3.0 hour\. per response. The burden estimate incltldes the time
. for reviewing instructions, searching cxi&1ing data sources, gathering and maintaining the needed data, and completing,
reviewing, and submitting the fonn. You are not required to respond to this collection of information unless a valid OMB
control number appears in the upper right comer of this form. Sl,nd commenls regarding the accuracy of the burden
estimate and any suggestions for roducing this burden to: Information Collections Management, Federal Emergency
Managelnent Agency, 500 C Street, SW, Washington, DC 20472, Paperwork Reduction Project (3067-0077). NOTE:
Please do not send your completed form to the above address.
PURPOSE OF THE ELEVATION CERTIFICATE
The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be
used to provide elevation information necessary to ensure compliance with community floodplain management
ordinances, to dctennille the proper insurance premium rate, and to .mpport a request for a Letter of Map Amendment or
Revision (LOMA or LOMR-F).
The Elevation Ce11ificate is required in order to properly rate post-FIRM buildings, which are buildings constructcd after
publication of the Flood Insurance Rate Map (FIRM), for flood insurance Zoncs A l-AJO, AE, AH, A (with BFE), VE,
VI-V30, V (with BFE), AR, ARJ A, ARlAE, ARIA l-AJO, ARJAH, and ARIAO. The Elevation Certificate is not required
for pre-FIRM buildings unless the building is being rated under the optional post~FIRM flood insurance rules.
As part of thc agrecment tor making flood insurance available in a cmnmunity, the NFlP requires the community to adopt
a floodplain management ordinance (hat specifics minimum requirenlents for rodueing flood losses. One such requirement .
is for the community to obtain the elcvation of the lowest floor (including basement) of all new and substantially
improved buildings and maintain a record of such information. The .Elevation Certificate provides a way for a community
to comply with this requirement.
Use of this certificatc does not provide a waiver of the flood insuran(>c purchase requirement. Only a LOMA or LOMR-F
from the Federal Emergency Management Agency (FEMA) can am~d the FIRM and remove the Federal mandate for a
lending institution to require the purchase of flood insurance. However, the lending institution bas the option of requiring
flood insurance even if a LOMA/LOMR-F ha.. been issued by FEMA. The Elevation Certificate may be used to support a
LOMA or. LOMR-F request LOWest floor and lowest adjacent grade elevations certified by a surveyor or engineer will be
required ifthe certificate is used (0 support a LOMA or LOMR-F request.
This certificate is used only to certify building elevations. A separate certificate is required for floodproofmg. Under the
NFl?, non-residential buildings can be tloodproofed up to or above thc Base Flood Elevation (BFE). A floodproofed
building is a building thai has been designed and constructed to be watertight (substantially impermeable to floodwaters)
below \he BFE. Floodpmoftng of residential buildings is not pcmdtted under the NFl? unless FEMA has granted the
community an exception for residelltial floodproofed basements. The community must adopt standards for design and
construction of tloodproofed basements before F EMA will grant :l basement exception. For. both floodproofed non-
residential 'buildings and residential tJoodproofed basement.~ in communities that have been granted an exception by
FEMA, a floodproofmg certificate is required.
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSUR.~CE PROGRAM
ELEVATION CEIUIFICATE
C.M.B. No. 3067-0077
Expires December 31, 2005
Im,?ortant: Read the Instructions an oal/es 1 -7.
SECTION A. PROPERTY OWNER INFORMATION
:~!l1'fiiMlili6!i!i;@m~lj'y;qjimm%jf~
::II~~mIJ;ir~l::~!(i:~;:.~~~m~mm::~11~~lt;~im~!~
6UI~DING OW~R~ NAME ~ L " \.... I '
,,~c,. l~OIt...._ "1)'0\ ""
BUliplNG STREEIJ>D~SS (!PI>ludlnl/ Apt.. Unit. Suite. endlor Bidg. No.) OR P.O. ROUTE AND BOX NO.
":>"2-0 \ ~~. YO...i.#- G\..,_\~ Se:
CITY (). l \. STATE \
~~ ~ fuw
PRjiP TV DESCRIPTION \\O/l.n~ ~~Nul1)lle"," Tax P'Ilf"1 !:!l'mber, Lega~'i~.criE!ion: etc.j . \ \
,(it'AG.,- ,,), ~1!~' .. <!d/. ~,y ~ . . ~l) L,\ - .Sc.,,-\-l ~l"'.~' .
BUlL ING USE (e.g., R~11 'f'fon-resldential, Addition, Accessory, eY!1,se a C:omments"rea, If necessary.) 1 .
::IM~I~~lim~~~I1~i~~!j:~ti~ilf;~~:\~m
-
ZIP CODE
t;;..;~
\'Y\~
LA TITUDElLONGITUDE (OPTIONAL)
( I#f. ##' . 1/#.##" or ##.#####')
HORIZONT AL DATUM:
LI NAD 1927 U NAD 1983
SOURCE: I_I GPS (Type):
U USGS Quad Map U Othe,
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
I B1. Ni;lP COMMUNITY NAME & COMMUNITY NUMBER I B2. COUNTYNAMIO ,\ I B3. STATE. \
.v"';M' \-"\<..,~ "_'I D ~'?n... S~'tt '('1\'N.
I 84. MAP AND PANEL I B5. SUFFIX'I Ba. FIRM INDEX B7. FIRM PANEL. I B8. FLOOD B9. BASE FLOOD ELEVATION(S)
NUMBER f\ DATE EFFECTIVE/REVISED DATE ZONE(S) (Zone AO. use depth of flooding)
bCl'l1.. \. l \-1"\-'1"1 H_\~.C'l" IX '\1'19."\
610. Indicate ihe source of the Base Flood Elevation (BFE) date or base flood depth entered in B9. .
. I_I FIS Pmfllej-l FIRM I~mmunlty D!Jlrmlned I_I Other (Deacriba):
B11.lndlcate the elevation datum used for the BFE In B9: ~GVD 1929 _I NAVD 1968 U Other (Describa):
B12. Is the building loceted In a Coastal Berrier Resources System (CBRS) ,,,eo or Otherwise Pmtacted Area (OPA)? 1-1 Ves l..!:::!"I'io
Designation Date:
SECTION C - BUILDING ELEVATION INFORMATION (SURVEV REQUIRED) .-'
C1. Building elevations are besed on: LIConstructlon Drawings" LII!ulldlng Under Construction" L~lnlshed Construction
"A naw Elevation Certificate will be required when construction of the bLilding is complete.
C2. Building Diegram Number -1- (Select the building diagram most simlblr to the building far which this cartificate Is being completed -sea
pages 6 and 7. If no diagram aCC\lrately represents the building. pmVids a sketch or photograph.)
C3. Elevations - Zonee A1-A30, PE., AH, A (with BFE), VE. V1-V30, V (with I!FE), AR, ARIA. ARlAE. ARIA1-A30. ARlAH, AR/AO
Complete Items C3.9-; below 9ccording to the building diagram specified in Item C2. State the datum used. If the datum is different fmm
the detum used for the BFE in Section B. convert the datum to that used for the BFE. Show fleld measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section Gt as appropriate, to document the datum conversion.
Datum Conversion/Comments ./
Elevation reference mark used Does tha elevation reference mark used appaar on tha FIRM? LI Yes ~ No
o a) Top of bottom floor (including basement or enclosure) 1\\0. . ~ ft.(m) 1
o b) Top Of next higher floor C\~. 5- ft.(m} ..
o c) Botlom of lowest horizantalstructural mamber (V zones only) . _ fl.(m} 1 ~
o d) Attached garage (top of slab) C:r~t-"fft2. -- el\ q .:L ft.(m) f i
o e) Lowest elevation of machl.nery and/or equipment Gl'Il'4I\e. \o~... 1:\\2..'0 i If
servicing the building (Describe In a Comments area.) >....l _ . . ft.(m) ~ 1i
o f} Lowest adjacent (finiShed) grade (LAG) '\l.Q. . ~ ft.(m) z ~
o g) Highest adjacent (finished) grade (HAG) 1:\ \q ..l.e.. ft.(m) I
6 h) No. of pannanent openings (flood vents) within 1 ft. above adjacent grade :!l
01) Total aree of all permanent openings (flood vents) In C3.h sq. In. (sq. cm)
SECTION D '.SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certlficetion Is to be elgned end ..a led by e land surveyor, engineer, or archiject authorized by law to certl1y elevation information.
/ certify thet the/nformatlon In Sections A, S, end Con this certificete "'p",,,ents my best efforts to Interpret the date avallsbls.
I understsnd thst sny fslse ststement msy be Dunlshsble by fine or ImDrisDllment under 18 U.S. Code. Section 1001.
CERTIFIER'S NAME 5t, H- WI. 5w~1\J 'sO,..) LICENSE NUMBER <{z..3o 9
TITLE \ . <!!" COMPA.NY NAME;. '\' 5 '" (lI.
I,..:A'ND~ ...........ol:L \/"'- .r,\ "'{\l~i\'\j '-b. t".".
ADDRESS\~l..'/) ~.....~\\~ -r-~\\ 5t: CITY~rilY \:.",\t~ STAT~N ZIPCO~E -:;<:''312-
6IGNATURE~l"III'Jn ~l D'~_'~D'I TELEPHONE<.:\'!"/Z,. '.\'.\1-'Z.'!:n(')
FEMA Form 81-31, January too:r See reverse side for continuation. Replaces all previous editione
IMPORTANT: In lhase spaces, copy the corresponding Information from !lactlon A.
BUI~DING STREET A:1Es~ncIU~lng~, Un.;Sulte. and/or Bldg, No,) OR P,O, ROUTE AND BOX NO,
~::l/'\ 't:::' r . \ ..\)" D.... I.,. -:,~
CITY /) , I I STATE \, ZIP CODE
f'''',....... \. ~ \'t\..... o;s1>,?
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elavation Certificate for (1) community officisl, (2) insurance agent/company, and (3) building owner,
COMMENTS~ Al\l.",h...~ \c, \fI""l...,o ; ~ -z........e "f.- (P.~f"lL ~k.....""",J' .\..u \\<.
t\"L.~..6... 4-ho_ '5C:tl~\I"'" -C.1l'r'rC &'" ~ \I\..,.....~ -CIMr -e\h"JI....'\ ',(. Qlo.1
~.., C,.,....-.......~~ P.t,<c.e ..f.lu,,'d) .., \.htool....~ k q...,q.q
;ffii}\~llg9ti!ll~,llnliiQllllm}!!!m!;l
r:i.[~:~I.~~~!;~j~1!1![j:;;t~;:f:[.~r~~!:1:il~~j:;l~~;[Jl::['f:~
!i;..!.11:118i~~~~jli~;~!~~:li'l.~i;l
t l Check here If attachments
SECTION E. BUILDING ELEVATION INFORMATION (SURVEY NOT REClUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE)
For Zone AO and Zone A (without BFE). complete Items E1, through ES, If the E"evation Certificate is Intended for use as supporting
inlonnation for a LOMA or ~OMR-F, Section C must be complated,
E1, Building Diagram Number _ {Select the buiiding diagram most similar to the building for which this certifICate is being completed -
see pages 6 and 7, If no diagrem accurately represents the buiiding, providE' a sketch or photograph.}
E2, The top of the bottom floor (Including basement or enclosure) of the building is L-LI ft. (m) LU in. (em) LI above or LI below
(check one) the hlghes,t adjacent grade, (Use natural grade, If avaiiable.) ,
E3. For Buiiding Diagrams 6-6 with openings (s.. page 7), the next higher floor (lr elevated floor (elevation b) of the building Is
1_1-1 ft. (m) U_lin, (em) above the highest adJacent grade. Complete noms C3,h and C3.i on front offonn.
E4, The top of the plettonn of machinery andlor equipment servicing the building Ia 1-1-1 ft. (m) 1_1_1 in. (em) LJ above or I_I below
(check one) the highest edJacent grede. (Use neluralgrada, ff avalleble.)
ES..For Zone AO only: If no flood depth number IS,jlvallable, Ia the top of the bottom floor eleveted In eccordance with the community's
floodolaln meneaement ordinance? I I Yes I,) No I I,Unknown. The locel officlel must certl{v.thls Information In Section G.
SECTION F . PROPERTY OWNER (OR OWNER'S RE,PRESENTATlVE) CERTIFICATION
The property owner or owne(s authorized representstlve who completes Sectlo',s A, B, C (Items C3.h and C3.1 only), and E for Zone A
(without e FEMA-Issued or communlly-Issued BFE) or Zone AO must sign here. The statements In Sections A, e, C, end E ere correct to
the best of my knowledge,
PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME
ADDRESS
CITY
STATE
ZIP CODE
SIGNATURE
COMMENTS
DATE
TELEPHONE
I I Check here if attachments
SECTION G. COMMUNITY INFORMJlTION (OPTIONAL)
The local official who Ia authorized by law or ordinance to edmlnlster the community's floodpleln management ordlnence can complete
Sections A. B, C (or E), and G of this Elevation Certificate, Complete the applicable item(s) end sign below.
Gl. U The Infonnatlon in Section C was taken from other documentation that hlls been signed and embossed by a licensed surveyor,
engineer, or architect who Is euthorized by state or locellaw to certlly elovsllon Infonnation, (Indlcetethe source and date 01 the
elevation data In the Comments area below,)
G2.U A communlly official completed Section E for e building located In Zone II (without e FEMA-Issued or communlty-issued BFE) or
Zone AO,
G3, U The following Infonnation (Items G4-G9) Is provided for community floodplain management purposes,
I Q4, PERMIT NUMBER I GS. DATE PERMIT ISSUED I Ga, DATE CERTIFICATE OF COMP~IANCElOCCUPANCY
ISSUED
G7, This pennll has been Issued for: LI New Construction U Substantial Improvement
Ga, Elevation of as-built lowest floor (Including basement) of the building Is:
G9, BFE or {In Zona AO} dapth of flooding ettha building site Is:
. _ ft, (m) Detum:
. _ ft, (m) Datum:
LOCAL OFFICIAL'S NAME
COMMUNITY NAME
SIGNATURE
TIT~;:
TE~E'PHONE
DATI:
COMMENTS
FEMA Form 61-31, January 2003
I I Check here ff sttachments
Replaces all previous editions
NOV-12-2003 10:32
08
P.01
Land Surveyors
Planners
Valley Surveying Co., P. A.
(612) 447.2570
Suite 230
16670 Franklin Trail S.E.
Prior Lake, Minnesota 55372
November 5th, 2003
Hagen Construction
8079 Kentucky Circle
BloonUn~on,~ 55438
~
-
RE: Top offooting certification
CERTIFICA TlON:
I hereby certify that I did, under my direct supervision, measure the top of the footing of
the house under construction at 5201 Frost Point Circle SE, Prior Lake, Minnesota, a.k.a.
Tract J, Registered Land Survey Number 29, Scott County, Minnesota. I further certify
that said top offooting is at elevation 910.36 N.GYn. The future lowest floor, not yet
poured, will be at elevation 910.7 +/- N.G.V.D.
-4
~,~f.{~
Minnesota Registration Number 42309
File Number 9735-Xl
-
Fe.. :..Hl- Y"Z.l\S
Oat. lit ,?J03 I"'~. I
Fnom I LJP,~_
Co\\c..\\.uI <;" R." .
-'4'\.-\ -"2..<;'10
Fax'
Post-it" Fax Note. 7671
ITo~ \\o~lI'\~
I co,o.pl~'6\.~t.l '\ '" <. f .
ptlOne' ....)
i
-.--// {'
TOTAL P.01
16200 Eagle Creek Avenue S.E.
Prior Lake, MN 55372-1714
On Friday 12/3/04 at 9:20 a.m. I was instructed by the
City of Prior Lake attorney, Susan Lea Pace that if
George Koblas signs an affidavit stating that Haugen
Construction walked away from the house at 5201 Frost
Point Circle. I should honor the request of Mr. Kob1as
and do the final inspection.
;;;;:;. p~ Building Inspector
www.cityofpriorlake.com
Phone 952.447.4230 / Fax 952.447.4245
12/02/2004 0g:40
gS2881g1S0
LAW OFFICE
PAGE 01
LOREN GROSS
ATTOANE;Y 06.1' LAW
8C09 LYNDA1.E: ~VE.NUt SO" sUITt 2!:'4
En,OQWfNGTON. t11INNESOTA 5S420
TEU:PMONt 1952} 881.8&36
FAX (9S21 eBI~~J1!!O
BY FACSIMILE ONLY
952-447-4245
December 2, 2004
Michael Peterson, Building Inspector
City of Prior Lake
16200 Eagle Creek Avenue SE
PriorLake,~ 55372
Dear Mr. P.;."....,,~un:
I am writing this letter at the request of and on behalf of my clients, George and Linda Koblas,
owners of the lot and new house being cons17ucted at 5201 Frost Point Circle Southeast, Prior
Lake, Minnesota.
Mr. and Mrs. KobJas have been living in a temporary arrangement with one oftheir children
during the consttuction of their new home. That new home is now finished and ready for final
inspection and issuance of an occupancy permit. We are aware that Mr. Hagen of Hagen
Construction has scheduled the final inspection on two occasions and later cancelled. It appears
he is arbitrarily refusing to call for final inspection because he perceives that it gives him some
leverage in collecting some disputed costs he has attempted to charge the Koblases.
In the meantime, the Koblases are prevented from moving into their new house and maldng use
of the propeny they own. They stand ready, willing and a'lle to pay Mr. Hagen and IUs
subcontractors what is justly owing, but they do not iJ.1tenli to allow Mr. Hagen to extort unjust
amounts from them by these or any other means.
As you know, I advised Mr. Koblas to call you to schedule. a final inspection. You should be
aware that for the past several weeks George and Linda K6blas have been managing the project
and personally worki))g on this house in any and all ways to advance the project to coropletion. .
Mr. Koblas axranged for and attended the final electrical Wspection. Mr. Hagen went to Florida
for two weeks and, since his return, his involvement in fmishing this project has been miniscule.
I
I
I have read carefully that portion of the Minnesota Buildiqg Code you have cited (Minn. Bldg.
Code 1300.0210, Subd. 4 - copy attached for reference). While the code says "The person doing
the work authorized by a permit shall notify the building fcial that the work is ready for
~
12/82/2884 89:48
9528819158
LAW OFFICE
PAGE 82
Michael Peterson
December 2, 2004
Page 2
inspection", it does not deftne that person more completely. Mr. and Mrs. Koblas have done
more recent work on this project than anyone else.
We do not believe the language of the building code gives you any justifiable basis for refusing
to schedule and perform a final inspection. The purpose of the building code provision was to
prescribe who should call for the inspection, but it does not specify that the permit holder is the
only one who can call for an inspection.
The Koblases ere taxpaying citizens of Prior Lake. They have lived in your community for
twenty years and will be there for the indefinite future. They n.eed your help in breaking this
bureaucratic impasse which prevents them ft"Om living in their now completed house.
I will ask Mr. Koblas to call you once again for a fina1 inspection with the hope you will go
forward with the scheduling and completion of the inspection. Of course, they fully expect to
comply with all code requirements and deficiencies which the irIspection may make known to
them.
.:z.s very truly,
;]h~Ll~
Loren Gross
LGllem
Enclosure
12/82/2884 89:48 9528819158
MitmesotaRule 1300.0210
LAW OFFICE
PAGE 83
Page 1 oD
Mi@e~QlltRIt.~.J!~.Q.:f..CbARten
IJi!'b.lJ;_9f.l<QJ;l.t~~,t'QI:_~,-U0.9.
1300.0210 INSPECTIONS.
Subpart 1. General. Construction or work for which a
permit is required is subject to inspection by the building
official and the construction or work shall rema,in accessible
and exposed for inspection purposes ~ntil approved. Approval as
a result of an inspection is not approval of a violation of the
code or of other ordinances of the jurisdiction. Inspections
presuming to give authority to violate or cancel the prOVisions
of the code or of other ordinanoes of the jurisdiction are not
valid. It Shall be the duty of the permit applicant to cause
the work to remain accessible and exposed for inspection
purposes. Neither the building official nor the jurisdiction is
liable for expense entailed in the removal or replacement of any
material required to allow inspection.
Subp. 2. Preliminary inspection. Before issuing a permit,
the building official may examine, or cause to be examined,
buildings, structures, and sites for which an application has
been filed.
Subp. 3. Inspection record card. The building official
shall identify which inspections are required for the work
requiring a permit. Work requiring a permit shall not be
commenced until the permit holder or an agent of the permit
holder has posted or otherwise made available an inspection
record card that allows the building official co conveniently
make all required entries regarding inspection of the work.
This card shall be maintained and made available by the permit
holder until final approval has been granted by the building
official.
Subp. 4. Inspection requests. The building official shall
provide the applicant with policies, procedures, and a timeline
for requesting inspections. The person doing the work
authorized by a permit shall notify the building official that
the work is ready for inspection. The person requesting an
inspection required by the code shall prOVide access to and
means for inspection of the work.
Subp. 5. Approval required. Work shall not be done beyond
the point indicated in each successive inspection without first
obtaining the approval of the building official. The building
official, upon notification, shall make the requested
inspections and shall either indicate the portion of the
construction that is satisfactory as completed or notify the
permit holder or an agent of the permit holder of any failures
to comply with the code. Any portion that does not comply shall
be corrected and the portion shall no~ be covered or concealed
until authorized by the building official.
Subp. 6. Required inspections. The building official,
upon notification, shall make the inspections in this part. In
addition to the inspections identified in this subpart, see
!.ttn.It,1IWW r"vi~or.le!!.state.mn.\.lS!arule/1300/021 O.html 12/I/2004
12/03/2004 15:58 FAX 6123387858 HALLELAND LEWIS
IJEC-l!IJ-2004 11:l!I1 Halleland
12/03/2004 10: 59 9528819150 LAW CFFICE
~ 003/00
6123387858 P.0V02
PAGE 1'12
STATE OF MINNESOTA
COUNTY OF HENNEPIN
AFFIDAVIT OF GEORGE KOlJ~.~
First being duly sworn, Goorge Koblas stateI B.Dd alleges as follows:
1. I 81U 0WII1lr of r."r ..~J at 5201 Frost Point CJrclo SB, Prior L8Jal. MN.
2. I ha~ oont:nwted with Hagen Collstruction to reccmstruot a new housc on the lot at the
above addmuI.
3. During tho past six (6) weeks I have had to W\I1lle prbDary IllSponsibility for nearly all
work that has been accOIlIplishod on this house. IkDow thIt Harold Hageo. bas called on
two OccuiClllS to schedule the &a1 ~ but thlll1 he has ClIIICellod those :....._.dON
for no raaaon reWed to the prDgRI8lI of the project
4. The hDUSO is IlOW completed for all intent and JIUlPOscs; Mre. Koblu and I bave bCCll on
site IlId ordering and sup<<vlsiDg viItaally evctylbing that has beel1 accomplished clurlai
the past six (6) weeks. Mr. Hagrm wrml to Florida far two ofthoso weekllIIIli baa bad
only miTrimlll involvm:llmt by phone conversatiOn8since his return.
5. 1 am mllln"g tbiA Affidavit in support ofmyrcqumt fur an i""""-diate final inspection or
my hOUiC so thaI a ;--r -..Il)' occupancy ponnit may bo illSlllld and I may !Dove in and
make use of my new ho~ '
Dakd:
12.-/3. r z..oc 4-
~~ /:/IL'
George Rbblas
Subscribed and swom to before me
fbilS 3;>ro~ember~/
~/tA-~
Notary Public
.- \
ERIK"" VAIUA
NclIBI'Y PubIlc
, 11M, I'. ..l
r8\tj~"'_".IlI1'31'1llll7
L
TOTAL P.02
.-=--.
! Drivewav: NA / FAil$' (COMPLIES )
. Maximum width at ~
I. Required setback
I. Maximum slope
I. All parking areas to be paved including R-Vor
spaces adiacent to the paraae
I. Location to match subdivision aradina plan
, Building Height: COMPLIES / FAilS
/- --
, Shoreland District: NA / FAllS,?c:OMPLlES )
Minimum lot area (square feet) ~
I Minimum lot width
I Shoreland alterations
I Impervious surface
Bluff in Shoreland~AllS / COMPLIES
. Setback from top of bluff
I. Bluff impact zone
I. Enqineering certification submitted/approved
I. Gradinq in bluff or bluff impact zone
Floodplain: NA / FAilS / COMPLIES
. 100 year flood elevation
I.
Lowest floor elevation
--"'-~'-- ----
Proposed lowest floor elev~
...
I
........
I.
I.
Elevations 15 feet from structure
Road access must be no more than 2 feet below
Reaulatorv Flood Protection Elevation
r'"'
, Accessorv Structure:{NA/ FAilS / COMPLIES
I. Size ~
I. Not located in front yard (Materials)
I. Side yard and rear yard setbacks
I. Maximum heiqht
I. Materials compatible with principle structure
L:\TEMPLA TEIBLDGLIST.DOC
Standard
24'
5. from side lot line or
30' from r-o-w on comer lots
10%
Proposed
',)01 tvtzLIC
5' /q'
"
s~~
White . Building
.sf: k - "n~- "LA.! :.~....~
Pink - Planning
Tht ('rRlfr of lbt I..kt ('e..nlf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
//:,; <}<-~ /~/)71,jt...L.
APPLICATION RECEIVED
)
(J" ~~i // ' ~-")
>1 >7 '( -r) :~.,..).
. _ 'u ".
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: I
.l.:u / " '.",
~),;<O-l./; T }./,jt"7f 1- ~_..f',,--
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
A41-li
Date:
9-:<!I-oj
Comments: See Rever!':p ~idp. for Arlrlitiol1::Jlll1forrnatiol"l
See Attachments: 1) Gradin'l Plan, 2) Erosion rontrol MP,lISl1T"~
"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,"
CWbltA - Buil~
Canary - ~ngineering
Pink - Planning
Tht Crnl.r of thr I.."r (.'ount.,..
BUILDING PERMIT APPLICATION DeeARTMENT CHI;CKLlST
NAMEOFAPPLlCANT I/a~ (l~.
APPLICATION RECEIVED )r'd-f-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: I
$;;'0/ -:::}-fiOO -r IJ~ f- ~
,
Accepted Accepted With Corrections ~
Denied
-
~ Date: 9fP/o:I
d.t ~~
~~ ~ ,AIJ~'-'U.A.D -10 ~ ~
----v r' ./~~
triA ~. ~"cl a..Lf ~ ~ d7 ~,
pUr /J .I ~/JtJ .
~~ ~ -oe lA- ~~
# ' ,
~ iJ6-4::1~rJ;-~ ..Ah"",,-z;J:.J) ~~
~/~J~eM2, 0
Reviewed By:
~..:
/&~~
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."
Th"C-"nlnnflh" 1.."tCOunlry
White . Building
Canary - Engineering
~IIII\ .. r~~~
BUILDING PERMIT APPLICATION DEPARTMENT CHeCKLIST
NAME OF APPLICANT
/;/..' t'
,(
,
.. ,..-J /.'/) , . t
_:' /'1.
APPLICATION RECEIVED
':> ;-)..::/.
l.__.J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
L I (" /'1
:;). ;2 () 1/ () -r 1.)1 f !-G.{..c.j'o...-
Accepted 'f:.. Accepted With Corrections
I
Denied
Reviewed By: ~ Date: q .a'J-..O~
V I..../'-"
Comments:
,*~~lQtc. €QLVO-.:tt.ev! ~~ ~
l.o.J(.J..().J'I~ #) ~C!.adC ~ O~CI.YJ~.
*vl~ ~ f>~ (~
aro'-V'd r-1eAUVCd IU.9> I~~ ~,
"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."
09/14/00 THO 12:06 FAX 8124474245
CITY OF P1l.IOR I..AKE
111001
_......
....u..ow . "....1CoWIT
IIOt.D . ar.,
CITY OF PRIoR LAkE
SEWER AND WATER PERMIT
NOTE:
S.W.No. 3-1']0 I
Sewer and water
contractors must
be re9istered'.
with the city.
APPT.: CANT: Llo'/t/ E'Ft:...v..ti',,~ ciA'"
ADOn;! SS: P.O. IJolC SI'f .Prl.,. J,.cl<. /A;,
SIGN~ ruRE:'~}IfI,.J .
SITE \OORESS: o.(} I F ~ f DI-1 e.~.
PHONE:
DATE:
9~) 'ffro -JdXl
'1"/" - ~~
BLDG. PERMIT II
PIot
FlIo!. IN THE BLANKS
1. H;timated length of water service
~o
feet.
4.
S~ze of water service I inch(es).
1. )cation of any couplings from str(re () feet.
l' 'pe of sewer pipe. ABS_ PVC Cast Iron_
f: irimat8d longth elf S"'.....L 11ne 10 _feet.
2.
3.
:i.
6;.~c:::ean out (if req\lired), located at
S ,ructure.
feet
from
.!.._..-=: '.!!:I==_=-_S;;;==;;:==!IIll_::::=:;;=:;::lIJ1!!!!~___=*===III!:::':&ii:;;:""""'_____ ===-==___=~~~;:s:=--_..
This '. ppllcation becomes your permit when approved.
BY DATE:
;:zs:::=::::! =_______~,__..~___...c::I:::::;;;=;_
" .===~;::__==~==s~==_____________==____'
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection pArmit,
surcharge
TOTAL
* l" e for either Sewer or water individually is ~..sHl plus
$ .50 surcharge.
*
, .u
U'
sued ~or new construction must be
ermit card at the time oe issuance
II ..ewe;r; and watsr pAltOWlTlfre
BUIUJ/NG PERMIT
AMOUNT PAID
DATE J: \IO
RECEll' ~ 1/
By
REC'D at
0-
16200 Bagl.: Creek Av. 8.13.. Prior Lake; Minnesota 55372/ Ph. (612) 441-4230 / FAX (612) 447-4245
An Equal Opportunity Bmployer
1 . cI
9EOE-Oll'1,-i!S6
~U1~eneox3 Phol~
ell'BO EO 01 no~
-
FEB~18-04 02:02 PM JUDKINS
65142341$9
P. ""
li"u\J,j.
02/11/02 'ED 11 :00 FAX 6l2HH24S
CI~ OF P~lOK ~AK<
CITY or PRIOR LAKE
!lEA TING/AIR CONDITIONlNGIFIREPLACE PERMIT
D... ~..
,,,,,1.,,
i
I
'=' I!::. 11'1tKMn~onJr. 17iIVlf!,
h_ .",- ~..... I
- ---.11 ZONING__I I r
~;~q;-Ws+- Pol d-
UlOAL O!SCRIJ>nON (_ u.. DIll';
I
I:
I
i
~:R-Bvd +\QCI.4.-Co-1\bt~cfJi)"~c) C)<;2..,Cj'Lt l-q~~H
::" 1mq .r<)w,'<!]%--l~ ()~JL.____:- - I:
(Namt~ urlA") I r\.A. -hi 0 Q:9-) NJ, ~ \ ~OI1el ~., S1S"'l
(Ac\d.IeSllJS\<;?S. "H- R..R.....O~ w~ l-<U~I' .
~ - (..). .J (or--' (7APCocIc)
(ContaaPorlOnl . I--y;..l~ 0d.~ f'-.!) (P~CDe) trf'"~1 . ~~- ~
, ^,PLlCANr stGNA: ' _ ~ ~ ;;;L I /0 "-f
-....-- --'- , --"-'- ,.--
tOT !tOo. -'DOmON
--.--......--...---., _._.. -'---._.__n.._._._..._.__._._n_.._......_
PIt>
I
. ,.. APPUCANT l'LEASE COMPLETE BELOW
,!'J.NEW CONS~UC110N.u- .QREl'LACWBNT CJ ALTERATIONS
FtJm\Cll MAla ~~O MOD!L L....D.A\ f\D )( ("" SI FI;BL 1\-..1 b-
FLUE SlZE lUlTt.JIU-l OPENINGS INPUT OU"n'UT
'X'YPE OF SYSTIlM HEA.~O OllJ'OmRI'LANT
. JW"", Air PlII\lII 8 51_
JOM'1)/ HQI Willi.
:l McohAniOll ' 0 RadlatlClll
.tAl. COftcliliDn'"" CJ SpcGlll D..I...
.avIDI, SYJ1I1lI CJ 01:11.. !)'ylc..
~ ().o~ f'1"\uG> t-
PLEASS MOTt:
AJr COIl.dillOllCl' ulllll
CcmQl JIlIerQteb "'lAI
llcqllircd Si40 Yard
Setblolt
Fl1lEl'LACE MAXI' AND MODEL
-
l.du,"Ia!, CommerciI! " MulU.PlII\lIy
P219CHJtl)ULi:
IYtol'JOb "'ft RllOIdrnlill,O.. Pitqll....
.J1?$O 1II1n11llll/ll.'
~50':::> R'lidendal. AddlUIN &. Allallllulll
$64.$0 ROIidtIlllal, AC Only
~
m.1O
13'-'0
l\csidontil!. Hwlnl & IVC (N.... ConttnlClJOll)
Resident",. 1'1..11.'1 001)1 (1'1"" CClIf\1UetlOll)
Eslilll&l.d COsl S
Bllildlnl Ptllllll #
s
s ~[) WE'\1'!(.J
S I:l~N n7j
(oru" UN 01111) _ G P~PJMT .
~-- ~- --~-- --- -~ ,"
nls A"pliolflon D~lDeI 'iollr BlIlWlllC PII'1lIIl When ....proVeAI
HtAnNO PE.R.\fiT FEE
STATE SURCHARGE
'fOTAL PERMIT I'll
f&lll
. \.-.lpt l'll!.
j'IIY
..114111II OIllciol
DIll
I m 1 8 2004
a. heur ..ll.. r...u lup..tlou ('SJ) 1"7-fI!ll. f.. ('r.I~) 4oI'..Z4S
1,,','1
"-' Y _.--
; ~h'l!-."f.lfjj("'i
~2-17-2~~4 11:36AM
MATTHEW DANIELS. INC.
423 3~17 P.~l
Dale Rec'd
CITY OF PRIOR LAKE PLUMBING PERM:IT
~ ~~::. I PER...'.IIT N~J~, ~I
J. Y.llOw A"'~"I V J , wtI,.,
(PIe... l'/P< or pfint and,~ at be""..)
ADDRESS
.sZOI \d-1uxrL Q~ G-l.k.diJ
ZONING (of\l<e...)
LOT
LEGAL DESCRIPTION (otli"" use only)
PlD
BLOCK
ADDmON
OWNE~ tL. nJ ~ Ii . -...,
(Name) ~. l(A i '<fiJ., J L ,,--J1 .1t-v' (~~one) ~ . q4j . 9..;;:.::p./-
(Address) '}f()1t:1 ~IJ.-tndu/j (1..1)':')';)' ..AOAi"/l~){"-rl.:J 50-.../.a.R'
APPLlC^,>..n: ) . ---..
(Name) ~-ttl ,,7) LJd J I d".,), ~H' (Phone) tsl. 4.2..,.,. ~-r7.d.n
(Address)....I.S:OI~ (I"J,}d /1 Yo II. ...v.LU.l-; q"", rl '" J r "-"L;) ...s:soMI
(Address) - Q . (City) (Zip Code)
(Contact Person) ll, i ; , 4 Jc. \. 4, ~I.J-x ') (Phone) ~J. ~. ,q'Z."lO
APPLICANT SIGNATURE
Quantity
~
~
~i:\
l-.
4-
~,
....~
S
DATE
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drai!l
Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 companmenl sink
Shower Stall
I Sinks
Bar Sink
[ Water Closet (Toilet)
Quantity
I
I
I JU...
I
Rough-ins
Water Heater
Water Sofiner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler .
Other t!J./d Jh/) I;nP,J." ,-,.. 111M )
Type of Fixture
I ,v...
I
FEE SCHEDULE
Industrial. Commercial oS: Multi-family 1% of job co" with. S39.50 minimum Residential. New On. & Two-Family S99.50
Residential. Additions & Alte,.tions $39.50
Estimated Cost S
Building Permit #
PLUMBING PERMIT FEE
I STATE Sl."RCHARGE
TOTAL PERWT FEE
~ qq.~"Po ~ ,~
$ !"fLJM. ~
'. ~,iJ AI
I paldJ.9'-'1 [.IllY ReCeipt No.
I Oal",.;(_ (/'I-I( ~
(Office \I.. Oldy)
This Application Becomes YOllr Building Permit When Approved
BuildlncOf'lid..t
Da..
24 bour noli.e for III inspections (952) 447-9850, fax (951) 447-4245
,
TOTAL P.01
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
.
INSPECTION RECORD
$201 F~~t tfIo,~~C/~S-
AlEW ,~
.
SITE ADDRESS
NATURE OF WORK
. USE OF BUILDING
PERMIT NO. 0.:3 - /30 ( DATE I~SUED ~ _07
CONTRACTOR .'ON PHONE'l · ,-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPkRATE DOCUMENT
~tJ.-r I(;-/!:/e:tt ~ INSPECTOR DATE
I FOOTING~L LUlrc., ~ tQ{31!e3
, FOUNDATION (Prior to Backfill) r Al fa.. ~ I L \ I L{ l G3
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC ~ . ~ L It Ie L tQ3
FRAMING / VV1P li-1-o<.i]
INSULATION -, -' //0/1 4- 1 :r-ol
ELECTRICAL I
PLUMBING 11.(,.-;tf J"lfI-ot1 ~ J-/.2--r:7i1
HEATING (if required) VVY l-1:'7-(\"
FIREPLACE V\tI/ 0/1 ~~\
GAS LINE AIR TEST ~. -:r-,.zs- ~ .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
'fJfTM~~ I I
, FINALS
GRADING (Prior to Sodding) ,It/L? / O. "2-7, (/~
BUILDING I/W /
ELECTRICAL
PLUMBING
HEATING
DO NOT
,
.
/L-C;.CP/
111111_
lz,yr
OCCUpy UNTIL ABOVE HAS
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.
f()~](!1. vt-I
1,l~'(7q
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
;'
Qlntifitafe of o&trnpantu
CITY OF PRIOR LAKE
~tparfmeuf of ~uilMug JJuspediou
~Anal Permitted 0 Conditional e.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 Classification SINGLE FAMILY
Occupancy Type R3 Type Construction VN
Legal Description TRACT J, RLS #29
_ Bldg. Permit No. 03-1301
. Fire Zone N I A _ Zoning Distrtct R1 SD
Owner of Building Site Address 5201 FROST POINT CIRCLE
Contractor's Name & Address _HAGEN CONSTRUCTION, 8079 KENTUCKY CIRCLE, BLOOMINGTON
ROBERT D. HUTCHINS YJP City Planner DON RYE
Ii Building Official
(, ()t {
-
,
Date:
Date:
..
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
.""
DATE TIllE
/J-.(;-oy
ADDRESS
..{' k>/ ht-4 PI P2..L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
[] FOUNDATION
o FRAMING
o INSULATION
If FINAL
[] SITE INSPECTION
o PLUMBING RI
[] MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(f)J)~.j.- C/t e~cJy,t;&L/
(la.{ft.AW! N.
/
~----/
/ /
( / {/\.<:;;;~
( ---r\./-
"--
--
~d d.- r//'-t-("so
OK
:5-/']17/
o EXlGRADlFILLlNG
[] COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
[]
t?/r Lrfl/~C
,
~~
t;c )
~
---
. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT /lVLL FOR REINSPECTlON BEFORE COVERING
Inspector. _1..11../' Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
1IaNOT'
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED 1(/to10..?
ADDRESS I'(""W), t1- O~"'\ ~ 'M.
OWNER CONTR.
PHONE NO. .
PERMIT NO.
~-l1,o I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
~WATER HOOKUP
~ SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS:
~)7,?
I
r~
I
~L-~{~ {
~ W,~M lpr~ I
-0'-'.~ ()~~.- I. \ j'\/'
"WORK SATISFACTORY, PROCEED vv ?
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~
-1
~
\j
r
,
t
r
I
I
l
-
1
OWner/Contr.
CALL 4<17.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNIm
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
h-)7-c'l d~IJD
ADDRESS Qol f'ti'Osr P6,',,+ l'.rrvl<..
OWNER CONTR. flt;~... (17 ",(,1.
V
PHONE NO. PERMIT NO. I? 7. -/..SO I
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ =~NSPECTlON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~ILLlNG
-0 COMJll:AINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
e,lil
~,y.-- t",!L
.
6(",,~-- f!)~
S.rl
X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector.4~ Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
"""""
DATE nilE
CITY OF PRIOR LAKE IO~LI~C!Y
INSPECTION NOTICE SCHEDULED
ADDRESS f rtJs+ f-J-r
OWNER CONTR.
PHONE NO. PERMIT NO. 7. D tJ I
[J FOOTING [J PLUMBING RI [J EXlGRADlFIUlNG
[J FOUNDATION [J MECH RI [J COMPLAINT
[J FRAMING [J WATER HOOKUP [J FIREPLACE RI
[J INSULATION [J SEWER HOOKUP [J FIREPLACE FINAL
[J FINAL ~LUMBING FINAL [J GASUNE AIR TST
[J SITE INSPECTION [J MECH FINAL [J
COMMENTS:
u( ..I)/MfJ'u(.. f(yffUOc,
-
[J 'WORK SATISFACTORY. PROCEED
~ORRECT ACTION AND PROCEED
[J CORRECT ~~R REINSPECTION BEFORE COVERING
Inspector: -fL-J--(' Owner/Conlr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
-,