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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT f-.:J~-D3
Main File
(Please ~ or print and sWa. at bottom)
ADDRESS
\l~5Y K(Vu-In,~h
lA..v _ ~~.
I.White File
2_ Pink City
3_ Yellow Applicant
LEGAL DESCRIPTI. ON (office use only) ~
LOT~ BLOCK 5 ADDITION J-<<rH.oLL ~
OWNER
(Name)
(Address)
, BUILDE~ ~ ~--y--?__
(Name) j ).f'.. _ _. .~_
(Contact Name) M,JC..L , hll~
(Address) 11)';>" A C. t.L.rA---br; ~I\C- ~ <;;+t -'00
r ~.......\ 'iL,- -All. ~0q::;f)""lS
TYPE OF WORK
JX:New Construction
OLower Level Finish
(Phone)
I PERMIT NO. 03~ /ZO'Z- I
ZONING (office use)
R-g..../
PID dS~ B98~/~-O
(Phone) R~tt '2,1;- '1 Q,og
, .. -------------
(Phone) 9~;)/'] Z/p-If73L.-
ODeck
OPorch
ORe-Roofing
o Misc.
o Fireplace OAddition OAlteration
PROJECfCOST/YALUE (excluding land) $ '1), "/51)
,
ORe-Siding
OUtility Connection
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 ,......,..w..J and that all construction will conform to all existing state and local laws and will proceed in accordance with
sub 'tted plans, I am..aware at the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
e r on the Y.....Y....J tope din 'ons.
Signature
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~
/60,
I/J.{). --
,35.50
1.//),--
This Application Becomes Your Building Permit When Approved
~~ q/q/iJ7
Building Official Date
~/)~1
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter SizeS/Sit; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
Illuilder's Deposit
I Other
I TOTAL DUE
I Paid 1.".f.J. I 7
I Date '#9 /.1": ,Q 1
, , - .:;..
#
#
lki /I
#
#
_<( -JI--tJ~
Date
$ 8'50. -
$ I:J., 75. --
$ 3 'i3'O.-
$ I 8(:'),-
$ laao,-
$ "7tJO.-
$ 1500~
$
I
$ 7953 .7'1 I
( I
I Receip1f}(o. ~~O/
By A-..
C
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
~ 1~ 9J9h3 RuJ a.I.( ~
Planning Director I ' Date Special Con#f:ions, if any
24 bour notice for all inspections (952) 447-9850, fax (952) 447.4245
\ 16200 Eagle Creek Avenue Prior Lake. MN 55372
\ /
..
..
Job Address
I "7 3~1( tt'\.~ ~ Ir<.~
,
Heating Contractor r... \ \. ~ t'<\~
Name otTester ~(~ .~
Date / 7..( '7..{,f:)::!"
Percent 0, CI O( Cl
Percent CO it 0 ~
I! dV~.
Percent CO, Ij;l ~
Stack Temp '3 ~ .. '\=
Combustion air is adequately supplied per
UMC Sec. 606
input
l.o L \{'
/
.f'.
~
.. .
~
Main File
White - Building
t ...an.rv - ;:~u;n_r..~
Pink - Planning
The ('''''Ifr nf I'" "au Counlr,
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
J tJ f?;{,it~-;1/-V}~..-/
f(' -,.:;2 5 .0 ~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/78 .5 // '~A.-/ /!!,t-f.J" to/,L )..I
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
tn4-R
Date:
o/~/03
Comments: See Reverse Side for Arlrlitinn~llnfnrm~tinnl.
~P.P. A tt""hmp.nt". 1) nradinr Phn, 2) Erosion Control MeaSllrp."
"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."
~~
Main File
(White - Buildiii!I.J
Canary - engineering
Pink - Planning
Tht Ctnltr of lht L.kf ('o."UI'}'
BUllDING..HRMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
If) (.( Mn~
~-dS .o~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
//7gQ~ ~~L.J
Accepted Accepted With Corrections /'
Denied
Reviewed By:
Comments:
~..:.
K~
'J~ Date: 9/9 fi,:3
.-L/ .A~~ /
"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."
MaiIl File
White - Building
Canary - Engineering
~K .. r:"'IBnntrl9:::>
Thr('''nlrrof Ihr I..ab('ounlry
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
l( K A.::J ZI/J1J
t!'-;) 5 .O~
APPLICATION RECEIVED
The Building, Engineering, and Planning DElpartments have reviewed the building permit
application for construction activity which is proposed at:
//73 5' // 1?c;'C--L/ LL~1'l ;0" .L ;../
Accepted
Denied
Accepted With Corrections /"
Reviewed By:
~
I(~ ~S-'
~
~NL'
~
.&u tJ~. ~ "I
-..../
Date: 9)h ':J
, ,
~~
v
Comments:
~,
"The issuance or granting of Ii permit or approval of plans, specifications and
computations shall not be construed to be Ii 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 proYisions of this code or other
ordinances of the jurisdiction shall not be yalid."
Ii
,
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
q>1.... ~ or olint and silm at bottom)
ADDRESS
/735<1- /735(P /7358
I /
~. =. ~:~ [PERMIT NO.O"2. IZ~
). Yellow AppIiClllt I mg. "'....
e: / (/6K.- Q/t/uVi L-N.
I ZONING(ol!lceuse) I
LEGAL DESCRIPTION (office use oDly)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phon~)
(Address)
APPLICANT '
(Name) r/~/o6 Hel"r'1b17I
(Address)
,
,
-
ftrJrt t::.-
(phone)
(,,5/ 0.33 Z-5" /
. ,
,
(Address)
(City)
(Zip Code)
(Contact Person)
, APPLICANT SIGNATURE
P/?67Vo/J 11{/.J7?)rJ
(Phone)
DATE
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FOEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
OAir Conditioning
~ OVent. System
(; FIREPLACE ~jE AND MODEL
---- .
Industrial, Commercial & Multi-Family
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:,
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Residential. Heating & A1C (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39,50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39,50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
PAID WITH
8.1J1L[HNG PERMIT
\,
(om.. Us. Only)
This Application Becomes Your Building Permit When Approved
Building ornel..
Date
~
Datle ;ll If-
,7. ()
Rec~
"'-
By fliILt _
24 hour nollce for all:.". ".:,'08 (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, MN 55372
200310:30AM
GENZ RVAN PLUMBING AND HEATING
No,9176 P. 3/8
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
:. ~'7. ~~ I PERMIT N~ ~.?, I
3, YItt16W "'JIPlblll - -;:;
11l-.se ~ or Prim ODd sj,"" "bOUOD1)
ADDRESS
1139-1 i2i~ Bi~ UrJ &G
ZONING (Ollla:_) I
LEGAL DESCRll'TION (oilie< us<: only)
ADDITION ~d.o J;t 41 ~tJ eld -ztn
LI
LOT BLOCK
PID
OWNER.
(NalDe) DR Horton Custom Homes
(Address)
APPLICANT
(Phone)
qe;2 - q ~c, - '1'6DCl
2O$~D KeVlB~1 D6e. Cr $re IDO
LAlu..villG MAN .5ml.JLj
(phone) ~< '_h '1_" bb
O'1ame) C"",.,.,._'D:;n.-. 'D1H_l--"'...._3 t.. ":I''''.....-i.,...:
Rosemount
}n:;'
55068
(Zip Code)
(Address) 14745 So Robert Trail
(Address)
(Contact Person) r,1/\ Ri sri -hr ! I)
APPLICANT SIGNATURE 0J 1J~ ~ OU")
" ,.'. ,'~ ~
QUAntity
l
I
I
:2
~
(City)
(Phone) 651-423-1144
DATE ~/df.-'03
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
I Floor Drain
/. Lavatory (Bathroom Sink) ,
Laundry Tray (1 or 2 compartment sink
Shower Stall
Sinks
Bar Sink
I Warer Closet (Toilet)
I
I
I
I
I
I
I
I
I
Quantity
I Type ofFi1tu~
Rough-ins
I Warer B'eater
I Ware:r Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Bacldlow Assembly Test
I Lawn Sprinkler
I Other
I .
l;k.-1:.
I
FE:E Scm:DUL:E
lndustnai, ComrnerCl.1 &. Mult,.fa,,"!y 1% of job oosr wITh a $39.,50 minimum Re..dentiol, New On. & Two.Famlly $99,SO
Residential, Additions &. Alterations $39"SO
Estimate<! Cost $
Building Permit 1#
PLUMBlNG PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$ ell~ .b-4JO ,.
$ p~~-~~ ~ ~' OIJ\lG ~
$ !II I ~~
ini ~:Dl~,:I,. N ~I
00t ~ .eIpt o.
IB), W I
[}
(Office Use Only)
This Application Becomes Your Building Pumit When Approved
I '.
~
Building Om""l
D...
24 hour notice fur aUlaspectlons (951.) <147-9850, fax (952) 4474245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
~7;~9
l ~ S.ourt I PERMIT NO. 3 - (J-.O ~
(Pleasetvoeororint:andsi2ll at bottom)
ADDRESS
/7?t9/b~//5;,/,./ (~/ ,<;'6-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER DR HORTON
(Name) - 20860 KENBRIDGE CT
(Ac4lress) LAKEVILLE, MN 55044
(phone)
APPLICANT ./10 A d..
(Name) /~///a.L,t.,. ,. '.J' 44.,/--../'
(AddreSS)"~~ ~4~~.. ~ ~
~Addres
(ContactPetson) A, ,.~~~
APPLICANT SIGNATURE "- .-.
(Phone).../:'S/- .-/f'?--I'??5
A'~4A' ~~-?
- (. . (Zip Code)
(phone) ~/-e;/~77S
OATR
APPLICANT PLEASE COMPLETE BELOW
, JiNEW CO~TRUCTION 0 REPLACEMENT [JALTERATI<?NS .
FURNACE MA~ AND MOD~/'Y-'" ~ ;?;,~~.v'l?.7t"? FUEL ~.j, fr....':-- .e
FLUE SIZE~~!f_d RETURN OPENINGS ',.INPUr.~ OUTPUT 6'Z_ r. " .........
TYPE OF SYSTEM HEATING OR POWER. PLANT
OWann Air Plants
OGravity
o Mechanical
~ir Conditioning
~ent. System
OStellll1
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
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
$39.50
$39.50
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ ~a::::>Building Pennit # ~ .0'""0
HEATING PERMITFEE $~/ ~",~/c::4/ ~/I\IG ~
STATE SURCHARGE $_. ~q, /:il/,fl)-
(OffieeUseOnly) TOTAL PERMIT FEE $l@"IC ~ if rlDI
This Application Becomes Your Building Permit When Approved ~PaSf'" 1 2 2003 lull Receipt No,
B I Date II By r..rr--
Building Official Date}{=- L-{'J-
-'" ---.ii -..- V
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Aug,28, 2003 10:29AM
GENZ RVAN PLUMBING AND HEATING
No,9176 p, 2/8
Date Rec'd
, ,
CITY.OF PRIOR LAKE
SEWER AND WATER PERMIT
, .
i :;;;:. ~~ I PERMIT NO. -:;;: ~/;).O ') I
1, (;.)ld AOPltCll.\tt :;,/ d--
Q?lease ~ or 'PJ1nt and. sil!D.ilt bottom)
~ S?/J I Z7X ilVQAQ.H t,i tZ1'.h Cvl Sl3
LEGAL DESCRIPTION (office",," only)
ZONING (Q_''')
- 1!:7,q/ Q3,C(':; i2'\/f,j.{ B,tzdr,PJ::.
. - .
LOT BLOCX
ADDmON 11t1d1.J:f=-t11 ~Q2;(;eld 1-/1-1
,
Pro
OWNER.
(Name) "'1
(Address)
2OSinO t<ev1~i<..\'t:6e C::r S...~jf\"
(Addm,)
(phone) _
La~~ die.,
(City)
go2-Q'65-'18M
GJ6"J-1U
(ZiQ Code)
l.l'1"\':'('r('n "',,~f-...._ u..............
APPUCANT
(N~~ Genz-Rvan Plumbing & Heating
(pho.nc)
651-423-1144
(Address) 14745 So Robert Trail
(Addras)
(Contact Person). (',0 JQ.i sti_ 6 ( is
'.ICANT SIGNATURE rLv~ ~
Rosemol'n t., MN
(City)
55068
(Zip c"do)
(phone)
651-423-1144
DATE
~-C)f-'/O?"
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
feet.
o Cast Iron
FEE SCHEDULE
ResIdential sewer and water Ime COllllectJon S35,.50 Industrial. Com'J '" Multi-family 1 % of job cost wIth a $39.50 minimum
Sewer connection only $17.50 Water cOJ)llectlOJl only S17.50
Estimated Cost $
Building Pennit #
D...
$
$
$
mlE @1fDW lE ~
I tlli ::It!" 1 2 LUUj l.leiptNo.
IT~e IB:I
.50
SUIt.. .o~/D ~
DIJ\te ;'~'If
.o~.b
riAl".
I
(
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL P:eRM!T FEE
,
(orne. UK Only)
I This Application Becom.. Your Building Permit Whe.n Approved
BuiJdiog Official
~
I'
I
~
24 hour notice !'or .Ulnspectlons (9S2) 447-9850, b% (952) 447-4245
PRIOR LAKE
.
INSP,ECTION RECORD
~v B"~
Main File
DEPARTMENT OF
BUILDING AND INSPECTION
i~TEU~~D~FE~~RKJ~~~ 1./
USE OF BUILDI~<l..s~
PERMIT NO. 0..,. / 'Z-. DATE ISSUED
CONTRACTOR PHON~Jk
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ INSPECTOR
I FOOTING I~ n~I'O...L- //1~
- I
I FOUNDATION (Prior to Backfill) 111ft./- err 1'ff-t.. f1td I /0-/-0>
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
"
DATE
q-/,f--ta
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING ~p U.fr. f/If IfH-1/3 ;j..&.fuw V.t,. '(IIf/~~vQ', r/;Jff [f'-IrJ-tI)
HEATING (if required) 'frr.~ tW I~ ;-/17 VU/JI-/4-rf!J
FIREPLACE ~ /1~/(;/--rJ)
GAS LINE AIR TEST 'Ut' II~ Ivl- t/'7
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
, Sh fa fl1,t.:::' I I/'f! I 7 )'-'(,43
FINALS r {l,
Iv t>
#N
J/J/f/J
//-14-1/]
.
GRADING (Prior to SOdding)
BUILDING (I~ UV\~ '\
ELECTRICAL
PLUMBING
HEATING
DO NOT
q-{-()l-I
1~''Vt.,oV
?#S/o'/'
IM/J
f1..o//
OCCUPY UNTIL ABOVE HAS
NOTICE
BEEN
I J--;~'()~
)-/L-(-OllJ
SIGNED
"
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.
FOR ALL INSPECTIONS (952) 447-9850
Ql~rtifttat~ of Ql}ttupantu
CITY OF PRIOR LAKE
~tpa:rtlUtut of lAuilbiug J/Ullfltdiou
rtrFinal Permitted D Conditional C.O. Expires 7/5 <,- .Ie:; c/ _
~,- , ~ ~
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
Bldg. Permit No._ 03-1202
Occupancy Type _ R3 Type Construction VN Fire Zone
Legal Description _ L4. B5, DEERFIELD 7TH
Owner of Building . Site Address )7354 RIVER BIRCH LANE
Contractor'sName&Addres' D.R. HORTON. INC.. 20860 KENBRIDGE CT., SUITE 100.,.LAKEVILLE
ROBERT D. HUTCHINS $# City Planner DON RYE -
Date: _?j// \' ~yOffiCial Date:
N I A Zoning District
R2
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TillE
SCHEDULED ~~
,
j('/l/5Ae d/AbT Ll'fll/~
/7354 - /73 95 /UVi;;7L 8IP~AJ. ,t?LA~
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO. 03./ Z()2.. - 03.' Z.07
CI FOOTING
CI FOUNDATION
o FRAMING
A1NSULATION
FINAL
SITE INSPECTION
COMMENTS:
CI PLUMBING Rl
o MECH RI
o WATER HOOKUP
CI SEWER HOOKUP
CI PLUMBING FINAL
o MECH FINAL
,
5~-r
CI EXlGRADIFILUNG
o COMPLAINT
CI FIREPLACE RI
o FIREPLACE FINAL
CI GASLlNE AIR TST
o
('A >>S (5 PI U:3:
a/
~WORK SATISFACTORY, PROCEED
/ ~ CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COYERlNG
~
Inspector.
Owner/Contr.
CALL "7.9850 FOR THE NEXT INSPECTlDN 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY/
-,
llA TE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEO
!(J'ZbUj
OWNER
.L"73$if_/I/'w/ E.u.~~ "=.V1
D.P.. rJ",,/rJ..,
OJ.-/2/n-
,)C(E~LLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
[] GAS LINE AIR TST
D
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
~L
[] SITE INSPECTION
[] PLUMBING RI
[] MECH Rl
[] WATER HOOKUP
[] SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
f,pt;.,,b.....;9L
)( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~.1 r ,,-,_ ownerIContr
CALL 447.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
_n
DATE T1ME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /-/?{-tJ?/
,
ADDRESS 17 Wi {hVVhIA'Vl
OWNER CONTR.
PHONE NO. PERMIT NO. 3-/2.<)z.....
o FOOTING o PLUMBING RI o EXlGRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~ULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL ~UMBINGFI~ o GASLlNE AIR TST
d SITE INSPECTION MECH FINAL ( 0
COMMENTS:
(,+J,
t@
Y/l1.:,1 ?o.rt.t-lAO. 14.<:~,,,,,
/W,wo-'l.::";r dy,,,,,- "",hi
sA-! <L ~'s tk-/ c:-Jev-tqPM_tT
7.; nnj/ tftI.j,- I
q-J-cJ'-f
,
o/S~ -I- r~c.I-e~ J
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
1!f CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. N Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & S.4.FETY!
1NSNOr1
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
n35f1 fb~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Cl FOOTING
Cl FOUNDATION
Cl FRAMING
Cl INSULATION
Cl FINAL
Cl SITE INSPECTION
Cl PLUMBING RI
Cl MECH RI
Cl WATER HOOKUP
o SEWER HOOKUP
". PLUMBING FINAL
o MECH FINAL
COMMENTS:
ti2.-w -hY1u.-.5
..j....
rf'.""'-hv<
DATE TIllE
Jj.-.L.1-t7 ?
"!, --)L.tJ 1..
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
r~ljff?5
Cl WORK SATISFACTORY. PROCEED
'CORRECT ACTION AND PROCEED
Cl CORRECT ~RK~L FOR REINSPECTION BEFORE COVERING
Inspector: j/V r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI