HomeMy WebLinkAboutBuilding Permit 04-0382
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3, Yellow Applicant
4/2$~ Roo'
[PERMIT NO. 04--. 0 ~ B ~
(Please.!VD~ or oTint and sign at bottom)
ADDRESS l
/3'lt~
~
ZONING (offi" use)
12/
LEGAL DESCRIPTION (office use only)
LOT or BLOCK ~ ADDITION /AJ~) c:~---'
PID~S""- Lf /3 -1)/ R- J
OWNER " l' 17 II 11
(Name)_/~,~V1Jb~~ D~-I (Phone)~~t;2"'l<"~"l.{~
(Address)!4.311 12~ AMi ..<. r~i3~L~h~~ . /lI A.J ,<':<...30"-
I . - I I
BUILDER . J < /J . 17
(Name) {"I~Ml/I~L-T.U~#--" (Phone) '7S~ tz9c..-X-l.JY;f>
(Contact Name) -1)...... . J....f.. . A) (PhoneL.9<~ ,~I.J.<-lj.'1'71")
(Address) 1'i3) I ~ ,Sl-f:"~~ ;/J'J;L)SS3a::;;;.
TYPE OF WORK
~ew Construction
DLower Level Finish
ODeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace DAddition OAlteration DUtility Connection
PROJECTCOST/VALUE (exc1udingland) $ / ')<:. DtJQ
. ,
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 y....t'-~:J and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;teru~IJ~::7::r~nee~:~") L ~-2 Q. I Cj / 4 -/9 -7) 'I
~ Signarure( / Contractor's License No. Date
,
o Misc.
I Permit Valuation IF Zt:J7J 000."0 I Park Support Pee # $
j Permit Fee $ 1t..'j5.5"'0 I SAC # $ /350.00
Plan Check Pee $ f/02-.<:lf( I Water Meter (jfze sjjJJ 1"; $ 2SC.oO
State Surcharge $ 10 '$. SO I Pressure Reducer $ 'f -:; .-fJ "
I Penalty $ I City SAC and WAC # $ /Zoo, Do
I Plumbing Permit Fee $ IOtJ,(JO I Water Tower Fee # $ 700_ () 0
I Mechanical Permit Fee $ /oo,otJ I Builder's Deposit $ / Sao, fJo
I Sewer & Water Permit Fee $ SS-: ~tJ I Other $
I Gas Fireplace Permit Fee $ 40. t)" 1 TOTAL DUE f'd&d 6" .i. t) tt--- $,r ZZ/, s ,f"
Ec3-d-,; .g-'i' .. - - -,
This Application Becomes Your Building Permit When Approved Paid Receipt No. Lfft:>!( cr )
~.~ S/~~if Date .K- / I-J-()U By G
I d>
Building Official r .-,
Date
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 con .tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
iss~ ..J. L .. _ ..I!::~,
- I Planning Director .s7~y AJ ~on';;"::;~y"""""'--~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
While - Building
Canary - En ineering
I"'1-rInK . ~Iannln
--
Th~ (-t'Rtfr or Ihf J,lkf COunlf')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/i"" //
/'
, ,!-/
"
,
)
. I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed fit:
r
'---
"
Accepted
Accepted With Corrections
~
Denied
.'
Reviewed By:
~
~ t..J
Date:S/0i'
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."
.~
~~
~hil" - Building-:,
Canary - Engineering
Pink - Planning
-
TIl~ (.~nl..r nf lh~ I....f COunlr,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
U/.-t.-?Jd u;v:d
<:/_ ;;(..0 -0 L/
~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/39/8' ~~1071 ~
/'
Accepted
Accepted With Corrections
Denied
r-
~~
Date: s/ <f ~ c(
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."
Thr ('rnlrrnf lhr l..kr ('nunll'}
White - Building
~- ,=nq,"eern~
Pin - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,
/ ,/ /
/ f /'" /~'V''',' I. ).J?.'~..;>
L/l ~.A"'(.--" ""...oJ..' ( . ,- ,- -
,
l"i~"'7
! () '. .'
APPLICATION RECEIVED
.. I """J ", {I
'~-I_ (~,<C". "~,..) .
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed lit: ,
7'....
. '0. .a/."."" / /") ."J
/t.'. C ~ ,_ ,;,..,r' ,''''
/ .~~, c;~./ )f'.-
I ,-' II .J
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;.',..(...-1'\.'<:-
Accepted ()(
Accepted With Corrections
Denied
Reviewed By: Il14 i3 Date:
Comments: SAP. Reverse Side for Additional Information!
Lj-')t'-c;L/
,
rlrivAwav Must Have A Concrete App,roach
See Attachments' I) GTluline Plan, 2) Erosion rnntI(ll Mp<lCllrpC
"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."
MATTHEW DAN I ELS, H~C.
423 3017
P.01
Uate Rec'd
CITY OF PRIOR LAKE PLUMBING PERiVIIT
(Ple:I.SC,E"11!e: Qr DrinC U1.d $ie;n ilt bottom)
ADDRESS
1-39/8" cX~ o.v~ ~ 11~
v
LECAL DESCRlPTION (offi"" ll<< only)
LOT q BLOCK ~ ADDITION. }~) J;v.r::Ci-ri~
I OWNER
I (Name)
I (Address)
~. ~~ ~:~ I PER1"IIT NOA~~_ ;...- Dr.-J
I YdlcNl "'WiM~ ""., . V G ~
ZONINC (offic.",<)
PlD
W-u"l,uIlAJ '-~')(I)
!!kill a-Ai J' i {j {L,; \..If .
V .
APPUCA.'IT~J . _______
(NameL_:::f},e.-ttLOJ ~ f1., J I dr. ) .~. 11 (Phone) tSl. -1.2..",. d"1~(')
(Address) 1.;:>1~ (J.A~J~I''''IL .J:;;~h q>'llJ'YlJur. '-1'/.;) ..5:5068
(Address) V . (City) (Zip Code)
(Contact Person) f1, 1 ; I d )C. \.. ~ J i +1' 'rJ"-' ') (Phone)' 1:.5"1. -k.'l . .~2:.'V)
&/J.-t."'.Ii~ Ii;")
APPUCANT SIGNATURE _
Quantity
,;J.
I
I
4-
I
I
I
...3
(Pnone) qShl- 'R9!5"""- 1f'l:!j'i?
DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Draip
Lavatory (Bathroom Sink)
Laundry Tta)' (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
....:J
J
J IU..
J
/I<-L
I
FEE SCHEDULE
Industrial. Com.mercia.l & Multi-family 1% of job Clost with a $39.50 minimum.
Estimated Cost $
Building Permit #
I Type of Fixture
Rough-ins
I Water Heater
Water Softner
I Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
! Other
Residential. New One.& Two-F~ily S99.50
Re:idential, Additions & AlterOlions S39.50
"'JJl:ir
c- . .r)BI)~
l"" ., ....__
"':'.i", ",;'i".. .t"(ji
QC/.6ZJ C"-J:J~G0@ /J2!gJ~[J/)f)Q.
.50 ~~Uir
J fJ/J. tJ"
(Offic:t U!e Only)
This AppUoatlon Be<:omes Your Building permitDW...hen Approved ~'p ~M: ~ ~ ~O: t:e1Pt No. q
8uildi.~ Olliei.1 L 1n ..:J..!!J
24 bour Rotiee tor .11 in,peetion, (!151) 447.98~,X (952) 447-4245 . - !J
PLUMBING PERMIT FEE
I STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
TOTAL P.01
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
5,].. 7.04-
I. Blue File
2. Gold City
3, Yellow Applicant
IPERMIT NO%?L/_ 3f'~
(Please type or Print and sien at bottom)
ADDRESS
ZONING (office use)
13q/?r 1!.R~.A76hL HIJu
''Y -
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
pm
OWNER
(Name)
/IJ~lL>>(rI r/~'
(Phone)
(Address)
APPLICANT
(Name)
1)LI2-U.d~ E)'c.
L/ f}1 {) ctk/l/WV-1 /Jdib
(Address) (7'
(Contact Person) .J ePP-- 'bP--Rv D~ ~
APPLICANT SIGNATURE &lfJi1:)ll:Jri.?.u!JtdP-.--
(Phone)
;If-.
(City)
jJ~/~~
(Zip Code)
(Phone).g C(? ( '2- q Lq LfI2.f'/
DATE s!Z7}nt./
(Address)
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
I Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Quantity
I Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
fndustrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
b ~ 8 jJ;J
Building Official
.50;
OQ
I Paid I I Receipt ~~ ? t "
Date 1 Dat~ '" ~ ') - D 01 By l\--.
24 hour notice for all inspections (952) 447-9850, fa. (952) 447-4245 ()
t6200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714
(Office Use Only)
This Application Becomes Your Building Permit When Approved
1:59PM METRO ~!A92t~4J:~11~n~LAKE NO,619
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
p, 1
lJl\\e Rec'd
I,rink
:101_1
,. V.lIow
g:,~ I PERMIT NOft'l_ ~ D ""
^rphCIMnl .(1 .~~
',," .
ZONING (om" u,,) .
(.r~as~J~~ or Clint ant! sim at botlOIl1)
A)?qRESS
_J-'" <'1 \ 9-. \<.., ~~ S';f"'\\~~ .p...,..;~
.
L~OAL DESCRIPTION (oInce u,," only)
LOT ~ BLOC!()., ADDITION '-\ ~ " " .\, Vv-'
PlD
OWNER
(N~IT1C)
(Mdrm)
\-\ " '" ~ \r\ (,)~~ ~~"""~
.~ '-4', "\ f:\ "" ':::>
\
'\'\'""'!> \\.
(Phone) G\n.~ Ii?~~-~I.\\.\ ~
0v..'-'I'\~\\\\\t s C;-:\QL~
, AFPpCANT '^ I -,-. r, S \ <I \ '<:7\ l{
(N.arj,e' \f\<l~ (\'\ \"<,.-- -1- n l, (Phone) '" ;),., '-l ""I l- '" d-
(^~dlesl) \~(\ ~\J \j ~\ L(J~ (\ V '- (l " <..'- \."Iu.. "'~ ,'; s:,~-, d.
(AddtclSJ (Cdy) (Zip Codn)
(C~nlac[Pellon) N tA,V\L.\J S L..~I(\".\\. (Phone) 9<;:~-\\'v\f' ~ \f)\..\
A~PVCANT SIGNATURE 0{\.1:IV\M.1 ulll 'h DATE S - \ '-\-Iv!
APPLICANT PLEASE COMPLETE BELOW
9EW CONSTRUCTION 0 REPLACEMENT 0 ALlEM TIO~. 1-
FUf<1>jACB MAKE AND MODIlL \"I ~ fl \ d () fUEL \\1 c.. T
fl.\J~ SIZE '$ II '(.1\1 <. RETURN OPENINGS ~ <'\ INPUT) ~ Cl: 60:) OUTPUT \ \ ~ ~ C)
TYPE OF SYSTEM HEATING OR POWER PLANT
" o Worm Air I'lonl'
OOrIV!ly
jMeohollicnl
Ir Con~iljonlng
Vent. System
o S,eom
o HOI Waler
o lUuliatioll
o Spoelal De.ie..
o Olhor Device.
I'LIIASE NOTE,
Air Conditionel' UllilS
Cnllnot Encroach into
Required Sid. Yard
Setbacks
FI~q/LAC:E MAKE AND MODEL
FilE SCHEDULll
Inol'!lliol. Comlne"ial '" Mulli.l'allllly 1% .(Job eOIt ReSiuenliol, O.s Ph'cpln..
$39,50 mlnlmulIl
Re,ld,l'lial, Heollng &. AlC (New COIlSlluelioll) $99,50 Resiuelllial. Mullions &. Allorollon.
ResidiJ1linl, lIealing Only (New COllslruelion) $64.50 R..i~ellllol, AC Only
F..slimated Cost $ \ ~ I.J ~ I:l "9" Building Penllil II
$,19,5D
HEATING PERMIT FEE
STATESURCHAROE
TOTAL PEHMI1' FEE
$
$:
$
,50
$39,5D
,i39,50
{~~ ^'
~~~;
. ,.p, %J!,~..
'/,V~ {..~:r~h,
'"~A ,/~/ (
.;.;,~ '~(-
'~;0,
"..~~,
(Ol\i.. lIse Ollly)
1'1111 AJll,Ueatlon Becomes Your Building Permit When Approve<! Paid
. Dale
By
I
( J.t--
o
ReceiJlI No.
UulldhlB orn,lol
Uft1C
24 hour 1I0lice r." nIlI1l8\I.ellon. (95)) ~47.9850, ra. (952) 4474245
08/24/04
13:53 FAX 7635530887
GUYERS BUILDERS SUPPLY
CITY OF PRIOR LAKE
REA TING/AIR CONDITlONINGIFIREPLACE PER.1\1IT
~002
Date Rec:'d
.---_.- ,-
~~::.. ~~. I PERMIT NO.O.&. 038 ')1
J. Vella..... "',ph~~ -, . e...t
, (Please EJEe or Drint and nm it bOllOm)
ADDRESS
J '3 Cf I f(, JV fl SI nqt() (\
~o r-t- I ZONING(olliccus<) I
~
LEGAL OESCRu- !iV" (olIi"" us, only)
LOT
BLOCK
ADomON
PID
O~R I (
(Name) I" ') (Y1(h.lJOO~
(phone)
(Address)
. APPLICANT /"1
(Name) l,? U '! '€.lIS
(Addl'ess) t 2:> 'I () 5'
ItF(J... I9-Ur:.-fl\J~
(Address)
(phone) 7iP 3-~1V -1!.t6J
PI'-fWLouf-h.. :5~<;"I1
(City) (zip Code)
(Contact Person)
\..... ~. (phone).
p~ ~ DATE
1IL~
APPLICANT SIGNATURE
APPLICANT PLEASE COMl'LETE BELOW
W"EW CONSTRUCTlON 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL S u ,,~; \ 0 r- FUEL 11/,,-+ G; 5
FLUE SIZE ;-5'[ ~ RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plant' 0 Steam
DGravily 0 Hot W.ter .
o M"hanical . 0 lWIi.<ion
DAir Conditioning 0 Spocial Devio..
OVcnL System 0 Other Devio..
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacl<s
FIREPLACE MAKE AND MODEL
Residential. HCating & AlC (N.... ConsttUCtion)
Residenti.l. Heating Only (New Construction)
FEE SCHEDULE
1% of job cost Rdidentiu. Ge.s Fireplace:
$39,S0 minimum
$99,S0 Residential. Additions '" Al\crotions
$04.50 RcoidentiaJ, AC Only
$39.50
$39.50
$39.50
Indu.stti.l. Commercial'" MulLi-family
Estimated Cost $ loOo. 06
Building Perm it #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.50
(Office Un Only)
This Applic1lion Becomes Your Building Permit When Approved
8uildin,? Offici.:al
Dm
rif~ ifB ~ U ill ifli"1.1 ReceIpt No.
IIFa8EP 1 0 2004 ~ i By
~
24 hour llotic.e for 211 j",spections ('51) 44"'; ~~SO. fax (95'2) 447-4245
....:...:.;,---
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS L3 'IP ~~~~II AtlrlJ"r
NATURE OF WORK Nf; W cTlO~
USE OF BUILDING $"'. F: D .
PERMIT NO. .01-.0382- DATE ISSUED S-/ 1.//0 t./
CONTRACTOR ,v,M ~ P~-.NS-t'ftd
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING riff ~ .4>-oq
, FOUNDATION (Prior to Backfill) I ;//1;:;7 I 0,7..1- cJvj
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC f/} 5',~
FRAMING / I ff1a- 7/~/:~
INSULATION ii, M'J !f/11/41 &4- .7 /,A;~~
ELECTRICAL .A? / 2.c~ y
PLUMBING YI/Y/ 7 - 1&0/
~I:~~:~= required) ~& ''1'1 :-/) #It t// ~
GAS LINE AIR TEST .~,)l T~J }?~r1A~ ?ftj'?:~ 1 !lfl~
COVER NO WORK UNTIL ABOVE HAS ,BEEN SIGNFD/ J
I LjfTHF /(t("r,,~~ SfaIJC I mfI- I fit lor
12 ni? 'l)&tJr' /3 ,rj/oc,kd FINALS - .
GRADING (Prior to Sodding) /J/P f (}. i/. 1f."L..... I
BUILDlNGre"";J' C~ ('), //P~~'t' ~ ~
ELECTRICAL
PLUMBING ,,11/4
HEATING Jf1~
/CJpz/Oj/
/o(/y/uy
/o/I'/ot.
/tJ//$PjI'
DO NOT OC53UPY IU~TIL ABOVE HAS BEEN SIGNED
jtJW..e/ )~(./c/ IS Ui--ffi4~ 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.
FOR ALL INSPECTIONS (952) 447-9850
(1l~rfifirat~ of @rrnpanrl!
CITY OF PRIOR LAKE
@.rparfmruf of 'lJjuilMug Jusprdiou
ftFinal Permitted 0 Conditional CO. Expires
This. Certificate issued pursuant to the requirements of Section J J 0 of the D Residential I D International
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 thelallowing:
UseClassificahon SINGLE FAMILY _ Bldg, PennitNo, 04-0382
Occupancy Type
R3
Type Construction_
VN
~ Zoning District
Rl
Legal Description
L9, B2, WINDSOR ESTATES
Owner of Building
Site Address
13918 KENSINGTON AVENUE
AVE S., #200, BURNSVILLE 55306
DON RYE
Contractor's Name & Address WINDWOOD HO~;~)4311 EWING
ROBERT D. HUTCHINS/~ City Planner
/~...t~l~cial Date
/ . r
Date:
.-, ".
DATE TIME
CITY OF PRIOR LAKE ~ /.'
INSPECTION NOTICE SCHEDULED /0// V'" Y'
ADDRESS /??/ tf ~ ~1'7.S/ 7~""'" ~e
OWNER CONTR.
oc/-J?2
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
-"""INAL 0 PLUMBING FINAL
o SITE INSPECTION ~ECH FINAL
COMMENT&! /
YLt"f/1 f<:; / F/"p,<;/
......--.
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~IREPLACE FINAL
o GAS LINE AIR TST
o
don-c / oj;, 5" ~/
12,.c-p, '~I Hdc J'-";Lc~;L;~c:.yd.,
--- " -" /
,hf7!kcr:- p_J,-e/ C/dJ
'U-/ t'h/u-<.- Id p?~--'/-:.-//
~r~h ,,0;,../ .
h' el'" e'L Vt:....J &J'Sc;.~ 7r~r
_ I/', ~ J
~cd ~ 7;--<~S C}/I"e /:..0/..-/4:--.-1 or
@ /y;c,",T-~h:,,-i /2- r~/.4:..~ u~~~_
(3) H'J'.:'t'.k ~~~r':;"f=--~/4-..;, 4s-,?;
~O~KSATISFACTORY. PROCEEOc.::;; ~ ec{ ?~ / ~~
~ CORRECT ACTION AND PROCEED ~~"""
o CORRECT WORK. CALL FOR REINSPECTlON BEFORE COVERING
#//~
,
Inspector:
OWner/Contr:
CALL 447-985Q FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
;kP1/ . C c}, 121'/ /~~y
/Pp/f</
~I""', )/;J~^- d L
CONTR.
OL(- J Ii Z--
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/?9/~
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH R1
o WATER HOOKUP
o SEWER HOOKUP
~LUMBING FINAL
o MECH FINAL
COMMENTS:
//kp__~~h-
/ :7
~sr
..,
~P/ .15
re ~--
1"'/C
/
Pnd/<:i ~6-
./
~
/-t '?~
/
/
/'
~t'C
0" TE TIME
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
""
c:J /(!;
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL OR RElNSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,
IN$NOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 137/&
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
OI!t-E1JlAL
o SITE INSPECTION
DATE TIME
SCHEDULED 1(')-1 K"Ci'(
f('1s'1Jb.... /lve
CONTR. w;N/wud ~
PERMIT NO. (',U ~3K 'l..-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
.
~ EXI~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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00 WORK SATISFACTORY, PROCEED
y ~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
lnspector:,&~ _ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
''''''''''
.Permit#
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'""",ConO-_ METRO A1f(
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.Pen:ent~
FinallMpeclion
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PERFORMANCE TEST
/Q,.3%
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'p,,_ CO {;1dt,
'SIaol< Temp. /(J 7d
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