HomeMy WebLinkAboutBuilding Permit 04-0786
SeL+e-.t~ -h',\~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See Main File
Date Rec' d
7, ~. ()~
I. White File I PERMIT NO ~
2. Pi,k Ci<y . 0/ / _ >riO.,.
3. Yellow Applicant ""7 . . '/.0. I .
q'lease type or orint and sien at bottom)
ADDRESS
4CfCj4 ~ O:J:.?O~,J-1)r,lxSS
LEGAL DESCRIPTION (office use only)
LOTl/ BLOCK ( ADDITIO~i'Lld io-A--
OWNER
(Name)
(Address)
~~)~;R..t-1ad-oniLc- ,
(Contact Nam~V\i.b.. U) OMo....:::l:ko....
.Ji7ols>D K.o......hA 'ci9-"-c::t. ....,...,00
(Address) L~l)7fj;.m-N' ~t(L/
<. I
TYPE OF WORK
)s:New Construction
DDeck
o Fireplace
DLower Level Finish
(Phone)
ZONING (office use)
Jet
PIDZ5. -tol.' II. 0
(phom(QS5;!'15S-7853
(PhonJ~~". 47?>Z-
- J
DPorch
ORe-Roofing
ORe-Siding
DUtility Connection
DMisc.
PROJECTCOST/VALUE (exdudingland) $ 151./'3_7)
,
DAddition
DAlteration
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'~Y-'~J and that all construction will conform to all existing state and loca11aws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this pennit for just cause. Furthermore, I hereby agree that the city official or a designee may
~t:P4:~ections ~2&5t l-l-Oc{
J (J Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee $, 80 .ac)
I Mechanical Permit Fee $ II'/{J . ^ n
I Sewer & Water Permit Fee $ 1(;,5"0
I Gas ~~rmi2' J $ 1ft) . OIJ
, 7n~7Buildingpr~~~~
V Building li!JI\'icia1 Date
I ~.4aJo Or.) I
-',Unto ~
'i N,,~ ~
,;.5V I
I Park Support Fee
I SAC ~
I Water Meter Si~'; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
I
I Paid
I Date
7071,.. ~tf
7 _ Lr ,OJ;..-
#
#
#
$ ~ ,crt'} .05
$ /. ,?jQ:).CO
$' 2<2;1. t::JO
$ /{';". 00
$ /, '2OiJ_aP
$ -7 M..LJ 0
$ -"
$
I
I
I
$7.07'l- 3aJ
I ReQ,t No. ~"Jd;,.I f
g<( .
o
#
!ication and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
remporuy cenmca; :~;m:ice md allo~ consttusoee"Mafiia Fi1(rpan~ must be
Date ' Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
j"
~~
,
TIw ("tftltr..' IIw 1...11' ('OUIII'"
White - Building
~.~'""'.. -!..tqWrt~.;..~~
----prnf( - Planning
BUILDING PERMlLAPPLlCATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D _ r:.:. . HC 1<:1'0 rJ
( ~.(;4--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
k- I:~J (-I' /' -- \. . C' '''---1' ,- ~\. 1./ (-) C" I {, i --{' I";. .1'2. .
, , ,~ v 'J C _J (.../ I"' r-- f- ,'i "-l t--
Accepted
><
Accepted With Corrections
Denied
Reviewed By:
~
.5t'~ /I1c"',,.. ~/f'
Date:
/- 23 -c:;<.{
,
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."
.
~~
See Main File
~ite - BI~i1din1l'>
Canary . Engineering
Pink - Planning
Thr ('rnlrr of lhr I..kt' ('ounll'}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T
NAME OF APPLICANT
APPLICATION RECEIVED
D.\2.. HO\<..I UN
1.'0.04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
+-qq 4- W6ST OA~ PO I NT DR...
Accepted X
Denied f) ~ il)
Reviewed By: ~~
Accepted With Corrections
Date:
/~::l2 - 0 y
Comments:
I /'i .A ^ ,
~ ~. I~ l"'-+,
"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."
See Main File
The Ctnltr of thr L.k" ('ounlry
White - Building
Cll'larv - Enqlneering
Qink _ - PI~nn,"~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
l). I.... . H (, 1< TL N
-l.j.c4-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.f'Vi 4--- \d:::/-T Cf\ r-- PC I/",T Dl<-.
Accepted
x
Accepted With Corrections
.
Reviewed By:
/) g' /i-
'/ /
/ / I
flu Pi _
Date:
j-::D - 0 t/
Denied
Comments:
.
~J JI4 IJtfi~ I~L,
,
.
"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." .
JUl, 19,2004 11: 05AM
GENZ RYAN SERVICE
NO, 431
p, 6
Date Rec'd
CITY ,OF PRIOR LAKE
SEWER AND WATER PERMIT
i ~=. ~ I PERMIT NOw.'" ,i4w'"
,. 00W ""JiGIIll (I"'T""'"..~
Rfj
ZONING(~...)
LEGAL DBSCRlPTIOr (olli<e UIe only)
LOT~LOCK ADDnJON
l\~pJ~ (~
PID
OWNER
(phone) _ qe2-q&:;- IBM
La.~~i\le.. "?~U
(citvi {zi!, Code) .
(Name) nn U...._...,1q ~UIJt.9m. 1l9m.9-,
(Address) _ 2D~ '4'.}')IOrt.\t:>C:e Cr ~.lN'\
(AdllleI,)
APPLICANT
ONun~ Genz~Rvan Plumbin~ & Heat1na
(phone). 651-423-1144
<""""1 14745 'lfhb~l~ . "'.-::; '"
(Contact Person) . . '1"1 (Phone)
-"T.lCANTSIGNATURE _ J_ . ) ~J P.(/1DATE
55068
(Zip Code)
651-423-1144 (
'.::It:( -oa
- ,
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type ohewer pipe, 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out ~jf required) located at feet from stnlcture.
FEE SCHEDULE
Roaldenlial sewer and water line connection $35,50 lodll81tial, Com'l '" Multi-family 1% of job cost with a S39.50 minimum
Sewer connection only $17.50 Water conllecticn only $17,50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
s
S
$
'~i'~~WGm~'~<lJrJ.J
.t1l'..~ ~:~jIII'~
l.;",_LIJ'
....' 10' ,
!
(om.. UI. ooly)
! .Tlli' Application Beccmlll Your BuUdlng Permit When Approved
L._
B~i1dl., om.1I1
, D'dl[9 ~ U ill ~ I rflfe.eipt No.
. Jf~L'2 9 2004 ~lrY
2411... IIO<<CI for allln.pecUollJ (952) 44~ ~850. rill (lIS2) 4474245
.}--- ==
Dlte
I'
I
JUl, 19,2004 11: 05AM
GENZ RYAN SERVICE
NO, 431 p, 7
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
.!,
q>>1weMs. arm:in~md'il!ll aJ:botrom'
I ADD4tfq 4' '/JVm nait- 121 !)(LIsE
l::: ~~ II'ERMIT NO~ ~..,
1."aJIo\II^flPIleIIll ~.u~
'I ZONING (omc.",:)
LEGAL DESCRIPTION (ollice usellllly) \ 11 L. tl 1 j[J.."
LOT II BLOC!<. I ADDITION /VL-f./j.f/;{ / (j I i1
OWNER.
(Name) DR Horton CustOlU H011les
_ (Address) , . ZO'blPD lUVlBlE..l!'x;e. Cr SR. }lJO
PID
(phone) %2-Q'iU'l-"7g0()
Ltljullr II!.. lU rJ .G601.j Ll
APPLICANT
(Name) t;4ftl7_lJy"" '0,.._,:,__",: L V9't'~
(phone) ~~1_b'1_11h.~
Rosemount
55068
(Zip Code)
651~423-1144 ~
r--f-Itl~ (j
(Address) 14745 So Robert Trail
nl/l'>f';~ )'
(Contact Person) J:L1IG( .
MN
APPLICANT SIGNATURE
(City)
'is~ ~ (phone)
) #11fL::l- DATE
- '-I
APPLICANT PLEASE COMPLETE BELOW
I Quantity I Type of Fimre I Quantity I ROUgh-ins Type of Fixture I
I ~ i Bath Tub with or without shower i I
I i I Di~hwasher I /, I Wafir Heater I
1 I I Floor Drain I Pj:' I Water Softner
I 1 j Lavatory (Bathroom Sink) J I I StandPipe (Waslling.Mach.ine) I
I I Laundry Tray (I or 2 oompartment sinJ<: I I Sewage EjeCtor I
I ,::; I Shower Stall I I Backflow Assembly I
I l I SinJ<:s I I Bacldlow Assemblv Test I
I , -) BarSinJ<: I I Lawn Sprinkler I
I I Watar Closet (Toilet) i I Other )
FEE SCImDULE
Industrial. Commercial & Multi-family 1% of job cost with a $39.50 minimum ll.csidonlial, New One & Two-Family $99.'0
Residential. AdditiODl& Altt:atioOI $39.50
Emmated Co&l $
Building Pennit #
(om.. u.. Only)
I This AppUcation Becomea Your Building Permlt,When Approved
PLUMBING PERMIT FEE $
STATE SURCHARGE S
TOTAL PERMIT FEE S
t:'.~"",,,~.,.....,
,...~, ~-"".;J.J~~J JJrJ .1.
.5(J'U'Jt[)WSl P~~jJ:"
BaUdlllg 0ll1d.1
"~.lri@ ~ D IJJ i:f1 Receipt No.
-< Date, 9 ~ Ilay
I JUI 2 2004 I
. --
24 hour nolic. tor alll..poe1ions (952) 4<1'.9850, fu (952) 447..045
By
II...
" . ' .
. . . -, '
... .... .... . . ... ....... .... CITYOFPRlORL.AIQ} .... ..... . '.
.1UJ~:l~(;/MR CONDITIONlNGmIREPLACE PERMIT .
It 1917.
. Date llec'd
';:'..-.
. -' '"., '.
......" . i.,>> ... . . . .f~:~~, IPE.RM;fI':N{).Dt/i'67~"1
~1.@r -<fl. ..l.~i"':; - .... . ~~
., - :';.:.-,\:;: .,
. ...i~=:::j~~~:..
. . '. '. ,>,;(,-,'f:,;':},;( ,'.'."'^--' -,',.....,. ...'.-....-,cl'..-,..
.()~DRHORTON
..~~~&'S 20860 KENBRIDGE CT
;,,/"'LAKEVILLE, MN 55044
..... ,~)~,,/,,;,;,.:;:tALjjANTMECHANICAL INC
:.~ii;~::~/"... -,.~" ii)';'i'J(c&i,,';t'i>..
..,.,~;fi;X~lJ~~lli~~,,\ ,..,.,.. 'dL!Jd~ ."~,, DATB..,~",."...."'i'."'""",,,.,,>,,.,,.., ..,
.. ""..,.
':.;\;;:t,. ., .". .. . . lmA1'ING'OR'OOWllltPtA.Nt'.... ..."..1'..",....,.., ..
. ..":(;',/... .'.<' '.' . .8i~~~l\':!~';!1;;/.\'~hi:.:,.:~<(l;i;:1i~:~ij::..;.."".:,:;M~l~;f?';, :.
. .,....'.. D.'S .....,....,.... '""'~"'. ........ .,................
"",_,.,.:_,.' pec:~~IIii;'_ '. ";"".' > ,i. "..'
. 'f.. . 0 Othtr.I>eVlces '. .. ': ,. .. ,.......'.. ... '.................,........'>....:.:..:'... ..'........' S....~,..~....,..,:..,..~.'...,.-?c.~;.k...,~..;. ..,i:.,;'.;...:[..~.:...'.:....!..,:_'......_'~,..'.~.~..,.\.....'.,...:.,~.~.......\.....::..~..~i;.,.._:.....'.;"~....'.:
".,: .. ....../,.,.....,.,';.....;...':..).':."..,..,:,.:..~........,:;....~...:.;.....-.:.~....,,:.....~'..':,................ ' ,', .,...,..:,.,~ ,,~ ,;...,..';,......... .....,." '.' .
:f.:~~~(,:t:>>, !','Wr'~ - -- ,'..:.:~.;~'.' '.:,:':':',.'.:~..;':,<,+. '>:i'" I . :~"~. , .~;' . " .
..."'Iri~~.;l~~~'~~~i~~............ ~r~~~:=~~ru~~~~~!);~I~.... ...',;.~.~...............
. RCsi.<lenli, aI, ~eati. ...... Jig !!\.-!i!/fJ..... ,~. ,..0. :.o..!'5'tU.clion.) $99.50 Re. sidenlilll. Ad. 'dWonS & AIWons . . . >$39.5i) .
. R#idenlial; Heatii1liOl1ISiW~F~ns,tti!clion) $64.50 ROsidena.l;J\.COIlly . . '~9.~.'
'.',',
...pm. ....
. -" --,,'
'EstUIililed Cost $
Buildin!! ~ennit # .
. HEA'fIN'G PERMiT FEE
STAlE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.l?AJD WIllI-
.soBUlLDING.
.KMIT
"',:;.\ .
(OllIe. u.. Only)
This Application Bec.omesYour Buildin!! Permit When APprov;;J' \ ~)lffd~ ~ U illlb
UuUdlngOlllclal Date _ ~r"1fuG 1'1 2004
ReceIpt No.
By
24 hour notice for all inspectiona (951) 4479850. fn(951) 447-4145
. By . J
Page 1 of2
Lynda Allen
From: Christa Wegwart [WegwartC@hearthnhome.com]
Sent: Thursday, September 09,20041:17 PM
To: Lynda Allen
Subject: PERMIT FOR 4995 W OAK POINT DRIVE SE
o
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNGIFIREPLACE
PERMIT
Date Rec'
4994 W OAK POINT DR SE
1. Pink File
l ~ i:,,,,,,, I PERMIT NO. 04-.07,%/
I ZONING(ollic<use)
~ease trPe or 1Jrint and sip at bottom}
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDffiON
PID
OWNER
<Name DR HORTON.
(phone)
(Address)
APPLICANT
(Name) ALUED FIRE~E DBA FIRESIDE HEARTH & HOME
2561
(Phone)
6S 1 .633-
(Contact Person)
2561
BRENDA HUSTON
ltOSEVILLE
(City)
(phone) _651-633.
55113_
(Zip Code)
(Address)
2700 NORTHFAIRVIEW AVENUE
(Address)
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
9-9-04
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT
OUTPUT
=A~~::TEM s:,ATINGORPOWEit1tXwWlSiillih:
Gravity Hot Water ~~er U lits
Mechanical Radiation . BUll ~ll!lbach i Ito
Air Conditioning SpeCIal DeVIces L {~~ide Yar I
Vent. System Other DeVices l' ..Jj~~
FIREPLACE MAKE AND MODEL flEA TN GLO SL-750TRD (2 FIREPLACES) ,..:-... _'''':'' _ .. .,... .
.~ll U; 10 ~ U III [glrt.1
FEE SCHEDULE "r"
Industrial, Commercial & Multi-Family 1% of job c~st Residential, Gas Fi . ,sEP l/J 1/lfil 1/ i., 39.50
$39.50 mmunum !l1"''l' U ,
l-d:
I
9/9/2004 By_ _ __~_ __u_..~
PRIOR LAKE
INSPECTION RECORD
(}.~ f)r-. ~in File
. ~fu~r~
DePARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS. ~~ UJ
NATURE OF WORK u.. _ 1
USE OF BUILDING ~F'-y.q.
PERMIT NO. (J4-,O'7?k DATE ISSUED 7- ~'2 -0 ~
CONTRACTOR () a Wr.~-L.-" PHONE q~-:n.(A .C/73~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR ,DATE /
'FOOTING I ~. I,? /ztf"/uf
, FOUNDATION (Prior to Backfill) ~.."jf U/#E/'A I j/jyj;,'
PLACE NO CONCRETI!'UNTIL ABOVE HAs BEEN' SIGNED
ROUGH - INS l '
SEWER IWATJ:R I SEPJIC . "i #/% r/h/6Y
FRAMING&t S4-7h,~ M ?/~" ~. SJpr/6~
INSULATION ~ #/}- l' /Jt1 /~f
ELECTRICAL , 7/~'ilo:I
PLUMBING de r;: /It!! %/rl/cf ,hf"7 ?m/~Y
HEATING (if required). j )'tfi- ?/A7o.f
FIREPLACE 1.'/;1/r5 .A(? ~ 91z%/oy
GAS LINE AIR TESf~/)r r ,J--tl- 't. ~ ? bi'/oy'
· COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 I I
FINALS
GRADING (Prior to Sodding) ..:J~e ~..-~ h;{. .
BUILDING ~ ,/#/~,
ELECTRICAL // p:z.'{o/'
PLUMBING t4t11 /1//7/by
HEATING ~ /~ At/'
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
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
QI:ertifiraf:e uf @r:cupanrll
CITY OF PRIOR LAKE
~eplldmtuf of ~uilMug J'usptdiou
;t(Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section lID of the 0 Residential! 0 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 the following:
Use Classification SINGLE FAMILY Bldg. Pennit No._ 04-0786
Occupancy Type
R1
Type Construction
VN
_ Zoning District R 1
Legal Description
LOT 11. BLOCK 1. DEERFIELD 10TH
Owner of Building
Site Address
4994 W OAK POINT DRIVE
Contractor'sName&AddressD R HORTON!_~8p KENBRIDGE CT 11100 LAKEVILLE 55044
ROBERT D HUTCHINS~. City Planner JANE KANSIER
Date: /-'1// hp'cial - Date:
}- /' I
M/W' TIME
~ '
/f'99;/ ta/cAL ~
CONTR.
PERMIT NO. M- ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO,
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
"..,rs~r-INAL
[] SITE INSPECTION
[] PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
~HFINAL
[] EXlGRADlFILUNG
[] COMPLAINT
D FIREPLACE RI
,I fiREPLACE FINAL
[] GASLINE AIR TST
[]
COMMEN')iS: ~ / /' /
,ff~-h-r&r/hJ-. / ~. ////..2/at/~
- , l ,
,z h;'~/~~~ f7k.~ t!;f{G.
~/a.~~5 (;;:> ~_/~6f
~';d r/~' 6?t'~ .-
>e:~C~t(;;~d Or <S~?- j6--r-
~ / .,. /'
/'7~1' / c;:rc
..-
~ ~/
/~ - /:'0
~ L-/ Q)~ r ~ . ':.--
/WORK SA II~;"M'" I Un-I, r n.u"a;.cu
~ORRECT ACTION AND PROCEED
[] CORRECT ~/~.~L FOR REINSPECTlON BEFORE COVERING
Inspector: ~t.---' Owner/Contr.
-~~.
~'
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
/1i$IIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATI! T1IIE
CITY OF PRIOR LAKE ',h"'/
INSPECTION NOTICE SCHEDULED.0- ~ '4
ADDRESS Y77V m~J-09'i //-
OWNER
CONTR.
PHONE NO,
PERMIT NO.
t!Jr- 7Yh
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ~R HOOKUP
.....er"PLUMBING FINAL
o MECH FINAL
o EXIGRADIFlLLING
o COMPLAINT
o AREPLACE RI
o FIREPLACE ANAL
o GASLINE AIR TST
o
COMMENTS:
'1~ /
./ //_~n P'1-"'~ i4!---
~r ~ OlE'"
/
~).(A
C./'/'c
4/
/
il""WORK SATISFACTORY, PROCEED
1'0'- CORRECT ACTION AND PROCEED
o CORRECT~.:/ ~.J'FOR REINSPECTION BEFORE COVERING
Inspector: ffi/b7- Owner/CoW.
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY/
INSI<<>n
.
~
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor ~ !Mull
Name ot Tester
_ll/W),-I
" .
Date
"
"'^"- """ r~ ~
Heating Contractor ..AU.M' 11-1 ~U
Name otTester a,.,
~
n.1~
C"RfJ...,
~qC}..
~.::
Date
Percent 02
Percent CO
Percent Co2
Stack Temp
Combustion air is adequal8ly supplied per
~~
~u~
UMC Sec. 606
Input