HomeMy WebLinkAboutBuilding Permit 01-0065
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I-If-OJ
(Please .!':De or print and sign at bottom)
ADDRESS
SJ/OtJ hwn /J1e"dow (,hJVt: ,/y~
LEGAL DESCRIPTION (office use only)
LOT I BLOCK I ADDITION 'Dc.u.{)dJ ird.
OWNER
(Name)
(Address)
BUILDER.,.
(Name) D. ~. I-i.-/"", .-;::;. t': -111,;/
(Address) :?'-ISq lik.{h'H"'/v... /)rivt sk;LIJ'1
p
TYPE OF WORK
00 New Construction
ODeck
OLower Level Finish
o Fireplace
o Mi&c,
1. While
Pink
3. Yellow
File
City
Applicant
,4
PID 25-3')3-001-0
(Phone)
(Phone) t.s- 1- ;?St,. 71:7 9
~.;:A" mAl SSI:7;{,
OPorch
ORe.Siding
ORe. Roofing
DAddition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $ 71) t, 70
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 property and that aU 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
enter upon the ~rop~ )f r.erform needed inspections.
X -Zf//A:;./!.d uJJ..L: dL!tJlJ5l$7 I-IR-O J
Signature Contractor's License No. Date
1 Permit Fee $ /'1('),"7"')1
1 Plan Check Fee $ 613."1'11
I State Surcharge $ 35'". c;o 1
I Penalty $ I
1 Plumbing Permit Fee $ I (!)(~. ~<b I
Mechanical Permit Fee $ (00."0 I
Sewer & Water Permit Fee $ 3s- . ':l"l> I
Gas Fireplace Permit Fee $ 4IJ.oo I
rfJjr~'-'~~";~=~
BuIldl~ OffiCial Date
'1IJoClO.c9Cl
1 Park Support Fee
I SAC
I
1
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
1 Other
I TOTAL DUE
#
~7C.130# '-...
-
Water Meter SizU' '''; /"
Pressure Reducer
$ H~U.ce, 1
$ 1//SD.(931
~~_~. ,.1
...... _ t
$ it) . CJ() 1
$ I. 'J..t"JCJ . CXJl I
$ ~rJO.6O 1
$ f. S-crJ .c:>0 I
$ I
$1335.74-1
#
#
Paid "1. 1:1(; 7,v
Date 'I v-1/ J() I
I Receipt W. .3 'fUt) 7
By t/1/' -
1/
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
~~~A:i:C;~'~n~':::'mpo,~ C'''ifi:' ~:n;g;m:Ii'n" ,nd '<:'ti~~n~,' C,"ifi"" ofO,wp,"'y mu"be
Planning Di"cta< Date - Special Conditions, ii'~
24 hour notice for all inspections (952) 447.9850, fax (952) 447.4245
~~
o I ~O(gS
Th.. ('..nlrr of Ih.. La".. Counny
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L>.
1 j
~
1-
H C f-:TC 1'\
I r - ( I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
84-CO 1- f\' 1\1 I-IEI-\\.)( ~\j
.--
\" \<.. " t::..-
Accepted
,/
Accepted With Corrections
Denied "
Reviewed By: ~~~~
Date:
VI/<9l
Comments:
/~C(Wi'71JA2. ~ J ~Je.<:' 1\' <{D '\tv_ (fMd li ~ ~ ('~
~p_ {J.L9,~, ~ \rJlAT~ I\:>~~.& ,SnJ
Ml~i00~
~)~I~~MfS&V\ <1ARLfi f:4,
t,~~5t ~~' ~ r<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."
ii~~
01 ~o(Xo6
Thf C..nlt. of th.. L.k.. Country
White - Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. R, HOKION
I-IR- 0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5400 ~A\J\J N t--1SA DOW
WR.\J5
Accepted
Accepted With Corrections Y
Denied Wit /
Reviewed By: ' . , ~,
{/ -
Comments:
,- {(."..rO CA.ll cdf",A,dA ~Q("~
Date:
1- 2~-7a-:'J 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."
The (:enteT of the L.ke COUnll'}'
01-(05
!Y\AHJ ~ILE
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
D. R. HOK( ON
1-/8- 0 I
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application tor construction activity which is proposed at:
5400
/
r-: A V\J N MEA DOW
(.U 1<- \J S
Accepted
Accepted With Corrections
Denied
,
.
Reviewed By:
LLL
Date:
1-29-01
Comments:
;
"
See Reverse Side for Additional Information!
, -r----..-
jj" ,
y
..,
r
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
3) Erosion Control Plan
"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."
JAN. 24. 2001 2:32PM
GENZ RYAN 5513225147
NO. 865- -P. 9/9-
CITY OF PRIOR LAKE
,PLUMBING PERMIT
1._ I'IJc
.._ all'
3.V__.
'I'1M c:.tIlon' Iff Ilk LlIIot c.nt...,.
# (J 1- OOlP5
Appli.cant (".." J/'o 7 - (1..1 J" .~ Phone:~I-14 2'3.-11 L/ tJ.
Addr~.:~ ~~.n-r -r1U - (P~~1C:CY'>11 n/ ~,.,) <;~lo'b
Signature: ' -I.l J' n 0
Legal Descriptlon: Lot Block Sub
Site Address: 4J.(Y"") .c:-A-I' "'- '\ ~ k n A-Qrn ~ \ (1 J l.K1.Vt.. Sr=_
Bullding Permit # PIO #
NOTE: This permi! "'!Ill not be p."....""scj without complete information,
riA I ~RE UNrrs
- ,
I Quantity Type of FIXIUI'1I
I f Bath Tub with or without shower
I I Dishwasher
I t Aoor Drain
I 2- 'Lavatory (!:lath room sink)
I laundry Tray (1 or 2 compartment sink)
I Shower Stall
I r Sinks
L~ Bat Sink
,J 2- Water Closet (toilet)
I'
Quantity
Type of FIXturB
1
e..ll
Rough-ins
Water Heater
Water Sellner
Stand Pipe (washing machine)
Sewage Ejsc:tor .
EladdIaw Assembly (RPZ. Daublll Check. PVB)
BacldIow AssemblyTesl
Lawn Sprinkler
Other
FEE SCHEDULE
"
_ Industrial, Commercia' & Multi-Family
(1% of job cost. $39.50 minimum)
Residential. New One & Two Family
Residential. Additions & Alterations
State Surcharge
GRAND TOTAL
S
$
$
$ .50
PAID WITH
$ BUILDING .;:;;::;:.:rr.
$99.50
$39.50
This permit is _<eel upon tho up..... conclidon tbal said
COJllrBCt... sh&I comply In all with tho ortIill8lU:CS
of tho Stale Plumbina "",..dmcnts thoroof.
-- RE ~~()I DATE
,
,
..-'
Call for all in
Al.i.c.:a1
ons 24 hour.; in advance.
16200 Eagle Creek Av. S.E.. Prior Lake. Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-42:15
An Equal OpJ!lortUlli1:Y EmplDyor
-~"-_.._--~~
JRN.24.2001 2:31PM
GENZ RYRN 6513226147
NO. 86S---P. 5/5
_. ....
'I'IU.OW .. .,. tc.ItIT
.... .. ar.
CITY OF PRIOR LAXE
SEWER AND WATER PERMIT
NO. 01"'00(05
.
NOTE: Sewer and Water
contractors must
be registered
with the city.
APPLICANT:.r~."'$.- ~r"'lPh.l_\:">I~_ u."'1"1"l<"~ PHONE:..../pOI-L.j.2'!.~I'&4LJ
ADDRESs: 1&.j'LlE>~I2." ..,..,_ "'....~,:r S''"cId'l.DATE:
SIGNATURE:-l^ .~~ .J. - - BLDG. PERMIT II
'SITE ADDRESS: i~~\.~lI..l01W'l\\J~~ PIDII
r J L V\JL '>.E.
FILL IN Lh~ BLANXS-
40'
1.
Estimated length
of water service
1<
,
feet.
2.
Size of w4ter service
inc::h(es).
,.-.,.
3. Location of any couplings from s~ructure feet.
4. Type of sewer pipe. ASS PVC X Cast Iron
s. Estimated length of sewer line~' feet.
6. Clean out (if required), located at feet
structure. . .
from
, ~,.I
Y
::. ::=::i:;:nrc::':':'i:~';:~':::=-"'.
BY, \~ D~'l'E: 7...,./~o"OI
-~-~._-----==--:=J--..:....-=....=~..=- "'0 .--- ....--.---__..__.._____ --..-...
FEES: $ 3S.~0 Sewer ana wa~er line connection permit.
$ .50 Surcharge
$, 35.50 TOTAL
-~- -~
* fee for either sewer or water individually is $20.00 plus
$ .50 surcharge.
* Sewer and water permits issued for new construction must be'
recorded on the building permit card at the time of 1ssuance
to insure that no duplicate sewer and water permits are
issued.
.:.J
DATE PAID
RECEIPT II
AMOONT PAID
REc'D BY
PAID WiTH
RIIII nlf\l~ _ .
. . "
. 4629 Dakota St S.E.. Prior Lake, Mtnnesota 55372 I Ph. (612) 4474230 I Fax (612) 4474245
AN EQIJAL OPl'OII'TUNlTY EMI'lD\'!R
11:58 651 633 8884
FIRESIDE CORNER
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONlNGIFIREPLACE PERMIT
#3534 P,OOl/004
u......:::.._......
;: ~ ~~ 11'ERMIT NO.
].'iel~ ~lIlW11
(Pi.... ~ or .ri.. 'Jl41il!1J at bolll>ml
I ADORE:: r.-.
..."Iy~ ~ Iho~ ;?'"',.....
- r:l
'Q~vLh~& 3
LEGAL DESCRIPTION (011I", use only)
LOT I BLOCK I ADDmON
ZONING (.Ilk....)
OJ -00& :i'
p~5'-~13-G>O/~
OWNER
(Name)
C7)e.
~
(Phone)
(Addr.....j
.',
. APFUCAN'I'
(Na~) ALLIED FIRESIDE DBA FIRESIDE CORNER
(Phone) .....e2)-..11- U;6l
(Address) 2700 N. 1l'U".VTPW WENUE
(AcUl....)
B:RJ::NPA Hll STON
(Contact Person)
APPLICANT SIGNATURE ~-=- AI~
~!::lOVTT.r,~. ~
(~)
(Phone) 6S1~633-2561
"ATE
.7~1' :-
(ZlpCocle)
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF S l;)lLl'rf
OWonn Air PllUlts
OOroy!ty
DM""hlUlica.l
OAi' Conditionln.g
DVent SY!llEm
FIREPLACE MAKE AND MODEL _{~c.f rJ (;c.,
HF-ATlNG OR POWER PLANT
JStoam
:J HoI Woter
:J Rodiorian
o Special Oovioo~
o Olhor Devices
..'~':' 71Vl'_
PLEASE NOTE:
Air Conditioner Units
Ci\JlJlot Enc:roach in/Q
Requir1:d Side Yard
Setba<:ks
Indu8lrial. Commercial'" Multi-Family
FEE SCHEDULE
1% of jOb cost RcoldOl1lfal,O...l'lreph_
$39.50 minimum
$99.'0 R..id..ti.l. Additions /I: AI..,.ion.
$64.50 Rosld...t1oJ, AC Only
$39.50
R.esidentiel, fleating ~ NC (N"" Con_etion)
Rosi4entiar. Healing Only (New Conalnl<tlon)
$39.50
539.50
Bstimllled Cost S
Buildina Permit #
HEATINOPERMITFEE $
STATE SURCHARGE :I>
TOTALPERMlT FEE S
.50 Pt>.\O \N1fRI.JoI1
BU\\.O\~G P
(Ome. Use Only)
This Application Decom.. Your Building hnnil Wben Apprnved Paid
Receipt No.
Bulldi.. omd.,
nATIl
Dllte LI-J 3 -() I I BQc---
v
:u hoar nolice fOr allln'p""tjono (952) 447-9Il5O, In (952) 447-4245
nPE OF SYSTEM
Warm Air Plants
Grallity' Additional inspeclions will be biled at $35.00 ead'l.
~echani~1 . House Healing Tesl Record must be submitted with buildin" RII!l!iI numne' before build-
Air Condftlon;'! ~-t" 1- -J-o 0 ing certificate 01 occupancy will be issued.
Vent System - 111. /6t/tI'l WI3,
l:IEAI CALCULATIONS REQUIRED with number of supply and return openings listed per
HEATING OR POWEll PLANT room with CFM's per opening. New structures or addiIions send lloor plan with suppiy
Steam and relUrn locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
Hot Water APPLICATIONS MAY BE MAILED 10 THE cln OF PRIOR LAKE, 16200 EAGLE
Radiation CREEK AVE. S.E. PRIOR LAKE, MN 55372. .
Special Devices
Date
Sf
8lNlYI r~J\J 55121-
J
f.1M 561lZ
Conn. Load
Fuel rJc0--
Flue Size
g
4
Output 5(1, tDD
Supply Openings
Return Openings
Input ~1D: D DO
Edr.
elm.
CJ15D
Other Devices
TYPE OFWORK
A~eralions
Repair
Replacement.
Est Comp. Date
Building Perm. II
IJ / -0 OCP;;-
New Construction
/../
Est Cost $
HEATING PERMrT FEE $
STATE SURCHARGE $.
TOTAL PERMrT FEES $.
.50
PAID WiTH
R. e\.l\I..OING \' E.?,;i.\1
ecelpl # .
TYPE OF STRUCTURE
J. Pilll::
2. cn...
3. Y'eUllw
.
.
......
Clly
Ca._
.
.
,
Single Family
Commercial
L---'
.
.
Two.Family .
Industrial
_ Multi-Family
Pubic Other
.
c
"
Fee Schedule
.
.
Indus1ria~ Commercial & Mulll-Family
Residential, Healing & AC
Residential, Healing Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
.
c
1%'01 job cost 1S39.50 minimum)
$99.50 PLEASE NOTE: ~
$64.50 Air Conditioner Units Cannt <
$39.50 Encroach Into Required Side ~
$39.5C Yard Setbacks. ~
$39.SC ~
.
.
Remember to add the State Surcharge on !he bottom of this application.
The price of yo.. healing perm~ Includes one rough-in and one linal inspection.
~
~
.
~
c
~
C11y Hall business hoUlS are 8 a.m. . 4:30 p.m.
...
:.
~
c
:.
I:-
..
~
"
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447~
I hereby apply for a mechanical systems permil and I acknowledge that lhe
information above is complele and accurale; thai the work win be in conformance
wilh the ordinances and codes of !he cily and w~h lhe slale buildinglmechanlcal
codes; thallhis form does not become a permit until signed by the BUILD I NG
OFFICIAL; that Ihe work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
A~t Z4i1W1JI,vmfHU (MAD')
'PP~!I!L .
BuUdil1g O~I'S Signature
P. L. FA>! 447- 42...4g
LI2DJ C I
Date
z-u, -0 I
Date
J!j;
co
co
...
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS.2!if;(') tCu.u'^ ~ \ cu..~
NATURE OF WORK tJ.p~.'\
USE OF BUILDING SFA
PERMIT NO. f)/ ~ {)()ros- DATE ISSUED 1- 2lc-~ 2.~
CONTRACTOR ..J).Q 1-t",,\J..:'rY\ PHONE ~L ?sf... ~ 1/'"J.."t
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING \}Jj0 I ~ INSPECTOR Izj/~/o;ATE
, FOUNDATION (Prior to Backfill) I fj;;., I ~/';-3'k / [ft.~ ifr gl"S/O{
PLACE NO CONCRETE UNTIL ABOVE HAS B~EN SIGNED
ROUGH - INS~ ~ 6/(o(I1{
SEWER I WATER I SEPTIC
FRAMING ~V~ .61118/
INSULATION & . ~ ~. 5jrP/a, .g>JII~ ,~J~IOI
ELECTRICAL I. I
PLUMBING I.l.e,~ ~. 3/5101 ~t,Wu.c.. fa;;, 4/~{"1 .p, N- - Lj..JL;0j
HEATING (if required) 1.hM'P.d - &. '(//7(.0-/ . ~\Jt"'fi sJol/i1/
FIREPLACE 'l>J~ Sfl'.l/fl
GAS LINE AIR TEST ~ ~ti 'b.LJ~ bIOI/D)
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
, ~ rfjy-, I Ifll/'p/ I
, v FINALS
GRADING (Prior to Sodding) 11/6
BUILDING-(C D. hR ~rd61 ~ t,,1J-'1JOI
ELECTRICAL i .
PLUMBING 6J-. (p / I z.i o)
HEATING j &rr I ~ (.){.,/:JI
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical seri/ice 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.
Vltf
/O-J. L-/-oJ-
11-2Jl- o:v
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
,:~
I....
".~
( '~
I. ,;
-,
~~
ADDRESS 5"/00
OCCUPANT.
HEAT LOSS.
SOLD BY
/-5,n/J
HOUSE HEATING TEST RECORD
A'1 J1 _ ~,c:
///p...,..J!OUJ (u/,J/P APT. _FLOOR
"WNER
JOB #_
.:I.. Cpr,p
C1Ty"I,d/" SUBUR'"
DATE HTG. INST. ~/I)/
Electrical Work By
TYPE OF HEAT
INSTALLED BY /ff'///J/J,..L
Gas line By _
GA _ FA A-HW _STEAM _ SPACE HTR. _UNIT HTR. _OTHER
GAS DESIGN
MAKE .P;.Yd~r
Mod.l ~ /?4'J}k" - J.:J.
S.,;ol .();;'o'/l__'
INPUT. t.O~,/J')f)
. - ...:. ..... ..
CONTROLS
THERMOSTAT ~Ar--1(.ot Plug
Valve uj~
Limit 'Ie VB..ot" ;:;::,.,c.,;,l-.
Limit Setting ,? fY)o~
Fan So";ng 1/'J~ff /fl/4(/,&/..I-i-
Pilot Type
Pilot Make
Pilot Model _
-
Pilot Timing
L.W. Cut Off
:r; 5'//
Pressure
Input CFH
Stack Temp. ~.,z:;;
Form 235
/1--- I
0_/ ~
Percent CO2 -..:z~ ~
Percent 02-R.)
Percent CO ~/?"1
MAKE OF BURNER
Model _
Max. BTU Rating
MAKE OF FURNACF
Model.
CONVERSION
~/-
/\...
,/ "'
<'-'//
Vent Size 7'
KIND OF LINER. r /",S:S g SIZE -5/.... .I::ION~.
Draft Hood _ Reguloror ~/..A.--t"/6-'?-V
Filters Size...!6.-v.J.Oy} Number J
Chimney Location Inside Y Outside
Chimney Construction -L..Ld~ X
,/
Door Pressure ~
Dol. Test.d -6./.1kJ/
, .
Company Testing FreQerick;pn Heating & Ale, 3650 Kennebec Dr., Eagan, MN 55122
Nome of Tester _ rk,hll
Smoke Bomb
Draft _
Wiring _
Test To'"
x~
Lighting Inst.
ADORES
DATE TIME
SCHEDULED /1- dO'~ d--..
5LIO~ FaW/J/ /t1rq,cfo vJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
CONTR. ~\
PERMIT NO(O 1- t, s -It-(" 7
o PLUMBING Rl ~D/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
5~/
0[ OS ~
..,....,
l-r Le.--
if WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector N II-}../'O,-
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/'IOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
./54rftJ
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED t:, /;.:;/~ f A { 1;
{
~~
CONTR.
PERMIT NO.
() (- !Jo0F
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
)!CPLUMBING FINAL
/0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL1NE AIR TST
o
~-~
~ WORK SATISFACTORY, PROCEED
/~ CORRECT ACTION AND PROCEED
:S:::O:ECT WO~Ll FOR REINS:~::/::~~FORE COVERING
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
(, -dhul !;3 ()
'1-tWnv ~LID3~
ADDRESS
511t{)
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/- 0S
o FOOTING
o FOUNDATION
o FRAMING
o IN}ULA TION
.G1'fNAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
.a-1iECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASL1NE AIR TST
o
COMMENTSI/)r+~ ~~ ~,
ff?J ~ t: -t:Juz.w ~ ~ J
(1~~lb' '
~-
"-----
/"ltc., () ,
..............--
,..~
~~
o WORK SATISFACTORY, PROCEED
'11 CORRECT ACTION AND PROCEED
o CORRECT W~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: 1:7-:r \ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTJ
CITY OF PRIOR LAKE
i INSPECTION NOTICE
ADDRESS
E LftJZ?
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~F1NAl
o SITE INSPECTION
COMMENTS:
5QOO - nt::.
5L/i)/ - Ol(
6LfOd-- O~
SLf"D(J., - Or.
jl/ If I t:---.
DATE
TIME
SCHEDULED I/) 'd'-l -)--
=h.uU7J YXk~ ~
CONTR.
PERMIT NO.
/J/- 1LJ.5
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
i7'EX/GRADIFILLlNG
/0 COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'Jd-"T
'(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ti'X'1;r"~_
CAll 447.9850 FOil THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INS/'fOTl