HomeMy WebLinkAboutBuilding Permit 01-0066
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
;-/1-01
I. White
1 rink
3 Yellow
File
City
Applicant
.,
1f#'"
I PERMIT NOYO()~
Ir~2-ffi""se)1
(Please ~e or orint and sign at bottom)
ADDRESS
5'1{)/
hwn
Lo~.--I- ::,E
LEGAL DESCRIPTION (office use only)
LOT / BLOCK I ADDITION bee-r!:t! /1 6,J.
PID7E-37~- 001-0
OWNER
(Name)
(Phone)
(Address)
BUlLDER~
(Name) LJ. r2.
j~/v."
kL - m/i/
(Phone)
/,,5l~;(:5-?- 7/29
(Address) ':/I./.,q 1,,,)12<;1.:,,1' J,;...
C/
~,.//<;.h-. ,:;J()tj ~L244n
I v
m./ S-rI.2.:?
TYPE OF WORK
~ New Construction
ODeck
o Porch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAddirion
OAlteration
OUtility Connection
o Misc.
PROJECT COST/VALUE (excluding land) $ 70. ~ 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 }-"VY"'UJ 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
;teruponth;;~rfortda:~ons ;;?tmS747 }-/,1-01
~ Signature Contractor's License No. Date
Permit Fee $ 7 q(), 7c;j Park Support Fee # $ e,~.ool
Plan Check Fee $ J-/~ ,7'( I SAC # $ '1~SD.odl
State Surcharge $ Je; sn I Water Meter 5i=- .-.. ~ll. $ o I
,5',l- I
Penalty $ I Pressure Reducer $ 0 I
Plumbing Permit Fee $ 100.00 I Sewer/Water Connection Fee # $ " ':H>O .cQjl
I Mechanical Permit Fee $ 100.00 I Water Tower Fee # $ /00 ~ I
I Sewer & Water Permit Fee $ 3~ .~-o I Builder's Deposit $ 0- I
I Gas Fireplace Permit Fee $ ([0.00 I Other $ I
tion Becomes Your Building Permit When Approved TOTAL DUE $ 5.5/6_ 74- I
~ I
j - '2s~~" ( Paid ~~I S", ~ ReceipHIfI'. 3 fj cJ II '1
Date Date 7-.-6-01 By /J"rV'-'
r
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
7Lt A^-lf\~r:~ 1-/' ~a(a;> \ ~ ~~~~n~ib.~~~
24 hour uotice for all inspections (952) 447-9850, fax (952) 447-4245
JRN. 24. 2001 2:31PM
GENZ RYAN 6513226147
-NO. 865--P. 8/9' -'
I. JI. Jill:
2. Gold 0...
3. Y_ ApplI_
# 01-00(0&
Phone: (iiSI.=:!:1.7."2.,- 114([
1II~"eJ.. &,,1 11">1"' ~~~
CITY OF PRIOR LAKE
,PLUMBINC3 PERM"
.APplicant: ~~2.- "~V"\
-...; r"-1t~ fJ; €,,- .....,
S~na~~:_ \. ~
Legal Description: L Block Sub
Site Acldress: !Sl-l-o I ?&l-IA).J fA,) 0 "-1''''' I (~ \ r IJ yP lJl, <-.Y:.
Building Permit II PID /I
NOTE: This permit wjll nat be precessed without complete information.
FIXTURE UNITS
TIW ~"'I'" Df I,", ~ CaMII7
Quantity
,
I
/-
,~,
....)
I .-
-z...
i
-"
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (bathrcom sink)
Laundry Tray <1 or 2 oampartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (toilet)
Quantity
(
eJl
Type of FIXture
Rough-ins
Water Heater
Water Saflner
Stand Pipe (washing machine)
Sewage Ejector,
BacfdIow AsseIrmIy (RPz, Cauble Check, I'VB)
Backflaw Assembly Test
Lawn Sprinkler
Other
$
$
is
$
.50
FEE SCHEDULE
, Industrial. Commercial & Multi-Family
(1% of jab cast. $39.50 minimum)
Residential, New One & Two Family
ResidenUal, Additions & Alterations
State Surcharge '
$99.50
$39.50
$
,
PAID WITH
BUILDING i. '::-::,:;T
,
GRAND TOTAL
This permi\ i. ;tIDted upon the ""pross condition lh~ said
conlrllctor. ,boll comply in 011 .....peets will1 cbo ordin1l1lCOS
of ~e ~lllll1lbing amcndmO/llS thereof.
'RE ;;9'01 DATE
ATIEST
Call for all i
. ans 24 hours in advance.
16200 Eagle CreekAv. S.E., Prior LaIc". Minnesota 553721 Ph_ (612) 447-42301 FAX (612) 447-4245
An Equal OPl'OrtUnilY Employer
JAN. 24. 2001 2:30PM
GENZ RYAN 6513226147
NO.B65' -P.4/9- ' ,-
_....
~ 'AhUeUr
DDLD .. ClT.
.,
CITY OF PRIOR LAKE
SEWER AND WATER. PERMIT
NO. () I ;...oO,,<t>
. '
.
NOTE: Sewer and Water
'contractors must
be reqistered
with the City.
APPLICANT: (.!" Y'l9: - 12 ~ PfUJ/rlb, ~ lit1TJ.ul'~ PHONE : Jp~I~ 4'2.'!.- "LlJ..I
ADDRESS: 1~"LlE:.~l" -r"" I<>_Clonau",r 5',,"CIoS DATE:
SIGNATURE: t~ !) __ BLDG. PERMIT #
SITE ADDRl!:SS:..E;u:k ~..,' II\.Jj)~I\(\III\lP PIDt
FILL IN THE BLANRSSE-
40'
1.
Estimated length
of water service
,<
I
feet.
2.
si~e of water service
incn(es) .
3. Location of any couplings from st;ructure
feet.
........, 4. Type of sewer pipe. ASS WC )( Cast Iron_
',,;.~) s. Estimated length of sewer lin~ I.JO I feet.
6. Clean out (if required), located at
structure.
::,.~=={ff;-;o~"
-- - =~~,- ----'J.'"'--~---
feet
from
~
permit when
D~TE:
approved.
2. ,/ fJ-''O (
-
-~;...-
----===
FEES:
$
$
$
35.00
.SO
35.50
Sewer and water line connectipn permit.
Surcharge
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 issuance
to insure that no duplicate sewer and water permits are
issued.
r-
DATE PAID AMOUNT PAID Ie PAIDIMlJ"H
l U/L.UING., __.,.. "_
RECEIPT # REC'D BY ,-" ", ,,'
.,,~
. 4629 Dakota St S.E-. PnOl' L.aI<e, M"lIlflllSOta 55372 I Ph. (612) 4474230 I Fax (612) 447-4245
Jo1I EQUAl OPPOI!J'\JMTY EMPtDVaI
11:58 651 633 8884 FIRESIDE CORNER #3534 P.003/004
(';lTl: ur I'KlVl< .....^~ ~-- ----
HEATING/AIR COlu~uI.ONINGIFIREl'LACE l'ERMIT
(PI"""" "!I".; or Min. IUlllsirn at b_1II1
ADDRESS
5~1 ~ Ch..r
~,~ ~.... \ PERMIT NO'O/-lJO(Pk, I
ZONING (ollice...)
LEGAL DESCRIPTION (olll.. ".. .Illy) \
LOT r BLOCK I Au....u.ON tJJ~~
- /j
iJ rcL PID,-x~ - 317 3 -COl-<.)
OWNER
(Name)
rJ:>/2 ~
(Phone]
(Addn:ss)
,',
APPUCANT
(Name) ALL.IED FIRESIDE CBA FIRESIDE: CORNER
(PhODe) 651--633-2,561
(Address)...1.700 N. FAIRVIEW AVWt.",
(A_IS)
(C P ) BRENDA HUSTON
ontacl: elSOn .
APPLICANT Sr;NAT1.1RE &;_12 kl-=-
'qQSF.:VTT,r.1<: Ml'oI
(Clcy)
(Phone) 651-633-2561
DATE
;"'''~
(ZIp Cod<)
VMol
APPLICANT PLEASE COMPLETE BELOW
f.8NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF ,),.;>u.oM
OWIIl'm Air Plants
DGraviry
:J Mec;h."ic:al
:JAlr Conditioning
JVenr. System
FIREPLACE MAKE AND MODEL ~ ~ (;,ro
HEAnNGORPO~RPLANT
OSt",,",
o HotWoIor
o Radi.tion
o Spocial Devl....
DO"'... Dcvic.,
~ 7.__
FEESCHl!:PVLE
Industrial, Commercial '" Multi.Family 1% of j.b ""01 R..identiol. G.. Fi"'P1o""
539.S0 mInimum
R..id..ti.l. He.ting'" AlC (N.... ConlllrUttion) 599.50 Residential, AddItions &. AlterOlion.
Rcsjdendal. H.Oling Only (New COll3lt11cllDnl $64,so Resldential. AC Only
Estimllted CD.t $ Buildin& Permit 1#
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
l.ome. v.. Only)
Thi. Application Becomes YDllr BuildiJlg Permit When Approved.
I Paid tj-J-3-D!
I Dlltetj_ c?3--D /
Blinding OIIidal
P.re
14 hour noff"" for .11 I..pectlo.. (951) 44.7-91511, fIX (9S1) 447~Z4S
PLEASE NOTE;
Air ConditiOner Uni15
Cannot Encroach mID
Required Side Yord
Selbacl..
SH.50
$39,50
539.50
PAID WITH
BUIWING PERMIT
llW1:I3d E)NI01lna
HJ.IM C1Vd
Receipt No.
By w..--/
. (j~'
'~~
Th.. Cenln of lh.. L.k.. (:ountry
While . Building
Canary . Engineering
Pink . Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
1\ I,;;
i./' '-
He c:.-iL 1<
-cl
, I,r
\ - ,r1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I--~ /-f, I r-" \ \
--,' 'I ~. r /-\ \ \i N
<, \ \' 'I /-r-
',_~, l.../ <-!
~.,F":
Accepted ~
Accepted With Corrections
Denied
Reviewed By: ~~~~
Date:
Z/f //? I
"
Comments:
~lt)I/~ 0 s:..J{",~~ "f0 ~ ~.onlVV\< ~
<p&_ ~ I~), -'^.~' ~ (J~ f&v- ~ 5vi ~ (
1>1l~L-.awf ~twg:-rm .:;~ -R~ A ~ ( ~5't ~
<fN_ l~uCct(~ ~ ~JIM ~~ rJ.v;~6
- - - ..
"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,"
-'~
iJ~');
o I ~ G(p
Th.. e..n.... of lhr L.k.. eounlry
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. K. f-IO~IU!'J
I-IR -0 I
/"
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, 54-0 I rA\N rJ ~Ol Jr.2.i SF:
V
Accepted
Accepted With Corrections
Denied
Reviewed By:
LLt-
Date:
/- Z9-0f
Comments:
,.....,......
,
)<
~'-'
,L~4:-..~-.
"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.nl.roflh.I,.k.Counlry
White - Building
Canary - Engineering
Pink - Planning
,BUILDING PERMIT APPLICATION DEPARTMENT CHECKlI!;T
NAME OF APPLICANT
APPLICATION RECEIVED
D. R.. HOK-tUN
1-IR-ol
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5401 ~A\NN WlJr<...( .:sF:
Accepted
Denied
Accepted With Corrections
QQ ~J.
I
Date:
{ . 2';:'--200 (
Reviewed By:
Comments:
~o
CjL.joo fu..cu\A- c.. t. 4;;,\- \i)(G....-C:::
,
C:i:r\ ,
"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."
PRIOR LAKE
INSPECTION RECORD
'CCJ~
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ,c::;t/Of h,C.rIlA
NATURE OF WORK u.w
USE OF BUILDING ~r"\' +c'-;~r
PERMIT NO. 0 ,. DOrow DAlt ISSUED (-2"1- /&,{
CONTRACTOR IT) () k..)t-~ PHONE t. 7'- '?c;t...-7/ 20/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ INSPECTOR
, FOOTING VSjr..-1 ~ 1;./1'1/01
, FOUNDATION (Prior to Backfill) I ~ I rJ.ld-%/oJ t:lr:1;'~ ~ ,sllO,
PLACE NO CONCRETE UNTIL ABOVE ~AS BEEN SIGNED
ROUGH - INS ~~ fb-r,3/iN
SEWER 1 WATER I SEPTIC '
FRAMING
INSULATION ~. {!;; a. 511/5"0,,
ELECTRICAL
PLUMBING 1~l.eiJ lA ~, f7:r, 3!t:(tJ 1 ~ ~.o.. ~ 4/Mbl
HEATING (if requiredrfA,.......A' ~-. <III 7/P I
FIREPLACE i.\'~ d d~1
GAS LINE AIR TEST pp, - S-q-O{ -g, VruNI S:}tID/
COVER NO ~ORK UNT!L ABOVE HAS BEEN SIGNED
~ ~ J///?/t;JI I
U ' I )FINALS
GRADING (Prior to Sodding) w!3
BUILDlNGf.C,d, t:Jt 11m/I fj". 7/1/t (
ELECTRICAL I
PLUMBING
HEATING
DO NOT
DATE
v:6,
A 13.-
5-S'~(
5-'1 -~,,(
_ /l.tI" ?fDI
~f-uh Pf;V1-it-Oj
16 -;24- 7}.
WP
1/- J.,( -1.Fl-
1-, \)~
~
OCCUpy UNTIL ABOVE HAS
NOTICE
(p t?-l \D \
(j 7/1 It) I
I
BEEN 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.
Call between 8:00 and 9:00 A.M. for all inspections -'_
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permn No. 0 1- OOCo0
Prior Lake, MN 5.5372
IO~~
~ HEATING APPLICATION I PERMIT
212DIO\
Site Address' 5'4. rJ I
Date
PlOtI
1 '1
r(lfjWIIVJ IVvY' Iff
HU\Jn
'Sf
Lot i Block --L Adallion
Owner's Name DR. +l-u ( +m1..
Addr8SS~45n V\f(lS~~mJrrVL 'j)y ~2D4
A', ,), , I
i ','Ij, ( A~" '1 ,'/1 ~. ',~ ':
Heating Contractor IddAd- 1~lfO rf.d'1l.LiU
Address:)lfC)j~) ,ti'11/1t'.11flUr '1:J=.j fll.Nm !viM 5'0/2'2..
Tele~honel (tC] i 45Z - 2..l1CS J
Furna<:e Make & Mode' bnl!tl1t- TYPE OF SYSTEM
. ;J.,Q1)tJI1 I Ir,'i , U"'D', - Warm Air Plants
Model Size ,..,. ~ L L-LI (; I ' Gravity .
ConI\. Load L 1 34.'1 Mechanical
r '. . 'IQ . . Air Condftio~ .bi:'JdO.A-t- Z- -HJ (l
Fuel rvC\;!- FJueSize 4' C/.ssf] V.nlSys1..mf_~tl1 I~FlL(1s,
Supply O~enings g HEATING OR POWEll PLANT
II Steam
'-t Hat Water
Radiation
Special Oevicoos
01clW1
j
I~J0 55.fZ2--
Return Openings
Input 10 ~ DO
OUlplll 511, tDa
Edr.
Cfm.
lit,
Other Devices
TYPE OF WORK
Afteralions
Repair
Re~laeement
_ Est Com~. Date
B "ilding Permft Ii
() j-CJ(!)c, (p
NllW ConSlrudion
v-
Est. Cost $
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
PAID wrn-l
Receipt # BUILDING r-c,?,;i.rr
TYPE OF STRUCTURI;
tP.iak
2. em..
3. Yd!ow
me
c:Jcy
ConQ:llcU)['
Single Family
Commercial
>-
,
,
,
't.--
Two-Femily
Industrial
Multi-Family
. Public, Other
>-
e
"
Fee Schedule
>-
>-
Induslrie~ Commercial & Mulli.FamDy
Residential, Heeting & AC
Residenliaf, Heating 0 nly
Residential, Gas Firep/ace
Residential, Additions & AIIeralions
Residenlial, AC Only
"
c
1%'ol jDb cost ($39,50 minimum) "
$99-50 PLEASE NOTE: ~
$64-50 Air Conditioner Units Carml c
$39.50 Encroach Into Required Side 5
S39.5C Yard Setbacks. ~
$39.5C ~
~
c
Remember to add the State Surcharge on the bottom 0/ this application,
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections wUl be bDle<l at $35.00 each,
House Healing Test Record must be submitted with blIikIimz I1lIIllliI number before build-
ing certilk:ale of occupancy will be issued.
I:lEAI CALCULATIONS REOUIRFD with number of supply and return openings r..ted per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR lAKE, MN 55372. '
CiIy Haft business hOUlS are S a.m" 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CALL CITY HALL
447~
~
"
"
~
c
"
..
~
"
c
~
,-
~
"
I hereby apply for a mechanical systems permit and I acknowledge that the
information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state buDding/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the wDrk will be in accordance with the approved plan in the
case of an wD,k which requires review and approval DI plans,
If" 11 ~ IJIv~2M:n J&t, '--' ( I'I'Jill J
-'-1Vf~P~7fJRL
Building ~"iCal's' Signature
2120/61
Date
2--z(' -0 /
Date
I!i;
c
c
...
PL. F~ 447- 42..4g
, ..."'" ,;~"""",..",;,;.;."~~,, '.... "" ~~~..-...~ ~ '" ~-,,-~
";.1 ~~,. ,--:,. '"iI':.., ~..-. -~:'-"i.:-.i"""<'" t ",.z""'c'"' t-~ ,.-t.~., '.f"- '"oj: ~. 'f .00;.:....'".. ~t,.~o.~.~~.'.""...I',.i'-.~~..~' ~~"(
- .- .
; . -, .- 1"'_- - -~ I:' K
- ,
QLertiftcalt of (0rrupancy
CITY OF PRIOR LAKE
1Department of .utlbing Jn~pettion
II Final Pennitted 0 Conditional C.O. Expires
This Certificau issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying thal at the time of isslllUtCe this structure was in complionce with the various ordintPlces of the
City of Prior We regulating building construction or use. For the following:
SINGLE FAMILY
Bldg. Pennil No
01-0066
Use ClassificatiOfl
Occupancy Type R3
_ Type Construction VN
Fire Zone lJ/ A
Zoning DUIrict
\
R?
LegalDesc:riptioo LI, B1, DEERFIELD THIRD ADDN.
Owner of Building _
D.R. HORTON, 3459 WASHINGTON DR., EAGAN, MN 55122
C_n_"~.v, '8 Name &. Address I -'
Ifip City PI_,
c:,iCe Address
5401 FAWN COURT SE
ROBERT D. HUTCHINS
Building Official
1/ ). I (7)..
DON RYE
Date:
Date:
POST IN A CONSPICUOUS PLACE
HOUSE H EA TlNG TEST RECORD
C;',,f
_APT. _FLOOR
'1WNER
JOB #
-",,~k
CITY/ r, ~f _SUBURB
ADDRESS 5"lo/,c/J/.IJ/l ("',
OCCUPANT
HEAT LOSS DATE HTG. INST. #,,/rJ!
SOLD BY ~'NSTALLED BY, /Y/(/;".,a,?
Elecfl'ical Work By _ _Gas Line By
TYPE OF HEAT GA_FAX-HW _STEAM_SPACE HTR. _UNITHTR. _OTHER.
-? GAS DESIGN
MAK~ SI'Y,,1'1,L-
Model ::r9'?/f"At,'t~~0 71'"\
5odol r) 7'nlJ/' /{.,V"V-r)-
INPUT .j..r",r-,OfJ '
CONTROLS
'j i11
THERMOSTA~~f(}d~V'U.hP' Heat Plug
Va Ive J.,} .'
L;mH 7c,y,..,< :;:;z...,~.
Limit Setting ~O;r:
Fan 5o'Hng...I.'t:~/4;?' L.ol.I.!/~LH-'
0,
Pilot Type -
p;to. Make L--I -<"' .-;--
Pilot Model II -)--1-
Pilot Timing _
L.W. Cu. Off .
Pressure
"[3 '.
_Percent CO2 ~
_ Percent O. P
_ Percent CO - :;)./)4#7
Input CFH
Stack Temp. ..J) 99 O,.c
Form 235
MAKE OF BURNER.
Model
Max. BTU Rating
MAKE OF FURNACE
Model
CONVERSION
\ ..
X
/
,,!/j,l
Vent Size ,-
KIND OF LINER (" la SS ,{$"
.5) I
_ SIZE ,NONE_
/#/1.v / finL.
/
Draft Hood Regulator
Filters size~hxdi')fI / __"'~mb.r
Chimney Location Inside X
Chimney Construction (' I d .::5.<. ~
Outs i d.
v/
Door Pressure_ /""'\.
Do.e Tes.ed iO/-o/()}---'
Company Testing Freferic~Heating & Ale, 3650 Kennebec Dr., Eagan, MN 55122
Name of Tester -------slk.JJ II~"'V.
Smoke Bomb
\.../"
/\
Draft
_Wiring
_TestTa~'
Lighting Inst.
---,--,,--~--,-'-'--------------'_.-~--"'---,--_.~--_..._",
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADORES
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CA TE TIME
SCHEDULED {' - ;)..o~;;;...
5'162> huJtf)@i-
CONTR, ~
o PLU;:I::I:INO. . cJ/: ~~:~
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 ME:5iLr ~
(!!/I
~I ,r"
U ()<;ch-4..
'II WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: fYf f l- J.. /- (f2. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INS/'lOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
54-0/
"qqW tV
OWNER
CONTR.
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 Afi\ 0 PLUMBING FINAL
o SITE INSPECTION ~ ~ MECH FINAL
COM~ENTS: 6J if ~~ J.e.rJf,
~ 'fa ~/:"""'_
@ ~ o-.-i.. ~,(liZ.<.
I
OA TE TIME
/."1.()/
3',3-b
/ - ("(,,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~-r/
~
('----, .e, 0,
"'---
,'"_..."_"~ .,,~_.___..'_w...~
T;JJ ~~)
/
~~
.;,..~-
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
(".Zfo I
9!sO
ADDRESS 54-0/> 54-11,":3 MfI/J
,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
01 - 00(,>(p
(') I - 00 (b,P;
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
{to SEWER HOOKUP
l;( PLUMBING FINAL
. 10 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
\~/V,,,^(),..v. ~ \u- c') L
/'
~RK SATISFACTORY, PROCEED
o CORRECT ACTlO]D PROCEED
o CORREC~, C LL FOR REINSPECTION BEFORE COVERING
Inspector: V. tfJ. jJJ, Owner/Contr:
CALL 447-98S0 FOR THE ~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI