HomeMy WebLinkAboutBuilding Permit 01-0092
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/
rJ!;l{MITNO. O/-~
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1. While
:2 Pink
3. Yellow
hie
City
Applicant
(Please .!.Y,ee or print and sign at bottom)
ADDRESS
..:PVClG ~ ~ ~-ft/~ ~
LEGAL DESCRIPTION (office use only)
6'<<2f',,? ?v'v/T 7
-I::8'f BLOCK ADDITION
l?o-......iP"ez<::) d"'l""
PID 2.C; -373-002--D
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
Date Rec'd
\-25 -0 (
(Phone)
667'"-~6ii5-7'/5,k
IO.~. ~"'9Z'...-v ~.
(Address)
-.;t-.y69 .p~ ~ tS ~ .;?t:7.y'
~- .J.~
~'/.;?.;;z,
TYPE OF WORK }i(I New Construction ODeck
OLower Level Finish 0 Fireplace
OPorch
ORe-Roofing
OAddition
OAlteration
o Misc.
ORe-Siding
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
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 J am the owner or
authorized agent for the above-mentioned property 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
enter upon the property to perform needed inspections.
~
I Paid r;;~ I r, '? ~ I ReceipliW'. ? 'l' Q r 7
I Date ?...-/h-"i By /!/V"
. "
This is to certify that the request in the above application and accompanying documents is in accordance with the City loning Ordinance and ma; proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of loning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
.~i~ 2/~fl Special Condihons, ifany
24 hour notice for all inspections (95-2) 447-9850. fax (952) 447-4245
x~
~~S~=>7
Signature
Contractor's License No.
7 J , OtJ CJ .0::;>
$ "Yi 0: lc\. Park Support Fee
$ ~ L '3 -'11 SAC
$ 3~SDI Water Meter Size 5(8"; 1".
,
$ I Pressure Reducer
$ /00.00 I Sewer/Water Connection Fee
$ I nO .c6 I Water Tower Fee
$ ..~S-.~ I Builder's Deposit
$ '10 .a? I Other
TOTAL DUE
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
;;: J..
'r ;1S
#
#
#
#
,/ -..;?--;C-CJ/
Date
$ A..S6.co1
$ I. (c:;n.C{J
$ "0
$ 0 I
$ I. 2.. t)(),M
$ 'l(J rJ .~
$ 0
$
I
$ ~5/5.74-1
I
I
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White . Building
Canary . Engineering
Pink . Planning
Thr rrntrr of thr l.akf Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. R. I-I CA:.::ITJ 1\ }
\-2~) -0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
54-60 t=: A \r-J 1'\1 f"'1 E F\.DOc,J CU/cV~ ':::,t
Accepted
Denied
Accepted With Corrections
Reviewed By:
Date:
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."
'~~
QI.60Q-z.."
Th~ Ctnlu of Ihr L.k~ Counlry
White - Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L -- 1<
IICi~T{
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I~.......( /,
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(.....1-\ i ". ,.
, I \.
. I ,-
i"! l"__ t--\.i__)(,. L\.._)
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--
-
'-
Accepted ~
Accepted With Corrections
Denied /1
Reviewed By: ~~~
v .,
Co ments:
Date:
2/~41
_ <)6j..../~1O~_ChA/~li;f7r1L JJ-
\~l (!) .~. +- ~/e/~ ~Q lD~
~ f\,pAW .~vd. A1di'iL&V1 c
~
"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."
~~
01' cO qz.,-
Th., (~.,nln of lh., L.b Counlry
White - Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. 1<-. HO~.I() f\]
l-ZS -0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
FAWN ME;A.DOW CUrvJb S~
54-00
)<
Accepted With Corrections
Accepted
Denied
Reviewed By:
Qo ~-:k::.
Date: (- 71 - Lad
Comments:
~
~ $c(oL/ +~ kM~ cl-. Cr~--f11r-..s=. 'de.
"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. 29. 2001 4:36PM
GENZ RYAN 6513226147
NO.049- P.8/9--
I. B_
1. Gold
:S. 'rcD_
Ale
c"
AP!lIlo=
CITY OF PRIOR LAKE
PLl,JMBING PERMIT # 1J/-OO'72-
Applieant Gti'lZ - ~ y--. Phone: (rJ-l.J7.~ -lllJU
Address: .rLj.11..}~ _ ' f.r:k/ ~-f -rl/U~ ()n.J.J/YY'rrJ. V1T" MIU ~I/&'
Signature: 1A. r ('\ ~. _J.- ,J
Legal Oes~ Blcc:k Sub_ ]yljtfpOi'\ ,It) I a.. "
Site Address: 6o...10lo ~-, R 1 n~, '_ r I~ .\t:
Building Perrnilit 0/- ()1)92- PIO czt:;- .~73 -002--0
NOTE: This perm~ will not be precessed without complete Information.
FIXTURE UNITS
'fIrM. el'lll" of Ih t.Hc C4Imt.,.
Quantity
I
I
I
2.-
I
Z-
Type of Fi:dUre
Bath Tub with or without shower
Dishwasher
Aoor Orain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
Bar Sink
Water Closet (tonet)
Quantity
Type of FIXture
ROLlgh-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
8ackfla.... AssemblY (RPZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
,
.
$
$
$
$
.50
\1'1\"\'0 .
< ~p..\O \-0':'"
." n\NG
~'-~
'-
I
/2./1
(
FeE SCHEDUL!
Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential. Additions & Alteralions
State Surcharge
$99.50
$39.50
$
This l"'rmi, is 8"M,.d upon III. exp..... condidon rhlC said
controccor, sh;lll comply in Ill! ~Pect5 with tho ordinances
of the Stile Plumbing Cl/d~ ~~dments _r.
- - .R,,' ./ J- ,01 0.4.1'2
, ....-- A TreST
Call for all inspedtions 24 hours in lIdVllJ1cc_
16200 Eagle Creek Av. S.E., Prior Lake. hi!innesOQ 55372/ Ph. (612) 447-4230/ FA."( (612) 4-l-74245
An Equ3l Opportunity Employer
GRAND TOTAL
JAN. 29.2001 4:35PM
GENZ RYAN 6513226147
NO.049-P.4/9-
_. ....
'ILLOW . -..callY
Galli . er",
CITY OF PRIOR LAKE
SEWER AND WATER p1l''tlMTT
NOTE: Sewer and Water
contr~ctors must
be registered
with the city.
NO.
(J/.-o092-
APPLICANT: r-,...Y\7'" - {;> tJ t'"'l Pt".""'nl>.::>r.,,... YfaJ:w,,- PRONE: ~I- i.J.2.~-" l.j.LJ
ADDRESS: '4,1lE> So ~"2.:r "1';2.. {&'!-,""''''"",. 5",~ DATE: 1/2t::l !(J J
SIGNATURE:.Jb...Jr)~ n - BLDG. PERMIT #...Q/ ~OOr2-
SITE ADDRESS: 5Ua.~ F""A1,j..1 l'l1ooimC(LpILSCpID# 26-373 - 66Z.-0
FILL IN THE BLANKS
40'
1.
Estimated length of water service
1,1
Size of water service inch(es).
feet.
2.
3. Location of any couplings from s~ructure
4. Type of sewer pipe. ~BS pVC ~ Cast Iron
5. Estimated length of sewer line~' feet.
6. Clean out (if required), located at feet from
structure. ;
feet.
::~;-::::::::~:~~1ZCi~-~OU:-::~it-:~en~::::~:~i~~~rO--=I-----~===
BY fI~ DA,TE: V-- q-
===~========~=lF~----.-==------~----~.~~====~-~---~-==~~~==~
FEES:
$
s
s
35.00
.50
35.50
Sewer and water line connection 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.
'It'l~;X"'N'.""
DATE PAID AMOUNT PAID "",\~ \!:cP'
t", Io..~o.:;.
~ECEIPT II REC'D BY "~,\\\J)
. 4629 Dakora St S.E., Prior Lak2. Minnesora 5.5372 I Ph. (612) 447.4230 I Fax (612) 4474245
__.'__.___ _.,__.'_~_"_ ____....~_,_.___" ,'n' _.__.
13:30 651 633 8884 FIRESIDE CORNER #5403 P.006/008
CITY OF PRlOK LAKJ!.: Uan" l(ec'Q
REA TING/AIR CONDITIONINGfFIREPLACE PERMIT
(Mease !"p!: or Drin11U1d.lrim at bQttmD'
I ADDRESS
5f.tor., ~ fh()d-.> I!wux k
; ~ ';;;;, I PERMIT NO. /.--q d- I
,. YII\cIw App!1(Wl(
I ZO~~'~) I
LEGAL DESCRlPTION (.Ill'" .... OIlly)
LOT .?--BLOCK I ADDmON
jQ {Jf~f7Q
( )
P!D~"" 3l3-c.v.;t4J
OWNER
(N a.me)
f{)~ ~
(Phone)
(Address)
APPUCANT
(Name) ALT-IED FIRESIOJ:; DBA FI!l.ESIOE: COllNER
(phone) J21.-!i33-20,/,;1
(Address) 2700 N. FAIR'lIEw AVE!l'1""
(A~r...)
(Conblct Person) J:\RENDA HUSTON /J
APPLICANT SIGNATURE ~"",A. 11~
,
RllSP.\ITT,r.F. 7f"
(01)')
(Phone) 651-633-2561
DATE
r:,~11 ~
(Zip C:od.)
APPUCANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION 0 REPLACEMENT 0 AI. TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
Ow."" Air I'lonta 0 SI.1lIl1
OOrov;,:y 0 HOI W.ter
o Mechonlcal 0 RBd!arJ.oo
OAir Condilicn.ing 0 Special Dev;ces
OV""T- Sys""" 0 Olhct Dev;"",,
FIREPI.ACE MAKE AND MODEL -Md iJ G Co .J:t 1S7J~
- -
PI.EASE NOTE:
Air CQnditioncr Units
Cannot Encroach iDtD
Requ.ired Side Yllrd
Se1backs
lndllstrlal. CommeTclal & Mulli.FIlIl1.I.ly
FEE SCHEDULE
I.'Y. crjcb coS! ~ldenll.l, G.. Firepl.ce
$39.50 minimum
$99.50 Residential. Addlllons & Aller.tlc..
564-.50 Residential, AC Only
$39.50
Residentl.l. He.dng & NC (New Con.tNct;on)
Residentiol. He.t,ing Only (New Con5lruClicn)
539.50
S39.50
Estimated CQst $
Building Permit #;
HEA TINO PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID WITH
aUILDING PEF.:J:JT
l.om", 11.. OnlY)
Tlli. Application kem.... Your BlIUdlnm Permit Wben Approved Paid
BoUdlnlomC/o'
DalO 0 -;-0 I
\
24 hoor ""rlec fnr Rlllnspoedon. (95%) 447-91150, r.. (95%) 447-4.%45
Dnn:
IBY~
t
I
I KeceiPt No.
-,
CITY OF PRIOR LAKE Me
16200 Eagle CreekAv. S.E. Permit No. () (-()012-
Prior Lake, MN 5.5372
TYPE OF STRUCTURE
1.Pi.11k
2. Greta
J. Yellow
,
,
Site Address 0'+0 hi ~\I\.J 1'"1
Lot -=t Black -.!k..-. Addfticn
Owne~sName 'DR. rl-Or-ton
Address~9 Washinahn 'br Su.ii-t.71ltt
fiealingCcntractcr A.llio..nr' ~1c.aJ
Address 31t50 Il..el'll'lti>ec:.. br- &u.i+f1 I EaM.n M.N'~z..
oJ
Telephone # u51 1.J~z. - Z T15
Furnace Make & Model "Erv/l..nf
,
ModelSize ~&3l(AV/)~D'1"l
Conn. Load 21. ~~
Fuel t\f eM- flue S"lZe 1t" dcU!O .B
Date
Supply Op..nings
~
4-
Return Openings
Inpul1D. DDtI _ Output-5IL, bt> (j
Edr.
C1m.
~Db
TYPE OF WORK
Alteralions
Replacement
Repair
Est. Cos! $
HEATING PEAMITFEE$
STATE SURCHARGE $
TOTAL PERMIT FEES $
Est. Comp. Date
Bujlding Perma #
.50
PIDII
M.<aabW r LV"!'" SE:'
F..
Coy
Conl:mcUlt
Single Family
CommE>,cial
t.-/
,
.
.
.
Two-Fomuy
Industrial.
Multi-Famlly
Public
Other
.
c
"
F&fl SChedule
.
..
Industrial. Commercial & Multi-Family
ResidE>ntial, Heaf"g & AC
ResidE>ntial, Healing Only
Residential, Gas Fireplace
Residential, Additions & A1\eratio!1$
Residential, AC Only
,
c
1%.ot job cast (S39.50minimum)
~9~0 PLEASE NOTE: ~
$64~0 Air Conditioner Units Canm c
$39.50 Encroach Into Required Side ~
.
S39.5C Yard Setbacks. ~
S39.5C ~
.
o
6'MUl IIAN 55lZ:Z.
J
TYPE OF SYSTEM The price of your heating permil includes ona rough-in and one tine( inspection.
Warm Air Plants
Gravity Additional inspec:lions wm be billed af $35.00 each.
~echani~l. ~ . House Healing Test Record must be submitted with buildino Ilmllli! ~ be10re bu~d-
Air ConcfttlDnlOg Br u.li.l\+ Z. 'hi", , ing c:ertilicale of occupancy will be issued.
VenL S~m 2.-5'bllf1o.......blli-k-rA.hS
!:!fAt CALCUI ATlONS REOUIRED with number of supply and return openings fisted per
HEATING OR POWEll PLANT ,oom wRh CFM's per opening. New structures 01 addiIions send flcor plan wiIh supply
Steam and return locations shawn. HEAT LOSS CALCULATIONS, PAYMENT AND
HOIWale, APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
Radiatlan CREEK AVE. S.E. PAlOR LAKE. MN 55372.
Spaclal Devices
Other Devices
New Construction
~
()/... ()OCfZ.
PAID WITH
BUILDING PERMIT
Rece;pl # '
Remember to add the Stale SurchaJge on !he bottom clthis application.
~
,
,
~
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~
City Hall business hours are 8 a.m. - 4:30 p.m.
"
~
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ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) . CAl.L CITY HALL
447-985(1
I hereby appiy for a mechanical systems pennil 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 wifh the state buUdingfmechanical
codes; thaI this form does not become a permit until signed by the BUILDING
OFFICIAL; that thE> wo';!< will bej,n.,ilccorr;tance with the approved plan in the
ca!:e'.af'lrr'~o1'f<Wl1i'~h.requires review and approval of plans.
l dW~. l.~)
'I s. r .. ..
, ..
,~ ....-
3)ulol
MAR ~ag 20UI
J!'i
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e
...
oJ
Building ONlcal's Sigilalure
~1
Date
.-:...
.~
PL. FA,>( 447- 424,g
PRIOR LAKE . DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 5...,L/ ()( n ji;u M fVl.RJdJen. ) (J ( ~- .-
NATURE OF WORK (20- " )
USE OF BUILDING ,<:::;;::-.4
PERMIT NO. ()/- OOQZ DATE ISSUED 1- 3(-'2L:JOr
CONTRACTOR !)!C. ~~ PHONE _~-L.st)-?/3'('
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING vJ(~ I ~ I S1tJ~/o , l
'FOUNDATION (Prior to Backfill) I ~ 11//7;b/ e;yT.~ ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED tt1~/ol
ROUGH - INS
SEWER I WATER I SE_PTIC /
FRAMING r:-rJ~. Ih. 0P/O, b;j? ~/~/b/
INSULATION~, 'Ik- "II/wI ~, bfJ9f~1
ELECTRICAL' A
PLUMBING~ U'~, &to L{h.ofo/ 1)..~~1f S-J-oJ ffy;r. ~ 195ft)}
HEATING (if required)1"lLt ~, J..//'Ul/6' #r.:r. fnld-:90/
FIREPLACE '61-, 10/ ~dJl
GAS LINE AIR TEST ji1'U ~ f/f-~. ~!d-'S/~ /
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
,- ~
I ~ I ~. I ~/jT-5r0)
) FINALS '
GRADING (Prior to Sodding) /:rJ.. ,.Iro. ,/3 /() -;)4-0;;'"
BUILDINGr:c..o.'tV1' Y/S/Cf~, (fIu/o, I/Vf IH../-OL--
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
..
17::r,-,
-~
tl'1/,)
rile/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 shaltbe placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
.-~"-,,r--=-~~~
" --J ~ - ,. t ,:.-. . ,,; ,,:" t 10;. ."" lo: ..;ot:'t"'-;.l':t ,:,..:.. t e..~.'""tIj" .-
f -r- w'~-'l~i;. ~~. "1~ 't - -'~:'" ..., ' . . ilItil. ~ .~~11:1~ .-:
:'~J Q!;trfffiruu nt <mr~ry lJ; :
:~~! CITY OF PRIOR LAKE
:.~~i iSepartment of JiuilbinlJ In.pection
(>>f fill Final Permitted 0 Conditional C,O'"Expires
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This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying thai at the time of issuance this structure was in compliance with the various ordiTUJrlces of the
City of Prior Lake regulaling building construction or use. For the following:
SINGLE FAm1.Y
Use Classificatioo
01-0092
Bldg. Permit Nr,
c..."... Type R1
Legal Description
T ')
~..- ,
Type CcL.~ VN _ Fire Zone r::. / A _ Zoning District
HI., DEERFIEW THIRD ADDITION (BLDC 2, UNIT 7)
R7
Owocr of Building
D.R. HORTON, 3459
Contractor's Name &: Address.
ROBERT D. HUTCHINS rill".J
r:ity Planner
5406 FAWN ~EADOW CURVE SE
~ilc Address
WASHINGTON DR., SUITE 204, EAGAN 55122
DON RYE
Date:
Building ()ffi(:ial
Ii ) I /\ J
,:, I l...-lL_
Dale:
POST IN A CONSPICUOUS PLACE
ADDRESS .5'10~
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By _
TYPE OF HEAT
HOUSE HEATING TEST RECORD JOB #
F/7~,1 /h"odO_<LcV'V'- s'k APT._FLOOR_CITY
"IWNER
_SUBURB
DATE HTG. INST. _p., ./~-O I
_INSTAl.LED BY. AlI.'",___.-t- f'f1..-c- (
I";aS Line By Ali ,'(:,.vl ~ l/J.'1...rr I,
GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. ~OTHER
2 .t- GAS DESIGN
MAK~ 17/ 'I U #") 'f
Modol _ -::l'/', :;> I( .4. V(/:J. '-1 (}"70
5...;01 ~j:fo I A t::5 '--I 0 LJ
INPUT ],f,/'X'/O -
Limit Setting_
F $e. I .~..-C/
an thng --,'
Pita'Type
Pilot Make
Pilot Model
Pilot Timing _
L.W. Cut Off .
-, "'., \ c."
Pressure <'. ,: V
THERMOSTAT /-I,
Volvo L.-v, I?,
limit
Input CFH
· Stack Temp. _
Form 235
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACE
Model
,
\"-..
""
CONTROLS
l/l..r
I _ Heat Plug _
Vent Size
it
KIND OF LINER
_ SIZF
_NONE_
. I
I-i
(
(' 'I
-., -+-
Draft Hood _ Regula,or
Filters Size II, X "/()", I Number
Chimney Location Insid. Outside
/' ! IA.
Chimney Construction j f:4' ~ <::'~ y)
Smoke Bomb
Draft
_ Wiring
Test Tag
lighting Inst.
\
:0;-:;-
("
'_Percent CO2
_ Percent 0
<
_ Percent CO
Door Pressure_
.~- .J -C I
F~~~~~~ng & AlC. 3650 Kennebec Dr.. Eagan. MN 55122
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Date Tested
Company T osting
Name of Tester
ADDRESS
6~~
DATE TIME
SCHEDULED ~;J., I~I J; 3 t1
~/J7? J11()AKfi~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(-q"d-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 lV'WER HOOKUP
J:l.-FINAL M~LUMBING FINAL
o SITE INSPECTION ~ECH FINAL
COMMENTS: (() '2,~
('2-) ~ i~
o EX/GRAD/FILLING
o COMPLAINT
~.!IREPl.ACE RI
'~IREPLACE FINAL
o GAS LINE AIR TST
o
.
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:..........
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