HomeMy WebLinkAboutBuilding Permit 01-0150
7. TYPE OF WORK
New constructiO~
Chimney LJ Misc.
a. PROPERTY AREA OR ACRES 19. PROPERTY DIMENSIONS 110. CULVERT SIZE
Sq. Ft d-.CJ III W;dth ;;lbG,. Dapth I 7 ~ Ves R
I hereby certify that I have fumisMd 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 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 permj~ just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X "-~,,~~:::tl\' I r ~d-C"ll ""ooa No J ~ ! la.oI.~ (') C>
~~
QAP= l;:u::r.J:"IV~1')
1Z.--13~OO
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign al bottom)
2. SITE ADDRESS
3~E~~~RI~TIO:un Va.,!
A-
ADDITION W O("')cl
1. DATE
/?-/I'd-JOO
J<zsD
LOT
BLOCK
VI e-l...U
C-- i y-c.- \ e.
5
s:=.::: ~-f 0 -/.p <"
(Address) (Tel. No.)
I 7 tL> 4S :Jun~ rev Pcd-h
L2t~ I' lIe M J:) No.)
(Addrass) I (Tal. No.)
q ~d - <3q;3--/I'd--O
PID
z.5 ~ 23f) - (]ztJ-()
4. OWNER
rYl L0
5. ARCHITECT
(Name)
'()Onn~n
(Name)
6. BUILDER
(Name)
Fireplace CJ
Alterations 0
OeckO
Ae-roofing 0 Porch D
Ae-siding D Finish Basement 0
Septic 0
Addition 0
Finish Attic 0
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
Front
Ba'"
Side
Side
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION 81t<Y'O .elO
USE OF BUILDING ~ F+\-
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Permit Fee ..........~i~~~~~...l...~...~..~... $~~. "7S-
PlanChackFea ........"................... $ 55'!. Cfc.J
StataSurcharga ............................. $ 4.6. ()t)
MAIN
flL~
pe~o.
L White
2. Pink
3. Yellow
File
City
Applicant
01-0150
BUILDING INFORMATION
11. SIZE OF STRUCTURE
IHa;ght~ (W;dth) '-2,;L (Dapthl4 ~
12. NO. OF STORIES I
13. TYPE OF CONSTRUCTION
5 .J:: 1-1-
14. FLOOR AREA APPORTIONMENT USE
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTP
SEATS
16. PROJECT COSTN~E(J
~OJO
17. COMPLETIUN DATE
r; -~O .-00
MATERIAL FILED WITH APPLICATION
SOIL TESTS 0 ENERGV DATA 0
PILING LOGS LJ PERCOLATION TESTS CJ
PLANS & SPECS LJ
SURVEY LJ
PLOT PLAN LJ
SETS
COPIES
Amount Brought Forward .................. 'I'
Park Support Fee ........................... $_fR5"().CPl
SAC ......................................... $ 'II .~().D'f
Collective Street Fee ....................... $
Sewer Tap ................................... $
45. en
Meter Horn ....... .... ................. ....... $
Water Mater ................................. $_' X'1~
Sewer & WaterConnect;on Fee ........... $ . I r~~ .<SO
WaterTowerFee ........................... $ c~CJO
Water Tap ................................... $
Bu;Jdars Deposit ............................ $ I, ,~f"lL). on
Other ......................................... $
TolalDue .............................. $ ~ 71'>d.. /7
Pa;d 7 'u;4fl Raceytu.J39/J74--
Ome By ~
request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may pr~ as req~ested. This document when
er co stitutes a temporary Certificate 9f ZonJPg compliance d allows c st ction t com n Before occupancy, aCe' . ate of ncy must be issued.
~/7f",1 .
lanner - Dale-
City:
Penalty ....................................... $
Pressure Reducer .......................... $
$
Plumbing Permit Fee ....................... $
I (') I') . f'J{?
I Of") .(')6
~c;-sn
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
ur Building Permit When AeEroved.
Date 1'l..',JJ')-~
Issued
24 hour notice for all inspections 447.9850
,_. __.'__ ^ -'~_'_' ~_""',~_ ""',-,,,,,,"""', . _~-_t".'_' . '..
Tht ('tnlrr of ,ht Lakt Country
((lAIN F;(.z=:
/11 l73g/
. D l S V 11%3> 511~rll-y elf':
D l' m'&~ I .
While 17 ~Zllding
Canary - Engineering
Pink - Planning
-~~
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
H W ToHNSON
12-- I?)- m
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I J 3 n I S V f\Jf<..f-\ V C.llc CAJS
/ I
Accepted Accepted With Corrections
Denied
Reviewed By:
LLL
Date:
3-8-0/
Comments: .
. See Reverse Side for Additional Information! .
tiee 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."
0/.0 (S-D
Th~ Cpnll'r of lhe L.kr Counl!'}'
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
tv\ W ~Ot-\ t\J S 0 f\.J
12..-- 13 - {)()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7373/ <5 UN RA\J C'JI ~_('~L6
f
Accepted
Accepted With Corrections
~
Denied n4 I
RevieWedBY~~",-~,~ Date: /2~2o-~
/
Comments:
I. r2J. ~(( d.-ffa.cW ~ ~
"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."
61-61r:V
Thr ernt.,. of lhr tab Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
t" \ \,\j "j C t \ 1\, '~~ 0 ~"j
12-- i_:>/- ()()
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
" -j:? C, I ~. " \' , -
i ....-/ r, :~ vi"" 1<1-\\1 , k.l L.
(
Accepted
~
Accepted With Corrections
-~~~....... Date: 3/7/.9(
CO!W~~ ;;d,;~''1lL~ Awmdl IJr.a-
+- ~*- ~~. ~ tA~~^)_ ~~~"
<~_ ~' ~ '\ I . 'l<~ oL-"{..r,e..p D.,. .~~
~kW~' . ~~(
-~
Denied
Reviewed By: Czi/"AL.
~.
"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."
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
h.S: 0/
(Please tvDe or orint and si2l1 at bottom)
ADDRESS
~.;;;~, ~:~y \PERMITNO'O/_OISO I
3_ Yellow Apphcant
/738/ StJNErlY ~/R-.
LEGAL DESCRIPTION (ollice use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
ZONING (office use)
PID 2.''';-'230 -nz.a_::..J)
---
(~~;;;~~ANT )~a}, F. SocleelJ?Ulsl (Phone) 9Y,J-.;n,- U,l.lc)
(Address) IJ,),L/ E. :;;;htkot1./u dw #,AOI :5Ao~n.AJ, 111/1/ SS3?9
(Address) . (City) , (Zip Code)
(Contact Person) Ypr+ll S':~t' f ~ _ (Phone) <=t ~r,).-,). 3 ~- /(,.<(,,-
APPLICANT SIGNATURE ~,1Ir) ~ _.....8 U, A7; DATE J"-L -S- r) I
~PLlCANT PLEAs{ COMPLETE BELOW {/ .
~ CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $ Building Pennit #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
(Office llse Only)
This A,
If
ion Becomes Your Building Permit When Approved
~.,,-'~ ~.}.Ol
uilding Official Date
I~
"' Date J _ ..-
1#'''' . 0 I
,
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.50
$39.50
'PAIl? Bi f!-
t>UI l/Dt/
IR~
Illy ~
'l
",.. C..I", .. '''11 LaM CM"I..,
612-452-0367
(TUE) 02. 20' 01 17: 42/ST. 17: 41/No. 3561851084 P 5
CITY OF PRIOR LAKE
PI.UMBING PERMIT
I. Utar. RIll
1. G."" efT
3. YotloW ^"U_,
PP 1'10. 0 J - () /.c::;'C2....
Phone,V' ,~.re'~("
Applicant IA/CA'2.I':;'.I.. /PAM
Address: -LU' Yrrltb;! At')
Signature: ~- - ~ _
Legel Description: Lol Block
Site Address: 17 J~ J ,f r.ldtlfAy f!:,/A'
Building Permit # (J / - () /.5V _PID 1#
NOTE: This permit ",III not be prccellSed without complete infolTTlstlon.
FIXTURE UNITS
I Type of Fixture Quantity
Quantity
J Bath Tub with or without shower J
J Olllhwas"'er J
I I Floor Drain
I I Lavatory (bathroom sink) I
I I Laundry Tray (' or 2 cOlTlpat'lment sink) I
I Sho.....er Stall ,
I I Sinks I
I Bar Sink I
/ I Water Closet (toilet) I
FEE SCHEDULE
"
Industrial, Commercial &. MUlti-Family
('0,4 01 job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
Stale Surcharge
$99.50
$39.50
GRANO TOTAL
Sub
Type 01 Fixture
Flough-ins
Watar Healer
Watar Solmer
Stand Pipe (washing machine)
Sewage Ejector
Baclcllow Assembly (RPZ, Dou\j\e Chadc, PVB)
Back1low Assembly Test
Lawn Sprinklar
Olher
5
S
5
$ ,50
!. [>.\0 \j\J~R\,^\1
s o;Jl~fI\~G
This pcrmiJ IS gr>>ued ~p:ln (he eK.prcss condim:m Lh.\ 5.id
c;on~rX[Or, shaU comply fn all respects \&lith the ordinances
or rh. 5.... P~~' Cod. Ul4.fb~.f't'fflI'ii'
.,.... RECElPf NO.; . LI)'An
/'., .'. . , . ATTEST
. L.,.
Call tbL.~~.c!iOhs '24 bours in ad_ceo
16:2.00 Eagle Creek. Av. S.E.. Prior Lake. Minnesota 553721 Ph. (612) 447-4230 1 FAX (612) 447-4245
An Equal Opponuniry Employer
'.
---
....... . ......
TII.LO'W - &.M\.JCI. I
QDLD - err 'f
CITY O? PRIOR LAKE
SE:\lER AND lIIATER PERMIT
NOTE:
NoOI- O/5(?
Sever and ~a~er
contractors must
be registered,
vith the City.,
APPLICANT:
1.A/7rjl~"L Y[U,I?")/';JIJI..
/ I,'~; /1_)(,
PHONE: (~~')~S?-/~G~
SIGNATURE:
/'t~;., }~;j~/~"'Z~''''), .'.1,./1,)
//&r~< :'(/,I(;A;~." __.
~ / / ,~-
SITE ADDRE.SS: )/;(ffJ ~;',h))2/1Y (U,I( i)~
DATE:
:1.,/ ;J'l/l))
ADDRess:
SLOG. PER'UT #
PID#CtS -J-30-0J-O-{)
FILL IN THE BLANKS
1. Estima~ed length of water service
feet'.
2. Size of water service
I
ihCh(es) .
J. Location of any couplings from structure
feet.
4.
Type of sever pipe.
ASS
pvc
./
c~st Iron
5. Estimated length of seWer line
feet.
6. Clean out (if required), located at
s~ructure.
feet
from
o;;;:=~======::;;;;;;o=="":=<=!l======________Zl:.:Z::=======_~==:=======::::; ="~_:!!====:;i:l:~=========: ~'C.
This application becomes your permit when approved.
BY
DATE:
=~~=~==~~~~=====~=~=~~=====~~===;;;o_~~==~~~____s__~===__=_~~~~~~~=;~~
FEES,
s
s
s
J5.00
.50
J5.50
Sever and va~er line connection permi~.
surcharge
TOTAL
~ Fee for either sever or water individually is $20.00 plus
S .50 surcharge.
~ Sewer and water permits issued for new construction must l:l'l
recorded on the buildin~ permit card at the time of issuanc'l
to insure that no dupl~cate sewer anc water permits ar"
issued. PAID WITH
DATE PAID AMOUNT PAID BUILDiNG r-;::~:..T
RECt!PT # REC'D BY /k- / t; - :;2-/
~f\1_
16200 Eagle C~ek Av. S.E., Prior Lake, Minnesota 55372 / Ph. (612) 447-4:230/ FAX (612) 447- i245
An Equal Opportunil)' Employer
II d SS91 SS19SS 'ON!I7S: Lo 'lS/9S: Lo 10,20 '110 (NOW)
L9So-2SI1-219 1VJINVHJ~W 1~ZN~M WOHd
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1 tt~ ( qo""tc-r f1..
NATURE OF WORK NeuJ
USE OF BUILDING Si=" lJ.
PERMIT NO. 01- 0/50 DATE ISSUED 1'2.~~o
CONTRACTOR _M UJ _ ~~orM.. PHONE s:f12 -77:20
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING I"B ~~SPECTOR I 4JJ;;TE
I FOUNDATION (Prior to Backfill) Wit I~. "III/I'D} I
PLACE NO CONCRETE UNTIL ABOVE H'AS BEEN SIGNED
ROUGH - INS
SEWER' WATER 'AEPTIC .. tJ;n i4( 7 M I
FRAMING ~ f1r 7 (}.:?JIO, ~Ie . I:ftr ?)..gIIoJ
INSULATION 1'i5+. 7/ rl- 51(u
ELECTRICAL
PLUMBING
HEATING (if required)
.etaE~
GAS LINE AIR TEST,,1kAJ ~tI.t ~1/.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
. I'H$, _ gh/oz,
tf1:r CJIN/OI 1fr1, mJ6~?/
I
wIt....
V>(e.
-
t'J:r, {t>(t9/{J/
'&'
7/ IJII/e I
"
GRADING (Prior to Sodding)
BUILDING,.(l.I'l,lJj lohZ5(b\
ELECTRICAL .
PLUMBING
HEATING
DO NOT
.
'flle- 0:l0 'II \blo ;1
f/f;t-. q I " /01
I
OCCUPY UNTIL ABOVE HAS BEEN
NOTICE
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 sluill 'be" placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR All INSPECTIONS (952) 447-9850
ADDRESS f73<81
OCCUPANT
HEAT LOSS
SOLD BY
s... ,,\ {<'PH
HOUSE HEATING TEST RECORD
C.e ~~""'-~APT._FLOOR_CITY
nWNER
SUBURB
DATE HTG. INST.
Electrical Work By
TYPE OF HEAT
_INSTALLED BY
L r""'KJS Line By -*-~r ;..-J;;\.~O yv-....CL~
GA _ FA HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
GAS DESIGN
MAKE J...uVoa.,1D#
Model C.., ~,"\{)9.1) ld l ~~ A \1 A-
S...lal ~ e \<tJ\a.~ "1<:\3.1 .
INPUT 'f'Jn :r-nn .&"'\ \A 11-\ CL
CONTROLS
THERMOSTAT~h\),\e.\\ Heat Plug
Valve .3kJec;:). - 7~
limit ,,'r:::.- -::>CInU \ -r:r:.<.
Limit Setting \ \4 Q - 3ot)
Fan Somng\\-""'" 0-4 o\Z~
Pilot Type ~C\\ ~~~~ -:i:r~",""'l;lo....\
Pilat Make SQI..L~1i'. 1
PHot Model PO?,\- (,)\06, - 00\
Pilot Timing;J ~~'-.......,1'^ \ jg("v,.,.......-r (~\ ..t>.&:'T'tt,C.'\.
L.W. Cut Off }...\/r:>.-
-~
Pressure ~...::::::.
Input CFH. 9'..fl
-<>
Stack Temp. ~
Form 235
Percent CO 9:..~
2 . '<::.
Percent O?~.
Percent CO . ~
CONVERSION
MAKE OF BURNER
Model
Max. BTU Rating
MAKE OF FURNACF
Model
n'J1\1 L\'\
Vent Size~,
KIND OF L1NER(' A ,f><!'i,.<:' \;. SIZF NONF
Oroh Hood _ Regulator _ ';?;.~~ .....a.
Fi It.rs Size ./Number_
Ch imney Location Insid. _ Outside
Chimney Construction ~~ \~
Smoke Bomb
Droit
Wirin,,:,
Tost Tag ,/
fighting fnst.
Door Pres sur.
Dot. Tested _ C\ ~ ~ -0\
Company Tos'lng ~u......."""t'> ""'-~~
Name of T.st.~r...,t-_ 1,. ,,~~~
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
17f<;f/
SCHEDULED 1J(()"~ Z-
~~.
CONTR. ~/-5 L.L,-O/-SS'P
PERMIT NO.~ -/~c
At.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~ J ~
~
~~ -
~~~,
/-~SOO ~ 4~
j$ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:.+ _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTJ
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~~ 7-oL
ADDRESS /7381- I 739 7 5;) f/ m y t..//"
OWNER CONTR. J'hhl.iol,,,j:nTl
PHONE NO. PERMIT NO. 0 I-ISo
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~X1~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
173~/-. Or-.
1"73$l3 - OIL
J 7 .5b>S - () t-
1138"7 - [;~
c;-rf" r
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector~~~ Owner/Contr:
-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JlfSNOTJ
/73B~NT:UN~
/-/50
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING ~ 0 WATER HOOKUP
MNSULATION~ 0 SEWER HOOKUP
FINAL 0 PLUMBING FINAL /.lfiI
o SITE INSPECTION ,.~MECH FIN'/,? ~
COMMENTS: /Ge.,. -- rf//?u:J.-t?
(/J) e-,~ ~_.t 5U T,n.-
,:-CJ ~ 00 A -dJ'
~ ft> ~ ,Q.'_- .-04......:r-
~)~<{~ ~ ~H~le4.
. ' I
-
I.
e,'
T:'C .0, .<i.6:.J..( / {J I, 'S /0 (
i'fJ
1f'
~
DATE TIME
'1/(/0 I I. ~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
4< p",
.
"h
o WORK SATISFACTORY, PROCEED
,)!ilCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I
IJmNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
TIME
9-//-()} /736
~~
U
I-I ~o
DATE
ADDRESS
I/?3 g/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
@JD SEWER HOOKUP
.. .0 ,eLUMBING FINAL
-li!I"MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: CiJ) ~
.o"\.A.4- ,~ ..a.::t;;. LA_S
<'A~'
g-~ ~~=t)^. 1~
IJ\~!~~ f
. 0 V
(~'-vvu
/ul~ ~
/.~
J
r
fA!"-'"
I~'t
- (. /
o WORK SATISFACTORY, PROCEED
)1QCORRECT ACTION AND PROCEED
o CORRECT WO~ALL FOR REINSPECTION BEFORE COVERING
Inspector: tor Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
DATE TIME
SCHEDULED ~/O lJ/ 2,'([?)
.sUtJl2IfE.- 0/R- .
r
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/730/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
~ 0 PLUMBING RI
vJ t- 0 MECH RI
o WATER HOOKUP
o EWER HOOKUP
N. ~LUMBING FINAL
~~ECH FINAL
COMMENTS:fn ~A
(2) ~iiuL ~
f&r.,;f
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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o WORK SATISFACTORY, PROCEED
\(lCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE TIME
'J::!~~~:~'
CONTR. ~7'
1- I S-O! 1 SI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/t?3YI-J3
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION ~MECH RI
o FRAMING ATER HOOKUP
o INSULATION WER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS@ Pv.:i fH..d- ~ ~ ~
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS~E AIR TST
o "".
ukL. LfO
\'-:lD~,
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
OWner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
ll'iSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/