HomeMy WebLinkAboutBuilding Permit 01-0126
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. Whi<, FiI, I PERMIT NO.
2. Pink City
3. Yellow Applicant
(Please !We or Drint and silm. at bottom)
ADDRESS
.5'$/,,;(/ ~N /n~ CH-'(J/E se
LEGAL DESCRIPTION (ollice use only)
$.(}7 tPM'r ~.J'
.L.O+- BLeCK ADDITION
OWNER
(Name)
(Address)
-"'"'-- .~,-"'-' .....~
~G... \' ~.J '-""
PID 25.373-013-0
BUILDER
(Name) V1.4. ..J<..e>.or<'n:YY ~
(Phone)
(Phone)
-:?S6 -?Y$
(Address) ,~.y..59 ~~....~~~
TYPE OF WORK
~ New Construction
o Fireplace
ODeck
o Misc.
OLower Level Finish
~
OPorch
ORe-Roofing
R2..
~/.;:? -::<
ORe-Siding
PROJECT COST/VALUE (excluding land) $ ?'-:t /~
OUtility Connection
.,.,.:(~~$7
Contractor's License No.
1 Park Support Fee
I SAC
I Water Meter
I Pressure Reducer
I Sewer/Water Connection Fee
1 Water Tower Fee
1 Builder's Deposit
1 Other
I TOTAL DUE
Size S/8"; 1 H;
I Paid S"L{t? Z _ 2--""
I Date J -/ ~ 0 ,-
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.....) 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 1;"~I;'';'nJ' to perform needed inspections.
x
~... ~...kz ~
,
Signature
$
$
1$
$
$
$
$0
$
Ii '7.If:\"
S/PJ.S4
3l...CO
100.06
100-OQ
~- ~~
40 . ct'l
1 Permit Fee
Plan Check Fee
State Surcharge
1 Penalty
1 Plumbing Permit Fee
1 Mechanical Permit Fee
1 Sewer & Water Permit Fee
1 Gas Fireplace Permit Fee
]?Il" kS YOmBUil~~;:'~~".:;roved
Buildin(l'6l1iciaI Date
OAddition
OAlteration
.-:l-,r _e:>/
Date
#
#
I $ 8'50 ,06
1 $ II' SO. O~
1 $ 0
1$ C
1 $ f. 200 . 015
$ . t'J()() . 00
$ 0
$
#
#
$ S;,pZ. 7f!
I Receipr(.l96. 3e; . ~ "1--
I By /JIt---
(I
,
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
;;"'~h'; ,ioo,d by 1~;:CO~'= tem~MY CmifiCa: of2n:ng ;:ptli'ance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
L-~"/& ~__~ ~~c.~
. Panning Director Date -- Special Conditions, if any -. --lF~;J
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
~~
OI.o/vIP
Th~ C.nln or Ih~ L.ke Counl..,.
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. R. HOemN
2..-12- 0 (
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
542/ PAWN ME:AOOW WRvr;
Accepted
~
Accepted With Corrections
Denied J/J/J ^
:::::V1"i(L / ~
Date: :2. . ?c-2a:J1
See. 5't20 TI1.WV\ t--\e.p~ Co.l-u.L. ~r Qla-c:.. c:-ft .
"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. 61~w
TIw C..-Ier .f 1M uke Co..cry
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. f2HCRTOrJ
2-12..-CI
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
tYIr 24- F/\ \ \! f\ I (vI E 1\ L)( vJ \.: \ ,: Ie. ~/ E"
V
Accepted With Corrections
Accepted
Denied
Reviewed By: ~ ~
Co ments:
Date: 2-/U / t:91
- ~eLY-ID ~ ~ 4- ~
,1/:\ ~ ~Li*" ~ ~~ ~~_t
.
-1k- {~fd:J% ~ ~./~ t;9~~ ~/-'"
---1L1.~~~ f{"~ (O.c~...~f'fe I~he ~~9~~
J/t)~;;Ji.J1 L-s- <T' '~1:~aL( _ No~ ~~ ~
~~ rlJ- ~1-. ~/~t~~ _ ,J~lltJ<e ~
~- ::::'1~ ~ l10 M cY~<. ,
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," .
S~1
White - Building
Canary - Enginl!l!ring
Pink - Planning
Th~ C~nl... of lh~ Lab Country
BUILDING PERMIT APPLICATION D.EeARTMENTCMECKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
D. t<.. ~()ewN
2-12-01
The Building, Engineering, and Planning Departmenls have reviewed the building permil
application for construction activity which is proposed at:
542 J ~AWN /V/EAOovY tURV(;
Accepted
y
Accepted Wilh Corrections
Denied
Reviewed By:
Comments:
NilE
Date:
2- "U-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."
FEB. 15.2001 12:36PM GENZ RYAN 6513226147
NO. 773 P.ll
,11IrC.......f...l.IlIIII~1I1ir
CITY 01: PRIOR LAKE ~a 5-
. PLUtlSING PERM" . ~
~pllcant: P:t1lf'1'2..- ~ Phone:J.of-J -u'Z.~ - '14'-1
AcIdms: ~... ~ P~.D:r' -ri? -' - 1/rY:'.P '1IV"Y'f:u.rr ~
8ignqJre: . <1. .. .
L..gaI Description: . ~Iock - Sub nu,,&Dn \Iii \n. c:...
SIIe AcId.....: k.l.?l ~~ '\.l t'l r l. "\ C \ I "'\J~ .~
Building Permit. . n I - 0 (Z PID *
NOTE: Thle pennlt w.ul lot be procHHd without complete InformatiOn.
FIXTURE UNITS
".,'
Quantity Type of Fixture
I Bath Tub with or without Ihewer
I Dllhwuher
I Floor Drain .
.~ Lavalory (bathroom link)
I Laundry Tray (1 or 2 compartment II lie)
I Shower Stall
I I Sinks
I~ Bar Sink
:'j Z- Water Closet (100lll)
i
Quantity
Type of Fixture
\
Rough-lne
Waler Heater
Water Sellner
Stand Pipe (Washing machine)
Sewage EjeClOT .
BacIclIow "-nlbIy (RPZ, DoWIe Qleak, PVB)
Backtlow Anembly Test
Lawn Sprinkler
Other
PEE SCHEDULE
~ Imlualrial, Commercial' Multj..Family
(1"" of job 1lCIIt, '311.50 minimum)
R..ldentlal. New One & Two Family
R..identlal, Additions & Alterations
Stale Suroharae
G~D TOTAL
,
$
$
$ .50 \'\
,,~\O \foJ~t='-M\i
$ ~\\,.O\~G ,
$1111.50
$39.50
~j
'!'hI. pormll i. IfI1lII d upon th. oap..... .0Ddillon lIIalslid
.0ntrlclQr, sholl .on ply 1IIIIIIIp"'" with the onllIllllC:I.
Dr th. SlaY P1umbbl, 'rJijOlld "'" ImOllChnonlllh_.
- R ~- 2.-01 DATIS
I ~ _ATl'BST
Call far all in~ =etion. 24 boWl In advance.
.. ,
16200 Eagle CreekAv. S.E., Prior Lake, MinI.CSOIl 55372 f Ph. (612) 447-4230 f PAX (612) 447-42~S
All Bqual Oppommi~ Employer
FEB. 15.2001 12:36PM
GENZ RYAN 6513226147
i'IO.773
P.8
_. ....
,....... . .,.. .~..,
-.. . "'.
I,
CITY OF PR40R~'
SEWER AND WATER PUMI'I'
NOT!::
No.nl"': nlZ0
Sewer and Water
'oontraotor. must
be reqi.tered
wi t.h the City.
APPLICANT:~~- ~~Ph~~~I'- u",-n...lt'_ P!!ONE:JGClI.~2:!l-II~
=::L~ ~~:~. """"::: __IT t n 1.012.0
SITE AOORISS~----1..CJ_.&I!:f (,:. Plof .
lIJ..L IN THE BLANKS
1. E.t.imated lenqth of water .ervice ~I
I"
2. Si.e of wat.er .ervice inchees).
reet.
3. Location of any couplinqa from .~ructure feet.
.-, 4. Type of sewer pipe. AB5_ PVcb Ca.t Iron
.. I' "f
.:.,..' 5. Estimated lenqth of .ewer lin.~ feet.
6. Clean out (if required), located at feet frol'll
.tructure.
:::IIIl_____--==,.""_.__ .._~. .."
... '".., . ''''',._~.....
.
..
. your permit wben approved.
/- D~TE: 3 - 2>0 /
This appl1catio
BY
.-
-
" .., ...----. .
FEES:
$
$
$
35.00
.50
::15.50
Sewer and water line connection permit.
Sureha:rqa
TOTAL
.,
'. ~
* Fee for either sewer 2[ water individually is $20.00 plus
$ .50 surCharge.
.. Sewer and water permit. i.sued for new oonstruction must be
recorded on the buildin! permit card at the time of i.suance
te insure that no dupl cate .ewer and water permits ara
i$sued.
DATE PAID AMOUNT PAID. ?~\O '-Ni\~o.M\\
\'tt\:i -
RECEIPT # REC'D BY ~\~
~.
. 4629 Dakota Sl &E., Prior L.aJc., MinnlllCllll 55372' I Ph. (612) 447-4230 I Fax (612) 4474245
~ EQUM. ...'rl' ........ ~ eHl'LO'tER
FIRESIDE CORNER
#4360 P.002l006
Date Bec'd
Il'IaRp ar_II3Cl......~l
ADDRESS
~'t;J1 ~ rnU.~ ~Jk.
~.;:. s... I PERMIT NOh/_ Id-b I
ZO~G (......)
Nod..
LEGAL DESCRIl'110N (011I.. _ oaly) ,
LOT3 BLOCK ;:;{ AD............ /....QfJ~c2 ~ rei
,)
PWd;;' -373-- 013-,6
. OWNER.
(Name)
(Addrcsa)
"J;l (l 1J...b.
(Phone)
APPUCANT
(N.rnel ALLIED FtII5liiIDE DBA Ii':tRES:tDE CXlRNEtt
cPhone) 651-633-256]
(Addles.) 2700 iii. PAIIWUJW A'I1EImJi' VSJSBlZ1u.... l4"
(Addren) (ClIy)
(ContacrPmcn) BRENDA KUS'rCN cPhone) 651-633-2561
APPLICANT SIGNATURE ./j'II...I. p. - DATE s1t!IJa,
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPLACBMENT 0 AL'I'BRATlONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETIJRN ...,.0, ,.NGS INPUT OUTPUT
TYn! OF S.... J>.d HEATING OB. POWER PLANT
'"]WlImI Air PI_ ~ SIIorn
30ravfly Hot W,. .
MedwUcal Ro4/P1on
"lr Condl~onjll/l [J SpooIoI Dovi_
JVonL S)'II'IOlIl. [JOlllerDevfcoa
FlRBPLACE MAKE AND MODEL ~ N (4lz, .,f<.. 'Jnm._
51:.".,
(ZlpCocIel
PLEASEI~"'.~:
Air Con;,'..i. ..rUnill
ClWIOt Enoro.cb 111IO
RecJlliRd Side Ysrd
Se1bIdcs
FEE s............."...E
lndusaia/.C... .. .101 "'Multi-l'anlil)' '%ofjobcast Resldantiol,OasFirepl_
$39.'0 minimum
Rnlclcntfa/, Heatlnl '" AIC (1)1- CoIlsrruction) $99,50 Ruldcnttal, AddIdans It ^I-wns
R03iclenlhll. Heatinl Only (I>Iow CoftsIrUetl.",) 164,50 Raidenll.., ,,"C Onl)'
$39,,0
$39.50
$39.50
Eslimllted COft S
BuUdlng Permit *
HEATING PERMIT FEE $
STATESURCHAllGE S
TOTALPERMl'l'FEE S
.50
. BlJ1L't;tS'G WlrH
PE:F=lMrr
(OIJIct U.. 0111,)
Tbll ""p"tRiton lkmlll. Yo.,. BulldbIJ Pe""lt WMn 11.. .' . I PaleI
DIIe
D... 5>//-(1 /
Racalpl No.
:u ho.... noli... fo,.II'. ,I '" (~) 447-"150. ru l'9J 447-4245
BYgt /
..lI<Ilq om...,
, .
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 542\ F'owv.. k~ Qu.1-UJL.
NATURE OF WORK ~PL i
USE OF BUILDING '3FA
PERMIT NO. 01- O{'zJ" DATE ISSUED "2.- Zo - 3=(
CONTRACTOR D. R. ~ PHONE ... c..~ - ;J.'-("-7/!l!
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I ~ ~PECTOR I ~lt'?IZlTE
I
'FOUNDATION (Prior to Backfill) I~. "'3MoI ~. ~3/t'lol
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING ~.V~ 6)~~OI
INSULATIONJ.d-_ O:iJ f5l!JI/b1 &,.. ~/ 6b<(ILJI
ELECTRICAL . . , - ,
PLUMBINGOauo !A,.Q. ~ '/'J6!OJ ~A-J. ik-. sf! ~1 /)/
HEATING (if required)D.'l'lJ,. Q. 3!'3ll/Cd ",,51.IIN' E) ~)&v'
FIREPLACE . ~. Sl/'? /0 I
GAS LINE AIR TEST ~ ~' S'J~)D(
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
,
Ititf!.JhL.S (z) ~ "1k/6, ~ t;- tJ/ittJ/
FINALS
_ fJj 0
~ '7irg/ol fJ~
'W
&. frJlC}%}:7J
~. '7 J n/u/
J , - i
OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
GRADING (Prior to Soddin~)
BUILDING\&.-<(),4.(J cr/f5/rJ/
ELECTRICAL .
PLUMBING
HEATING
DO NOT
7-~-J1.
q-1d-~~
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 Me
16200 Eagle CntekAv. 5.E. Permit No...Q..J- 012(P
Prior Lake, MN $372
HEAnNG APPlICATION I PERMIT
Dale 31 ~ I PI"
Site Address . 642.1 r1J.wn ~w .cu..n/l. SG"
Lot ~ Block -=:L AddItion
Owner'sName DR. H-~r-ton
Address~ 'br SLU+t.71JtJ
HaatfngC_.._~.,,.. I\llio...,J" ~1f.D..J
Addr_ 31t5() lleM-e.hec..."by- ~ { E.1Aan Mt.J' ~z..
.J
Telephone' lr.5J l.Jsz - z-ns
Furnace Make & Model 1> rv tl.nf
.
Model Size ~8~lt:.AV 02.4011'1_
Conn.load 2.1. ~~
Fuel N'cd- FbtSlze Ll-1I~i J
~
4-
DE: OF STRUCTIJRE
J. PiDk
2.. 0.-
3. YdIow
.
.
.
.
II
II
FiIo
C>ly
Co.,,,..,,
SingleFan1iIy
Commerciel
Mulli-Famiy .
/.--'"
Two-Family
Industrial
Pubic
O1her
,.
c
~
Fee Schedule
jo
.
.
c
Industrial, Ccl.....~...:.J & Uulli-FemiIy
R......;,;.....aI, Heali'lg & M;
. R....:,;..~ Healing Only
~ttl("." MN 56hz.. r:,..;';".Jial. Gas F1FlIplace
" . Residential, Additions 8< A1lerations
A ~: ;:, ;,:.J, AC Only
TYPE OF SYSTEM The price of your I>e8ling permit includes one rough-in end one flllJl inspection.
Warm Air PI8nls
GrelIily . AcfdiIional : ..~ ,_I.ens wil be biIJecj at $35.00 each.
Mechanical ~ House Healing Tesl RecoJd must be submflled with blIlI!:IioQllIIIDiI!llI!!!RIr beIo!e build-
Air Condllianing jSr IlI1.l\-t Z. tlln ing cerlilicale of OCCUPBllCy will be iseued.
Vert. Syam 1.-5'C~,h,. .bdll:fAhS
- - J:lW CAlC:ULAT1ON.~ REOUIRED with number of supply and relurn openings listed per
HEATWG OR POWEll PLANT room with CAh per open!nl!. New strudlns or addlIions send floor pIar1 will aupply
Steam and nltUm Iacations sl1own. HEAT LOSS CAlCULATIONS, PAYMENT AND
HotWaler APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. 15200 EAGLE
Radialian - CREEK AVE. S.E. PRIOR LAKE, MN 55372. .
Spec:la! Devices
Supply Op&nings
Return Openill!ls
1nput1!>. DDb Olllpul.5lJ.. bO b
Edr.
CIm.
~Ob
Other Devices
TYPE OFWORK
AlIerations
a.--""
Replacement
Est Comp. Date
Building Penn. #
New Construction
Repair
Est. Cost $
tJ{- O(2fp
HEATING PEAMrrFEE$
STATE SURCHARGE $
TOTAL PERLlIT FEES $
.50
"
PAID WITH
RBcePlllBU1LDING PERMIT
1."..of job COS\ ($39.50 minirTxJm)
S99.5Cl PLEASE NOTE: ~
$64.5Cl Air Condi tioner V nits Carml :
$39_50 Encroach Into Required Side ~
.
$39.5C Yard Setbacks. ~
$39.5C ~
.
~
Remember to add the S1ate Surcharge on Ihe bottom of this application.
~
~
~
~
c
~
~
~
~
c:
~
CIty Hall business hours are S a.m. - 4;30 p.m.
~
..
"
All WORK MUST BE INSPECTED lROUGH-W AND FINAL) - CALL CITY HALL
<M7 -!IlI5O
I hereby apply for a mechanical systems permil and I acknowledge that the
information above is complete and accura1e; lhatlhe work win be in conformance
with the ordinances and codes of the city and with the stale buldlngfmechanical
codes; thai this form does not become a permit until signed by the BUILD I NG
OFFICIAL; that the work will be in accordance with Ihe approved plan in lhe
case of.a/l WDrk which requires review and approval of plens.
Gt~ 7..LM.a.u.r~ t.~)
'2AAi=GiPPl ~'.' . e
A . ~ .
J-i J' \,
lA-- ( .,c.. ~
..~_...BlliJdJngOllf( s. .,,~
.$/UllH
Date
__ - tl i'UUI
Date
I!!i
c::
c::
...
PL. FA>! 447- 4248'"
Itrtiftcau of ODcctq1WtqJ
CJ.J. ~ OF PRIOR LAKE
1Department of .uilbing JnJpettion
~ Final Permitted 0 Conditional C.O. Expires
'This Cenificate issued pllTSUll1It to 1M requireme"'s of Section 307 of the Uniform Building Code
cenifying that at the time of issuance this structure was in compliance with 1M various ordinDnces of the
City of Prior Lake regulating building C01lStruction or lISe. For the following:
SINGLE FAMILY
Use Clwificatk-
BId,. Pamil N"
01-0126
LeplD.....:.
R3 _ Type Cons_ VN FireZone ....l1./ A ZooinsDialric:t R2
BUILDING 7. UNIT 28. DEERFIELD THIRD ADDITION
O<cupancy Type
Owner ofBuildin, _
Si..Addms 5421 FAWN MEADOW CURVE SE
c. .,
...,'.Nome.l:AddmsDR HORTOlL 14~<l W~~HTNGTnN..J!R_. ~TlTT~
ROBERT D. HUTCHINS /"f);~ City _ _ DON RYE
Buildiq 0lIidal 1] --
q--I;;t- ~_ Dote:
?04_ ~N ~~l?Z
0.":
......
-
JOB #
5~.JI ~'''A
~t'",61....,
rr~"""'./'
HOUSE HEATING TEST RECORD
SUBURB/?'..... ~#K-
ADDR ESS
OCCUPANT
HEAT LOSS DATE HTG. INST. {, -,?-O}
SOLD BY ~.r/u~r INSTALLED BY ~//"~~,,.-
Electrical Work By Ga. Line By ~~//~Ar ~,\ ~>J;"
TYPE OF HEAT GA _ FA LHW _STEAM _SPACE HTR. ~UNIT HTR. _otHEV
1'" //.4 GAS DESIGN CONVERSIQN
MAKF ~T/,,/(.)7 , _MAKE OF BURNER I
Mod.1 'J tr '" vtt;'D) " ~ . Mod.1
S..I.I_ ODIAJ-r?..7) Mo.. BTU Rating
INPUT (~r,.. t'r&t1 MAKE OF FURNACE
t Model
CONTRbLS
THERMOSTAT .li.:../-,o' H.at Plug
Valve _ / J...J I .IP .
Limil-
LimrtS."ing
...fo~n ~tting.
Pilot Type _
Pilot Male.
Pilof- Mod.J .
Pilot Timing
L. W. Cut Off
Pressure '7 "'-nJ>,., LJ .' (".
Input CFH
Stack T.mp. "7<;'IO
Form 235
J J .__
/ I /' (j
1.---7 \ /
7 I /
I J/~
Petcent co2-L-...l
Percent 02~'?
Percent CO )
-'
.-/
APT._FLOOR_CITY .
'~WNER
,
.
Vent Size _ '1/
~
KIND OF LINER
Dtci:ft.......ood
SIZE
Regula,or.J"'fn- v n-,......,
_Number
NON~
Size ./1"/ K!.)..fi' J
Filters
Chimney Location
Chimney Construction
Inside_
/7,r.,-r.r J
Out.id.
Smoke Bomb
Draft
}-
t,-t.-[lf
K
. Door Pres sur.
Wir'ng
.Test TQ'"
LightinCl"nst.
Dat. T..ted
Company T..tlng r~ Heating & Ale, 3650 Kennebec Dr., Eagan, MN 55122
Name of Tester ,...-,.../
/
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED tof,;..~O{ ~~"$O
ADDRESS r;tfd-.I ~ ~ ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS: (!)
o PLUMBING RI 0 EXIGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
Afi\ 0 SEWER HOOKUP 0 FIREPLACE FINAL
~ 'iIfJ PLUMBING FINAL 0 GASLlNE AIR TST
10 MECH FINAL 0
~ Rm-1 (l~
r '
~~
{)j,v
;(WORK SATISFACTORY, PROCEED
(0 CORRECT ACTION AND PROCEED
:':::O:ECT ~ALL FOR REINS:::::~:FORE COVERING
CALL oU7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALm & SAFETYI
lNSNOTl
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ MECH FINAL
COMMENTS:1i1 M i (}..Jl..s...-,
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
5'72-/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED 7/2. 3(.. r
~~.).
,(),~t"l
, -
CONTR.
PERMIT NO. !lI-/;){,
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
~ FIREPLACE FINAL
o GASLINE AIR TST
o
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT ~LL FOR REINSPECTION BEFORE COVERING
Inspector:~ ;' OWner/Contr:
,
CALL 0147-9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
Jo' .
" ~'
\ ... .. I
'c?rv OF PRIOR LAKE
INSPECTIO\NOTICE
A~ESS
OWNER)
,"":.Ji
'i'!;)O
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o . INSULATION
~FINAL
, 0 SITE INSPECTION
;l COMMENTS:
54;;'0 ""..-Itf'
& ",tI..
54:J./ h".d,
DATE
SCHEDULED
7-Ji-01
'<,;.
PM
~ 111l'/jchL.' 1',,;
CONTR.
PERMIT NI\).
..0 PLUMBING RI
o MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
ol-~ /~
""JKJ E~lLLlNG
- CI COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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X WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:~#~ _-Owner/Contr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
i
INSNOTl
TIME
).
Cm' OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS S;;';;'f)( "4;).1 ffUdn
OWNER
DATE TIME
9-1;)-8--
fJ10acUuJ
PHONE NO.
CONTR.
PERMITNO.O/- 1~5";'- /;;).f,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
SifT
Or..
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(J j J'j? . I /
}! (U/-r; If'/
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector.
(UP
OwnerlConlr.
CALL 447.9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE_
Dm<DTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALm & SAFETYl