HomeMy WebLinkAboutBuilding Permit 01-0195
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~ or urint and sign at bottom)
ADDRESS
/7~6 .o~,c~ vOJf/VE ~
Date Rec' d
3-/-0/
I. White File
2. Pink City
3, Yellow Applicant
0'0/-0/'151
LEGAL DESCRIPTION (office use only)
LOT /? BLOCK / ADDITION ~-S."..~ ~
OWNER
(Name)
(Address)
I ZON;ttffioeuse)
PID :U5-'572- 011-0
(Phone)
BillLDER
(Name) V?..e. ~~~
(Address) .j-Y!SY a..--JfllSI.v~ ~ ~.;zo.y"
TYPE OF WORK
~New Construction
o Fireplace
ODeck
o Misc.
OLower Level Finish
(Phone)
~.s-/-e:R~ -7......3.6
__;i'JJ.ltt;l."....
OPorch
ORe.Roofing
-=s$"7...< ~
ORe.Siding
OUtility Connection
PROJECT COST/VALUE (exc1udingland) $,/~ e;;l75-
=<~~S7
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other s:...tJ R.../1A."1~
I TOTAL DUE
I Paid
I Date
~ OlD, (0"'1
{::;-K-oI'
,
OAddition
OAlteration
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 }',uy...nJ' 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.
L7. ~.Xz ~
x
,
Signature
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
11 q~ . 7~ I
~lJC:-. "lei I
56. 00 I
I
I
$
$
$
$
$
$
$
1fY').on
I IX) . t90
35'.50
t.(() .()iJ
~. ati n G_-_.7'Your Building Permit When Approved
~ 3-(,-z.-1
B ilding 9'f[Clal Date
#
#
#
#
~-~-<7/
Date
$ B SCl . c:c:1
$ '1'5'0.0").
$ L 25. on.
$ qt:;.~O
$ L '2 I'm .t!:0
$ . ~D".OZ> I
$ ~d>
$ -<"> .S" tJ I
$ (Q,070.ft,Q I
I ReceiptNo3'fc;g<-(
By ff0
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
I :~i~ bnn~cmutiMes::rUYc~;;;oemd~_;o~ :cr;;:r;;;:ffi;:must~
Planning irector Date ecia onditions, if any _ __
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ~f) ~~
,
OI,W-t(
TIle C....ter ., .... lAk.. C__ky
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
n.l2. H(I<TC~I
? _1_ /"./
''____-' L..I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
tJ~ I)E t-:- 1--:-1=/ EI I) 1)1<.. S t:...
Accepted
Accepted With Corrections t./'
Denied
Reviewed By:
/' --)- IL
c. ....7~{}(J. =-'--~ Date: _~/t&~1
Comments:
~M"'~ ~ gvL9L"'tc.J.<'aD ~ f?vv./rY!rL.
_A1}w-~ ~ a,~L~~A~)~
~~~ qo~ ~",JL
. \~U.I:\ ~ p~ ~ ~...rQ~J1 h~~
"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."
.
DI.otQS
Th~ CrnlPr .,f ChI!' L.ke C.....nlr)'
White - Building
Canary - Engineering
Pink - Planning
B.U.LLDING Pf;RMIT APPLICATION DEeARTM~NT CHECKLIST
NAME OF APPLICANT
D. ,e. - Ho R-TON
3-1-01
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/7? VJ~ f)EEr2..~IEU} Dre ,sE:
Accepted -.L
Accepted With Corrections
Denied (J {i( ..4
Reviewed BY\:jJ('~i;%7
Comments:
Date: S-c:'-'2at:!:> I
/. ~ n~ Gl'J
.
D.:>...rC--e1J... Or. C~ GXa..'_~ ,.Su~(J etr ~
"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."
MAR. 13.2001 5:10PM
GENZ RYAN 6513226147
NO. 995
P.16
~!' ....
'-'__IIT
... . .,9
..
CITY OF PRIOR wa: HO..OJ-Oltt6
SftER AND WA'rIR PDMl'r
HOTE: Sewer and Water
. contractor. must
be l'eqlltered
w1th the city.
APPLICANT: J2.l:"'o - ~n Ph... _101 ~-- u"o,-n.ut2. PHONE: ~ - ~2:!I- r I ~LJ
ADDRESS: .. "'"",,-DATE: ~ r:",'I\^'
SIGNATURE: \ I ^- BLDG. PERXJ:T 'OI-DI.95
SITE AODRIl!SS: ..~r"'l~PID' ;;>.C::;~31~-Oll- n
FILL IN THE BtANXS
1. Estimated lenqth of water service 40' feet.
2. Si.e of water service , \1 incbee.) , .
:l. Location of any couplinq. from .~ctur. feet,
~ 4. Type of sewer plpe. ASS pvcY Ca.t Iron
~'.' , .\
.....iI S. Estimated lenqth of .ewer lin~~' feet.
15. Clean out (if required) , located at feet from
structure.
.
This ap
BY
~#~zJ''''e
/!"~ ,~"" 'r1VfY,H .
/ .. 'I. .
',..1.' " "".' , '.'0""'''.'"' .. ' ','
~,,,,. . , If' 'r'
o ~r permit when apl!t~v.d.. .
?"', -0,/,""'" ,.
/'. D~'rJ::.. MAR il..2llD1
=-=--=.---
".,..",...",..".....
, ..".
FEES:
$
$
$
35.00
.50
:5:1.50
Sewer and water l1ne connection permit.
Surcbarqe
'1'O'1'AL
,',''''1,\
. I
.... ,..;
.;
Fee for either .ewer 2E water individually i. $20.00 plus
$ .50 surcharge. .
* Sewer and water permit. issued tor new .construction mu.t be
recorded on the bUildiny permit card at the time of issuance
to insure that no dupl cate .ewer and water permits are
issued. './11'1"\-\ l\
DATE PAID AMOtJN'1' PAID" ~~~~ \'~\'..~~
~u,...".
REC'O BY
REClUPT t
. 4629 Dakota SL s.E., PJ10r LaM, Mlnnuota 55372 I Ph. (612)4474230 I Fax (612) 447-4245
~ IClUAL OI'PlllmJNlrV IMP\DYIR
MRR.13.2001 5:10PM GENZ RYRN 6513226147
NO.99S P.15
,
-CITY OF PRIOR LAKE
,PLUMBING PERM"
I. ... ....
L CIoN" aq. r
s,y_'~'
t# nl~
Applicant: "hone:.i~-l.lT""" -IIU<J
Addrell:, \u,",\~c....;' ~ r.."D.IIII"'" ~ I rl"trc.I J~ I...If'<r' ~,,~
Si;natura: \1. ~ 0
Legal D ,. I,.lan: Lol \ l, Block I Sub \"'yo? r\j1P D,..., /1"IrJ
Site Add,...: 1""1"'1.1 ol,p ~ ~,,~ i""I ~. c..F
BuildinG Permit' fll.::.D.J.!1.. PID . 7. e::;. "~,I? ,- 0 IJ:..Q
NOTE: Thll permit ~I not be pracellled without complete In '. .,"".. ~n.
""I,, . I JAE UNITS
"" c......, 11M ~ QIHtt.,
.,
Quantity , Type crt Fbltura
I Bath Tub WIth or without shower
\ Cllhw.,her
\ Floor Dl'lIin
? Lavatory ~thraom ,Ink)
, Laundry Tray (1 or 2 compartment link)
I Showlr Stall
I Slnlc8
~ Bar Sink
i' ,'" 2- Waler CIoIe1 (toilet)
/'
Quantity
I
If,..\ ,
\
FH SCHEDULE
~ IndualriaJ, Col'l1ll1lrcial & Multi.Famlly
(1 % of job col1. m.so minimum)
Residential, New One & Two Family
Residen1lal, Additions & Alteralione
. State 8urch.roe
$88.50
$38.50
Type of Filllura
RCUllh.lnl
Water Huter
Waler Sellner
Stand Pipe (waIhinll mactlllll)
Sewalle Ejec:tClr '
BackIIow Aulmbly (RPz, Colm/e ChKk, PIIB)
Beclcflcw AIIIfIlbIy TeIt
Lawn SprlnlcJer
Other
s
$
$
.
.50
PAID WITH
BUILDING p~RMIT
GRAND TOTAL S
" .
, ,-'
16200 Eagle CreekAv. S.B., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
All Squat Oppcmulllt)' Smploy.r '
651 633 8884 ___F]R~S.~DE CORNER #0456 P.003/003
HEATING/AIR CONDmONlNGIFIREPLACE PERMIT
;Ci~
: ~ S..1 PE.!..iAU NO. 1- J1l'l
ZONING 1_"""
R\
IP\oolw:!'I2! cr _,..." 11m "_,
ADDRESS
/7;)U, D~~/..Q~, .R?
LEGAL DESuw: uON (.IIia:......."
LOT 1/1 BLOCK r Au..,uoON
drJd
OWNER
CNa=)
(Addm;sl
'!;?R. Um
(P/JmIe)
APPUCANT
(Namel AI.I.I.ED FIRESIIIE tIIlI\. ~"""""......g ~...._
PJDd)-31d~()/J-O
0?b0D~ 651-633-2~1
(Address)..1.Z90 N _ FAJlN7EW A...., .,;
~
(C ctP ) SJilENDA ..~"'.....
on~ e~D .
APPUCANT SIGNATURE ~
, ..".._,, --
~"I'TT"', .......
(cay)
651-633-2561
"'..n.~
(7Jp CDde)
(Pbcme)
DAT!
APPLICANT l'LEASE COMPLETE BELOW
~",,,,,,,,,,,,UCTJON OREPLAC8MENT o ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OpENINGS INPUT OUll'UT
TYPEOF"'....~ HEATING OR POWER. PlANT
JW...... Ai, PI..... J Slc8m
:JOl'IVflY J Hat W_
J MoclllUllcal J RldiMion
JAir COlIdhltlBinI J Spocllll o..i_
JVcnt. SYSl... J 0IIl0r IlcYICIlIS
. FIREPLACE MAKE AND MODEL .i.ls._~ JJ c,r.. ~ c... "7roIX-
FEE SCIlJtDVLE
Indu$1l'loJ. CommomoJ & Mulli-FIIIIlIl)' l'llo of'job <OSI ll.oldendlll. OtIs PI"",,_
S39.5D lIIinhnum
ResldeTltial, Heat!lII11 Ale (Nell' C. ......:,.; SW.5D JCajdalt.... MdIIIons.. ~
RcsldOlldal, Hcattnl Only (New C, _~.., ... _ SKJO JCajdClldol, M: Ont)-
E$timllllll Cast S
Buiklillll Permit #
HEATING PERMIT FEE
STA'FE SUKCHARGB
1UI'ALnRMlT FD:
$
$
$_
,so
10m.. tI.. Onl7J
TIll. AppllutioR Becomes Your Illrildillg Pennlt ""101I AppJ'llWd - "-id
BaNdI.. OIIId.,
-Dtdll rJ---- J3 -(j}
boll
3A _1IOIia fin' oIll., .' .,. l'5lIl .7-~. fa (9!%) 447..0145
. PLJWD: NOTE:
A/J' COIIlIilioner UIIitlo
CImIOl Eacraec/l iBID
R.qulnd Side Y....
Selhclcs
$39.50
539.50
53'.50
/'
~u. ,()
'/(o.':<10
~Q tt,i')::
;C)~ It
. J1-~No. ~~)-
By or ./
/, ~
(/
.'-
vI J T Vf" ....ruUH LAKE Me /"
16200 Eagle Creek Av. s.e. PermH No. 0/- D I q ::J
Prior l.ake, MN 5,5372
TYPE OF STRUCruRE,
2..__
;,y.u...
City
'-'-~'-
,'t-.. ~1
IU rn
, , HEAnNG APPLICATION I PERMIT
Dale 3l:?,8lol PIHI:TS - 3;I)J-OII-O
SiteAddress 11o.Vk l>p...r~lJ Or. _
Lot JLBlock I Addition 0 Og)\trQQc9 ..vA.P)t\d/
Own81's Name "'D 12. t-\-ortDn
Adclr_ ~ WdSh.MtDn ~ SWtt..- U)Ll. ~(.lAa.n
Heating Con!rldOr N \ ~ 'M.e1:.ho..n. W c.J
Addr_ 3{,51) kmntbu- 'Dr-- Suiff./ ~a.n NJJ.5JJ2.
....
Telepnoll8' -1.15 J LJ52 - 2,115
F~ lWll<o & Model ,y, n.ltu:l.::t"
oJ
Mode'Size .J.N), IJM 'Bi1A qz. ./.
Conn. load
FU8I '/JiLl-
Ale SIz8 J.'/t.ll -o\lc.
Supply Clpllnings
ReMn Openings
Inplll
Edr.
C1m.
0UlplIl
,
.
,
.
.
.
Single Family
Commercial
l../'"" l'No-Family
lr1duslrial
..
c
~
MuIti-FarrIly _
Other
P~
Fee Schedule
l-
I-
.
c
1%'01 job CDSI (S39.50 mioirrum)
S99.5O PLEASE NOTE: ~
S64.5O Air Conditioner Units Canm:
$39.50 ~Jt1t9 Required Side;
$39.& 'iaM-Seth. ac1cs. ·
II' U -
$39.& ,. . ~
:(1 MM30200l ~
.,' I
R8R1ember to add the Slale Sun:hmge on \he bottom oIINiS! '8fJIPIication, >
~ I.....,...__._._........_.oc./
- The price of your healing penni! includes one ~h-in ;...;i_fine! 'nspectiDll.--_n__J
AddiIiona/ inspediDl1S will be biUed at $35.00 each,
House Healing TBSl Reco,.; must be BUbmftted with bi.JillillII R.mlil1!l.ll!l2lr belofe build-
ing certiIcaIB of occ:upancy will be ieau8d.
c
1:lEAI ~I ATlON~ REQUIRED wilh msmber oi supply and return openings fISted per .,
room with CFU's per operjng. New slruclures or llllcIIIions send IIoor plan wlIh supply
and return Io<:aliD<Is shown. HEAT LOSS CAl.CULATlONS. PAYMENT AJlD
APPl.ICATIONS MAY BE MAll.ED TO THE CITY OF PRIOR LAKE. 16200 EAGLE
CREEK AVE, S,E, P~R LAKE. MN 5537~ '
Industrial. CoIlU'lleftial & MulIi-Family
Residential, Huting & AC
Aasilianlial. Heating Only
1\AtJ5S'I1.Z.R,,;:.. ;,.}!, Gas FlI'epIaI:e
RasidenIiaI, Addlions &. A1lerallons
ResidenIial. AC Only
TYPE OF SYSTEM
Warm Air PIanls
GralIily
Mechanical
Air Conditioning ~411""
Vent. SysIem
HEATING OR POWEll PLANT
St&am
HoIWaler
Radiation
Spacial Devices
Other Oevioes
Alteralions
TYPE OF WORK
New Construction
..v
Aeplacemart
Est. Cornp. Date
Repair
Est- Cost $
1000.0D
BUdding Panni! g
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
.50
~
RaceiJI /I
PAID WITH
BUILDING i-c,-""rr
~
~
~
~
Clly Hall business hoUR! ere 8 a.m" 4:30 p.m.
ALL WORK MUST BE INSPETED (ROUGH-IN AND ~l) . CALL CITY HAlL
441~
.,
"
~
c
"
r-
>
6.
I hereby apply for a mechanical systems permil and I acknowledge Ihat the
inlormalioo above is complete and accurale; lhalthe work wiD be in conformance
wilh the ordinances and codes of the city and with the slale buHdingfmechanical
codes; Ihallhis form does not become a permit until signed by the BUILDING
OFACIAL; thallhe work will be in accordance with !he approved plen in the
case of an work which requires review and approval of plans,
A.J J 1.1 II ...J..llMAth M.QA_J~)
~~GK:ure
Bui1din9 ~'s Signature .
~I
, Dare
If;- a - I
Date
I!i
c::
c::
..
PL. ~A;;>! 447- 4248'
P R I 0 R LA KE DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS P7.:1fou> '1>eerr~e\& :Dr-.
NATURE OF WORK lJe.w
USE OF BUILDING S. F"J4..
PERMIT NO. _ Q1.=...O.1E ~ DATE ISSUED 3 - C, - 20::::.1
CONTRACTOR ~,.,_'_...A PHONE ~S"1-2S7_ -?L2~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
IN~CT. OR
, FOOTING ~ I ,,/1(/1;1
, FOUNDATION (Prior to Backfill)iM.a::..J ~ ft;( V? 't fJ( I ~, - u ( (?..It:J1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL _
PLUMBING U.&, t,,1c1-llgy " t:4- Fj3tJ/OJ
HEATING (if required) fA. , V'4>".Io/
FIREPLACE Ch. 7'4 /a I
GAS LINE AIR TEST lM-~ hf. 4-, 1~ /d.l
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
,( rJ;;;
~. jtJ/'?"~1
I .
~
'1IG Ill)
Cj/rt!O(
GRADING (Prior to Sodding)
BUILDlNGI.c.f). 1:A.AA rt 11M..
ELECTRICAL ' I
PLUMBING
HEATING
DO NOT
/o-n-o }
J ,
f? !::} /(. lo~~.J
I3r /tJ/~'f /"1
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
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
;;j>V'Y~"1tY.-:"'~ .... ,.
; A'" . .& ,~.~". '"' ",j'.'1o; ...,.' '" ,,.-,. "II! ',* t -'Ill' .,.p.., ."'- I .
'''.7<'1 ".....' ~~";'il'~"""'I"("''If''~.~'' :''';-/'
'",.. "\!llt."~Pl.'\". ~:If.", ,./.. ~......r.."".JI..",,
(,",
(c - t
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(c'";. I
(~I'
(.f
( ,.J'<
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lfr'
(;i
1,*.,
.;~
'-
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I~ .
;~
it1....~.'
(i.;~
(J":
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(~.
l.._
(...~
err,
(''!'
......
~trtiftrat! at (Jrrupanry
ell i OF PRIOR LAKE
Department of .uUlIing Jn~ptttion
. Final Permitted 0 Conditional C.O. Expires
'This Certificate issued purslUllll to the requirements of Section 307 of the Uniform Building Code
certifying tiuJl at the time of isslUUlce this structure was in complimu:e with the various ordi1lO1lCes of the
City of Prior Lake regulating building construction or use. For the following:
Use C1usificatior
SINGLE FAMILY
BId., Permit Nn
01-0195
Occuponcy Type
R3
Type Construction VN . Fi1'O Zone N / A
B1, DEERFIELD SECOND, APl}I.TrrON
U'~~.-
Zonina District R1
Lep! Description
L11,
Owner of BuiIdi"l
C, ,',,' '.Name",Addrest>R HORTON, 3459
ROBERT D. HUTCHINS M'
IO'~Orial
,
'ite Aildress 17266 DEERFIELD DRIVE SE
WASHINGTON DR., SUITE 204, EAGAN 55122
o.te:
~ity Planner
o.te:
DON RYE
POST IN A CONSPICUOUS PLACE
, .'-..
If
.
.11..... 'C.'"hd".j..,i,,',l_,.._',I<.''''
"'" '/., .,.....:.
ADDRESS r7;lc;.t, O"'-~"ucl
OCCUPANT
HEAT LOSS
SOLD BY ,
Electrical Work By
TYPE OF HEA T
DA TE HTG. INST.
HOUSE
0.....
HEATING TEST RECORD
JOB #
APT._FLOOR_CITY
OWNER
SUBURB
INSTALLED BY
Gas Line By _
GA_FAA...HW _STEAM_SPACE HTR, _UNITHTR. _OTHEP
MAKf
Mod. I
Serial
INPUT
GAS DESIGN
nr...~'\..
"). r.... Il ),."1 Cl4~q I
')~ '.....,.rl.l.,,\.f
<ir1i'. ,,",00
CONTROLS
THERMOSTAT ."'......,~\ H..t Plug ,
Valve
limit
limit Setting
Fan Setlin'"
PU.t Typ. ~ E
Pilot Make
Pilot Model
Pilot Timing
L, W, Cut Off
").S-
Input CFH
Stack Temp,
Farm 235
'3~g
Percent CO2
Percent 0,
--0-
Percent CO
~.~
'.J
Pressur..'
MAKE OF BURNEP
Mod.1
Mox. BTU Rating
MAKE OF FURNACF
Model
Vent Siz-
Y.
KINO OF LINER
Orah Hood
Filter. Siu \co.... ':l.~,c.. \
Chimney Location
Chimney Construction
Insid.
Smoke 80mb _
Draft
Door Pressure
Oat. T..t.d. (0-\... - <::>\
Company Testing
Nome of Tester
CONVERSION
SIZ~
_ ReguloTor .
Number _ ,
Outside
NON~
Wiring
Test Tag
lighting Inst.
Alliant Mechanical, 3650 Kennebec Dr., Eagan, MN 55122
lC.L~ ~ "'"
DATE TIME
SCHEDULED /~ 0-' tJ 0
~E4'
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/ 7;;J- ~ ("
OWNER
PHONE NO.
PERMIT NO.
tJl -/9 s;-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION~ 0 SEWER HOOKUP
~FINAL ~ ~ 0 PLUMBING FINAL
o SITE INSPECTION ~J& MECH FINAL
COMMENTS: 7) IdA .
~rf:;L :~A--~1JJ~
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~~,
" ..-...,1,';1/0 i!-
._'f1!IJJ.!1T~
71 ~, tJ,
.d:/~:'
.'
~~
o WORK SATISFACTORY. PROCEED
)t CORRECT ACTION AND PROCEED
o CORRECT WOlJ' CALL FOR REINSPECTION BEFORE COVERING
Inspector: d~ ( Owner/Contr:
.I
CALL ...7-8850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
\
\
\
/
,-~. .
/"
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATI! TIlle
10-0'6/ f/l1
SCHEDULED
ADDRESS / 7 ~~1 -{~ R 1J~,(J.(;'dJ Dr.
OWNER CONTR. D R _ HtJ(!" "'-
PHONE NO. PERMIT NO. (') /-lq3
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
CIi(flNAL
[J SITE INSPECTION
:11f EXIGRADlFILLING
[J COMPLAINT
[J FIREPLACE RI
[J FIREPLACE FINAL
[J GASLINE AIR TST
[J
[J PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
COMMENTS:
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~(LI/r. ~
inD'If - -f')t.
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11117 Sf-I
~WORKSATlSFACTORY.PROCEED
[J CORRECT ACTION AND PROCEED
[J CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
4'7..... (- '. Ow
Inspector: '7/o..._..........--_____".::.. ner/Contr.
CALL "7-9880 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
,/
---
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DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE @CHEDUL.E.D
ADDRESS /72(;2 Z(,f) Pec.e,A/n-O
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
COMMENTS:
SOD /7X-e6
I
C-AO:){:'
11 .:r.
.LJL.
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
D FIREPLACE FINAL
o GASLINE AIR TST
f;)'
~
f-iu
"1! WORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector: Iff> (0 ~10-o.2..Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOfJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
.
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