HomeMy WebLinkAboutBuilding Permit 01-0196
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I,White File
2. Pink City
3. Yellow Applicant
(Please '!'vpe or print and sim at bottom)
ADDRESS
/7~6a- '" ~, _::-r 0 ~/{/<!? ,~
LEGAL DESCRIPTION (office use only)
LOT/~LOCK / ADDITION ,. .-."..,.~ ~
OWNER
(Name)
(Address)
BUILDER
(Name)
.-?A ~~~~.
(Phone)
Date Rec' d
3-/-0/
0'OJ-O/1(P I
I ZON~/(officeuse) I
PID 2.5-372.- 0/'2...-0
(Phone)
~S7-~Z,' 7..-a.1:
.s"S7.:>;Z
(Address) .?..y~ ~ .a.rr ~ ~
TYPE OF WORK ~ New Construction ODeck
OLower Level Finish 0 Fireplace
o Misc.
~.";""",,,,,V
OPorch
OAddition
ORe-Roofmg
OAlteration
PROJECT COST /V ALUE (excluding land) $ 9~ ~ ?3!1
OUtility Connection
ORe-Siding
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 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 1".....1".... OJ to perform needed inspections.
x
~~~
v Signature
I R.eceiPtNO..-S c.t'~'1
By ~ ..-'
7/
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceM 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
7'~g:~ _~/~t;-(l91 ~~ ~fL\t:/'~:v~.-
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 (;,i)''O''-'''''' j,/~
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
~~' .,".~
(. di:'ffficial
'-...-.
$
$
$
$
$
$
$
$
cr~. i<:"
1..2~.ICJ
q t'J. <:;0 I
I
100. eo I
/11/,>. ~C) I
35-.5/':)1
l{t') . 00 I
Permit When Approved
kJp~ 2e>c/
Date '
-?-.:?Sl55"7
Contractor's License No.
'1~""",.ClO
I Park Support Fee
I SAC
I Water Meter SiZ~; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid
I Date
0(/(U.~-1
t:;" //r> / /') I
-.:;.... f ,
...< ~r-a/
Date
#
#
#
#
n.. Cntln' of 1M I..ab C....".
O(.OIQ(P
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
rJ. k.. HUcTC~1
---:S-I- CI
The Building, Engineering, and Planning Departments have reviewed the building pennit
application for construction activity which is proposed at:
'-7~~ I) E t-. 1< 1=-/ Ell) I) 1<::. . -S t:.-
Accepted
Accepted With Corrections ~
Denied
.-, Ii
(" --~~tHl. ~~ Date: _~/01~
Reviewed By:
Comments:
~ ffil9L'l ~_ ~ fly\/"_ I/~ /" 1....
(9t.Jev ~~ ~ c.~ ~)~
IQ~\~~ ~<~
\~U.I:\ .d- p~ ~ WrL)&~~J ~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a pennit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Pennits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid.' .
~~
DI.Olql,
Thlr Ct.lu or lhl" L.kl" COlin,,.,.
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. R.. BOR-ION
3-1-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/77 tOPJ DEE~ Dr<.. 5E
Accepted .X-.
Accepted With Corrections
Denied f
RevieWedBY:~--_~\
tf -
Date: 'g-G,-2f::.o1
Comments:
~..L
1'12 c..~
D.a..,. i=:..J.t
n~.
..h:;l,-
\I:lQ.o..C\ _
s...,.v__
l.J
~.
"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."
651 633 BBB4 ___ !ItE} IpE:SQ.ll!'LEL____ #0456 P.001/003
BEATING/AIR C..h~Al,....ONlNGIFIREPLACE PERMIT
'~~
,-.
IPIouo!"P' ~_ ...4.... "-"'1
ADORESS
/1;2C?K 'D~.1
LEGAL DBSCRIP170N (oIIhz _ nI)-) <
LOT/rsLOCI< f ADDmON 10 P.hlJu.uid? d-~
.: ( J
::~:. ~ I PIl.AL~"'~ ,_0. f-Iq b
&-.....1.. ~_ ~G (ank:tu.e)
R\
PwdS.3n-()f7J....-()
OWNBR.
(Name)
rn 1;> 1J..Ah.
(phone)
. (Add11:ss)
APPUCANT
(Na=1 ALLIED P'UlESmE DBA pTDllSIDE COIlIIIltR
(ph01'le) --Ml-"'11-~
(Address) 2700 N. FALA..>bN AVllRIW
(Mllenl
BlmNDA IIUl
(Contad: PetSon) I
APPLlCANT. SIGNAroRE, _ ,~ 6:t.'*'i5
~~F-V!T.T~Jl! MN
(Clly)
(phone) 651-633-2561
!'lATE
.5...., 1 ~
(Zip CDcIo)
APPLICANT PLEASE COMPLETE BELOW
~"'\J".....li~".u" t1REP/.A...e'~le..T 0 ALTERATlONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE UI'URM ,."..,1",,05 INPUT OUTI'UT
TYPE 01' ........w4 IlEAnNO OJt POWER PLANT
IJWtvIII Air ".... 8 s-.
Olin.fly JlG& w_
010( J .-" I B lladItWon
CJAlt C . ,. .~. : Ie Spooial Davl...
OVent. ~ OQll"rDovi.",
FIREPLACE MAKE AND MODEL ---.1li4L.J.Lhp. ~_{J-~~
PLEASE NOTE.:
Air Conditioner UIIits
Cannel ):. _ _... iIno
llequirccl Side YIIli
SelbllClcs
PIJls....~"I.;,JLE
Indu:Rrllll. Comm....jal ol Multl-flO'ftlly I%afiob'" Jlesjdenlial. G.. Flropla<:.
$39.50 ,-,',
Rosj~ntlal. Hoating .. AJC (New ConslIII~) S9UII Residential, Additlol\!l '" AllETlllons
Restdentio.l. HutlnlOnl)' (NewC. ".. _., .) S5oUO ResidlOlltial, AC Onty
539.50
539.50
$39.50
a..:. ,,,.,,. ~ CallI $
llUilcllng Pennit II
HEATlNG PERMIT FEE $
STATBSURCHARGE $
TOTAl. PERMIT liD S
lJu PA.I"
11.01 v 1t1.771
.50 'lVG fJ/2J{4t/7"
!Orr... v,. On",
I Thll ApplicatlDn IIcalma YDlIr BulhllIII Pamlr WIIaI Apprand . Pai.<1
-DDU.8-N-O!
I Receipt No. ^
..Hal", 0IIId0l
IIu
18>' jv
2A hoar ..... for alII, ." '" (952) 447-91150, 1.. ~) 447-4145
MAR. 13.2001 5:09PM
GENZ RYAN 6513226147
NO. 995
P.14
2.
3.
- 4.
"". ~,1 5.
6.
....11
.
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,...... . ~ICAII'I'
__, an
.
CITY 01' nIOR t.AD
SEWER AND WATD PDMI'l'
NOTE:
NO."'O' ~()I~(p
Sewer and Watar
. contractors must
be reqbtered
With the City.
APPLICANT:.(.l,,1f'\9. "lr.r\PIL.lWl'o'.~ u,n""'utl. PHONE:~-II~
_"~~"r ___llA,...~1
SIGNATURI: . A.. BLOG. PElUfI'I' . Ol-Olq~
.,.. .00....' -, " - ~ ~~'DI 25- ,"11. -(jl7,-o
FILL IN THE BLANKS
40'
1.
Est1mated lanqth ot water service
I 'f
si.. ot watar service inch(es).
reet.
Location of any couplinqs trom s~ructure teet.
Type of sawer pipe. ABS PVC~ e~st Iron
Estimate~ lenqth of sewer lin.~ feet.
Clean out (if requir.d), located at t.et from
structUre.
..'....".A
~p~.".. ....~'::;}~.':... :...~..'~.r.' pe;'it ~~e:.
'/f,'JP?1Ifl.' l J "~?;~~, i:c~_ __
r, . D~TE:
.,.",_:11.
This
BY
.
apPl:;"ov.d.
jVIAK l 6 1'.0'01
.........""",,, .
......... ...'
.. ,0" ""._____
PIES:
$
$
$
35.00
.50
35.50
Sawer and water line connection permit.
Surcharge
TOTAL
· Fe. for elth.r .awer or watel:;" in~ivi~ually is $ZO.OO plus
G .50 suroharqa. --
· Sewer and water permits issued tor n.w construction must be
recorded on the building permit card at the time of issuanoe
to insure that no duplicat. sewer and water permits are
issued. ~,
DATE PAID AMOUNT PAID _.'n'Jl\~""~J
, O\~\;) .
RECEIPT . REC'D BY "
. 4629 D.kobI Sl S.E., PrIor Lalur, M1nnaata 55372' I Ph. (612) 447-4230 I Fall (612) 447-4245
AI'lIQUIIL OPl'CllT\JNlTV !Io\1'Ul't'S\
,
CITY OF PRIOR LAKE
. PLUMSING PERMIT . 6/- n ,q c,,_
AIlPIillant: ~ .l""\? .-. ~ ~h-;_L~.:J:i,?"~-t 1!:f1L
Addr...: IU"1S ~~...- \lLJ '~~In..' ~
Sianatul1l: IA. ef - .- ,'.
I.IpI Deflcrlpllon: Lot I L Ilock_ I sub_~l'Y,A/~() /lA.r1
Slta AddI'tIu: ''''1' l"," <1'V" II' ~p 0 l'.. '~ <:.e:.
BuUdlng Parmlt' ~ PID ....,j-r:;. :";72 - 0 1'2. -0
NOTE: Thill permit ~U not be plIlcn.wd wI1hout oomp_lnformatlol'l.
....., JRB UNITS
MAR. 13. 2001 5: I1l9PM GENZ RYRN 6513226147
llN_.,.,LI!"l:Iloooo,
-~,
Quantfty Type at Fixture
I Bath Tub with or without ahower
I Dllhwahar
\ Floor Drain
Z. Lavatory (bathroom link)
, Laundry Tray (1 ar 2 ool\'lPlnm.nt sink)
, Shower StIli
\ 81nlel
-- Bar Sink
" ',"tf ') Water CIoIet (taRat)
I
Quantity
I
l(.ll
I
PlISCHEDULE
'. IndUltrlal, Camlllllllill . Multi-Family
(1% af job COlt, $se.5O minimum)
Allidentlld. New 0118 . Two Family
RIIldantIal, AcIcIitlana 6. AIta....tlana
Stete Surcharge
$88.50
$38.50
GRAND TOTAL
1'10.995 P.13
J..... PlIo
...- Or
'- y- .......
Type of Fhclulll
Flaugh-1M
Wllllr Heltllr
Water Softnar
Stand PIpe (wuhinG fMChlna)
Sewage ejector .
8IckIIoW ~ ..., ,. J (APz. DcdlIe ChIck, PVB)
Backflow Als.mbly TlIIt
Lawn Sprinkler
Other
s
s
S
$
.50
.. pft"O t~1rP.M\i
S ~U\\.O\~ .
",.. pcmIt II IJ'IIllH IIpDII Jbe OllPRII ODIIdIIIon lhal ..lei
oonlrllalof . .tiIc llIlIInI_
Q~1IJtI " ..~ 6 2001
^T'I'a8T
Call for all i.,. 'It ..,:;'111'11 24 haulS In adv~.
..C~'''l
:-....
16200 Ellie Creek Av. SJl., Prior Lake, Minnesota ~~3721 Ph. (612) 447~230 I FAX (612) 447~2~~
All Equal opponunicy ADlplllyer
,.-
,t::.~'~'
10 .- ra
,
...... I ...r rn.vn LAIU: Me
16200 Eagle CnIlIk Av. S-E. Permh No. (J / - tJ /q 0
Prior l.ake, MN 5.5372 .
1..0....
1.Y_
City
0dlw0D<
Single Family
TYPE OF STRUCTIJRE
\../" Two-FamiIy Mulli-FarriIy
HEATING APPLICATION! PERMIT
Date 3~fPJ 0 I PfD"r:B /' ~/]). - O/,;yO
StBAddrassl'7<ft.1.tJ8 '-j)....-.rOe.l(~L'h _ ..n..
l.DI (a~ I AdIfItion~...I.Ij1(/ Jfu~ InduslJla~Co...".,..;.J&Mutli-FaITiIy 1"'oljDbCllS\tS39,50minin1lm) ~
'"D tto ~l ) . Residenlial, Healirog & AC $99.51l PLEASE NOTE: ~
Own81's NaIIlll R. rtn n . Resiliential, Healing Only $64.51l Air Conditioner Units Cannl:
Address ~ W4ShlMtDn 1:1r' SW+e...~.D4 ~aAa_n j\W5'5'IU.F...,:~".;'..ll,I3asFnpIace S39.51l EncroachlntoRequiredSldf~
t.. I \ ' ~ ,U ~ .1_ ^ _' _ _ I c/ Residential. '. AddiIians &. Alterations $39.5C Yard Setbacks. . ~
Heating ContrIdOr ~ I4YlT 'V~L\J IlM UUU R . - .. ".. A,C Only .,.".. 5C .
......'....,,'JL-U," ~;t. ..
Ad.cIr_ ~.sb .tt..nn~ 'Dr Sui ~ J ~a.n ftW 2SJ},Z. .. .. . ~
TeIaptlone' .JJ51 J.J5Z.-J,115 RemembertDaddtheStaleSurctllllgeOnlheboUomolthis~r3 0
F\Iflll)Ce Iof8ke & Model ~:r TYPE OF .:Il~'gol ,. . " - The price llfyour:.~";:'_" p<lrmitincludes llI1Il ~ ;..d'oner..l~sp;ti-on.
i"^ Ah -n.: nz.'J Warm Air PIanIS
Madel Size ...LI&" INIJ DIM. "1 .. Gnr;Ity Addilional inspections will be billed at $35.00 each.
~ochani~ . House Healing Test RecoId must be IIlIbmitled with IllIiIIlimlI!lllIllI!lm!2lr before buid-
Air Conditioning I1>w-Ill1n.joo inll ce\1ii<:ale ol occupancy will be issued.
FluaSize '''/1.'' ....."c., Vlnt.8ysr.m ~ c
~ !::lE61:"..\I C:ULATlONS REQUIRED with number-of supply and rllhm1 openings rlSted per ~
HEATING OR POWEll PLANT room with CfM's per opening. New stru_ or addIIians sllfld fIDor plan with supply
Steam ancll8lUm loc:aJions shown. HEAT l.OSS CAl.CllLATIOHS, PA'fMENT AND
Hal Waler APPUCATlONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. '6200 EAGLE
Racliaticln CREEK AVE. S.E. PfllOfI LAKE. MN 55372. .
Special Oovicos
Commercial
IndusIJial
Pl4>Iic
Olh&'
..... ~hedule
Cllnn_ I..cad
Fuel )In.J..
Supply Op&ning$
R&lUrn Openings
InpUl
Output
CIty Hall business hours alll 8 a.m. - 4:30 p.m.
Edr.
C1m.
AU WORK MUST BE IHSPECTal(ROUGH-IN AND FINAl.) . CALL CITY HALL
","-9850
OIhlrDavices
TYPE OF WORK
I r.ereby apply for a mechanical systems permit and I acknowl&<lge that \he
infllrmation above Is complete and accurate; !bat tlIe work win be in conformance
with the ordinances and codes 01 the city and with Ihe state buBdingfmechanical
cooes; thai tr.is form does not become a permit lIntil signBCI by the BUILD ING
OFFICIAL; thaI the worl< will be in accordance with It1e approved plat1 in the
case of an wt>rI< which requires review and approveJ of plans.
~Mh
, Oale
t{-d.-}
Alterations
Repair
Replacement
Est Comp. Date
New Construction
~
Est. Cost $ . [000.00
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEES $
Building Permi ~
-441/'~~~r.-)
. 9ui1~ Offical's SlgnatlJre
Da,e
.50
PAID WITH
BUILDING PERMIT
c
Ree.ipl II
Pc _ FA>C 447- 4248"
,
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PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS !72t4P:J rn&>r-.('~d' OJ,
NATURE OF WORK k )~...~
USE OF BUILDING <~ A
PERMIT NO. QI-Q(C{rp DATE ISSUED .3-(o~~
CONTRACTOR .D.(l. thl-~ PHONE &5:1- 2c;t.,~ ?17.C.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~~PECTOR ~ATE
I FOOTING ~I I ~/'1/0/
I FOUNDATION (Prior to Backfill) t~ ~ M MOl I tk-.. (p ( ( z,lo I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING U .6-. '~i?V /::;" y/';;O/IJ
HEATING (if required5 d5:r. jJ~Oh)
FIREPLACE ~ ?ha/tJJ
GAS LINE AIR TEST r~ ~ {Sf, ~ 'i'/:roJ ~J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~
/f):n.
~
JY36(a /
1/5/6/
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
A Ja.-fcr-
-(~~
(O-}(~-n
to ;24/bl
I
~y IO-Pf..AV
--g \JfLWJ 10 /J4./ OJ
OCCUpy UNTIL ABOVE HAS ~EEN 'SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until ail inspections have been approved. On buildings and additions
where no service cabinet is available, card shall belltacetTnear main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
~V~-- - - ~
'.: ., :"~,,'."',,; ,~'.-Io! i'l'f'",. ,.,' . 'It; i"':.-:'~'''''-i:'''' "; _ ,.,' tho
(.....7 '~-" .".....'-.";"~'!S-,..(~tii!-~""~.JoilI..,...-(l": .1;
,&., .. .!'t~,. .I!l It, .11'. f;
r~..! QLertitlrau of (0cmpancy
Lll r OF PRIOR LAKE
Ilepartmtnt of .uilbinll Insptction
. Final Pennitted 0 Conditional C.O. Expires
.~. ,'.;.,~ -,
7his Certificate issued pursUQ1lt to the requiremelllS of Section 307 of the Uniform Building Code
certifying that at the tiJM of issUQ1Ice this structure was in compliance with the various ordi_us of the
City of Prior Lake regulating building construction or use. For the following:
Use CJusificatir,~
SINGLE FAMILY B1dl.PennilNo 01-0196
R3 . Type consUUc:lion VN Fire Zone N / A ZoninB District Rl
L12, Bl, DEERFIELD SECOND ADDITION
17268 DEERFIELD DRIVE SE
Occupancy Type
Lepl Description
Owner ofJluildi"ll~te Addr<ss
Contno:tor',NIlIIO&Addres' DR HORTON, 3459 WASHINGTON DR., SUITE 204,
M/ City Planner
EAGAN 55122
Date:
. ROBERT D. HUTCHINS
-"ll Official
/n- 3D.OL
DON RYE
Dale:
";';~'..,.t.,L,,~.,j>>~.', ....,:;;. ...i.~,
"""'...'" '.. .';~-
",' ...~
" ~
ADDRESS \I.).~g- o..~ r~'.dc\
OCCUPANT
HEAT LOSS
SOLD BY
Electrical Work By
TYPE OF HEAT
HOUSE
Or:
DATE HTG. INST._
HEATING TEST RECORD
JOB #
APT._FLOOR_CITY _
OWNER
SUBURB
INSTALLED BY
Ga. Line By
GA _ FA ~HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER_
GAS DESIGN
MAKF 6,..,o--~
Mod.1 ...38-~ 'LAv c::.\j~ 0"'1.
5'';01_ ,'2..C;3\~t-'3"1""\
INPUT ~.~~.....
CONTROLS
THERMOSTAT ~"'-<7_"'\ H.ot Plug
Valve _
Limit _
Limit Setting
Fan Setting.
Pilot Typ'"
Pi lot Make _
Pilot Model _
\'"}o.
Pilot Timing
L.W. Cut Off
Pressure "), S-
Input CFH
Stock Tomp. :3'-1:1"
Form 235
Percent CO2
Pereent O2
Percent CO
~_.;l.
c..::l.
.- ~-
.MAKE OF BURNER
Mod.1
Mox. STU Rating
MAKE OF FURNACE
Mocl.1
y~
Vent Siu'
KIND OF LINER
Draft Hood
Filte,. Sixe \Co",,-:l..(::).I'
Chimney Locotion I"sid__
Chimney Construction
Smoke Bomb
Draft
Door Pressure
CONVERSION
SIZE NONF
RegulaTor
.Numb.r
Out.id.
Wiring
Test Tar'
Lighting 'nst.
Dat. T e.t...1
Company Tuting
Name of Test.r
I O-IC, _ 0\
Alliant Mechanical, 3650 Kennebec Dr., Eagan, MN 55122
\tc.: ~ .s.
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
I ?~tf"
hl.J/. Vl/AA
SCHEDULED ~ p. U(J
~QJ &t,
p
CONTR.
OWNER
PHONE NO.
PERMIT NO.
~/- /9h
o FOOTING
o FOUNDATION
o FRAMING
^- 0 INSULATION
n JII FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH Rl
o WATER HOOKUP
1>- 0 SEWER HOOKUP
TJL 1lt PLUMBING FINAL
rJ ~ MECH FINAL
COMMENTS: ~a ,
'1'
.'bu 10 Dt'if;:;}
. ",.Jl,r. -lr."" I r- d"ne/ Of IAA"-'" l-
o EXlGRADIFILLING
o COMPLAINT
^_ 0 FIREPLACE RI
IT IE FIREPLACE FINAL
o GASLINE AIR TST
o
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: 't), \ fJ 1 JIJ I OWner/Contr.
CALL~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
1N$NO"
;
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.,
/'
../
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DATE nMI!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10-1/-6/
ff11
ADDRESS / 7 :?~:l -~ R f)~.eJr:;f-1I Dr.
OWNER CONTR. DR- H{)r-/"~
PHONE NO. PERMIT NO. () /-1C,3
[J FOOTING
[J FOUNDATION
[J FRAMING
[J INSULATION
csi.f!NAL
[J SITE INSPECTION
xl EXlGRADlFILLING
[J COMPLAINT
[J FIREPLACE Rl
[J FIREPLACE FINAL
[J GASUNE AIR TST
[J
[J PLUMBING RI
[J MECH Rl
[J WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
COMMENTS:
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[J CORRECT ACTION AND PROCEED
[J CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~/A.:.....--J'" . C .'::- Owner/Contr:
CALL "7-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ff_1.
ADDRESS /72(PZ - ~:€ }~ez.,o .LJL.
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNOA TlON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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;f! WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ {O -10-c:>2..Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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