HomeMy WebLinkAboutBuilding Permit 01-0243
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Z-7-0/
(Please tvD~ or orint and silUl at bottom)
ADDRESS
,/?,.:?6p .o~H'~ ~/;'~
; ';i~i:' ~::y I PERMIT NO. (J.I/- O~ A 'Z I
J. Yellow Applicant I /- ~
~
I I
ZONING (officeu",)
K./
LEGAL DESCRIPTION (office use only)
7 ,/
LOT BLOCK ADDITION 1O~.A"'&-~
OWNER
(Name)
(Address)
BUILDER
(Name)
d?"J:.,o
PID 25-372.- t)07-0
(Phone)
,657-.;<G;D- :;>-/:3-6
.A~'~l:l!:';aV 657'.;::t;;?
.a 4'" ~ m-'V ~. (Phone)
~69 ~~ ~ ~ <:>?o-Y
(Address)
TYPE OF WORK
~ New Construction
o Fireplace
ODeck
o Misc.
OLower Level Finish
OPorch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
OUtility Connection
PROJECT COST/VALUE (exc1udingland) $ ~~ t5~6-
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 J"'....y"'a)' 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'
Signature
~~
x
1 Permit Fee
1 Plan Check Fee
1 State Surcharge
1 Penalty
1 Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
1 Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
qs~ .7s
(0.:23. 1 c:;
4tr.Q1
\lXl.<90
(M.CJO
~5'. sO
~O.06
~7YOmBuildin~:t;-:;:;d
Buildingjlfficial Date
~~~S7
Contractor's License No.
-it. -~ -0 /
Date
(!:>~ 000.0:;"
1 Park Support Fee
1 SAC
I Water Meter
I Pressure Reducer
1 Sewer/Water Connection Fee
1 Water Tower Fee
1 Builder's Deposit
1 Other S.!-lAJ
I TOTALDUE
#
#
8'50. () 0
1150.0 "
S~';l";
#
#
1
1
3.5'.501
$~,olo.'1-1
I
I
~e..IV\~
I Paid
I Date
,~/')/o. 4-tt-
1.'f~(J!
I Receip,*,::1,. 13 b
By /?If7"="
j
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
:~'Kty Plm=,mporary cmifiCa;Oj;: 7;ce md allows consttuenon 10 conun",,, B,fore occupmcy, a Cmilica" of Occupmcy must b,
f~g Director Date SpecIal Conditions, ifany _ /
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ~
Thlr Clrllllrr of tlllr Lalklr Counll)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. f2-. t-4()1<-TnrJ
Z-j-()I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
D..2S(f) DEE:erISLY) DR- se:-
rf...-.
Accepted
Accepted With Corrections
Denied
Reviewed By:
Comments:
~6
Su t'1",'~ r:: Ir
Date: 3-'jtJ.'Q/
"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."
"
White - Building
Canary - Engineering
Pink - Planning
The C..nl..r of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. g. 1-40kT(;,J
2-1- C I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
1,2S{() DEE'k-rlE-Lt) DR- ~E:
r/'
Accepted With Corrections
Accepted
Denied /"\
Reviewed BY~ - i
~
Date:
2/~M
comm~ovdl . C?"
~~,~~.j.
2-vJ v~.
C'Jr1j)tY;~<"
.~f-~ ~M
"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."
T"~ C~nC~' of th~ Lab COUlltry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. g.. I-tOr<..TnrJ
2-,-0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
025iLJ D5~g;16Lf) DR- <S~
<:
Accepted With Corrections
Accepted
Denied
j
Date: ;;2 - 1'3 - 'bJo (
Reviewed By:
Comments:
S,,_ If)'252 ~~j;.Q,{& "'i"AI\}.o ~~~'5' e:tc
"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 12:39PM GENZ RYAN 6513226147,
NO. 773 P.21
,
.~ CITY OF PRIOR LAKE :=- =-
"a'~ ,PLUMBINGPERMrr 41 Ol.~
,..-'-
, "'~ , ' Appl~ 8u/Z.- J"..!:! W"1 !"hone: ~n~/-Ll'Z:3 -/11..14
. , . Add,.... ~~- ~- '- ~-r- -rYJ,j. - ~ VY"'VOrot .1J"lT- -,; , ~ "
ne,E.......,'...l4IIiee.u...... ....., , ...,... a \" -t. ~p ~-- __ _ _ ___ ....,I;..'~
. " .', SIgnature: '_
- . . L..gal C.eCl!pllon: Lot ., ~Iock I $ub~ '2.-\(,)
SlteAdclre..: r7z.~" ~~J1h.... "', c..f;..
Building PermlU !"IC .....z.s -31:2..- 001- 0
NOTE: T~ permit w,l1l not be prac:...d without r:omplel8 I ' lion.
FIXTURE UNITS
Quentity
I
\
\
2-
i'.'j 7-
" -',
, "
:......1
','
Type of Fixture
Bath Tub with or wtthout .hower
Dilhwuher
Floor Drain
Lawtory (bathroom sink)
Laundry Tray (1 or 2 compartment aink)
Shower Stall
S1nka
Bar Sink
Water Cion! (toilet)
, Quantity
Type of Fixture
Rougll-ine
Water Heatar
Water SofIner
Stand Pipe (watling mar:hlne)
Sewage Ejector,
BacIcIJow "NImblY (FIPz. Double CMck, PVB)
Baekllow Ass.mbly Tell
Lawn Sprinkler
Other
$
$
$
$
.50
( r~:~-rf\MI1
~~.~' ,
I
/2../1
,
lie SCHEDULE
~ Induetrtal. COmm.l'Cliel & Multi-Family
(1% of job r:oet, $311.50 minimum)
R.eldenllal, New On. & Two Family
R..lclentlal, AdQltlone & Alta,.tIonl
State Surr:hal'lle
$98.60
$39.50
$
~RANOTOTAL
Thi. pomdtllll1lltcd IIpOIItho np.... OlIlIdldoft that .lid
_lIlr. .haIl colllply 1ft Iil retpeOlS with tile d..._.
of.... s.... PlullIblq CDdo IIICI tha ~lIIOIItIlh""".
~ RBCBI!'!' N~~- ~ - D{DATB
I ..u..:.,....--- ATI'EST
Call for 1111 inspections Moun in advance.
16200 5.,le Ctllek Av. S.E.. PrlDr Lake, MinnesDta 553721 Ph. (612) 447-4230 1 FAX (612) 447-4245
AA Equal Oppol'llllllty Ilmpllly.r
FEB. 15.2B01 12:38PM
GENZ RYAN 6513226147
NO. 773
P.1S
_. ....
'I'Ia&OIIr......._
-'.CII"
CITY OF PlUOI. LAD
SEWER AND WATER ':"'A.._.
NOTE:
No.O/-0Z43
Sever and Water
. contractor. must
be reqisteZ'e4
with the city.
APPLICANT:~"''''- ~L..l....nl~"'- UrnrloUtl" PHon: '-~-4'2:!!.-11~
ADDRESS: 14$~~~ '~-."'r S"C"~... DATI:
SIGNATURE: 0_. BI.CG. PERMIT'
SIT! ADD...., 11'.<> _ - ....9>.0,., 'V<- sf:-- "Df 75 -"572. -007 -0
FILL IN THE BLANKS
40'
1.
Estimated lenqth ot water .ervice
,.r
Slze ot vater service inch(e.).
te.t.
2.
-
3. Location ot any couplinqs from s~ructuZ'. teet.
4 . Type ot .ewer pipe. ABS PVC )( cast. Iron .
5. Estimated length of sever lin.~' feet.
6. Cl.an out (it required), located at teet
struct.ure.
trom
\ ~ ,;, .;
---.
--~..._-
This application becomes youZ' permit when approved.
BY
DltTE:
=
IIIIL..._ _,_"__'_'_.,~",
--
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharqe
TOTAL
· Fe. for either sever or water individually is $20.00 plus
S .50 surcharqe.
....
Sewer and water permit.s issued tor new construction must. be
recorded on the buildini permit card at the t.ime of issuance
to insure that no dup11cate sewer and water permits are
issued.
DATE PAIC
RECEIPl' j/
LI~ fo-O I
\f'I\~'" ~ .~~
AMOUNT PAID - ,t~ e f~\'"
REC'O BY '~\\J>\~ ~
.....,.
, 4629 Dakota St. 5.E, Prior Laka, Mlnnaotll 55372' I Ph. (612) 447-4230 I Fill (612) 447.4245
AN BQUAL. ..... .....,JNr'T'Y DiPlDYIR
FIRESIDE CORNER
#6543 P.002l005
Date R,ec:'d
I.....
,.-
3. y"'.....
~_ I PERMIT NO. 1 - d tj3 I
(P'.""'~Ot_...dJl...",_)
ADDRESS
/7d~"
J)~, ':1. ~
~ctdd
J
ZONING (_Ole)
f2( sO
LEGAL DESCRIPTION (0_ _ ""'Yl
T.OT () BLOCK ~ ADDmON
PID ds ~ ~ 7d-. -oOl-()
OWNER <'J"\~ '1/_
(Name) '.!.IL.~
(Phone)
(Addn:ss)
APPUCANT
(Namel ALLIED FIRESIDE Cl!A FIRESIDE CORNER
(Phone) 651-633-2561
(Addn:s.) 2700 N. I!'AIRVIEW AVEN[!~ 1>(l$F.VTT.T.1> """
(AllI:l.....) (CI~)
(Contact Person) BRF.NDA llUSTON_. (phone) 651-633-2561
APPLICANT SIGNATURE ~~- DATE j~
APPLICANT PLEASE COMPLETE BELOW
I2NBW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HF.ATING OR POWER. PLANT
~WIllD Ai, Pllllllll
JGnvill'
J Me&:hlUllcal .
:JAr. Conditioning
JVo.1. S)'stem
FIREPLACE MAKE AND MODEL JIH;J t;~
-.
1::'\;11.1
(Zip Code)
3 SIeI1lll
HolWalcr
ltodiotlon
J Spociol D..'...
J om... Devices
PLEASE NOTE:
Air Condition.r Units
CaMCIl Encn:Jach into
R.equired Side YIlld
$aback.
..x~
Industrial. Comrnon:lol & MuJli-P"",i1)'
Rosldenti.l. H~inl.l: Ale (Now CODSlrUCliOll)
Residential, Helli.1 Only (Ne'" C4lnstrllcllon)
FEE SCHEDULE
1% of job cost R..idenlial. 0.. Firepl....
539.S0 mInimum
599.S0 RAosidontlol. AddiJlon$ a: AllllTDlion"
564.S0 Ro.ldcntloJ. AC Onl)'
S39.S0
S39.S0
539.S0
Estimllted Cost S
Building POtmil #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
s
s
S
.so
BU11.6-4'D 11',.,..
ING p f Ii
c:r:;,' n,.,..
V'II
f.Offi'" 1.1.. Only)
TIll' AppUatlon BecnmCII Your BJlllcllng Permit When Approved
D...
I Paid
I /Jate-?_ .;1-0 I
ReCeipt No.
II.H41011 0IlIe1..
BYr
Z4 hopr nollce for oUln.pelltlon. (9S2) 447-!1llSO. r.. (952) 4oC7..4Z4S
HEATING APPLICATION I PERMIT
Date 31u..Jp, PD._ 25-'372- (JO/-O
SiIe Adclr8ss. li2.Slo 'l)uy--t1ud br 51:::
lDt -=:1 Block --1- Addition Industrial, Ce.. ,..:aJ & Wli-FaJTiy
Owll8r's Name DR. ,..hsr-to n Residential, HeaIi1g & AC
. . AesQential, Heamg Only
AdcIr_3 'br S~2btt 6wI-ll l1M155tz.l.. r",;;" :',.1/, Gas FnpIace
---;,' .
Heating ~ Alii/).. ~,eaJ
AddrllSS 31&51) 1le.Mt..bec.. 1:Ir &w.tt I 1 EtlMn MN' ~
.....
Telaphone' l.G51 45Z. - 2"15
Furnace Make & Model i>ru4.nf
,
Model Size ~g~Jc:.t\V l)z.4 01,.,
2.1. ~4t=i
Fuel I\I 0.1- Flue SIze Lj!1~~"
~
4-
TYPE OF SYSTEM The price of your: .":,, permit includes one rough-in and one final inspe<:tian.
Warm Air PIan1S
Gravity AddiIonaI inspedions wil be billed BI $35.00 each.
Mechanical " House Healing Tesl AeeOlli must be submilled with buildina 1I!IIlI!iI!llI!!!l!l!r bef"", builll-
Air Conditioning ~r IlIl..1\-t Z. tlln" ing certilicaIe of occupancy will be issuect
VenL S)'*m l..-5tlllMo..bt.l'H\""AhS
" J::lE&[ CALCULATIONS REQUIRED with number of supply and retwn openings listed per
HEATIIIG OR POWEfI PLANT room with CFM's per opening, New Slruclu",s or additions send ODOr plan with supply
Steam and relUrn locations shown. HEAT LOSS CALCULATIONS. PAYMENT AND
Hal W';'r APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE. l62<lO EAGLE
Racliation CREEK AVE. S.E. PRIOR LAKE, UN 55312. .
Special Devices
CITY OF PRIOR LAKE Me
16200 Eagle Ct88kAv. s-e. Permh No. (J 1-0 ZA- '3
PrIor Lake, UN 5.5372 -
Conn. Load
Supply 0...:.....
RlI1urn Openings
InpUl1C. DDtL OU1pUl.5lJ., bO 0
Edr.
Clm.
~Ob
Other Devices
TYPE OFWORK
Ailerations
..........--
Repair
Est Cost $
Replacement
Est Camp. Date
Building PlHIIIiI II
New Construction
HEATING PEAMlTFEE$.
STATE SURCHARGE $
TOTAL PEFI!.I1IT FEES $
.50
.
PAlO~
Rec.~1 pu\\J)\NG p-"
~ OF STRUCruRE
1. flok
2., en-
J. YcIIow
,
.
,
.
.
.
F;Ie
a.,.
""-
Single Family
l,.../
Two-Famiiy
Mulli-Famiy .
Commercial
Industrial
Pubic
. Other
,
c
"
Fee Schedule
,
,
.
c
AesidelGd, Alic:iIions 8< Alterations
R ...'.:.. .;~,J, AC Only
1%01 job COSl ($39.50 miOOTum)
S99.!i1l PLEASE NOTE: ~
$64-50 Air Condi lioner Units CarmL c
$39.50 Encroach Into Required Side ~
$39.5C Yard Setbacks. ~
S39.5C ~
.
.
Remember to add the stale Surc:l1arge on the bottom 0/ this appllcalion.
~
~
~
~
c
~
CIty Hall business hours are S Lm. - 4:30 p.m.
~
:<
~
c
:<
,.
:-
,.
"
ALL WORK IftlST BE INSPECTED (1'I0UGH-IN AND FllllAL) . CALL CITY HALL
447.Q50
I hereby apply for a mechanical systems permit and I acknowledge that the
Informalion above Is complete and ac:c:urate; that the wort< win be i~ conformance
w"h the ordinances and codes of the city and with !he slate buldingfmechanical
coOes; thai this form does not become a permit until signed by!he BUILDING
o FACIAL; that the work will be in accordance with the approved plan in lhe
case of all work which requires review and approval of plans.
AdJ.,... 7..LM.wr~ l~)
~~rs~:
BUIlding Offical{f Signature
.5/U/DI
Date
LI- !o -0 (
Date
I!'i
<::
<::
...
PL. FA;<( 447- 4245'
PRIOR LAKE DEPARTMENT OF
. . BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS tr:::JS(o ~ Vr-
NATURE OF WORK U€A.tJ
USE OF BUILDING S C=V\
PERMIT NO. () .:- 074::::s DATE ISSUED 2,-/ S-'d:of
CONTRACTOR ~~ PHONEJd;i' -?~t..-7/30
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~PECTOR DATE
, FOOTING I C-~~ _ : I s-~.,lo,. ~ ~ F~) ~
, FOUNDATION (Prior to Backfill) 'f.JelL~1n3 ~~I ~l<?' j:, J fS..
PLACE NO CONCRETE UNTIL ABOV/E HAS BEEN SiGNED
~OUGH ~S
SEWER I WATER I SEPTIC) ,~
FRAMING .. />r;f.
INSULATION t..J... KNee7'- 8<fil~/Jif+
ELECTRICALr '
~
PLUMBING /J€y /&If ~'/7.()1 A. ?/.d"~/
HEATING (if required) . J!!5g.. /~. 7/ tJl
FIREPLACE ~ ' 71!t. It; (
GAS LINE AIR TEST ~\E". f!s:t.. 7/CJ7/01 . .
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
A 7t'l3;O~ I
FINALS
~~
v .
fp
~4
?~,; 7 l/f /
, <j?-;;;l -b t
t4/~ Ie)
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
t
DO NOT 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- !teen 'approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
9//? Itn
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
.'~..~~~ :1.- ~~
; . ,,~ ,'~; "" :~'. 'l~ ,.oIio. "Ioj j''';' "II;, lIf'" ,."'. ".,.. '". . ....- .
I .....~ ~.. .'. .... ." ....., " . ","
~ . - .
~.:.It .
~,~i , (rrtifuau of ODcmpanry
:'1' ell i OF PRIOR LAKE
.~ 1Department of Jiluilbfng 3JnJpectton
:; III Final Permitted 0 Conditional C.O. Expires
~~.'~
lr;.
il"".-..lI1,..
, ,
. .-
r "
'..... '.,
~.:
'): ..
This Certificate issued pursUD1lt to the requirements of Section 307 of the Unifonn Building Code
certifying that at the time of iSSUD1lCe this structure was in compliance with the various ordinances of the
City of Prior lAke regulating building construction or use. For the following:
SINGLE FAMILY
01-0243
Use Classiflcatioo
BId.. Pmnil No
Occuponcy Type
R3
VN _FireZone N/ A
SECOND ADDITION
Zoning District
R1
Legal t --':r~'"
Type Construction
L7, B1, DEERFIELD
17256 DEERFIELD DRIVE SE
Owner of Building
IiUte Address
Conlr8Clor's NameltAddr.Jl. R. HORTON, 34,59 WASHINGTON DR.. SUITE 204. EAGAN 55122
ROBERT D. HUTCHINS 1/11'1 rity Planner DON RYE
BuUdi"l OIliciol
/1- LI_ OL Date: .
..............
'~',
";/~""'I';';':;";'I""'-"
:'-;'
HOUSE HEATING TEST RECORD
ADDRESS t"7c350 ~f-(lIb(J Or. 's""'EAPT._FLOOR_CITY
OCCUPANT OWNEP
HEAT LOSS _DATE HTG. INST
SOLD BY
Electrical Work By
TYPE OF HEAT
.IOU
'UBURB
INSTALLED BY .
Ga. Line By
GA _ FA ')C HW _STEAM _SPACE HTR. _UNIT HTR. _OTHER
.0 ;"\ GAS DESIGN
MAKE~C\~
Mod.1 '. '. . 04 ~{'}ql
*101 ~ ~b~
INPUT $~, e:cx:::.o=r( 4H
THERMOSTAT
Valve
Limit.
limit Settinl'"
Fan Setting
Plio. Type.
Pilot Mak. _
Pilot Mod.1
Pilot Timing
L.W. Cut 011
Prenur.., '3 \. S
Inpu' CFH_
Stock T.mp. ~O
Form 235
CONVERSION
MAKE OF BURNER_
_ Mod.1
_ Max. BTU Roting
_ MAKE OF FURNACE
Model
CONTROLS
Heat Plug
t..\ \ ,
Vent Size.
_ KIND OF LINEP
_NONE
. SIZE
_ Draft Hood Regulator
~ Filter. SizeU""'...x:~ __Number
_ Chimney Location Insid. nutsld.
_ Chimney Construction
_ Smolee Bomb
_ Draft
_Wiring
_T... Tag
Lighting Inst.
. Percent CO2 .k \ \
Percent O2 ~~ \ ...,
Percent CO _ A
- Door Pre. sur'"
_ Oa.. T...../1'. ~o-a\
_ Company T."lngrf~~ lifating &A/C, 3650 Kennebec Dr., Eagan, MN 55122
_ Name of Tester'~ - ~ l
-"
-...........-......-....
ION()'
~~ &-1.
V
CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS / '( rS G.
OWNER
DATE TIME
A,',
PHONE NO.
PERMIT NO. ~/- .J.tf.3
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
n5\ 0 PLUMBING FINAL
l!:Y!l' MECH FINAL
COMMENTsfi) ~~ ~ -1l'}1 ~ "1~
rD~'r~b~~ I
, ,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
7:<:'-.0, -o.J.-f 10/"31 Ja I
~~
o WORK SATISFACTORY, PROCEED
"'CORRECT ACTION AND PROCEED
b CORRECT WORK:&;LL FOR REINSPECTION BEFORE COVERING
, ,.
Inspector: OWner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION 2A HOURS IN ADVANC~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSJWTl
ADDRESS
/7Z5 ~
DATE TIME
SCHEDULED q 'I7~O J I : I r
Df:E~/ELn OIZ-.
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1- zA-3
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 UECH RI
D FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWERHooKUP
o FINAL 'j( PLUMBING FINAL
o SITE INSPECTI~ /0' MECH FINAL
COMMENTS: !/l ~ ~ r1rr.
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~~
"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT~, CALL FOR REINSPECT/ON BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL <147.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
IN8JW}TJ
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OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE ~CHEDULED
~ ,5"(,
ADDRESS /7252.. zse j;)~/6t..D .o.e...
II.T.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXlGRADIFILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
o MECH FINAL 0
sao /7lU56 !/JJ
'U./
COMMENTS:
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I j O)~
7'- I
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- ------.
!'WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wy{'j,'))jALL FOR REINSPECTION BEFORE COVERING
Inspector: 11 y r / 11- t. 0)... Owner/Conlr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
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