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Home My WebLink AboutBuilding Permit 01-0284 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CO~ECTION PERMIT 1'1F/IN Pl/A5 ~- Pl.-c.,! I PERMIT NO. O/,02PJ4- I MAA 2 8 2001 I. While File 2 Pink City 3. Yellow Applicant (Please'!ype or print and sign at bottom) ADDRESS ,py~.5 ~A/ ...-.n~ Ot<<'-ry~ .;:F~ LEGAL DESCRIPTION (office use only) ~/~ VA/"r 0;2. -he'f '1 BLOCK 1- ADDITION ~~.-_~ ~ OWNER (Name) (Address) BUILDER (Name) ..-7_ ~~ ~ Date Rec'd 3-2-f{ -0/ ZONING (office use) f!.2- PID25-?;P,-0f7-0 (Phone) (Phone) b?/-...?$- :;:>.=Vd?;;; .A~ o67".7~ (Address) "';'.. v"'; ~~ ~R ~ ~C/.,c , r:;3\New Construction D Fireplace TYPE OF WORK DLower Level Finish DMisc. x 1 Permit Fee Plan Check Fee State Surcharge 1 Penalty I Plumbing Permit Fee 1 Mechanical Permit Fee I Sewer & Water Permit Fee 1 Gas Fireplace Permit Fee DDeck Dporch DRe.Roofing DAddition DAlteration PROJECT COST/VALUE (excluding land) $ 7.,,<', /e?-CJ cX~S15O/ Contractor's License No. Cp '8, ~ OeJ -t9(j $ $ $ $ $ $ $ $ 1 (per . 7')" I I Park Support Fee 500 .. '$'f I SAC 34. 00 I I Water Meter I I Pressure Reducer I I Sewer/Water Connection Fee I I Water Tower Fee I I /00.00 I 00. DO ~S,6c) tf:O.CO TP:lJO"1r:tBuilding ~,~~ ~;:;PPwved BUilding~al /) Dale 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 property to perform needed inspections. ~~ Signature # $ B$O.0iJ I ;;.:- --r J. I ~-C .<!rI1 It $ ?SQ4. S9 . I Rec;t!jJ .:l,73f4 / By l: - ' Size :J/b ,'" , ~:::inr DUtility Connectien -..7'.""''''-0/ Date $ '47&-:1'901 $ , '-10,(')/11 $ 1.<2<XJ ~ I $ .; tct:o .C1 GJ I $1,Sro,c.:JO! $ I 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 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 issue # # I Builder's Deposit I Other I TOTAL DUE I Paid 7- 594-..5'1 I Date . 4--/3-1J I , ~{Ja~ r~~Fev Date "Special Conditions, if any I ~ 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 ~' . WVr/;::>, t./ /10 (&\ o I. D~~t}/ Thf Cfntu of lh., L.I<., Counlry White ,. Building Canary . Engineering Pink ,. Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D Je.,. HOR-IO fJ 3-2-13-0/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 5443 HlWrJ I1EADOW WfGV6 Accepted Accepted With Corrections '-;:I-. J-- Date: '1.Pf -~( ~(2:::Q , . ~(l ~j) .~d) ~ GetO lot Ll~ M.u l h 1=",....._;(..._ , ?e-....t..~c..Jo...-, ~- "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." . a I-01/~eV Thf ('..nl... of lh.. L8k.. Country White . Building Canary - Engineering Pink - Planning c BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLlCATI.oN RECEIVED L) K. tIL/~IC k) ~., ('; C I ~ ~ c:- ,/':'I -'I , The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: :44.2 f/-li.~/j //f:fll..Jt[V c~v!<-.vC Accepted Accepted With Corrections ~ Denied //: Reviewed By:~_ ...- ~1L- ~>Q .,.. ~ ~ Date: '-I/CD (e( Comments: &~ rJAr2v:~( ~J~e ;t-/~ lei) % r JMA T l^'v~~ ~ ~e.r"~ ut.!k I/f6'\~(P 'Fi-~. t?~~'1e ~tkM~ {dr~~ ~ W}~LtL rz~~~- I/\)~IJ . ",U ~<"-a-'{,; ~ ('~5lM~ 0, {).~. .4vVJ ~~ ~ .' ,5uJ. , , "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." ThrCrnlrrO!lhrL.IlrCounlry o H)1A~;Y fYI4i... F; Ie. White -~ Canary,- Enalneerina ") Pink . piannmg . BUILDING PERMIT APPLICATION DEPARTMENT CHI;.CKLlST NAME OF APPLICANT APPLICATION RECEIVED D. ;C., HO/2-1O J0 3-2fj-0/ The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 5443 FA {IV N /1fJ-1 OU~V eu A!-V6 Accepted Denied \ Accepted With Corrections Reviewed By: NIiB Date: .s -~?-O I Comments: _See Reverse Side for Additional Information! " See 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." Apr. 2. 2001 10:07AM GENZ RVAN PLUMBING AND HEATING No. 0911 P 2. ~:;~ Quantity Type CltFiXiure Quantity Type of FIXture I \ Bath Tub with or without shower Rough-ins , \ I Dishllllasher I I Water Heater I 1 I Floor Drain I I Water Softner I .3'Qs.. I Lavatory (bathroom sink) I I Stand Pipe (washing machine) \ I Laundry Tray (1 or 2 compartment sink) I I Se....age Ejector \ j Shower Stall I I 8acktIow Assembly (RPt, Double Checl<, PV8) l I Sinks I I Bsckflow Assembly Test I Bar Sink I I Lawn Sprinkler Jz.;: I Water Closet (toilet) I I Other CITY OF PRIOR LAKE PLUMBING PERMIT Applicant: {;? Jli7~- Q tf .Q..PI ~ Lbr~ Address: \Lh\~.S ~ ~It,;LvlT IVLL.. Signatur..: IA. i ~_......-A. Legal Description: Lot"-------'> ;Y Block ~- Sub JJ!-e.4h.R..D 3ruC> Site Address:,syU.~ ~~, I/lA...Q. ~ (' tJ i2 \/(1 _ <:::J,E... Building Permit # PID # /;1.5- NOTE: This pennlt ~iIJ not be processed without complete information, AXTURE UNITS ",. Clty "wll- # 19/" t'J.jrlf 1. ""'" 2. Gold ,.. Y..... no: c-.~..r lho: Lal..: C_11"J' Phone; I "f'-.J - <.J 7 ~ -I I 40 I2~T Q;:N~ FEE SCHEDULE . Industrial, Commercial & Mufti-Family (1 % of job cosl. $39.50 minimum) Residential. New One & Two Family Residential, Additions &; Alterations Stale Surcharge $99.50 $39.50 $ $ $ $ .50 GRAND TOTAL $ This penmt 15 granted upon the e:tp.rc$$ condition that said conlt'actor. shall c:lJrnply in all respects witb the ordinanCC$ o~ the Stare Plwnbing Code lIIId the am""dments thereof. ...c-:--.- RECElPTNO YjiPj {J/ DAlE 'If./ . A1TEST Call for all inspecti~ns 24 boW1l in a.dva1)ce. ,.. PAID WITH BUILDING PEr"... , 16200 Eagle Creek Av. S.E., Prior L.ake, Minnesota 55312 I Ph, (612) 447-4230 I FAX (612) 447-4245 An Equal OpponunllY Employer #7298 P.OOl/o06 Date Rec'd FIRESIDE CORNER CITY OF PRIOR LAKE HEATING/AIR CONDmONINGIFIREPLACE PERMIT I. Pin" ,-., J, '1'''''_ ~~....I PERMIT NO. )'7;7,J tj I ZONING (om","",) Ed- CPIe8R tome crt Drint and IUm at bortnm,' ADDRESs r~ ~ ~ K.U.J..h f'N..~~' C'..vw.e. See. OWNER (Name) 'DR- ~Jrd ~~ PloJ5 -~/3-U/ 7~~ LEGAL DESCR1PTION (olllcto use only) LOT 1 BT.OCK 'J. ADDITION (Phone) . (Address) APPLICANT (Nwne) ALLIED FIRESIDE DBA FIRESIDE CORNER (Phone) ~1-633-256J (phone) lL), ~~ DATE ... L'U APPLICANT PLEASE COMPI_ETE BELOW .xJNEW CONSTR.UCTION 0 REPLACEMENT 0 AL TERA TlONS FURNACE MAKE AND MODEL FUEL I'J \nA~ FLUE SIZE R.E11JRN OPENINGS INPUT OUTPUT ~~. ~ - -' TYPE OF SYSTEM HEATING OR POWER PLANT OWIltm Air Pll1lllS 0 Sleam DOrav;!)' 0 Hot WIJlI::r o Me<:hlllllClll 0 Rodlotlon OAlr Condidoning D Spec/Ill Dey;COB OVcnt Srs_ 0 Other Dcyiees FIREPLACE MAKE AND MODEL.fuu N ~. ~ .....,~'112--C- (Address) 2700 N. FA1.RV1I!:W AVENUE' _ . (Addn!"l B~DA HI.lSTON (Comact Person) TOY APPT.JCANT SIGNATURE~ ~ RO~~TTT~ ~ (Cily) 651-633 -2 561 5Cl': (Zip Co"",) 1-1'1-( ') l PI.EASE NOTE: Air Conditioner Un/Ill CilllnOt Encro.cn In", Required S ido Yard Selbl1:k5 FEE SCHEDULE lnw.trlal. Commcrellll & MoJd-FlUllily 1% of job cost R05ldentlal, G.. Firep!"", $39.50 minimum Rosldend"'. Kcoring /It AlC (New Construction) $!I9.S0 R.esidon~lll. Addlllons &:. AlterlllJon. Rosidontia/, Heating Only (Ne'" Coostnll;ljon) $64.50 R""ldonllll, AC Only Est;mared Cost $ \ lC'R) . d,) Building Permit # $39.50 539.50 539.50 HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ S .50 PAID WITH BUILDING PERMIT (Orne. UIe Only) Tbls Application Becomcsl'Du.r BniJdlJllll'.mfl When ApprDved Bolldln,Omd.I Dn,! I Paid ~ IDalll 7-)3-01 I Rocoipt No. I IB~ %4 hOllr notl.. for alllnspllflttans (951) 447-9850, f.. (952) 447"'24~ Apr. 2. 2001 10:09AM GENZ RVAN PLUMBING AND HEATING No. 0911 P 10/41 ;:j p~~ ~f /lVE\ _uti . ....~ YEI.l.OW . APPUCA.-r GeLD . Ct.,.,. 1- 2 . 3 . ...,.., 4 . 5. 6, CITY OF PRIOR LAKE SEWER AND WATER r~IT NO.{f)/ -jiii NOTE: Sewer and Water contractors ~ust be registered with the city. APPLICANT: r-,.,Y'l.%..~J2t1.n PhJ"'=''oI~ 6'fa;("M.:c-.... PHONE:J...51-42~-1 1411 ADDRESS: p,j,l.J6. Sn ~-r -r02.L ~w'arH'r S-~tlI<lii DATE: 4/2)tJ J SIGNATURE: \/\ b \~ '\t 0 _' _ .BLDG. PERMIT 1/ SITE ADDRESS: 54~ ~ "'-""-1 ~ L~1rS.!7~ FILL IN THE BLANKS 40' Estimated length of water service 'I feet. Size of water service inch (es) . Location of any couplings from s~ructure Type of sewer pipe. ABS PVC ~ Cast Iron I Estimated length of sewer line~ feet. Clean out (if required), located at feet from structure. feet. =====~~~=~~=~======~~=~~~~~~~~~-=======~--~==~~---~===~~=~~ This application becomes your permit when approved. BY DATE: =____a___________~========~~~_____~~============~~___~==~====== FEES: $ $ $ Sewer and water line connection permit, surcharge TOTAL 35.00 .50 35.50 * Fee for either sewer or water individually is $20.00 plus $ .50 surcharge, * Sewer and water permits issued for new construction must be recorded on the building permit card at the time of issuance to insure that no duplicate sewer and water ijAlanwt"EH are issued. BUILDING PER;,/ilT l/ - /15-01 DATE PAID RECEIPT 11 AMOUNT PAID REC'D BY ~ V . 4629 Dakota St S.E., Prtor Lake, Minnesota 55372 I p~ (612) 4474230 I fax (612) 4474245 AN EOUAL OPPOJmJNrN Fi'<P11l'I'F.R CITY OF PRIOR LAKE HEA TING/AIR CONDlTIONING/FlREPLACE PERMIT Date Rec'd l ~;,~" ~::y I PERMIT N001_ ..., rv I I ). Yellow AppllcBnt , , c::r- '6"'1' (Please t'(pe or orint and sign at bottom) ADDRESS 5'443 H1Wn ffiPMDW ~lLY vt; ZONING (office use) LEGAL DESCRIPTION (office use only) L01 ~. "LOCK d -\DDITION 1 Q ~~t'P II :;:) rcL. pm ~':~Rl) (( r\Dycfli\ (Address) '~lbq WllLc;kLh~lm1~ Ave ~~;~~;ANn!llaM 'fflUJllti1/CaJ (Address) :3thD ~vmtbe.ul)r ..';tll-k I r: (Address) , (Contact Person) Jftnt0. l llmrnp.1:;YYltLIL-- APPLICANT SIGNATURE ~1", f/ LJlnmlYtna/l 'Iii iJ , APPLICANT PLEASE COMPLETE BELOW [BI'ffiW CONSTRUCTION D REPLACEMENT 0 ALTERATIONS FURNACE MAKE AND MODEL g,.LJtnI- 2,g~k.AVD2JID7 D FUEL f\t'tfu..ral FLUE SIZE l-\l\ GlQ S3 & RETURN OPENINGS y.. iNPUT 1D, DDD OUTPUT Sic, bD~ SWk iDl/ (Phone) EaMJ1 MIU 55/2-2- J (Phone) /if51 4-52- - l1"6 ' (City) (Zip Code) (Phone) [d5 I 45Z- 2-,76 (ffY1D)DATE L/-JZ3/0/ DWarm Air Plants DGravily o Mechanical ~ir Conditioning [J:P<"ent. System HEATING OR POWER PLANT o Steam o Hot Water o Radiation o Special Devices o Olher Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks TYPE OF SYSTEM FIREPLACE MAKE AND MODEL Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alteriltions $64.50 Residential, AC Only $39.50 $3950 $39.50 Residential, Heating & AIC (New Construction) Residential, Heating Only (New Construction) Estimated Cost $ Building Permit # HEA TINa PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 PAID WITH BUILDING PERMIT ~ (Office Use Only) This Application Becomes Your Building Pe.-mit When Approved Bliilding Official Date I Paid I Date/j~,}S_O/ Receipt No. 24 hour notice for 8n inspectious (952) 447'9850, (ax (952) 447.4245 BYrJ r PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS '34<../'<, ~u.J1A ~~ \ c..1- NATURE OF WORK fJw USE OF BUILDING SFA- PERMIT NO. 01- DZ9A- DATE ISSUED ~ J CONTRACTOR [)J~(. I-\dl-~ PHONE G.61- ~sc.-7/.?G2 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR OATE I FOOTING r~ i'~ 4ltCZ!tJ ( f",,*'~. ~/';I>!o) , FOUNDATION (Prior to Backfill) pr-Pi3t5--'i'-1 'ff:f-7r{1/'1/,..e Ii I ~Aft,.1 PLACE NO CONCRETE UNTIL ABOVe HAS BEEN SIGNED ROUGH - INS SEWER I WATER I SEPTIC FRAMING INSULATION ArY.. ltJ.. ~, ~ I.f&, ( ELECTRICAL \ PLUMBING l.I&- ~~1.5' I( <),Ln Ub PH .'71<-'0 I tb6. 711 ~{OI HEATING (if required) fAr.- f,~ sill I ~ ?I~/(y/ FIREPLACE 6+ . l!~ m GAS LINE AIR TEST ~:;; {::, fir & /'/<3-':/0" COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I.L~ A- 7/.;l5/6fl ~ <?/d.Pl-;b~ 8:h "V FINALS 1 17/3 f:::k 9()(, /D I th. ~, 71c:dIJJ '7/;;;> ?/cJ/ GRADING (Prior to Soddin~) BUILDING 1."t..O, -li)J. IOfj% I ELECTRICAL PLUMBING HEATING DO NOT Rb II-~-~) q- (d,-~ fJ:r ~ i~ OCCUPY UNTIL ABOVE HAS NOTICE er/7 11)) ~1/~),,) BEE~ ~IGNED 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 shQII be .placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850 ~. ,+;.. I .- 0' f"." I ~i (>> I"'''' (~: ( J".. ." -' r....{ t7!.- (~..~ 1 yo; j I . i .~ It; ii7 (-"-'~- I~" i;;'t'. (.~ I..... I~ ..~.,;~. ~.:w--.~~.:~~.~~,.~.~.~.~i~~_<~~~ 7 (!;t,Ii....rau of (JmqtlII1qJ . ~, CITY OF PRIOR LAKE ":. Department of .uilbing Jn~pettion ~ina1 Permitted 0 Conditional C.O. Expires This Certificate issued PUr9UD11t to the requirements of Section 307 of the Uniform Building Code certifying that atlhe time of issU/J/ICe this structure was in compliance with the various ordilltlllCes of the City of Prior lAke regulating building construction or use, For the following: DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED /I.t-ol AM ADDRESS 54'-13 -54:;0 ~Vh fh~<":/'9V(_'hl/{ OWNER CONTR. j)J( HtVIo- PHONE NO. PERMIT NO. D 1- ;;!. 'tI'-/ 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 Cl!(EXlGRAD/FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o COMMENTS: /t/f oK.. ~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! J!V8NOTl CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 5" -9'o/'.B 7~ OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING ~ C!)NSULA TIO ~ ~INAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP A')[] PLUMBING FINAL l..J:9Jf.I MECH FINAL DATE TIME ~ \ OJ ;cru 9-;;&-01 IJ7 -"I';;;; , ~ - J.' I-~~ o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o . ~ I COMMENTS:(/) ~,.' nn,. ~-rnt -h ~. 0 0' II tn~~~~~ T,~. t;, ~~ /O/J'a/Ol o WORK SATISFACTORY, PROCEED )lOCORRECT ACTION AND PROCEED o CORRECT WO'OCALL FOR REINSPECTION BEFORE COVERING Inspector: ~ Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED tf-- 7-/ ;::r:ot) ADDRESS 5 1.)'13- ~././.r;.) 'Y7I-Mc:fg-W . OWNER CONTR. PHONE NO. PERMIT NO. J - dJ' Lf-- o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP J1 PLUMBING FINAL o MECH FINAL o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: et'<-~ ~r . ~~~ ~ 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! " lNSNOTl CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ~ L,/~3 - <;'1- L;''SL/0 ADDRESS 5qLlJ - 4K - 49- 50 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 o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: .:s y -r I /) ('- A j'L. ft. / f) /U/~ UV' DATE TIMe q- Po-;J." f(:uo?v //JUa.ciow ~~ xL! ;) r-;)- o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o (\, I /') J-- ) I""C.... ( o WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRg, T RK:ALL FOR REINSPECTlON BEFORE COVERING Inspector:\ 'h Owner/Cantr: ~ CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. lNSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED IO-8-o( ADDRESS 5 'i'f3 -5'160 Fc,Wrt rr7a./lr9loJ DIn/( OWNER CONTR. DR. H,)rf.n"l ol-J.R'I r ~ EaX/GRAD/FILLING o COMPLAINT o FIREaPLACEa RI o FIREaPLACEa FINAL o GAS LINE AIR TST o PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION .1!!(FINAL o SITE INSPEaCTION o PLUMBING RI o MEaCH RI o WATER HOOKUP o SEaWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: ':J 41./ 3 (:7r<t~ - rJ K. 5 '7'1 LI (yrtwL. olC.. r<.c,/~L. V""l-f~Vc,{V-( Fw<~ w,A &/~. S~tj5 b,,,A- oK 5l/tJ ~ & 1'4 ~- o1L ')l(L{ 7 (,rJ- 0/( ~'t'1't, hrvU, - C' K.. 5'1'l'f 6r~ _ 0/( 5tJ'.FO bruh~~<9 r<... o WORK SATISFACTORY, PROCEaED o CORREaCT ACTION AND PROCEaEaD XCORRECT WORK, CALL FOR REINSPEaCTlON BEaFOREa COVERING Inspector: ~~ - &"~er/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! INSNOTl A ..- APPLIANCE PERFORMANCE TEST Attach 10 gas line adjacenllo regulator Heating Contractor Name of Tester J\ \. \. l ""(\. \-- .A9Ju:.- V\- L.::> L '1,- l ~. 0 \ Date Percent 0, 5'''{'-{)~~ ~\\\'\A\ ~J.-^ t.2> >- ~-\~-ol "'1r \ ~ t) (p \ \ :J..tp l ~ Job Address Heating Contractor Name of Tester Date Percent CO Percent CO, Stack Temp Combustion air is adequately supplied per UMC Sec. 606 ( 1b c... input ~. eco(t.iUl-I