HomeMy WebLinkAboutBuilding Permit 01-0324
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT WIt 3 0 luUI
I. White
2 Pink
3. Yellow
File
City
Applicant
(Please .!YP~ or print and sign at bottom)
ADDRESS
,s'Y2:?.!' ~ /n~ ~"fP'e;- ~C-
LEGAL DESCRIPTION (office use ouly)
~3 ?';IN~~
-W'P BLOCK ADDITION
L/Jf- ~ JoIL I
OWNER I
(Name)
ZONING (office u>oJ
<R-~
.a.e--~. J~
[JPP.Y-J,-' Ie. Id ::5 rd
PID ,:)5- 303-o0.j-{>
(Address)
BUILDER
(Name) Y"? </? /</~~TO-"'I/. ~
(PhDne)
(Address) .:i'-Y~~ ~ ~ ~;:lC>Y ~
(PhDne)
6"67' - -?:5G - 7"/3 t;
~New Construction
DLDwer Level Finish
TYPE OF WORK
DDeck
D Fireplace
DMisc.
DPDrch
DRe-RDDfing
~7..<"~
DRe-Siding
PROJECT COST/VALUE (excluding land) $ 7.;1, /&7'0
DUtility CDnnectiDn
""",~Si56~7
Contractor's License No.
7 2,OtlO.oc)
I Park SUPPDrt Fee
I SAC
I Water Meter
I Pressure Reducer
I Sewer/Water CDnnectiDn Fee
I WaterTDwerFee
I Builder's DepDsit
I Other
I TOTAL DUE
--
Size 5/8";~
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 pennit for just cause. Furthermore, I hereby agree that the dty official or a designee may
enter upon the yavl'......J' to perform needed inspections.
Date
x
~~
-(!7
"/'h~
Signature
I Permit Fee $ '1 'lf1 . 'l~
I Plan Check Fee $ 5' fA. ")<.f
I State Surcharge $ .Tto .Dn
I Penalty $
I Plumbing Permit Fee $ , 0(') . O?!J
Mechanical Permit Fee $ 10(') .00
Sewer & Water Permit Fee $ ~5' .SO
I Gas Fireplace Permit Fee $ <ItJ .19 0
es Your Building Permit When Approved
t./-9-2rx>f
DAdditiDn
DAlteratiDn
..7 -~9-o/
Date
#
#
$ 8so.crh
$ I. I 5'0 .O~
$ ';;2 ~f). oeD
$ IJ n . t<\a,
$ /, 2~t').C!lil
$ '71'>/) .LiCL
$ /, e;.M . C'Y')
$ .
$1, 34-7. 7q I
-.
#
#
I Paid 1.7"tJ. ~ 1'7
I Date -4' J4f ,el!
.
I ~~cp 3'1 rofP
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 ,igned by tht'nne< constitutes a tempo,"'1' Certificote of Zoning compli,nce and allow, construction to commence. Befo" o,,,,poncy, a Certificote of Dccupancy must be
",u~r.f-:-t
<-:r~~PI in;~~-:-- ~/lki~: l -S~ ~~e~~Y~<V rRWD\~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
(Please tvDe or orint and sign at bottom)
ADDRESS
54D~ HlWn rYWMDW tUXVf.l
; ~;:., ~:~ r PERMIT NO.O J -O~ --, Ii I
). YellOw Applicant " JO"VJ,
,
ZONING (office use)
LEGAL DESCRIPTION (office Use Drily)
LOT ID BLOCK 3 ADDITION
PID
~~e~R .l)~ \-tD(M
(Address) '?J~ Wl\.<IttLn~h;Jtt AvL
1~:;~~ANnt lletn+ YlkcJ1tUl/caJ
(Address)_3thD j(U}Vlrbfr./v( -.\u'I-k I
C (Address) .
(Contact Person) Jp.tn.etj .lLAmmP~~
APPLICANT SIGNATURE ~h f/ LJmmenna/1
'hi U
. APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION D REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL Br':JU1l-- '21g~j.U:rv D2Jlb 1 D FUEL f~a.1
FLUE SIZE L.\l\ G\a.SS B RETURN OPENINGS Y. INPUT 1D, DDD OUTPUT 510. bDD
,Sw-k lfl~
(Phone)
~ Mf0 55/2-2-
(Phone) Iifj/ 452- -lT15 ,
(City) (Zip Code)
(Phone) ~5 / 45Z - 2-776
(t1Ylf)) DATE L//Z3/iJ I
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
W.ir Conditioning
i:i:P"'ent System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE Not}::
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Residential, Heating & AIC (New Construction)
Residential. Heating Only (New Construction)
Estimated Cost $
Building Penn it #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID WITH
BUILDING PERili:IT
~
(Office Use Only)
Date
r Paid
I Date z:-
)-
Receipt No.
This Application Becomes Your Building Permit When Approved
Building Official
'1-01
BY~
o
24 hour notice fur all inspections (952) 447"9850, fax (952) 447-4245
APr. 1. 1001 10:11AM
GENZ RVAN PLUMBING AND HEATING
No.0911
P, 12/41
1.. Blua
2.. Gold
3. Y......
"""
0,>
Affti....
3~lf
CITY OF PRIOR LAKE
PLUMBING PERMIT # /J J-
Applicant ~..J!I7_ - C? ~...n PI ~ Lh-r=--Phone; ( ON - l.i 7 b -114-Y-
Address; 1!d:::1l is ~ L.=.b VI T IYl.l. IJ "<.J L~ ~V\T ~.l.&
Signature: IA.. J... ~
Legal Descriptlon: Lot~ Block SuI'>
Site Address: ~~ Kl."ru IJ\.AJL~
Building Permit # PID #
NOTE: This pelTTln w.1II not be proce.ssed without complete informatlcn.
FIXTURE UNITS
'The ~~.~ or II'. ulill' CJril.I~
Quantity
I
\
1
3~
\
\
l
~t4t\dD 3-UJ
('jl LIZ \/1} <:l.F"",
:.;::"
I Type otFbdure
I 8ath Tub with or without shower
I Dishwasher
I Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
I . Quantity
I
I
I
Type of Fixture
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (washing machine)
I Sewage Ejector
I BacJdlow Assembly (RPl, Double Check, PVB)
8ackffow Assembly Test
Lawn Sprinkler
Other
I Bar Sink
..'2-:: I Water Closet (toilet)
FEE SCHEDULe
. Industrial, Commercial & Multi-Family
(1% of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
$
$
$
$
.50
GRAND TOTAL
$
This pennH 15 granted. upon the ~press condition that said
c:onlnr;tor, shall comply in all respects with chi: ordinana:s
o( the ~cace Plumbing Code and the amendmentsrereot
. RECElP'l' NO. L;- 4-0 DAlE
JfI/ ATrEST
Call for aJl inspections 24 h~ in advance.
PAID WITH
BUILDING PERMIT
16200 Eagle CreekAv. S.E., Prior Lake, Minnesota 55312 / Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opportulllty Employer
GENZ RVAN PLUMBING AND HEATING
P 18/41
A P r. 2. 2001 1 0 : 11 AM
~
1-
2.
3.
~ 4 .
5.
6.
No, 0 9 11
-.....,
"lLOW ~ .....PUCA.-r
aoo.J> . ......
CI~Y OF PJl:IOR IAKE NO.O t- 3? Lj
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registe"red
with the city.
APPLICANT:J~""'Y'l"'- ~PhH':',,",I~ LJpfPn.uc~ PHONE:J.,z61-4rS-II4L-l
ADDRESS: -' i.I,U!S &-, fl~l2:r -r"" t<.r,-y..ro....JClr S-.ol&l DATE: Y/2 ftJ J
SIGNATURE:~ \~Q--, __ BLDG. PERMIT #-
SITE ADDRESS: ,h.,U~ h:.'-'-"....,MOJl(f;(j)j c.~~se
FILL IN THE BLANKS
- 40'
Estimated length of water service
1"
Si~e of water service inch(es) .
feet.
Location of any couplings from s~ructure
Type of sewer pipe. ABS PVC X Cast Iron
I
Estimated length of sewer lin~ ~ feet.
Clean out (if required), located at feet from
structure.
feet.
===~=====~~~~~-=======~~~~~~~~~=~============
~-----
---~--
This application beco~es your permit when approved.
BY
D~TE:
========================:_----=~~~~~~==----============~========
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 perm~$-.a~,.
issued. t'AIU WI I ,
BUILDING PEf"", I
t:)-t/-Ot
AMOUNT PAID
,
DATE PAID
./
/lo ./
REC'D BY /~
(j
RECEIPT #-
. 4629 Dakota St SE., Prior Lake, MJnnesota 55372 I Ph. (612) 447-4230 I Fax (612) 447-4245
AN FOC fAI rlPPnRT11NrrY PMP'I nvt:=R
!i~~
DI/03~
The {"rnt.,. of Ihe Lak., Counlry
White - Building
Canary - Engineering
Pink - Planning
J3U1LDING PERMIT APPLICATION DEPARTMENT CHECKLISt
NAME OF APPLICANT
APPLICATION RECEIVED
D R fk; r-h5,J I/Vc-
t.;-:3 -oj
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
....5 If 0 8' P(2W A/ /YJea:/O j,U al/ / I/C $ F
Accepted
Accepted With Corrections '-.../
Denied
~
Date:
4-9-U;:of
Reviewed By: .
Comments:
~ all a*Ctc~ ~ ~
,w-( ud ,...... -
. if
~J
Mul\.c f'--.:y
C?...~t~h.J,'dL-9-
"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
Th" (~"nt"r of Ih" L.k" Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,! ,./
" G-
(/-:;-~jJ
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ,-'-
I . 0, J I {
,,,,:.. "/ (._) )(' , '{ / l " . .I I c:
_,' < rv f'./ ./. . //", .//./... '...- .,'
~
Denied /J J1
Reviewed By: ~~ Date: Lf/t~(
v
~B.I"J) -;:; 4J,"L't 113 'fLv Q,4fi9vK &0-
Q /JI{)J6, ~ {JldJ- ~ (k,~
3v-J. .~T'~. . .
Accepted With Corrections
No l~'i\~ oP gw.JKwe- Sl'vv'~ f},<!.v,
+- {1;J;~< L!.4.J1 gvtLV~~ f)v.ev ~
"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."
\
Th~ ('~nl~r of lh~ L.k~ Counlry
01- 3!Z.Lf
(Y1f/1"" h' k
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D 7< f/ar+o/.J
1./- 3 -oj
Z.vc-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
...7)!/(j:? raWA/ /n""aJOI{j (t/.f/f/c.SF
Accepted X
Accepted With Corrections
Denied
Reviewed By:
11MI'>
Date: '1-5-0 I
Comments:
::iee Attachments: 1) liraolng t-'Ian, 2) I:roslon 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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS S-Qo8 h."J.... /Uj~) GJru.JL..
NATURE OF WORK -':,.)00
USE OF BUILDING SFI4
PERMIT NO. ()[-032-4- DATE ISSUED Lf- 9 ':6 >")1
CONTRACTOR ..1) K... ~ PHONE (osl _ 2~ If ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING ~ ~. th.- U;;$'/tJ1 I ,.ell I ~j.,J
, FOUNDATION (Prior to BaCkfi'lI) I '1:. ~\\'~ I b II ~ o(
PLACENQ.CONCRETE UNTIL ABOVE HAS BEEN SIGNED
7l3PNJ1715 r/f ~(
)( 0I3f1/A/77U: @4- 5-17-0~ ROUGH - INS Deep 1/61 ,BFI ~_/7-0)
SEWER I WATER I SEPTIC ~
FRAMING "'- ~
,INSULATION~. Tv.04-- fft, 1//J-14.~
ELECTRICAL . I ~ _
PLUMBING~ ~~._~. ~1-:;{Ot--t)~.'9I;;.:>/O} .
HEATING {ifrequired)J>;1..fut\M+"~. cr;J/~//)t T~. ih. I '~lJ I ffn.?~ I
FIREPLACE . ~, . "31/4.1 .
GAS LINE AIR TEST M. ~,F: e, ~. 8? 3ll" I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
~.. O/~!bl I
FINALS
7lJj
l{)b~/iJ ( !P I?J
GRADING (Prior to Sodding)
BUILDINGi.to, --8.i r/lfoz- ~
ELECTRICAL
PLUMBING
HEATING
I
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
I~
INSPECTOR
I DATE
rlYtIe,
'ile/lof
jt-&-O)
Q, I J. - d-"
~
fA.- I
k,
/0/1/01
/ri~/ol
, .
BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections hate .bJletLapproved. 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
;JJ:~-----'~------ -----
.......~~i;....;~~~~:;'1.t~...., ,.~"...~......i"',...i~....I., .~t., '~i"
( -:'~'~~,.--'f{,.A~.......- ..~n~tt,~-...,'~".:,) r..
~' ;.
: '. ~i ! QLtmftrau of ODrrupanry
:t-~' Lll'f OF PRIOR LAKE
: .~i' Dtpartmtnt of Jluilbing )n~ptttion
11.-::: ~Final Pennitted 0 Conditional C.O. Expires
l'"
r ~.,. This Certificate iss/U!d pursUlJ1lt to the requirements of Section 307 of the Uniform Building Code
yo; certifying that at the time of issUlJ1lCe this structure was in compliance with the various ordinances of the
I,.;" City of Prior Lake regulaling building construction or use. For the following:
:.'<
x.-
rJ;
:t:
i:';
I~:-
I:...:'
~
[".4
~J
I~~
:;.~.~
I:'
Use Classificaticm
SINGLE FAMILY
Bldg. Permit N,.,
N/A
R2
01-0324
R3
VN
Zoning District
Occupancy Type
_ Type Construction
Fire Zone
Legalllescriplion
L3, Bl, DEERFIELD THIRD ADDITION (BLDG 3. UNIT 10)
Owner of Building
DR HORTON, 3459
o ..,.... 'sName&.Addrc'"
ROBERT D. HUTCHINS;;;!;?)
Building official V -
<1 - ;) J j- C>--.
C;itc Address
5408 FAWN MEADOW CURVE SE
WASHINGTON DR., SUITE 204, EAGAN 55122
City Planner _
nON RVF
Date:
Date:
POST IN A CONSPICUOUS PLACE
I
JOB #
ADDRESS 6'-b'i:5
OCCUPANT
HEAT LOSS
SOLD BY
HOUSE H EA TING TEST RECORD
r-c..~t\ ~d6b) (CO, S~PT._FLOOR
,",WNEP
CITY
SUBURB
DATE HTG. INST. '3-!C") \
INSTALLED BY ff&' ~(. (~.'"
\, , "-
Electrical Work By Gas Line By
TYPE OF HEAT GA_FA~HW _STEAM_SPACE HTR. _UNITHTR. _OTHEP
~ . ~ GAS DESIGN CONVERSION
MAKE I A C:tl" \ MAKE OF BURNER
M.d.1 "~Al )fr.::I.~nT. ~ M.d.1
5.,;.1 . ~a\ ~ l<?'-\\,.Q~I Mo.. BTU R.hng
INPUT .1.0 L., bOO mul-l MAKE OF FURNACE
CONTROLS
THERMO~TAT \'\"'~5'\ ~... tUg
Volv.~ ^ )~. k. t ,~A <;.
limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
/'
~
~~
Pilot Timing
L. W. Cut Off
Prossur..' t..? l S.......
Input CFH~
Stock T.mp. -:\..j;+.
Form 235
Percent CO2 -:Z>, \
Percent 0 ~ ,.....,
2
Percent CO C-,
Model
Vent Siz-
q\ '
KINO OF L1NEP
Draft Hood
Filters Sin
Chimney Location
Chimney Construction
Smoke Bomb
Draft
Door Pressure
SIl,E NONF
R.gul.... JV\c....lC\ W-- 0 \
Number
Inside ~- Outside
_Wiring
Test Tag
Lighting Inst.
Do.. Test.d Ib- i l -D\
Company TestingnAlliqrt, Mech9niCritL ~6~O Kennebec Dr., Eagan, MN 55122
Nome of Tester '~G..XC ('-t... \-0, \ I
DATE TI~
CITY OF PRIOR LAKE /"'-tr1
INSPECTION NOTICE SCHEDULED '1- ;{-;}., -,17 v....
..,jl/Of- /0 ~ ~e:u;-ur
. ADDRESS K L/()q - / I '=Iatun CL T
OWNER
CONTR.
PHONE NO.
PERMIT NO.
OI-03d//-3~
..:5~(" - 6~'1
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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:
cSTI
(j/(/
{L!t ~ .p
t\ , /
r r /'t-/
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:.::ECT p~ALL FOR REINS::::::'FORE COVEmNG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .t SAFETY!
UGMTn
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
((-t--el
fI>1
OWNER
r;, w ,/I fYI, ~ de, w Cu r
D/r florid,
PERMIT NO. (') I- ,~2 LI
CONTR.
ADDRESS S 7f~
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)l't.fLNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~X1GRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Vo,+1/ \/.. (r/C - C> fC
br<;L.,'0 ~ '-' K
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~-c;:-- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
IOdJ-o( ;2;00
ADDRESS !i tiO ~ .s '-/ /() I .5 '-/ Oq: 5 tf / / ffavn /1;1
OWNER
CONTR.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATI9,/t)\
~INAL (~)
o SITE INS~ "'.. ..,J.N
o PLUMBING RI
RI
o WATER HOOKUP
o SEWER HOOKUP
i'i0. ~LUMBING FINAL
~ ,.,ECH FINAL
PERMITNO.I_3;).Lj 3,;)5,,'3;;L": 6d7
I
o EXIGRAD/FILLING
,17f) i::I ~OMPLAINT
. ~IREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
PHONE NO.
COMMENTS:
.5''10?- ~
54/0 ~ ~
;54 (j q - cr(..
5Lfll - ~
AA-.( 8,)~ ~ --rn ~ 10
~, (:2J{;~-;~ u~.~
-. .H__._.j 'f'
~~- g;fOII"q
o WORK SATISFACTORY, PROCEED
)!f 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!
INSNOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/0/.,/0/ /0:30
ADDRESS
5,/07 ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJ (-3::J-r.{
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS(]
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~ 0 SEWER HOOKUP
\UY ~PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
IU~ f~.
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~~L FOR REINSPECTION BEFORE COVERING
Inspector: 'L/ /) 1 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl