HomeMy WebLinkAboutBuilding Permit 03-0139
CITY OF PRIOR LAKE BUILDING PERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
See 'Main File
I. White File
2. Pink City
3. Yellow Applicant
(Please.!VD~ or orint and sien at bottom)
ADDRESS
-fitn2. cu~Ul {)~~i-"t/"ro..r--p_
LEGAL DESCRIPTION (office use only)
LO~ BLOCK J ADDITION t U ~\A CJ~ '"
OWNER
(Name)
(Address)
(Phone)
Date Rec' d
rll-13
/
I PERMIT NO. 0.1':..0 13q I
i
tONING (office use)
}?tSJJ
.(
PID d5'~~L/-D04-'6
BUILDER n ..L ~
(Name) ,\l.Q...~.s _, ~ (Phone)$').,- <J,~~-rQ.,sq I
(Contact Name) -Br> ......+ ."'......t--....tf'- (Phone)~2-,Q.00-<<~3 Lf'
(Address)~o.Ro)c~7'ez~3 ~Le_-'Jn_t\.evM n_ />012.. St
, TYPE OF WORK ~ew Consttuction ODed< OPorch ORe-Roofing ORe-Siding
o Misc.
DLower Level Finish
o Fireplace
OAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
OUtility Connection
I hereby certifY that I have furnished information aD 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 rAWr,,"uJ and that all construction will conform to all existing state and loca11aws 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
:reV~~;;~~~
Signature Contractor's License No. Date
I Permit Valuation
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
~/~~. (J()O.()O
$ 1p1~c1,/S
$ ltbtn, /t)
$ 7 2-d) fJ
$
$
$
$
$
100, f) 0
/04. ()O
35 '>0
~().Od
This Application Becomes Your Building Permit When Approved
~ .y~ P/J'A1:1
Building Official Dare
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
I Paid
I Date
tLl/'?.7
..J/,,-.n
# $ A~o,oo
# $ /2 7S;,cJ 0
$ 2So.00
$ 4'5-00
# $ /Zoo, Del
# $ 100. 00
$
$
~ $ftJn/3.75
u '
I ~f~' 4-'?<1-~';;
BO .
.
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
issuedA?'. ' ~:;;:-., /J '/1 ,.
~C-4 t..L ~ .2/3'/4.1 _KIl~~ ~/JI/ {, ./,..~{ 17<-....;
Planning Director 'Date Spe~iatConditions,lIfany
24 hour notice for allluspectious (952) 447-98S0, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
See Main File
Thr(',..., of I"" 1...llr CO.lllry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION [}ffARTMt;NT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
I:,; t
.... } /~. - ..
, ,I' A.,.,
'_,_ .-",-",V'" '_,..,_
...... i/..__. "i ,/
-"-(",,,''''/1;;.. /1-/
" , '-.# , V'l_J.........,.<.
.--" 1',......
J '1'-' ,'\
-,..., (/---:
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
....... , /!
t' ' , 1"'\ ") /,. ./)'''''/'' ",,/''''''-',' _- "" /' '
h 1/ U....,t /l,,/Lf(.( / / '.(:t..h;;;../ ", /t1,.1/ij;e:.e,;;,,::..-/
Accepted
)(
\
Accepted With Corrections
Denied
Reviewed By:
/Y)tJ[3
Date: 1- 30 ,- D '3
Comments: ~pp ~r~p Ride for AdditionallnforfTl::ltion!
~ee A tt:lchments' 1) ('.rading Plap, 2) Erosion Control M"':I~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,"
See Main File
Tht ("'dIU"f lht I..", ('Ollnlry
(Whit~ - l;Iuildi~
Canary . Engineering
Pink - Planning
BUILDING PI;RMIT APPLICATION DEeARTMeaT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/)t1/vT6 ~
1- r7-()G
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/-/.-/AW 1l~c2(/A/J~
Accepted With Corrections /
~Ll6d
Accepted
Denied
Reviewed By: ~ ~
r::/~ /.J
Date:
2/3;6 .,
( {
Comments:
See Main File
"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,"
~1
See Main File
White - Building
Canary - Engineering
Pink - Planning
Th~ ("t'nIPro' lh.. l..k,Counlry
,';',',_i"'""o,'.":,t
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/ wT J - i/JJ1,(.I.;../-
/- 1/-03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ii' /, l / " iI/'-/' ",>,;(, ,
CJ' jd i./:..L/" (; / /'<~""'" '2.-;1,.:'''',(/,< ~
\
Accepted
Accepted With Corrections
Denied
oj'
Reviewed By:
Comments:
Date:
- ..--"..~.
1!
"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."
12/28/2aa4 15:49
9528947972
LAKE SIDE PLUMBING
PAGE a1
Date Rcc'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. ~llIe r:ile I PERMIT NO I
2, c." t.1~ "03- J 3q
J. 'VllIllllw ^~plj!:ll1lt .
q'1....1'IpC orllfint and .i.. ill bottom)
ADDItESS
j~ LA\: l~ I'lAIl<.
ZONING (0/11" .,,)
LEGAL DESCRIPTION (ollia u<c only)
ADDITrON
"!~j PID
V
/11 J ~ f'f.~~ (phone) _~~. ~1.. - 'i::li''''
~1J,,~\j
LOT BLOCK
OWNER 0 ,
(Name)~ \k-..
(AddrCllS) PI'l Rq.'i ;J&.ji) ("q ~
APPLICANT
(Name) J ~'.I.~ '::;l~~
(Address) ~ Ioq 7\<l.r.... QJl:t ~
(Address)
(Contact Person) ~ (Phone) "IS'}'- ~qo{. '1t-
APPLICANT SIGNATURE -1\~- .R-".lL DATE JP-.:l~. o~
APPLlCANT PLEASE COMPLETE BELOW 1/ V
Type of Fixture Quantity ~TYt!Jl,Al1' Fixture
Bath Tub with or without shower I Rough-ins f\.
Dishwasher \ Water Iirca
I Floor Drain \I#ter ~ner
I Lavatory (Bathroom Sink) n 1\ / \ '\ I )iJti1\tl)'ipe (Washing Machine)
I Laundry Tray (lor 2 compartment{sin/<: I V-/ \}1' S~age Ejector
I Shower Stall \ I OJ; ~ ~ Backflow Assembly
I Sinks T:'"') / I 1 ] Baokflow Assembly TeRt
I Bar Sink I / I I Lawn Sprin'kJer
~ I Water Closet (Toilet) V I 'I Other
I
I
I
I
I
I
t
I
Quantity
\
\
\
1
,
I
I
DI.... \.,,,..
~
(phone) '1S"J,- fjqa/- %~"
,,~i
(Zip Code)
(~
Fl:E SClJEDULE
Il1dustrial. Commucial &. Multl-ramil)' 1 % ofjnh <0" with a $39,50 minimum
R..,idonti.l. New One'" Two-Family $99.50
Rosideotial. Addilioo, & Alterations $39,50
Estimated Cost $
Buikling Penn it #
0&1
~
PLl1M13ING PERMrT FEE $
STATE SURCHARGE $
rOTALPERMlTFEE $
.50
10m.. ll.. Only)
This Applieation Becom.. Your Building Permit Wben Approved
'uildlnJ!!: orncfal
r Pai'l-it 13 #:-1 Re~
I Di~ ~~-o'-l I BY6-
, {/
24 hour oot,;<< for.1I in.pection. (952) 447-9850, f.. (952) 447-4245
162()(l Eagle Creek AVl!,. S.E., Prior lAke. MN 55372-1714
Plte
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please type or orint and sUm at bottom)
I ADDRESS
ttlO;)
i~: ~:~ I PERMIT NO. A'J_ /314'
3. Yellow Applicant {/.,;}' II
wdaJ {jJ~~
ZONING (officeusel
LEGAL DESCRIPTION (office use only)
LOT Lf BLOCK} ADDITION
OWNER
(Name)
(Address)
&A~
/JJ~ ~
~
APPLICANT _ I J._
(Name) //O~
(Address) R07~
14 CteA Y"-'\ S fr / l....... \0;-.../.-
A?, '/kX'$.h,-,Yt" B L)tJ~
(Address) /
(Contact Person) (h '; k 'C A-~ .,e.4-;vt ~
APPLICANT SIGNATURE ~ 0 ~~ ""
Quantity
2--
/
I'
'"
/
z....
I
4)
'i
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower I
Dishwasher I
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
PID
(Phone)
(phone) Co f 2 - 2. ..,r-:::9CfO <!J
k 1<J!:.d .4 { -t' ISb L.J (,
(City) (Zip Code)
(Phone) SA~ ""<.
DATE 2 -,2 ~-C>.3
-
Type of Fixture
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SCHEDULE
Industrial, Commercial & Multi~family I % of job cost with a $39.50 minimum
Estimated Cost $
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(omce Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39,50
Building Permit #
$
$ .50
~,.,~pJ
I Date ;} r ')/r?3
Receipt No,
Bt--'
14 hour notice for all inspections (951) 447-9850, fax (951) 447-4145
16100 Eagle Creek Ave., S.E" Prior Lake, MN 55371-1714
U~'ll-'OJ TUE IJ:.\2 FAX 61~,~90~7SJ
STOCKER EXCAVATING
@OO~ .._
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I Crl:'lln
t Ydl_
) Gold
~~',~ I PERMIT NO, 03-0139 l
....p"li~1 .
(Please tV1K or OMC a.nd. ~ipJI ;r.( LKHtuml
ADDRESS
6402 Wild Oaks Terrace
ZONING (off..,.,,,.) I
LEGAL DESCRJPTION (otliee use only)
LOT
i3LOCK 1 ADDITION
PlD
OVINER
(Name)__. Barts Romes
(Phone) 612/306-41~f<..
(Address) P.O. BOX 240593
(A.dctte~:)
A~~~. V~ll.v. MN 55'24
(Cicy)
(Zip Code)
APPLICANT
(Name) ~rnrlr,..,.. vv.....',..,,.;n.e ("'n ,II'....
(Phone) --S;;J./ S90",1,?', ,
(Address)
1"':I?~ 'l2.~').n.C.._A.v.,:,,-"'"
(Addr.:ss)
~~,:. ~~~
~,r:: "1"'0
(ci.y) , ..
(!-ip C..;Lde)
(Contact Person) ~':rt, W'~- .,i ')", ../._ .' ?-k-/J..i (Phone)
APPLICANT.SIGNATURE -:-!~~, ~4=--_ DATE
952/890-4241
_'_11_11,...
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches,
Location of any cOLlplings from structure
Type of sewer pipe, 0 ABC 0 pVc
Estimated length of sewer line feel.
Clean QUt (if w{uired) locat~d at, fcct from structure,
"-' . '. ..
feel.
o
Ca>t [re,n
Residential sewer and wafer line connection
Sewer. connection only
FEE SCHEDULE
$3550 Industrial, Com'l & Multi-family l'Yo orjob cost wirh ^ $39.50 minimum
$17,50 Waterconnechononly $\7.50
Estimated Cost $
Building Permit #.
SEWER AND WATFR I'ERMrT FEE
STA TE SURCHARGE
TOTAL PERMIT FH
$
$
$
ji}
,
r..:;:::t._'1
Building Omcilll
~'f(I)re ~ ~ I1fJj (~r!
Paid - ~ w l..:::J ~ I Receipt No.
.1""r" ... 'J ..
rKiJ!'-' ""'i.U/J,j' I'By /.012/
J _'I . . ~~
'dV I V.
l" hour notice (or "II inspections (952) 44ii Nl'l'" r" ~L!n.d7J5 I
-'-':::::::.::::J
O"tc
(OlTiccUSt:Orlly)
This Applic2tion Becomes Your Building Pcrn~il When Approved
Monday, March 17, 200312:21 PM
12/11/01 ~O~,FA1 61ZU1!ill
Lofgren Htg & Ale 651-4601208
CITY OF pal OR IAllE
\!lUUl
p,03
C1TY OF mORLAn
DATING/Am CO'~"":'u....~...~ ""t'I,N!.PLACE PERMIT
D... Rle'd
.3 -/7-03
;:5:. ~, ~NO'C1J-oI.391
~~_IIIII"'''-
I c:, '10 J.J) ),} 0. cI 0('.1 ~f) ~j)~I2_ ! I ZONINChollc.U<) I
LEGAL ............ u"'.. (--ooIJl
Lar BLOCK
A.DDmON
pm
OWNEll 0. _ I I
(N-)...J:.K:L.L:1 7 ,J'i
IAddlc8)
tLutn 0
(Phodc)
=~o~ Y!:t. ~ I1)r (PIlDIIC) k.j / "Ih{) 8,3 J~
(Address) , ?)9-- -+- 1.-// #4 {,,})mu:;ji/1/Y}' IJ?f) ,f.<.Q.O~
~ lCll71 / (ZipC:W1
(CaIllIa:hn=) 11a.f\~ (I" K () ('~ f" ; l/ ,_ (Phillie)
IJ'PLlCANt SlGNATUU J rtJ!J OATE -::s - ~ '7 -r) ?
APPI,. . PLEASI: COMPLETE BELOW
CjlNP' CONSD: qN 0 lI.EPI.ACEMENT 0 AL lEMTIONS
JIl1KHACEMAlCEANDMOPEL t;., AI)} llJl .L{9; my 4f>r;.,/j FlJEl.
ft.UESlZE :::I" p\J t llETtJRN~GS -'/ - OOouT OU'll'UT
TYPIlOF ......>><,( HEATING Olt POWER l'LANT
s:o;fV."~ ~oir:=
..I;:~. Spa:IoI Doolcos
ev... s,.- Olhcr 1)ov;_
PLEAR NOTE;
Ail Coaolltiofter u,""
CUoot Enctoach inlll
~Sid. Y.d
SodlICks
FlllEPLACi MAKE AND MODEL
nE SCIW)ULI
l.cNsuiaI,., ..."...:.....1IIIi-F_ly .~.rjoll_ Rosi_al,GooF"",,I... $39,.10
SJUI "
IIcsldcIldIl. ~ a NC (NoW CoI\stJIIclioIII nUl -"';11. AoIdi..... & Alllnliona S39JO
...wliOliol.HailIaOllIy(N...c...., ...:, ) SMJO lWicItIIliI~ACOIl\y $39,$U
HEAlING PEIlMlT FEE S
STATE StJllCHAllCiE S
tOTALPDMlTJU S
a;J-O/39
PAlO WITH
,50 BUILDING PERM""
~Co.s ~~~~t
.-IJaOoolJI
n.. AppIIU1Iaa .......a Y..r ..lIdiJII....k W_ Appnrot4
-..-..
o.ll
~.~I~
~4 7~03 I B~-'- /M
... l'S3)4t7.-....(9SI)~1.c<S /~'.
U_r....lIorall'..
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Pl.... tnIe or orint and sian at bottoml
ADDRESS
i~~;~,IPERMITNO. 3-/~ql
6402 WILD OAKS TERRACE
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) HART'S HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FTRF~IDE HEA RTH & HOMR
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
,ROSEVIT T P
(City)
(Contact Person)
BRENDA HUSTON
ZONING (office use)
PID
55113_
(Zip Code)
APPLICANT SIGNATURE
BRFNDA HUSTON
DATE
(Phone) _651-633-2561
5/9/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
DGravity
o Mechanical
DAir Conditioning
OVen!. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR-OAK
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
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
(Office Use Only)
This Application Becomes Your Building Permit When APprov~ Il:
Buildi"" Official Dale /I n 1 M
24 hour noti.e for aU inspections (9l~, )":w7-9850, fax (952) 447
IBv_
-__""lk,~.."........
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39,50
$39,50
PAID WITH
BUILDING PERMIT
Receipt No,
By ~
PRIOR LAKE
INSPECTION RECORD
SITEADDRESS '1/i):J..- Wild ~ ~
NATURE OF WORK ~ -1-
USE OF BUILDING ~ If: A- ~ep l\1ai11, Pile
PERMIT NO. t).. {)/31 DATE ISSUED . . ~
CONTRACTOR PHON~. 801.- t.t;;J.~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I FOOTING ~ 'J-h'-Vta!>
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST wf.I 4-~4}
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
__Se~ ~h AYe
j Vy/ J J-.-].d4I
JI'1/r
iJAI7
Lf- 'l> --v!7
4r//~cn,
~
-vil/
3 lL~ta5
?j r~ 4J,
- ,
GRADING (Prior to SQddl~!;
BUILDING K4" 3/~OS-
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
VVf/
~
OCCUpy UNTIL ABOVE HAS BEEN
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 shail be placed near main entrance.
( j,,- ?tJ~()<-/
I J..,- lq.-C;t-I
SIGNED
FOR ALL INSPECTIONS (952) 447-9850
-.. . . .-
QItdifttab of ~trnpantll
CITY OF PRIOR LAKE
~tpadtutuf of ~uilMug J/usptdiou
fFinal Permitted D Conditional CO, Expires _
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code certifying
that at the time of issuance this structure was in compliance with the various ordinances of the City of Prior
Lake regulating building construction or use, For the following:
Occupancy Type
R3
Type Construction
SINGLE FAMILY
VN
Bldg. Permit No.
Fire Zone
N/A
_ Zoning District
03-0139
R1SD
Use Classification
Legal Description
L4, B1, WILD OAKS
Owner of Building
Site Address
6402 WILD OAKS TERRACE
Contractor's Name & Addres,!!ARTS HOMES. POST OFFICE BOX
ROBERT D. - RU'l'CHIN~ ' City Planner
~ / Buj,kfing Official
Date: ~ /Y /.., Date:
, .
240593. APPLE VALLEY
DON RYE
55124
.'
J
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
6 ~tJ..7.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA nON
,AH'lflAL
o SITE INSPECTION
COMMENTS:
~ /
hnc:;-/
~
/ _/'
~JC).se
DATE TIllE
SCHEDULED ~~~-
U1'// Ch~ ;f'/r
CONTR,
PERMIT NO.
CJ-s -/Sj-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o~
'~
,.-r \ '"
r--:~ /
~
- -
/v.:oRK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO/~5~OR REINSPECTION BEFORE COVERING
InspeClor: /'''7'-- OwnerlContr:
CALL "7-9850 FOR THE NEXT INSPECTION 2<1 HOURS IN ADVANCE.
CODE REQUlREME~ A/IE FOR YOUR PERSONAL HEALTH" SAFETYI
1J<$NDfJ
COMMENTS:
~2 ~, f\(fttfL,.,n on. afts rJ.._
z, ') S koS ()\ 't'4.-rt--. r~ fir" '\
(J) (j..I,,~ 'l1fY~ I
'-" J
.;c-
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
t{ (,()l.-
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
J7FfNAL
o SITE INSPECTION
k/J~,
..
~/DW+
(J)
CA"
61V
~
DATE TillE
I'
/1-- ~O~
SCHEDULED
wr/.1 ~
CONTR,
PERMIT NO,
~-(J"I
o PLUMBING RI 0 EXlGRADlFILUNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP ({) 0 FIREPLACE FINAL
'PLUMBING FINAL 0 GASLlNE AIR TST
~ MECH FINAL 0
d;s-lY t?1I1 V
I
.f=-;",,,, I P1nrek
,71-0 c;tke-f.r~
,
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
~ CORRECT ~7L FOR REINSPECTlON BEFORE COVERING
Inspeclor: Owner/Contr.
CALL "7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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