HomeMy WebLinkAboutBldg Permit 03-0746
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND PTlLITY CONNECTION PERMIT
Date Rec'd
~, 1.03
(Please.!VD~ or Print and si2ll at bottom)
ADDRESS
/.5' 3S~ ::];.Jf,<<s
MfD File
Pa.s ::.
I. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. f)3-7lf!o
I I
ZONING (office use)
IC-I
LEGAL DESCRIPTION (office use only)
LOT Z BLOCK 3 ADDITION R.eqaJ
rl
C-R es t-
PIDt5' 3fh - 052--0
OWNER
(Name)
(Phone)
(Address)
BUILDER /? II
(Name)=-eCJ//ec;r c;1e., /ft!Jm..-S
f::rld / L- ...J
79....20 LaJ!eu,lle. Blvd
(Phone)
(Phone)
9S.2-9't:>7- th700
(,/.2 -/cy,:;,- - 3.:207
(Contact Name)
(Address)
L.~ lev ,'lie
/hi)
.:5stJ <:/ t../
TYPE OF WORK
c;tNew Construction
ODeck
OPorch
OAddition
ORe-Roofing
ORe-Siding
DLower Level Finish
o Fireplace
DAlteration
DUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
..2 t, 'l.0(){)
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. am aware the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter u e p rty to P fo needed in~ /.2 Jj :1 &, It, ~
Contractor's ticense No. I Dk--
I Permit Valuation ;;) ".el, 000 I I Park Support Fee # . I
I Permit Fee $ I Cj 4-0, .S, I I SAC # $ t:).1S-, ~ I
I Plan Check Fee $ JJ,-f.,l'LO.1 I Water Meter Size5/8"j 1"; $ '2-51J, - I
I State Surcharge $ /3Y,S-b .1 I Pressure Reducer $ ~-- I
I Penalty $ I I City SAC and WAC # $ 1:16(') .- I
I Plumbing Permit Fee $ IOb,'- I I Water Tower Fee # $ rz 0eJ .- 1
I Mechanical Permit Fee $ IOD.- I I Builder's Deposit $ /. 500. - I
1 Sewer & Water Permit Fee $ ,~SDI I Other $ I
I Gas Fireplace Permit Fee $ 40,Ou I I TOTAL DUE $ <aSR/.~ I
- lLi!fr;,(J
This Application Becomes Your Building Permit When Approved I Paid <;t 6 'KI d--o I Receipt No.
~ ~ ~/30/o3 I Date j~ ?-~ -tJ~ Of Bv 1ft'
Building Official Date
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
~~~
Planning Director
t, ht)j.. ~ /?---.,{l. tZ-IL( ~ */ -1
, 'Date Special Condilfons, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~~
Main File
White - ~uil!lin!l.
~rv - t:nqlneerln9")
Pink' - Planning
Th~ CrnlCOfoflhr I.ah("ounlry'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
,1
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(-.~,}
NAME OF APPLICANT
APPLICATION RECEIVED
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The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity whic~,is proposed at:
,.. ,
/-') 3 <;-'c:/
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., f)
':;:::. ')
. (.-
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)
/
Accepted 'X
Accepted With Corrections
Denied
Reviewed By: ~h "'-
Comments: Lo'l~ ~ d- G t-J EiO
Date:
'7 ( 1<11 o"'S
. .
(puu.eE. n. APP R.0f40I~ f. ~
See Reverse Side for Additional Information!
See Attachments: 1) Gradinq 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_"
6~%
Main File
White - Building
Canary - Enl,lineering
Oink - Plannln!!,:)
The ('tnler of the L.kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
""
NAME OF APPLICANT
APPLICATION RECEIVED
.~' ~
-t
(:~-I"1,,
^ ,
/qi 1 )
I
.1Me Buildi'ilg, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
. /'~ :;'~.' ,-- /j
) --'.)
I
, ./
'"-._~
Accepted
/'
Accepted With Corrections
Denied
r
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IJ-:e, t':'~ ~- '. ,..+-
~dH~.
(.)
Date:
"/J>a~ :3
,
~~
Reviewed By:
,,.,
Comments:
,'~
"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,"
5~1
M.ain File
......,
Co ~~i!e - BUII~Iii9">
Canary - Engineering
Pink - Planning
Thf ('tnlrr of lht L.kf Counlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.
NAME OF APPLICANT ~ h~ tf~ ~
APPLICATION RECEIVED 10 - ~a\ &-3
- -,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/.7' 3SLj ,.
Accepted
Accepted With Corrections
-----
Denied
~
Reviewed By:
~ 9-~
A&.6d ail
Date:
0ha/O :5
I .
.3. 't;;
Comments:
~
"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."
Jill 18 :003 i:40PI,1 . GEIE RVAN PLlJI,I8[:I'3 MI[ HEATiNG'
110 : 7 61 P i r; i 2
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CITY OF PRIOR LAKE
SEWER AND WATER PERl'1IT
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~ ~w ~.;~ I PERMIT NO'Oj /r 0 1VlA' I
). G>><l ~ph=t ~'-rf:()~.
, Date Rec'd
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:$ ;: ~
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~le~e tYPe ortlriIlt md sign at bo!loJn)
I ADDRESS
1")"654 \ kff~~s
/tw,s
I ZONING (otfu:< .<<),:;t--
LEGAL DESCRll'TION (office use only)
LOT ~ BLOCKh ADDITION f!J I/i /J 1/ ep/l:f
- / -
~=RCOI \eqe, rJ}/I rl1m1\t's, [VlQ.
(Address) 10W LClke.;j,1/<, 'Blvd. 1 )JJ,/lj7/vill{; I
I (Addi<..) (City')
, APPLICANT ~Ir.--Z _ 10 /,1/1 II { -, LJ- J I, f
(Name) L-1~1 (Phone) jl/] - ?-:S-II'-flf
(Address) WL/S- S. ~.let "11.11. ,J2!J);.{friOJIrll I/lfJVl ~C(P6
(Addt""). - , (Ci<y)' (Zip Code)
(~.onractPeIson) Qh Ilis.h .Jizl;i (phone) I oV; f - Lf2.::O -w-fIJ
,,'LICANTSIGNATURE OJ J_ ~ ~ I//} DATE "7-lk-1J3
'''-.,It,,.
PID
(phone) Cfr;2-L/(c4- laqw
W) n- c:r;()l,l~.
(Zip Code)
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches,
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet,
Clean out (if required) located at feet from struc:ture_
feet
o Cast Iron
FEE SCHEDULE
ReSidential sewer and water line connection $35-50 Industrial, Corn'I & Multi-family 1% of job cost wim a $39_50 mro.UDWll
Sewer connection only $17.50 Water connection only $17.50
Estunated Cost $
Building PermIt #
SEWER AND WATER PERlVlIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAlO WITH
BUILO/NG PERMIT
(Offic.e USt Ooly)
This Appli<ation Becom", Your Building Permit When Approved II~j~f r~ If'ui \i! k 1;'1 ceiptNo,
I U. ~_' -, u. I
I..'.......
Building Offici~1 Datt I Me JUI 2 2 Z003 LL .
24 hour notice for aJllnspcc:tioll3 (952) 447.98 50, fax (95;'.) 447-4;'.45
By__n_..._
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Jill:] ~Q011~4QPM
GEN= RVAN PLUMBING AND HEATING
N0.~7S3 p. Ii i~
Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
- $0" -
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.~.-r
fllle:asc tvf'c or oMtand!)Jl;rl atboaom)
I ADDRESS
\ t/53sL( detfqes Pass
I LEGAL DESCRIPTION (office use only)
LOTg BLOCK S ADDITION Kuia.-l C {:ee~
-
~="-CollliVI 01)[1 !jrWYllJ lht
(Address) lQXJ IIlAtZviltfi 'l%lVd.. Lal/-iWzll-e
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",,-.,.
I. Blue file
l. ~Id Ciry
3. V.llow AppllQ:lJlt
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::~?i
I PERMIT.~;t'67~'1
ZONING (ofl\"~i'l'
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PID
(Phone) tlf CJ 2- - Lf (aC)- fA DD
m f1 qg;iLf
l\l'PLICANT P II) I .
(Name' :'?O'iz- r<-1AiJl1/
J
(Address) IY7Li6' ,S;. rZtfoC/21 Tj,e.{,
(Address)
(ContactPersoo) 0M JtCSff fa[ ()
r A A if;1))) -frJ J J. ;f.
(Phone) Iif::j/- Lf'2-3~ IJlfL/
,/2,0 C-6VYlD7ilJ11., h1 VI 'J~()l.P8
(City) (Zip Code)
(Phone) (rP5 1- L! l:::~=L I ~ l{
DATI 7- (8'-03
".f'l'LlCANT SIGNATURE
.'
Quantity
I
I
,
':l-
I
I
I
~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
I Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 companmeut sink
Shower Stall
Sinks
I Bar Sink
Water Closet (ToiJet)
I
lL-1:
I
Type of Fixture
Rough-ins
Water Heater
Water Somer
Stand Pipe (Washing Macbine)
Sewage Ejector
I BackfIow Assembly
Backflow Assembly T,,-'l1:
Lawn Sprinkler
Other
FEESCREDULE
Industrial, Commercial &. MuJtI-fa.[r)l)Y J ~.~ of Job cost With a. $3950 minim.um ReSidential, New One & Two<faIIllly $99 50
Residential, Additions & Alterations S39 50
Estullated Cost $
Buildmg Peunit #
PLUMBING PERlvllT FEE $
STATE SURCHARGE $
TOTAl, PEM1IT FEE $
(Office Use Only)
~lti.o Application Becomes Your Building Permit When Approved
Building Offici.1
D.",
,50
PAID WITH
BUILDING PERMIT
IfJ~: ~ ~ l~O:'; I~'" No
({
24 hour notlce for all inspections (952) 447-9: 8lY fa:< (952) 447-4Z45
hl:8 =0011=4GPM
GENZ RVAN PLUMBiNG AND HEATING
N 0 . ~ 7 S 3 p, i: 11
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
: ,
Date Rec'd
if-
~.if
,:;:~..."."
(P1c:.a.se _cvue or nrin[ and l'i1'J1 a.l: bottom)
ADDRESS
It;" ,1; c)L/ Jeff-e/0, {kS,S
.r
~ ,
. ~;,;:;,"rl f
.. :J~: 1:'" r
~:; I PERMU'N~!i7A-Y-'. 'j.
,s.~~l~ t ,J~~~:~yV --np.
~"l~'~~: .~.
I !'!nTc
2.~
:t ycl,lQW
:~. ...
ZONING (officiUi.] ','
#', .,..
.:',.:
. . ~ "
, LEGAL DESCRIPTION (offico",o only)
LOT g BLOCK,::<) ADDITION
Krz/1U f!f2.fgf
IJ
I OWNER t (\" I . i
(Name) ,0l,1C0-t l.AlLJ. ~ VIr.,
(Address) 1 q W I CI.!L/V / !} ~ f; hid, . LulQ li ;/ It;
APPLICANT n 'J? It' /J
(Name) i1J)(} l- J\ U f/I IlL
(Address) lL/l45 j, ~'l9f# Tv J, )
(Contact Person) ~,j/J I~_i& i-r'drO'fir j!-.-J __
APPLICANl SIGNATURE _f!-L!.../;;iJ;;l '-1iJ?J,o<'J
PID
(phone) 0h'J- L{lfq'(CtJW
fh YJ PFlJZ/c/
(phone) (h!~Lld-3- (1c(L(
/0) lrLVfliJUlf1;f , m n Vj ~{A.#J
(City) (Zlp COde)
(phone) (CS/- 4;;)-3- /IL/C/
. DATE ~:.JE.::O?-'
APPLICANT PLEASE COMPLETE BELOW
'- ~W CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL (If/) /7D V e 2:fe:{) ~- 7 ~ FUEL n AT -b /Pr<.,
fLUE SIZE RETITRN OPENIN~S X'. lNPUT ~rJm) OUTPUT I rfl? 1flJ7)
TYPE OF SYSTEM fffiATING OR POWER PLANT
gpNann AIr Plants 0 Steanl
oGravity 0 Hot Water
bL Mochamcal 0 Radiation
~ir Conditioning 0 Special DCV1CCS.
OVen!. System 0 Other Devices
PLEASE NOTE:
Air CoodllJoner Units
C3IlIl0l Encroach into
Required Side Yard
Setbaeks
FIREPLACE MAKE AND MODEL
h,dustnal, Commercial & Multi.Famlly
FEE SCHEDULE
1 % of Job cost Residential, Gas FITtpJace
$39.50 minimum
$99 SO R03!dential, Additions &- AI"->rations
$6450 R03jdentiaJ, AC Only
$39 SO
ResIdential, H<8l1ng & NC !New Construcl1on)
R""idcntiaJ, Heating Only (New Constmction)
$3950
$39.50
Estimated Cost $
BuJIdlOg Pel1llil /I
REA TING PERMlT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
PAID WITH
BUILDING PERMIT
.50
." 'C U~e Only)
Jhlilding Official
D.",
I pfi~ ~ L15 IJ; U IJJ ~ fffrpt No.
L:1tl JllI 22 20031l!1l_
q--
,is Application Becomes Your Building Permit When Approved
24 .our norio. for.n inspections (952) 4'17-985t Sf' (95:2) 447-'1215.__
07/11/2003
,,'. ->.. .....
09:52 5077445565
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BADiSER EXC
PAiSE 02
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.',,,,,,.0<(11)
Date Rn'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
~k"e fY!t. O' eMI IM:.. &l: bocrocD.)
I ADDRESS _ ~
I 1 $" 35<-[ ~ ~
. 1-,v-
I LEGAL DP.SCRIP110N (otll.. UJ< ooV,)
l...~ BLOCK 3 ~DrnON ~lrc.1l-
IOWNP.R
I eN orne)
, ...;. ~I. I PERMIT NO.' '7 - 1L-( II,
J YIlI.. (l" J 'd>
,. G.I. .~1tIN
I ZQNING (0"'"""'1 I
~
PlD
i (AddJ.,.,,)
I
('A~ lib' (,~ ~
71;),,6 "-c.J.~ 6(vJ
(Adcfrt,,)
CfS"J_ -Yf?-<D 9/1')
v~ oW
(7.j> Co4o)
APPLICANT n I L r.~_ sr:>1-7YL/__I~ r-
(Nomt) l'l?O~A--, c::-.xc<<U_'''i _ (Pho"l) , ~~
(Ad<lret,) ~31() W /O~ .s1-r.&'--D,.::f-km..~Ju.k ~~
(...dIlru.) - tel,>,) (ilel Codt)
I (CoMI'" Perlon) ~ .s I . 1'YIcJY1 . (pho".) 52:> I ~ ,Yy--, ~ ,-..
LA?PlICANTSroNATURE ~~_ DATP. .___I-'X"--o2>
1-
APPLICANT PLEASE COMPLETE BELOW
Size of waLtr solViee -.L... inches.
Loutlon of any coupllngs from struCture -=- foel.
Type of sewer pipe:. 0 ABC ffrPvc 0 Cut Iron
E:stimatcd Jeneth of sewer line .51) feet.
Clean out (if required) located at feet from structure.
FEE SCHtDULE
R..idential stWIlllld W11.r 111I1 COI\lleodon SJ~.SO Industri.I, Com'l '" Mvhi'fllllily 1% of job colt with I S39JO minimum
s."" cunnection only '\7.\0 Wlte, connoc:tion only S 17.$0
Eitimated COlt S
Bulldin, Pennlt N.,---"
SEWER AND W A TEF. PERMIT PEl!
StATSSURCHARGE
TOTAL PERMIT Fll
$
$
$
~
8u,it'D W,.,",.,
~tvG PI2F1A1rr
10m.. L .. 0.1,\ "
I """".'" ..... ,.. ..".."".,,,.,_ A".~.. - mil."' ~; D \'Ii r, ~ j..., " i
l ''''.''1 01ll~,' '''It U lottiJ.ili .j, LUUj il,/1'1' - .) ~l I
H ...r .0tlCl ror al1l..p.etlo., ('5%) 41' "'50. tn f9tl'1 "f~l4$ 'f!
-
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CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or vrint and silOl at bottom)
ADDRESS
15354 JEFFERS PASS
~: EODw ~:~icanl I PERMIT NO. "3 - 7L-lb
ZONING (otliceuse)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name COLLEGE CITY HOMES
(Phone)
(Address)
APPLICANT
(Name) AT J -TRn FrRR~TnF DRA FlRRSTDR HEARTH &. HOME
(Phone)
651-633-251\1
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/28/03
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
D Special Devices
D Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEATN GLO 6000TR-OAK X 2
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
_50
PAID WITH
B<JI!D/!\IG P,=O~~!T
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Date
I Pai<J
I Date
Receipt No_
Buildine Official
NOV ()3 ZOU! By
r
24 hour notice for all inspections (952) 447-98501, fu~ (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
Je~~5 P4~!.
DEPARTMENT OF l\A glen pOl
BUILDING AND INSPEctT~ 1 e
SITE ADDRESS '--is ..3 Slf
NATURE OF WORK ~
USE OF BUILDING F 14
PERMIT NO. fij ISSUED
CONTRACTOR I \ PHON~ I~.. 6J'~. .i"'''
NOTE: THIS IS NOT A PER IT FOR ANY F THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
:; u-v./t; IN~P~CTOR
, FOOTING Ik c 1.- If1h
, FOUNDATION (Prior to Backfill) 3~ ~ A I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
j( CJU;ff ~.& _ , tl'-n
ILK. n~
;::?~
DATE
/-~1
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING l.A:t PI)
HEATING (if ~equired)
FIREPLACE
GAS LINE AIR TEST
/2-)
VI-V) -o~l
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
rtj
MT
'7-18
GRADING (Prior to Sodding)
BUILDING 'Ji,.JC,,-^J...J
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
~.
VI}
VW)
M'
. -
'-/~J,'")
I
Lr],..-o()
& ' I/l!i
SIGNED
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 shall be placed near main entrance,
FOR ALL INSPECTIONS (952) 447-9850
O/Z:;~ TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS I tj'" S -:;- L( J,~ f~~
OWNER CONTR,
PHONE NO. PERMIT NO. ""7- 7<-lt,
lJ FOOTING lJ PLUMBING RI lJ EXlGRADIFILLlNG
lJ FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE R1
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
..B"FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
r cb.,Q lJ,J:;,..... s..flr",,--- __
f \ I
'---\6$-0
-IR I\r
\ - ,-,t:~lf
o )'I<lRKSATISFACTORY, PROCEED
-6 CORRECT ACTION AND PROCEED
o CORRE OR~OR REINSPECTION BEFORE COVERING
Inspector /7 / Owner/Contr:
CAI L 71seio..6R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQ~MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
7-~- lNSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
1j[Jr~Ol.{
SCHEDULED
K~'-( -~ f),.s<;
CONTR
PERMIT NO,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
).lfPLUMBING FINAL
;II{ MECH FINAL
r"l-~
. .
OA TE TIME
'-2-D;)
1- 7l/C.
o EXIGRAD/FILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~":~LL FOR REINSPECTION BEFORE COVERING
Inspector: III/r Owner/Contr:
,
CALL <&47-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE_
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH I< SAFETYI
UlSHOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
1/ -IZ~
ADDRESS I S'3S''1 r.drtd A.sJ
OWNER CONTR. 1o/l~ C,'7
PHONE NO. PERMIT NO. 155. ~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~LLlNG
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~- 0(.
L,ulb ;~f- elL
~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!
lNSNOTl