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HomeMy WebLinkAboutBldg Permit 03-0520 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Main File Date Rec' d ..j-;) ~ (Please Jvoe or orin! and sien at bottom) ADDRESS 1 White F,le 2_ Pink City 3. Yellow Applicant I PERMIT NO. tJ3- '],J..(J I ~ ]<Jyt t't'#"" .J' ;(61)# NIAJ ~'I ZONING (office u>oJ RJ /I ~Sl'),','r)" LEGAL DESCRIPTION (office use only) LOT ABLOCK / ADDITION ~T I' ;::;':-1' rJ' SA bI J- PID:J.j'-:..3 75 - 00;). -tl OWNER (Name) (Phone) (Address) BUILDER L I (Name) tJt'Nf/?7t?/I/# /~OI7' f'f (Contact Name) C;)~4r/ ..:r(jA/VJ~/Y (Address) /tf ?5~ /~ 2~ Or/;JP TYPE OF WORK ~e;;onstnlction (Phone) J'S-/- "/V {,. .yYtltl (Phone) /. a - 36 f- It / 2... ~a 9p/V .m..IV, ")5/;:J.. .2... >J DDeck DPorch DAddition ORe-Roofing ORe-Siding OLower Level Finish o Fireplace OAlteration OUtility Connection o Misc. PROJECT COST IV ALUE (excluding land) $ I Permit Valuation I Permit Fee I Plan Check Fee I State Surcharge I Penalty ) Plumbing Permit Fee I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Permit Fee 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 confonn 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. Furthennore, I hereby agree that the city official or a designee may enter upon ~ property to perfonn neeped in~ons. X h-.lo.-r- /....../ ~ .,. / Y Jr' ~---:l -0 ~ - /' I~ture' V "/15"5. ddd, 00 $ IjD;' 75 $ . Rt:t tn. JL{ $ 77/e:;~ I $ I $ I $ I $ 1$ Contractor's License No. Date - ) I Park Support Fee # I $ I I SAC # 1$ /275.00 I I Water Meter ~e5/801"; 1$ Z50.00 I I Pressure Reducer I $ 'I'S. Dol I City SAC and WAC # I $ /2..0tJ.OO I I Water Tower Fee # I $ 70(). 0 () I I Builder's Deposit I $ 1e:)()tJ. 00 I I Other 1$ I I TOTAL DUE $; 4-70.<0'11 . I I Paid 1/~'lv:d3 I ReceiptNoi iJt1Gf5 I 0)~;;;;:~ :t0~~, IOt).OO 100.00 ..3S. '50 ~O.fJtJ This Application Becomes Your Building Pennit When Approved ~' ~~ 49/02 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 "~Iann;?~:t~~ ~~3 fJ ~;wijh~; a~ 24 bour notice for all inspections (952) 447.9850. tax (952) 447.4245 16200 Eagle Creek Avenue Prior Lake. MN 55372 ~",,-,_._,,-_.- -. ._....__....._._..w_.... ,._~.,~,._ .__._____.____~_____..__.___.,.____._m___.____ ~~ Main File White . Buildinq ~rv . ~naine..ring.> Pink . Planning Tit.. (",,"In of lh" I,.kr ('01ln1rr BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED / .J../,~ _.)~.~..I' " ..(J;;; z~. r'~'- r2 '"-" ...~~ .' , The Building. Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ~:"~',;) 'j l//,~ ir / t.:. _,' ) /-'t';' - ,t -it.','j " I ",[\,' '-''','' .., 1') ~,.r(,;.Q......- Accepted x Accepted With Corrections Denied Reviewed By: JJ1t.f5 Date: 5""- /z-03 Comments: --5ee Reverse Side for Additional Information! /J'lc,,'J/l (,'/r See A tt;!c.hment~. 1) lTT";!c1ing PI;!n, 2) Erosion rontrol Measures "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.h~ Crnlrr of thr l..h Counlf)' Main File ~,\Ite .- aUllam!l> -Canary - t:ngmeering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T NAME OF APPLICANT APPLICATION RECEIVED ;/) O/J?LVYJ!~ ~ - - 5- ;2-00 The Building, Engineering, and Planning Departments have reviewed the building permit application for constr~39aqZ Whi;f ;;;;s~ f( I ~ - / 0- V Accepted Accepted With Corrections /' Denied IA-' ~ -;7~ /f3:J. ~Lf' ,A ~ ~ .t2 - ~ . ~ ~L ~ ....:/ .4'1,,~J)6f} - ~ . ~ #A?r1 /1"'1[;&; '1y ~ / .....J .,10 ~......./") /-H:n.--. Date: s,//?/aJ Reviewed By: Comments: ~ / - Hzn,.,. 7~' -.0 ~d.:r.-- , ~~ ~. "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," ",,~:i PR/OIi' ( D ~~. Main File ,White . Building 9mi'rv . ~naineering ('Pink - Planning:::, - The (rnln of lhf L.kf COUnl11' BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ,/ ) .'~"'" ,- ~'- , ~ -( '-- Tt!1e Building, EngineeriQg, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ..'- / ' // ,0.1 V / .i,G Accepted Accepted With Corrections /" Denied ~~viewed By: Comments: ~~ 7J.1~. ' '.J ./~ J Date: .s;}9'h,3 ~ "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." ----- 0NI!r.. . nt,Z 't'l:.u.ow . "''''UC''..A.,. GO\.? . Cf'TT c- :) C!~Y OF PRIOR LAKE SZ\-<ER MlD WATER ?E?.":IT 3' - L- d-.O NO. J NOT;::: Se"'er and Water contractors must be re<;istered ....ith the City. PHONE :~SJ-'l9.~Jst5 DATe;: 5'/ J;;lJO~ i'.P?LICAllT: W~~€..\ ~~~, I\DOR~SS :Sj~ ~ )2:i~,:\~ \ s -: ~:~).,":"f_~?-::: ~ =~_:G. ?::?.:~!:' - F!LL IN Tr.E: BU.NXS 30 f29t.-. 1 . Es~i~2t2d leng~h of water se~Jice / ~ "-. Size 0: water se~vic~ ~ . Lcca~io~ of any co~plings from inc"-(es) . A s-:.::-~C'':.ur~ 1A...9, V\ P'iC ~ 3tl feet.. 4. ~ype of sewer pi~e. A3S C~st I:::on 5. 6 . E3~i~2~ed leng~h of sew"e::- line Clean out ( . ~ L_ rec;:'"..lired) , loca~.;ci Fo,~"" at-~1Ji1=-f"'2t f:-o~ s-::="":c':.u:::-e. ====:=======-=========================================-==========~ ?~~s a~~lic?-ti~n cec~mes ~O~~ pe~~t ~hen 2p~~ovec. B'C DA~:::: =~======================================================;;=====~== ::::::s: s s s 35.00 .50 ~5.50 Se~er and w~~e= line connec~ion pe~it. Surcharg'" TOT.". I. * Fee :~~ eithe~ sewe~ c= wate~ i~civid~a~ly is $20.00 plus S .50 s'..l:::c~a::::;e. * Se~e~ and w2te~ pe~its issuec fo~ ne~ cons~r~ction ~~s~ be =,;c;o=~r\"'" ~~:.. t.......:.-:..-p.inS pe=mi.-=. c~:::-:i 2.t. the ti!ne of i:;~ua:"1ce ~:l it~:E,{lc'tIT"!~F\I}~I,I,qf.1:;Ju..cate se..e= ar:d ;rater- pe"..-::Iits are 1-55'" r .LS ll) ~' I tlAID WITH D;.":'::: ?A: bt MAY 1 3 7003 ~ II A::~OuN'!" p-'..::o BUILDING PERMIT ?,:::c:::?'!' By ____ R:::C'D S.! .. " :. '. '.~ ..:.. T '" ',,' '( ~ _ " .' " _. ~ .. . ,','- ., -:"- . ~ . .., ,,- 1'-''-'''- .', I ':::,'"' ~,...-.= ,,7~"1 .'".... 8 d SOOES0098l>ON.IOSI 'ISlOSI EO ,liS (NOW) L9EO-lSl>-IS9 0NIIV~H ~ DNI8Wf11d 1~ZN~M WOB3 10/24/01 WED 11:22 FAX 812147t245 r.rTY OF PRIOR LAKE \O"'''InO-''(lU:Io<...\.......~u.''''''.> @OOl Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ll!tlw: ,iI.. I. Colli Cill , V.tkrw AppltC'll/'lI , PERMIT NO. 3- S- OL q erIcaX' _lY1JC or :Drint ILtld sUm at bottom) ADDRESS 3'lWc, ~~~~€-\2J., ZONING (oftlcc...) , LEGAL OF-SCRlPTION (olliee uleonIY):s-~ ~ ~ V'. LOT 3 BLOCK I ADDITION. ~\.J :> ~~e~R t~\ett'\Sm~X\Y\ ~O~e.s fPhone)6S)-'-tO?:,-l/lIoo ,(Address) j2>~S-~lo,~~~. ~\'k~D t>('\~Y\ ,~t\\ ~'::>J;Zz. - I ~;;:~ANT L,)~cl \'\b~ ~ \\\~~, (Phon,,) ~/-fsJ~/5CS- (Ad<Um) 17/D 'I\~C\~J.~ \~J, ~R~, 551:21 (Add:r~,) ..-' (City) (Zip CodeJ-- (ComaaPer>on) \1-eel \-\~9.~_ .- (phone) ~5'I.-1s;2.-15bS A}>PUCANTSIGNATURE #$/fI!t(l[ DATE li'/12)03> .ufrUCANT PLEASE COMPLETE BELOW Type of Fixtllre I Quantity Bath rub with Or without $how~r I Dishwasher I Floor Drain I Lavatory (Bathroom Sink) I Laundry Tray {I or 2 compartment Sink I I Shower Stall , Sinks Bar Sink , Wal~r Clooc:t (ToilC\) Quantity I I I q I a I '"'S PID Type of Fbnare f Rough-ins Water He'lt.,. W'ller Softner I Stand Pipe (Washing Machine) I SllWa~ Ejec:tor Bacld10w Assembly Baeld10w Assembly Test Lawn SprinltJer t Othl;:r I FEE SCHEDULE lndumiul. Commerdl:ll &: Muhi.rilJT1i1y ''''.ofjob t:o,t Iollith a $39.50 minimum Resldentlll. New One &. Two--Famil)' 599.50 Residenti.1. Additions a:. Altenllons: SJ9.50 (omCt Vie Ont)') ES1)mared Cost S Building rcrmit # PAID WITH BUILDING PERMIT PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ .50 m A>:::,:::.::.~mm Y.m "'.'" p'm",~'" A."..~ I}: 11' : ::,," i ~ II i ::.'. "'/{I :a hoc,' 'ilotice !u'(.1I iOlptft[on. <"51,"1 ~1)5.j. r~lr. ~~S1) ~',......Z~5 f / L, d SOOES0098vO:llOSllS.1JSl EO .GiS (NOW) "hv v~f-i~9 SUIF3: i :JNI8Wflld 1!ZN3NI lM.l ~ .lJ..,~..:.: S I.JL:...... anc:l wa1:.e.l.- contractors must be registered with the city. APPLICAlft': S: &Ak. ~ F~. ":,'.'''':,: tJ;) -;)JJ-3f;)0 Aw,...-ss:~d ~~~I"'~ TG-UMl.DAft: 7/lflD,~ SIGNlbu~: ~ ~,~ BLDG. A:..........._ ~ SI'l'B A..~:_ (13~hi.:eeE~p:rDt !ILL IN THE BIANKS L Estimated length of water service "-~() feet. " 1/ 2. Sille of water serviceS;" - / inch (es) . 3. Location of any couplings from structure feet. 4. Type of sewer pipe. ADS PVC V Cast Iron , . 5. Estimated length of sewer line ~(J feet. 6. Clean out (if required), located at structure. feet from --- -- _.__~__~__,~.;II=L_________==-=_ This application becomes your permit when a~~~u~ed. BY DATE: ---,-- - ".-...--.:==. _.~- ---,- --'--'---~--- .._,_. --.- ,-- ^------.-- ---- -===========------ .===== FEES: ~ $ 35.00 .50 35.50 Sewer and water line connection permit. Surcharge TOTAL ... Fee for either sewer or water individually is $20.00 plus $ .50 surcharge. ... S "'''' <-.<<,,,O>d _t-.n'" <;... ,its i...........J for DBV _..._~__1:ion aust be re-:~i\' 1t,it.i:~'X.iJ.ing, ..., it cud at the time of ~ssuance to 1 f~I",j., 'tblIt! ftb'-~, ., ,licate 5,,-,,, ~._ and vater per1l1ts are iSSUI~) ii H JUL 1 5 2003 i,." PAl DA1'E PAII~Ll lL): AM~u.'" PAID~ D IN/TN RECEIPT ~y--- -=-______1 REe' 0 BY l/VG PEFiMtr 16200 Eagle Crcelt Av. S.B.. Prior Lake. Minnesota 553721 Ph. (612) 447-4230 / FAX (612) 441-4245 . A.. Pft1..1 t\t\nt\1'tl1ftih, 'Rftlnt.......-r te-d 89~L 'P8S 2::~6 .~x~ ~ ~Nlawn'd ~~~s Wd ~2:2e 200Z-~1-'n~ 08/26/03 09:13 FAX 65189499?5 "~NZEL HEATING & AC ~001 CITY OF PRIOR LAKE HEA TING/AIR CONDITIONlNGJFIREPL-ACE-PERMlT Date Rec'd ~ ~ ~:~ I PERMIT NO. '3 - S~ \ J. Yellow AIl~IClIIIC (Please tY'Oe or Drint and sim at bottom) ADDRESS 3910 '~o<:;k,P~--'j LEGAL DESCRlP'T10N (office we only) ~'Jr tl I ZONING(offioew,) I LOT BLOCK ADDITION PlD OWNER (N ame) /J bA r'5/'fb fff\ ~ (phone) ,,51-4-r-h-4 4-~ (Addr~) " APPLICANT _ / ,/ / (Name' 'u"b",,/ .7.o{ ~""'5 (Address' 47-?/ dd "<::;/&h ~/'/1 ~J\J (Acl<In:s>) / ' (phone) t-,~/-~~ ~~H ~ty) ~f{2.. (Zip Co,",) (Contact Person) (phone) DATE APPLICANT SIGNATURE APPLICANT PLEASE COMPLETE BELOW )ii!!!f<EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS fURNACE MAKE AND MODELb!/IIr.,1 h 5"1 {;)"?,. 'i. cs- FUEL ",...bJ- FLUE SIZE .;)-:<' / RETURN OPENINGS (~ INPUT 7S; r::nJ OUTPUT ~ TYPE OF SYSTEM REA UNO OR POWER PLANT g:rWarm AirPI:llltJ 0 Steam OGravity 0 Hot Water 2~~c:hanical 0 Radiation ~ir Conditioning 0 Special Dc:vices j;3VenL System 0 Other Device. PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Industrial..Commereial &. MultiaFamily FEE SCHEDULE 1% of job eost Re.idcnri.l, Gas Firoplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only $39.50 Residential, Heating & NC (New Conruuction) Residential. Hcoting Only O"ew Conruuction) $39.50 $39.50 Estimated Cost $ Building Permit # HEATING PERMIT FEE ST ATE SURCHARGE TOT AL PER.mI' FEE $ $ S PAID WITH BUILDING PERMIT (om" Us. Only) This Application Becallles Your Building Permit When AppraVedr\ '1'~ ,..:;--~-: ',. l.c; \ i,lll Receipt No. I I, 0-~\;' i " L' Ii Il I'l "il . BuildingOffici.1 Oal< i';dD~~p 04 2003 i HJ By 24 hour notic. for all in,p~ction' (9~2) 44 ~r~';~: (95=)~!~24~_J - -- - -.- - - -.. . ----- .,~..~- CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd (Please true or urint and siJtIl at bottom) ADDRESS ; ;;;,~ ~::y I PERMIT NO. ~ - ... ~ 3. Yellow Applicant ..J-..J~ ZONING (office use) 3946 RASPBERRY RIDGE ROAD LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name WENSMANN HOMES (Phone) (Address) APPLICANT (Name.) ATJ.TED FIRESIDE DBA FIRESIDE HEARTH & HOME (Phone) 651-633-256J (Address) 2700NORTHFAIRVIEW AVENUE (Address) ROSEVILLE (City) 55113 (Zip Code) (Contact Person) BRENDA HUSTON (Phone) _651-633-2561 , APPLICANT SIGNATURE BRENDA HUSTON DATE 6/21/04 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA nONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM HEATING OR POWER PLANT DWarm Air Plants DGravity o Mechanical DAir 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 HEATNGL06000TR-OAK X2 Industrial, Commercial & Multi~Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99,50 $64,50 $39,50 Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) Residential, Additions & Alterations Residential, AC Only Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Permit # $ $ $ .50 $39,50 $39.50 ~, P.Ng W!rH ,~''UJi;i/) 1Rl,,' '''l~B · ~'~'ii1~ ~ ' .,':. ~RMn- (Office Use Only) Buildine: Official I Y ] rE ~ rE n wl: ID] I 24 hour ootice for all inspections (952) 447-9850 fax (952) 447-4245 By Date This Application Becomes Your Building Permit When Approved PRIOR LAKE INSPECTION RECO SITE ADDRESS . ~911 b~ r NATURE OF WORK USE OF BUILDING PERMIT NO..o - '0 DAI'i ISSUED . CONTRACTOR ~~;V /!fII"'.sPHON~~.~" 7&. J;}- NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF Main File BUILDING AND INSPECTION D id~ ~N.~/,~OR DATE I FOOTING 7 CJ H-A ~ if') I G,~r v? I F04NDATION (Prior to Backfill) I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGt:I - INS SEWER I WATER I SEPTIC \.0 )00/'-\'" (i) (( FRAMING (~ ! C/ ~ INSliJLATION LI\J ) L-' ~~ ELECTRICAL (/~ PL~MBING HEATING (if required) FIREPLACE GAS LINE AIR TEST COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED , ,1 f'.. . I I "-p~ ,h~~FINALS I,... I GRItDING (Prior to Sodding) /~ t;; BUIIf.DING -illS ELECTRICAL PLU!MBING , HE~TING DO NOT OCCUpy '7-(( it 7tY 2o'l ~L IN ~ fA 7tL 4& \I\'J '~~ II /~t? (I)" , )1- :!~ g-tp-.orJ wCP,6 A-'< (J// UNTIL ABOVE HAS NOTICE ~_"'D, BEEN 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 --,---~_._~--_.__.__..,--^.- DATE TIME CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED "Cf-oS- ADDRESS :r? <-J ~ R.CLAP, ~. u OWNER CONTR. PHONE NO. PERMIT NO. j - 5 ~a o FOOTING o FOUNDATION o FRAMING o jllSULA TION XC!'INAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRADIFILLING o COMPLAINT o FIREPLACE Rl o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: (\k +0 " _~I\ n;. ) ~~~~ ~RK SATISFACTORY, PROCEED ~REC AND PROCEED o CO . ECT WORK CALL FOR REINSPECTlON BEFORE COVERING Owner/Contr: 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE., CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/ PUlWrI CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS 311./1 D ~.a~. 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 'xPLUMBING FINAL o MECH FINAL COMMENTS: ) I.~~~ 2. ~G...~ - ~..v."'-4f. ' 1 J 1. G,lu,.t. f"~ L./. 0..~ \7..... M-n , :). t'.~ \:}J.:\l l~.s - DATE TIME 8-2,.-0 " '3 . S:<o o EXIGRADIFILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o 1./ In, 'tl!>"78 o .JIORK SATISFACTORY. PROCEED I'f CORRECT ACTION AND PROCEED o CORRE1ip\CALL FOR REINSPECTION BEFORE COVERING Inspector: IJ----V--I Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE, INSNOTI CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI DATE TIllE CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED LJ-3()-O/ ADDRESS S') 'I' t,~r~v ~i't /ld, OWNER CONTR. Wrl1bM4no'\ J-ItJ1W5 PHONE NO. PERMIT NO. (') S j-U ~~ILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o o FOOTING o FOUNDATION o FRAMING o INSULATION ~nNAl o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: 6r..k, l!J ~ Lo/'/!::. Br.~ __" It kf WORK SATISFACTORY, PROCEED /,{}cORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING Inspector:-?,ffdA - - Owner/Contr: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .l SAFETY! "",om