HomeMy WebLinkAboutBldg Permit 04-0576
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
White
Pink
Yellow
File
City
Applicant
I PERMIT NO.O 1-- 057'" I
(Please troe or print and silU1 at bottom)
ADDRESS
a0~Y W~\~ (t,~, tq.-t"'fl1'~. Aj~_
LEGAL DESCRIPTION (office use only)
LOT~ BLOCK I ADDITION(lQJ'!'\'\'(I)A'\("
~.~ t?{le.-
Date Rec' d
J -db-Olj
ZONING (office use)
elfP
PI~ ~G$I-Of.)f+-O-~
OWNER
(Name)
(Phone)
(Address)
~
~
~C~~~~Name))\f1..J~~M,e'S I_LC---, (Phone) V;~~O~%3Y
(Contact Name) l\(' ~~ ~\\':\;--1"\r (PhOne)<?\':L-~()h-~Y
(AddreSS)\?O~\.t) ~ CiO ~~rl<l' _ \J QJ/\,.u~{,,- ~ lr:Ly
TYPE OF WORK ~New Construction DDeck o Porch ORe-Roofing ORe-Siding
OAddltlon DAlteratlOn DUtility ConnectIOn 0 Misc.
DLower Level Finish
o Fireplace
CODE: DLR.C. DLB.C.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECTCOST/VALUE S~-t
(excluding land) <ita g~ 00 0
I
E
II
F
I
III IV VA
HIM R
2 3 4 5
I hereby certify that I have h.lmished information on this application which is to the best of my knowledge true and correct. I also certify (hat I am (he owner or authonzed agent for the
above-menuoned property and that nstruction will conform 10 aU existing state and local laws and wiU proceed in accordance with submitted plans. I am aware that the buildmg
r JU t CiIU Furthermore, I hereby a~ee that the city official or a designee may enter upon the propelty to perform needed Inspections
X gna:-~- Qn?;;o~~t~S(Li~seNo Date
Permit Valuation
Park Support Fee
#
#
;)/<) ~.c'lO
,
IJtf3.5'0
I :13~. 21L
. '01 . 5t>
----..
Water Meter ~";l";
Pressure Reducer
Permit Fee
SAC
Plan Check Fee
State Surcharge
Penalty
Sewer/Water Connection Fee
Water Tower Fee
#
#
Plumbing Permit Fee
I,.,,., _" ()
Mechanical Permit Fee
100.00
Builder's Deposit
Other
Sewer & Water Permit Fee
: I.~:~I
$ ';tSO.a51
$ LIlt;; .OD I
$ 1,2~ .001
$ 'Ot').m.
$ I. c;oo
$ ,
Paid
Date
q {O L{'.. '?d'
(~, / -']- Lf
I $q, /54. 7~
. - ..;./
Receil'tNo.LI&.1('; Cf
By??
U-......
TOTAL DUE
ThiS is to certify thaI the request in the above application and accompanying documents is in accordance wilh the City Zoning Ordinance and may proceed as requested. This document
whe . ned by t ty Planner consl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
;""d (p~LotJ .~~,R t.Uf c,,, wY~.."7;;:;;
--, Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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Main File
~itA .. Rllildin9
"Iarv . EnaineerinD::>
Pink . Planning
Th.. ("..nl.r nflh. L.k. COllftlry
BUILDING PERMIT APPLICATION DEPARTMENT CH~CKLlST
NAME OF APPLICANT
APPLICATION RECEIVED
~f\ \'2T:: H6fi E ~
'::..; . ? Ie . 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Ct ~ S 4- VI! I L- D Of\ ,?-S I T-/ 12..I('../-\ ~
Accepted
x
Accepted With Corrections
Denied
)
Reviewed By:
fJIYfD
Date:
(,- IcJ-oi
Comments: See Reverse Side for Additional Information! "
/fle, ,'r. -r,' ((
See Attachments: 1) Grading Plan, 2) F.rosion C'1Ultl1I1 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." .
~~
Ue~
Main File
White - Building
Ca,!ary - En ineering
( "'mK - Plannm
Till' (""n!e, or Iii.. 1..10... ('ountl'l
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,"
> <}-
'-. /
( l< '-
i Ii \' I.C
! .. -, - ....
Accepted
/'
Accepted With Corrections
Denied
. Reviewed By:
~~
.6~
./~~
..,
Comments:
AY--
~
(/
m/1 " r--.J
Date: c;,,I / / Ie cf
~ h --6-< ~.....tU
~ G;i) If. t), vJ { fJ_f#t!.R. ~
d,~-/ fJc:y
r
.od-€...,R-Li ~.
,
"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."
~~
Ue~
Main File
r\_\~I=I_it8 B~ild~
i.;anary - I:ngmeering
Pink - Planning
Th~ ("l'nll'r or lhr t.b ('ountr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
BA\<T5 HOI-1 (::,5
5 _ "2..(p . 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~364- WIL-.D OI\~ It-./~
Accepted
Accepted With Corrections
.,.,(
Denied ) )tf. r2_
Reviewed By: ( 4~-.
Comments:
UPo.~ ,-JO a4r~ ~O ~
Date:
rs,. ~ -oy
"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."
06/18/04 FRI 12:04 FAX 952 890 2753
STOCKER EXCAVATING
@QQ.L
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
1 (;t"""
2. Y~lIo"
). Cold
~::~. I PERMIT NO.
IIpPhU,,1
tf- 571:,
04-0576 I
(Please t'\::Pe or Print and si~ at bottonl)
I ADDRESS
6384 Wild Oaks Terrace
I ZONING (.ff"".,,) I
LEGAL DESCRIPTION (office us. only)
LOT 6 aLOCK 1 ADDITION Wild Oaks
PID
OWNER
(Nal'"'~\
Barcs Homes
(Phone)
612/306-4384
(Address)
P.O. BOX 240593
(Address)
Apple Vallp.y, MN 55124
(Ciey) (Zip Cod.)
APPLICANT
(Namel STOCKER EXCAVATING COMPANY. INC.
(Address)
12336
Boone Avenue
(Addrc!:s)
Curt
Savage, MN
(phone) 952/890-4241
55378
(Cicy)
(Zip Codc:)
APPLICANT SIGNATURE
.. J < /J ~_ (Phone)
.,~ p 'AJ~~ .f}!,:~(Q:-f_8'-OY-
v . V~
same
(Contact Person)
~
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from strUCIure feel.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet fTom structure.
Residential sewer and water line connection
Sewer c(lnnection only
FEE SCHEDULE
S35.50 Industrial, Com'l & Multi-family I % of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
.50'~~
. '%~~~
~t...'
(Office: ()se Only) .,~
"" ":~:,:::~::.:'m. ,,,' ~.",., ,,,.,::.m A"mn< 1~~.r: : ;:o~~IW, "'.oN, '~;
" ..., "". .",o;.'.m.. on, ~M' I~:" on, ~H'" - - \ (f
SEWER AND W ^ TER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
,
09/03/2004 14:33
9528947972
LAKE SIDE PLUMBING
PAGE 01
CITY OF PRIOR LAKE PLUMBING PERMIT
Date Rec'd
(Please ~~ or tlrint ~nd st2n .n bottom)
ADDRESS
lo3~ ,.\:1\ ~S
LEGAL DESCRIPTION (o/licl: u<e only)
LOT BLOCK
ADDlTlON
OWNER (J .
(Name) =-
(Addxess)
I-l:!!~
APPLICANT I
(Name) ,;J,gJ, ".I~"
~
(Address) 1:;)>/ Lq 4;l\r"", 0;.J1l..
(Address)
(Contact Person) 1\0....
APPUC....mSlGNATURE ~
Quantity
;;J
I
I
i:;
I
3
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower I
Dishwasher ,
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
. Water Closet (Toilet)
" Dille fila
1 Cold CII1
}, V~Il_ All!lil1::lnt
I PERMIT NO'04-. OOlb I
I ZONING (olllotuse)
I
PID
(phone)
(Phone) q~~. f'l~ -lioN>
(~~~~r
(Phone) 5<:uwIe_
DATE q-~-o~
.I{~~
(Zip Code)
Type of Fixture
\
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I' Lawn Sprinkler
Other
FEE SCHEDULE
Industrial. Commercial &. Multi-family 1% of jl;lb cost with a $39.50 minimum Residential. New One & Two-Family $99.50
Rc:sidonti.al. Additions & Alterations $39.50
(orncc U8C O'rlly)
.-'-Rf":'j
ji)p'~ WI] ~ 11
ill} \ o.a.t' 1 0 ,UU4 1 By
Estimated Cost $ J1.;2 \ ()
Building Permit #
PLUMBING PERMIT FEE $
STATESURCf~RGE $
TOTAL PERMlT FEE $
This Appllc.tion Becomes Your Bujldin~ Permit When Approved
Itlllldin:r.OiJ'lclal
D."
q'l.$o
.50
.no
Receipt No.
:14 hOUT no'ice for .11 ;n.peetlons (952) 4- .B150, r..x "52' 447-~~,
Ui200 Eaglt: Creek Ave., S.E., PrIOr ...-.t....", ~.,u" :J:l!.,)'1.L-1714
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please tvvc:: or print and siltll at bottom)
ADDRESS
;:i:."", ~::y I PERMIT NO. i.J _ ,--,L
3. Yellow Applicant ! . \",.iiI ~I/:I
6384 WILD OAKS TERRACE
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name BART'S HOMES
(Phone)
(Address)
APPLICANT
(Name) At.t.tFDFIRFSlDF DRA FmFSlDF HFARTH "'HOMF
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(AddIess)
ROSEVI.t T P
(City)
55113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(phone) _651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
10/11/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM
OWarm Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL.
HEATNGLOPIER-HV-IPI & 6000TR-OAK
Industrial, Commercial & Multi.Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Additions & Alterations
Residential, AC Only
$39,50
$39.50
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
.f"/.';,,; ..
18. ''''~.{ift:,_,,,
," t'/f - _ "~""'~ :<~"''!
'" i'~,"""', '"-''' · t,'.'" h<'
'-'",""" '",..,
I,:ru ''''''''''.
1"<::!~'vF.7'
(Office Use Only)
BuildiD2 Official
Date
I~~JJ; ~~ I~ II \I)
lR~e ULI
",r'I";'N"
1 3 2004 ~1.
This Application Becomes Your Building Permit When Approved
24 hour notie. for all inspections (952) 447-98 JG1ax (952) 447-4245
';,,:':
FEB-18-85 01:25 PM JUDK1NS
6514234189
P.01
FAX C1HHUa
CITY OF PRIOR L.~E
".J \.I~I..
cln OF PRIOR LAKE
HEATING/AIR CONDITIONlNGIFIREPLACE PERMIT
Date RIle"
\."*
t._
1,"..
S_ I PEAAtIT NOf;J- 5"7t ~
. _._d_ fi6N1NC,h_''''j
'~~attlo~1'a'
At)t>Pi!SS
flbg~~
UG....1. D!SCRIPnoN \._ u.. .MY)
toT _nB.!,9.cx _'_'_n~P-DI1!.cll"
Pro
., =~-.:EilV~++(WW~ ________ '. (Plume) liJd -~-42&i\
.1Mdns,l ~fCd- ~Y:a6q?, 1 kp-P~ Va ,tleL{---.. . .. .----
~~~~(J01~.Hf\S +1ecili~ {Aiv- (phone) -.i.a.S,l-4:+-~':'R7S1
CAddles,j--16lES C'..oxrOl..lo/l ~__ t hfD~e .
""""'_. ~ ~c, . ""'" , I '" a. I
~Pl.l~T~O}l^'I'UlU! Uh 'fur /L I)A'JE dLlfiI/OS- __'OJ
APPLICANT PLEASE COMI'LETl BELOW
ONEW CONSTRUCTION .-Cl REPLACEMENT 0 A.LTERAll0NS . -.----
I'tJ1UIlACI!MAQANDMOD1.L GS/ MP-?iof.1>-()1{) FI.;-CL~.s
I1'l.UE SlZE rJ.' I W l'.. .. RETlJJL'i OPENINGS 5r INPUT :Jy r.:cJ:).... OlJTl'UT .__.
'li'l'l! 01' SYS'tI!M HilA miO OK POWEP.. PLANT
iO.::'1)IA"PIlnl! ~~alo'
. chlniQl ~11t(oo
J.I, C""dilio.in~ D Spcti&l 0.;1""
"'1 S~l"" D Othor Devl,o,
I F'lREPL..a; M,6J(E AND MODIlI; _ _______ __.
I PUIAS!.1'IOTl:
All' ClllIdllk.nor I.Inlu
CllIllOll!llcrOlah InIO.
I Requlml ~lda Yard
s.c~.
Ir.ilwtrlal, CommeNi!.! 11 M".lti-FlII\ily
IWlldtl11lal. rttulnl " A1C (New Cor.!:trllClion)
llaidentl". ~"ll.g C>nl~ (Now C"""'"Cllon)
ntE SCH!,DULE A. &
1'\ oIJ.~ Otlll R..,d."lal, 0.. Fiteplle' ~~
S39.~ minimum .
199.1O R<ai41!\,lal,Addiuans&AIlo..,jon. ~ ~~~,so
11l4.SO R..!denlill. At Only ~ ~ ~.lO .
'.'i"-" ~ ~-~-lc
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I PIl4 1.~'IPC No Ii
1,1~
I Dall FEB 2 4 2005111)1
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E51illl&!otl CO!t~
imA TINO PE\l.."dJT FEE
STATE SURCHARGE
'CQ'!',u, nRllOT FEE
tOIic. u.. Oulll
this Application Duom.. Your lanolille P..",1t '\I\Ihen Appl'C~.d
_I1IllOllldal
no"
14 hour ..lict fa. aUlo'p.<1lam ('S2) ..l.faSO, fu('jS2) "1-41~~
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PRIOR LAKE
INSPECTION RECORD
()dL~ /6TaA.L Mai.nWe
McuV\ +v'le
DEPARTMENT OF
l. UllDING AND INSPECTION
SITE ADDRESS 1i3B<./ LtklJ.
NATURE OF WORK 1d...,..J
USE OF BUILDING _"FA-
PERMIT NO. 04.oS7& DATE ISSUED 6 - {'j - oct
CONTRACTOR --gdth ~ PHONE ~/2:' '?a.f" .cf.~y
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
OATE
I FOOTING ~ ~/.:LI/+
I FOUNDATION (Prior to Backfill) ;1~t.V~~1 .H1'~ LY.z-1' /ne,/
PLACE. NO CONCRE.TE UNT'L ABOVE MAS-BEEN S'ON1!D
L,J' sj6t(4~ ~ff7kROUGH - INS ,
SEWER I WAfER I SEPTIC / . _ ~ ,/~ I
FRAMING ~r7 t{/.,// 4t/ iIli'r ., P/f #~;; q L.L. ~
INS~LATIdN-...2"'~ U/d~ Qd ~?"k - /{1-- / //1"" /df ~I..~.,...
ELECTRICAL 9P? /q! _
PLUMBING ~ r/ft? /0</
HEATING (if required) J.)1. /411-- IIf; 11 Jt~~ .& hi #?(
FIREPLACE ( r7- I ffi'~ //h~</
GAS LINE AIR TEST /il"h, /4~ro! 1'#/ /# ///s~Y
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
- --
- ~i/se Wrtf/J ~/L ~Wftl ~ I /?/u;0~
. , FINALS
GRADING (Prior to Sod~ing) / #8 3~: ~s-
BUILDINGtbIY/' c. avnfl ;;J/<?S AJj _*&Ios- /Pj/
ELECTRICAl
PLUMBING
HEATING
DO NOT
Wf~y
//ff
JY/;r-jr
Y//iY/6S~
:2//1 p~
~~P;:5-
BEEN SIGNED
OCCUpy UNTIL ABOVE HAS
NOTICE
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
tfi~-/
h,(R7/ cA./,,// e/s ~/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO_
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,.erFIRAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
[J WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
./
~;( ./
~t'l/C
~
c-ke
oc/- S7L
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~,
,-L-/ / Q
---
~
o CORRECT ACTION AND PROCEED
o CORRECT WO"~~7INS~ECTION BEFORE COVERING
Inspector: ~~ ~.-..0wner/Cont~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
f"SfO'"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
q~LATION
".8'FINAL
o SITE INSPECTION
COMMENTS:
4E:)
~DULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
_ AI" /' .--:: /
/,/"/ C'c 4,//..-zq /
~e>>O p.e ~ /-c,.-- *J /- 6'~ ,
~$h~ ~ &~,,{...- r')k-
Q
4e.~'/ . ("~CUJ
/)..-.r h / A:> rf
@ ~/A.' ~.n~v", c! IJ2Y~"'C-iL V~klr
~ r:;-- Ck.HrI .-:7/-' 4?/Pv_ c/ A, *~ev...
,e:?-LkLoLs-:/-- h,p .
/l
r-/;"/s ~
o~/
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o CORRECT WOR'; ~~rOR REINSPECTION BEFORE COVERING
InspeelOr:~!--- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
DWV(}Tl
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
CQMMENTS: . " j1
(j;/ r;// ~A"!!!t:: O:..y. A':%/~ ~
nh4!/ rz._~ -Wdp'.........lJQ I .
/'l- (]t..?J~ Gi' y0/- 9'PJ~
C~S~4~P7~~ //<='; ~ ~<-
@ .N-eed k)?}fy 7fO;'- U/.~-e'9 .
^';'~i2'/ j., ...... n;? C ,/4.,;/- A~-- ~/A-
I;?~" a, 4, 1M- 9' ' ~ ~/ 'o~;L A . .'.
cfr-IJHk -h1L-. 1.L/_/e6 -:$- 9r1-.!!...._~:A,
- // /p
(, O. LJh/;. y~/~-~
.J':;. t- Y? ~
/
/:z/ / / d:;y_hu.5 L) fP chp,,--,
- ~..L_ "
~ -..... a-/ .,,-#?S ,,?v-<> /"~LJ
/
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
Inspector: -4
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
UiSNOTI
DATE TIMe
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
3-2-0$"
PHONE NO.
c~~r [y,W cYqKs I>,ttre.
CONTR. &r k f!tzvIV j
PERMIT NO. 6L/-S7~
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: .
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o WORK SATISFACTORY, PROCEED
)(CORRECT ACTION AND PROCEED
'd 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 .l SAFETY!
tNS/llOTJ
DATE TIME
~~J-
/{J rf't( tU.,(j CJ415
PERMIT NO. M"-S76
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
D FINAL
D SITE INSPECTION
SCHEDULED
CONTR.
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
~PLUMBING FINAL
D MECH FINAL
D EXIGRADIFILLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLlNE AIR TST
D
COMMENTS:
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D WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
D CORRECT WORK, CAL F. R REINSPECTION BEFORE COVERING
/ /
A/<?J P rI
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Inspector:
Owner/Conlr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN AOVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSlWTI
Olrrfifirafr of OOrrnpztut1Z
CITY OF PRIOR LAKE
,/ ,Department of ~uiIM.g J ..pedin.
"AJ Final Permitted [] Conditional CO. Expires
This Certificate issued pursuant to the requirements of Section 110 of the U Residential / U International
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:
SINGLE FAMILY 04-0576
Use Classification'"
Bldg. Pennit No
Occupancy Type
Type Construction
1.8, Bl, WILD OAKS
R3
VN
Zoning District
RISD
Legal Description
Owner of Building
BARTS HOMES, P.O.
Contractor's Name & Address /ft - /'
_ ROBERT D. HUTCHINV..u=?-
(~ ,)luj)dfng.2fficial
Date: ci"".. C ) /0 \
'J {--
Site Address
6384 WILD OAKS TERRACE N.E.
BOX 240593, APPLE VALLEY, MN 55124
DON RYE
City Planner
Date:
J -I-(:)~
,..
if - 1 ..oj
GAS LINE AND
APPLIANCE PFRFnRM~r:F TF~T
(Contractor to complete * items)
(Attach to gas line adjaCe~t to regul~~)
'Heating Contrac!o,::r wAJ f:." )\ s ff'fG
c
'JobAddress (,,3VI,t f,J.Ja<5At:.<jL
-
"---;::::#~'e-
!lAB LINE ANQ
APPLIANCE PERFORMANCE TEST
(Contractor to complete' items)
(Attach to gas line adjacent to regulator)
'Heating Contractor ;J'...rk..; VLS tffq
'JobAddress (.oJgcl W:iJ I'lAi~
Approved
.Percent CO2 lft.'
.Percent 02
li.$"
.Permit #
.Permit #
.Percent CO
C9
.Stack Temp. -9-7..
bag" /J.J:ido'iKS
4
* Job ~dress
.Heating Contractor ::r"""d t< ,1", S
.c\ ~
"Testers/Signature
"Gas Line
Pressurized
Inspected
Qlllo
Iilm
P~RFORMANr.F= ~~T
.Percent C02 <0, , .Percent CO
.Percent 02
q,.S"
Final Inspection
'Stack Temp.
Pounds
~
~
Q70
Date
\
Approved
'Pe",en! CO2 (... q
'Pe",en! O2 --9... A
'Permit #
- ,
--/ ~t ler
-Permit #
'Percent CO A--
'StackTemp. -9l..'"
'JobAddressc..~gl.(. w;/~~
II-Tv
'Heating Contractor eC.~ ~~
"Testers/Signature
"Gas Une
Pressurized
Inspected
Qlllo
Pounds
~
Iilm
EEflFn~MANr.1= Tl=!=:I
'Percent C02 ~ *Percent CO
'Percent O2 j) J 8 *$tack Temp.
Final Inspection
&-
Q{p .
Date