HomeMy WebLinkAboutBldg Permit 01-0742
U~~<'t._ QMf DOrO'''.EQ CITY OF PRIOR LAKE
.. life (;, /"?- q- 0 I TEMPg~~~~NgE~~~~~~TE OF
f./ ZONING COMPLIANCE
--~I AND UTILITY CONNECTION PERMIT
I DIRECTIONS 1. DATE
SPACES NUMB~RED 1 THRU 17 MUST BE FILLED IN ..,., fJJZ., 7fI' ZOO!
BEFORE PERMIT!IS ISSUED (Please Print or Type and sign at bottom) (J VI G4/
12 SITE ADDRESS /1/27/ 77lV1cJ1lfr Ar;L, R - I
3. LEGAL DESCRIPTION
/ BLOCK 1/ PID Z)'-jztj-()57-0
&vlJlA/s lJI/1fJt/d~ .' 1(m (fIJ/J/TTtJ7V
.tM1~) )f-S jj{//t{)~ddressl
(Nam) A . . -
rf-lt7(/{j], ~
I White
2. Pink
3 Yellow
File
City
Applicant
1)/ {)142--
Permit No.
BUILDING INFORMATION
11. SIZEJF STRUCTURE
(~ (~/
12. NO. OF STORIES
(D~/
L'
LOT
13. TYPE OF CONSTRUCTION
~/J ~W
14. FLOOR AREA APPORTIONMENT USE
ADDITION
4. OWNER
(Tel. No.)
5. ARellll'~t."I'
~,
6. BUILDER I (Nama) I/dd~ /31'1
~Uwsr.;~, ~fi.ZrM- 5JlV!f
7. TYPE OF WORIk: Fireplac~ Septic 0 beck 0
New constructiOj>( Alterations ~ Addition 0 Finish Attic 0
Chimney 0 Misc.
18. PROPERTY ARjoA OR ACRES 19. PROPERTY DIMENSIONS 1 10. CULVE~
Sq. Ft /5i tI,J60 Width Ida I Dapth 15() Yes ( No..-/
t I have u ished informs' n on this application which is to the best at my knowledge true and correct. I also certify that I am the owner or authorized agent for
d propertyFJ:t all 0 struction will conform to all existing stale and 10 callaws and will proceed in accordance with submitted plans. am a are that the
revoke this t for' cause. Furt~~~r'tt.! hereby agree thai the city official or f1..9~i9rr~~enter upon the property to perte'"'] n ad j pections.
. "/t..-Z-/ . ZOJ lIX 0/ tJ "'I ~ 'Z 'tJ /
Signature License No.
(Address)
,1;51-Jij Z ()7Z'/
(Tel. No.1
15. NUMBER OF OCCUPANTS OR SEATS
f52-?!Z-77()Y
OCCUPANTS
SEATS
Re-roofing 0 Porch 0
Rs-siding 0 Finish Basement 0
:: ~R~)5??'mo
I }f;;;;~TI/~lf~}/_ () /
x
Date
FOR ADMINISTRATIVE USE
SETBACKS: Raq~ired
~ual
MATERIAL FILED WITH APPLICATION
Back Side Side SOIL TESTS 0 ENERGY DATA 0
OFF STREET PARKING PILING LOGS 0 PERCOLA liON TESTS 0
SPACES REO. PLANS & SPECS 0 SETS
SPACES ON PLAN SURVEY 0 COPIES
PERMIT VALUATION J SLf,.~ .CYL PLOT PLAN 0
Front
BUilDING DEPARtrMENT VALUATION
USE OF BUILDIN<i _
C"t::'r')
TYPE OF CONSTj'lUCTION: I II III IV V
Occupancy Group: A B E F HIM R S U
Division 1 234 lI'"')al_ Ie:::-
Permit Fee.......;........................... $~
Plan Check Fee .....oo.moooooooo...oo..... $ B<I? 57"l
ASh. 1'11<"
I. 15'f'l.~o
.
Amount Brought Forward .................. $
Park Support Fee .............. ............. $
SAC ......................................... ~
Collective Street Fee ....................... $
Sewer Tap ................................... 'l::
d" '
Pressure Reducer .......7'/tJ............. $
Meter Hom ... ............. .... .... ........... $
City:
77 . (")-6
State Surcharge ............................. $
Penalty ...........~........................... $
4'6 ex-
f Of'). dO
/ t"9t) . Of?
Plumbing Permit Fee ........... .... .... .... $
~o\
1,,1
Wate, Mete, ..moooooooooooooo....oooooooooo $ / ~5'.M
Sewer & Water Connection Fee ........... $-1, -:J,t:JO . CJl1
WaterTowe,Fee oooo.oooooo.......mmoo. $-'--"l~f'l.~a
Water Tap 0000.........0000000000..........00 $( d
Buildars D~i1 .oooo.moo.........oooooooo $ Ie; &t:l.eJ
Othe'oo..::l{'~~r..$ ,~-
Total Due .oooooooooo..........oomoooo $-S::;~ "I / S
pald&. ~~ I. /~ Receipt No. ~/6Z
Date "1. UJ. 0 I By I1fo.--
This is to certify tha the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed's requested. This document when
sig the aoner constitutes a temporary Certifjca~f Zicng compliance and allows construction to commence. Before occupancy, a Certificate 01 Occupancy must be issued.
:1"',_''--- ~ '1, ~
ity Planner' Date Special Conditions if any
Mechanical permi~Fee ..................... $
Sewer & WaterPerml ..................... $---.35" ,S-lJ
(Jt') .1")(')
ing ~:t:nit i~7~ed~2.~ r'
Issued
24 hour notice for all inspections 447-9850
'l.~X PRIOR <'
!:::.. ... ~
u '"
White - Building
Canary . Engineering
Pink . Planning
Thf ('tnlft orlh, L.kf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT L0~ ~
~ -cJ7-0 /
APRLlCATION RECEIVED
The IBuilding,' Engineering, and Planning Departments have reviewed the building permit
application for construction activity wpich is proposed at:
/1-/;)-7/ \/L/n1CV-c; ~
X
Acc~pted
,
Accepted With Corrections
Denij:ld
Revi~wed By:
~
Date:
i
[
ComlTIents: ~F!F! Rf!vf!r~f! ~idf! for Additional Information!
~ee Attachments: 1) Grading Plan, 2) Erosion Control Measures
!
~) Frt'l~inn Control Plan
"The Jissuance or granting of a permit or approval of plans, specifications and
comp~tations shall not be construed to be a permit for, or an approval of, any violation of
any o~ the provisions of this code or of any other ordinance of the jurisdiction. Permits
presurjning to give authority to violate or cancel the provisions of this code or other
ordinajnces of the jurisdiction shall not be valid." .
~
ii~~
White - Building
Canary - Engineering
Pink - Planning
-
Thr (rnlrriof thr L.kr (.'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~~ ~
ARPLlCATION RECEIVED t, -d 9-0/
i
Th~ Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity wpich is proposed at:
. /tfd-7/ c-~LL ~
o
Acpepted
Accepted With Corrections
-<
,
:~::edBy.941Z /A.. Date /-I;l-2.cr
Cc mments: ,
(J.~//{)j "f-kcL.) 1fJ~
- . -
"The issuance or granting of a permit or approval of plans, specifications and
co nputations shall not be construed to be a permit for, or an approval of, any violation of
an { of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pn isuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
.
APPLIANCE
PERFORMANCt: TEST
Attach to gas line adjacent to regulator
ltllt..,./l ~<.."'.
Heating Contractor
Name of Tester
Date
$1'~
,t:>-t1-1
Heating Contractor
17'1.. 7 I ;,-,..-711-)"
~ _ 17'~.
l.Wt-"'of'- kA.."-(."
Job Address
Name of Tester
Date
,-->>1""'t,~
Percent 0,
Percent CO
10 -/'1-o(
10.(
~ C>-
Percent CO,
Stack Temp
5.1...
tOb
Combustion air is adequately supplied per
UMC Sec. 606 'It...S
input 3l>,<Xl<>
m
~~
White - Building
Canary - Engineering
Pink - Planning
Tht (-rntrr of Ihr L.kr <,'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NtME OF APPLICANT /~~) i)
,~
c . -,--
I, _"."')'" .,', I
!j-\.i ~~,,^-'"
A~PLlCATION RECEIVED
(/)
/ /
'/-u
,
,
I
Th~ Building, Engineering, and Planning Departments have reviewed the building permit
ap~lication for construction activity wtlich is proposed at:
I It!) -;/ // -; L.
, I
',.J
,/ /. /:
4./ ,~....
Ac :epted
~
Accepted With Corrections
I
D~nied _
R+ewedBY: ~~W~~
cotnments:
~J~~~"-\-r~ Tv11At?~~
~C:7->.~Y~~~ L/Czl<' . v
{J;dJDswD U' (),AAI J Tvv~ ~J~ 5.2-
.~. ~~ -c~qJ
V~~{\~ ~.et~Lk<v~~ ~.(
JJ Y2 - ~ ;: il...S"{
Date:
r;/q 1t"/1
~
/:;-
'(~~~ _ AT G /.~~
5L~/IAA'1: ~yt"'P_
, 1 - 2-cj"c.J~
I"/Yl ~~Te....
"T~e issuance or granting of a permit or approval of plans, specifications and
co nputations shall not be construed to be a permit for, or an approval of, any violation of
an I of the provisions of this code or of any other ordinance of the jurisdiction, Permits
pnsuming to give authority to violate or cancel the provisions of this code or other
or1inances of the jurisdiction shall not be valid."
I
GREEN. F...E
YELLOW . APPLtCANT
QOLD.CIT'I
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
s.W N/) (- 7l/:J
NOTE:
Sewer and Water
contractors must
be registered
with the City.
AP'LICANT:
hA/R/~~/J? //./G
13/S'~~-r~/ ~4'r<:.
SI';NATURE: ~~ '
SIPE ADDRESS: /~1/21J/ ~//~
v
AD)RESS:
PHONE:_ 9~ '~?-/..2;;0
DATE: 17--.;(4'--0/
BLDG. PERMIT #0( 07'18--
PID#;>S-- /dlf-()7;,-D
1.
FILL IN THE BLANKS
,--'
Estimated length of water service ~S feet.
2 .
Size of water service
)
inch(es) .
/./0
-
feet.
3 .
Location of any couplings from structure
4 .
Type of sewer pipe. ABS PVC ,~
Estimated length of sewer line ~~/
Cast Iron
5.
feet.
6. Clean out (if required), located at
structure.
C) feet
from
==t===============================================================
Thls application becomes your permit when approved.
BY
DATE:
--.----------------------------------------------------------------
--.----------------------------------------------------------------
FE~S:
i
,
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is ~1~ plus
$ .50 surcharge.
Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
I to insure that no duplicate sewer and water ~r~i~,sTHare
issued. au YA/UW
'7 _ '\ '7 _ () / . lLOING PEF;,V.IT
DA"E PAID (- ~ -
*
AMOUNT PAID
REC'D BY ifG
RE':EIPT #
16200 Eagle Creek Av. S.B., Prior Lake, Minnesota 55372 / Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
FIRESIDE CORNER #1367 P.003(004
....~ ~ .. UJ:' r. .l'.lun. I.".'\.A,I!. JJatc 1<",,"Q
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
(Please ~ or TJJmt md sjg;n, at bo(CDml
ADDRESS
H=- ~~;~, , PERMIT NO. ()l- ,Lfd-1
(f./;r;, ~mD~ a.x;.iF
_ _ J I ZORTOffi~~)
LEGAL DES.CRIPTION (.lliee ""e .nly) ), -
LOT I Br.OCK U ADDITION f7'mA~
OWNER
(N am.el
'1110 /I!LbV 4~
PIP.:)')- {JLj- 1)3'7-6
~~~.
(Phone)
(Address)
APPLICAN1
(Name) AI r.J.EO FIRESIDE DBA FIRESIDE CORNER
I
(phone) 651-633-256]
(Address) 2 ~ 00
N. FAIRVIETII .l\V~T1"
(Add/1:s,)
BRENDA HUSTON
(Contact P~I'$' >11)
APPUCANl SIGNATIJRE
~ ki.~
....._.._~"""TT,r.F: MIll
(elm
651-633-2561
(Phone)
~'iJ-'~
(ZIp Code)
DATE
.?'l!JGlof
APPLICANT PLEASE COMPLETE BELOW
DNEW CONSTRUCTION 0 REPr.ACEMENT 0 AI- TERATlONS
FURNACE M U<E AND MODEL FUEL
FLUE SIZE RETIJRN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWIlI'ITl Air Plonrs
OOravity
o Mech~nical
OAi, Conditioning
OVon~ Syst"'"
;;J~ AJ6~
o Steam
o HOIWal.r
o Radlalion
o SpecioJ Cevlces
o OIhcr Oovlces
->t.. 7~
PLEASE NOTE:
Air Condi,tionor Unil$
Cannot Encroach inlO
RequiTed Side Yard
SeJ:l>acks
FlREPLACF. , !AKE AND MODEL
Induslrial. Comr ,erel.1 &. Mul~-F.mlly
FEE SCHEDULE
J% of Job eo.' Residential,OllSl'ireploce
539.50 minimum
599.50 Rcsidenll.l. AddilfOlls /Ii- A.lrera/iol1S
564.50 Resldentl.l. AC Only
539. SO
Residenli,l. ROll :fng /If. Ale (New ConlllNctlon)
Residenti.,. HOlI ing Only (New ConslfUcdon)
539.50
539.50
E.lfma1:t\d COSI S
Build.ing Permit ~
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PI PA,ID
"...1/'0 IA,/",
. :i\!C/~{';!,
...tjJ;/;rr
l,Omct flle Only)
This AppU", tloll Becomes Your Building Permit When Approved
Paid
J(e:eejf;t Nn
-
1I.1I~"', O/Jid.1
Dart:
Da~/ 31--61
BY?
U hour ..olioe for.II Inopaetinn. (952) 447-985&, fax (952) 447....245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
7-/fo-o}
,
1~;~1:~tands:~ottom~ Av~
LEGA~l:~PTIO~'(:c~useon~) ,
LOT! BLOCK L/ ADDITION)') () V-~
; ~;.:" ~::y I PERMIT NO. -7/J J.-
3. Yellow Applicant ( - I-}
ZONING (office use)
(7(
,
y1l~ Lj-tA
PID ;;{'S ~ I:) 1/- () 37 ,()
OWNER ,12
(Name) Drenn.(;,V
(Address) '11>()~'J.
~~;~~A ,T t\ m ~f MJ,C-ha.fl j eaA
(Address)_3(p5D It.mne-bt6 Dr
(Address)
(Contact P, !son) 'B'd I M.i Ile..r-
~
APPLlCAJ,fTSIGNATURE ~
CJm sfylAC+io n
I ~'I-f I iliVLUt.
(Phone)
55bLf.1..1-
Su. i.J.t..,
(Phone) lP5/ "-?5Z~ 21'75
(C~tU1 MN ~!J'L
(Phone) 10'51 4'52..- 1-1'75
- iii: ~
.
.
DATE
I
I APPLICANT PLEASE COMPLETE BELOW
i ,lJNEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACEIMAKEANDMODEL cJ#-1UUCK- !)!<; _J04.l!)/?c", of?o FUEL ~/'i!-6N<
FLUE SIZE 1"f'C- RETURN OPENINGS 17) INPUT et;,t'rOC OUTPUT 7~ ~
TYPE OF SYSTEM HEATING OR POWER PLANT
~arm Air Plants
ItJGravity
$<f Mechanical
) )lAir Conditioning
. i!lVent. System
f
. FIREPLACf MAKE AND MODEL
!
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
Industrial, Cc mmercial & 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
Residential, I [eating & Ale (New Construction)
Residential, I [eating Only (New Construction)
$39.50
$39.50
Estimated Cost $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
11/1[/'AIO V'VITH
""-' ...Df/VG p;::". ,,__
C:r I!vd i
(ORite Use Oily)
This Application Becomes Your Building Permit When Approved
Paid
Receiot No.
BIl ilding Official
Date
-Date 7~ ;}6--0/
By^
(f/
24 hour notice ror all inspections (952) 447-9850, rax (952) 447-4245
CITY OF PRIOR LAKE
PLUMBING PERMIT
09/12/2001 02:57
9528947972
LAKESIDE PLBG
\ \'!UO.(:,
~~~
I
II" , ""In ..I !hr I,~~f C,lUIlH\
PAGE 01
j fj:'IJ~
2 Oohl
J 'fr.lhm
l"il~
CilY
Ajll'lj'~;I;\1
#
0/-0742.
ApplicBnl: ul1t"'J/..4-iL~.Y1Tl k'}?J Phone:_~ - 9'7'F 7u'-':~_
Address: /.2<114" J' "..~._.thr"
Signature: ~u'M-~~'" _~_____ _......_.__
Legal Description: lot / Block 4- Sub..lJ~IVO//V'..J' n.flNOI'f?-~
Site Address: /4-Z_7/TI1'10?!f1l AIi~__.__ '___
BUilding Permit # ()/-{)74Z- PID # 2::J.::JZ.~- 037- 0
NOTE: This permit will not be processed without complete information,
FIXTURE UNITS
..') I .
~L}.'(I"Vl\.(.(.I-~
I
Quantity
Type of Fixture
Quantity
2.
I
~~
J
'AU
-1..,1.(1
.t l\.,h.) ,v,.
Batll Tub with or without shower
Dishwasher
I
I.f
J
Floor Drain
lavatory (bathroom sink)
Laundry Tray (1 or.;' compartment sink)
Shower Stall
I
Sinks
Bar Sink
:3
Water Closet (loiIBt)
Type of Fixture
Rough-ins
Water Heater
Water Soflner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (RPZ, Double Check. PVS)
Backflow Assembly Test
Lawn Sprinkler
Other
i., " I u~ ,e-i?i.JLoa.<-) ..t.d 6.t..L'IV-J/ ..IJm",-"',
{..L.("'~. r-
(,,<. ~.J d o<..^iJ tk- S<>,.~.
'/:i..",.,~ j((J<~/
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % at job cost, $39.50 minimum)
F\osidentiai, New One & Two Family
ReslClential, Additions & AltBrations
State Surcharge
$99.50
$3950
GRAND TOTAL
$
$ 7-7~"
$ -----
$ .50
$~.
~~~~'
~~
Call for all in pections 24 hours in advance.
16:201l ,"gle Creek AV, S.E.. Prior Lake, Minne~ota 55372/ Ph. (612) 447-4230 I FAX (612) 447..;\245
An Equal OpponUlllty Employer
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ - 1.'WlDI-k...._ ~ .
NATL RE OF WORK /o,j~~' P
USE ')F BUILDING 5~n
PERMIT NO. ~/-()747~ _ D~TE ISSUED ~-'L/'C>-'I .
CONuRACTOR '~_A.~r ~~ PHONE~~2/)~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
\ INSPECTOR DATE
I FOdTING I~, I .7b-l/()}
I FOJNDATION (Prior to Backfill)Va:..:" I~ 7/ ~~ I ~ ~/
. .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - IN_S
SEvrER I WATER I SEPTIC . 1'---$
FRAiMING /f ~k ~
INSULATION 19-. j//?M ~.
ELE CTRICAL d
PLUMBING (A-.
HEA TlNG (if required) .fr"WIL I~_
FIRE.;PLACE k
GA~ LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
&-/
9/1:1/0/ q//7/P, ~?
9117/01 i.
9/7/01
tj/,.)/n {
4/1 21M
" .
~~?#/~
GR~DING (Prior to Sodding)
BUIl.DINGfc,,,, 8Wf)J I) /(J'Z.. &-.
. ,
ELE :TRICAL
PLU MBING
HEAjrING
i DO NOT
~ 11, I
/1>/2- '2/ "I
f
~
iolnlo\
r'o/II/()7.-
I
~,~
fit
OCCUPY UNTIL ABOVE HAS
NGTICE
/~//& In/
/~bJ;'1
BEEN SIGNED
rhis card must be posted near an electrical service cabinet prior to rough-in inspections
md maintained until all inspections have been approved. On buildings and additions
"here 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
1--
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J 4~ 7/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
Z FINAL
to SITE INSPECTION
COMMENTS:
SCHEDULED
-' JII
/~
v
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
t'
:it,/
DATE TIME
~~'2- ~:OO
~,
CJZ--7Q2.-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
tf~.~
~~)~~,
:,
f'
iJ'fi
j
T../vLL
e, (J, ~<AnJJ
~
1l..A.tAk
(/
)!?wORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
J!ur- ~,
V
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 & SAFETYI
lNSNOT/
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/tJ-)J-Of .M
ADDRESS /'117/ lImo+t. r 611 C-_
OWNER CONTR. Brc.nflf'.if C-&.ns/.
PHONE NO. PERMIT NO. () / - 7 '11
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
MINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
LVlb l!o~- of'
/"',~J" - t'>K
./ r "r-
~l,Ir~' .r
O(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'nspector~d .;1"s:::.--. OwnE;rIContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
10 -.;2;).-o( f; 15
OWNER
-
/ l/ ;;-11 't:-J.M'J,r1 (j-rj, (Jf-
~ U
CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
/J/LJd/
o FOOTING 0 PLUMBING RI 0 EXlGRAD/FILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TIO~ 0 SEWER HOOKUP /i:J\fi<' FIREPLACE FINAL
)i"FINAL ~ ~PLUMBING FINAL \lJl.)D GASLINE AIR TSrr
o SITE INSPECTION ~ MECH.FINAL 0 I11rLMrrnu~
COMMENTS:(\) ~---...P fl~ -4..o-cn ~
~ ~y,,':~[~.J} (#-'~
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK;7ALL FOR REINSPECTION BEFORE COVERING
Inspector: t1==t I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
ADDRESS
/~ ;;>- 71
DATE TIME
SCHEDULED /# 10.' 50
T~
V
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
01 - ?"f2..
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
W 0 WATER HOOKUP
o SEWER HOOKUP
,! PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:01 ~~ W ~
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o
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M~.v~~
o WORK SATISFACTORY, PROCEED
" CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~I
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl