HomeMy WebLinkAboutBldg Permit 01-0759
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please tyQe or 1l int and sign at bottom)
ADDRESS
~Jih1dt.mo( ~ CbA
I. White File
2_ Pink City
3_ Yellow Applicant
-OJ
'OI-CJ75q
ZONING (officeu",)
~I
LEGAL DE~ CRIPTION (office use only)
LOT 11.. BlOCK
ADDITION OGf;f r: /1=/..()
PID,..,7S'- 3/0-0/~-D
OWNER
(Name)
(Phone)
(Address)
BUILDER f\
(NameL_J: ~c7_ ~JYtr1Yl U"'-I
(Contact Nan Ie) S-revt..- [.....,dSOYl-
(Address)!Jl r~(j k"H1bndM" tj, f::h;.. 10(\
"
(Phone) Cfff)- 7BOfl
(Phone)_15Z-z;u,. /33<1
TYPE OF Wi )RK
Jz1 New Construction
DLower Level Finish
ODeck
OPorch
ORe-Roofing
ORe.Siding
OUliJity Connection
o Misc.
o Fireplace DAddition DAlteration
PROJECT COST IV ALUE (excluding land) S I.., Il S(Q
I hereby certify tl .at 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 Ifor 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. I am aware the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;'eru~;;; m ededinspections 0()()()5lj,f)'7 '7/a/ol
Conttactor's License No. Date
I Permit Valuatic n 15~J~m" I Park Support Fee # $ ~.~J
I Permit Fee $ I."2M.Ql:) I SAC # $ /. ( 50 .6l."!)
~
I Plan Check Fee $ .R~. 22..1 I Water Meter Si~5~1"; 1$ , (25',06.
I State Surcharge I $ 7c:' . (!)O I I Pressure Reducer I $ · 4~.fJO I
I Penalty I $ I I Sewer/Water Connection Fee # $ I, ~()O. cO I
Plumbing Perm' Fee $ (6{) .CXJ I I Water Tower Fee # $ .,
/0"'. c:97f
Mechanical Per nit Fee $ /00.0() I I Builder's Deposit I $ I, F>on '/)D
I Sewer & Water IPermit Fee I $ 15: ':;0 I lather I $ .
I Gas Fireplace P ~rmit Fee IS <10.00 I I TOTAL DUE I $ 9, 04-1 (PI
_n I -I
~)lica 0' 7 Your Building Permit When Approved I Paid Ro4-'l. G; I ~c~1k- 4Gi i"74-
I Date >?'7~4--4i
1:J7-7~ ( . !l
Ildi ()fficial Date f
I
. This is to certify thai 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 I :ity P anner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
a=-------- '7/t't~ ~~y {\.......J_~~~
F I m irector Date . . Special Conditions. if any " ..
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Jul.17 2001 10:59AM
GENZ RVAN PLUMBING AND HEATING
No,8063 p. 2/:j
Date Rec'd
U.l r OF PRIOR LAKE PLUMBING PERMIT
{ ~"
lPleos. type orprlni a:nd SlllJi';'Oo""-'!l)
ADDRESS ,4 ~ 0 -. ..
~ [l')t\Cix~
~~: ~ I PERMIT NO. {- 1C:9 I
3. y~~w App&.nt J
n,_, 0_
I.... ' "r:::..
ZONING (Of!ia:UIC)
Rl
LEGAL DESCl :tPnON (otDce.... only)
LOT )2.BLOCK ( ADDITION DR'!? _y ~ Q.o r-:,
PID 8'7 -31D-()/Jr-O
OWNER
(Name) DR He ~t:on Cuecom Homes
(phone) 651-454-4663
(Ad~e~) 3459 Washington Dr Ste 204 Eagan, MN 55122
APPUCANT
(Name) r:!.?:es:-iVil1i PJn~:pr-';"",: A. u..........,.f_!
(phone) _"~1_1,?"_111.."
(Address) 14745 So Roben Trail
(Address)
Rosemounc
MN
55068
(Zip Code)
(City)
(Contact Persbn) Mary Olson
" i
APPUc.A;en' SIi }NATURE
(phone) 651-423-1144
DAn;: _ "'1/l1 b,
EASE COMPLETE BELOW
Quantity
2-
\
\
.3
I
\
I
Quantity
~
,.
I Type of Fixture
Rough-ins
I Water Heater
I Water Sc:iftner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Ba.ckfIow Assembly
I BackfIow Assembly Test
I Lawn Sprinkler
I Other
,~
FEE SCHEDULE
lndUSlrlal, Conune cia] & Multi.family 1 % ofjob cost with. $39.50 minimum Rcsidcntial, New On. & Two-Fa<nlly $99.S0
Residential, Additioos & Altc:rations $39.50
Estunated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.so
CL'./6;~~ 'if/,.., r
~Ri'v:/.,.
(om"" u.. OPIy) .
I This Applicatioll Jle<:owes Your Buildillg Perwit Who.. Approved .
:U bour not/a: for all iDspec:tion. (.9s2) 447-9850, fn (95Z) 447-4Z45
Bycr/
I
I '/l...
i ',,-:,.'
i
'J
\,J
L
lloildinll 011...1
II.",
!Pald ,~
I Date '1-J-t,- 0/
I J~,,~ei"tNo_
P.DOI/OOI
1I11"C:~'"
J. Pin' '", I DERMIT NO
:I. ar.n ell,. I .
3. TIIIIl.. AfopIialIne
1- 7$9 I
I'Pleasctme Ol'm Dtan4lia ilLtbonrtml
ADDRf':.SS
/7/90 U);;t/PM~n (]f .5.G.
ZONING (.-...)
7<-1
LEGAL DES ::RIPTT.ON (om", Of( only)
LOT (.')at DeK / AJJJ.JJ. ..ON
PID.;L5- 87{)~ ()/;)..-o
. .
OWNER
(Name)
--:0'12
. (Phone)
(Address)
APPUCANl
(Na.me) AI,LIED FIRESIDE DBA FIRESIDE COmER
(Phone) 651-633-2561
(Address) 2.'00 ~. FAIRVIEW AVENP~
(Acldress)
BRENDA HU2
(Con.tact Per.; )0)
. APF.'LICAN1'ST.GNATURE 17A'.Il.
/
Jhl-bc
roSEVllloE.-'f"
(City)
(Phone) 651-633-2561
.551"'13-
(Zlp Code)
DATE
/IJ/'" IN
APPLICANT PLEASE COMPLETE BELOW
c:JM!;'W CONSTRUCTION 0 REPLACEMENT 0 AI. rERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RE11JRN OPENINGS INPUT OUTPUT
TYPE OF".", e,.,{ HEATING OR POWER PLANT
OWonn Air Plants :J St.e&m
OOravity :J Hot Wale'
o Mechanical :J RlIlliodon
DA;r Condidon;ng J Spe<:illl Device.
OVenl.. SySlcm J OlhcrOeviee.
rik.r f1J Cc"
PLEASE NOTE:
Air Conditioner Unils
Cannot Encroach into
Required Side Yord
Setback.
FIREPLACE ',/fAKE AND MODEL
k7JO
InduSlrial. COlT meFda! &. Multi.Famlly
FEESCHEDtILE
J% of job cost Re.identiol, 0.. Fi'opJ.o:c
$35.50 minimum
$55.50 Resldenool. Addlliono 8< Alleralion.
$64.50 ResidenlW, AC Only
$39.50
539.50
539.50
Residential. H. Uing &. NC (Ne... ConstnJotlon)
Rc.iden,ill.J, H. mng Only (N.... ConstnJc:t;on)
Estfmated Cost $
Building Permit #
HEA TINO PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
S
.50
BUll ~~fO W.n-r '
... ~JNG p''''
'ERM1t
(om"" IJ.. On~ ,)
Thl, AppJj, :ation Becom.. Yonr Building PermIt When Approved
Paid
I Rc'pcipr No
B.lllinJ Omcial
Dote
D.I{O~/O'--cJl I B~(' ...;>
:u hour notice ror oil ;n'p.etion. (!152) ~7-9S50, f"l?SZ) ..7-4245
~4/~~!~883 83:14
'3528'34 ('372
LAKE :3IDE PLUHBItIG
PA(,E 01
CITY OF PRIOR LAKE PLUMBING PERt\1IT
Date Rec'd
(PI.east'J ype or erine aod ~:i1tl1 a.tbottOm)
ADDI.ESS
/",7>t2e /,.!. ^ A-.r:> ""_
" 7 v<-''/ .v"C/c'A~!;")" L.J.
i~: ~:~ I PERMIT NO. / _ 7'-c-Q i
J, Yell.,... ....;.pllnftf ....:; L.J
ZONING (offic.:usej
LEGA l DESCRIpnON (office ICe only)
LOT
BLOCK
ADDInON
PID
OWNI:R
(Name /?/c;/.hI4() ?.e-<./...u~c....
. (Phone) 9S.J..-<;/l/o-,s</1I
(Addre; s)
..5.J1A-.e fi.~ -4/j<:.-JoC
, APPU:ANT
(Name <:::'/M:"-t" .5/0,J!:, """G#6 q;. ~
(Addrm) /'<</6'1 Z/.lJb1~ A'v,;E; ~t//!/,.?
(Address)
(Contac: Person) C4.ec... .-A-?/?~ el.s
APPL!<:ANT SIGNA~ _/J ~.1:-.....~
APPLICANT PLEASE COMPLETE BELOW
CPhohe) 9S..2 - .??"/' - 76'0 D
.sS37,r
(City) (Zip Code)
(Phone) ,S"".... e:.
DATE
9"~?/o3
I quan titv I Type of Fixturo Quantity Typ
I I Bath Tub with or without shower Rough-inS-
I I Dishwasher I. Water Heater
I I Floor Drain Water Sallner
I I Lavatory (Bathroom Sink) Stand Pipe (Was
I I Laundry Tray (lor 2 compartment sink Sewage Ejec"j[
I I Shower Stall Backflow Assem
I I Sinks Backtlow Asserii
I Bar Sink I Lawn Sprinkier
I I Water Closet (Toilet) Other
e 01 .l'.ixture
hing Machine)
~y -
OIY I est
FEE SCHEDULE
Industrisl, Commercial & Multj~family 1% of job COST with a $39.50 minimum
Re.sidc.ntial. New One &: Two~Family S99.50
Residential, Additions &. Alteration! ~
Estimated Cost S Building Permit # :}~ ~
PLlflvlBING PERMIT FEE $ ..:?7.. so f.()1Ik ~ ~
STATE SURCHARGE $ .50 'G .b:"'1t
TOTAL PERJ'\1IT FEE $ ,yO. <PO ~~
IOffico Use. ',Iy) ~/)-
I .__
rhi. Ap ,licl1tion Becom.. Your Building Permit When Approved rD,\~a~ [E 0 \fl [E 11 ~7eiPt NO__
. . '\ I Date I By (f k
luildlngOmc:ial Due ~I llpR ?3 7001 ~ TJ
24 hour notite for lilt In!lpectlons (952) <1 ., 1.50, f.ax (952) 447-42450.)
By .
Jul.17 200110:59AM
GENZ RVAN PLUMBING AND HEATING
No,B063 P,3/3
Date Rec'd
~~!)
. ~JfIHld
\.;,1.1 i ,OF PRIOR LAKE
SEWER AND WATER PERMIT
(Pl...e 'YO. Dr1>dnl an<!. mn.at boUnml
I ADDRESS ( .-,(f)':1Q . - ,
~4 .ll);\~.~ CT S:c...
~ ~~ ~ I PERMIT NO. J- 7.~ I
;I. GDk1 Awll,*-, :..) I
ZONlNG(oJDco",.)
t<(
LEGAL PESO lPTION (Dfti= _ Duly)
. LOT 1'l- BLO( :x: \ ADDlnON '":be~ y ~ eJl. .f"'>
'OWNER
(Name) 7''0 u~...f-.......... r~1""+-""~ t:r....'W...-
PlD :J'i ~76 - OfJ.--<?
(phone) 6.51 '-154 ',6""
(Address) 3459 WashinglOon Dr SlOe 204
~)
Eagan. MN
(City)
55122
(Zip Code)
APPliCANT
(Name) Gen::-Rv= PlulIlbing & Hea1::ing
(Phone)
651-423-1144
(Address) 1474:; So Robert Trail
I I (Address)
Roselllount. MN
(Cily)
55068
(Zip Code)
(Con=~<;fi,9h) Marv Olson ,"I _ , r
~UCANT SI(;NATUREJ.L ~ 0-^--
~
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 sttucture.
DATE
651-423-1144
{In/or
(!'hone)
feet.
o Cast Iron
FEE S....J:UId.J ULE
Residential sewer '" Ld water Jin. oolll1OClion $35.50 Industrial, Com'l.lt Multi-fiunily 1% of job cost with a $3950 minim11lIl
Se""er conneotion 0 ,Iy $17.50 Wmr conneotion l>I1ly $17.50
Estimated Cost $
Building Permit #
SEWERANDWATERPERMITFEE $
STATE SURCHARGE $ .
TOTAL PERMIT FEE $
.50
P"D
13UIL.D;N' i!1,n-H
j Gp
~F;.v.rr
,
,.
(omc. u", Only)
r This Applicatioll leeo",... Your Buildillg Per",it Wbell Approv~
lIujldiDg 0lI'<10I
n...
, Pa;d
I Dl!te~'FJ&-O /
I ReceitJt No.
IBY~
V
24 bnur uolice for all iu.pectiolllJ (9~) .&47-98SO, fa", (95%) 447-4ZA5
1--"-"-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please ~ e or Print and Si211 at bottom)
ADDRI>SS
IllqD Wildtrnc~s ~
I,Pink
2, Green
3. Yellow
FU. I PERMIt NO-
CI~ .
Applicant
/- 7s1~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT U..BLOCK l ADDITION
-I{I
~=~I b.K. HOr+(')V1 (Phone)
(Addressl.,]1.I5Q L4aShf'nCj+On }X-. __~+e~Q!L__~n :?5/02.;L
~~:~~~"NTA 1/ ;ant M ecJ,a.V1 1(10.1 me (Phone) u5/- ~5 & - cfl775
(Address 3(050 '-V:V1l1eber!. J)n [,o...C{QVJ 66/,.J~
(Address) (cld-J (Zip Code)
(Contact 'erson) ~ e. rr Z j mm e..rrYlCln 1 (Phone) X c20 I
APPLIC"NTSIGNATUR~),.~ (I. ~ATE ID 1/5//)1
v v v v
APPLICANT PLEASE COMPLETE BELOW
IX)NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNAC J MAKE AND MODEL 7\r<jo.",-t 9~% FUEL !\.Jat. GaS
FLUE SIZ E of $/2.. nr/t' RETURN OPENINGS INPUT /(X),OO 0 OUTPUT 80. ~
.
1~~2&
PIr:bt5 - ,=37t>-O/,;l.-(,)
TYPE OF SYSTEM
HEATING OR POWER PLANT
o Steam
D Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
DWan"Q Air Plants
OGravity
o Mechanical
&Air Conditioning
OVent. System
FIREPLAI;E MAKE AND MODEL
Industrial, ( ommercial & 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'IHeating & AIC (New Construction)
Residential. Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ 1000. &D
Building Penn it #
(Orfice lIsee.ly)
This Apllication Becomes Y ollr Building Permit When Approved
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
B lilding Official
Date
I Paid
I Date /0- )1-1
r PAID WITH
.~T_
24 hour uolice ror all inspeclions (952) 447-9850, rax (952) 447-4245
~
f
White . Building
Canary - Engineering
Pink - Planning
Thr (-ulr of lhr L.kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJ \ME OF APPLICANT
/) R IJ~
7- S--ol
AI'PLlCATION RECEIVED
n e Building, Engineering, and Planning Departments have reviewed the building permit
a~ plication for construction activity which is proposed at:
11/ 9t; I//$h~ (];;j-
--/.-
Ac cepted
Accepted With Corrections
DE'nied ./)/1;/ /I =
RE,viewed By:Wf/f:-~~
<fiments: ()() 1/ .
{)'2wP aXJ( I'PT{LtC~
Date: "/-I? ---C?100(
~ rJ(~
- -
"T le issuance or granting of a permit or approval of plans, specifications and
co mputations shall not be construed to be a permit for, or an approval of, any violation of
arw of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pn lsuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
~~
While - Building
Canary - Engineering
Pink - Planning
Thr {tnlt of the L.kf ('oUnl'1'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLI~T
NJ \ME OF APPLICANT
APPLICATION RECEIVED
I '. I".., /1/ 17(",. j
./ '\! v{(~' r-.-
'1- .;)-0/
ne Building, Engineering, and Planning Departments have reviewed the building permit
ap plication for construction activity which is proposed at:
/ /) If () //;1: it./! /ll;kJ.rJ~.!~ f-
Accepted
~
Accepted With Corrections
DE nied _
/~~
Re viewed By: ~~
tY .
Ccmments:
-A/' - ~};..p4~/AQ ~
~~~ .---'h~~l~
~ 1/98.
Date:
7/tS/B (
'^~~Jfl~
~ ~
"Tt e issuance or granting of a permit or approval of plans, specifications and
cor!nputations shall not be construed to be a permit for, or an approval of, any violation of
an:' of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
orc inances of the jurisdiction shall not be valid."
< " " ~,-,.....,.-.
*'_._--~--"-'-.'''.''~' ..... - ~--,.
"'1:"
~_..
&~~
~~~rin:>
rnnary - Engin~
ThtC"rlrrroflhr I.lb('ololnlry
aUILDlNG PERMIT APPLICATION DEPARTMENT CHECKtl~-':
f\ AME OF APPLICANT
AiPPLlCATION RECEIVED
j) R II tJiTt7}LJ
~- S--o/
T 1e Buildi~g, Engineering, and Planning Departments have reviewed the building permit
a )plication for construction activity which is proposed at:
/1/ qiJ IIJ$hA~ 0-!-
A xepted
)(
Accepted With Corrections
o 3nied
R wiewed By: -!vtl13
,
Dr
ate: .
)-/).-01
G lmments: --S",,,, R"'wm::p ~idp for Additional Information!
.,
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
::\~ ~r"",irm Control PI;m
"Tt Ie issuance or granting of a permit or approval of plans, specifications and
cor 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
pre;suming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE PEPARTMENTOF
- BUILDING AND INSPECTION
INSPECTION RECORD
SITE,\DDRESS I~\'l() LA)t'\&slr0.0c:::., cr-.
NATU =IE OF WORK ~)
USE OF BUILDING ~ t='lJ .
PERfvlT NO. () \ -O--rsq DATE ISSUED 7 - I 'l ~ 2.00 (
CONl RACTOR -D R.. ~ -k-h~ PHONE 't5L - 'Y2..1 ,-n'?t.(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE ~ERMIT IS BY SEPARATE D~o~NT OATE
, FOOlflNG _ I {t':J _. I g - { J
, FOU ~DATION (Prior to Backfil~&_ I fd:r., ~)I/' / tJ / \
PLACE NO-CON.CRET~~NrIL..ABO'i;tiAS BEE'r4 SIGNED
r.Ac.--~ """'"RO uG H~ i ~ SlID I
SE~R/WATERISEPTIC 4, j/'/~~Oj
FRA ING ,~o rts g)
INS LATION / / &. _ 'jO/.?-,;;Mf
ELEC :TRICAL / L1
PLUIIIBING tA., 61. ui4. Ii !?/;;7.f /iJl q /0//71/" I
HEATING (if required) 6)g, -10 -~f 'v - ,
FIRE PLACE Pb ^
GAS LINE AIR TEST iQ r3 ' (
GRA DING (Prior to Sodding)
BUIUDING-(.e..o. +JJ Sri lo~ ~
ELEC :TRICAL . ~
PLUIIIBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/VI>
/, ~~Aiu rYJ tJ
I I'~ I
/>
~
v/& 7/ H->
If. z.f'"tll../
/Z/I dOl
Jhl/ )2--->
< '"
BEEN SIGNED
. 'his card must be posted near an electrical service cabinet prior to rough-in inspections
llnd maintained until all inspections have .been approved. On buildings and additions
1 where 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
"
QLtrtiftcau of (J}ccupanry.
CIl i OF PRIOR LAKE
1Dtpartmtnt of .uilbing Jn~ptdiol1
liD Final Permitted 0 Conditional C.O. Expires
This Certificate issued purslUllll to t~ requiremenls of Section 307 of t~ Uniform Building Code
certifying that at the time of issULJ1lce this structure was in compliance with the various ordinDllces of t~
City of Prior Lake regulating building construction or use. For the following:
SINGLE FAMILY
Use CJassificatior
Bldg. Permil No.
01-0759
Oc:cuponcy Type
R3
Type Construction
VN _FireZone NI A
Zoning District
Rl
Legal Desc:ripliOll
L12, Bl, DEERFIELD
OwucrofBuilding Si"Address _17190 WILDERNESS COURT
D.R. HORTON, 20860 KENBRIDGE COURT, SUITE 100, LAKEVILLE
Contractor's Name &. Address
ROBERT D. HUTCHINS ~
Building Official
1-1~-OJ..
rity Planner
Da..:
DON RYE
Da..:
POST IN A CONSPICUOUS PLACE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE
TIME
C(-J..r-
ADDRESS
i, /c{o 1A..J../df'01f'SS c..T
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
o PLUMBING FINAL
o MEcH FINAL
5~ / I~(:'s
COMMENTS:
OI-07s-ct
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASlINE AIR TST
o
?M
~
~~o')C \ _'IL
~ORKSATlSFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPEcTION BEFORE COVERING
Inspector: r/IP q-tb -ol.. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
~2-
/7110 W/flertla.s GT
CONTR. --D. R. Harlan.
PERMIT NO. 61- 7~
SCHEDULED
ADDRESS
OWNER
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
J!(EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
("iJ~, OL
~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!
INSNOTJ
ADDRESS
~E TIME
SCHEDULED O~ 4- -' 00
-'. J ott..
/7! ero (/(/rc.t'~s ~/~
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
cONTR.
PHONE NO.
PERMIT NO.
6/ - '5'7
o FOOTING 0 PLUMBING Rl 0 EX/GRAD/FILLING
o FOUNDATIOW 0 MECHRI 0 COMPLAINT
o FRAMING.~ 0 WATER HOOKUP @t FIREPLACE RI
o INSULA TIO 1'1 0 SEWER HOOKUP FIREPLACE FINAL
~INAL AITf.l PLUMBING FINAL GASLlNE AIR TST
o SITE INSPECTION V" MECH FINAL 0
COMMENTSCi) ~ " ~ wo>-O'1.4-)/(L - 0: U
- ~~v"-~~~ ~~?
_ P-JIf- ~ -J~ ,~~f::iJi:j ,
~~ ~ ~ -oJ! tJ'v--
~ ~. t- ~.4-> Jli'R-A-
~ I<~ p~ J...o..f, I~ ~ ~
io .;.l:t-~ (~ ~ ~ ,'l
. , 0
7,-e,o, -/:;:jJI !11/0t...-
~
~: 'I'_"---P
o WORK SATISFACTORY, PROCEED
7! CORRECT ACTION AND PROCEED
:s:c~:ECT W~~L FOR RElNS::::::::FORE COVERING
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
17110
SCHEDULED lefl/jol L!: c?c
~ (7:1-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
AI - ') ~<;
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
~ PLUMBING FINAL
o MEcH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:t1S) ~ ~ ~,
()
~ J~' w.e. -~
~ fV1 0 J.2 A~ . AuYJLex \
o WORK SATISFACTORY, PROCEED
)it CORRECT ACTION AND PROCEED
:s::o~ECT W~L FOR RElNS:~::,::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTJ
.
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contraclor
Name ot Tester
Date
Job Address
Heating Contractor
Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp
F\ \ \ i _.... Mt..h...
~,,~ ~.
1,7.-I~-"'\
n\'1o \.)'~<"""jc.t.
A\\;-_", \-'\..........
v:..<; t'- :S.
I ;;l - Id-" \
c..Y
-0-
s.y
\~")o
Combustion air is adequately supplied per
UMC Sec. 606 (. "
input
lOO.""Q